The global burden of pneumococcal diseases is high, with young children and adults ≥50 years of age at highest risk of infection. Two types of vaccine are available for the prevention of pneumococcal diseases caused by specific Streptococcus pneumoniae serotypes: the pneumococcal polysaccharide vaccine (PPV23) and the pneumococcal conjugate vaccine (PCV7, PCV10, and PCV13). Despite pneumococcal immunization programs in adults and children, the burden in adults has remained high. Most European countries have national or local/regional vaccination recommendations. The objective of this review was to provide an overview of the government recommendations for pneumococcal vaccination outside routine childhood vaccination programs for 16 Western European countries as of August 2014. We found that recommendations for pneumococcal immunization across Europe are complex and vary greatly among countries in terms of age groups and risk groups recommended for vaccination, as well as which vaccine should be administered. Clarifying or simplifying these recommendations and improving their dissemination could help to increase pneumococcal vaccine uptake and decrease the high burden of pneumococcal diseases in adults, both through a direct effect of the vaccine and via a herd effect in unvaccinated individuals.
The present work is a cross-sectional study aimed at assessing the risk perception and evaluating the community outrage linked to environmental factors among a self-selected sample of citizens living in an area characterized by the presence of industrial structures of high emotional impact. An anonymous questionnaire was administered to the population by publishing a Google form URL code in local and regional newspapers and via social media. The resulting data were entered on Excel and analyzed. Qualitative variables were summarized with absolute and relative (percentage) frequencies. The results showed that the event that causes the greatest worry was air pollution, with 92.6% of the respondents stating that they perceived the problem as "very" or "quite" worrying. Furthermore, all the health problems investigated in relation to environmental quality aroused concern among the interviewees, with 93.1% believing there was a cause-effect relationship between environmental quality and health. Overall, as other studies had previously underlined, the survey shows that the perceived risks are not always in line with the real ones, Thus, it is imperative to articulate interventions aimed at offering the population objective tools to enable them to interpret the risks themselves. In this regard, a fundamental role is played by adequate communication between the competent bodies and political decision-makers and the population.
Recenti studi sulla salute pubblica si sono concentrati sulla determinazione delle influenze dell'ambiente costruito sullo stato di salute fisica e mentale della popolazione. Al fine di promuovere il trasporto attivo e l'attività fisica, considerati comportamenti favorevoli per la prevenzione delle malattie non trasmissibili (NCD) come l'obesità, è necessario ridurre gli effetti negativi dell'ambiente costruito e sviluppare quelli positivi, come, ad esempio, uno spazio urbano percorribile. Lo scopo della ricerca è definire un quadro di valutazione della percorribilità della città in grado di evidenziare punti di forza e debolezza nel suo ambiente urbano. Tutti gli aspetti che hanno un'influenza diretta (basata sull'evidenza) sulla promozione dell'adozione di stili di vita sani o sulla promozione del trasporto attivo come strategia per aumentare il livello di attività fisica a causa dell'esistenza del viaggio urbano quotidiano. Dopo aver condotto una revisione della letteratura volta a identificare tutti gli strumenti di valutazione esistenti, sono stati esaminati in dettaglio 20 studi di ricerca. Il nuovo metodo di valutazione nasce dal confronto e dalla selezione critica dei vari indicatori qualitativi-quantitativi trovati, integrati in una struttura di analisi multi-criterio di indagine a doppia scala, con riferimento alla calpestabilità e prestando attenzione a quegli indicatori che hanno implicazioni sulla promozione della salute . Il nuovo framework di valutazione, denominato MilanoWalkability Measurement (MWM), è applicabile in diversi contesti urbani ed è stato testato in due diverse aree di Milano. La dimensione Macro (vale a dire, densità, diversità e criteri di progettazione) si riferisce alla scala urbana ed esamina la città da una vista dall'alto. Descrive quantitativamente i fattori urbani complessivi (dimensione dell'area urbana pari a 1,5 Km2; tipologia di dati: archivio). La Micro dimensione (vale a dire criteri di Utilità, Sicurezza, Comfort ed Estetica) indaga la città a livello di scala stradale. Descrive qualitativamente le caratteristiche degli spazi esterni (lunghezza della strada di circa 500/700 mt; tipologia di dati: osservativa). Infine, il quadro è stato ponderato rispetto a un gruppo di esperti. I risultati attesi sono stati riflessi nelle raccomandazioni di progettazione basate sui dati qualitativi-quantitativi raccolti. Il metodo di valutazione sviluppato porta criteri innovativi come la fase di valutazione multi-scaling (Macro e Micro) e la capacità di prendere in considerazione aspetti che secondo la letteratura hanno relazioni con la promozione della salute legate al miglioramento di uno stile di vita sano, legate al quotidiano scelte di trasporto attive. Le raccomandazioni di progettazione sono utili sia per i responsabili politici, per fare scelte specifiche basate sull'evidenza, sia per i progettisti, per capire quali aspetti dell'ambiente urbano devono essere migliorati o implementati al fine di promuovere una città percorribile. ; Recent studies in public health have focused on determining the influences of the built environment on the population's physical and mental health status. In order to promote active transport and physical activity, considered favorable behavior for the prevention non-communicable diseases (NCDs) such as obesity, it is necessary to reduce the negative effects of the built environment and develop positive ones, such as, for example, a walkable urban space. The aim of the research is to define a city's walkability assessment framework capable of highlighting points of strength and weakness in its urban environment. All of the aspects that have a direct influence (evidence-based) on fostering the adoption of healthy lifestyles or promoting active transport as a strategy to increase the level of physical activity due to the existence of daily urban travel should be considered. After conducting a literature review aimed at identifying all of the existing assessment tools, 20 research studies were examined in detail. The new evaluation method arises from the comparison and critical selection of the various qualitative-quantitative indicators found, integrated into a multi-criteria analysis structure of dual-scale survey, with reference to walkability and paying attention to those indicators that have implications on health promotion. The new assessment framework, named MilanoWalkability Measurement (MWM), is applicable in different urban contexts and was tested in two different areas of Milan. The Macro dimension (i.e., Density, Diversity, and Design criteria) refers to the urban scale and examines the city from a top view. It describes quantitatively the overall urban factors (urban area size equal to 1.5 Km2; typology of data: archival). The Micro dimension (i.e., Usefulness, Safeness, Comfort, and Aesthetics criteria) investigates the city at the street scale level. It describes qualitatively features of the outdoor spaces (road length of about 500/700 mt; typology of data: observational). Finally, the framework was weighted by comparison with a panel of experts. The expected results were reflected in the design recommendations based on the collected qualitative-quantitative data. The developed assessment method brings innovative criteria such as the multi-scaling assessment phase (Macro and Micro) and the ability to take into consideration aspects that according to the literature have relationships with health promotion linked to the improvement of a healthy lifestyle, related to daily active transportation choices. The design recommendations are useful both to policy-makers, to make evidence-based specific choices, and to designers, to understand what aspects of the urban environment must be improved or implemented in order to promote a walkable city.
The microclimate is a particularly important environmental aspect in operating rooms (ORs), where more than in other hospital environments, it is extremely important, and at the same time extremely difficult, to reconcile the needs of different types of occupants (patients and operators). Moreover, unsuitable microclimatic conditions may affect the onset of infection. The present study aimed to analyze the periodic monitoring of the microclimatic conditions carried out in ORs over 10 years, to verify the adequacy of the thermal comfort conditions for all occupants. The evaluation of thermal comfort was carried out using the Fanger indices and the standards required by current legislation and specific guidelines. Non-compliant values for at least one parameter were found in 98.8% of the examinations performed in the ORs. A condition of thermal discomfort was calculated for 3.6% of healthcare professionals and 98.3% of patients. The monitoring of microclimatic conditions is particularly important in the OR as an indicator of inadequate functioning of the air conditioning system, which might affect the thermal comfort of all occupants and lead to microbial contamination of the room.
