Esperanza de vida con la introducción de nuevos medicamentos a la terapéutica

En este trabajo fin de grado se refleja la relación que existe entre la esperanza de vida y los nuevos medicamentos, concretamente aquellos comercializados en España desde el año 2011 hasta noviembre de 2015, última referencia consultada. Nuestro estudio farmacoepidemiológico muestra también otros datos recogidos sobre la población española: su esperanza de vida, sus causas de muerte y la evolución del virus de inmunodeficiencia humano (VIH) en los últimos años. Todo ello sirve para marcar el punto de partida de este proyecto, que muestra como la innovación terapéutica llevada a cabo por la industria farmacéutica, es un pilar importante para nuestra supervivencia. Está claro que los medicamentos influyen en la cantidad y calidad de vida. El modo de medir ese progreso y evolución de la vida de los pacientes tratados farmacológicamente, está disponible en los diferentes estudios clínicos elaborados por los profesionales de la salud, y que se han utilizado en el presente trabajo para poder señalar como y cuanto influyen los nuevos medicamentos introducidos en la terapéutica. En total 130 nuevos medicamentos han sido comercializados estos últimos 5 años, pero no todos son innovadores. Se ha revisado solamente 13 fármacos, considerados los más relevantes, pertenecientes a 10 de los 13 grupos terapéuticos presentes en el trabajo

Effects of an intervention to prevent the bullying in first-grade secondary schools of Palermo, Italy: the BIAS study

Background: Bullying is one of the most common expressions of violence in the peer context during school years. This study investigates the prevalence of bullying and the short-term effects on students’ bullying perceptions of a preventive intervention conducted among teachers of first-grade secondary schools in Palermo, Sicily (Italy). Methods: Between the 2017/2018 and 2018/2019 school years, a pre-post intervention study was conducted among nine school institutions, sampled and categorized by neighbourhood socioeconomic index. A questionnaire investigating physical, verbal, and indirect bullying, the role of observers, prosociality, and resiliency in bullying was administered before and after intervention with formative cascade training of the teachers of the selected classes. Three different methods (sentinel questions, the five-question method, the ‘score of seven’ method) were used to detect the baseline level of bullying. Results: A total of 402 students participated in the study (72.7% response rate). A decrease in the number of bullying episodes after the intervention was reported by the students in all types of bullying explored (physical, verbal, and indirect bullying, observers, resiliency, and prosociality), with all three methods. In particular, a statistically significant decrease in all the bullying areas investigated (except for resiliency) was reported for students attending schools of an intermediate socioeconomic level. Conclusions: Even if many school-based interventions have been implemented to reduce school bullying throughout the world, this is one of the first conducted in Europe and it assesses the effectiveness among students of an antibullying intervention tailored for teachers. The encouraging results in reducing the number of bullying episodes together with the low cost in terms of human and economic resources could suggest an extension of this research on a regional/national scale

THE BIAS (BULLYING IN SICILIAN SCHOOL) PILOT STUDY: INVESTIGATING THE PREVALENCE OF BULLYING IN SCHOOL OF PALERMO CITY. A RESEARCH STUDY PROTOCOL

Being a serious threat to physical and emotional health of children and adolescents all over the world, bullying in school represents an important public health issue. Since 2007, in Italy, the Ministry of Education (MIUR) has promoted activities to face and prevent bullying in schools of all levels while at the same time national and local Health Authorities have implemented effective social-health strategies. To date, the lack of consistent data needed to properly describe the concerning increase of this Public Health phenomenon prevents both the ability to systematically survey and measure the effectiveness of the public health strategies against bullying. The Bullying In Sicilian Schools (BIAS) pilot study’s aims: i) to estimate the prevalence of bullying in a sample of secondary first-grade schools of Palermo, the largest city in Sicily, investigating its characteristics, and ii) to assess the feasibility of alternative methods for the detection of the prevalence of bullying in schools. Here we present the research protocol and the questionnaires that will be used

Increased vaccination coverage among adolescents and young adults in the district of Palermo as a result of a public health strategy to counteract an ‘epidemic panic’

During the summer of 2016 four cases of invasive meningococcal disease in rapid succession among young adults in the district of Palermo, Italy, resulting in one death, were widely reported by local and national mass media. The resultant ‘epidemic panic’ among the general population overloaded the vaccination units of the Palermo district over the following months. Strategies implemented by the Sicilian and local public health authorities to counteract ‘meningitis fear’ included the following: (a) extension of active and free-of-charge anti-meningococcal tetravalent vaccination from age class 12–18 to 12–30 years old; (b) implementation of vaccination units during normal clinic hours in rooms tailored for vaccine administration; (c) development of informative institutional tools and timely communication throughout local mass media to reassure the general population. In 2016, an increase in the anti-meningococcal coverage was observed in the Palermo district (+18% for 16-year-olds and +14% for 18-year-olds) and at the regional level (+11.2% and +13.5%, respectively). Concurrent catch-up of other recommended vaccinations for age (diphtheria-tetanus-pertussis-poliomyelitis and papillomavirus) resulted in a further increase of administered doses. The fear of meningitis, managed by the Sicilian public health authorities, had positive impacts in terms of prevention. In particular, the communication strategies that were adopted contributed to educating Sicilian young adults about vaccination issues

Exopolysaccharidic matrix from biological soil crusts from arctic environments

Environmental Engineering and Management Journal March 2012, Vol.11, No. 3, Supplement, S162 http://omicron.ch.tuiasi.ro/EEMJ/ “Gheorghe Asachi” Technical University of Iasi, Romania P102 EXOPOLYSACCHARIDIC MATR IX OF BIOLOGICAL SOIL CRUSTS FROM ARTIC ENVIRONMENTS Federico Rossi 1 , Gianmarco Mugnai 1 , Giovanni Colica 1 , Stefano Ventura 2 , Claudio Sili 2 , Cristina Mascalchi 2 , Roberto De Philippis 1 1 Department of Agricultural Biotechnology, University of Florence, Florence, Italy; 2 Institute for Ecosystem Studies, CNR, Florence, Italy Abstract Biological soil crusts (BSC) are soil-surface communities that repr esent a typical example of microbial adaptability to harsh environmental conditions. They im prove soil fertility and promote plant growth, representing a valid putative tool to fight desertification processes. Various mechanis ms allow them to withstand constraints such as drought, high solar irradiation and wind erosion. These organisms produce extracellular polyme ric substances (EPS), excret ed in response to the envi ronmental characteristics, which are known to primarily contribute in ma ny ways to the increase of constraint to lerance. While various features of these excreted molecules have been investigated in axenic bacteria l cultures, a not definitive and re latively low number of studies c ome from the direct study of the entire matrix of microbial aggregat es, with limitative information on how they contribute to micro bial survival in extreme environments. The aim of this study was to investigate the microbial compos ition and the characteristics, both qualitative and quantitative, of the EPS extracted from BSC collected by several sites in Ny- Ǻ lesund, Svalbard Island, Norway, in a landscape mostly characterized by the high arctic tundra, where environm ental conditions are extreme and where BSC play a key role in creating a favorable habitat for plant growth af ter deglaciation processes. A proper method for extracting EPS directly from the crust samp les was optimized. Exopolysacchari dic fractions were quantified and analyzed using ion-exchange chromatography (IEC) to determine the monosaccharidic composition. Size exclusion chromatography (SEC) was also used to determine the si ze distribution of the EPS fractions. Abundance of phototrophic microorganisms, which are known to primarily contribute to EPS excretion, was also eval uated in all the samples. Results underlined the complexity of the polysaccharidic fractio ns, displaying a high number of constituent sugars; the matrix was found to be constituted by two main fractions, a higher molecular weight (MW) fraction (apparent MW around 2 10 6 Da) and a lower molecular weight fraction (MW < 100 10 3 Da). Fluctuations of these results were observed along the sampling sites suggesting the influence of e nvironmental factors and substrate characte ristics on the formation of EPS matrix. This study presents novel data concerning E PS of BSCs matrix in cold environments and the results represent a starting point to deepen the knowledge on the mechanisms at the basis of th e high tolerance showed by BSC microorganisms to extreme conditions. The knowledge of these mechanisms in different extreme environments (bot h hot and cold) can improve the outcome of the exploitation of these communities to increase the ferti lity and the stability of soils in constrained environments

Impact of Communicative and Informative Strategies on Influenza Vaccination Adherence and Absenteeism from Work of Health Care Professionals Working at the University Hospital of Palermo, Italy: A Quasi-Experimental Field Trial on Twelve Influenza Seasons

Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of several initiatives in order to increase HCWs&rsquo; awareness about influenza vaccination. Vaccines administration within hospital units, dedicated web pages on social media and on the UH of Palermo institutional web site, and mandatory compilation of a dissent form for those HCWs who refused vaccination were carried out during the last four influenza seasons. After the introduction of these strategies, influenza vaccination coverage went up from 5.2% (2014/2015 season) to 37.2% (2018/2019 season) (p &lt; 0.001), and mean age of vaccinated HCWs significantly decreased from 48.1 years (95% CI: 45.7&ndash;50.5) to 35.9 years (95% CI: 35.0&ndash;36.8). A reduction of working days lost due to acute sickness among HCWs of the UH of Palermo was observed. Fear of adverse reactions and not considering themselves as a high-risk group for contracting influenza were the main reasons reported by HCWs that refused vaccination. Strategies undertaken at the UH of Palermo allowed a significant increase in vaccination adherence and a significant reduction of absenteeism from work

Improvement in vaccination knowledge among biomedical students following an integrated extra curricular intervention

IntroductionVaccination coverages threaten to decrease because of false beliefs in their unsafety and inefficacy. Therefore formation of future health-care workers on this topic is fundamental to deal with any doubt and to promote active immunization among general population.MethodsIn order to assess health-care students knowledge about vaccination before an integrated seminar on this topic, and to evaluate their improvement after the educational intervention, an integrated educational intervention was held by a multidisciplinary team. Before and after the seminar, 118 students of medicine and biology schools at Palermo University were asked to answer 10 multiple-choice questions regarding vaccine history, mechanism of action, side effects, composition, use and nowadays issues (hesitancy). Two more questions investigating possible changes on students’ attitudes towards vaccination and the usefulness of the formative intervention,  were added at the post-test phase of the survey.ResultsEighty-one out of 118 students (68.6%) answered to both pre- and post-test questions. 97.6% and 81.5% of the participating group also completed the two additional questions about their improvement in knowledge (question 11) and attitudes (question 12) towards vaccinations. The post-test results showed a significant improvement for all questions administered, except for number 3, with a overall percentage of correct answers increasing from 38.8% to 77.6%  (p&lt;0.001).ConclusionsThe present study highlights the importance of educating health-care professions students by means of integrated extra-curricular intervention to be held early in their degree curricula in order to improve knowledge and attitudes towards vaccinations and to prepare them to promote vaccines among the general population.

Rilevazione della prevalenza del Bullismo in un campione di scuole di Palermo

Il bullismo è uno dei problemi sociali e sanitari più rilevanti in ambito scolastico per i bambini e gli adolescenti di tutto il mondo. Dal 2007, il Ministero Italiano della Pubblica Istruzione (D.M. n°16 del 5 febbraio 2007) promuove attività per il contrasto e la prevenzione del fenomeno in scuole di ogni ordine e grado, ed allo stesso tempo le aziende sanitarie locali o provinciali dovrebbero farsi carico di una risposta socio-sanitaria efficace al problema. Nella città di Palermo, negli ultimi anni, sia alcune scuole che alcuni distretti sanitari hanno messo in atto attività ed interventi per cercare di contrastare il fenomeno in questione. La mancanza di un dato rilevato in maniera uniforme a livello regionale e provinciale e la radicalizzazione del problema rendono necessaria ed urgente una risposta strutturata valutabile in termini di efficacia in linea con l'obiettivo 2.3 del Piano Regionale di Prevenzione 2014/2018 (PRP Regione Siciliana - D.A. n.351 del 08/03/2016) che prevede, anche in tal senso, azioni per promuovere il benessere mentale nei bambini, adolescenti e giovani. Tale impostazione, tra l'altro, è condivisa dal Protocollo d'Intesa interistituzionale "Una nuova alleanza per la Salute dei bambini e dei giovani" siglato tra l'USR-Sicilia e l'Assessorato della Salute-DASOE (Decreto Assessorato della Salute del 17/06/2016). Negli ultimi decenni la problematica del bullismo tra bambini e adolescenti ha guadagnato sempre più interesse in sanità pubblica, catalizzando molti sforzi sia di ricerca che di azione. Per bullismo si intende un abuso sistematico di potere che si manifesta con intimidazione/forme di persecuzione fisica, verbale o psicologica, ripetute nel tempo, concepite ed agite con l'intenzionalità di causare paura, angoscia o danni alla vittima; perpetuata da una persona o da un gruppo di persone più forti e potenti nella relazione con la vittima (Farrington et al. D. P. 1993, Gredler et al., G. R. 2003). Intenzionalità, durata nel tempo e asimmetria nella relazione sono, quindi, le parole chiave nella definizione di bullismo. Le vittime sono selezionate per la loro condizione di diversità, che può essere rappresentata dall'obesità, dalla timidezza, dalle scarse competenze sociali, dall'identità sessuale, dall'etnia, dallo stato socio-economico, da disturbi dello spettro autistico, dislessia e differenze di simile natura. Il bullismo coinvolge un'importante percentuale di bambini in età scolare: secondo i dati ISTAT 2014, 2 ragazzi su 10 tra gli 11-17 anni hanno subito atti di bullismo due o più volte al mese, con una prevalenza maggiore per le ragazze (Istat, 2014). In Sicilia, il fenomeno del bullismo è oggetto di particolare attenzione, tanto che l'Ufficio Scolastico Regionale per la Sicilia (USR) è stato tra i primi in Italia ad aver costituito un Osservatorio regionale,che ha prodotto strumenti operativi quali delle linee guida per la prevenzione del bullismo nelle scuole (Beckman L. et al. 2012). La prevalenza stimata di bambini tra gli 11 e i 15 anni che dichiara di aver subito almeno un atto di bullismo negli ultimi due mesi, in regione Sicilia, risulta essere del 14%, secondo gli ultimi dati disponibili della sorveglianza HBSC (2014) (Regione Sicilia. Osservatorio epidemiologico,2014). La letteratura scientifica dimostra una forte associazione tra l'essere stato vittima di bullismo e l'insorgenza di problematiche di salute mentale e fisica, sia a breve che a lungo termine ((Beckman L. et al. 2012 Gini, G. et al. 2009). Inoltre esiti di salute negativa si riscontrano anche per i bulli. Per questo, diversi programmi di prevenzione specifici, basati sul setting scolastico, sono stati creati ed attuati, a partire dal primo grande programma anti-bullismo su larga scala realizzato in Norvegia nel 1983 e perfezionato poi da Olweus nel 1991 (Olweus, D. 2001), che si dimostrò fin da subito di grande efficacia e che tuttora rappresenta il modello d'intervento di maggior successo. Una revisione sistematica (Ttofi, M. et al. 2011) di 44 programmi ha dimostrato come i programmi di prevenzione a scuola siano in grado di ridurre la prevalenza di bullismo, in media, del 20-23%. Obiettivo del progetto BIAS (Bullying In siciliAn School) vuole essere quello di valutare la prevalenza baseline dei fenomeni di bullismo nelle scuole siciliane, proporre un intervento preventivo evidence-based e adattato al contesto locale e infine di valutarne l'efficacia sul campo nel prevenire o ridurre i fenomeni di bullismo. Nel presente rapporto epidemiologico si riportano i risultati preliminari dello studio di prevalenza "pilota" in un campione di scuole nella città di Palermo, capoluogo di Regione e comune con il maggior numero di abitanti della Regione Siciliana. Obiettivi del lavoro sono per l'appunto la valutazione della prevalenza del bullismo in un campione di scuole nella città di Palermo, lo studio delle caratteristiche dei fenomeni di bullismo che si verificano in relazione alle differenti tipologie di scuola e la possibile applicabilità di metodi alternativi al "gold stardard" per la rilevazione della prevalenza del fenomeni di bullismo nelle scuole

Determinants of vaccine hesitancy and effectiveness of vaccination counseling interventions among a sample of the general population in Palermo, Italy

Counteract vaccine hesitancy is a public health priority. Main objectives of the cross-sectional study conducted were to evaluate knowledge, attitudes, and behaviors regarding vaccination issues, to estimate the prevalence of vaccine hesitancy and to estimate the effectiveness of vaccination counseling on community advocacy in a sample of general population. An anonymous validated questionnaire was administered in April 2017 at the main shopping center of Palermo and was followed by tailored vaccination counseling interventions. To estimate the effectiveness of the interventions four main connection parameters to the vaccinarsi.org website were evaluated, in the two months before and after the intervention and in the two months before the intervention compared with the same period of previous and following years. Among the 299 subject enrolled 12.7% were hesitant about vaccinations, and 4.7% declared being against vaccinations. General practitioners (GPs) and pediatricians were the most affordable source of information about vaccinations. A higher probability of vaccination hesitancy/refusal was reported among subjects who considered “alternative strategies” the best way for the prevention of infectious diseases (adj-OR = 7.01, IC95% 2.88–17.09, p-value < 0.001). A considerable increase of all the vaccinarsi.org website indicators analyzed was observed, from the area in which survey participants lived. Prevalence of vaccine hesitancy among population surveyed is consistent with the literature data. HCWs, such as GPs and pediatricians, should play a key role in modifying personal convictions and choices about vaccinations. A proper vaccination counseling could improve attitudes regarding vaccination issues, such as quality of web-based research

Human Papilloma Virus Infection and Vaccination: Pre-Post Intervention Analysis on Knowledge, Attitudes and Willingness to Vaccinate Among Preadolescents Attending Secondary Schools of Palermo, Sicily

In recent years, vaccination coverage rates against Human Papilloma Virus (HPV) in Europe have shown a decreasing trend and remain below the required standard. The present study aims to assess knowledge and attitudes regarding HPV infection and vaccination among a representative sample of preadolescents of Palermo, Italy. A survey was carried out throughout two questionnaires, before and after carrying out an educational intervention scheduled during school hours. A total of 1702 students attending first-grade secondary schools of the province of Palermo were enrolled (response rate 68.9%). Students attending third classes (adj OR = 1.18; CI 95% 1.03-1.36), being of higher socioeconomic status (adj OR = 1.35; CI 95% 1.05-1.73), who had previously received information about sexually transmitted diseases (STDs) at home (adj OR = 1.62; CI 95% 1.27-2.07) or at school (adj OR = 2.15; CI 95% 1.70-2.71) and who had ever heard in the past about HPV (adj OR = 1.80; CI 95% 1.42-2.29) showed a significantly higher baseline level of knowledge regarding HPV. Willingness to receive HPV vaccination, in a 10-point Likert scale, significantly increased between the pre- (8.51; SD \ub1 1.79) and post- (9.01 SD \ub1 1.52) intervention questionnaires (p &lt; 0.001). A total of 188 out of 272 (69.1%) preadolescents attending five out eighteen schools involved in the project, who had not previously received the HPV vaccine, were vaccinated. During past years, education campaigns on HPV were mainly dedicated to adult women, excluding teenagers and omitting young males. It should therefore be of primary importance that school-based education and vaccination programmes be standardized