Incidence of Type 1 Diabetes among Children and Adolescents in Italy between 2009 and 2013: The Role of a Regional Childhood Diabetes Registry.

BACKGROUND: Surveillance represents a key strategy to control type 1 diabetes mellitus (T1DM). In Italy, national data are missing. This study aimed at evaluating the incidence of T1DM in subjects <18 year olds in Apulia (a large southeastern region, about 4,000,000 inhabitants) and assessing the sensitivity of the regional Registry of Childhood-Onset Diabetes (RCOD) in the 2009-2013 period. METHODS: We performed a retrospective study matching records from regional Hospital Discharge Registry (HDR), User Fee Exempt Registry (UFER), and Drugs Prescription Registry (DPR) and calculated T1DM incidence; completeness of each data source was also estimated. In order to assess the RCOD sensitivity we compared cases from the registry to those extracted from HDR-UFER-DPR matching. RESULTS: During 2009-2013, a total of 917 cases (about 184/year) in at least one of the three sources and an annual incidence of 25.2 per 100,000 were recorded, lower in infant, increasing with age and peaked in 5- to 9-year-olds. The completeness of DPR was 78.7%, higher than that of UFER (64.3%) and of HDR (59.6%). The RCOD's sensitivity was 39.05% (360/922; 95% CI: 34.01%-44.09%). CONCLUSIONS: Apulia appeared as a high-incidence region. A full, active involvement of physicians working in paediatric diabetes clinics would be desirable to improve the RCOD performance.

An audit about clinical governance skills in Italian medical managers.

BACKGROUND: The objective of this study is to describe the knowledge and skills of managers working in health organizations in the Region of Puglia (South of Italy) on the principles and tools of clinical governance. METHODS: A KAP (Knowledge, Attitudes and Practice) survey was conducted using a questionnaire. The target population of the survey was represented by Hospital Directors and Managers of local health care structures (Primary Care Districts, Public Health Departments, and Mental Health Departments). RESULTS: 92 managers participated at the study (response rate was 90.2%). 98.9% of respondents reported being aware of the concept of clinical governance and believe that clinical governance is an appropriate strategy for the continuous improvement in quality of services. 96.7% of respondents had heard of Evidence Based Practice and 80.6% reported using the method of EBP in nursing practice. The availability of guidelines for consultation was reported by 54.9% of respondents. Of those interviewed, 79.8% knew about Health Technology Assessment. 95.5% reported they have heard of clinical audit and 98.9% knowing the concept of risk management. CONCLUSION: In our survey, an high value judgment about clinical governance was reported by medical managers. The lower attitudes towards the use of the tools of clinical governance highlights an important discrepancy with respect to knowledge and opinions, which becomes more evident in community care structures. Above and beyond training managers, it is also necessary to change training methods used on all health personnel, which should be oriented towards EBM in order to build an adaptable organizational climate.

[Pneumococcal polysaccharide immunization strategies in Italian regions]. / Strategie per l'offerta della vaccinazione anti-pneumococcica 23-valente nelle regioni italiane.

The aim of this study is to describe the immunization strategies for 23-valent pneumococcal vaccine in the Italian regions. Sixteen regions offer pneumococcal vaccine to elderly people and 18 regions to risk groups. Nine among them offer the vaccine free of charge and perform the call for immunization. Five regions created a database of the risk groups. Data about vaccination coverage are available for seven regions; in the other only the number of administered doses is collected yearly. Different immunization strategies may represent a determinant of health inequalities.

Communication skills in HPV prevention: an audit among Italian healthcare workers.

This study aims to investigate the knowledge, the attitudes and practices on HPV vaccination of health professionals of Mother and Child Service of Puglia Region (Italy). The study was conducted through a standardized questionnaire. Of 455 respondents, 74.2% judged HPV vaccine very important for immunization calendar. 88.9% did not believe that the administration of HPV vaccine implies consent to the initiation of sexual activity but 34.2% sustained that vaccine can give a false sense of protection against sexually transmitted diseases. 62.2% believed that boys should also be vaccinated. Skills necessary in the implementation of strategies in the promotion of health are partially inadequate and appropriate ongoing education should be carried out for health care workers.