A multicenter study on the appropriateness of hospitalization in obstetric wards: application of Obstetric Appropriateness Evaluation Protocol (Obstetric AEP). Studio multicentrico sul protocollo di revisione dell’uso dell’ospedale in ostetricia: applicazione dello PRotocollo dell’Uso dell’Ospedale in Ostetricia (PRUO ostetrico)

Objectives This study has been based on the implementation of the Obstetric Appropriateness Evaluation Protocol in 7 Italian hospitals to determine inappropriate hospital admissions and days of stay. Design A cross-sectional study. Methods The outcomes examined were: appropriateness/inappropriateness of admission and "percentage of inappropriateness". Results A total number of 2196 clinical records were reviewed. The mean percentage of inappropriateness for a hospitalization was 22%. The percentage of inappropriateness for the first ten days of hospitalization peaked in correspondence of the 4th and 5th (42%). The emergency admission was a protective factor of inappropriated admission, OR= 0.23 95%CI (0.16-0.35). To be hospitalized in a Teaching Hospital, in a hospital with ≥30 beds and to be admitted during the Winter/Autumn and in the workweek were risk factors of inappropriateness, respectively with OR=3.50 95%CI(2.30-5.34), OR=2.04 95%CI(1.41-2.97), OR=2.14 95%CI(1.41-2.97), OR=1.85 95%CI(1.12-3.04). The linear regression model underlined that the "percentage of inappropriateness" significantly increased in inappropriate admission and in obstetric wards with ≥30 beds; the admission in a Teaching Hospital and the hospitalization in South Italy was inversely associated to the percentage of inappropriateness. The R2 model was 0.367. Conclusions The present study suggests that the percentage of inappropriate admission depends especially on the inappropriate admission and the large number of beds in obstetric wards. This suggests that the management of big hospitals, which is very complex, needs improving the processes of support and coordination of health professionals. The obstetric AEP tool seems to be an useful instrument for the decision makers to monitor and manage the obstetric wards

A set of key questions to assess the stress among bank employees and its reliability: Bank Employee Stress Test (BEST8)

The aims of the present study are: to realize a tool, clear and helpful, to assess the occupational distress level in bank employees in Italy; secondly to assess the reliability of the tool. Eight sentences were considered after a consensus meeting that involved different professional figures. 70 questionnaires were collected. The overall Cronbach’s alpha was 0.596, a sufficient reliability was found. The elimination of one sentences (“I haven’t time to dedicate myself to my hobbies/activities/stuff”) increases alpha’s value from 0.596 to 0.620, and thus reach fully sufficient score. The claim “The pace of change on work place exceeds my capacity for adaptation” maximises the change of the level of reliability (Inter item Correlation = 0.528)

Knowledge, attitude and behaviours towards recommended vaccinations among healthcare workers

Healthcare workers (HCWs) are an important group of professionals exposed to biological risk during their work activities. So, the aim of this study is to perform a survey on the knowledge, attitude and behaviour of Italian HCWs towards the vaccinations recommended by the Ministry of Health. A cross-sectional study was carried out during the period September 2014-August 2015 in the Lazio region. The study was conducted by recruiting HCWs and biomedical students. The sample was comprised of 571 responders, of whom 12.4% were physicians, 18.9% were nurses, 34.3% were other HCW, and 34.3% were biomedical students (medical and nurses students). Hepatitis B virus (HBV) is perceived as a risk for personal health by 457 (80%) participants; TB is also worrying (434; 76%). Moreover, HBV (70.9%) and tuberculosis (TB) (79.2%) are perceived as a risk for health, while influenza is not considered so by most participants (46.2%). There is an underestimation of the role of influenza, perceived as a risk for 137 respondents (24%). The vaccination rate among these HCWs is highest for Hepatitis B virus (HBV) (82%), and lowest for influenza (28.5%) and varicella (40.3%). The vast majority of responders are in favour of HBV (77.8%) and TB (64.8%) vaccines. For other vaccinations there is less interest (between 33% and 40% for measles, mumps, rubella, pertussis and influenza). This study shows that knowledge of recommended occupational vaccinations is insufficient in HCWs, with few exceptions represented by HBV and TB. There is a need for novel approaches in this field, with the aim of enhancing vaccine coverage among HCW

Passive smoking indicators in Italy: does the gross domestic product matter?

BACKGROUND: The aim of this study is to analyse the correlation between regional values of Gross Domestic Product (GDP) and passive smoking in Italy. METHODS: The outcome measures were smoking ban respect in public places, workplaces and at home, derived from the PASSI surveillance for the period 2011⁻2017. The explanatory variable was GDP per capita. The statistical analysis was carried out using bivariate and linear regression analyses, taking into consideration two different periods, Years 2011⁻2014 and 2014⁻2017. RESULTS: GDP is showed to be positively correlated with smoking ban respect in public places (r = 0.779 p < 0.001; r = 0.723 p < 0.001 in the two periods, respectively), as well as smoking ban respect in the workplace (r = 0.662 p = 0.001; r = 0.603 p = 0.004) and no smoking at home adherence (r = 0.424 p = 0.056; r = 0.362 p = 0.107). In multiple linear regression GDP is significantly associated to smoking ban respect in public places (adjusted β = 0.730 p < 0.001; β = 0.698 p < 0.001 in the two periods, respectively), smoking ban in workplaces (adjusted β = 0.525 p = 0.020; β = 0.570 p = 0.009) and no smoking at home (adjusted β = 0.332 p = 0.070; β = 0.362 p = 0.052). CONCLUSIONS: Smoking ban is more respected in Regions with higher GDP. For a better health promotion, systematic vigilance and sanctions should be maintained and strengthened, particularly in regions with low compliance with smoking bans

Economic evaluation of HBV vaccination: a systematic review of recent publications (2000-2013).

Aim: To conduct a systematic review of the economic evaluations (EE) of HBV vaccination, taking also into account the studies published in the new millennium. Methods: An extensive scientific literature review was conducted using two electronic medical journal databases: Scopus and PubMed engines for published studies on EE of HBV vaccination. Results: 22 articles were reviewed, 9, 5 and 8 cost-effectiveness, cost-benefit and cost-utility analysis, respectively. Studies were mainly concerning EE of universal vaccination (UV), mostly with regards to low or low-medium income countries. For high income countries, EE were focused on the possible implementation of HBV vaccination in particular settings, such as diabetic, renal and other chronic conditions care, as well as infectious diseasesUV has usually a very good cost-effectiveness ratio (80%), ranging from cost-saving (China) or few Euro per LY/QALY gained (in Thailand, and Vietnam) to 630.00$/ QALY in USA (Asian and Pacific Islands) Moreover, EE of HBV vaccination are favorable in the infectious diseases field as well as for chronic conditions. In relation to diabetes the studies gave controversial results. Conclusion: This systematic review highlighted the importance of introducing HBV vaccination not only for infant UV program but also for other settings in which patients are people affected by communicable and non-communicable diseases

Are bank employees stressed? job perception and positivity in the banking sector: an italian observational study

Background: The epidemiology of stress on bank workers in Europe is only at the introductory stages. This study investigated for the first time the association between occupational stress level in bank-employees using the BEST8, Karasek-Model and socio-demographic and working factors in Italy. Methods: The observational pilot study involved 384 employees. Three questionnaires were adopted to collect data: Karasek-Model, BEST8 (p < 0.001) and Positivity-Scale. Results: 25% of the sample belonged to high stress group. The workers more stressed were older with a commercial role and consumer of antidepressants/sedatives. Women were much more likely to agree with the perception of feeling unsafe in a possible robbery (OR = 2.42; 95% CI: 1.50-3.91) and with that sales requests were in conflict with one's own personal moral code (OR = 2.31; 95% CI: 1.38-3.87). Older employees declared feeling inadequate in the workplace (OR = 1.97; 95% CI: 1.07-3.65) and younger employees referred to be anxious about meeting financial budget goals. Workers who had a low positivity had a lower probability of adaptation (OR = 0.88; 95% CI: 0.83-0.93). Conclusions: The occupational stress level in the banking sector involves many aspects: gender, type of bank, role, personal morals, high job-demands, low level of decision-making. This study recommended that banks should implement strategic interventions for well-being of employees, and consequently for their productivity

Socioeconomic deprivation status and air pollution by PM10 and NO2: an assessment at municipal level of 11 years in Italy

The aim of this observational study was to assess the relationship between environmental risk factors and some aspects of social economic status (SES) of the population in different Italian municipalities. Nitrogen dioxide (NO2) and particulate matter (PM10) annual means were extracted from ISPRA-BRACE (environmental information system of 483 Italian municipalities, 6% of the total amount of administrative units) from 2002 to 2012. As an indicator of sociodemographic and SES data, we collected the following: resident population, foreign nationality, low level of education, unemployment, nonhome ownership, single-parent family, and overcrowding. Low educational level, unemployment, and lack of home ownership were indirectly associated with the higher mean values of NO2 at the statistically significant level (). Major resident population and rental housing percentage determined higher levels of PM10. Northern regions showed similar results compared to the national level, with the exception of foreign residency that showed direct correlation with the increase of PM10. The central regions showed a direct relationship between NO2 and PM10 levels and higher educational levels and between NO2 levels and percentage of single-parent family. In the southern areas, higher NO2 levels were correlated with a higher rental housing percentage, as well as higher PM10 levels with a higher percentage of unemployment and lower housing density. The study shows high heterogeneity in the findings but confirms the relationship between high educational level and employment with the increased concentration of pollutants. The higher rental housing percentage may increase the pollutants’ levels too. The housing density does not seem to be in relationship with NO2 and PM10 at the national level. The analysis stratified by geographical areas showed that the direction of the correlations was different over time as the analysis was at a national level. The study represents an example of how data from national information systems can provide a preliminary evaluation and be a comparative tool for policy-makers to assess environmental risk factors and social inequalities

The use of yoga to manage stress and burnout in healthcare workers: a systematic review

The purpose of this systematic review is to analyze and summarize the current knowledge regarding the use of yoga to manage and prevent stress and burnout in healthcare workers. In February 2017, a literature search was conducted using the databases Medline (PubMed) and Scopus. Studies that addressed this topic were included. Eleven articles met the inclusion criteria. Seven studies were clinical trials that analyzed yoga interventions and evaluated effectiveness by gauging stress levels, sleep quality and quality of life. A study on Chinese nurses showed statistical improvement in stress levels following a six-month yoga program (χ2 = 16.449; p &lt; 0.001). A population of medical students showed improvement in self-regulation values after an 11-week yoga program (from 3.49 to 3.58; p = 0.04) and in self-compassion values (from 2.88 to 3.25; p = 0.04). Four of the included articles were observational studies: They described the factors that cause stress in the work environment and highlighted that healthcare workers believe it is possible to benefit from improved physical, emotional and mental health related to yoga activity. According to the literature, yoga appears to be effective in the management of stress in healthcare workers, but it is necessary to implement methodologically relevant studies to attribute significance to such evidence

How much do needlestick injuries cost? a systematic review of the economic evaluations of needlestick and sharps injuries among healthcare personnel

objective. To provide an overview of the economic aspects of needlestick and sharps injury (NSI) management among healthcare personnel (HCP) within a Health Technology Assessment project to evaluate the impact of safety-engineered devices on health care methods. A systematic review of economic analyses related to NSIs was performed in accordance with the PRISMA statement and by searching PubMed and Scopus databases (January 1997–February 2015). Mean costs were stratified by study approach (modeling or data driven) and type of cost (direct or indirect). Costs were evaluated using the CDC operative definition and converted to 2015 International US dollars (Int$). results. A total of 14 studies were retrieved: 8 data-driven studies and 6 modeling studies. Among them, 11 studies provided direct and indirect costs and 3 studies provided only direct costs. The median of the means for aggregate (direct + indirect) costs was Int$747 (range, Int$199–Int$1,691). The medians of the means for disaggregated costs were Int$425 (range, Int$48–Int$1,516) for direct costs (9 studies) and Int$322 (range, Int$152–Int$413) for indirect costs (6 studies). When compared with data-driven studies, modeling studies had higher disaggregated and aggregated costs, but data-driven studies showed greater variability. Indirect costs were consistent between studies, mostly referring to lost productivity, while direct costs varied widely within and between studies according to source infectivity, HCP susceptibility, and post-exposure diagnostic and prophylactic protocols. Costs of treating infections were not included, and intangible costs could equal those associated with NSI medical evaluations. conclusions. NSIs generate significant direct, indirect, potential, and intangible costs, possibly increasing over time. Economic efforts directed at preventing occupational exposures and infections, including provision of safety-engineered devices, may be offset by the savings from a lower incidence of NSIs