Human Papillomavirus Epidemiology and Prevention: Is There Still a Gender Gap?

Background and aim: Human papillomavirus (HPV) is sexually transmitted, one of the three most common sexually transmitted infections (STIs) in both males and females, and the most common viral STI. A crucial public health strategy to protect people against HPV is vaccination, which has shown its effectiveness in preventing HPV-related diseases. Presently, three types of vaccines are available (bivalent, quadrivalent, and nonvalent), and they all target the two most oncogenic virus genotypes (HPV 16 and 18). In recent years, the need to implement vaccination programmes that include all genders has been discussed in order to achieve herd immunity against HPV. To date, only a few countries have included young males in their vaccination programmes. Thus, our objective with this review is to provide an overview of the epidemiology of HPV and HPV prevention strategies and report the latest findings from the scientific literature

How to Improve the Drafting of Health Profiles

Delineating patients’ health profiles is essential to allow for a proper comparison between medical care and its results in patients with comorbidities. The aim of this work was to evaluate the concordance of health profiles outlined by ward doctors and by epidemiologists and the effectiveness of training interventions in improving the concordance. Between 2018 and 2021, we analyzed the concordance between the health profiles outlined by ward doctors in a private hospital and those outlined by epidemiologists on the same patients’ medical records. The checks were repeated after training interventions. The agreement test (Cohen’s kappa) was used for comparisons through STATA. The initial concordance was poor for most categories. After our project, the concordance improved for all categories of CIRS. Subsequently, we noted a decline in concordance between ward doctors and epidemiologists for CIRS, so a new training intervention was needed to improve the CIRS profile again. Initially, we found a low concordance, which increased significantly after the training interventions, proving its effectiveness

Inter-regional patients' migration for hospital orthopedic intensive rehabilitation: the Italian experience

Background: Following the introduction of administrative federalism in the Italian National Health Service, inter-regional patients' mobility has become increasingly relevant because, in addition to being an indirect index of the quality of care, it has important economic and financial implications. This study aimed to evaluate the fulfillment of the need for hospital orthopedic intensive rehabilitation on site and care-seeking patients' migration to other regions. Methods: From 2011 to 2019, the data of intensive orthopedic rehabilitation extracts from the Hospital Discharge Cards provided by Italian Ministry of Health were analyzed. We studied the hospital networks of every Italian region (catchment areas). The epidemiological flows of inter-regional mobility were analyzed with Gandy's Nomogram, while the financial flows were analyzed through Attraction Absorption and Escape Production Indexes. Results: Gandy's Nomogram showed that only Piedmont, Lombardy, A.P. of Trento, E. Romagna, Umbria and Abruzzo had good public hospital planning for intensive orthopedic rehabilitation, with a positive balance for all studied periods. Lombardy, E. Romagna, Piedmont, Veneto and Latium have absorbed approximately 70% of all financial flows (about EUR 60.5 million). Conclusions: Only six regions appear to be able to satisfy the care needs of their residents, with a positive epidemiological and financial balance for all studied periods. © 2022 by the authors

The Structures and Activities of Health Promotion in the Italian NHS

Background: In Italy, the Ministry of Health is the main decision-making entity in healthcare. The local health authorities (LHAs) are responsible for health promotion (HP) activities, based on national and regional health plans. Our aim was to investigate the structured activities of HP in Italy at national, regional, and territorial levels. Methods: From February 2020 to July 2021, we searched for online information about the structures, projects, and responsibilities at the different levels mentioned above. The sources were the official sites of the Ministry of Health, the regions, and LHAs. Results: During the “prevalence period” of 2014–2021, we found 41 active facilities dedicated to HP: 7 complex operational units and 34 simple units. The other 30 facilities also had HP activities despite the absence of dedicated units. The most discussed topic seemed to be physical activity (63%), followed by addictions (53%), nutrition (48%), and prevention (33%); in the queue appeared dental hygiene and family/parenting (both at 7%). The LHA of the City of Turin and the LHA of Salerno had the most significant number of topics. Conclusions: The results showed great heterogeneity, in the Italian context, concerning HP activities. We assume that the phenomenon depends on reduced attention to the digitalization of information. The Italian Society of Health Promotion is pursuing the goal of the construction of an organic system of HP—with its own articulations, competencies, and scientific and operational goals—at different levels, thus transcending the health care system (which is often powerless in regulatory activity) and providing the one harbinger of the most promising results in terms of cost/benefit

Game of Mirrors: Health Profiles in Patient and Physician Perceptions

The relationship between general practitioners and patients is privileged. The aim of this study was to assess the concordance between the health profile perceived by the patient and the one described by the doctor. We conducted a cross-sectional study between 2019–2020. Patients completed the 5d-5L (EQ-p) and clinicians completed it “from the patient’s perspective” (EQ-d), also consulting the clinical diary. Statistical analysis was performed using Stata 14 (Cohen’s kappa; Fisher’s exact test). The sample consisted of 423 patients. The mean age was 56.7 ± 19.2. There were significant differences by gender in usual activities, pain, and anxiety/depression (74.6% of men had no limitation in usual activities versus 64.5% of women (p < 0.01), 53.9% of men had no pain versus 38.5% of women (p < 0.01), and 60.3% of men had no anxiety/depression versus 38.5% of women (p < 0.01)). Physicians did not detect these differences. The concordance between EQ-p and EQ-d was substantial for mobility (k = 0.62; p < 0.01), moderate for self-care (k = 0.48; p < 0.01) and usual activities (k = 0.50; p < 0.01). Concordance was fair for pain/discomfort (k = 0.32; p < 0.01), anxiety/depression (k = 0.38; p < 0.01), and EQ Index (k = 0.21; p < 0.01). There was greater agreement for “objective “dimensions (mobility, self-care, and usual activities). A good doctor, to be considered as such, must try to put himself in the “patient’s pajamas” to feel his feelings and be on the same wavelength

Use of <i>Lactobacillus plantarum</i> in Preventing Clinical Cases of American and European Foulbrood in Central Italy

American and European Foulbrood (AFB and EFB) are considered the most contagious infectious diseases affecting honeybees worldwide. New sustainable strategies need to be implemented for their prevention and control, and probiotics may represent one solution to investigate. In our study, we evaluated the efficacy of one strain of Lactobacillus plantarum (L. plantarum) isolated from northern Italy, orally administered to the bees for AFB and EFB prevention. From March to September 2014, a total of 979 honeybee colonies (9.6% of Viterbo province—Central Italy) were taken under observation from 22 apiaries. Overall prevalence of AFB was 5.3% in treated colonies and 5.1% in the untreated ones. On the contrary, EFB prevalence was lower in the treated colonies (2.5%) compared to the untreated ones (4.5%). L. plantarum showed a significant effect in reducing insurgence of cases of EFB up to 35 days after the end of the treatment (p-value: 0.034). Thanks to this study we could investigate the preventive efficacy of L. plantarum in controlling AFB and EFB, and obtain official data on their clinical prevalence in Central Italy

Prosafe: a european endeavor to improve quality of critical care medicine in seven countries

BACKGROUND: long-lasting shared research databases are an important source of epidemiological information and can promote comparison between different healthcare services. Here we present ProsaFe, an advanced international research network in intensive care medicine, with the focus on assessing and improving the quality of care. the project involved 343 icUs in seven countries. all patients admitted to the icU were eligible for data collection. MetHoDs: the ProsaFe network collected data using the same electronic case report form translated into the corresponding languages. a complex, multidimensional validation system was implemented to ensure maximum data quality. individual and aggregate reports by country, region, and icU type were prepared annually. a web-based data-sharing system allowed participants to autonomously perform different analyses on both own data and the entire database. RESULTS: The final analysis was restricted to 262 general ICUs and 432,223 adult patients, mostly admitted to Italian units, where a research network had been active since 1991. organization of critical care medicine in the seven countries was relatively similar, in terms of staffing, case mix and procedures, suggesting a common understanding of the role of critical care medicine. conversely, icU equipment differed, and patient outcomes showed wide variations among countries. coNclUsioNs: ProsaFe is a permanent, stable, open access, multilingual database for clinical benchmarking, icU self-evaluation and research within and across countries, which offers a unique opportunity to improve the quality of critical care. its entry into routine clinical practice on a voluntary basis is testimony to the success and viability of the endeavor

Regione Toscana, Piano di indirizzo territoriale con valenza di piano paesaggistico

Redatto tra 2012 e 2014 durante l'assessorato di Anna Marson, il Piano di indirizzo territoriale con valenza di piano paesaggistico (art. 145 del DL 42/2004) è parte del documento di indirizzo della pianificazione regionale, PIT Regione Toscana, ai sensi della LR 65/2014. Il Piano paesaggistico è approvato dal Consiglio regionale in data 27 marzo 2015