Table of Contents
Editorial in Public Health Policy
Vaccinations and media: An on-going challenge for policy makers
Author: Francesco Chirico*
*Health Service State Police, Ministry of Interior, Italy
Keywords: Vaccination; health policy; mass media; policy makers; internet.
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Original Article in Sociology of Health
Development and validation of the Iranian Social Health Questionnaire (IrSHQ)
Authors: Hassan Rafiey1, Mostafa Amini Rarani2, Fardin Alipour3,
Esmaeil Khedmati Morasae4
1Social Welfare Management Research Centre, Department of Social Welfare, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2 Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Social Welfare Management Research Centre, Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4 Centre for Systems Studies (CSS), Hull University Business School (HUBS), Hull York Medical School (HYMS), University of Hull, Hull, UK.
Background: Social health is a fundamental dimension of health, and plays an important role in promoting social well-being. Research in social health needs reliable and valid tools, which should be also applicable to any type of social context. This study was aimed to develop an effective social health questionnaire for the social context of Iranian society.
Methods: The study was conducted in three phases: 1) A preliminary 43-item questionnaire was created based on an extensive literature review; 2) The questionnaire was validated. Firstly, social health experts evaluated content validity; secondly, an exploratory factor analysis and Cronbach’s coefficient test were used; 3) The questionnaire was tested in a representative sample of 500 persons, who were selected through a multistage sampling in Tehran, Iran, in 2015. All analyses were carried out using SPSS software (version 22).
Results: We developed the Iranian Social Health Questionnaire (IrSHQ) consisting of a 29-item questionnaire organized in seven subscales – ‘Social interaction’, ‘social responsibility’, ‘conscientiousness’, ‘attitude to society’, ‘empathy’, ‘family relationship’, and ‘social participation’−. Internal consistency using Cronbach’s alpha coefficient was 0.86. Validity and reliability of our questionnaire were confirmed.
Conclusion: Due to the size and diversity of participants, validity of results, compliance with Iranian culture, and its relative shortness, the IrSHQ appears to be a very useful instrument for measuring individual’s social health in the Iranian social context.
Keywords: factor analysis; reliability; social health; questionnaire; validity.
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Original Article in Occupational Medicine
Prevalence and risk factors for Sick Building Syndrome among Italian correctional officers: A pilot study
Author: Francesco Chirico1, Giuseppe Ferrari2, Giuseppe Taino3, Enrico Oddone4, Ines Giorgi5, Marcello Imbriani4
1 State Police, Health Service Department, Ministry of Interior, Italy
2 Italian Society of Integrative Psychotherapy for Social Development (SIPISS)
3 Hospital Occupational Medicine Unit (UOOML), ICS Maugeri SpA SB, Pavia (Italy).
4 Occupational Medicine Unit “S. Maugeri”, Department of Public Health, Experimental and Forensic Medicine, University of Pavia (Italy). Hospital Occupational Medicine Unit (UOOML), ICS Maugeri SpA SB, Pavia (Italy).
5 Psychology Unit, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS “S.Maugeri”, Pavia, Italy.
Introduction: Over the past two decades, numerous studies on indoor air and the Sick Building Syndrome (SBS) have been conducted, mostly in office environments. However, there is little knowledge about SBS in police officers. This study was aimed to fill this gap.
Methods: A cross-sectional questionnaire survey was conducted in 2016 at the Triveneto Penitentiary Center, Northern Italy. Chi-square was used to test the difference of prevalence between office workers (OWs) and correctional officers (COs) of personal characteristics, cases of SBS, and general and mucocutaneous symptoms associated with SBS. A binary logistic regression was used to identify among individual, environmental, and psychosocial characteristics, factors associated with correctional officers’ Sick Building Syndrome.
Results: Chi-squared analyses revealed that there were statistically significant differences in the estimated prevalence of SBS general symptoms (χ2 (1) = 12.22, P < .05), SBS mucocutaneous symptoms (χ2 (1) = 9.04, P < .05), and cases of SBS (χ2 (1) = 4.39, P <.05) between COs and OWs. COs reported that their health had been affected by the passive smoking (β = 2.34, P < .05) and unpleasant odour (β = 2.51, P < .05) as environmental risk factors; work-family conflict (β = 2.14, P < .05), psychological and physical isolation (β = 2.07, P < .05), and negative public image (β = 2.06, P < .05) as psychosocial risk factors. Finally, atopy (β = 2.02, P < .05) and to be current smoker (β = 2.02, P < .05) were statistically significant behavioral predictors of SBS among correctional officers.
Discussion: Our survey showed that symptoms compatible with the sick building syndrome are common in correctional officers and that psychosocial work climate and exposure to passive smoking could have a strong influence on the prevalence of both general and mucocutaneous symptoms associated with SBS. A health policy for passive tobacco smoking within prisons, and for work-related stress management among COs could improve occupational wellness and decrease potential SBS symptoms among COs.
Keywords: Sick Building Syndrome; environmental tobacco smoke; correctional facilities; psychosocial risk factors.
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Original Article in Health Care Risk Management
Risk assessment of look‒alike, sound‒alike (LASA) medication errors in an Italian hospital pharmacy: A model based on the ‘Failure Mode and Effect Analysis’
Author: Nestor Ciociano1, Lucilla Grisi2, Lucia Bagnasco3, Maria Giovanna Elberti2, Marcello Mazzarella4
1 ASL TO4 Chivasso, Turin, Italy
2 San Giovanni di Dio e Ruggi d’Aragona Hospital, Salerno, Italy
3 ASL CN 1 Savigliano, Cuneo, Italy
4 Faculty of Pharmacy, University of Salerno, Salerno, Italy
Introduction: Look alike/sound alike (LASA) drugs errors can take place in hospital wards, and they can place patients at risk for adverse events and death. This study was aimed to realize a risk assessment model for preventing LASA drugs distribution errors by the ‘S.Giovanni di Dio e Ruggi d’Aragona’ hospital pharmacy, in Salerno, Italy.
Methods: We used the ‘Failure Mode and Effect Analysis’ (FMEA) technique in combination with the Recommendations released by the Italian Ministry of Health in 2010. Our analysis led to the identification of the potential failure modes, together with their causes and effects, using the risk priority number (RPN) scoring system. A paired T test was used to compare means of RPN 1 and RPN 2, respectively before and after their application, in order to evaluate the effectiveness of corrective actions.
Results: In total, 6 phases, 16 steps, and 13 different potential failure modes were identified. The highest ranked failure modes, with an RPN score of 48 pertained to wrong drug dosage selection. Some of the critical failure modes in sample processing (phases n.1, 2, 3, and 4) were improved by 69.7% in the RPN by focusing on automated technology systems. T test showed that the difference between RPN 1 and RPN 2 was statistically significant for all corrective measures provided by our action plan.
Conclusions: Our study showed a lot of potential failure modes related to LASA drugs distribution system provided by the hospital pharmacy. Information technology solutions can be effective to reduce this risk, but the potential for error will remain unless these systems are carefully implemented.
Keywords: risk management; risk assessment; LASA drugs; drug safety; FMEA; patient safety.
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Case report in Internal Medicine
Hyponatraemia and hypothyroidism: A case report
Authors: Giulia Cantoni1, Gabriella Nucera1, Pietro Marino1
1 Department of Emergency, ASST Fatebenefratelli Sacco, PO Fatebenefratelli, Milan, Italy
In the literature, hypothyroidism-induced hyponatraemia is rare and probably occurs only in severe hypothyroidism characterised by myxoedema. An 82-year-old woman arrived at an emergency department with aphasia and a progressive cognitive impairment associated with walking problems during the last week. Examinations excluded neurological disease. The diagnosis showed a clinically relevant association between hyponatraemia and hypothyroidism disorder characterised by neurological symptoms. In conclusion, this could be one of the few cases, to our knowledge, of non-severe hypothyroidism-induced hyponatraemia.
Keywords: Hyponatremia; hypothyroidism; neurology.
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Original Article in Occupational Medicine
Awareness of workplace hazards and preventive measures among sandstone mineworkers in Rajasthan, India: A cross-sectional study
Authors: Absar Ahmad1
1 Giri Institute of Development Studies, Lucknow, India
Objective: The aim of this study was to assess awareness of workplace hazards and personal protective equipments (PPEs) among mineworkers employed in a sandstone quarry in Rajasthan, India.
Materials and Methods: A cross-sectional study of 218 miners was conducted in Karauli, Rajasthan, India. We used a standardized semi-structured questionnaire that was administered to each subject by face-to-face interviews. Descriptive statistics and Pearson chi-square test were used to show frequency distributions and associations between variables.
Results: Almost all respondents were aware of at least one hazard in mining occupation (93.6%), but no of them was trained by a recent (within 1 year) health and safety training course. However, mineworkers recognized only the risk of injury (74.3%) and exposure to crystalline silica dust (40.4%). A high percentage of mineworkers were aware of PPEs (87.6%), but an only 16.5% of them used PPEs during their employment. The only PPEs mentioned by mineworkers was the dust protective mask. Occurrence of at least one occupational injury during work-life was associated with use of dust masks, while work-related diseases were associated with a low level of education, underweight (BMI < 18.5 kg/m2), and current smoking. Awareness of workplace hazards was associated with age less than 60, young age of starting work in mines (< 30 years), hours work per day (< 8 hr), and no availability of drinking water facility. Failure to use PPEs at work was statistically significant associated with belonging to scheduled castes or scheduled tribes, lower distance from home to workplace (1‒3 Km), hours work per day (< 8 hr), and no availability of safe drinking water.
Discussion and Conclusion: In Rajasthan, India, there is a certain level of awareness about workplace hazards but usage of PPEs by sandstone mineworkers is very low. Policy makers should implement health and safety training programmes to promote use of PPEs among mine workers.
Keywords: India; miners; awareness; personal protective equipment; occupational injuries; occupational diseases.
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Original Article in Health Economics
Prevalence and economic costs of diarrheal illness among adult slum dwellers in Khulna City, Bangladesh
Authors: Faijan Bin Halim1, Mohammed Ziaul Haider1
1 Khulna University, Khulna, Bangladesh
Introduction: The aim of this research was to determine prevalence, determinants and economic costs of diarrheal illness among adult slum dwellers in Khulna City, Bangladesh.
Methods: This was a cross-sectional study in adult aged 20 years or more living in slum areas of Khulna City. Descriptive statistics, logistic regression, and a multivariate analysis with a generalized linear model of Poisson, and a Tobit model were conducted using STATA software. The statistical significance was set to P < 0.05.
Results: The highest prevalence of diarrheal illness was at the age group 30-39 (31%), among illiterate (46%) and married (92%) slum dwellers who were living in small families with ≤ 4 household size (66%), and with a household income level ≤ 5,000 BDT per year. Awareness of diseases was the only negative predictor of diarrheal illness (P < .05). Socioeconomic variables such as age (P < .001), to be married (P < .05), household income (P < .001), BMI (P < .001), and behavioral variables, such as hand washing (P < .001), awareness of diseases (P < .05), daily water consumption (P < .001), boiling water (P < .05), and household with latrines and piped sewer system (P < .001), were statistically significant associated with number of days of work missed due to diarrheal illness. Age (P < .05) and cooking food (P < .05) were associated with overall burden disease (direct and indirect costs). The overall cost calculated for each episode of diarrheal illness was BDT 1,120 (14 US $).
Conclusion: Our study showed prevalence, determinants and economic costs of diarrheal illness. Our findings can be important for policy makers in order to reduce prevalence and economic burden of diarrheal illness among slum dwellers in Bangladesh.
Keywords: Diarrheal disease; Bangladesh; cost of illness; slum dwellers; public health.
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Original Article in Health and Social Behavior
Effect of social support networks on maternal knowledge of child health in rural Odisha, India
Authors: Ranjan Kumar Prusty1, Sayeed Unisa2
1 Indian Institute of Health Management Research (IIHMR) University, 1, Prabhu Dayal Marg, Jaipur 302029, India
2 Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai 40088, India
Introduction: Mothers’ knowledge of child health is associated with their children’s well-being, and depends on their educational level and social support networks. In India, literature on social support networks as determinants of maternal knowledge of child health is scarce. This research was aimed to fill this gap, focusing on social determinants of maternal knowledge in rural Odisha, India.
Methods: A multistage cluster sampling design was adopted for the present study and 379 mothers (age: M = 28.79, SD ± 4.03) were randomly selected by eight villages. A mixed-method research was used to integrate quantitative and qualitative data collection and analysis.
Results: Chi square test showed that a low level of maternal knowledge was statistically significant associated with the scheduled tribes/caste, a low level of education, the poorest wealth category, and with early marriage and young maternal age at first birth. The presence in own social support networks of high-educated (β = 0.06, P < .001), female (β = 0.04, P < .01) and old-age (β = 0.05, P < .05) people, and healthcare providers (β = 0.01, P < .01) as members was found to be positively related to a high level of maternal knowledge. Surprisingly, the presence of female (β = 2.68, P < .05) and high-educated people (β = 0.59, P < .05), and at least one healthcare provider (β = 0.33, P < .05) as social support networks members was statistically significant associated with a high level of maternal child-health knowledge also in low-educated mothers.
Conclusions: Maternal knowledge of child health does not depend only on the levels of mother’s education, but also on the presence of an effective social support network that include female and high-educated people, and healthcare providers as members. Therefore, policymakers should promote social support networks in order to improve maternal knowledge of child health.
Keywords: maternal knowledge; maternal education; child health; social support; social network; child nutrition.
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