Ensuring timely access to affordable vaccines has been acknowledged as a global public health priority, as also recently testified by the debate sparked during the COVID-19 pandemic. Effective vaccine procurement strategies are essential to reach this goal. Nevertheless, this is still a neglected research topic. A narrative literature review on vaccine procurement was conducted, by retrieving articles from four academic databases (PubMed/MEDLINE, Scopus, Embase, WebOf-Science), 'grey' literature reports, and institutional websites. The aim was to clarify key concepts and definitions relating to vaccine procurement, describe main vaccine procurement methods, and identify knowledge gaps and future perspectives. A theoretical conceptual framework was developed of the key factors involved in vaccine procurement, which include quality and safety of the product, forecasting and budgeting, procurement legislation, financial sustainability, and plurality of manufacture, contracting, investment in training, storage and service delivery, monitoring and evaluation. This information can be useful to support policymakers during planning, implementation, and evaluation of regional and national vaccine procurement strategies and policies.
Immunization polices in Italy has recently reached important milestones, including the approval of the National Immunization Prevention Plan and of a new law mandatory immunization; this stimulating a lively debate at the scientific, political and societal-level, reflected on the media. We applied a model previously published to quantitatively and qualitatively assess media coverage on vaccines and immunization-related topics on the most read Italian newspaper, "Corriere della Sera", over an 11-year study period (2007-2017). We retrieved relevant key words and articles, reported on included articles' topic, position, approach to immunization and on other selected indicators' summary statistics, temporal trends and correspondence with key epidemiological and policy events. Over the study period the quote "vaccin*" was mentioned on average 325 times per year; with an increase of 150% after the approval of the new law on mandatory immunization in 2017. In the same year, on average, two first-page articles per week were published on the topic. We report a clear association between key events (i.e the H1N1 influenza pandemic, the "Fluad case", the approval of the new law on mandatory immunization) and their media coverage. Overall, 84% of articles had a positive attitude towards immunization, this share decreasing to 79% when only considering articles published after the approval of the law on mandatory vaccination. Media play a crucial role in channelling health-related information and significantly influence health behaviours. We urge public institutions, health authorities and the scientific community not to underestimate the opportunity to monitor media coverage on key healthcare topics and to convey evidence-based health education messages through the media.
Sexual and gender minority youth are at risk for negative mental health outcomes, such as depression and suicide, due to stigma. Fortunately, sense of community, connection, and social support can ameliorate these deleterious effects. Youth express that most of their social support comes from peers and in-school organizations, but these sources require in-person interaction. Past research has identified social media sites as virtual and anonymous sources of support for these youth, but the role of YouTube specifically in this process has not been thoroughly explored. This study explores YouTube as a possible virtual source of support for sexual and gender minority youth by examining the ecological comments left on YouTube videos. A qualitative thematic analysis of YouTube comments resulted in six common themes in self-identified adolescents' YouTube comments: sharing, relating, information-seeking, gratitude, realization, and validation. Most commonly, adolescents shared feelings and experiences related to their identity, especially when they could relate to the experiences discussed in the videos. These young people also used their comments to ask for identity-related advice or information, treating the platform as a source of education. Results suggest that sexual minority youth's use of YouTube can be advantageous for social support and community, identity-related information, identity development, and overall well-being.
Background: The Human Papillomavirus (HPV) is generally recognized to be the direct cause of cervical cancer. The development of effective anti-HPV vaccines, included in the portfolio of recommended vaccinations for any given community, led to the consolidation in many countries of immunization programs to prevent HPV-related cervical cancers. In recent years, increasing evidence in epidemiology and molecular biology have supported the oncogenic role of HPV in the development of other neoplasm including condylomas and penile, anal, vulvar, vaginal, and oro-pharyngeal cancers. Men play a key role in the paradigm of HPV infection: both as patients and as part of the mechanisms of transmission. Data show they are affected almost as often as women. Moreover, no screening procedures for HPV-related disease prevention are applied in men, who fail to undergo routine medical testing by any medical specialist at all. They also do not benefit from government prevention strategies. Discussion. A panel of experts convened to focus on scientific, medical, and economic studies, and on the achievements from health organizations' intervention programs on the matter. One of the goals was to discuss on the critical issues emerging from the ongoing global implementation of HPV vaccination. A second goal was to identify contributions which could overcome the barriers that impede or delay effective vaccination programs whose purpose is to eradicate the HPV infection both in women and men. Summary. The reviewed studies on the natural history of HPV infection and related diseases in women and men, the increasing experience of HPV vaccination in women, the analysis of clinical effectiveness vs economic efficacy of HPV vaccination, are even more supportive of the economic sustainability of vaccination programs both in women and men. Those achievements address increasing and needed attention to the issue of social equity in healthcare for both genders.
Background Since the World Health Organization (WHO) declared the coronavirus infectious disease 2019 (COVID-19) outbreak a pandemic on March 11th, severe 'lockdown' measures have been adopted by the Italian Government. For over two months of stay-at-home, houses became the only place where people slept, ate, worked, practiced sports, and socialized. As consolidated evidence exists on housing as a determinant of health, it is of great interest to explore the impact that COVID-19 response-related lockdown measures had on mental health and wellbeing. Methods We conducted a large web-based survey on 9261 subjects in Northern Italy, one of the Regions most heavily hit by the pandemic in Europe. Participants were recruited among university staff, faculty and students. The questions included socio-demographic features of the participants; international evaluation scales designed to recognize depressive-, anxiety- and sleep-related symptoms, impulsivity, quality of life; architectural parameters investigating housing physical characteristics. Results As emerges from our analysis poor housing is associated with increased risk of depressive symptoms during lockdown. In particular, living in apartments < 60 m2, with poor quality view and indoor area is associated with, respectively, 1.31 (95CI), 1.368 (95CI), and 2.253 (95CI) time the risk of moderate/severe and severe depressive symptoms. Subjects reporting worsened working performance from home were over four times more likely to also report depression (OR = 4.28, 95%CI). Conclusions Our findings suggest housing played a major role in influencing people mental health and wellbeing during COVID-19 pandemic. We argue strengthened multi-interdisciplinary approach involving urban planning, public mental health, environmental health, epidemiology, and sociology, is needed to inform the planning implementation and monitoring of housing policies centered on population health.
Contesto e scopo del lavoro. La pandemia in corso di COVID-19, che al giorno d'oggi ha superato 2,5 milioni di infezioni notificate nel mondo e circa 200.000 morti, è un forte promemoria che l'urbanizzazione ha cambiato il modo in cui persone e comunità vivono, lavorano e interagiscono, ed è necessario rendere i sistemi e le capacità locali resilienti per prevenire la diffusione di malattie infettive. Come possiamo riprogettare il concetto di sanità pubblica in relazione all'ambiente costruito e alle città contemporanee? Metodi. Secondo le dichiarazioni e lo scenario precedenti, l'obiettivo di questo documento è integrare gli obiettivi strategici di Urban Health, concentrando le possibili risposte, sia immediate che a medio-lungo termine, agli attuali aspetti ambientali, sociali ed economici del "periodo" di distanziamento fisico. Risultati. Le azioni immediate sono 01. programmare la flessibilità degli orari delle città; 02. pianificare una rete di mobilità intelligente e sostenibile; 03. definire un piano di servizi di vicinato; 04. sviluppare una digitalizzazione del contesto urbano, promuovendo le comunità intelligenti; 05. ripensare l'accessibilità ai luoghi della cultura e del turismo. Le azioni a medio lungo termine sono 06. progettare la flessibilità interna degli spazi abitativi domestici; 07. ripensare le tipologie di edifici, favorendo la presenza di spazi semi-privati o collettivi; 08. rinnovare la rete dei servizi di assistenza di base; 09. integrare i piani di emergenza ambientale esistenti, con quelli relativi alle emergenze sanitarie; 10. migliorare la consapevolezza delle parti interessate sui fattori che influenzano la salute pubblica nelle città. Conclusioni. Il decalogo delle opportunità di sanità pubblica può fornire una base utile per progettisti (architetti e urbanisti), responsabili politici, esperti di sanità pubblica e agenzie sanitarie locali, nel promuovere azioni e politiche volte a trasformare le nostre città in ambienti di vita più salutari e salutogenici. ; Background and aim of the work. The ongoing pandemic of COVID-19, which nowadays has exceeded 2.5 million notified infections in the world and about 200,000 deaths, is a strong reminder that urbanization has changed the way that people and communities live, work, and interact, and it's necessary to make the systems and local capacities resilient to prevent the spread of infectious diseases. How we can re-design the concept of Public Health in relation to the built environment and the contemporary cities? Methods. According to the previous statements and scenario, aim of this paper is to integrate the Urban Health strategic objectives, focusing the possible responses, both immediate and medium-long term, to the current environmental, social, and economic aspects of the 'period' of physical distancing. Results.Immediate Actions are 01. program the flexibility of city schedules; 02. plan a smart and sustainable mobility network; 03. define a neighborhood services' plan; 04. develop a digitization of the urban context, promoting the smart communities; 05. re-think the accessibility to the places of culture and tourism. Medium-long term Actions are 06. design the indoor flexibility of domestic living spaces; 07. re-think building typologies, fostering the presence of semi-private or collective spaces; 08. renovate the basic care services' network; 09. integrate the existing environmental emergency plans, with those related to the health emergencies; 10. improve stakeholders' awareness of the factors affecting Public Health in the cities. Conclusions. The Decalogue of Public Health opportunities may provide a useful basis for Designers (Architects and Urban Planners), Policy Makers, Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform our cities in healthier and Salutogenic living environments.
This paper outlines the characteristics of scientific leadership and the role of Scientific Associations with their specific activities. The recent activities of the Lombard Academy of Public Health are subsequently described, including the creation, in 2019, of the Academy of young leaders in public health. Comparing to other sectors, scientific leadership dynamics take into consideration different aspects. Besides awards (Nobel Prize or several other) and prestigious affiliations, eventual indicators might be academic roles, fundraising abilities, relevant positions among scientific associations, editors of prestigious journals or editorial series and, more recently, high bibliometric indicators. The peculiar topics of public health encompass interactions with institutions, authorities, politicians, involved in different levels in health policies. Recently, in Italy, the Ministry of Health has identified parameters to be accreditated as a scientific and technical association. The role of SItI (Italian Society of Hygiene), EUPHA, ASPHER, and WFPHA appears relevant in PH, in national and international contexts, with Italian praiseworthy members constantly achieving leading roles. Considering that few training opportunities aimed to improve research and leadership skills are available, Accademia Lombarda di Sanità Pubblica (ALSP) designed the AYLPH (Academy of Young Leaders in Public Health) program. AYLPH program is a 1-year training to shape leadership skills among young professionals. A set of didactic, theoretical and practical methods was offered and evaluated.
Health as a common good is a prior essential objective to be pursued by an alliance including citizens and local administrations. Role of cities in health promotion is emphasized by urbanization, entailing 70% of the global population living in urban areas. Cities are therefore perfect laboratories within which to act: studying and monitoring dimensions that determine the level of quality of life in cities, improving their sustainability and capacity for growth, is fundamental for a new governance model able of managing this complexity. Under the premises, the Health City Manager (HCM) has been launched, a professional gaining skills in PH management, sociology of communities, urban design and control in reducing health inequalities. A course lasting 80 hours gives then the opportunity to put into practice, at municipal level, knowledge, competences and abilities achieved. In the background, both the former EU Commissioner for Health and the Committee of the Regions warmly supported the establishment of HCMs, who would coordinate a process ensuring alignment of policies on a macro and micro scale. During G7 in 2017, Ministry for Health and Presidency of Italian Municipalities signed the Urban Health Rome Declaration, underlining the need for a stronger synergy facilitated by HCMs. In 2019, Ministry of Youth and Sport approved and financed the project. On the basis of a core curriculum, validated by a group of experts, the course is starting in 2020 for the first 120 HCMs. Innovation lies in the holistic approach, a multidisciplinary project managing method overcoming silos logic. Customization of public policies and participatory process make the figure ideal to be applied in all countries. Sustainability is ensured by a relatively high return on investment. Main impact relates to improvement of the quality of life through a full involvement and accountability of local administrations; contrast of climate change identifying strategies of urban resilience.
AbstractPurposeThe purpose of this mixed-methods triangulation study was to assess the face validity and comprehension of a femicide risk assessment tool, the Danger Assessment-Brazil (DA-Brazil) among women seeking care in a one stop center for abused women in Curitiba, Brazil. Our secondary aim was to assess professionals' perceptions of feasibility for using the DA-Brazil in the same setting.MethodFifty-five women experiencing relationship violence completed the instrument and participated in cognitive interviews about their experience; professionals attending survivors were also interviewed.ResultsThe vast majority of women described the DA-Brazil instrument as being easy to comprehend (n = 41, 73.2%). Nearly half of participants (n = 26, 46.4%) had some kind of question regarding the DA-Brazil calendar, a tool to visualize abuse frequency and severity. Queries aligned with five categories: recollection of dates, scale, relationship status, terminology, and discomfort. Professionals reported that the DA-Brazil instrument would support referral decision-making.ConclusionThe overall face validity and comprehension of the DA-Brazil appears to be high. The majority of challenges were around the calendar activity. Professional perceptions of the DA-Brazil suggest a high degree of feasibility for its use in Brazilian healthcare settings. In order for the DA-Brazil to effectively be administered with facilitated support there is a need for training on the best use of the instrument. Accurate assessment of femicide risk is critical in a country like Brazil with high rates of femicide. The DA-Brazil provides a valid assessment of femicide risk and has the potential to trigger early intervention for those at risk.
