scholarly journals Impact of the COVID-19 Pandemic on Clinical Pathways for Non-SARS-CoV-2 Related Diseases in the Lazio Region, Italy

2022 ◽  
Vol 19 (2) ◽  
pp. 635
Author(s):  
Maria Piane ◽  
Lavinia Bianco ◽  
Rita Mancini ◽  
Paolo Fornelli ◽  
Angela Gabriele ◽  
...  
Keyword(s):  
Negative Impact ◽  
Clinical Pathways ◽  
Central Italy ◽  
Specific Treatment ◽  
Diagnostic Tools ◽  
Care Pathways ◽  
Local Health ◽  
Lazio Region ◽  
Health Authorities ◽  
Local Health Authorities

Clinical pathways (CPs) are multidisciplinary clinical governance tools necessary for the care management of the patients, whose aim is to outline the best practicable path within a health organization related to an illness or to a complex clinical situation. The COVID-19 pandemic emergency has created the need for an organizational renewal of care pathways based on the principles of “primary health care” recommended by the WHO. In Italy, the Hospitals and Local Health Authorities (ASL) have tried to guarantee the continuity of non-deferrable treatments and the maximum safety of both patients and health professionals. This study analyzes the organizational and managerial responses adopted in pathology-specific care pathways to assess how CPs as diagnostic tools responded to the COVID-19 pandemic in the first two waves. Twenty-four referents of Operational Units (UU OO) from Hospitals (AO) and Local Health Authorities (ASL) of the Lazio Region (Central Italy) that apply four different CPs responded to a survey, which analyzes the managerial and organizational responses of CPs in regard to different contexts. Results show that the structural and organizational adjustments of the CPs have made it possible to maintain an adequate level of care for specific treatment processes, with some common critical aspects that require improvement actions. The adjustments found could be useful for dealing with new outbreaks and/or new epidemics in order to try to mitigate the potential negative impact, especially on the most vulnerable patient categories.

scholarly journals The recent Italian vaccination law and the role of Local Health Authorities: the case of LHA Roma 1

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E M Frisicale ◽  
M T Miceli ◽  
M R Romagnuolo ◽  
R Agostinacchio ◽  
F De Angelis ◽  
...  
Keyword(s):  
Personal Data ◽  
Community Services ◽  
Vaccination Status ◽  
Vaccine Hesitancy ◽  
Local Health ◽  
Lazio Region ◽  
Health Authorities ◽  
Unaccompanied Foreign Minors ◽  
Local Health Authorities ◽  
Web Platform

Abstract Issue/problem The increase of vaccine hesitancy is leading to decrease vaccination coverage. In Italy, a new vaccination law was approved in July 2017 to contrast the spread of preventable infections. 10 vaccines became mandatory for children and unaccompanied foreign minors aged 0-16 and provided for free according to the national immunization schedule for each birth cohort. Being vaccinated is now required to attend schools and kindergartens even if a ban for students aged 0-6 or a fine for the other are previewed. Description of the problem According to the law, in Lazio Region, a web platform was realized in May 2018 in order to permit schools to update the list of their pupils. Medical doctors from LHAs had to evaluate continuously the updated lists, verifying the vaccination status of each student in order to approve their enrolment at schools or to recall parents providing counseling about vaccination. Results From August 2018 to March 2019 schools settled in the area of LHA Roma 1 registered 121.687 pupils (among those 105.720 pupils were also resident in the area of LHA Roma 1). After a preliminary check within data already present in the regional vaccination registry, around 30 healthcare operators, from the 6 healthcare districts of LHA Roma 1, were widely involved in order to evaluate pupils’ vaccination status. The number of evaluations decreases in the same period from 19.634 to 4921, but 4908 out of these 4921 were pupils not found in the regional vaccination registry, probably for errors in the registration of personal data such as the fiscal code. Some students’ families received vaccination counseling. Lessons The web platform realization was an innovative way to monitor vaccination status: it facilitates a further collaboration among schools and LHAs in order to guarantee health in community and to increase awareness about vaccinations and their benefits. A great involvement of schools and healthcare operators was observed. Key messages Although some problems such as pupils not found in the regional vaccination registry persist, the way of working in a collaborative way addressing community troubles is clearly traced. Technology and information systems help community services in monitoring and improving health outcomes. Their use has to be improved and promoted.

OBSTETRICS AND LOCAL HEALTH AUTHORITIES

BMJ ◽  
1924 ◽  
Vol 2 (3329) ◽  
pp. 741-742
Author(s):  
J. G. Bennett
Keyword(s):  
Local Health ◽  
Health Authorities ◽  
Local Health Authorities

scholarly journals Mobility, exposure, and epidemiological timelines of COVID-19 infections in China outside Hubei province

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Xiao Fan Liu ◽  
Xiao-Ke Xu ◽  
Ye Wu
Keyword(s):  
Hubei Province ◽  
Mitigation Measures ◽  
Quality Data ◽  
Local Health ◽  
Travel History ◽  
Health Authorities ◽  
Virus Exposure ◽  
Public Disclosures ◽  
Local Health Authorities

AbstractThe 2019 coronavirus disease (COVID-19) is pseudonymously linked to more than 100 million cases in the world as of January 2021. High-quality data are needed but lacking in the understanding of and fighting against COVID-19. We provide a complete and updating hand-coded line-list dataset containing detailed information of the cases in China and outside the epicenter in Hubei province. The data are extracted from public disclosures by local health authorities, starting from January 19. This dataset contains a very rich set of features for the characterization of COVID-19’s epidemiological properties, including individual cases’ demographic information, travel history, potential virus exposure scenario, contacts with known infections, and timelines of symptom onset, quarantine, infection confirmation, and hospitalization. These cases can be considered the baseline COVID-19 transmissibility under extreme mitigation measures, and therefore, a reference for comparative scientific investigation and public policymaking.

scholarly journals Childhood Immunisation Coverage during the COVID-19 Epidemic in Italy

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 120
Author(s):  
Michela Sabbatucci ◽  
Anna Odone ◽  
Carlo Signorelli ◽  
Andrea Siddu ◽  
Andrea Silenzi ◽  
...  
Keyword(s):  
Vaccine Coverage ◽  
National Health System ◽  
P Value ◽  
Local Health ◽  
Rate Decrease ◽  
Rotavirus Vaccination ◽  
Health Authorities ◽  
Vaccine Type ◽  
Childhood Vaccine ◽  
Local Health Authorities

The COVID-19 pandemic has affected national healthcare systems worldwide, with around 282 million cumulative confirmed cases reported in over 220 countries and territories as of the end of 2021. The Italian National Health System was heavily affected, with detrimental impacts on preventive service delivery. Routine vaccination services were disrupted across the country during the first months of the pandemic, and both access to and demand for vaccines have decreased during the pandemic. In many cases, parents preferred to postpone scheduled appointments for routine paediatric vaccinations because of stay-at-home orders or fear of COVID-19 infection when accessing care. The objective of the current study was to assess the routine childhood vaccine coverage (VC) rates during the COVID-19 epidemic in Italy. We compared 2020 and 2019 VC by age group and vaccine type. The Italian Ministry of Health collected anonymised and aggregated immunisation national data through the local health authorities (LHAs). Results were considered statistically significant at a two-tailed p-value ≤ 0.05. VC rates for mandatory vaccinations decreased in 2020 compared to 2019 (range of VC rate decrease: −1% to −2.7%), while chicken pox increased (+2.2%) in 7-year-old children. Recommended vaccinations were moderately affected (range of VC rate decrease in 2020 vs. 2019: −1.4% to −8.5%), with the exception of anti-HPV in males, Men ACWY, and anti-rotavirus vaccination (VC increase 2020 vs. 2019: +1.8%, +4.7% and +9.4%, respectively). In the COVID-19 era, the implementation of coherent, transparent, and effective communication campaigns and educational programs on safe childhood vaccinations, together with the increase in the number of healthcare staff employed, is essential to support strategies to reinforce vaccination confidence and behaviour, thus avoiding health threats due to VPD during and beyond COVID-19 times.

The Public Health Police

2017 ◽  
Author(s):  
Trevor Hoppe
Keyword(s):  
Public Health ◽  
Hiv Positive ◽  
Local Health ◽  
Health Departments ◽  
Adherence To Treatment ◽  
The Public ◽  
Treatment Regimens ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Local Health Authorities

As the HIV epidemic wore on in the 2000s, public health authorities became enamored with the idea of “ending AIDS.” That is, if they could just get HIV-positive people to take their pills and stop infecting other people. Health departments began to track HIV-positive clients more closely, aiming to control their behavior and ensure their adherence to treatment regimens. This chapter explores how local health authorities ensure that HIV-positive clients behave in a manner officials deem responsible—and how they catch and punish those who do not. While the state maintains that the work of local health officials is done solely in the interests of promoting public health, their efforts to control HIV-positive clients reveal that they are also engaged in policing and law enforcement.

scholarly journals Spatiotemporal distribution of a non-haematophagous bat community and rabies virus circulation: a proposal for urban rabies surveillance in Brazil

2019 ◽  
Vol 147 ◽  
Author(s):  
R. A. Dias ◽  
F. Rocha ◽  
F. M. Ulloa-Stanojlovic ◽  
A. Nitsche ◽  
C. Castagna ◽  
...  
Keyword(s):  
Relative Risk ◽  
Rabies Virus ◽  
Urban Areas ◽  
Positive Sample ◽  
Local Health ◽  
Health Authorities ◽  
Passive Surveillance System ◽  
Local Health Authorities ◽  
Near Future ◽  
The City

AbstractIn Brazil, rabies surveillance is based on monitoring domestic and wild animals, although the most prevalent lineage of the rabies virus (RABV) currently diagnosed in Brazil is associated with bats, particularly non-haematophagous bats. Disease control is based on the mass vaccination of dogs and cats. We used data collected by the passive surveillance system of the city of Campinas from 2011 to 2015, to describe the temporal and geographic distributions of the bat specimens and RABV and discuss the current rabies surveillance with the advent of the declaration of canine and feline rabies-free areas in Brazil. We described the species, locations and health statuses of the collected bat specimens. Moreover, all samples were submitted for RABV diagnosis. Then, we performed a time series decomposition for each bat family. Additionally, we determined the spatiotemporal relative risk for RABV infection using the ratio of the kernel-smoothed estimates of spatiotemporal densities of RABV-positive and RABV-negative bats. From the 2537 bat specimens, the most numerous family was Molossidae (72%), followed by Vespertilionidae (14%) and Phyllostomidae (13%). The bat families behaved differently in terms of seasonal and spatial patterns. The distribution of bats varied geographically in the urban environment, with Molossidae and Phyllostomidae being observed downtown and Vespertilionidae being observed in peripheral zones. Concurrently, a significant relative risk of RABV infection was observed downtown for Vespertilionidae and in peripheral zones for Molossidae. No RABV-positive sample clusters were observed. As a result of the official declaration of RABV-free areas in southern Brazil, mass dog and cat vaccinations are expected to halt in the near future. This stoppage would make most dog and cat populations susceptible to other RABV lineages, such as those maintained by non-haematophagous bats. In this scenario, all information available on bats and RABV distribution in urban areas is essential. Currently, few studies have been conducted. Some local health authorities, such as that in Campinas, are spontaneously basing their surveillance efforts on bat rabies, which is the alternative in reality scenario of increased susceptibility to bat-associated RABV that is developing in Brazil.

A New Pattern in Day Hospital Development the West Middlesex Day Hospital

1963 ◽  
Vol 109 (458) ◽  
pp. 29-36 ◽  
Author(s):  
Brice Pitt ◽  
Morris Markowe
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Local Health ◽  
Day Hospital ◽  
New Era ◽  
Health Authorities ◽  
Hospital Boards ◽  
Hospital Development ◽  
Mental Treatment ◽  
Local Health Authorities

Slowly but surely the emphasis of the mental health service is moving from the mental hospital into the community which it serves. The trend of these community developments can be seen as far back as the establishment of psychiatric out-patient clinics at general hospitals under the Mental Treatment Act, 1930, together with arrangements for after care, and continued by mental hospitals and regional hospital boards since the advent of the National Health Service. While the new era in British psychiatry awaits the implementation by local health authorities of their mandatory functions under the Mental Health Act, 1959, much can still be done within the hospital services proper to shift the emphasis into the community. One such method is described in this study of a Day Hospital developed within a large general hospital.

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