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Background and Aim: The low measles vaccination coverage contributes to the re-emerging of measles in Italy. This study aimed to estimate the measles burden, expressed in Disability Adjusted Life Years (DALYs), in Umbria, for the period 2013-2018., Methods: Data on measles cases in Umbria were obtained from the MoRoNet. While data related to the resident population, were obtained from the website of the National Institute of Statistics. The estimated DALYs was calculated using the Burden of Communicable Diseases in Europe toolkit. The results are expressed in DALYs per year, per case and per 100,000 subjects, for acute illness and for sequelae., Results: The estimated incidence in mean for the entire period was 52.50 cases per year. Resulting in an average loss of 3.10 DALYs per year., Conclusions: The data obtained from this analysis provide important information on the impact of measles in the Umbria region, and offer useful data to the Health Authorities that can be used to reduce measles incidence in the region.

Background and Aim of the Work: Since several years, Italy is facing an important flow of immigration. Umbria is not a region of disembarkation of refugees, nevertheless is one of the Italian regions with the highest rate of foreign population compared to the total resident population. Aim of this paper is to collect data on migrants and refugees' health care services access, focusing on migrants' characteristics arrived and living in Umbria., Methods: We conducted a retrospective cohort study at the Local Health Unit Umbria of Perugia, Italy. Descriptive analysis was performed in order to identify the characteristics of the migrants living in Perugia area. Data analysis was performed using Excel® software. All frequencies are expressed as percentage., Results: Between 2015-2017, 2,688 migrants came to Umbria Region. The mean age is 23.6 years, almost all are male, and however the majority of female comes from Nigeria. Only 25.5% of migrants durably sojourned in Umbria Region, and only half of them are residents and received the assignment of general practitioner., Conclusions: Unplanned migration may cause an abrupt rupture of the social-cultural supports that sustain both psychological and physical well-being. Regional Health Service should collect data on migrants and refugees' health and their health care services access, in order to offer an efficient and appropriate regional health system.

Introduction: DianaWeb is a community-based participatory project open to Italian breast cancer patients. The aim of the study was to assess the effectiveness of a lifestyle intervention in improving the prognosis after patients received diagnosis and surgery/chemotherapy. The DianaWeb study uses an interactive Web site (www.dianaweb.org) to monitor patients' lifestyles, and to obtain clinical and anthropometric data. Although detailed instructions for measuring height, body weight, waist circumference, and blood pressure (BP) are provided, individuals might tend to overestimate or underestimate those parameters. The aims of the present study were: (1) to compare self-recorded data with those from standardized ambulatory measurements; (2) to determine the trueness of a subject classification in the overweight/obesity or hypertensive subgroup on the basis of the patients' own measurements and estimates; and (3) to identify confounding variables., Patients and Methods: We compared self-reported with ambulatory measurements in a subgroup of 200 randomly selected women of approximately 1000 enrolled in the DianaWeb study (from September 2016 to March 2018)., Results: Bland-Altman analysis showed a close agreement for self-reported and ambulatory-measured height, weight, and body mass index (BMI). On the contrary, women overestimated waist circumference and underestimated BP. Cohen κ statistics showed fair agreement only for hypertension. Binary logistic regression analysis showed that BMI and diastolic BP self-measurements were biased according to age., Conclusion: The results suggest that self-reported height, weight, and BMI are satisfactorily accurate for patients in the DianaWeb study, such as accuracies of overweight/obese and central obesity classification, and that these data can be useful for our research., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: The role of vaccination in reducing the incidence, morbidity and mortality of vaccine preventable diseases is well-known; however, vaccination uptake for some vaccine-preventable diseases remains low among Italian healthcare workers. The aim of this study was to evaluate knowledge attitudes and practice regarding mandatory vaccinations among Italian health science university students., Methods: A multi-center study was conducted in 14 Italian universities. A standardized, previously validated and anonymous questionnaire consisting of 21 questions was administered to health science students. The students were informed on the questionnaire during a Hygiene and Preventive Medicine lesson of their degree course, so they were asked to fill it out. A multivariable logistic regression model was used, the results are expressed as adjusted Odds Ratio (aOR)., Results: A total of 3131 students completed the questionnaire, of whom 90% were found to be in agreement with the introduction of a mandatory vaccination law for children and 87% with the potential introduction of mandatory vaccination for health care workers. Having an insufficient/sufficient/fair level of knowledge related to vaccine preventable diseases and vaccinations, compared with having a good/excellent level of knowledge, was associated with being less supportive towards the mandatory childhood vaccination law (OR 0,64; IC 95% 0.44-0.93)., Conclusions: We found that having good/excellent knowledge regarding vaccine preventable diseases and their related vaccinations is associated in a statistically significant manner to the propensity towards supporting mandatory vaccinations. This is probably due to a greater awareness of the importance of immunization and its value.

Communication in health is an emerging and constantly evolving topic, taking more and more new aspects and concepts over time. The objective of this work is to present, through a narrative review, the most important aspects of communication in health field. Communication in health traditionally is known as interpersonal communication between health care workers and patients. In reality, it also includes the community one with the population (e.g., through the media), as well as with users of health service (e.g., complaint management). Moreover, it promotes both social responsibility and citizen's empowerment because communication directs the institutions, the third sector and the profit companies towards the values of social cohesion and sustainable development. Adequate communication strategies can contribute to reduce the environmental, cultural and socio-economic barriers that hinder the knowledge and the conscious adoption of behaviours that promote health.

Background: Technological advancements, such as patient-centered smartphone applications, have enabled to support self-management of the disease. Further, the accessibility to health information through the Internet has grown tremendously. This article aimed to investigate how big data can be useful to assess the impact of a celebrity's rheumatic disease on the public opinion., Methods: Variable tools and statistical/computational approaches have been used, including massive data mining of Google Trends, Wikipedia, Twitter, and big data analytics. These tools were mined using an in-house script, which facilitated the process of data collection, parsing, handling, processing, and normalization., Results: From Google Trends, the temporal correlation between "Anna Marchesini" and rheumatoid arthritis (RA) queries resulted 0.66 before Anna Marchesini's death and 0.90 after Anna Marchesini's death. The geospatial correlation between "Anna Marchesini" and RA queries resulted 0.45 before Anna Marchesini's death and 0.52 after Anna Marchesini's death. From Wikitrends, after Anna Marchesini's death, the number of accesses to Wikipedia page for RA has increased 5770%. From Twitter, 1979 tweets have been retrieved. Numbers of likes, retweets, and hashtags have increased throughout time., Conclusions: Novel data streams and big data analytics are effective to assess the impact of a disease in a famous person on the laypeople.

Background: Vaccines are an important tool to prevent communicable diseases. Despite their importance, vaccines seem to be victims of their own success and declining levels of vaccination uptake have been recorded in Europe and Italy. For this reason, Italy introduced a new mandatory vaccination law on July 31, 2017. We aimed to validate a questionnaire to assess the opinions and knowledge of Public Health residents about this issue., Methods: A team of public health residents developed a questionnaire and validated it by administering it to a panel of 10 Public Health residents, members of the Vaccines and Vaccine Hesitancy Working Group of the Public Health residents Assembly of the Italian Society of Hygiene and Preventive Medicine. Cronbach's Alpha and Cohen's Kappa tests were used to analyse results., Results: The final version of the questionnaire consisted in 23 items. The validation process showed a high level of internal consistency (alpha=0,82). The tests showed a relevant level of agreement (k= 0,75 ± 0,07). Finally, the feasibility test pointed out that 80% of respondents declared the questions were clear and easy to understand., Conclusion: The designed questionnaire is a valid and useful tool.

A systematic review and meta-analysis of the literature was performed to assess the relationship between chocolate intake and cardio-cerebrovascular risk in the general population. A structured search of the literature was performed in the PubMed database up to September 26, 2016, using predetermined keywords. Epidemiologic studies evaluating the risk for cardiovascular diseases (CVDs; i.e., stroke, acute myocardial infarction [MI], heart failure, coronary heart disease) were included according to different rates of chocolate intake. The software ProMeta 3 was used to perform the meta-analysis. The systematic review identified 16 eligible studies. The majority of the studies showed a protective effect of chocolate intake compared with unexposed individuals. The overall risk ratio (effect size [ES]) of CVD for the highest versus the lowest category of chocolate consumption was 0.77 (95% confidence interval [CI], 0.71-0.84; P = 0.000) with a moderate heterogeneity. The risk related to subgroups of CVD and in particular, the risk for MI was further analyzed: ES = 0.78 (95% CI, 0.64-0.94; P = 0.009) without statistical heterogeneity (I 2  = 46.56%; P = 0.13). Moreover, the analysis performed based on sex found an ES = 0.85 (95% CI, 0.77-0.95; P = 0.003) for women, with a very low grade of heterogeneity (I 2  = 62.21%; P = 0.005). The results of the meta-analysis showed a potential protective effect of moderate consumption of chocolate on cardiovascular risk, especially for women, and against MI for both sexes., (Copyright © 2017 Elsevier Inc. All rights reserved.)

There is growing concern about possible genotoxic hazards for healthcare personnel handling cytotoxic chemotherapy drugs (CCD) due to increased use in the treatment of not only neoplastic diseases. It is therefore necessary to monitor health care workers and prevent exposure. We performed a structured computer search on Pubmed/Medline for molecular epidemiological studies reporting results referring to chromosome aberration (CA) in nurses exposed to CCD. Selected studies reported average group data relative to frequency of structural/numerical CA and the corresponding measures of dispersion. We calculated the ratio of mean as a measure of effect. We conducted a meta-analytic review of 26 studies. In most of the cases, studies showed a high frequency of CA in the exposed personnel compared to non-exposed subjects. Our study shows a statistically significant increase of CA in exposed personnel RoM=2,01 (IC95%=1,68-2,42). According to the prognostic value of CA, the studied population appears to be much more at risk to develop cancer than unexposed nurses. This finding clearly indicates the necessity to improve some steps in the administration process and nurses' awareness of genotoxic risk.

Introduction: Nowadays, the community pharmacist's role is undergoing profound transformations. As a healthcare provider of the National Health Service, pharmacists are expanding their expertise in Public Health through disease prevention and health promotion programme. In relation to health education and health promotion interventions, this research was aimed to evaluate the knowledge, attitudes and behaviours of a selected sample of private and public pharmacists, working in the Province of Perugia and Terni, Umbria region., Methods: Cross-sectional study conducted using two detection tools: a 29-items self-administered, anonymous questionnaire and a 21-items environmental evaluation sheet, compiled by students of Pharmaceutical Sciences., Results: 70% of umbrian pharmacists participated in the project, 68.9% of them consider health education interventions "very important", 57% support the gratuity of these interventions with a 14.5 hours/week dedicated to these activities., Conclusions: The survey shows a good pharmacist sensitivity to the issues of health education. Actually, the pharmacist can and should play an essential role in responsibly involving all citizens in promoting new health behaviours in collaboration with physicians.