Low level of attention to health inequalities in prevention planning activities of the Italian Regions

Background: Health promotion and prevention activities should tackle health inequalities to reduce disparities in health among disadvantaged populations. This study aimed to assess the extent to which the Italian Regions considered health inequalities during the planning of prevention activities, to detect geographical differences and to identify the possible determinants of differences in attention to health inequalities. Methods: The 19 Regional Prevention Plans (RPPs) developed by Italian Regions within the National Prevention Plan (NPP) 2010-2013 were assessed using a specific tool to address the level of attention to health inequalities. Univariate and multivariate analyses were performed to identify regional characteristics associated with a higher level of attention to health inequalities. Results: Of the 702 projects included in the 19 RPPs, only 56 (8.0 %) specifically addressed issues related to health inequalities. The results of the multivariate analysis showed that a higher level of attention was associated with the macroarea of intervention 'prevention in high-risk groups', with the higher quality of the Strategic Plan Section of the RPP and with the higher percentage of migrants in the Region in 2010. Moreover, projects that addressed the topic of health inequalities were more likely to be developed in the Northern Regions, in Regions with a lower level of 'linking social capital' and with a Higher Regional Health Care Expenditure (RHCE) as a percentage of Regional Gross Domestic Product (RGDP) in 2010. Conclusions: The level of attention to health inequalities in the regional planning process of prevention activities 2010-2013 in Italy is low. The results of this study supported the new round of prevention planning in Italy, and highlight the urgent need to increase the number of policies and interventions able to reduce health inequalities

Childhood vaccinations: A pilot study on knowledge, attitudes and vaccine hesitancy in pregnant women

Background. The objective of this pilot study was to test a questionnaire aimed at assessing knowledge of and attitudes towards vaccination, as well as intention to vaccinate, among pregnant women. Methods. The questionnaire was self-administered by 49 pregnant women attending antenatal classes at three Family Centers in Rome. Results. Poor knowledge of vaccinations, inadequate attention from healthcare professionals, recurrent consultation of unreliable sources of information, and misconceptions about the side effects of vaccines, all contribute to vaccine hesitancy. Where appropriate, questionnaire sections were shown to be internally consistent. Conclusion. The questionnaire proved reliable and is suitable for further studies

Identification of delivery models for the provision of predictive genetic testing in Europe: protocol for a multicentre qualitative study and a systematic review of the literature

Introduction: The appropriate application of genomic technologies in healthcare is surrounded by many concerns. In particular, there is a lack of evidence on what constitutes an optimal genetic service delivery model, which depends on the type of genetic test and healthcare context considered. The present project aims to identify, classify, and evaluate delivery models for the provision of predictive genetic testing in Europe and in selected Anglophone extra-European countries (the USA, Canada, Australia, and New Zealand). It also sets out to survey the European public health community’s readiness to incorporate public health genomics into their practice. Materials and equipment: The project consists of (i) a systematic review of published literature and selected country websites, (ii) structured interviews with health experts on the genetic service delivery models in their respective countries, and (iii) a survey of European Public Health Association (EUPHA) members’ knowledge and attitudes toward genomics applications in clinical practice. The inclusion criteria for the systematic review are that articles be published in the period 2000–2015; be in English or Italian; and be from European countries or from Canada, the USA, Australia, or New Zealand. Additional policy documents will be retrieved from represented countries’ government-affiliated websites. The results of the research will be disseminated through the EUPHA network, the Italian Network for Genomics in Public Health (GENISAP), and seminars and workshops. Expected impact of the study on public health: The transfer of genomic technologies from research to clinical application is influenced not only by several factors inherent to research goals and delivery of healthcare but also by external and commercial interests that may cause the premature introduction of genetic tests in the public and private sectors. Furthermore, current genetic services are delivered without a standardized set of process and outcome measures, which makes the evaluation of healthcare services difficult. The present study will identify and classify delivery models and, subsequently, establish which are appropriate for the provision of predictive genetic testing in Europe by comparing sets of process and outcome measures. In this way, the study will provide a basis for future recommendations to decision makers involved in the financing, delivery, and consumption of genetic services

Which BRCA genetic testing programs are ready for implementation in health care? A systematic review of economic evaluations

Purpose: There is considerable evidence regarding the efficacy and effectiveness of BRCA genetic testing programs, but whether they represent good use of financial resources is not clear. Therefore, we aimed to identify the main health-care programs for BRCA testing and to evaluate their cost-effectiveness. Methods: We performed a systematic review of full economic evaluations of health-care programs involving BRCA testing. Results: Nine economic evaluations were included, and four main categories of BRCA testing programs were identified: (i) populationbased genetic screening of individuals without cancer, either comprehensive or targeted based on ancestry; (ii) family history (FH)-based genetic screening, i.e., testing individuals without cancer but with FH suggestive of BRCA mutation; (iii) familial mutation (FM)- based genetic screening, i.e., testing individuals without cancer but with known familial BRCA mutation; and (iv) cancer-based genetic screening, i.e., testing individuals with BRCA-related cancers. Conclusions: Currently BRCA1/2 population-based screening represents good value for the money among Ashkenazi Jews only. FHbased screening is potentially very cost-effective, although further studies that include costs of identifying high-risk women are needed. There is no evidence of cost-effectiveness for BRCA screening of all newly diagnosed cases of breast/ovarian cancers followed by cascade testing of relatives, but programs that include tools for identifying affected women at higher risk for inherited forms are promising. Cost-effectiveness is highly sensitive to the cost of BRCA1/2 testing

Are knowledge and skills acquired during the Master Degree in Nursing actually put into practice? A pilot study in Italy

Background. Literature on the evaluation of the Master’s Degree in Nursing is scarce. The objective of this pilot study was to test a questionnaire aimed at monitoring the activities of nurses after receiving the Master’s degree. Methods. An electronic questionnaire was administered to 36 graduates who obtained the Master’s degree during the academic year 2010/2011. Results. Almost 80% of the participants judged their level of improvement in knowledge and skills during the course to have been satisfactory, but the level of implementation of these competencies at work was quite low. Conclusion. Competencies acquired during the Master’s degree course are not always put into practice

Epidemiological trends of Tubercolosis in Italy, 1990-2004

<p><strong>Background</strong>: During the last two decades, tuberculosis (TB) has once again emerged as a significant public health problem in Western Countries. The aim of this study is to describe the epidemiology of TB in Italy in the last fifteen years. All routine information sources available (annual notifications, mortality and hospital discharges) were used, and attempts to investigate gender and geographical differences were made. Methods: Age-standardized annual notification, mortality and hospital discharge rates were calculated. Time trends of annual notifications, mortality and hospital discharges for TB were modelled through Poisson regression, and whenever necessary, negative binomial regression.</p><p><strong>Results</strong>: The analysis of the temporal trend of TB using the three indicators shows an increase until the middle of 1990s and a following decrease. TB is more frequent in men than in women, with a decremental. North to South gradient. There are important geographical and gender differences of the TB decline in Italy, since the decrease of TB frequency is more pronounced in men than in women and it is less evident in the central and, to a lesser extent, the southern parts of the country.</p><p><strong>Discussion</strong>: Italian guidelines for TB control, which are largely consistent with the international recommendations for low-incidence countries, need to be fully implemented throughout the entire country in order to reach the ultimate goal of disease eradication. Given the high number of TB cases among foreignborn persons, a strong public health commitment on TB control for immigrants, which includes screening, prophylaxis and treatment, is urgently needed.</p&gt