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tization with symptoms and medication. Sensitization to at least one woody plant was 23%; to ash (Fraxinus excelsior L.) 8.1%; hazelnut (Corylus avellana L.), olive (Olea europaea L.) and mulberry (Morus alba L.) 6.5%; juniper (Juniperus ashei J.Buchholz) 4.8%. Correlations between Fagales allergen sensitizations were significant. Sensitization to at least one weed was 22%, sensitization to dock (Rumex crispus L.) 12.9%, ragweed (Ambrosia artemisiifolia L.), and mugwort (Artemisia vulgaris L.) 4.8%. Sensitization rates correlated significantly with the length of the Main Pollen Season. selleck chemicals Conclusions. The European Standard Panel is suitable for the geographical area of Greater Istanbul, if it comprises Johnson grass and ash. Ragweed has become clinically relevant in this region. Mulberry and dock were exclusively associated to polysensitized individuals suggesting pan-allergen involvement.Barbara Pacelli, a young Italian epidemiologist, passed away unexpectedly in September 2019. During her prolific professional life, she gave several scientific contributions to natural disaster epidemiology, particularly in relation to the medium and long-term health effects of earthquakes. In this opinion paper, we reflect on Barbara’s legacy and outline potential actions that could arise from her work. Particularly, availability of electronic health records would enable a systematic and large-scale investigation into the long-term health effects of earthquakes in Italy, a country with high seismic risk. This effort would have high societal value as it would likely enable mitigation of substantial morbidity and mortality in areas affected by earthquakes. In this paper, we define scope, objectives, potential data sources, and analysis methods that could be used to systematically assess the chronic health effects of recent earthquakes in Italy. Keywords earthquakes; chronic diseases; electronic health records; retrospective cohort; case crossover study.
to describe the epidemiology of diabetes within the city of Turin (Piedmont Region, Northern Italy) and to present the process initiated by the city network of diabetes care for the improvement of prevention and treatment of the disease.
ecological study based on administrative database.
residents in Turin from 2016 to 2018.
incidence and prevalence of diabetes, percentage of glycosylated haemoglobin testing, and case-fatality.
in the considered three-year period (2016-2018), the cumulative incidence of diabetes was 11.5 x1,000; as of 31.12.2018 the prevalence was 5.9%. 77% had performed at least one measurement of glycated haemoglobin during the previous year, and the case-fatality was 12.6% in the three-year period. The standardized prevalence per statistical zone varied from a minimum of 2% (95%CI 1.2-3.3) to a maximum of 10.2% (95%CI 9.1-11.4). The highest values were recorded in the most deprived city areas. The geographical distribution of incidence, varying between 5.1 x1,000 (95%CI 2.7-10.0)led to identify as a priority interventions for the reduction of unhealthy behaviours, and for the improvements of patient care pathway, starting form the most disadvantaged areas of the city. A process of listening and involvement of all actors potentially interested in the prevention and treatment of diabetes has been started.
to estimate and analyse the trend of paediatric hospitalisations for Ambulatory Care Sensitive Conditions (ACSCs) from 2008 to 2018 in a region of southern Italy and to assess the association with the socio-economic deprivation index (DI).
retrospective observational study.
ACSC hospitalisations in children (<=18 years) were identified. Discharges for ACSC of the Abruzzo Region from 2008 to 2018 were selected and the deprivation index of the municipality of residence was assigned to the hospital discharge record where the patient’s residence was reported.
the rate of paediatric preventable admissions (PPHs) related to ACSC, standardized by age and gender with the direct method, was calculated for the years of observation. The average annual percentage change (AAPC) was calculated with a trend analysis. In addition, the odds ratios (ORs) of hospitalisation for ACSC were calculated using a hierarchical logistic regression model.
252,513 hospitalisations were examined, of which 16,264 (6.4%) attribu to prioritize public health interventions.
paediatric patients residing in Abruzzo have a risk of undergoing a preventable hospitalisation associated with an ACSC which depends on the deprivation index of the municipality of residence. Although it is difficult to evaluate the mechanisms involved in the relationship between economic deprivation and hospitalisation, DI can be useful to identify the areas which are most at risk on which to prioritize public health interventions.
to explain differences in effectiveness of paediatrician-led motivational interviewing (MI) in decreasing body mass index (BMI) between children of mothers with low or high education level.
secondary analysis of a randomised control trial.
individually randomized controlled trial previously conducted from 2011 to 2013 in the province of Reggio Emilia (Emilia-Romagna Region, Northern Italy). Eligible participants included in the trial were 372 (187 in the MI group and 185 in the control group) overweight children (BMI percentile >= 85th and < 95th) aged between 4 and 7 years, residing in the province of Reggio Emilia and under the care of paediatrician for >= 12 months. link2 The intervention included 5 MI sessions based on the transtheoretical model of addiction and behavioural change delivered at 1, 4, 7, and 12 months after the baseline visit, when families had to define specific goals in changing physical activity (PA) and diet behaviours.
primary BMI score variation (ΔBMI) from baseline to 12 m to be weakly or not associated with goal choices and achievement within MI, it is rather an effect of unmeasured behaviours which possibly mediate association between MI and BMI reduction.
MI intervention was not effective in reducing BMI in children of mothers with low education level. This does appear to be weakly or not associated with goal choices and achievement within MI, it is rather an effect of unmeasured behaviours which possibly mediate association between MI and BMI reduction.
less access to appropriate care during pregnancy for immigrant/ethnic minority women can lead to worse health outcomes and higher costs for health services.
to conduct a systematic review of studies on the economic evaluation of maternal and child healthcare among immigrants and racial/ethnic minority groups in advanced economy countries.
the main biomedical/economic bibliographic databases and institutional sources were searched. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
encouraging breastfeeding and reducing inappropriate hospital use/length of hospital stay proved potentially able to reduce costs. link3 Most studies showed a cost reduction if immigrant and ethnic minority women were included both in national and targeted programmes, such as nutritional programmes or case management. Screening campaigns targeting immigrants and ethnic minority groups were more cost-effective than broader, universal or non-screening strategies. Screenings were cost-effective when extended to newborns/relatives of pregnant women (Chagas disease) and were cost-effective for unvaccinated women in low-vaccination rates regions (rubella), immigrant women reporting no/uncertain vaccination history (varicella), and first-generation immigrants (HCV).
promoting inclusion in pregnancy healthcare programmes or in targeted screening campaigns could be effective in cost saving for health services.
promoting inclusion in pregnancy healthcare programmes or in targeted screening campaigns could be effective in cost saving for health services.
socioeconomic inequalities in reproductive outcomes have been consistently reported in several countries. In a European collaborative study conducted in 2012 whose aim was to investigate the association between socioeconomic position (SEP), measured through maternal education, and preterm delivery inconsistent results were found for the NINFEA birth cohort. However, NINFEA contributed to that study with the first 2,500 pregnancies only, and estimates were not adjusted for any potential confounders assuming that SEP is a distal exposure, that could not be affected by other preterm risk factors.
to investigate the relationship between SEP and the reproductive outcomes using the entire NINFEA cohort and compare the results with the population-based Piedmont Birth Registry (PBR), accounting for potential baseline collider bias both in the cohort and in the registry.
observational study.
5,323 NINFEA singletons, whose mothers registered into the study before the 36th week of gestation, were analysed. Analybability of being a member of such source population have to be accounted for to allow causal inference.
low SEP is associated with adverse reproductive outcomes in a contemporary Italian population.
low SEP is associated with adverse reproductive outcomes in a contemporary Italian population.
to evaluate the impact on prenatal/perinatal care and pregnancy outcomes of the main social determinants (education, professional status and citizenship), with the aim of identifying the areas of care and the subgroups of women who are most at risk as priority targets of interventions for the reduction of inequalities; to evaluate the impact of the pregnancy Agenda on the appropriateness of care.
cross-sectional observational study.
the childbirth assistance certificates (CedAP) related to childbirths occurred in the Piedmont region in the years 2010-2018 were analysed.
for each indicator of prenatal and perinatal care, multiple Poisson regression models were performed to estimate the prevalence ratios for the social determinants, adjusted for maternal age, parity, year of birth, and area of residence/maternity ward.
the observed deliveries were 274,086 and the newborns were 278,473, with a 25% reduction over time. Among pregnant women, there has been an increase in schooling, a reduction in employed women, and a stabilization of the percentage of immigrant women from countries with strong migratory pressure. Foreigners and inactive women show greater risks of poor prenatal care and less adherence to screening; education has greater impact on pregnancy outcomes. The trend towards greater adherence to the guidelines appears to be related to the introduction of the pregnancy Agenda, in turn associated with a greater use of public health services.
social inequalities persist in prenatal/perinatal care and pregnancy outcomes. The results of this study support the hypothesis that offering quality and low-threshold services, such as family health centres, could be a first effective measure to tackle inequalities.
social inequalities persist in prenatal/perinatal care and pregnancy outcomes. The results of this study support the hypothesis that offering quality and low-threshold services, such as family health centres, could be a first effective measure to tackle inequalities.