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Background: Hemorrhoidal artery embolization (Emborrhoid) is a novel method for the treatment of severe hemorrhoidal bleeding. Despite having a technical success rate of 93%-100%, the clinical success ranges between 63% and 94%, with a rebleeding rate of 13.6%., Aim: To evaluate the effectiveness of this procedure in reducing hemorrhoidal flow and hemorrhoidal bleeding., Methods: This prospective observational pilot study was conducted at Division of General Surgery 1 and Tertiary Referral Pelvic Floor Center, Treviso Regional Hospital, Italy. In a 2 months period (February-March 2022), consecutive patients with hemorrhoidal bleeding scores (HBSs) ≥ 4, Goligher scores of II or III, failure of non-operative management, and a candidate for Emborrhoid were included. Endoanal ultrasound with eco-Doppler was performed preoperatively and 1 month after the procedure. The primary endpoint was to quantify the changes in arterial hemorrhoidal flow after treatment. The secondary endpoint was to evaluate the correlation between the flow changes and the HBS., Results: Eleven patients underwent Emborrhoid. The overall pretreatment mean systolic peak (MSP) was 14.66 cm/s. The highest MSP values were found in the anterior left lateral (17.82 cm/s at 1 o'clock and 15.88 cm/s at 3 o'clock) and in the posterior right lateral (14.62 cm/s at 7 o'clock and 16.71 cm/s at 9 o'clock) quadrants of the anal canal. After treatment, the overall MSP values were significantly reduced ( P = 0.008) although the correlation between MSP and HBS changes was weak ( P = 0.570). A statistical difference was found between distal embolization compared with proximal embolization ( P = 0.047). However, the coil landing zone was not related to symptoms improvement ( P = 1.000). A significant difference in MSP changes was also reported between patients with type 1 and type 2 superior rectal artery (SRA) anatomy ( P = 0.040). No relationship between hemorrhoidal grades ( P = 1.000), SRA anatomy ( P = 1.000) and treatment outcomes was found., Conclusion: The preliminary findings of this pilot study confirm that Emborrhoid was effective in reducing the arterial hemorrhoidal flow in hemorrhoidal disease. However, the correlation between the post-operative MSP and HBS changes was weak. Hemorrhoidal grade, SRA anatomy and type of embolization were not related to treatment outcomes., Competing Interests: Conflict-of-interest statement: The authors of this manuscript declare that they have no conflicts of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background and Objective: The second victim (SV) phenomenon concerns health care workers (HCWs) whose involvement in a medical error, as well as non-error patient safety events, has affected their well-being. Its prevalence ranges from 10% to 75% and can predispose HCWs to burnout, increasing the probability of committing errors. The primary aim of our study was to determine the prevalence of HCWs involved in an adverse patient safety event in Friuli Venezia Giulia Region (Italy). The secondary aims were to use latent profile analysis to identify profiles of SVs and factors influencing profile membership, and to evaluate the relationship between the severity of symptoms and desired support options., Methods: A cross-sectional survey through the Italian version of the Second Victim Experience and Support Tool tool was conducted in 5 local health authorities. Descriptive statistics were conducted for all variables. Associations and correlations were assessed with statistical tests, as appropriate. Latent profile analysis was based on the scores of dimensions measuring SVs' symptoms. Factors affecting profile membership were assessed through multinomial logistic regression., Results: A total of 733 HCWs participated. Of them, 305 (41.6%) experienced at least 1 adverse event. Among dimensions measuring SVs' symptoms, psychological distress had the highest percentage of agreement (30.2%). Three latent profiles were identified: mild (58.7%), moderate (24.3%), and severe (17.0%) symptoms. Severe symptoms profile was positively associated with the agreement for extraoccupational support and negatively associated with the agreement for organizational support. A respected colleague with whom to discuss the details of the incident (78.7%) and free counseling outside of work (71.2%) were the support options most desired by HCWs. The severity of symptoms was directly associated with the desire for support strategies., Conclusions: The prevalence of HCWs involved in adverse events is consistent with the literature. Three latent profiles have been identified according to SV symptoms, and the higher the severity of symptoms, the greater the reliance on extraoccupational support., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Clinical record (CR) is a tool for recording details about the patient and the most commonly used source of information for detecting adverse events (AEs). Its completeness is an indicator of the quality of care provided and may provide clues for improving professional practice. The primary aim of this study was to estimate the prevalence of AEs. The secondary aims were to determine the completeness of CRs and to examine the relationship between the two variables. We retrospectively reviewed randomly selected CRs of patients discharged from the Academic Hospital of Udine (Italy) in the departments of general surgery, internal medicine, and obstetrics between July and September 2020. Evaluation was performed using the Global Trigger Tool and a checklist to evaluate the completeness of CRs. The relationship between the occurrence of AEs and the completeness of CRs was analyzed using nonparametric tests. A binomial logistic regression analysis was also performed. We reviewed 291 CRs and identified 368 triggers and 56 AEs. Among them, 16.2% of hospitalizations were affected by at least one AE, with a higher percentage in general surgery. The most common AEs were surgical injuries (42.6%; 24) and care related (26.8%; 15). A significant positive correlation was found between the length of hospital stay and the number of AEs. The average completeness of CRs was 72.9% and was lower in general surgery. The decrease in CR completeness correlated with the increase in the total number of AEs (R = -0.14; P = .017), although this was not confirmed by regression analysis by individual departments. Our results seem to suggest that completeness of CRs may benefit patient safety, so ongoing education and involvement of health professionals are needed to maintain professional adherence to CRs., (© The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The phenomenon violence against health professionals has received increasing attention in recent years because of its frequency and significant impact on victims' mental health and disruption of health services. Despite this attention, little is known about the incidence of workplace violence in the highly politicized immunization services. Therefore, we decided to examine the prevalence of workplace violence in the COVID-19 immunization campaign, the risk and protective factors, and the impact on victims' mental health., Methods: Between March and April 2022, we conducted an anonymous online survey among health professionals working in COVID-19 vaccination centers in the Friuli-Venezia Giulia Region (Italy). We used the Questionnaire for Workplace Violence in Healthcare Settings and the Impact of Event Scale-Revised., Results: Of the 200 participants, 93 (46.5%) reported being victims of an act of violence during the vaccination campaign, 60 of them verbally and 7 physically. In 35.5% of cases, the IES score indicated a possible post-traumatic stress reaction in the victim. Opinions on measures to prevent violence and support workers in the workplace differed according to the sex of the health professional, with women emphasizing the need for self-defense training and improvement of security arrangements ( p < 0.001)., Conclusion: One-third of health professionals involved in the COVID-19 immunization campaign reported that their mental health was affected by workplace violence. Public health professionals dealing with politicized and debated issues such as immunization should receive more attention, as should the implementation of a more structured and multidisciplinary approach to the problem within healthcare organizations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Brunelli, Scarpis, Lo Presti, Fiorillo, Campanella, Zuliani, Farneti, Croci, Pellizzari, Cocconi and Arnoldo.)

Aim: The management of a complicated duplex kidney remains a challenge for paediatric urologists. The aim of this study is to report a 10-year experience of the surgical management of complicated duplex kidney in a single tertiary care paediatric referring hospital., Materials and Methods: Clinical records of all children who undergone a surgical procedure for complicated duplex systems between January 2009 and March 2019 at our institution were retrospectively reviewed. Clinical manifestations, surgical procedures, complications and follow-up were collected and analysed. Logistic regression was performed to explore if any patient's characteristic or underlying associated comorbidity (ureterocoele, ectopic ureter, obstruction, etc.,) could be positively linked to the chance to develop recurrent urinary tract infections (UTIs)., Results: We have identified 95 children who received a surgical treatment for 102 complicated duplex kidneys. The presence of an ureterocoele was recorded in 41 (43.2%) patients, an ectopic ureter in 25 (26.3%), a vesicoureteral reflux (VUR) in 40 (42.1%), a vesicoureteric junction obstruction in 24 (25.3%) and an ureteropelvic junction obstruction in 3 (3.2%). An invasive approach such as an heminephrectomy (71.6%) was required in the majority of cases. Higher risk of developing a UTI has been demonstrated in children diagnosed postnatally (P < 0.001) and in those with an associated obstruction (P < 0.05)., Conclusions: No standardised management could be recommended for the surgical treatment of complicated duplex kidney. Children without antenatal diagnosis and with either an upper tract obstruction or VUR are at greater risk to develop UTI and need to be looked after more closely., Competing Interests: None

Objective: Second victims are defined as healthcare workers involved in an unanticipated adverse patient event, who experienced professional and psychological distress. The Second Victim Experience and Support Tool (SVEST) is a survey developed and validated in the United States, which describes the experience of second victims. This study aims to perform the cross-cultural adaptation of the SVEST and to evaluate its psychometric characteristics in the Italian context., Methods: Translation and cross-cultural adaptation process was performed according to the World Health Organization guidelines. Then, 349 healthcare workers, including nurses, doctors, residents, and technicians, involved in direct patient care-a potential second victim-completed the Italian version of SVEST in a validation survey at the Academic Hospital of Udine. The SVEST consists of 29 items, divided into 7 dimensions, 2 outcome variables, and 7 support options. The Italian version was assessed for internal consistency through Cronbach α, for content validity with content validity index for scales and for item and for construct validity with Confirmatory Factor Analysis., Results: The internal consistency of the instrument was adequate in its overall evaluation with Cronbach α value of 0.88 (95% confidence interval = 0.86). The content validity index for scales was 0.94 and that for item was 0.70. The confirmatory factor analysis results showed a good model fit for the 9-factor structure (χ2 = 676.18, df = 327, P < 0.001). Root mean squared error of approximation, Akaike information criterion, and comparative fix index Tucker-Lewis index values also suggested a good fit to the data., Conclusions: The Italian version of the SVEST can be used to evaluate second victim experiences, demonstrating adequate validity, reliability, and good psychometric properties., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The aim of the study was to evaluate the short-term and mid-term technical and clinical outcomes of the Bolton Treo endograft in subjects with abdominal aortic aneurysm (AAA) requiring endovascular aortic repair (EVAR) and assess if presence of hostile proximal neck would represent a risk factor for increased failure rates., Methods: A retrospective review of all consecutive patients who had undergone elective or non-elective EVAR with the Bolton Treo endograft at 5 institutions located in the North-East of Italy (January 2016-December 2020) was performed. The main exposure variable for this study was presence of hostile (HAN) or friendly (FAN) aortic neck., Results: A total of 137 consecutive patients were treated with the Bolton Treo endograft at participating institutions; of these 63 (46%) presented HAN while 74 (54%) had FAN. At baseline, no significant differences were observed in the distribution of demographics and comorbidities between study groups. Two type Ia endoleaks (EL) were detected at completion angiography, all in patients with HAN but none in patients with FAN (3% vs. 0%, P = 0.04), but no type III EL were identified in the whole cohort. The median duration of follow-up in the study cohort was 30 months (IQR 22-34 months) and was similar between study groups (P = 0.87). At 3-years, survival estimates were 89% and 91% (P= 0.82) in patients with HAN and FAN, respectively. At three years, patients with HAN had significantly lower freedom from type IA endoleak as compared with patients with FAN (87% vs. 94%, P= 0.02). No significant differences were found between study groups in the three-year estimates of freedom from reinterventions (80% vs. 86%, P= 0.28). Using cox proportional hazards, presence of type II EL (HR 3.15, 95%CI 1.18-8.5, P= 0.02) and presence of type IA EL (HR 4.22, 95%CI 1.39-12.85, P= 0.01) were found as independent predictors for reinterventions in univariate analysis, although they were no longer significant in the multivariate model. Freedom from sac increase >5mm at three years were not significantly different between study groups (92% vs 91%, P= 0.95)., Conclusions: Within a contemporary multicentric real-world experience, EVAR with the Bolton Treo endograft shows a satisfactory safety profile in the immediate postoperative phase and acceptable outcomes during mid-term follow-up. Presence of HAN is correlated with development of type Ia EL (either early following stent-graft implantation or late after EVAR) which, in turn, may represent a significant factor leading to reinterventions., (Copyright © 2021. Published by Elsevier Inc.)

Aims: Renal vascular malformations, congenital or acquired, are sometimes challenging for urologists and interventional radiologists to resolve. Arterovenous fistulas and pseudoaneuryms are usually embolized by interventional radiologists, with a low rate of complications. We propose a new endourological/interventional radiology technique to treat a source of arterovenous bleeding coming from a renal calyx in a minimally invasive way., Methods: A combined endourological and interventional radiology procedure is described, using a Flexible Fiberoptic Ureteroscopes to undertake a retrograde intrarenal surgery (RIRS) to identify the source of bleeding; subsequently the VortX Coil® is inserted through a microcatheter to stop the bleeding and the correct position of the VortX coil is evaluated. Furthermore, we made a literature research on Pubmed and Medline to look for similar procedures., Results: In case of a renal bleeding that could not be treated by endovascular way, a combined urological and interventional radiology procedure can be undertaken. We did not find similar endourological and interventional radiology procedure on Pubmed and Medline, so this is the first tecnique of endourological closure of a bleeding point using a coil., Conclusion: From our experience this could be a mininvasive technique to solve renal bleedings coming from a calyx that are not found by endovascular approach. Indeed, in our knowledge, the technique here described is the first that provides the use of an endovascular coil by endourological way in renal vascular malformations.

Purpose: To assess the technical and clinical success rates of superior rectal artery embolization in the treatment of symptomatic Grades 2 and 3 hemorrhoidal disease., Materials and Methods: Since March 2019, 43 patients (24 men and 19 women; mean age, 52 years [18-77 years]) with symptomatic hemorrhoidal disease have been treated and completed the 6-month follow-up with anamnestic questionnaire and disease scores, including French bleeding, Goligher prolapse, visual analog scale for pain, and quality of life. Clinical success was assessed at 7 days, 1 month, and 6 months of follow-up by updating the clinical scores. Statistical analysis was performed using SPSS 25.0., Results: In all, 25 patients had Grade 2 prolapse and 18 patients had Grade 3 prolapse, with 96% and 77%, respectively, having bleeding as a symptom. All patients were discharged within 24 hours. The reduction in the French bleeding score (global and single entity) in Grade 3 prolapse was statistically significant (P = .001). Improvement in the quality of life was significant in both groups (P < .05). No serious complications were registered., Conclusions: Hemorrhoidal embolization was a safe and effective technique in the treatment of symptomatic hemorrhoidal disease with minimal hospitalization, pain, and disruption of daily activities. It can be offered to patients unwilling to undergo a surgical procedure but can also be indicated in the emergency setting for patients on anticoagulant therapy or those unfit for surgery., (Copyright © 2021 SIR. Published by Elsevier Inc. All rights reserved.)

Background: No studies have assessed the differences in the incidences of falls and other patient safety events (PSEs) during handovers performed away from patients compared with when nurses are on the unit., Purpose: The primary aim was to explore the incidence of falls and their severity during handovers compared with during nonhandover times; the secondary aim was to explore the occurrence of other PSEs during handover versus nonhandover times., Methods: This was a retrospective study of all PSEs that occurred from 2013 to 2017 in a large Italian academic trust., Results: There were 1966 falls and 1523 other PSEs. The incidence of falls per 100 hours was 4.9 during handovers and 4.4 during nonhandover times. The incidences of other PSEs were 2.9 and 3.5, respectively. No significant differences in fall outcome severity emerged., Conclusions: No differences emerged in the occurrence of falls during handovers performed away from patients and when nurses were on the unit. Other PSEs decreased in occurrence during handovers as compared with other times during the shifts., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To describe rates and types of critical incidents in Intensive Care Units., Research Methodology: A retrospective study in four intensive care units of an Academic Hospital located in the North-East of Italy. All critical incidents recorded in an incident reporting system database from 2013 to 2017 were collected., Results: 160 critical incidents emerged. The rate was 1.7/100 intensive care-patient admissions, and 2.86/1000 in intensive care-patient days. Nurses reported most of the critical incidents (n = 113, 70.6%). In 2013 there were 19 (11.9%) critical incidents which significantly increased by 2017 (n = 38, 23.7%; p = 0.034). The most frequent critical incidents were medication/intravenous fluids issues (n = 35, 21.9%) and resources and organisational management (n = 35, 21.9%). Less frequently occurring incidents concerned medical devices/equipment (n = 29, 18.1%), clinical processes/procedures (n = 18, 11.3%), documentation (n = 14, 8.8%) and patient accidents (n = 13, 8.1%). Rare incidents included behaviour, clinical administration, nutrition, blood products and healthcare associated infection., Conclusion: Over a five-year period, documented incidents were steadily increasing in four Italian intensive care units. A voluntary incident reporting system might provide precious information on safety issues occurring in units. at both policy and professional levels., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Percutaneous ultrasound-guided renal biopsy (RB) is the gold standard for diagnosis of renal diseases. The standard procedure involves biopsy in the prone position (PP) for the native kidneys. In high risk patients, transjugular and laparoscopic RB have been proposed. In patients suffering from obesity or respiratory diseases, the RB of the native kidney in the supine anterolateral position (SALP) represents an alternative to these invasive and expensive methods. We illustrate the technique of execution of RB in the lateral position (LP) on native kidneys. The procedure is safe, effective and has reduced the path travelled by the needle biopsy compared with PP and SALP.

Goodpasture's disease (GD) is an uncommon and severe autoimmune disorder caused by circulating autoantibodies directed against the glomerular basement membrane cross-reacting with the alveolar basement membrane. GD is clinically characterized by rapidly progressive glomerulonephritis, often associated with pulmonary hemorrhage representing a nephrological emergency. We present the clinical features of 9 cases, diagnosed in 1997-2012, in our Renal Unit. Contrary to previous reports, we found a predominance of GD in females and we observed unusual clinical patterns, such as the association with renal vein thrombosis in a pregnant patient, thrombosis of the pulmonary arteries and a late isolated recurrence of alveolitis. In dialysis-dependent patients, renal transplantation can represent an available treatment option.

Uremia associated with anticoagulant therapy is a high risk factor for bleeding complications in patients undergoing hemodialysis. We report a case of intrarenal hematoma arising in a uremic patient treated with warfarin. The hematoma was rapidly diagnosed by ultrasonography of the abdomen and treated with embolization. Our experience confirms that the availability of an ultrasound facility within the renal unit allows better assessment of our patients, also in the management of the most fearsome and rare complications. Moreover, it strengthens the evidence that uremic patients are at high risk of bleeding complications when treated with oral anticoagulants.

Aims of the study was To define predictor factors of academic success of student in an Italian Nursing School. The recent introduction of the first level nursing education at university in Italy primed many changes processes and required to think new methods and contents. The study was descriptive and retrospective. The setting is an Italian School of Nursing. It was considered a sample constituted by 2 three years. Academic success was defined such as the capability of the student to finish formative pathway in three years with a final mark &gt;90/110. An half of sample (53.7%, 66/123) finished the studies in three years. Variables that more influenced academic success were age, nationality, admission mark, evaluations obtained in professionals and tutorship formative activity. To know factors influenced academic success provides some indications that should be useful to define "at risk" students for which to plan formative pathways and specific supports.

Aims of the study was to compare perception of both clinical preceptors and nursing students in relation to clinical nursing practice in Italy. The recent introduction of primary level nursing education to Italian University primed many changes in processes and required to think new methods and contents. Special attention was adopted on revaluation of clinical practice. The study was part of a large investigation conducted from 2005 until 2006 as prevalence survey throughout two questionnaire addressed to nurses student and to clinical guides. Participants were all students (tot. 172) from one School of Nursing and their clinical guides (tot.120) working in a high specialization hospital located in a large urban area in Northern Italy. Students' and nurses' perceptions differed in these fields: knowledge of students' learning objectives, explanation of students' competences and objectives already reached, prevalence execution of assistance activity, organization of briefing/debriefing meetings, planning of a learning programme with students at the beginning of tutorship, choosing occasions related to nursing subjects discussed in classroom, filling an intermediate evaluation of the student tutorship in addiction to the final. The perceptions of the students and preceptors were opposite on several factors. This means that students and clinical guides approach the clinical experience from individualized viewpoints.

A voluntary professional quality improvement project involving preventive departments and vaccination centres of an Italian region was carried out through two surveys (in 2001 and in 2006) performed using a quality assessment manual including 12 standards and 157 criteria. After the first survey, a feedback was sent to all participating centres. All six local health authorities participated, as well as all regional vaccination centres, 48 in 2001 and 41 in 2006. The overall adherence rate to the criteria was 56.0% (3258/5820) in 2001 and 74.4% (3784/5085) in 2006. The improvement was obtained without mandatory interventions from regional authorities.

This study examines the socio-demographic characteristics of first-year students on first degree healthcare courses at Udine University (Italy). The survey tried to elicit useful information in a field where literature is scarce. Every student starting healthcare courses in the 2007/08 academic year was contacted and asked to fill in a questionnaire. Two hundred and sixty students were identified, belonging to six different courses: Nursing Sciences, Obstetric Sciences, Physiotherapy, Radiography, Neurophysiopathology Techniques, Biomedical Laboratory Techniques. Each questionnaire included 26 items (25 closed and one open) and had four sections: personal data, family data, training background, criteria affecting the decision to attend a healthcare course. The overall response rate was 87% (226 out of 260). Major findings were: women prevail on men (77% vs. 23%), many students chose these courses because some family member worked in the healthcare field (22.1%), 19.9% of students are older than 26 and 7.1% of them are postgraduates, 12% come from foreign countries, and job opportunities and former work experience influenced the choice of course. This database provides an important benchmark for comparing future trends among students in the healthcare profession in terms of socio-demographic characteristics and personal attitudes.

Background: Sharps injuries in health care personnel still represent a significant problem worldwide. Many studies show a reduction in sharps injuries following the introduction and use of different protection devices, but few studies focus on the role of training programmes in the prevention of such injuries., Aims: To analyse the influence of training programmes on sharps injuries in health care workers (HCW)., Methods: The study was carried out in a 350-bed university hospital in north-eastern Italy with 700 HCW. Training courses on biological risk for physicians, nurses, ancillary operators and laboratory technicians have been in place since 1998. Data on all sharps injuries reported by HCW between 1998 and 2006 were analysed together with information on HCW who attended the training courses., Results: Between 1998 and 2006, there was a reduction in the incidence of sharps injuries from 11 to 4% (P < 0.01). During the same period, the number of trained HCW increased from 26 to 69% (P < 0.01). Trained personnel had a statistically significant lower relative risk (RR) for injury with RR = 0.06 (95% CI 0.02-0.18)., Conclusions: A continuous educational effort for HCW leads to a reduction of sharps injuries.

The study analysed two key questions: (i) the prevalence of informal caregiving in medical and surgical wards of a high specialization hospital; (ii) the reasonable cost for the structure that would have to pay to replace informal caregiving? The study was conducted in June 2006 as a prevalence survey, using a questionnaire administered to informal caregivers and nurses working in medical and surgical wards of a high specialization hospital by ad hoc trained personnel. Questionnaire consisted in three sections: the first focused on patient's characteristics, the second on caregivers and the third on nurses' perception on caregiving phenomenon. One hundred and twenty-four eligible caregivers were identified. During the study patients admitted to hospital medical and surgery wards were 520. Among these 16.5% (86/520) was assisted by one or more caregivers. Caregivers' response rate was 69.4% (86/124), corresponding to 66 patients. This study yielded an average of 455.9 minutes per day (SD = 370.2; range = 120-1440) or 52.9 hours per week. Caregiver's presence was recognized in 88.9% (56/63) of patients. Despite the societal perspective, the costs and effects of informal caregiving to the informal caregiver are often ignored in economic evaluation. The costs of informal care are an important extent related to time inputs by relatives and friends of the care recipients. Our approach has been to monetize the informal activity care contribution of family members and/or caregivers.

Background: The aim of the study was to evaluate the impact of a 2-year vaccination program on the compliance of healthcare workers (HCWs) employed in an acute care university hospital to influenza vaccination., Materials and Methods: The study was carried out in October/November from 2004 to 2006 in a 286-bed acute care university hospital located in northern Italy employing 523 HCWs. The study cohort consisted of 473 HCWs continuously present in the hospital from 2004 to 2006. In 2005 and 2006, a vaccination campaign was made available in the wards that supplemented a pre-existing (2004) employee health service program. A personalized informative letter was sent to all HCWs explaining the risks and benefits of influenza vaccination for both patients and HCWs and indicating the scheduling of the additional vaccination service., Results: The additional 2005 and 2006 campaigns produced significantly higher vaccination rates among HCWs than those achieved in previous years, from 10.4% in 2004 to 36.6% in 2005 and 23.2% in 2006. The year 2005 was characterized by an avian flu threat, which likely accounted for the highest vaccination rate of the 3-year study period. Physicians had the highest vaccination rates in the 3-year period (20.8%), while nurses in 2005 had the highest single vaccination rate (42.5%)., Conclusions: Providing easy access to vaccination in the wards is a useful approach for improving vaccination rates among HCWs, but further tailored interventions are needed because overall vaccination rates remain too low. Subgroups, such as nurses and ancillary staff, should be considered as specific targets of such vaccination programs.

Objective: To know how Italian nursery and primary schools survey and manage children with food-related problems., Design: A pilot study during the period March-May 2005, filling out a questionnaire., Setting: All nursery and primary schools in a Northern Italian region (Friuli Venezia Giulia)., Subjects: There were 479 eligible schools, Results: Global response rate was of 29.6%. In 77.5% (110/142) of the schools there were children with food-related pathologies. Programs about nutrition were carried out by 44.4% (63/142) of the schools in the previous two years; 9.5% (6/63) dealt with food-related pathologies and 57.1% (36/63) required the intervention of outside experts to have these projects realized. In the same period training courses about nutrition for teachers were conducted in 9.2% (13/142) of the schools., Conclusions: Data provide a first overview of the situation in Italy on food-related topics in children attending nursery and primary schools. Therefore many programs could not rely on funds to be developed, but had to use internal resources of the school.

In Italy NHS Prevention Departments (PDs) are central in Public Health (PH) management. Objective was to describe profile of Medical Doctors (MDs) working at Italian PDs. The study, part of another survey, was conducted in 2003, using a phone questionnaire to administer to a sample of Italian MDs in PH. Response rate was 72.3% (603/833). Physicians of PDs were 255, 42.3% of whole sample. Job satisfaction mean (scale: 0-100) was 66.6 (SD = 19.3). 81.6% (208/225) of MDs said that Regions must monitor health status to identify collective risks and problems, while 77.3% (197/255) of them answered that function of State is to develop politics and planes to pursue individual and collective health. The study gives a positive frame of MDs at PDs. They were satisfied and persuaded of importance of State and Regions in PH management.