Drivers involved in road traffic accidents in Piedmont Region: psychoactive substances consumption

Introduction. The role played by psychoactive substances in road safety has become object of increasing interest: these substances can reduce driving performance and increase accidents risk. Aims of the study are to establish the dimension of the problem and to describe the characteristics of people involved in accidents under psychoactive substance effects. Methods. Target population consists of people from 18 to 60 years old involved in accidents afferent in Emergency Rooms. Subjects were interviewed by surveyors and a urines was collected for psychoactive substances screening. Results. In 18.5% of people we found substance consumption. Cocaine was the most frequently detected substance (9.5%), then benzodiazepines (7.5%), methadone, morphine and marijuana (THC) (3.5%). In 5.5% of subjects more then one substance was found. Considering only illegal substances detected, female have a higher risk to be consumers (OR = 1.36) and the young age (18-35 years) seems to be at higher prevalence and risk for substance use (OR = 1.86). Discussion. Considering all psychoactive substances detected, clearly the problem about substances consumption and driving is not restricted to youngest but involves all age groups. Conclusions. In order to decrease the number of accidents due to substance use, new prevention programmes able to involve also middle age groups should be planned

Smoking ban policies in Italy and the potential impact of the so-called sirchia law: state of the art after eight years.

Objective. The aim of the present work is to describe the state of the art of tobacco habits in Italy, eight years after the law was introduced. Methods. Time series analyses, based on estimates of smoking prevalence/consumption derived from the openly available data of national surveys performed during the 2001–2013 period, were performed. Data have been expressed in percentage of smokers and daily cigarettes consumption. Time changes are expressed as expected annual percentage change (EAPC). Results. Over time, the percentage of Italian smokers shows a constant and statistically significant decrease (from 28.9% in 2001 to 20.6% in 2013, EAPC = −2.6%, and P<0.001). Regarding data stratified by gender, we found a stronger reduction among men (EAPC = −2.9%, P<0.001) than in women (EAPC = −2.5%, P<0.001). Similarly, the consumption of tobacco smoking, measured as the number of daily cigarettes smoked, registered a downward trend (P<0.001). No join point (time point when a significant trend change is detected) resulted from the trend analysis. Conclusions. Data show a constant decrease of tobacco consumption in Italy, with no join point related to the introduction of the banning law. These findings require to reflect on the priorities of the smoking banning policies that may be focused on other intervention activities such as to increase the price of cigarettes

The impact of Shared Decision Making on the length of hospital stay and the health expenditure

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Italian Health Care System: Methodology Suggestion for the Financial Equilibrium and Essential Level of Care

Italian Regions are the accountable entities for healthcare policies: their activity is not limited to policymaking but includes also management and financing of the Healthcare Public Utilities and services. A first step will be the creation of a dataset of revenues and expenditures of the Healthcare sector. Second, the cofinancing policy will be analyzed using comparative grids of in/out-flows of each Region. Third, it will be taken into account the regional fiscal coverage of the balance deficit. The sample is composed by the Italian Regions. Last the analysis between our theoretical approach based on law and the real economic balance. Furthermore it will be analyzed the National and Regional Healthcare System financing (in)-stability, highlighting current cash flows, sources and investments using the \u201cseparation\u201d of the Healthcare accounting items in the Balance Sheet. Through chi-square test analysis and method of OLS the group of study look a possible relation be-tween balance and respect of lea without finding a relationship. Latter, it will be represented an analysis of the National Health Fund allocation to the Regions. It will be also conducted a critical analysis of the current allocation formula and it will be proposed a simplified criterion of allocation

No correlation among expressed emotion, anxiety, stress and weight loss in patients with overweight and obesity

The onset of some types of obesity may correlate with specific familial relational patterns, and expressed emotion (EE). The aim of this study is to address the current gap in the literature about EE and obesity, assessing EE in a sample of patients with overweight or obesity and their relatives. A further objective is to assess patients' weight loss, patients' and relatives' anxiety, perceived stress and their possible correlation with EE and diet compliance. A total of 220 patients with overweight or obesity and 126 relatives were recruited. Patients' baseline body mass index (BMI) was negatively correlated with educational level, but we failed to find any correlation between BMI and the other variables assessed. We found a positive correlation between EE median and stressful life events, as well as between median EE and state and trait anxiety. Our results seem to suggest that other factors than the psychological ones we investigated may play a role in treatment adherence and outcome in patients with overweight and obesity

Implementation of genomic policies in Italy: The new national plan for innovation of the health system based on omics sciences

The complexity of omics sciences and related applications such as personalized medicine, certainly requires a governance from the healthcare systems. Implementing a personalized approach to health care will also require a change in the organization of health services. On a broader basis, public health leaders are responsible for helping to catalyze change in the organization of health services and public policies to ensure that genomics and other technologies are used to best effect