The Role of Pharmacists in Counteracting Vaccine Hesitancy: Effectiveness of the 2019 Carnia Project in Improving Adherence to Influenza Vaccination among Target Population.

Vaccine hesitancy has been included among the top ten threats to global health by the World Health Organization. Pharmacists can play a pivotal role in removing the individual barrier to vaccination, because of the relationship of trust they have with citizens and their ease of access. The aim of this study was to examine the impact of a pharmacy-based intervention to support the 2019 influenza vaccination campaign conducted in the Carnia district through one-to-one counseling. We analyzed data collected by pharmacists between 22 October 2019 and 20 January 2020, and trends in vaccination adherence in the context of the Local Health Authority and the entire province of Udine since 2016. The results showed that 77.2% of people who had not received an influenza vaccination in the previous year changed their minds about vaccination after receiving counseling. The pharmacy-based intervention improved influenza vaccination adherence in the target district (+13.4%), even when compared to the neighboring district of Gemona or considering the data in the broader local and provincial context, and this effect was particularly pronounced among those aged 65 to 74 years (p < 0.01). Considering these findings, pharmacies should be more effectively involved in the provision of public health services aimed at improving accessibility, timeliness, and equity.

[The role of the public health personnel in the Prevention Department (in the Hygiene Services and Public Health Care and Hygiene of Food and Nutrition): proposal for the future of public health care]. / Il ruolo del medico di sanità pubblica del Dipartimento di prevenzione (nei servizi di Igiene e Sanità Pubblica e Igiene degli Alimenti e Nutrizione): una proposta per il futuro della sanità pubblica.

A global and local discussion on Public Health relevance is taking place, including the future role and organization of its services. Noteworthy becomes the role played by Public Health Specialists. This work presents the results of a workshop, carried out following the Guilbert methodology, whose aim was to define Public Health Doctors functions and their related activities. The programme involved 30 professionals from Triveneto area (North Eastern Italy), working in Prevention Departments at National Health Service and Universities. The key-functions identified were: 1) Health status assessment and identification of community risk factors, 2) Health Promotion, 3) Prevention, 4) Protection, 5) Planning, 6) Communication, 7) Professional Training, 8) Alliances and resources for complex Public Health programs, 9) Crisis management in Public Health, 10) Research. For each function activities were identified, meaning concerning areas and contents that must be warranted by professionals. This experience allowed to share existing attitudes and experiences present in Triveneto area, and it can stand as a feasible instrument for different settings. Nevertheless, it appears mandatory explaining at each level in the society role and functions of Prevention Departments.

[Evaluation of the effectiveness of influenza vaccination among the elderly in Friuli-Venezia Giulia (Italy)]. / Valutazione dell'efficacia della vaccinazione antinflurenzale nell'anziano in Friuli-Venezia Giulia.

OBJECTIVES: To evaluate the effectiveness of the influenza vaccination in reducing medical visits, hospital admissions, and deaths among the population > or =65 years of age in Friuli-Venezia Giulia. DESIGN: We conducted a retrospective and a prospective cohort study. For the retrospective study, we used data from the regional health electronic database. For the prospective study, we integrated this source of data with data provided by a sample of general practitioners. SETTING: The Friuli-Venezia Giulia region, Northeastern Italy. PARTICIPANTS: The population > or =65 years of age assisted by the Regional Health Service. MAIN OUTCOME MEASURES: Mortality from any cause, deaths, hospital admissions, and medical visits due to influenza, heart disease, and respiratory disease, also stratified by age and comorbidity. RESULTS: With the exception of some population subgroups, the retrospective study showed that the vaccination was not effective in reducing the risk of hospital admission and death. On the contrary, the vaccination was associated with an increase in hospital admissions due to influenza, heart disease, and respiratory disease (increased by 7%, 13%, and 17%, respectively). On the other hand, the prospective study showed an association between the vaccination and a 26% reduction in the risk of admissions for respiratory disease and a 21% reduction in the risk of all-cause death, whereas visits due to respiratory disease were increased by 55%. CONCLUSIONS: Overall, the influenza vaccination appeared to have a low impact on the study cohorts. The vaccination was more effective in subjects <85 years of age and in those affected by comorbidity.

[Road traffic accidents in the province of Udine: estimation of drivers' injuries attributable to personal, environmental, and vehicle-related factors]. / Incidenti stradali in provincia di Udine: stima degli infortuni di conducenti attribuibili a fattori personali, ambientali e relativi al veicolo.

OBJECTIVE: To estimate injuries attributable to personal, environmental, and vehicle-related factors among drivers involved in road accidents in the province of Udine. DESIGN: Analysis of data contained in the ISTAT road accident reports. SETTING: Road traffic accidents with personal damage that occurred in the province of Udine from 1991 to 1998. MAIN OUTCOME MEASURES: Fractions of injuries and deaths attributable to various risk factors. RESULTS: From 1991 to 1998, 24261 drivers were involved in accidents: 462% were uninjured, 51.8% were non-fatally injured, and 2.0% died within 7 days. The greatest proportion of injuries (10.59%) was attributed to being on a two-wheeled vehicle. On the other hand, with respect to death the highest proportion of cases was attributed to driving during the night (29.19%) and to non-using seat belts and helmets (26.30%). CONCLUSIONS: This study provides information useful for establishing priorities for the prevention of road accidents and injuries.

Risk factors for fatal road traffic accidents in Udine, Italy.

In the Province of Udine, Northeast Italy, mortality from road accidents is 37% higher than in the country as a whole. To identify the major risk factors for fatal crashes in this area, we analyzed the Police reports of 10,320 road traffic accidents that occurred from 1991 to 1996. Logistic regression was used to evaluate the association of characteristics of drivers and accidents with accident severity. The risk of involvement in fatal rather than non-fatal accidents was lower among females than among males (odds ratio (OR) = 0.65; 95% confidence interval (95% CI), 0.53-0.80). Compared with subjects < 30 years of age, subjects aged > or = 65 had a significantly increased risk of fatal injury as pedestrians (OR = 10.87; 95% CI, 4.45-26.54), car drivers (OR = 1.85; 95% CI, 1.08-3.18), moped riders (OR = 3.53; 95% CI, 1.42-8.78), and bicycle riders (OR = 7.72; 95% CI, 2.56-23.29). In accidents that occurred from 1:00 to 5:00 h the risk of death was higher than from 6:00 to 11:00 h among pedestrians (OR = 8.88; 95% CI, 2.58-30.52), car drivers (OR = 4.95; 95% CI, 3.09-7.95), motorcycle riders (OR = 13.44; 95%CI, 2.54-71.05) and moped riders (OR = 8.76; 95% CI, 2.42-31.69). Risk of death among pedestrians, car drivers, moped, and bicycle riders was also significantly increased on roads outside the urban center. Driver's injury was strongly associated with lack of use of seat belts (OR = 13.27; 95% CI, 9.39-18.74, for fatal injury; OR = 2.49; 95% CI, 2.17-2.86, for non-fatal injury). Simple interventions focused on protecting the weakest road users and based on law enforcement, behavioral change and environmental modification might result in reducing the significant excess of road traffic accident mortality found in the study area.