scholarly journals Improving pertussis vaccination in pregnant woman. A new pathway in an Italian Local Health Authority

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Massetti ◽  
S Saracino ◽  
F Scaccia ◽  
R Rossetti ◽  
V Moroni ◽  
...  
Keyword(s):  
Public Health ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Health Authority ◽  
Optimal Level ◽  
Local Health Authority ◽  
Local Health ◽  
Great Opportunity ◽  
To Receive ◽  
In Pregnancy

Abstract Pertussis is quite common in adolescents and adults, but it is especially dangerous in new-borns. The national immunization plan (NIP) 2017-2019 recommended a Tdap booster for every pregnancy at 28-36 weeks, but adherence is still far from the optimal level. This work aims to evaluate the effectiveness of a dedicated pathway organized by the department of prevention to improve the Tdap coverage among pregnant woman attending antenatal class. The women attending from November 2019 to October 2019 the public antenatal class organized by the local health authority have been evaluated for their Tdap coverage in pregnancy. From May 2019, public health experts have been involved for 30 minutes during the first lesson to explain the NIP with a focus on vaccination in pregnancy. Then the eligible women (28-36 weeks not yet vaccinated) who voluntarily agree were accompanied to the ambulatory to be vaccinated. Pre-post Tdap vaccination coverage and pregnancy weeks at vaccination have been evaluated respectively by chi2 and t-test. 90 pregnant women have been included in the study. Their mean age was 32.3 (SD 5.2) and the overall Tdap coverage was 44.4%. The Pre-post Tdap coverage was 26.7%(12/45) before May 2019 and 62.2% (28/45) after the introduction of the new pathway (p = 0.001). 50% of the vaccinated women decided to receive the booster the same day of the antenatal lesson, while the remaining 50% delayed the vaccination till a maximum of 30 days. We observed a clinical, but not statistically, significant anticipation in the pregnancy week in which they received Tdap booster (32.4 weeks before and 31.3 after May 2019; p = 0.150). The introduction of a short intervention on vaccination in the antenatal class followed by the opportunity to receive the booster in a dedicated time and without waiting list significantly improved the Tdap coverage in pregnancy. This study encourages the cooperation among the different public health actors involved in the field of antenatal care. Key messages Antenatal class represents a great opportunity to improve vaccine confidence in pregnant women. Intervention aimed to ameliorate vaccine convenience could improve Tdap coverage in pregnancy.

scholarly journals Describing the Process and Tools Adopted to Cocreate a Smartphone App for Obesity Prevention in Childhood: Mixed Method Study

10.2196/16165 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16165
Author(s):  
Paolo Giorgi Rossi ◽  
Francesca Ferrari ◽  
Sergio Amarri ◽  
Andrea Bassi ◽  
Laura Bonvicini ◽  
...  
Keyword(s):  
Public Health ◽  
Childhood Obesity ◽  
Focus Groups ◽  
Obesity Prevention ◽  
Health Authority ◽  
Mobile App ◽  
Reggio Emilia ◽  
Local Health Authority ◽  
Local Health ◽  
Childhood Obesity Prevention

Background Childhood obesity prevention is a public health priority in industrialized countries. The Reggio Emilia Local Health Authority has implemented a program involving primary and secondary prevention as well as the care of obese children. There are many health-promoting mobile apps, but few are targeted to children and very few are sponsored by public health agencies. Objective The goal of the research was to describe the process and tools adopted to cocreate a mobile app sponsored by the Reggio Emilia Local Health Authority to be installed in parents’ phones aimed at promoting child health and preventing obesity. Methods After stakeholder mapping, a consulting committee including relevant actors, stakeholders, and users was formed. Key persons for childhood obesity prevention were interviewed, focus groups with parents and pediatricians were conducted, and community reporting storytelling was collected. The results of these activities were presented to the consulting committee in order to define the functionalities and contents of the mobile app. Results Three key trends emerged from community reporting: being active, playing, and being outdoors; time for oneself, family, and friends; and the pressures of life and work and not having time to be active and socialize. In focus groups, interviews, and labs, mothers showed a positive attitude toward using an app to manage their children's weight, while pediatricians expressed concerns that the app could increase their workload. When these findings were explored by the consulting committee, four key themes were extracted: strong relationships with peers, family members, and the community; access to safe outdoor spaces; children’s need for age-appropriate independence; and professional support should be nonjudgmental and stigma-free. It should be a dialogue that promotes family autonomy. The app functions related to these needs include the following: (1) newsletter with anticipatory guidance, recipes, and vaccination and well-child visit reminders; (2) regional map indicating where physical activity can be done; (3) information on how to manage emergencies (eg, falls, burns, fever); (4) module for reinforcing the counseling intervention conducted by pediatricians for overweight children; and (5) a function to build a balanced daily diet. Conclusions The pilot study we conducted showed that cocreation in health promotion is feasible, with the consulting committee being the key co-governance and cocreation tool. The involvement of stakeholders in this committee made it possible to expand the number of persons and institutions actively contributing to the project.

scholarly journals Describing the Process and Tools Adopted to Cocreate a Smartphone App for Obesity Prevention in Childhood: Mixed Method Study (Preprint)

2019 ◽  
Author(s):  
Paolo Giorgi Rossi ◽  
Francesca Ferrari ◽  
Sergio Amarri ◽  
Andrea Bassi ◽  
Laura Bonvicini ◽  
...  
Keyword(s):  
Public Health ◽  
Childhood Obesity ◽  
Focus Groups ◽  
Obesity Prevention ◽  
Health Authority ◽  
Mobile App ◽  
Reggio Emilia ◽  
Local Health Authority ◽  
Local Health ◽  
Childhood Obesity Prevention

BACKGROUND Childhood obesity prevention is a public health priority in industrialized countries. The Reggio Emilia Local Health Authority has implemented a program involving primary and secondary prevention as well as the care of obese children. There are many health-promoting mobile apps, but few are targeted to children and very few are sponsored by public health agencies. OBJECTIVE The goal of the research was to describe the process and tools adopted to cocreate a mobile app sponsored by the Reggio Emilia Local Health Authority to be installed in parents’ phones aimed at promoting child health and preventing obesity. METHODS After stakeholder mapping, a consulting committee including relevant actors, stakeholders, and users was formed. Key persons for childhood obesity prevention were interviewed, focus groups with parents and pediatricians were conducted, and community reporting storytelling was collected. The results of these activities were presented to the consulting committee in order to define the functionalities and contents of the mobile app. RESULTS Three key trends emerged from community reporting: being active, playing, and being outdoors; time for oneself, family, and friends; and the pressures of life and work and not having time to be active and socialize. In focus groups, interviews, and labs, mothers showed a positive attitude toward using an app to manage their children's weight, while pediatricians expressed concerns that the app could increase their workload. When these findings were explored by the consulting committee, four key themes were extracted: strong relationships with peers, family members, and the community; access to safe outdoor spaces; children’s need for age-appropriate independence; and professional support should be nonjudgmental and stigma-free. It should be a dialogue that promotes family autonomy. The app functions related to these needs include the following: (1) newsletter with anticipatory guidance, recipes, and vaccination and well-child visit reminders; (2) regional map indicating where physical activity can be done; (3) information on how to manage emergencies (eg, falls, burns, fever); (4) module for reinforcing the counseling intervention conducted by pediatricians for overweight children; and (5) a function to build a balanced daily diet. CONCLUSIONS The pilot study we conducted showed that cocreation in health promotion is feasible, with the consulting committee being the key co-governance and cocreation tool. The involvement of stakeholders in this committee made it possible to expand the number of persons and institutions actively contributing to the project.

scholarly journals Subsequent attendance in a breast cancer screening program after a false-positive result in the Local Health Authority of Bologna (Italy)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lorena Squillace ◽  
Lorenzo Pizzi ◽  
Flavia Rallo ◽  
Carmen Bazzani ◽  
Gianni Saguatti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Positive Result ◽  
Breast Cancer Screening ◽  
Health Authority ◽  
False Positive ◽  
Screening Program ◽  
Local Health Authority ◽  
Local Health ◽  
False Positive Result

AbstractWe conducted a cross-sectional study to assess the likelihood of returning for routine breast cancer screening among women who have experienced a false-positive result (FPR) and to describe the possible individual and organizational factors that could influence subsequent attendance to the screening program. Several information were collected on demographic and clinical characteristics data. Electronic data from 2014 to 2016 related to breast screening program of the Local Health Authority (LHA) of Bologna (Italy) of women between 45 and 74 years old were reviewed. A total of 4847 women experienced an FPR during mammographic screening and were recalled to subsequent round; 80.2% adhered to the screening. Mean age was 54.2 ± 8.4 years old. Women resulted to be less likely to adhere to screening if they were not-Italian (p = 0.001), if they lived in the Bologna district (p < 0.001), if they had to wait more than 5 days from II level test to end of diagnostic procedures (p = 0.001), if the diagnostic tests were performed in a hospital with the less volume of activity and higher recall rate (RR) (p < 0.001) and if they had no previous participation to screening tests (p < 0.001). Our results are consistent with previous studies, and encourages the implementation and innovation of the organizational characteristics for breast cancer screening. The success of screening programs requires an efficient indicators monitoring strategy to develop and evaluate continuous improvement processes.

Peri-operative elective path optimization through algorithms in the Local Health Authority of Bologna

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Leonessi ◽  
P Tubertini ◽  
A Longanesi ◽  
E Malaguti ◽  
S Guicciardi ◽  
...  
Keyword(s):  
Mathematical Models ◽  
Health Authority ◽  
Surgical Planning ◽  
Waiting Times ◽  
Local Health Authority ◽  
Local Health ◽  
Surgical Interventions ◽  
Patient Preparation ◽  
Surgical Teams ◽  
Available Resources

Abstract Background High costs of healthcare and population ageing force the health system to constantly improve its efficiency in order to provide patients the best possible care with the available resources. In this perspective, the Local Health Authority and the University of Bologna started an experimentation to re-organize, manage and control the peri-operative elective path of general surgery, a discipline that works in a multiplatform environment according to a Hub & Spoke logic. Methods The experimentation is built on two mathematical programming models. The first one defines patient preparation appointments (i.e. diagnostic and anesthesiologic visits), harmonizing patient preparation with available resources, and planning migration from Hub to Spoke platforms, in order to optimize waiting time and facilities utilization. The second model defines weekly optimal admission plans. Both models consider the availability of resources in terms of surgical teams, operating room slots and number of beds for each operating unit. The proposed approach works on a four-week time horizon following a rolling horizon framework (weekly update) in order to effectively manage high priority patients. Results Both models have been tested on real-world instances over a six-month observation period. Overall, it was possible to increase the efficiency of surgical programming by reducing the waiting times for surgical interventions in over 20% of cases of high priority patiets in four local departments. Conclusions The proposed model represents one of the few cases in Italy of surgical programming developed through mathematical models. It will be necessary to evaluate the evolution of its effectiveness to optimize the system's ability to respond to the growing health needs of the population. Key messages Mathematical models are needed to optimize surgical planning. Efficiency of surgical planning may reduce waiting times for high priority procedures.

LOCAL-HEALTH-AUTHORITY CLINICS

The Lancet ◽  
1961 ◽  
Vol 278 (7198) ◽  
pp. 368-369 ◽  
Author(s):  
R.L. Midgley
Keyword(s):  
Health Authority ◽  
Local Health Authority ◽  
Local Health

scholarly journals An outbreak of measles in Reims, eastern France, January-March 2008 - a preliminary report

2008 ◽  
Vol 13 (13) ◽  
pp. 1-2
Author(s):  
S Thierry ◽  
S Alsibai ◽  
I Parent du Châtelet ◽  
on behalf of the investigation team
Keyword(s):  
Health Authority ◽  
Preliminary Report ◽  
Local Health Authority ◽  
Local Health

Between the end of January and 12 March 2008, 16 cases of measles were reported to the local health authority in Reims in eastern France. The outbreak has to date affected nine adults and seven children, aged from seven months to 28 years. Among these cases, 13 were biologically confirmed.

scholarly journals Prevalence and aetiologies of anaemia among first trimester pregnant women in Sri Lanka; the need for revisiting the current control strategies

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Gayani Shashikala Amarasinghe ◽  
Thilini Chanchala Agampodi ◽  
Vasana Mendis ◽  
Krishanthi Malawanage ◽  
Chamila Kappagoda ◽  
...  
Keyword(s):  
Public Health ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Blood Count ◽  
First Trimester ◽  
Full Blood Count ◽  
Red Cell ◽  
Middle Income ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Abstract Background The Sustainable development goals, which focus strongly on equity, aim to end all forms of malnutrition by 2030. However, a significant cause of intergenerational transfer of malnutrition, anaemia in pregnancy, is still a challenge. It is especially so in the low- and middle-income settings where possible context-specific aetiologies leading to anaemia have been poorly explored. This study explores the prevalence of etiological factors significantly contributing to anaemia in pregnancy in Sri Lanka, a lower-middle-income country with a high prevalence of malnutrition albeit robust public health infrastructure. Methods All first-trimester pregnant women registered in the public maternal care programme in the Anuradhapura district from July to September 2019 were invited to participate in Rajarata Pregnancy Cohort (RaPCo). After a full blood count analysis, high-performance liquid chromatography, peripheral blood film examination, serum B12 and folate levels were performed in anaemic participants, guided by an algorithm based on the red cell indices in the full blood count. In addition, serum ferritin was tested in a random subsample of 213 participants. Anaemic women in this subsample underwent B12 and folate testing. Results Among 3127 participants, 14.4% (95%CI 13.2–15.7, n = 451) were anaemic. Haemoglobin ranged between 7.4 to 19.6 g/dl. 331(10.6%) had mild anaemia. Haemoglobin ≥13 g/dl was observed in 39(12.7%). Microcytic, normochromic-normocytic, hypochromic-normocytic and macrocytic anaemia was observed in 243(54%), 114(25.3%), 80(17.8%) and two (0.4%) of full blood counts in anaemic women, respectively. Microcytic anaemia with a red cell count ≥5 * 106 /μl demonstrated a 100% positive predictive value for minor haemoglobinopathies. Minor hemoglobinopathies were present in at least 23.3%(n = 105) of anaemic pregnant women. Prevalence of iron deficiency, B12 deficiency and Southeast Asian ovalocytosis among the anaemic was 41.9% (95%CI 26.4–59.2), 23.8% (95%CI 10.6–45.1) and 0.9% (95%CI 0.3–2.3%), respectively. Folate deficiency was not observed. Conclusion Even though iron deficiency remains the primary cause, minor hemoglobinopathies, B 12 deficiency and other aetiologies substantially contribute to anaemia in pregnancy in this study population. Public health interventions, including screening for minor hemoglobinopathies and multiple micronutrient supplementation in pregnancy, should be considered in the national programme for areas where these problems have been identified.

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