Angela Vinelli

Underage drinking on saturday nights, sociodemographic and environmental risk factors: a cross-sectional study

BackgroundExcessive alcohol consumption in underage people is a rising phenomenon. A major proportion of the disease burden and deaths of young people in developed nations is attributable to alcohol abuse. The aim of this study was to investigate social, demographic and environmental factors that may raise the risk of Saturday night drinking and binge drinking among Italian school students.MethodsThe study was conducted on a sample of 845 Italian underage school students, by means of an anonymous, self-test questionnaire. Multivariate logistic regression was applied to identify independent risk factors for alcohol drinking and binge drinking. Ordered logistic regression was used to identify independent risk factors for harmful drinking patterns.ResultsThe independent variables that confer a higher risk of drinking in underage students are older age classes, male sex, returning home after midnight, belonging to a group with little respect for the rules, or to a group where young people are not seen as leaders. The higher the perception of alcohol consumption by the group, the higher the risk. Spending time in bars or discos coincides with a two-fold or four-fold increase, respectively, in the risk of alcohol consumption.ConclusionOur findings show that certain environmental and social risk factors are associated with underage drinking. The most important role for preventing young peoples exposure to these factors lies with the family, because only parents can exert the necessary control and provide a barrier against potentially harmful situations.

An update review on risk factors and scales for prediction of deep sternal wound infections

Surgical site infections are the most common nosocomial infections in surgical patients. The preventable and the unmodifiable risk factors for deep sternal wound infections (DSWI) have been amply assessed in the literature. The aim of this review was to describe the results of the numerous published studies to describe all the DSWI risk factors and the scales devised to predict SWI, with a view to providing an update on this issue. A comprehensive search of the Medline and Embase databases was performed (considering studies from January 1995 to April 2011); and a manual search was also conducted using references cited in original publications and relevant review articles. There are several risk factors associated with DSWI, which could be classified in four categories as demographic (e.g. sex and age), behavioural (e.g. smoking and obesity), baseline clinical conditions (e.g. diabetes, hypertension and COPD) and surgical operative risk factors (e.g. duration of operation and emergency operation). Six scales for predicting the risk of DSWI are described in the literature: they vary not only in accuracy but also in ease of application and they are applied at different times (some only preoperatively and others also postoperatively). This study provides a broad update on our knowledge of the risk factors for DSWI and the scales for prediction with a view to improving the management of infections at cardiosurgery units.

Strain and health implications of nurses’ shift work

ObjectivesThe study investigated whether nurses’ different working schedules are associated with different levels of job-related strain, health symptoms and behavior. No reports have been accessible in the relevant literature on the possible association between shift work and job-related strain in nurses.Materials and MethodsThis was a cross-sectional study conducted at a large university hospital in North-East Italy, involving 806 nurses working in selected departments. A multilevel logistic regression was applied to assess the association between work shift conditions and selected outcomes.ResultsNight shifts were associated not only with higher odds of having a high Job Demand, but also with lower odds of having a high Decision Authority and consequently with a stronger likelihood of having higher levels of Job Strain (high Job Demand score ≥ 38 and Low Decision Authority). The night shift was associated with various symptoms, particularly exhaustion (p = 0.039) and gastric pain (p = 0.020). Nurses’ working schedules did not affect their job satisfaction scores.ConclusionsIt has been confirmed that night shifts are a risk factor for nurses’ health perception and working night shifts carries a considerable degree of strain. This is a condition that hospital nursing managements need to consider carefully to avoid burnout in nursing personnel and prevent an excessive turnover in this profession, which is a recurring problem for health care organizations.

Is moderate alcohol consumption a risk factor for kidney function decline? A systematic review of observational studies.

OBJECTIVE The aim of this study was to conduct a systematic review of published observational studies on the association between alcohol consumption and renal functional impairment. METHODS A search of Medline and Scopus (1985 through June 2013) was performed and supplemented with manual searches of bibliographies. Of the 430 studies considered, 15 were judged eligible for this systematic review. The quality of the studies was scored using a checklist of 22 items recommended by the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS Among 12 studies on the adjusted association between moderate alcohol consumption and renal function decline, most of the studies with higher quality scores found no such association. This systematic review indicates that moderate alcohol consumption has not been demonstrated to be a risk factor for kidney function decline. CONCLUSION Although alcohol consumption in selected populations was inversely associated with renal impairment, a beneficial role of alcohol consumption on renal function has not been consistently demonstrated.

A cost-consequence analysis of hepatitis B screening in an immigrant population.

OBJECTIVE Screening for HBV among groups at risk, such as migrant populations, has proved to be a cost-effective strategy. With a view to advising local policy-makers, the cost-consequences of HBV screening was assessed using a modeling approach. METHODS This cost-consequence analysis of an HBV screening strategy was conducted in a cohort of adult migrants in the province of Padua, northern Italy. RESULTS The population targeted for screening consisted of 65 405 migrants, among whom the weighted rate for the prevalence of HBV was 0.04972, with 3251 people infected. Over a period of 5 years, the screening strategy prevented 565 cases/year of chronic hepatitis, 141 of compensated cirrhosis, 9 of decompensated cirrhosis, 14 hepatocellular carcinomas and 12 deaths. The above data revealed that the incremental cost of the screening strategy compared to no screening strategy was € 7 974 959 over the five year period. The cost per life saved amounted to € 676 709. CONCLUSIONS The present study provides useful information to policy-makers at local and regional levels.