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"Canzone, Giuseppe"
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408 Delivering obstetric care to maritime migrants: the Lampedusa protocol
by
Genco, Fabio
,
Sisti, Leuconoe Grazia
,
Sansosti, Alexandra
in
At risk populations
,
Aviation
,
Borders
2025
Abstract
OP 6: Health Policy 2, B308 (FCSH), September 3, 2025, 15:45 - 16:45
Background
While Lampedusa Island has long represented the “Doorway to Europe,” migration is considered an emergent phenomenon rather than a constant occurrence. Vulnerable populations – particularly pregnant women – require both routine and urgent medical services. We describe a novel approach to triaging pregnant migrant women, observed clinical presentations, and the effects on healthcare resource utilization.
Methods
The Lampedusa Protocol was implemented in March 2023 by the Agenzia Sanitaria Provinciale (ASP) of Palermo. Clinical and demographic data from 28 March 2023 to 31 May 2024 were collected and analyzed by cross-referencing the clinical databases of the policlinic of Lampedusa and the Italian Red Cross, the managing entity of the migrant Hotspot. Resource utilization data were collected from the helicopter transfer data recorded by the emergency medical service for the island. Associations between Multidimensional Global Poverty Index (MPGI) and need for helicopter evacuation were assessed using multivariable logistic regression. Our abstract and manuscript are currently under consideration for publication at the Journal of Migration and Health.
Findings
571 pregnant patients were evaluated between 3/28/2023-5/31/2024. Patients represented 23 nationalities, average age was 26 years (SD = 6.6 years), and average ultrasound-estimated gestational age was 25.2 weeks (SD = 9.6 weeks). The most common causes for helicopter transfer were late gestational age or concern for, or symptoms of, labor. Compared to the pre-implementation period, the proportion of patients requiring any flight decreased by 23% (24.5% to 18.9%, p = 0.027) and the proportion requiring urgent flights decreased by 52% (8.3% to 4.0%, p = 0.003) in the post-implementation period. There was no association between MPGI of origin country and helicopter evacuation. Women with known nationality had reduced odds (OR = 0.49, 95% CI = 0.27-0.90, p = 0.02) of requiring urgent helicopter evacuation.
Interpretation
We demonstrate improved resource utilization with protocolized care pathways for maritime migrants in European borderlands.
Journal Article
Documento di consenso ANMCO/SICP/SIGO: Gravidanza e cardiopatie congenite
2016
The success of cardiac surgery over the past 50 years has increased numbers and median age of survivors with congenital heart disease (CHD). Adults now represent two-thirds of patients with CHD; in the United States alone the number is estimated to exceed 1 million.In this population many affected women reach reproductive age and wish to have children. While in many CHD patients pregnancy can be accomplished successfully, some special situations with complex anatomy, iatrogenic or residual pathology are associated with an increased risk of severe maternal and fetal complications. Pre-conception counseling allows women to come to truly informed choices. Risk stratification tools can also help high-risk women to eventually renounce to pregnancy and to adopt safe contraception options. Once pregnant, women identified as intermediate or high-risk should receive multidisciplinary care involving a cardiologist, an obstetrician and an anesthesiologist with specific expertise in managing this peculiar medical challenge.This document is intended to provide cardiologists working in hospitals where an Obstetrics and Gynecology Department is available with a streamlined and practical tool, useful for them to select the best management strategies to deal with a woman affected by CHD who desires to plan pregnancy or is already pregnant.
Journal Article
ANMCO/SICP/SIGO Consensus document: Pregnancy and congenital heart disease
by
Agnoletti, Gabriella
,
Geraci, Giovanna
,
Adorisio, Rachele
in
Decision Trees
,
Directive Counseling
,
Female
2016
The success of cardiac surgery over the past 50 years has increased numbers and median age of survivors with congenital heart disease (CHD). Adults now represent two-thirds of patients with CHD; in the United States alone the number is estimated to exceed 1 million.In this population many affected women reach reproductive age and wish to have children. While in many CHD patients pregnancy can be accomplished successfully, some special situations with complex anatomy, iatrogenic or residual pathology are associated with an increased risk of severe maternal and fetal complications. Pre-conception counseling allows women to come to truly informed choices. Risk stratification tools can also help high-risk women to eventually renounce to pregnancy and to adopt safe contraception options. Once pregnant, women identified as intermediate or high-risk should receive multidisciplinary care involving a cardiologist, an obstetrician and an anesthesiologist with specific expertise in managing this peculiar medical challenge.This document is intended to provide cardiologists working in hospitals where an Obstetrics and Gynecology Department is available with a streamlined and practical tool, useful for them to select the best management strategies to deal with a woman affected by CHD who desires to plan pregnancy or is already pregnant.
Journal Article
Documento di consenso ANMCO/SICP/SIGO: Gravidanza e cardiopatie congenite
2016
The success of cardiac surgery over the past 50 years has increased numbers and median age of survivors with congenital heart disease (CHD). Adults now represent two-thirds of patients with CHD; in the United States alone the number is estimated to exceed 1 million.
Journal Article
Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document
2016
The importance of lifestyle and dietary habits during pregnancy and breastfeeding, for health of mothers and their offspring, is widely supported by the most recent scientific literature. The consumption of a varied and balanced diet from the preconceptional period is essential to ensure both maternal well-being and pregnancy outcomes. However, the risk of inadequate intakes of specific micronutrients in pregnancy and lactation is high even in the most industrialized countries. This particularly applies to docosahexaenoic acid (DHA), iron, iodine, calcium, folic acid, and vitamin D, also in the Italian population. Moreover, the risk of not reaching the adequate nutrient supply is increased for selected groups of women of childbearing age: those following exclusion diets, underweight or overweight/obese, smokers, adolescents, mothers who have had multiple or close pregnancies, and those with previous unfavorable pregnancy outcomes.
Journal Article
Acute Effects of Plantar Proprioceptive Training on Dynamic Balance and Ankle Range of Motion: A Pilot Randomized Controlled Trial
2026
Background: An important role in postural control is played by the plantar proprioceptive inputs, as they contribute to the sensorimotor integration of the Tonic Postural System (TPS). Although plantar stimulation is an excellent strategy for improving balance, evidence remains limited. Therefore, the aim of this pilot study was to examine the acute effects of plantar proprioceptive training on dynamic balance performance and ankle range of motion (ROM). Methods: In this randomized controlled trial, 26 physically active young adults were divided into an experimental group (EG; n = 13) and a control group (CG; n = 13). The EG performed plantar proprioceptive training including walking on a reflexology mat and balance exercises on a proprioceptive pad. The CG remained lying supine on a couch for the same amount of time as the experimental intervention. The Y-Balance Test (YBT) was used to assess dynamic balance, while the ankle ROM (i.e., dorsiflexion and plantarflexion) was measured using an inertial sensor. All measurements were taken before (T0) and immediately after (T1) the experimental or control condition. Results: Improvements in the YBT were found in the EG from T0 to T1 for both right (p = 0.002; SE = 1.24) and left (p = 0.015) foot, but no changes from T0 to T1 were observed in the CG for both right and left foot (p > 0.05). No changes were observed for ankle ROM in both groups (p > 0.05). Conclusions: These preliminary results suggest that plantar proprioceptive training can provide acute improvements in dynamic balance with no significant changes in ankle ROM. The findings support a potential role of plantar stimulation in postural control mechanisms.
Journal Article
The Influence of Ankle Mobility and Foot Stability on Jumping Ability and Landing Mechanics: A Cross-Sectional Study
2024
Practicing physical activities or sports that involve frequent jumping and landing can strain the muscles and joints of the lower limbs, especially in those who do not have adequate physical preparation. The objective of this study was to (a) determine the correlation between ankle range of motion (ROM) and landing stability following jumps; (b) assess the association between the jump height in a counter-movement jump (CMJ) test and ankle ROM; and (c) examine the connection between stabilometry during specific jumps movements present in many sports and in ankle stabilization. Sixty-two healthy amateur volleyball players participated in the study (age: thirty-seven females and twenty-five males; age (years): 16.5 ± 4.25; height (cm): 166 ± 11.4; weight (Kg): 61.6 ± 13.7). Participants were recruited for the study in collaboration with student sports associations. The evaluations encompassed the measurement of ankle joint mobility for both lower limbs using an inertial sensor, a static baropodometric and stabilometric analysis using a pressure platform, and the CMJ test using the Microgate system. After the assessments, participants performed a “specific jump landing task”. Significant correlations were found between foot range of motion (ROM) and counter-movement jump (CMJ) performance. Specifically, the ROM of the right foot had a strong correlation with the CMJ (r = 0.81, p < 0.001), while the left foot ROM showed a moderate correlation (r = 0.46, p < 0.001). The specific jump task revealed substantial changes in stabilometry parameters, particularly during forward hops compared to lateral jumps. Dorsiflexion ROM significantly impacts jumping ability. Evaluating landing patterns and stabilometry during targeted activities can help optimize training, improve dynamic balance, and reduce ankle injury risk.
Journal Article
Experimental study on physical exercise in diabetes: pathophysiology and therapeutic effects
by
Messina, Giuseppe
,
Francavilla, Vincenzo C.
,
Mingrino, Omar
in
Cholesterol
,
Diabetes
,
Diabetes mellitus
2023
Diabetes is a chronic disease. Some complications can be prevented, their effects can be slowed down. Sedentary lifestyle increases the risk of obesity and consequently the predisposition to diabetes II. The article aimed to demonstrate the positive and negative effects of exercise on active and sedentary diabetics and on pathophysiology, evaluating the effects after 3 and 6 months. The study involved 90 participants, both male and female, with type II diabetes, aged 45, divided into two groups: Group A (n=50, sedentary) and Group B (n=40, active). We evaluated anthropometric parameters, blood chemistry values, which are fundamental for the transversal evaluation of the results. In group A improvements were less noticeable than group B. The most improved parameter is blood sugar, Glycemic values and BMI. Cholesterol and Hb1Ac decreased but more slowly than previous parameters. The expectations of the study were, not only in recognizing the therapeutic and preventive powers of exercise, but above all in choosing to program a motor protocol after a team work between diabetologist, sports doctor and kinesiologist and/ or personal trainer. Physical activity is an additional therapy to insulin.
Journal Article
Telecoaching as a new training method for elderly people: a systematic review
2024
Background
The numerous restrictive measures implemented during the recent COVID-19 pandemic have reduced the levels of physical activity (PA) carried out by elderly people and telecoaching (TC) could be a training method to maintain the recommended levels of PA. In fact, TC uses information and digital communications technologies, such as computers and mobile devices, to access training services remotely. Thus, this study aimed to systematically review the scientific literature to verify the application, efficacy, and safety of TC training programs.
Methods
PubMed, Scopus, and Web of Sciences databases were used for this review, and randomized controlled trials analyzing TC training programs for elderly people were included. Only articles written in English and published in the last decade were considered.
Results
3 articles were included in the qualitative synthesis including 194 elderly people. The sample size ranged from 12 to 117 and the TC training program from 8 to 12 weeks. The TC training programs were applied to elderly people with metabolic diseases and respiratory diseases. TC training program was effective in elderly people with metabolic diseases while the benefits for respiratory diseases have yet to be clarified.
Conclusion
TC seems to be a safe, effective, and injury-free training method, despite its limited application in elderly population. Future studies should better investigate this training method in elderly people in order to evaluate the effectiveness in a wider range of diseases.
Journal Article
Applicability of the Cumberland Ankle Instability Tool in Elite Volleyball Athletes: A Cross-Sectional Observational Study
by
Giustino, Valerio
,
Ferrantello, Elena
,
Figlioli, Flavia
in
Ankle
,
ankle instability
,
Athletes
2024
Background: The ease of administration of the Cumberland Ankle Instability Tool (CAIT) could represent a methodology for periodically evaluating athletes, preventing ankle instability injuries. This study aimed to achieve three objectives: (a) to evaluate the applicability of the CAIT scale in volleyball; (b) to explore whether ankle instability presents a greater risk in lower-level volleyball categories and whether elite athletes demonstrate an ability to mitigate this risk; and (c) to identify potential predictors of ankle instability. Methods: Eighty female volleyball players participated in this cross-sectional observational study. The CAIT was administered to evaluate the athletes belonging to some teams in Series A, B, and C. Results: The Spearman’s ranks correlation coefficient showed significant correlations between CAIT items. Additionally, the Cronbach’s α showed a high internal consistency. Our results showed a significant difference between athletes who reported pain and those who did not (p < 0.001). The multiple linear regression model analysis showed that pain was a predictor of ankle instability (p < 0.001). Conclusions: Our findings suggest that the CAIT can be used to evaluate ankle stability in volleyball players. This scale could represent a valuable tool for implementing specific intervention programs to prevent ankle injuries in athletes.
Journal Article