Costs of chronic obstructive pulmonary disease (COPD) in Italy: The SIRIO study (Social Impact of Respiratory Integrated Outcomes)

SummaryChronic respiratory diseases affect a large number of subjects in Italy and are characterized by high socio-health costs. The aim of the Social Impact of Respiratory Integrated Outcomes (SIRIO) study was to measure the health resources consumption and costs generated in 1 year by a population of patients with chronic obstructive pulmonary disease (COPD) in a real-life setting. This bottom-up, observational, prospective, multicentric study was based on the collection of demographic, clinical, diagnostic, therapeutic and outcome data from COPD patients who reported spontaneously to pneumological centers participating in the study, the corresponding economic outcomes being assessed at baseline and after a 1-year survey. A total of 748 COPD patients were enrolled, of whom 561 [408m, mean age 70.3 years (SD 9.2)] were defined as eligible by the Steering Committee. At the baseline visit, the severity of COPD (graded according to GOLD 2001 guidelines) was 24.2% mild COPD, 53.7% moderate and 16.8% severe. In the 12 months prior to enrollment, 63.8% visited a general practitioner (GP); 76.8% also consulted a national health service (NHS) specialist; 22.3% utilized Emergency Care and 33% were admitted to hospital, with a total of 5703 work days lost. At the end of the 1-year survey, the severity of COPD changed as follows: 27.5% mild COPD, 47.4% moderate and 19.4% severe. Requirement of health services dropped significantly: 57.4% visited the GP; 58.3% consulted an NHS specialist; 12.5% used Emergency Care and 18.4% were hospitalized. Compared to baseline, the mean total cost per patient decreased by 21.7% (p<0.002). In conclusion, a significant reduction in the use of health resources and thus of COPD-related costs (both direct and indirect costs) was observed during the study, likely due to a more appropriate care and management of COPD patients

Determining biokinetic coefficients for the upflow anaerobic sludge blanket reactor treating sugarcane wastewater in hot climate conditions

Acknowledgements The managing director of Imam Khomeini (pbuh) Agro-Industry in Shushtar and the laboratory expert of Agro-Industry Treatment Plant are highly appreciated for their cooperation in conducting this study.Peer reviewedPostprin

Distribution of Salmonella enterica isolates from human cases in Italy, 1980 to 2011

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Measuring knowledge, attitudes and behavior of nurses in medication management. Cross-cultural comparisons in Italy and Malta

Medication errors are one of the most common causes of negative events affecting patient safety all over the world.&nbsp; Scientific literature divides the factors that contribute to the occurrence of harmful events into factors related to the characteristics of the healthcare workers and factors related to the organization of the drug management process. The aim of the study was to examine the knowledge, attitudes and behaviours related to medication errors among Italian and Maltese nurses

Il concetto di Health Literacy e la sua importanza per la professione infermieristica

Introduzione: La salute degli individui e della popolazione dipende da una serie di variabili tra cui decisioni sociali, ambientali, economiche e culturali che mettono in connessione l’individuo con la società. Per poter decidere, le persone devono possedere un insieme di competenze che determinano la capacità e la motivazione di accedere ed utilizzare le conoscenze necessarie ad effettuare scelte consapevoli. Scopo: Scopo del presente lavoro è di sintetizzare e valorizzare l’importanza del concetto di Health Literacy (HL) e definire la sua importanza per la professione infermieristica, attraverso una revisione narrativa della letteratura con: analisi e focalizzazione delle diverse definizioni di HL presenti in letteratura ed elaborazione di un modello multidimensionale di HL; valutazione, attraverso revisione della letteratura, della correlazione esistente tra la professione infermieristica e l’ Health Literacy. Metodo: La revisione narrativa è stata condotta attraverso le banche dati PUBMED e CINAHL, utilizzando il termine “Health Literacy” e termini relativi associato al termine Nursing e termini relativi su studi pubblicati nel periodo 2010-2015 in lingua italiano ed inglese. Risultati: Le due direttrici di questo studio ci consentono di affermare che il concetto è variamente e largamente esaminato; allo stesso tempo l’attenzione da parte degli infermieri verso l’health literacy è ridotta, sia per non piena comprensione degli esiti sulla salute dei singoli sia per la carenza di valutazione. Dallo studio delle 28 definizioni è emerso come i concetti espressi dagli Autori siano ricorrenti e orientati su poche abilità e competenze individuali applicate al contesto sanitario (lettura, scrittura, comprensione, ascolto, etc.). Conclusioni: La presenza di tante descrizioni in letteratura, legate all’aspetto multidimensionale dell’HL rende complesso racchiudere così tanti concetti in un unicum. L’HL è legata a troppe variabili sociali, individuali ed ambientali in continua evoluzione sia arduo arrivare ad una definizione statica di HL da poter essere applicata ad ogni contesto. Allo stesso tempo diventa sempre più cogente che moduli formativi relativi all’Health Literacy vengano stabilmente integrati nella formazione sanitaria ed allo stesso tempo è necessario uno sforzo da parte dei professionisti e dei decisori per fornire risorse e strumenti alla popolazione per una migliore comprensione del sistema sanitarioIntroduction: Individuals and population’s health is influenced by environmental, social economical and cultural aspects which in turn connect individuals to society. In order to decide autonomously, independently and consciously individuals should have several competences. Aim: The aim of this study is to identify, analyse and emphasise health literacy concept relevance per se,its relationship with nursing through a narrative revision focused on: Health literacy definition recognition and analysis; Evaluation of connection between nursing and health literacy. Method: A narrative review was carried out through PUBMED and CINHAL, using ‘health literacy’ and nursing related terms, in English or Italian between 2010 and 2015. Result: Results show that ‘health literacy’ is fully appraised, while attention paid by nurses on the topic is poor due both to a lack of awareness of its relevance on individuals’ health and of appraisal. Twenty-height definition emerged from the revision; concepts expressed by scholars are mainly focused on very few individuals’ abilities and competences applied to the health context (reading, writing, calculation, comprehension , listening and so on). Conclusion: According to the results it is difficult to define ‘health literacy’ due to its multidimensional nature. Notwithstanding the above an attempt to develop a unique new definition of health literacy has been carried out although its multidimensional nature and its strong connection to several variables constantly under development. Nevertheless it is imperative that educational modules would be developed and stably integrated in health care education, at the same time a strong effort is due from professional and policy makers to provide population of the necessary tools in order to improve their health

On the dimensions of secant varieties of Segre-Veronese varieties

This paper explores the dimensions of higher secant varieties to Segre-Veronese varieties. The main goal of this paper is to introduce two different inductive techniques. These techniques enable one to reduce the computation of the dimension of the secant variety in a high dimensional case to the computation of the dimensions of secant varieties in low dimensional cases. As an application of these inductive approaches, we will prove non-defectivity of secant varieties of certain two-factor Segre-Veronese varieties. We also use these methods to give a complete classification of defective s-th Segre-Veronese varieties for small s. In the final section, we propose a conjecture about defective two-factor Segre-Veronese varieties.Comment: Revised version. To appear in Annali di Matematica Pura e Applicat

The hyperornithinemia-hyperammonemia-homocitrullinuria syndrome

Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare autosomal recessive disorder of the urea cycle. HHH has a panethnic distribution, with a major prevalence in Canada, Italy and Japan. Acute clinical signs include intermittent episodes of vomiting, confusion or coma and hepatitis-like attacks. Alternatively, patients show a chronic course with aversion for protein rich foods, developmental delay/intellectual disability, myoclonic seizures, ataxia and pyramidal dysfunction. HHH syndrome is caused by impaired ornithine transport across the inner mitochondrial membrane due to mutations in SLC25A15 gene, which encodes for the mitochondrial ornithine carrier ORC1. The diagnosis relies on clinical signs and the peculiar metabolic triad of hyperammonemia, hyperornithinemia, and urinary excretion of homocitrulline. HHH syndrome enters in the differential diagnosis with other inherited or acquired conditions presenting with hyperammonemia

Molecular characterization of multidrug-resistant strains of Salmonella enterica serotype Typhimurium and Monophasic variant isolated from human infections in Italy

Salmonella enterica serovar Typhimurium (STM) represents the prevalent cause of foodborne gastroenteritis in Italy with the majority of isolates exhibiting multidrug resistance. A resistant pattern that includes ampicillin (A), streptomycin (S), sulfonamide (Su), and tetracycline (T) (ASSuT) but lacks resistance to chloramphenicol (C) has recently emerged in Italy among strains of STM and of its monophasic variant, S. enterica subspecies enterica serovar S. 4,[5],12:i:-. With the aim to evaluate their clonal relationships, 553 strains of STM and S. 4,[5],12:i:- with the ASSuT and ACSSuT resistance patterns isolated in Italy from human infections between 2003 and 2006 were characterized by pulsed-field gel electrophoresis (PFGE) according to the PulseNet-Europe protocol and nomenclature. Among both the STM and S. 4,[5],12:i:- ASSuT strains, the predominant PFGE profile was STYMXB.0079 (53.2-73.0% of strains, respectively), while the STM ACSSuT strains belonged to the STYMXB.0061 (37.2% of strains) and STYMXB.0067 (29.9% of strains). Bionumerics cluster analysis of the nonunique PFGE profiles showed that more than 90% of ASSuT and ACSSuT-resistant strains were included in two distinct clusters with a genetic homology of 73% each other, suggesting that the ASSuT-resistant strains belong to a same clonal lineage different from that of the ACSSuT strains. Phage typing showed that 23% of the ASSuT STM strains were not typeable and 22.3% were U302. The same phage types were observed among the ASSuT strains of S. 4,[5],12:i:-. A different figure was observed for the ACSSuT strains: the STM isolates mostly belonged to DT104 (70.2%), while none of the S. 4,[5],12:i:- strains belonged to this phage type. This study indicates that the tetra-resistant ASSuT strains of STM and S. 4,[5],12:i:-, increasingly isolated in Italy, belong to a same clonal lineage and that the S. 4,[5],12:i:- strains circulating in our country mainly derive from this STM clonal lineage

CUGC for hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome

From 1999 to date, 50 affecting function variants have been identified and associated to HHH syndrome [1–5]. As it is not available in the literature a complete up-to-date list of disease-causing variants for SLC25A15 gene, we included this information as a Supplementary Excel sheet (See Supplementary Material File #1): this list was created by using LOVD and ClinVar databases and liked to the relevant literature reference. Reported variants consist of: 29 missense variants, 4 frameshift, 11 nonsense, 2 splicing, 2 small deletion, 1 in frame insertion, 1 gross deletion