Influenza vaccination coverage among medical residents: An Italian multicenter survey

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P < 0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P < 0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future. © 2014 Landes Bioscience

Reingegnerizzazione del processo di analisi dell’appropriatezza prescrittiva delle prestazioni di TAC e RMN: sperimentazione nell’AUSL di Piacenza

INTRODUZIONE: In merito all’appropriatezza, l’AUSL di Piacenza ha condotto, nell’anno 2014, uno studio che, attraverso l’acquisizione di uno strumento informatico (“con.SOLE”) e motori semantici (“piattaforma QBox”), valutasse la percentuale di adesione delle prescrizioni ai criteri definiti dalla DGR 704/2013 per l’appropriatezza prescrittiva di TAC e RMN del rachide ed osteoarticolari allo scopo di ridurre l’inappropriatezza delle indagini radiologiche pesanti, contenere i Volumi prodotti, rispettare i tempi di attesa, ridurre la mobilità passiva extraregionale. METODI: Acquisito il SW, individuati i quesiti diagnostici delle prescrizioni (QD) e la sede di recupero dati (Rete Sole), sono stati caricati i dati delle prescrizioni Sole ed elaborati secondo: - Presenza o meno del QD - Su QD presente grado di consistenza e inconsistenza - Su QD consistente analisi del livello di appropriatezza e inappropriatezza - Appropriatezza sul totale del prescritto - Presenza o meno della classe di priorità - Inappropriatezza grave (QD assente+QD inconsistente+QD consistente con criterio non trovato) Verificata l’adesione dei QD ai criteri della DGR 704, si sono declinati per distretto, nucleo e singolo prescrittore. RISULTATI: Nel 2014 sono state prescritte, complessivamente (MMG, PLS, Specialisti), 9152 prestazioni TAC e RMN rachide ed osteoarticolari. Di queste il 23% non indicava la classe di priorità, nel 6% il QD era assente. Tra le prestazioni con quesito presente l’8% era rappresentato da quesito inconsistente, il 92% da quesito consistente. L’appropriatezza su QD consistente era 47%, quella sul totale del prescritto 31%. L’inappropriatezza grave sul totale 58%. DISCUSSIONE: L’appropriatezza prescrittiva bassa nelle categorie di prescrittori analizzate, l’inappropriatezza grave mai inferiore al 50%, rendono necessaria la formazione dei prescrittori per incrementare la loro adesione alle LG regionali, la loro consapevolezza, per perseguire l’efficacia, la sicurezza delle prestazioni prescritte, liberare risorse e ridurre i tempi di attesa

Immunization practices in athletes

INTRODUCTION: Immunization practices of athletes is a topic of growing interest in preventive medicine. Several reasons contribute to support such statement including: the demonstrated decrease of the immune response of athletes, the recent increase in vaccine-preventable diseases, the increasing mobility of professional athletes and coaches and sports doctors' frequent lack of awareness of on the issue of athletes' immune prophylaxis. RESULTS: This review offers a concise and schematic framework to the immunization practices in athletes, based on the most recent scientific evidences and the vaccine schedules proposed by international organizations and scientific societies including the recent "Life Vaccination Schedule" proposed by four Italian Scientific Societies and Professional Associations. CONCLUSION: vaccination in athletes, if correctly managed, represents a powerful, costly and long lasting tool for athletes sport teams

Immunization practices in athletes

INTRODUCTION: Immunization practices of athletes is a topic of growing interest in preventive medicine. Several reasons contribute to support such statement including: the demonstrated decrease of the immune response of athletes, the recent increase in vaccine-preventable diseases, the increasing mobility of professional athletes and coaches and sports doctors' frequent lack of awareness of on the issue of athletes' immune prophylaxis. RESULTS: This review offers a concise and schematic framework to the immunization practices in athletes, based on the most recent scientific evidences and the vaccine schedules proposed by international organizations and scientific societies including the recent "Life Vaccination Schedule" proposed by four Italian Scientific Societies and Professional Associations. CONCLUSION: vaccination in athletes, if correctly managed, represents a powerful, costly and long lasting tool for athletes sport teams

[Economic class syndrome: epidemiological features and preventive measures]

The term "economic class syndrome" is generally used to describe the occurrence of venous thromboembolism (VTE) in travelers after long-distance airline travel in economic class. However, cases of VTE have also been reported in business class travelers and in subjects exposed to prolonged periods of immobilization while using other forms of transportation such as automobile, train, and bus. VTE manifests with deep vein thrombosis and pulmonary embolism but may also present with less severe, reversible manifestations such as headache, vertigo, and respiratory symptoms. Epidemiological studies have shown that the risk of VTE doubles following airline travel lasting longer than four hours. The risk of VTE increases with increased duration of air travel even in the presence of multiple stop-overs. In subjects with known risk factors, incidence of VTE depends on the degree of risk (low, medium, high) and on the duration of the flight. The main factor leading to VTE is prolonged immobilization and the pathogenesis is based on Virchow's triad: venous stasis, vessel wall injury, and hypercoagulability of blood. Specific characteristics of airline travel such as jet lag, low air quality and dehydration may increase the risk of VTE with respect to other forms of travel. This article discusses epidemiological aspects and pathogenesis of travel-related VTE and prophylactic measures that should be undertaken

Case della Comunità e Ospedali di Comunità

Il documento di CNETO, un'associazione di esperti nell'ambito dell'edilizia socio-sanitaria, affronta il tema cruciale della riforma dell’assistenza sanitaria territoriale, parte essenziale del PNRR, e della definizione dei nuovi modelli organizzativi di case della comunità e gli ospedali di comunità. Il documento riflette sulle sfide progettuali e di gestione connesse a queste strutture, evidenziando l'importanza di considerazioni tecniche, efficienza amministrativa e coinvolgimento della cittadinanza. La progettazione architettonica è vista come un contributo cruciale per garantire non solo la qualità tecnica-funzionale, ma anche per conferire significato e integrazione a queste strutture nel contesto urbano