Methods to increase participation in organised screening programs: a systematic review.

Background: The European Community recommends the implementation of population-based screening programmes for cervical, breast, and colorectal cancers. This recommendation is supported by many observational studies showing that organised programmes effectively reduce mortality and control the inappropriate use of screening tests. We conducted a systematic review of studies assessing the efficacy of interventions to increase participation in organised population-based screening programs.

The effect of physician's recommendation on seasonal influenza immunization in children with chronic diseases.

Background: Despite recommendations by Health Authorities, influenza immunization coverage remains low in children with chronic diseases. Different medical providers involved in the management of children with chronic conditions may affect the pattern of influenza vaccine recommendations and coverage. The likelihood of vaccination by type of provider in children with chronic conditions is poorly understood.

[Human Papilloma Virus (HPV), cervical cancer incidence and screening uptake: differences among Northern, Central and Southern Italy].

Objective: this article presents a review of evidences about Human Papillomavirus (HPV) and cervical cancer in Italy, highlighting geographical differences.

Design: two systematic reviews recently published were updated, one collecting studies on the prevalence of HPV types in Italy in the general population and the other collecting prevalence of HPV types in cervical pathologic samples.The search was updated to 31.

How socioeconomic status influences road traffic injuries and home injuries in Rome.

Road traffic injuries (RTI) and home injuries (HI) are a relevant public health problem, especially among people living in deprived areas. The objective of this study was to explore the relationship between morbidity, hospitalisation, mortality from RTI and HI, and socioeconomic status (SES) of the area of residence. RTI and HI surveillance based on the Emergency Information System, the Hospital Information System and the Mortality Registry of Lazio region are the three sources of this study to create a unique surveillance system.

HIV incidence estimate combining HIV/AIDS surveillance, testing history information and HIV test to identify recent infections in Lazio, Italy.

Background: The application of serological methods in HIV/AIDS routine surveillance systems to identify persons with recently acquired HIV infection has been proposed as a tool which may provide an accurate description of the current transmission patterns of HIV. Using the information about recent infection it is possible to estimate HIV incidence, according to the model proposed by Karon et al. in 2008, that accounts for the effect of testing practices on the number of persons detected as recently infected.

[Methods to increase participation in cancer screening programmes].

Objective: to synthesize scientific evidences about methods to increase cervical, breast and colorectal cancer screening participation.

Methods: a multidisciplinary working group has been set up to define the scope of the report and to conduct the evaluation. The scope and the final evaluation have been submitted to a stakeholder committee, including the Ministry of Health, the National Screening Observatory, regional screening program coordinators, scientific societies, and Lega Italiana Lotta ai Tumori, for comments and integrations.

Hospital cluster of HBV infection: molecular evidence of patient-to-patient transmission through lancing device.

Introduction: In western countries the transmission of hepatitis B virus (HBV) transmission through multi-patients lancing devices has been inferred since early '90s, however no study has ever provided biological evidence which directly link these device with HBV cross-infection. Here we present results of an outbreak investigation which could associate, by molecular techniques, the use of lancing device on multiple patients with HBV transmission in an Italian oncohematology unit.

Methods: The outbreak investigation was designed as a retrospective cohort study to identify all potential cases.

Early and mid-term clinical outcome of emergency PCI in patients with STEMI due to unprotected left main coronary artery disease.

Objectives: Evaluation of acute and mid-term outcomes of patients with ST-elevation myocardial infarction (STEMI) undergoing emergency PCI due to unprotected left main coronary artery (ULMCA) disease.

Background: STEMI patients due to ULMCA disease represent a rare, high risk group. Percutaneous coronary intervention (PCI) may be the preferred strategy of myocardial revascularization but there are few data about this topic.

The combination of depressive symptoms and smoking shorten life expectancy among the aged.

Background: Depression is a potential risk factor for mortality among the aged and it is also associated with other chronic diseases and unhealthy lifestyles that may also affect mortality. The purpose of this study was to investigate the association between depressive symptoms and mortality, controlling for health, nutritional status, and life-style factors.

Methods: A cohort of elderly people (N = 167) was followed-up for ten years.

Can we use the pharmacy data to estimate the prevalence of chronic conditions? a comparison of multiple data sources.

Background: The estimate of the prevalence of the most common chronic conditions (CCs) is calculated using direct methods such as prevalence surveys but also indirect methods using health administrative databases.The aim of this study is to provide estimates prevalence of CCs in Lazio region of Italy (including Rome), using the drug prescription's database and to compare these estimates with those obtained using other health administrative databases.

Methods: Prevalence of CCs was estimated using pharmacy data (PD) using the Anathomical Therapeutic Chemical Classification System (ATC).

A case-control study on risk factors of domestic accidents in an elderly population.

The aim of this study was to evaluate the combined influence of several lifestyle, health and housing factors in the occurrence of home injuries (HIs) among the elderly. The subjects were recruited from 10 hospitals in Rome, Italy. This study is a paired case-control study.

Triage and Injury Severity Scores as predictors of mortality and hospital admission for injuries: a validation study.

Background: Many emergency departments use a rating system to establish priority based on urgency: "triage". The aim of this study was to evaluate the validity of triage in predicting hospitalization and mortality compared to that of the ICD-9-CM based Injury Severity Score (ISS).

Sources: The Emergency Information System 2000, the Hospital Information System 2000-2001 and the Mortality Register 2000-2001, of the Lazio Region.

[Defining a set of indicators for the evaluation of healthcare needs and of the performance of local health authorities].

A set of indicators for assessing healthcare needs and evaluating healthcare services are needed. This paper presents a set of indicators for evaluating healthcare districts, defined by a local health authority in the city of Rome. The set of indicators was developed by selecting 11 areas of interest and assigning to each area indicators that would allow an evaluation of its main functional aspects.

An integrated surveillance system of road traffic injuries in the Lazio region of Italy: results of a 5-year study (2001-2005).

Road traffic injuries represent a relevant public-health problem. In the Lazio region of Italy, a surveillance system was activated. The aim of this work is to describe the surveillance system and report the health information in terms of temporal trends for the 5-year period 2001-2005.

Description of two measles outbreaks in the Lazio Region, Italy (2006-2007). Importance of pockets of low vaccine coverage in sustaining the infection.

Background: Despite the launch of the national plan for measles elimination, in Italy, immunization coverage remains suboptimal and outbreaks continue to occur. Two measles outbreaks, occurred in Lazio region during 2006-2007, were investigated to identify sources of infection, transmission routes, and assess operational implications for elimination of the disease.

Methods: Data were obtained from several sources, the routine infectious diseases surveillance system, field epidemiological investigations, and molecular genotyping of virus by the national reference laboratory.

Physician and patient characteristics associated with prescriptions and costs of drugs in the Lazio region of Italy.

Objective: Prescribing medications is one of the most important therapeutic activities of a general practitioner (GP) and the quality of such practices is a relevant issue. Our objective was to use regional administrative databases to assess the following: (a) the prevalence of prescription drug use by patient age and gender, (b) different GPs' prescription volumes and average drug expenditure, and (c) how GPs' socio-demographic variables may be considered as predictive factors in their prescribing practices.

Methods: An observational cross-sectional study was carried out in the primary care setting (GPs and paediatricians only) on drug utilization in the period 1st January-31st December 2007.

Risk factors for sporadic pancreatic endocrine tumors: a case-control study of prospectively evaluated patients.

Objectives: Pancreatic endocrine tumors (PETs) are heterogeneous tumors with increasing prevalence. Little is known about the molecular pathogenesis and risk factors for the occurrence of sporadic PETs. The aim of this study was to identify the risk factors associated with the occurrence of sporadic PETs.

Morbidity experience in populations residentially exposed to 50 hz magnetic fields: methodology and preliminary findings of a cohort study.

A morbidity study of the population of a district of Rome built in part under a 60 kV electric distribution line, included 345 subjects resident in the study area in any period between 1954 and 2003, excluding those deceased before 1998. Residential magnetic field levels were estimated based on current load, line characteristics, and distance of the dwellings from the power line, and the study area was divided into sub-areas with differing magnetic field levels. Standardized morbidity ratios were computed from hospital discharge records dated 1998-2003.

Road traffic injuries in one local health unit in the Lazio region: results of a surveillance system integrating police and health data.

Objective: Different sources are available for the surveillance of Road Traffic injuries (RTI), but studied individually they present several limits. In this paper we present the results of a surveillance integrating healthcare data with the data gathered by the municipal police in the southeastern area of Rome (630,000 inhabitants) during the year 2003.

Methods: The Municipal police RTI reports, which list the exact location, circumstances and some risk factor of the crash, were searched in the emergency visit, hospitalization and mortality databases, to integrate them with the information on health consequences.

[Continuing care: experimental project of integration from San Camillo Forlanini Hospital and Local Health Unit in Rome].

The continuity care process tip to realize a rationalization of the distance of the patient from the acute phase, to the acute phase subintensive care area and in the territorial care. In this last phase, the project proposed to implement the experimentation through the determining role of the nursing profession and health care professions. These professions will carry out the function hinge between the truth hospital worker and that territorial one.

Validating regional Hospital Information System data through comparison with a local cancer register to identify interval cancers of a breast screening program.

The objective of this study was to evaluate the accuracy of the Hospital Information System (HIS) in monitoring the breast cancer incidence and interval cancers compared with the cancer registry (CR). The HIS data linked with CR and Mammographic Screening Information System data for breast cancer cases diagnosed in the period 1999-2003. The sensitivity and positive predictive value of the HIS data were calculated using the CR as a gold standard.

Incidence of bacterial meningitis (2001-2005) in Lazio, Italy: the results of a integrated surveillance system.

Background: Monitoring the incidence of bacterial meningitis is important to plan and evaluate preventive policies. The study's aim was to estimate the incidence of bacterial meningitis by aetiological agent in the period 2001-2005, in Lazio Italy (5.3 mln inhabitants).

[Screening and vaccine: toward an integrated cervical cancer prevention programme].

The identification of the human papilloma virus (HPV) as the necessary cause of cervical cancer introduced two new tools for prevention: HPV DNA test and vaccine. In this paper we analyse the plausible changes that will happens in the cervical cancer prevention in Italy and what we will need to have a governance of these changes. From a public health point of view, screening and vaccination are interventions directed to the whole community and their goal is to reach high coverage of the target population.

Continuing medical education and evidence-based clinical pathways. Training emergency health workers in Latium, Italy.

Background: In recent decades, studies that evaluate training programmes have shown that continuing education for physicians is not very effective in improving performance and behavioural changes. One of our goals was to create a Continuing Medical Education Programme (CMEP) that would result in changing the behaviour of health professionals. In early 2005, a new CMEP was offered to emergency medical services and emergency room professionals to introduce an Emergency Critical Pathway (ECP) for the management of acute stroke patients.