Policy and planning of prevention in Italy: results from an appraisal of prevention plans developed by Regions for the period 2010-2012

Health policies on disease prevention differ widely between countries. Studies suggest that different countries have much to learn from each other and that significant health gains could be achieved if all countries followed best practice. This paper describes the policy development and planning process relating to prevention activities in Italy, through a critical appraisal of Regional Prevention Plans (RPPs) drafted for the period 2010-2012. The analysis was performed using a specific evaluation tool developed by a Scientific Committee appointed by the Italian Ministry of Health. We appraised nineteen RPPs, comprising a total of 702 projects, most of them in the areas of universal prevention (62.9%) and prevention in high risk groups (27.0%). Italian Regions established prevention activities using an innovative combination of population and high-risk individuals approaches. However, some issues, such as the need to reduce health inequalities, were poorly addressed. The technical drafting of RPPs required some improvement; e.g. the evidence of the effectiveness and cost-effectiveness of the health interventions proposed was seldom reported. There were significant geographical differences across the Regions in the appraisal of RPPs. Our research suggests that continuous assessment of the planning process of prevention may become a very useful tool for monitoring, and ultimately strengthening, public health capacity in the field of prevention. Further research is needed to analyze determinants of regional variation

Evaluation of the endorsement of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement on the quality of published systematic review and meta-analyses.

Introduction PRISMA statement was published in 2009 in order to set standards in the reporting of systematic reviews and meta-analyses. Our aim was to evaluate the impact of PRISMA endorsement on the quality of reporting and methodological quality of systematic reviews and meta-analyses, published in journals in the field of gastroenterology and hepatology (GH). Methods Quality of reporting and methodological quality were evaluated by assessing the adherence of papers to PRISMA checklist and AMSTAR quality scale. After identifying the GH journals which endorsed PRISMA in instructions for authors (IA), we appraised: 15 papers published in 2012 explicitly mentioning PRISMA in the full text (Group A); 15 papers from the same journals published in 2012 not explicitly mentioning PRISMA in the full text (Group B); 30 papers published the year preceding PRISMA endorsement from the same journals as above (Group C); 30 papers published in 2012 on the 10 highest impact factor journals in GH which not endorsed PRISMA (Group D). Results PRISMA statement was referred in the IA in 9 out of 70 GH journals (12.9%). We found significant increase in overall adherence to PRISMA checklist (Group A, 90.1%; Group C, 83.1%; p = 0.003) and compliance to AMSTAR scale (Group A, 85.0%; Group C, 74.6%; p = 0.002), following the PRISMA endorsement from the nine GH journals. Explicit referencing of PRISMA in manuscript was not associated with increase in quality of reporting and methodological quality (Group A vs. B, p = 0.651, p = 0.900, respectively). Adherence to PRISMA checklist, and the compliance with AMSTAR were significantly higher in journals endorsing PRISMA compared to those not (Groups A+B vs. D; p = 0.003 and p = 0.016, respectively). Conclusion The endorsement of PRISMA resulted in increase of both quality of reporting and methodological quality. It is advised that an increasing number of medical journals include PRISMA in the instructions for authors

Prevención de la obesidad en alumnos de Educación Primaria. Su relación con patología ortopédica

He buscado una relación entre el Índice de Masa Corporal (IMC) y las más frecuentes patologías de pie y rodilla en edad escolar. He utilizado como muestra a los alumnos de 5º A de Educación Primaria del Colegio Romareda de Zaragoza, con los que he realizado las Prácticas del 4º curso del Grado. Los resultados obtenidos demuestran que el mayor grado de IMC está relacionado con menor consumo de fruta y verdura y con menor realización de ejercicio físico. Además, está en relación con pies planos y con la rodilla en genu valgo. Sin embargo, aunque los datos descriptivos indican claramente estas relaciones, los resultados estadísticos resultan no significativos debido a un dato: entre todos los alumnos de la muestra a la que he tenido acceso no había ninguno obeso, ni con sobrepeso. De haber sido así, los resultados hubiesen sido estadísticamente significativos, porque los datos apuntan claramente a ello

Mi bicicleta y yo, un mundo que explorar

Dentro de la Educación Primaria encontramos un apartado fundamental: la formación de alumnos y alumnas en conocimientos que les ayudan a adentrarse en el mundo con el que interactúan de una forma óptima, y con ellos conseguir desarrollarse. Es muy importante que los alumnos posean un buen estado de salud y sean capaces de mantenerlo mediante la actividad física. Con intención de inculcar unos hábitos saludables, como es que los niños y niñas puedan ir a sus colegios en bicicleta desde sus hogares, además de fomentar la actividad física en la comunidad. Muestro una propuesta para realizar actividad física mediante el uso de la bicicleta y el senderismo, fomentando una movilidad sostenible. Para que se lleve a cabo de un modo adecuado es imprescindible la adquisición de las normas de circulación para desarrollar un transporte alternativo. La bicicleta es una gran herramienta para combatir los problemas relacionados con los problemas de salud, medioambientales (contaminación acústica, humos, etc.) y de movilización (atascos, alta ocupación de la vía pública) que se producen en nuestras ciudades

Cómo aumentar el tiempo de práctica de la educación física en educación infantil

Con el presente trabajo, se pretende precisamente mejorar la acción educativa de los maestros para poder desarrollar unas buenas clases de educación física. La propuesta es explicar las técnicas y estrategias adecuadas para mejorar las habilidades de enseñanza. De este modo, poder ganar más tiempo en la práctica para lograr mejores resultados y crear en los alumnos una actitud positiva hacia la práctica de la actividad física dentro del entorno escolar y fuera de él. Finalmente, con el presente trabajo, se quiere lograr que la educadora tenga los conocimientos o fundamentos básicos adecuados para llevar a cabo las actividades propias a la edad de los niños de la mejor manera posible

El Nordic Walking como promotor de la salud

El presente trabajo realiza un análisis sobre todos los aspectos más destacados de la marcha nórdica relacionados con la actividad física y con la mejora de la salud. Se centra en las ventajas fisiológicas, psicosociales y de implementación que recaen sobre el practicante tras su correcta ejecución. Además, se presentan estudios que demuestran sus beneficios, tanto físicos como psíquicos, en personas que padecen cáncer, linfedema, diabetes y enfermedades coronarias tras su rehabilitación mediante esta práctica. Se hace hincapié en efectos como el fortalecimiento del músculo afectado y la mejora de la capacidad cardiorespiratoria en el cáncer, o incluso la prevención, la manutención y/o el control del linfedema. La propuesta descrita es la implantación de dicha práctica en centros educativos de Educación Primaria para concienciar a los jóvenes acerca de la necesidad de una vida saludable a través de, entre otros aspectos, la actividad física

Cómo tratar la inclusión en Educación Primaria a través de las Actividades Físicas en el Medio Natural

Se trata de un trabajo orientado para las Actividades Físicas en el Medio Natural y la inclusión en la etapa de Educación Primaria. Además, se realiza una propuesta de intervención docente en el que realizaremos una actividad con un grupo de alumnos de unas características muy diversas entre los cuáles tendremos también alumnos con discapacidad

Trends in avoidable hospitalization rates in Italy, 2001-2008

Background: hospitalization for Ambulatory Care Sensitive Conditions (AC SC), also known as avoidable hospitalization (AH) has been proposed as effect measure of the accessibility and effectiveness of primary care. In the last years in developed countries, including Italy, hospitalization rates have decreased as well as the rates of AH. The decline of AH-rates could be just an effect of the general trend of hospitalization. The objective of our study was to examine the adjusted trend of AH rates and to test possible associations with measures of primary care (re)organization. Methods: hospital discharges from 2001 to 2008 were analyzed. Main outcome measures were hospitalization rates, both as inpatient and day hospital. ACSCs were grouped in acute conditions, preventable through early diagnoses and treatment and chronic conditions, preventable through good ongoing control and management. Expected time-series rates of AH, estimated on the hypothesis of same time trends of Total Hospitalization (TH), were compared with observed ones using a Chi Square test. Adjusted hospitalization rates were analyzed in conjunction with indicators of primary care. Results: in the studied period, in Italy, the TH rates declined with an average decrease of 19.6%, while the decrease for AH was 16.4%. The rates of AH adjusted for the trend of TH significantly decreased only for chronic conditions. Decreasing trend of AH was correlated with the impact of reorganization of primary care in associative forms. Conclusions: the presented methodology can be used to evaluate the real effectiveness of policies aimed at reducing hospitalization for ACSCs

Social relationships and HRQL: A cross-sectional survey among older Italian adults

BACKGROUND: The aim of this study is to investigate the association between social relationships and Health Related Quality of Life (HRQL) among the elderly in Italy. METHODS: A sample of 33,744 Italian residents, representing the non-institutionalised population aged 60 years and over was extracted from the national ISTAT cross-sectional survey during 1999-2000. HRQL was measured with the SF-12, from which the Physical Component Score (PCS) and Mental Component Score (MCS) were obtained. Data were subjected to descriptive analysis and multiple logistic regression models with adjustment for the main confounders. RESULTS: Our analysis shows a gradient in PCS and MCS among the terziles in seeing/meeting "friends" and "family" and, for PCS, a North-South gradient among the Italian regions. Females, the elderly who reported a lower household income, those who spent less time in recreational and religious activities, who lived too far from their relatives and had few relationships with friends and relatives, were significantly less likely to have an MCS above the median value. For PCS, an increase in HRQL was likely to be associated with a higher educational level, while lower PCS scores were associated with: age 75+, inadequate household income, unmarried status, infrequency of seeing/meeting friends, too high a mean distance from own home to relatives' homes, lack of leisure time spent in recreational activities, living in the Centre-South of Italy, chronic diseases, reduced autonomy, and use of drugs during the previous two days. Significant interactions between suffering from one chronic disease and the use of drugs were also found for both MCS and PCS. CONCLUSION: Some dimensions of social relationships were significantly associated with HRQL. These findings are crucial for devising welfare strategies at both the regional and the European level, i.e. in countries such as Italy where the primacy of family support of the elderly has declined in recent year