How can we bring public health in all policies? Strategies for healthy societies

New scenarios are emerging in the European and worldwide context: the ageing of society, the climate changes, the increasing of health inequalities and the financial crisis. In this context, the scientific community and the decision-makers agree on the role of health in all policies (HiAP) strategy in improving the population’s health. The HiAP takes into account factors not strictly related to health but with important health consequences. To bring public health in all policies a change is needed, but there are some obstacles to overcome: for instance, the lack of evidence regarding the governance tools and frameworks for HiAP, the difficulty of convincing stakeholders and producing a cultural change in the political positioning of decision-makers. Consequently, it is necessary: i) to implement stronger and responsible decision-support approaches, such as health impact assessment and health technology assessment; ii) to encourage and coordinate all relevant sectors in playing their part in reducing health gaps within the European Union; iii) to strengthen cooperation and make better use of existing networks and existing public health and related institutions. The final aim will be to monitor the impact of the health determinants in order to promote the effective implementation of HiAP approach

Effectiveness Cost of HIV rapid tests in Italy and Europe

In the United States, about a quarter of the estimated 1.1 million people living with human immunodeficiency virus (HIV) are not aware of their HIV status. HIV tests in communities with outreach settings can be an effective strategy to identify people with unidentified HIV infection. The spread of innovative rapid tests represents an additional opportunity in the field of HIV prevention. HIV rapid tests represent an excellent diagnostic tool to reach the rural or poor population where accessibility to test is limited or populations with high-risk infection. Cost-effectiveness point of view, this service always has the potential for early diagnosis by affecting lower hospital spending, preventing clinically aggravated cases with decreased CD4 and acquired immunodeficiency. The study analyses the characteristics of rapid tests by evaluating what can be used in Europe and Italy from case studies. The sensitivity, specificity and project needs are the main factors of choice in testing project

Exploring the possible health consequences of job insecurity: a pilot study among young workers

Objective: Socio-economical changes in Europe are leading to the rise of new issues regarding the labour market and health of young workers. Job insecurity is a widely studied phenomenon that involves an increasing number of young workers. We investigated its association with mental health and hazardous behaviours. Method: In this pilot study, 504 subjects aged between 18 and 40 were interviewed. STROBE guidelines were used. Socio-economic factors were evaluated. Adapted forms of validated scales were used to assess depression, anxiety disorder, alcohol and drug abuse and smoking habit. Univariate and multivariate analyses were performed. Results: Job insecurity appeared to be partially connected with the type of employment. Most respondents with a permanent contract felt their situation was secure, while this proportion was reduced when referring to temporary jobs and other kinds of contract (p < 0.001). Job security perception was associated with depression, anxiety, alcohol abuse and smoking habit (p < 0.001). Conclusions: Job security perception appears to be the most important predictive factor for the presence of depression and anxiety symptoms, alcohol consumption and smoking habit compared to other socio-economic factors under study. Resumen: Objetivo: Los cambios socioeconómicos en Europa están provocando el surgimiento de nuevas cuestiones sobre la salud de los trabajadores jóvenes. La inseguridad laboral es un fenómeno que involucra una cantidad creciente de trabajadores jóvenes. Nuestro estudio tiene como objetivo investigar la asociación entre inseguridad laboral y salud mental y comportamientos peligrosos. Método: En este estudio piloto fueron entrevistados 504 sujetos con edades comprendidas entre 18 y 40 años. Se evaluaron los factores socioeconómicos. Se usaron formas adaptadas de escalas validadas para evaluar la depresión, la ansiedad, el abuso de alcohol y drogas, y el hábito de fumar. Se realizaron análisis univariados y multivariados. Resultados: La mayoría de los encuestados con contrato permanente consideró que su situación era segura, mientras que esta proporción se redujo al referirse a trabajos temporales y otros tipos de contrato (p < 0,001). La percepción de la seguridad laboral se asoció con la depresión, la ansiedad, el abuso de alcohol y el hábito de fumar (p < 0,001). Conclusiones: La percepción de la seguridad laboral parece ser el factor predictivo más importante para la presencia de síntomas de depresión y ansiedad, el consumo de alcohol y el hábito de fumar, en comparación con otros factores socioeconómicos en estudio

Cross sectional study investigating the differences in knowledge and behaviors about HPV between vaccinated and non-vaccinated girls

IntroductionThe aim of the presents study was to compare the level of knowledge about Human Papilloma Virus (HPV) in vaccinated and non-vaccinated girls and to highlight the reasons why non-vaccinated girls refuse vaccination.MethodsA cross-sectional study was conducted from October 2012 to June2013 inTurin (Piemonte Region, Italy). Questionnaires were administered to girls attending secondary and high schools randomly selected.ResultsA total of 576 were compiled. The principle sources of information were parents and health workers. The main reported reasons for non-adherence to vaccination were the disagreement of the parents among the 11-12 years group (45.3%) and the lack of evidence on efficacy among the 18 years group (26.8%). By comparing the level of knowledge there was a statistically significant difference between groups: vaccinated girls reported higher score than the unvaccinated group in several questions (p≤0.05).DiscussionOur findings show a lack of information about HPV infection. Parents, school and health care workers have a central role in girlâs education and choices about HPV vaccination.The communication campaign for the prevention of cervical cancer must therefore be characterised by messages able to clarify and consolidate messages that may have been partially received or misunderstood