Igiene e sanità pubblica
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Igiene e sanità pubblica · Mar 2014
Multicenter StudyPaediatric emergency department utilisation: is it necessary an educational intervention?
Over the past ten years there has been a progressive increase in accesses to services for paediatric emergency room, documented in Italy and abroad. The aim of the study is describe the sociodemographic, cultural, subjective and objective factors for non-urgent access to paediatric emergency service in an Italian region. It was adopted a descriptive survey of a sample of non-urgent accesses to two paediatric emergency room services in an Italian region during the period from February-March 2009, through the administration of questionnaires and the consultation of facilities databases. ⋯ Approximately half of the accesses to the paediatric emergency department could be managed by primary care services. The convenience of the service, the self-referred and the proximity to home are emerging as the only influential factors reported by literature. In the future it should become crucial providing strategies for education/health information focused on non-urgent paediatric problems and offering people a call center phone service in order to filter and prevent the inappropriate accesses.
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Igiene e sanità pubblica · Jan 2011
Multicenter Study Comparative Study Clinical TrialThe impact of integrating food supplementation, nutritional education and HAART (Highly Active Antiretroviral Therapy) on the nutritional status of patients living with HIV/AIDS in Mozambique: results from the DREAM Programme.
DREAM (Drug Resources Enhancement against AIDS and Malnutrition) is a multiregional health program active in Mozambique since 2002 and provides free of charge an integrating package of care consisting of peer to peer nutritional and health education, food supplementation, voluntary counseling and testing, immunological, virological, clinical assessment and HAART (Highly Active AntiRetroviral Treatment). The main goals of this paper are to describe the state of health and nutrition and the adequacy of the diet of a sample of HIV/AIDS patients in Mozambique on HAART and not. A single-arm retrospective cohort study was conducted. 106 HIV/AIDS adult patients (84 in HAART), all receiving food supplementation and peer-to-peer nutritional education, were randomly recruited in Mozambique in two public health centres where DREAM is running. ⋯ The improvement in BMI was significant and substantially higher in HAART patients because of the impact of HAART on nutritional status of AIDS patients. Subjects on HAART and with a DDS > 5, showed a substantial BMI gain. This association showed an additional expression of the synergic effect of integrating food supplementation, nutritional education and HAART on the nutritional status of African AIDS patients and also highlights the complementary role of an adequate and diversified diet in persons living with HIV/AIDS in resources limited settings.
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Igiene e sanità pubblica · Jan 2010
Multicenter Study[Analysis of services and standards commitment charters in hospitals in the Campania Region (Italy)].
The healthcare services and standards commitment charter is a document produced by local health authorities/hospitals in Italy and aimed at citizens/healthcare users. With this document hospitals aim to openly express their philosophy and state which services they will commit to offer to users. ⋯ The online versions of the document were available and updated for all hospitals while the printed versions could be found only in three. With regard to the relative legislation's highly innovative contents concerning the safeguard of patients-citizens, however, study results revealed notable shortcomings with respect to all parameters analysed, in all charters.
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Igiene e sanità pubblica · May 2009
Multicenter Study Comparative Study[Safety Walkround as a risk assessment tool: the first Italian experience].
In 2007 the Study Group "Clinical Risk Management" of the Italian Society of Anaesthesia and Intensive Care Unit (SIAARTI) performed a multicentric study in Intensive Care Unit (ICU) to assess the feasibility and efficacy of the Safety WalkRound (SWR) as a tool for the risk assessment. As the environment and organization of ICU are more complex than anaesthesia ones, mainly due to the severity of patients, high number of involved healthcare givers and different kinds of procedures, the Study Group decided that a check list is not fit for ICU and , after a careful review of the literature, chose to test the Safety WalkRound. in four Italian General ICUs. The SWR was born in 2003 when Frankel plans a structured interview of 15 questions (about 50% open) to collect operators' opinion about rate and type of errors, near misses, communication, problems regarding the report of adverse events and suggestions to increase patient safety. ⋯ The results of this study have demonstrated that the Italian translation is fit for the model by Frankel and makes available a lot of information useful to improve patient safety. The study has demonstrated the sensibility, efficacy and efficiency of this tool in detecting the vulnerabilities in every ICU of the four ones. SWR is marked by feasibility, high compliance of operators and low costs; besides increases safety culture in the staff and demonstrating.
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Igiene e sanità pubblica · Mar 2009
Multicenter StudyThe role of environmental factors and distance from Emergency Medical Services on the severity of road accidents.
Aim of this work is to assess the effect of some environmental factors on road accident severity in Tuscany (Italy). ISTAT data on road accidents occurred in Tuscany in 1991-2003 (228,833 accidents) have been analysed, considering the following variables: road type and characteristics, population density in the municipality where the accident occurred, presence of Emergency Medical Services (EMSs) in the municipality, distance between the municipality and the nearest EMS, according to 3 different criteria. The effect of each variable in accident severity (fatal vs not fatal) was assessed through logistic regression analysis. The results confirm the role of structural and environmental factors in influencing accident severity, in particular population density, location on the road and road type, while the effectiveness in preventing serious consequences due to distance from EMS is limited to the municipalities very close to hospitals.