Igiene e sanita pubblica

Publisher: Associazione dei medici provinciali italiani


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    Igiene e sanitá pubblica
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Publications in this journal

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    ABSTRACT: Defensive medicine is a significant force driving the high costs of healthcare systems and has a substantial influence on physicians' behavior because they primarily concern about malpractice liability and not patient's health protection. This attitude disagrees with deontological duties and could impair physicians' ability of judgment and clinical reasoning. Reducing defensive medicine also could mean improving the quality in healthcare systems and eliminating unnecessary costs.
    Igiene e sanita pubblica 03/2014; 70(2):235-46.
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    ABSTRACT: The aim of the study was to evaluate the quality of hospital-territorial services relationship and community care to ensure continuity of care and to avoid, or reduce, the risk of hospitalization for complications or problems in the Health Districts of Umbria region (Italy). They are considered some of the outcome indicators proposed by the Assessment Document on Determinants of Health and the Strategies of the SSR, sponsored by the Region of Umbria in 2004 and based on Agency for Healthcare Research and Quality Indicators : the rate of unplanned readmission to hospital within 28 days after hospitalization for hip fracture, stroke, acute myocardial infarction, asthma, and the rate of hospitalization for chronic complications of diabetes, pneumonia and influenza. The most significant feature is the marked variability between different districts of the region. This variability requires careful verification, as well as the quality of intra-hospital, also the quality of the relationship hospital-territorial services and the different skills and ways of taking care of patients by the health district. To reduce the risk of rehospitalization/readmission not programmed for specific diseases, even considering that this risk is influenced by various determinants, it is desirable to improve the quality of community services.
    Igiene e sanita pubblica 03/2014; 70(2):171-84.
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    ABSTRACT: Background: Physical activity is influenced by individual, socio-cultural and environmental factors. The aim of the study is to describe the practice of physical activity in 11-18 year old students and to identify its correlates in a specific area of central Italy. Methods: Data were collected in secondary schools of the province of Frosinone (central Italy) using an opportunity sample on 856 students by means of a self administered questionnaire. Results: More than 50% of students reported to practice physical activity 2-3 times a week. Most of the students practiced football or five-a-side football as main sport (25.3%), followed by gymnastic and fitness (19.8%) and swimming (18.8%). Active commuting to school was reported by less than 20% of the sample while private car was the most common mean of transport (52.8%). Differences in physical activity practice were shown according to the residential municipality. Parents' educational level and their physical activity attitudes were positively associated to children's physical activity. These associations persisted after adjusting for age, gender and residential area. Conclusions: Socio-economic position and parental behaviours are important predictors of physical activity practice in children and adolescents.
    Igiene e sanita pubblica 03/2014; 70(2):197-210.
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    ABSTRACT: 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. Half of the accesses to the paediatric emergency room are not urgent and are to be referred to the paediatric primary care. 80% of the users do not call for advice before coming to the emergency room. The convenience of the service, which accounts for more than 50% of the case, and the proximity from home are reasons to go to the emergency room. 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.
    Igiene e sanita pubblica 03/2014; 70(2):141-50.
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    ABSTRACT: The use of innovative technologies in the health sector can be a key element in clinical risk management. In order to reduce errors in medical recording and to provide medico-legal evidence, Digital Pen & Paper technology has been adopted by medical staff of a hospital in Milan. The Authors introduce the first results of this trial: notable advantages have been reported in compilation, transmission and storage of medical records. Furthermore, this technology could provide evidence in evaluating medical malpractice claims.
    Igiene e sanita pubblica 03/2014; 70(2):223-34.
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    ABSTRACT: According to Italian Legislative Decree no. 81/2008, workplace safety will have to be introduced in school and university curricula. The main objectives of this study of the Italian Ministry of Labour were to verify knowledge about workplace safety among primary and secondary school students and evaluate the effectiveness of a training course in improving students' knowledge. Three provinces with an above average workforce/injuries ratio (with respect to the national average) were identified. An evaluation questionnaire was administered to students in the three provinces. Students then attended training courses about workplace safety and were then administered the same questionnaire. Primary school students improved by an average of 35.5%, middle school students by 33.3%, high school students by 18.6%. Results suggests that the training intervention was effective.
    Igiene e sanita pubblica 03/2014; 70(2):211-22.
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    ABSTRACT: Non-communicable diseases are a leading cause of morbidity worldwide and are predicted to increase in the next years. In 2008, 36.1 million people died from conditions such as heart disease, strokes, chronic lung diseases, cancers and diabetes (1). According to the WHO, 63% of the deaths, 77% of the loss of Healthy Life Years and 75% of health expenses in Europe are caused by cardiovascular diseases, cancer, chronic respiratory illnesses and mental health problems. All of these diseases have in common is the presence of modifiable risk factors (such as tobacco smoke, low consumption of fruit and vegetables, excessive intake of fats). Acting on these factors would lead to a reduction in the incidence of the aforementioned diseases. According to several studies conducted in the USA, Canada and Europe, the workplace seems an ideal place for implementing successful preventive strategies for the improvement of lifestyles. In 2006, the European Network for Workplace Health Promotion launched the Move Europe campaign to promote a healthy lifestyle at work, with the financial support of the European Commission. This campaign set new quality standards in behaviour-related workplace health promotion (WHP) and identified and documented good practices. Another aim of the campaign was to promote the benefits of implementing WHP, particularly focusing on four fields of life-style related WHP: physical activity, smoking prevention, nutrition and mental health. In two years, 65,215 contacts have been recorded in dedicated websites, of which 9,761 in Italy. A total of 2,548 enterprises in Europe asked to be certified and 125 events (such as seminars, workshops, conferences)were held.
    Igiene e sanita pubblica 03/2014; 70(2):185-96.
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    ABSTRACT: The new Plan for Elimination of Measles and Congenital Rubella 2010-15 recommends the local health unit (ASL) to analyze the immunization coverage data available in the adult population cohorts, in order to identify susceptible people. The aim of this paper is to estimate the susceptibility to rubella in resident women of childbearing age, through integration of all ASL data sources, in order to implement the most appropriate vaccination strategy for susceptible women. In ASL Roma C, the "PASSI" surveillance system estimates a 53% prevalence of childbearing age women immune to rubella; as many as 43 % is not aware of her immune status and 4% is certainly susceptible because of reporting a negative result "rubeotest" (years 2008-10). The data extracted from the database of the ASL Roma C laboratory (year 2010) estimate a prevalence of approximately 20% of susceptibility among women who spontaneously perform a rubeotest at the hospital laboratory for any reason (control or pregnancy). Childbearing age women susceptible to rubella, residing in the territory of our ASL, are definitely more than 5%, ranging from 4% estimated by the "PASSI" surveillance system to 20% detected by hospital laboratory.
    Igiene e sanita pubblica 03/2014; 70(2):247-54.
  • Igiene e sanita pubblica 03/2014; 69(5):491-6.
  • Igiene e sanita pubblica 01/2014; 70(1):53-5.
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    ABSTRACT: A cluster randomised trial was conducted to evaluate the efficacy of a health promotion intervention aimed at improving knowledge and preventing sexually transmitted diseases (STD) amongst Grade 9 primary school students in Salerno (Italy). Students were randomized to either one of two groups: intervention group or control group. The intervention group was required to attend three meetings, each lasting one and a half hours. A questionnaire was then administered to both groups to evaluate knowledge of STD, contraception, sexuality, affectivity, satisfaction with interpersonal relationships with family, social groups and healthcare professionals. Variations of knowledge in the two groups were evaluated through calculation of odds ratios. Three hundred twenty-two students participated in the study. All students who received the study intervention were able to identify at least one STD post-intervention, while 2.5% of students in the control group did not indicate any. Students in the intervention group were more likely to select condoms as the most suitable contraception for young people (OR 5.54; 95% CI 3.27 -9.38), compared to controls (OR 1.91; 95% CI 1.20 - 3.05) (p = 0.002). They were also better aware of the possibility of contracting a STD even after incomplete sexual intercourse (OR 0.21, 95% CI 0.13 to 0.35), with a statistically significant difference (p <0.001) compared to the control group (OR 0.71, 95% CI 0.45 to 1.11). In addition, students in the intervention group were more likely to turn to their own parents when having doubts about sexual issues (p = 0.004) and female students to consider their gynecologist as a reference figure. In conclusion, the findings indicate that students randomized to the intervention group were more informed and aware of issues related to sexuality and its associated risks.
    Igiene e sanita pubblica 11/2012; 68(6):821-840.
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    ABSTRACT: A cross-sectional study was conducted in the years 2003, 2005 and 2006, to assess client satisfaction in a nursing home in Piedmont (Italy). A structured questionnaire was used to evaluate three dimensions of care: interpersonal relationships, clinical care received and room comfort. Six-hundred eighty-four patients participated in the study. Of these, 33.6% were surgical patients, 33.6% were rehabilitation patients and 32.8% were medical patients. Overall, quality of care was reported as being "excellent" by 85% of patients in 2003, 85.3% of patients in 2005 and 66.1% in 2006. The study has made it possible to give a general description of client satisfaction regarding quality of services provided in a nursing home, and to identify the major critical areas. These should be analyzed in more detail, in order to identify which factors are most relevant to the patient and to implement corrective actions.
    Igiene e sanita pubblica 11/2012; 68(6):803-819.
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    ABSTRACT: The use of thermal waters in swimming pools for recreational use is widespread in Europe and in the rest of the world. The biological and chemical properties of spa waters make it difficult to treat them with conventional disinfection methods. The authors present an overview of European and international laws and regulations on this subject and highlight their strengths and gaps.
    Igiene e sanita pubblica 11/2012; 68(6):863-873.