159 research outputs found

    The antecedents and consequences of health literacy in an ecological perspective: Results from an experimental analysis

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    This study analyses the relationship between the antecedents and consequences of health literacy (HL) at the ecological level among the nations involved in the European Health Literacy Survey (HLS-EU). The antecedents and consequences were investigated by means of proxy indicators. The HL was measured using the 47-item HLS-EU questionnaire (HLS-EUQ47) and the Newest Vital Sign (NVS). The two measures stood in significant correlation to the outcomes of the sub-discipline of the Euro Health Consumer Index (r = 0.790 for HLS-EUQ47; r = 0.789 for NVS). The HLS-EUQ47 also stood in correlation to the percentage of population with post-secondary education (r = 0.810), the reading performance for 15-year-old students (r = 0.905), the presence of a national screening program for breast (r = 0.732) or cervical cancer (r = 0.873). The NVS stood in correlation with the unemployment rate (r = −0.778), the Gross Domestic Product (r = 0.719), the Gini coefficient (r = −0.743), the rank of the Euro Patient Empowerment Index (r = −0.826), the expenditure on social protection (r = 0.814), the Consumer Empowerment Index (r = 0.898), the percentage of adults using the internet for seeking health information (r = 0.759), the prevalence of overweight individuals (r = −0.843), the health expenditure (r = 0.766), as well as the percentage of individuals using the internet for interacting with public authorities (r = 0.755). This study provides some preliminary considerations regarding alternative means by which to study HL and proposes new methods for experimentation. The methods and the results could offer a means by which the relationship between society and overall healthcare protection could be strengthened

    Surveillance of adverse events following immunization with meningococcal group C conjugate vaccine: Tuscany, 2005-2012

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    Introduction. Post-licensure vaccine safety studies are essential to identify uncommon events that may be difficult to assess during prelicensure studies. The aim of our study was to evaluate the safety of serogroup C meningococcal conjugate (MCC) vaccine in Tuscany from 2005 to 2012. Methods. All adverse events (AEs) to MCC vaccine notified from 2005 to 2012 were obtained from the regional health authority. Results. Following 451,570 doses administered, 110 suspected AEs were notified (mean annual reporting rate: 2.8/10,000 doses). The most frequently AE reported was fever (60%), fol- lowed by swelling at the injection site (11%) and febrile seizures (10%). Overall, 77.3% of cases were not severe, while 21.8% required hospitalization. Almost four months after the receipt of the vaccine, a one-year-old infant was diagnosed with a pervasive developmental disorder with disturbance of speech, but any link with the vaccinations received was refuted. Most AEs (80.9%) occurred after co-administration with other vaccines, especially with MMR or MMRV vaccines (42.7%) or the DTPa-HBV-IPV/ Hib vaccine (33.7%). Discussion. Our study confirmed the high level of safety of MCC vaccine in Tuscany: AEs proved rare and all cases had only tem- porary and self-resolving consequences. As usually only the most severe suspected AEs are reported, the true proportion of AEs requiring hospitalization was most probably overestimated, and it is plausible that most of these cases were in fact only temporally related

    Health literacy among non-familial caregivers of older adults: A study conducted in Tuscany (Italy)

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    Many older adults who live at home depend on a caregiver. When familial support cannot provide the necessary care, paid caregivers are frequently hired. Health literacy (HL) is the knowledge and competence required of people to meet the complex demands of health in modern society. The aim of this study is to assess the HL level of paid non-familial caregivers who were enrolled through two different sources: from the homes of assisted people in two Tuscan health districts (first sample) and during job interviews in a home care agency operating in Florence (second sample). The two different recruitment contexts allow us to provide a broader view of the phenomenon, presenting a picture of the HL level of those who are already working and those who are looking for a new job in this field. One-on-one face-to-face interviews, which include the administration of the Newest Vital Sign (NVS) to measure HL, were conducted. Recruitment resulted in 84 caregivers in the first sample and 68 in the second sample. In the first sample, the mean age was 51.2 ± 9 years; 94% of the participants were women. A high likelihood or likelihood of inadequate HL (i.e., a low level of HL) was found in 73.8% of cases. In the second sample, the mean age was 43.7 ± 11.5 years; 83.8% of the participants were women, and 80.9% had a low level of HL. In both samples, HL was statistically associated with the level of understanding of the Italian language. In conclusion, inadequate HL is an under-recognized problem among non-familial caregivers. Educational programs that aim to increase HL skills could be an effective approach to improving the qualification of informal healthcare professionals

    Budget impact analysis of universal rotavirus vaccination in the Local Health Unit 11 Empoli, Tuscany, Italy

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    Background. Rotavirus (RV) infection is the first cause of acute viral gastroenteritis in children under five years of age all over the world; it mainly affects children between six and 24 months of age and can cause serious acute diarrhoea and dehydration. The aim of this study is to perform the budget impact analysis of universal rotavirus vaccination in the Local Health Unit (LHU) 11 Empoli, Tuscany, Italy.Methods. An ad hoc mathematical simulation model was developed to evaluate the budget impact analysis of 5-years universal rotavirus vaccination. Particularly, incidence of rotavirus gastroenteritis (RVGE), hospitalizations, nosocomial diarrhoea, medical consultations, prescriptions and accesses to emergency department were taken into account in the analysis. The direct medical costs due to RV diarrhoea and the costs of vaccination campaign were considered as the main outcome measures in the study.Results. The adoption of universal rotavirus vaccination campaign for five years in the LHU 11 Empoli results in relevant savings due to the health cares avoided. These savings would overlapped the costs of vaccination yet from the second year after the introduction of vaccination. The saving for the Health Service would be 1.5 million Euro after five years of campaign.Conclusions. Universal vaccination against rotavirus results clinically and economically favourable for both the Health Service and the Society perspectives

    Non invasive diagnosis and anatomo-clinical correlations of macrocystic pancreatic neoplasia

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    Pancreatic cystic tumors represent an heterogeneous group of neoplasms with a various clinical outcome. The incidence of these neoplasia is growing if compared with the past and this is mainly due to the larger use of more and more performing imaging techniques. The role of MRI and in particular of Cholangio-Pancreato Magnetic Resonance (CPMR) seems to be fundamental in the characterization of these cystic lesions. Between May 2009 and May 2011 a hundred and seventy six (176) patients with a suspect cystic lesion of the pancreas were evaluated. All patients had already undergone ultrasound and/or CT scan. CPMR was realized in each patient. Among these patients we only considered 51 without neither solid lesions or pseudocysts nor clear signs of malignancy. We found 10 Serous Cystic Tumors (SCT), 7 Mucinous Cystic Tumors (MCT) and 34 Intraductal Papillary Mucinous Neoplasia (IPMN). Thirty two (32) out of 34 IPMN revealed at CPMR a communication with the main pancreatic duct. This sign is pathognomonic of these lesions. CPMR seems to be mandatory to discriminate IPMN among the other pancreatic cystic neoplasia. Its role is fundamental for an early diagnosis and to give the best chance of cure in these aggressive and insidious tumors

    A Virtual Laboratory for Digital Design

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    This paper presents a virtual laboratory for digital design, specifically conceived for educational application and for supporting project work both locally and at distance: the Deeds. It covers combinational and sequential logic networks, finite state machines, microcomputer interfacing and programming at assembly level. The virtual lab is based on three simulator integrated together, combined with a large repository of application projects, available on the web. The paper contains an example of a laboratory session, structured accordingly to the Project Based Learning methodology
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