Enrica Frasson

Background: The global shortage of healthcare professionals is critical, with the WHO reporting a deficit of 5,9 million nurses in 2020 - a number expected to increase due to rising demand and high turnover. In high-income countries, absenteeism among healthcare workers, defined as absence due to personal or health reasons, worsens this shortage, causing service disruptions, reduced productivity, and higher costs. In this context, this study examines the increase in absences among non-medical staff at the Azienda Ospedale-Università Padova (AOUP), a large hospital in the Veneto Region, employing nearly 7,000 staff. Methods: This descriptive longitudinal analysis includes all non-medical employees at AOUP, analyzing data from January 2018 to December 2023. Absence days per capita were calculated using Full-Time Equivalent (FTE) and categorized into vacation, illness, injury, maternity leave, authorized leave, unpaid leave, and COVID-related absences (from 2020 onward). Results: From 2018 to 2023, average absence days per employee rose by 2.86 days, peaking in 2022. Increases were notable in illness and injury (4.6%), authorized leave (24.8%), and unpaid leave (6.1%), while maternity leave decreased by 6.2%. Younger nurses (under 30) showed the sharpest rise in absences, while older nurses and healthcare assistants saw moderate increases. Discussion: This study is one of the first in Italy to investigate the trend in hospital staff absences. The combined impact of a surge in absences and staff shortages poses challenges for healthcare resource management. Although absence rates decreased post-pandemic, they remain above pre-pandemic levels, driven by factors like burnout and workload intensity. Between 2018 and 2023, illness and injury were leading causes of the increase in absences at AOUP, consistent with global trends. Permits, which increased by 24.8%, highlight the need to balance work with physical, mental, and family needs. Absence analysis by age revealed a significant increase among nurses under 30.

Introduction: Invasive bacterial diseases (IBDs) such as meningitis and sepsis are significant public health concerns, particularly in pediatric populations. This study analyzes the incidence, outcomes, and bacterial serotype distribution of pediatric IBDs in the Veneto Region over 17 years. Methods: An observational study was conducted using data (2007–2023) from the surveillance system of the Veneto Region, including microbiologically confirmed cases in individuals < 18 years. Differences by age groups and trends were statistically assessed. Results: A total of 535 pediatric IBD cases were reported, with Streptococcus pneumoniae (54.6%), Neisseria meningitidis (19.6%), and Streptococcus agalactiae (13.5%) being the most common pathogens. Haemophilus influenzae infections were more commonly represented in infants under 1 year (41.5%), whereas S. pneumoniae and N. meningitidis were more frequent in the 1–4-year age group (40.8% and 37.1%, respectively). Sepsis was the most common clinical presentation (57.2%), followed by meningitis (36.3%). Serotype analysis revealed that S. pneumoniae serotype 3 was the most prevalent, while serogroup B dominated N. meningitidis cases. Temporal trends generally showed a decline in cases until 2019, a drop during the COVID-19 pandemic, and a subsequent resurgence in 2022–2023. Conclusions: Our research underscores the value of evidence-based epidemiology through robust surveillance systems in tracking IBD trends and serotype shifts, essential for guiding vaccination strategies and public health interventions. These insights highlight the effectiveness of vaccination programs and the necessity of ongoing monitoring to inform public health policies. Improved data integration and completeness are recommended to enhance surveillance accuracy.

Antimicrobial resistance represents a global health challenge, with Italy among the most affected countries in Europe. In response, the Veneto Region developed governance models to enhance antimicrobial stewardship (AMS) and infection prevention in both hospital and community settings. This study assessed the implementation of these models and explored strategies for improvement. A survey targeting hospital medical and district health management, hospital pharmacies, and primary care pharmaceutical departments was conducted to evaluate governance adherence, resource allocation, training, and reporting practices. Findings were analyzed by a focus group comprising regional experts, infectious disease specialists, microbiologists, and policymakers, which identified critical gaps and proposed actionable recommendations. Results revealed disparities in AMS implementation between hospital and community care, with key challenges including limited multidisciplinary collaboration, inconsistent resource distribution, and gaps in training. The focus group emphasized the need for stronger governance, standardized protocols, and improved communication to address these shortcomings. This study underscores significant gaps and opportunities within the Veneto Region’s healthcare system and provides a framework for enhancing AMS and infection prevention strategies, bridging the divide between hospital and community care to combat antimicrobial resistance effectively.

Antimicrobial resistance represents a global health challenge, with Italy among the most affected countries in Europe. In response, the Veneto Region developed governance models to enhance antimicrobial stewardship (AMS) and infection prevention in both hospital and community settings. This study assessed the implementation of these models and explored strategies for improvement. A survey targeting hospital medical and district health management, hospital pharmacies, and primary care pharmaceutical departments was conducted to evaluate governance adherence, resource allocation, training, and reporting practices. Findings were analyzed by a focus group comprising regional experts, infectious disease specialists, microbiologists, and policymakers, which identified critical gaps and proposed actionable recommendations. Results revealed disparities in AMS implementation between hospital and community care, with key challenges including limited multidisciplinary collaboration, inconsistent resource distribution, and gaps in training. The focus group emphasized the need for stronger governance, standardized protocols, and improved communication to address these shortcomings. This study underscores significant gaps and opportunities within the Veneto Region’s healthcare system and provides a framework for enhancing AMS and infection prevention strategies, bridging the divide between hospital and community care to combat antimicrobial resistance effectively.

Left ventricular non-compaction (LVNC) is a rare heart muscle disease defined by the presence of prominent left ventricular trabeculation, deep intertrabecular recesses, and a thin compact layer. Several hypotheses have been proposed regarding its pathogenesis, with the most recently accepted one being that compact layer and trabeculated layers develop independently according to an “allometric growth”. The current gold-standard diagnostic criteria (in particular, the Petersen index non-compaction/compaction ratio > 2.3) reflect an excess of myocardial trabeculation, which is not a specific morpho-functional feature of LVNC cardiomyopathy but merely a “phenotypic trait”, even described in association with other myocardial disease and over-loading conditions. Accordingly, the European Society of Cardiology (ESC) guidelines have definitively abolished the term ‘LVNC cardiomyopathy’. Recently, evolving perspectives led to the restoration of LVNC cardiomyopathy by distinguishing “hypertrabeculation phenotype” and “non-compaction phenotype”. It has been proposed that the disease-specific pathophysiologic mechanism is a congenitally underdevelopment of the compact layer accounting for an impairment of the left ventricular systolic function. Future prospective research should focus on the clinical and prognostic relevance of compact layer thinning rather than excessive trabeculation, which could significantly influence the management of patients with LVNC. The review aims to update current knowledge on the pathogenesis, genetics, and diagnostic criteria of LVNC, offering modern insights for future perspectives.