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1.
Safety and Health at Work ; 13:S162, 2022.
Article in English | EMBASE | ID: covidwho-1677022

ABSTRACT

Introduction: During the pandemic, the use of personal protective equipment (PPE) has become essential for Healthcare Workers (HCWs) to fight safely against the virus. However, the extensive and prolonged use of PPE may cause various adverse skin reactions due to the use of alcohol hand cleanser and protracted use of masks and goggles. The aim of this study is to evaluate the skin problems caused by PPE in HCWs and the possible consequences on their work. Materials and methods: An online ad hoc questionnaire, composed by 35 questions about sociodemographic characteristics, work related issues and exposure/habits about PPE, was administered to a sample of Italian HCWs. Univariate and multivariate analyses were performed in order to explore possible associations between variables. Results: We tested 3 types of PPE: Gloves, Hair Bonnets and Masks for different time of utilization (<1, 1-3, 3-6, >6 hours). The sample included 1184 participants: 292 workers reported a dermatological pathology nested in four different pathological groups: 45 (15%) had Psoriasis, 54 (19%) Eczema, 38 (13%) Acne, 48 (16%), seborrheic dermatitis and 107 (36%) other. 25 workers had a loss of occupational days due to dermatological illness;56 occupational physician surveillance visits were asked for;in 30 cases were recognized limitations in working duties. Conclusions: Protecting HCWs requires the use of PPE, but occupational dermatitis is an emerging problem in the midst of the COVID-19 pandemic. National data for affected healthcare professionals could contribute to a better understanding of the problem and prevention initiatives in the workplace

2.
European Observatory on Health Systems and Policies. European Observatory Policy Briefs ; 2021.
Article in English | MEDLINE | ID: covidwho-1668445

ABSTRACT

Digital health tools hold the potential to improve the efficiency, accessibility and quality of care. Before the pandemic, efforts had been made to support implementation across Europe over many years, but widespread adoption in practice had been difficult and slow. The greatest barriers to adoption of digital health tools were not primarily technical in nature, but instead lay in successfully facilitating the required individual, organizational and system changes. During the COVID-19 pandemic many digital health tools moved from being viewed as a potential opportunity to becoming an immediate necessity, and their use increased substantially. Digital health tools have been used during the pandemic to support four main areas: communication and information, including tackling misinformation;surveillance and monitoring;the continuing provision of health care such as through remote consultations;and the rollout and monitoring of vaccination programmes. Greater use of digital health tools during the pandemic has been facilitated by: policy changes to regulation and reimbursement;investment in technical infrastructure;and training for health professionals. As the pandemic comes under control, if health systems are to retain added value from greater use of digital health tools, active strategies are needed now to build on the current momentum around their use. Areas to consider while developing such strategies include: Ensuring clear system-level frameworks and reimbursement regimes for the use of digital health tools, while allowing scope for co-design of digital health solutions by patients and health professionals for specific uses. Combining local flexibility with monitoring and evaluation to learn lessons and ensure that digital health tools help to meet wider health system goals.

6.
European Journal of Public Health ; 31:2, 2021.
Article in English | Web of Science | ID: covidwho-1609951
7.
European Journal of Public Health ; 31:76-76, 2021.
Article in English | Web of Science | ID: covidwho-1609828
8.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1515070

ABSTRACT

Background Vaccine hesitancy is the reluctance or refusal to be vaccinated. While it has been widely studied for various contagious diseases, there is still a lack of knowledge about this phenomenon for COVID-19, especially if health workers' hesitancy is considered. Methods An extensive review of the literature was conducted to identify the main determinants of vaccine hesitancy in health workers, as well as to find already validated surveys to evaluate the knowledge, attitudes and behaviors (KAB) of health workers towards vaccination, both in general and with specific regard to COVID-19. Building on the available information, a new survey was developed to assess the KAB of Italian health care workers towards COVID-19 vaccination after validation with a pilot study in a diverse sample of 30 Italian health workers. Results A new survey was validated to assess the KAB of health workers towards COVID-19 vaccination in Italian health workers. The survey requires about 6 minutes to complete and is composed of 30 questions, investigating different domains: socio-demographic and professional characteristics (6);health status (2);attitudes (11);behaviors (6);knowledge (4). The survey will be administered to a representative sample of at least 385 Italian health workers through the web platform SurveyMonkey in the period June-September 2021. Preliminary results will be available by the end of October 2021. Conclusions By analyzing KAB towards COVID-19 vaccination with a new tool, the magnitude and determinants of health worker's COVID-19 vaccine hesitancy will be evaluated to understand how to improve health workers' perception towards COVID-19 vaccination and, consequently, foster their positive influence on the general population. Key messages We explore the knowledge, attitudes and behaviors towards COVID-19 vaccination in all categories of health workers operating on the Italian territory to understand the reasons of vaccine hesitancy. Understanding the determinants of COVID-19 vaccine hesitancy in Italian health workers is necessary given their influence on the perception of the general population in Italy.

9.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514946

ABSTRACT

Healthcare workers (HCWs) are on the frontline fight against the ongoing pandemic with an increased risk of infection from COVID-19. As of December 27, 2020, approximately 89,879 COVID-19 cases had been reported among HCWs in Italy. Vaccination plans recommend that initial supplies of COVID-19 vaccine be allocated to HCWs because their early protection is crucial to preserve capacity to care for patients. The aim of this study is threefold: to investigate the factors influencing the likelihood towards vaccination, to estimate the vaccine efficacy (VE) in a hospital setting and to assess the frequency of adverse reactions (AR). This retrospective study was conducted in an Italian teaching hospital from December 28, 2020 to March 31, 2021 (before the introduction of mandatory vaccination for HCWs). A total of 6,649 individuals was included. HCWs were divided into physicians, nurses and other HCWs. Univariate analyses and a multivariate logistic regression were run with an alpha of 0.05. VE was estimated as the proportionate reduction in disease attack rate between the unvaccinated and vaccinated. Out of 6,649 HCWs, 5,162 were fully vaccinated against COVID-19. Among the selected job categories, 82% of physicians, 79% of nurses and 68% of other HCWs were vaccinated. The findings of the logistic regression depicted that the 41-60 years old age class, compared with the youngest age class, was statistically significant (OR 1.17, 95% CI 1.03-1.33) in influencing vaccination, as well as being nurses (OR 0.80, 95% CI 0.69-0.92) or other HCWs (OR 0.45, 95% CI 0.39-0.52) in comparison with physicians. VE equaled 92.83% (p < 0.05). The frequency of serious and not serious AR was 0.03% and 2.9%, respectively. Sustaining and boosting COVID-19 vaccination campaigns is effective for preventing SARS-CoV-2 infection in real-world conditions. COVID-19 vaccination among HCWs is a critical public health measure to safeguard HCWs themselves, patients and the hospital community. Key messages In light of the encouraging efficacy and safety of COVID-19 vaccination, it represents an essential strategy to protect HCWs themselves, their patients and the hospital community. Despite the introduction of mandatory vaccination, policy-makers should set up tailored strategies of clear communication to reduce reluctancy to vaccination among HCWs.

10.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514805

ABSTRACT

Background Italy was the first European country to implement a national lockdown because of the COVID-19 pandemic. Worldwide, this pandemic had a huge impact on the mental health of people in many countries causing similar reaction in terms of emotions and concerns at the population level. Our study investigated the impact of the COVID-19 pandemic on psychological well-being in a cohort of Italian university students. Methods We conducted a cross-sectional survey in the period immediately after the first lockdown through the administration of a questionnaire on the personal websites of students attending their undergraduate courses at the Università Cattolica del Sacro Cuore. We used the Patient-Health-Engagement-Scale, Self-Rating-Anxiety-Scale, and Self-Rating-Depression-Scale to assess engagement, anxiety symptoms, and depression symptoms of our sample. Results The sample size was 501 subjects, of which 35.33% were classified as anxious and 72.93% as depressed. Over 90% of respondents had good understanding of the preventive measures despite over 70% suffered from the impossibility of physically seeing friends and partners. Around 55% of students would have been willing to contribute much more to face the pandemic. An increase in the occurrences of anxiety was associated with being female, being student of the Rome campus, suffering from the impossibility of attending university, being distant from colleagues, and being unable of physically seeing one's partner. Performing physical activity reduced this likelihood. Conclusions University students are at risk of psychological distress in the case of traumatic events. The evolution of the pandemic is uncertain and may have long-term effects on mental health. Therefore, it is crucial to study the most effective interventions to identify vulnerable subgroups and to plan for acute and long-term psychological services to control and reduce the burden of psychological problems.

11.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514683

ABSTRACT

Background High rates of vaccination are worldwide required to establish a herd immunity stopping the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. Methods A systematic literature search was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Multiple databases were searched, namely PubMed and Web of Science, on February 24th, 2021 using a set of developed keywords. Inclusion criteria included the study to be 1) conducted in English;2) investigated attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population;3) utilized validated measurements techniques;4) have the full text paper available and 5) be peer-reviewed prior to final publication. The Newcastle Ottawa (NOS) scale for cross sectional studies was used to assess the quality of the studies. Results 73 studies were included in qualitative synthesis. Overall, vaccine acceptance rates ranged from 23.6% in Kuwait to 94.3% in Malaysia and Nepal. A variety of different factors contributed to increased hesitancy, some of which included having negative perception of vaccine efficacy, safety, convenience and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, less educated, with lower income, with no insurance, living in the rural area and self-identified as a racial/ethnic minority. Conclusions Vaccine hesitancy rates against COVID-19 vaccine ranged widely among across different populations. Identifying the factors that interplay and result in high hesitancy rates among a population can allow formulating a directed intervention to increase their vaccination uptake rates. Key messages It is necessary to understand the factors that contribute to the COVID-19 vaccine hesitancy. It is important to inform policy-makers and formulate direct intervention measures that will successfully handle the pandemic.

12.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514603

ABSTRACT

Issue/problem Italy was one of the four European countries that started to join forces to accelerate access and distribution of a much-needed vaccine against COVID-19. When the first vaccine was approved, a National Strategic Plan for COVID-19 vaccination, examining the most relevant domains for Health Technology Assessment (HTA), has just been issued in Italy. Description of the problem Considering the possible provision of COVID-19 vaccines in the short time, in Autumn 2020 the necessity for a comprehensive assessment came up. In Italy HTA has been identified as the method for assessing the broad value of existing and new vaccines by the last two National Immunization Plans. However, the pandemic highlighted the need for a quick introduction and distribution of COVID-19 vaccines. A multidisciplinary Steering Group was therefore appointed by the Ministry of Health, in order to define vaccination strategies, organizational models, economic aspects, communication and social issues. Results Taking into account plans already released by other countries, a National Strategic Plan for COVID-19 vaccination was issued in December 2020. Main topics covered were: epidemiology and priority groups to be immunized, logistic and organization, efficacy and safety monitoring, economic and burden of disease assessments, communication. The application of these recommendations has finally proven to be difficult, because of vaccines procurement delays, suspected adverse events, inequalities in the different Regional settings. Lessons Given the concerns and difficulties faced by Italy and other European countries in the appraisal and management of COVID-19 vaccines, a HTA adapted framework could be an option for guiding the definition of National Strategic Plans. This could offer a common structured approach, make decision-making process more transparent, and be significant for a timely, convenient, and affordable access to new vaccines against SARS-CoV-2.

13.
Global & Regional Health Technology Assessment ; 8:134-139, 2021.
Article in Italian | Web of Science | ID: covidwho-1444671

ABSTRACT

The current COVID pandemic crisis made it even clearer that the solutions to several questions that public health must face require the access to good quality data. Several issues of the value and potential of health data and the current critical issues that hinder access are discussed in this paper. In particular, the paper (i) focuses on "real-world data" definition;(ii) proposes a review of the real-world data availability in our country;(iii) discusses its potential, with particular focus on the possibility of improving knowledge on the quality of care provided by the health system;(iv) emphasizes that the availability of data alone is not sufficient to increase our knowledge, underlining the need that innovative analysis methods (e. g., artificial intelligence techniques) must be framed in the paradigm of clinical research;and (v) addresses some ethical issues related to their use. The proposal is to realize an alliance between organizations interested in promoting research aimed at collecting scientifically solid evidence to support the clinical governance of public health.

14.
Giornale italiano di medicina del lavoro ed ergonomia ; 43(2):93-98, 2021.
Article in Italian | Scopus | ID: covidwho-1396015

ABSTRACT

SUMMARY: The legal responsibility of the vaccinating doctor is one of the central issues in the current setting of the Covid-19 pandemic. The aim of this statement is to outline the profiles of the medical legal liability, with a focus on the figure of the vaccinating physician, in criminal, civil, and disciplinary terms, based on the Italian legislation in force. The vaccinating doctor responds for his work in the field of vaccination in the same way as any other health service should perform (diagnostic, therapeutic, etc.). Helpful in this context is the adoption of the L. 76/2021;it was developed to find a balance between safeguarding the person privacy and greater guarantees for the doctor. This law introduces a criminal shield that can put a limit to litigation, curbing the phenomenon of so-called defensive medicine. The climate of uncertainty and fear of legal repercussions for the doctors, and the constant updating and redefinition of the indications of operability in the vaccination campaigns, underline the need to focus on the knowledge of the responsibilities and the safeguard of the vaccinating doctors. In addition to the regulatory cornerstones, the statement also addresses the issue of informed consent and the role of the occupational doctor as a central figure in the vaccination campaign in the workplace. Copyright© by GIMLE. La responsabilità medico-legale del medico vaccinatore rappresenta uno dei temi centrali nello scenario attuale della pandemia da Covid-19. L’obiettivo del presente statement è tracciare i profili di responsabilità medico-legale, con particolare attenzione alla figura del medico vaccinatore, in sede penale, civile e disciplinare sulla base della normativa italiana vigente in materia. Il medico risponde del proprio operato in ambito vaccinale allo stesso modo di qualsivoglia altra prestazione sanitaria dovesse svolgere (diagnostica, terapeutica, etc.). Giova in tale contesto l’approvazione della L. 76/2021, nata con l’intento di ricercare equilibrio tra tutela del vaccinando e maggiori garanzie per il medico, inserendo la presenza di uno scudo penale che possa porre un limite al contenzioso, arginando il fenomeno della c.d. medicina difensiva. Il clima di incertezza che alimenta il timore di ripercussioni medico-legali, il costante aggiornamento e la ridefinizione delle indicazioni di operabilità nelle campagne vaccinali, sottolineano la necessità di porre l’attenzione sulla conoscenza delle responsabilità e delle tutele del medico vaccinatore. Lo statement affronta, oltre i capisaldi normativi, anche il tema del consenso informato e del ruolo del medico competente come figura centrale nella campagna vaccinale negli ambienti di lavoro..

15.
G Ital Med Lav Ergon ; 43(2):93-98, 2021.
Article in Italian | PubMed | ID: covidwho-1346946

ABSTRACT

The legal responsibility of the vaccinating doctor is one of the central issues in the current setting of the Covid-19 pandemic. The aim of this statement is to outline the profiles of the medical legal liability, with a focus on the figure of the vaccinating physician, in criminal, civil, and disciplinary terms, based on the Italian legislation in force. The vaccinating doctor responds for his work in the field of vaccination in the same way as any other health service should perform (diagnostic, therapeutic, etc.). Helpful in this context is the adoption of the L. 76/2021;it was developed to find a balance between safeguarding the person privacy and greater guarantees for the doctor. This law introduces a criminal shield that can put a limit to litigation, curbing the phenomenon of so-called defensive medicine. The climate of uncertainty and fear of legal repercussions for the doctors, and the constant updating and redefinition of the indications of operability in the vaccination campaigns, underline the need to focus on the knowledge of the responsibilities and the safeguard of the vaccinating doctors. In addition to the regulatory cornerstones, the statement also addresses the issue of informed consent and the role of the occupational doctor as a central figure in the vaccination campaign in the workplace.

16.
European Observatory on Health Systems and Policies. European Observatory Policy Briefs ; 2021.
Article in English | MEDLINE | ID: covidwho-1196319

ABSTRACT

COVID-19 can cause persistent ill-health. Around a quarter of people who have had the virus experience symptoms that continue for at least a month but one in 10 are still unwell after 12 weeks. This has been described by patient groups as "Long COVID". Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, shortness of breath, and cognitive dysfunction, and the mechanisms involved affect multiple system and include persisting inflammation, thrombosis, and autoimmunity. It can affect anyone, but women and health care workers seem to be at greater risk. Long COVID has a serious impact on people's ability to go back to work or have a social life. It affects their mental health and may have significant economic consequences for them, their families and for society. Policy responses need to take account of the complexity of Long COVID and how what is known about it is evolving rapidly. Areas to address include: The need for multidisciplinary, multispecialty approaches to assessment and management;Development, in association with patients and their families, of new care pathways and contextually appropriate guidelines for health professionals, especially in primary care to enable case management to be tailored to the manifestations of disease and involvement of different organ systems;The creation of appropriate services, including rehabilitation and online support tools;Action to tackle the wider consequences of Long COVID, including attention to employment rights, sick pay policies, and access to benefit and disability benefit packages;Involving patients both to foster self-care and self-help and in shaping awareness of Long COVID and the service (and research) needs it generates;and Implementing well-functioning patient registers and other surveillance systems;creating cohorts of patients;and following up those affected as a means to support the research which is so critical to understanding and treating Long COVID.

17.
European Journal of Public Health ; 30, 2020.
Article in English | ProQuest Central | ID: covidwho-1015260

ABSTRACT

Background Several countries facing the COVID-19 pandemic were not prepared to manage it. Public health mitigation strategies, ranging from isolation of infected cases to implementation of national lockdowns, proved their effectiveness for the outbreaks control. However, the adjustment of public health measures is crucial during transition phases to avoid new outbreaks. To address the need for designing evidence-based strategies, we performed a systematic review, identifying healthcare systems approaches, experiences and recommendations used to manage COVID-19 and other epidemics. Methods PubMed, Web of Science, Scopus and Cochrane were searched to retrieve eligible studies of any study design, published in English until April 17th, 2020. Double-blinded screening process was conducted by titles/abstracts and subsequently eligible full-texts were read and pertinent data were extracted. We performed a narrative analysis of each implemented strategy. Results We included a total of 24 articles addressing the public health strategies implemented for respiratory viral infections outbreaks as COVID-19, influenza A H1N1, MERS and SARS. The identified strategies are ascribable to two main categories: healthcare systems management at a national level and healthcare providers strategies at a local level. The key components of the transition strategies regarded the implementation of evidence-based contextual policies, intrahospital management approaches, community healthcare facilities, non-pharmaceutical interventions, enhanced surveillance, workplace preventive measures, mental health interventions and communication plans. Conclusions The identified healthcare systems strategies applied worldwide to face epidemics or pandemics, are a useful knowledge base to inform decision-makers about control measures to be used in the transition phases of COVID-19 and beyond. Key messages Healthcare systems strategies that can be implemented to manage pandemics/epidemics transition phases are a useful knowledge base to inform policy makers about the most effective solutions to adopt. The evidence reporting the healthcare systems management of respiratory viruses epidemics/pandemics, show the lack of a common and shared approach and more evidence-based research is needed.

18.
Eurohealth ; 26(2):51-57, 2020.
Article in English | GIM | ID: covidwho-942067

ABSTRACT

Finding ways to increase the surge capacity and flexibility of the health workforce has been fundamental to delivering an effective COVID-19 response. This article explores the strategies that 44 countries in Europe plus Canada have taken to maintain and increase the availability of health workers using data from the COVID-19 Health System and Response Monitor. We show that all countries have used a variety of strategies to repurpose and mobilise the existing health workforce, while some have also augmented capacity by utilising foreign-trained or previously retired or inactive health professionals, medical and nursing students and volunteers.

19.
The European Journal of Public Health. 2020 Sep 30|30(Suppl 5): ckaa165.210 ; 2020.
Article | PMC | ID: covidwho-865879
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