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Aboul-Enein BH, Kelly PJ, Raddi S, Keller T, Almoayad F. Effectiveness of hand hygiene campaigns and interventions across the League of Arab States: a region-wide scoping review. J Hosp Infect 2024; 147:161-179. [PMID: 38492646 DOI: 10.1016/j.jhin.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/18/2024]
Abstract
Hand hygiene is a standard public health practice for limiting the spread of infectious diseases, yet they are still not routine global health behaviours. This review aimed to examine the effectiveness of various hand hygiene interventions conducted across the League of Arab States, identify gaps in the existing literature, and propose areas for future research and intervention development. A scoping review was conducted across 16 databases for relevant publications published up to and including October 2023. Forty studies met the inclusion criteria; of these, 34 were hospital-based and six community-based. Of the reviewed studies, 24 provided adequate details that would enable replication of their intervention. Eighteen of the studies used some variation of the World Health Organization's Five Moments for intervention content or assessment. More than half (N = 25) reported healthcare worker or student hand hygiene behaviours as an outcome and 15 studies also included some form of patient-centred outcomes. Six studies specified the use of theory or framework for their evaluation design or intervention content, and four studies mentioned use of local government guidelines or recommendations. Future research should focus on bridging the literature gaps by emphasizing community-based studies and integrating cultural nuances into intervention designs. Additionally, applying theoretical frameworks to hand hygiene studies could enhance understanding and effectiveness, ensuring sustainable improvements in hygiene practices across diverse settings in the League of Arab States.
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Affiliation(s)
- B H Aboul-Enein
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, London, UK.
| | - P J Kelly
- Thomas Jefferson University, College of Nursing, Philadelphia, PA, USA
| | - S Raddi
- University of Bisha, College of Applied Medical Sciences, Department of Nursing, Bisha, Saudi Arabia
| | - T Keller
- New Mexico State University, School of Nursing, Las Cruces, NM, USA
| | - F Almoayad
- Princess Nourah Bint Abdulrahman University, College of Health and Rehabilitation Sciences, Department of Health Sciences, Riyadh, Saudi Arabia
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2
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Tarozzi I, Franceschetti L, Simonini G, Raddi S, Machado D, Bugelli V. Response to Letter-to-the-editor, concerning the article entitled "Black box of diving accidents: Contribution of forensic underwater experts to three fatal cases". Forensic Sci Int 2024; 357:112004. [PMID: 38522321 DOI: 10.1016/j.forsciint.2024.112004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Ilaria Tarozzi
- Modena Local Health Unit, Department of Legal Medicine and Risk Management, Modena, Italy
| | - Lorenzo Franceschetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
| | | | - Silvia Raddi
- Health Science Department, Forensic Pathology Section, University of Florence, Florence, Italy
| | - Davide Machado
- South-East Tuscany Local Health Unit, Department of Neuroradiology, Grosseto, Italy
| | - Valentina Bugelli
- South-East Tuscany Local Health Unit, Department of Legal Medicine, Grosseto, Italy
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Raddi S, Tarozzi I, Cecchetti M, Chericoni S, Franceschetti L, Bugelli V. An unusual case of a triple suicide pact at the time of the COVID-19 pandemic. J Forensic Sci 2023; 68:2194-2199. [PMID: 37565422 DOI: 10.1111/1556-4029.15358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/02/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
In December 2020, the World Health Organization (WHO) declared SARS-CoV2 a global pandemic. Home confinement, low social contacts, and fear of virus transmission played a major role as risk factors for suicides during the following period. Suicide pacts, in particular, showed a different pattern. A rare case of a triple suicide pact among members of the same family nucleus is presented. The victims were an elderly, severely ill woman and her adult children (a son and daughter), linked by a morbid relationship. The last time the family was seen alive was 40 days before the discovery. All corpses presented decompositional changes. After a full autopsy, the cause of death was determined to be a lethal intake of morphine for the mother and acute blood loss due to self-stabbing at the neck for the siblings. The younger woman was under the effects of a large amount of heparin. Toxicological analysis was positive for opioids and alcohol in both siblings. Suicide pacts have rarely been described during the COVID-19 pandemic. In the few cases reported, the victims were more often relatives than people in a romantic relationship. The involvement of three people is unusual, as is the use of different suicide methods among the victims. In the presented case, the elderly mother's imminent death from terminal cancer, her concern over dying in a nondomestic environment, and the siblings' fear of being alone likely led to the conception of the suicide pact. Social isolation and economic difficulties also played a contributing role.
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Affiliation(s)
- Silvia Raddi
- Health Science Department, Forensic Pathology Section, University of Florence, Florence, Italy
| | - Ilaria Tarozzi
- Department of Legal Medicine and Risk Management, Modena Local Health Unit, Modena, Italy
| | | | - Silvio Chericoni
- Forensic Toxicology Laboratory, Department of Surgical, Medical, Molecular, Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Lorenzo Franceschetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Valentina Bugelli
- Department of Legal Medicine, South-East Tuscany Health Unit, Grosseto, Italy
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Tarozzi I, Franceschetti L, Simonini G, Raddi S, Machado D, Bugelli V. Black box of diving accidents: Contribution of forensic underwater experts to three fatal cases. Forensic Sci Int 2023; 346:111642. [PMID: 36963130 DOI: 10.1016/j.forsciint.2023.111642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/04/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023]
Abstract
Diving is a popular activity, largely practiced worldwide. Diving fatalities are not rare events, with drowning being the most common cause of death, followed by cardiac-related natural causes, immersion pulmonary edema and arterial gas embolism. In such cases, positive signs of drowning are not specific, depending also on the time of submersion of corpses. Moreover, drowning can be the terminal event. Over the years, measures to perform appropriate post-mortem examination in cases of diving fatalities were suggested, including the execution of post-mortem CT-scan, the use of a decompression chamber and the adoption of specific autoptic techniques. Although a multidisciplinary approach in forensic investigations concerning diving fatalities is discussed, poor cases focus on how the analysis of diving computer records and equipment can contribute to determining the cause of death. The present study shows how the cooperation between a forensic underwater expert and a forensic pathologist played a crucial role in interpreting radiological findings, guiding the autopsy and confirming/denying circumstantial data emerging from the investigations. Technical analysis of dive computer records and diving equipment is a fundamental step in the definition of the cause of death in diving fatalities. All diving computer data, not only those related to maximum depth and ascent's profile, should be considered in detail, and the immersion graph carefully studied by both the forensic pathologist and the forensic underwater experts. The diving technical data can often play a crucial role in explaining any legal issue related to the circumstances of death, possibly leading the prosecutor to further investigation.
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Affiliation(s)
- Ilaria Tarozzi
- Modena Local Health Unit, Department of Legal Medicine and Risk Management, Modena, Italy
| | - Lorenzo Franceschetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy; Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli, 37, 20133 Milano, Italy.
| | | | - Silvia Raddi
- Health Science Department, Forensic Pathology Section, University of Florence, Florence, Italy
| | - Davide Machado
- South-East Tuscany Local Health Unit, Department of Neuroradiology, Grosseto, Italy
| | - Valentina Bugelli
- South-East Tuscany Local Health Unit, Department of Legal Medicine, Grosseto, Italy
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Raddi S, Baralla F, D’Argenio A, Traverso S, Sarchiapone M, Marchetti M. Do Homicide Perpetrators Have Higher Rates of Delayed-Suicide Than the Other Offenders? Data from a Sample of the Inmate Population in Italy. Int J Environ Res Public Health 2022; 19:16991. [PMID: 36554869 PMCID: PMC9778990 DOI: 10.3390/ijerph192416991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Homicide-suicide can be defined as homicide followed by the suicide of the perpetrator shortly afterward. In the so-called "homicide-delayed suicide", homicide and suicide occur but within a wide and not strictly defined timeframe. This study analyzes data concerning the suicide of 667 inmates in Italy between 2002 and 2015, considering homicide perpetrators compared to all offenders. The analyses revealed that inmates who had committed homicide were more likely to commit suicide (71% versus 45%; χ2 = 10.952, p = 0.001) and the odds of suicide increase concerning 1.58 times among homicide perpetrators. The time-to-suicide interval after homicide ranges between 0 to 9.125 days (mean = 1.687,9; SD = 2.303,1). Moreover, the intimate-homicide offenders who committed suicide had a significantly shorter survival time after the offense than did the other non-intimate offenders who died by suicide (t test, t = -3.56, df = 90, p = 0.001). The link between homicide and higher suicide risk in homicide perpetrators should be highlighted because of all the homicide offenders passing through the criminal justice system. Superior knowledge about the path of homicide-delayed suicide will be of particular use to professionals in evaluating and treating homicide inmates.
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Affiliation(s)
- Silvia Raddi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Francesca Baralla
- Department of Humanities, Social Sciences and Education—SUSeF, University of Molise, 86100 Campobasso, Italy
| | - Alberto D’Argenio
- Department of Neuroscience, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Simona Traverso
- Department of Medical Science, Chirurgical and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Marco Sarchiapone
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
| | - Marco Marchetti
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
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Focardi M, Gualco B, Scarpino M, Bonizzoli M, Defraia B, Carrai R, Lanzo G, Raddi S, Bianchi I, Grippo A. Eye-opening in brain death: a case report and review of the literature. Clin Neurophysiol Pract 2022; 7:139-142. [PMID: 35676910 PMCID: PMC9168374 DOI: 10.1016/j.cnp.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/08/2022] [Accepted: 03/23/2022] [Indexed: 11/18/2022] Open
Abstract
Careful attention is needed at the time of clinical examination to rule out any cerebrally mediated function. In some cases it may be difficult to distinguish spinally mediated responses from cerebrally mediated responses. In these instances, ancillary testing may be required.
Background According to Italian law, brain death is diagnosed when the patient is in a coma, showing the absence of respiratory drive under specific clinical conditions, and without any brain stem reflexes. On the other hand, presence of spinal reflexes, when correctly identified, does not hamper the diagnosis. Case report We present a case of eyelid elevation two seconds after thoracic pain stimulation in a patient who otherwise fulfilled all clinical and instrumental brain-death criteria due to a residual preserved function of the superior cervical ganglion. Conclusion Although the observed reflex is to be considered extracerebral, and therefore it should not hamper the diagnosis of BD, the authors propose implementing cerebral flow evaluation, considered “prudential”, as a preliminary assessment before determining BD.
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Focardi M, Grassi S, Raddi S, Rosati ME, Cazzato F, D'Onofrio P, Doretti V, Bianchi I, Vetrugno G, Oliva A, Pinchi V. Trend in 167 cases of minors witnessing violence: The role played by COVID-19 pandemic. Front Pediatr 2022; 10:949922. [PMID: 36275057 PMCID: PMC9581130 DOI: 10.3389/fped.2022.949922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There currently is no evidence that COVID-19 has had an impact on the rates of psychological abuses occurring when a minor witnesses interpersonal violence. AIM Our aim was to describe the accesses of the last four years to the Emergency Department of a tertiary hospital (Careggi University Hospital-Florence, Italy) due to this issue and then to evaluate whether the COVID-19 has had an impact on this trend. METHODS We collected data regarding cases of abuse in which at least a minor had reportedly witnessed the event. Medical records stored between January 1, 2018 to January 1, 2022 were analyzed, extracting sex, age and nationality of the victim; sex of the perpetrator and relationship with the victim; known previous episodes of abuse in the medical history of the victim; setting of the abuse (domestic vs. non-domestic); type of abuse (physical, psychological, sexual); whether the perpetrator was under the influence of alcohol/drugs; whether the victim was hospitalized; prognosis of the victim; number, relation with the victim and involvement in the abuse (as co-victim) of the minor(s) who witnessed the abuse. RESULTS A total of 167 eligible cases were registered. 69% of victims had previous episodes of abuse. The perpetrators were all known and mainly males (96%).The abuses were mainly domestic (79%). In 74% of the cases only a type of violence was perpetrated. In 12% of the cases, the minors were also victims of physical abuse. No statistically significant relationships were found between the start of the COVID-19 pandemic and the changes in the number of cases of domestic abuse (p = 0.07), physical abuse (p = 0.62), psychological abuse (p = 0.83) or sexual abuse (p = 0.88). However, during the institutional lockdown in Italy (March-May 2022) only two cases occurred - a number that did not allow period-specific statistical inference. CONCLUSIONS Empowering the hospital policies specifically aimed at identifying and protecting the victims of violence/witnessed violence remains a critical goal from both a public health and medico-legal point of view.
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Affiliation(s)
- Martina Focardi
- Department of Health Science, University of Florence, Florence, Italy
| | - Simone Grassi
- Department of Health Science, University of Florence, Florence, Italy
| | - Silvia Raddi
- Department of Health Science, University of Florence, Florence, Italy
| | | | - Francesca Cazzato
- Legal Medicine, Department of Health Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paola D'Onofrio
- Responsible for the Unit of the Rose Code, Area of Emergency Rooms of Careggi Hospital, Florence, Italy
| | - Vittoria Doretti
- Head of Department Health Promotion and Health Ethics, Azienda USL Toscana Sud Est, Careggi Hospital, Florence, Italy
| | - Ilenia Bianchi
- Department of Health Science, University of Florence, Florence, Italy.,Department of Law, University of Macerata, Macerata, Italy
| | - Giuseppe Vetrugno
- Legal Medicine, Department of Health Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Oliva
- Legal Medicine, Department of Health Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vilma Pinchi
- Department of Health Science, University of Florence, Florence, Italy
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Bianchi IA, Focardi MB, Grifoni R, Raddi S, Rizzo A, Defraia B, Pinchi V. Dental identification of unknown bodies through antemortem data taken by non-dental X-rays. Case reports. J Forensic Odontostomatol 2021; 39:49-57. [PMID: 34999580 PMCID: PMC9343057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The dental radiographic comparison is one of the most reliable and scientifically accepted methods for body identification (ID). The heterogeneity between AM (ante mortem) and PM (postmortem) x-rays images continues to stand as an issue for the forensic odontologist. Casual dental findings on X-rays for investigation of other structures than teeth or maxillaries, could eventually be a relevant source of dental data for the ID especially when AM dental files or X-rays are lacking. Two cases are reported in which the body ID was achieved through the comparison of PM dental X-rays with dental images obtained by radiographies of other structures (e.g. X-rays of the skull or cervical spine). These cases highlight that these occasional dental findings might provide sufficient evidence for a body identification. In the collection of AM data of missing people, the collection of all available records and radiographies of the head, neck and chest should be carefully reviewed by forensic odontologists, seeking for any available dental data.
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Affiliation(s)
- I A Bianchi
- Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Italy
| | - M B Focardi
- Legal Medicine Unit, Careggi University Hospital, Florence, Italy
| | - R Grifoni
- Legal Medicine Unit, Careggi University Hospital, Florence, Italy
| | - S Raddi
- School in Legal Medicine, University of Florence, Italy
| | - A Rizzo
- School in Legal Medicine, University of Florence, Italy
| | - B Defraia
- Legal Medicine Unit, Careggi University Hospital, Florence, Italy
| | - V Pinchi
- Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Italy
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Haddish K, Kumar H, Raddi S, Chierto E, Di Vella G, Bogale A, Kidane E, Yizengaw A, Getaneh Y, Robino C. Y-chromosomal haplotype diversity for 27 STR loci in the Tigray population (Northern Ethiopia). Forensic Science International: Genetics Supplement Series 2019. [DOI: 10.1016/j.fsigss.2019.09.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ripullone F, Rivelli AR, Baraldi R, Guarini R, Guerrieri R, Magnani F, Pe Uelas J, Raddi S, Borghetti M. Effectiveness of the photochemical reflectance index to track photosynthetic activity over a range of forest tree species and plant water statuses. Funct Plant Biol 2011; 38:177-186. [PMID: 32480874 DOI: 10.1071/fp10078] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Accepted: 01/27/2011] [Indexed: 06/11/2023]
Abstract
In this study, we investigated the potential of the photochemical resistance index (PRI) to track photosynthetic activity under water stress conditions by measuring PRI, leaf fluorescence, the xanthophyll cycle and photosynthetic activity in different forest tree species subjected to progressive drought. The PRI declined with pre-dawn water potential and a significant relationship between PRI and the xanthophyll de-epoxidation state (DEPS) was observed, although with large interspecific variability in the sensitivity of PRI to changes in DEPS. For single tree species, a strong relationship was observed on either PRI light saturated photosynthesis or PRI maximum photochemical efficiency of PSII (ΔF/Fm'); a larger variability in both relationships was apparent when data from different species were pooled together. However, an improved correlation was shown only in the former relationship by plotting the ΔPRI (dawn PRI minus the midday PRI values). Thus, we conclude that PRI is able to provide a good estimate of maximum CO2 assimilation at saturating light and ΔF/Fm' for single tree species, despite the severe drought conditions applied. PRI should be applied more cautiously when dealing with multispecific forests because of confounding factors such as the strong interspecific differences in the initial value of PRI and in the sensitivity of PRI to changes in DEPS in response to drought.
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Affiliation(s)
- F Ripullone
- Department of Crop Systems, Forestry and Environmental Sciences, University of Basilicata, viale dell'Ateneo Lucano 10, 85100 Potenza, Italy
| | - A R Rivelli
- Department of Crop Systems, Forestry and Environmental Sciences, University of Basilicata, viale dell'Ateneo Lucano 10, 85100 Potenza, Italy
| | - R Baraldi
- Institute of Biometeorology, National Research Council (CNR), via Gobetti 101, 40129 Bologna, Italy
| | - R Guarini
- Department of Crop Systems, Forestry and Environmental Sciences, University of Basilicata, viale dell'Ateneo Lucano 10, 85100 Potenza, Italy
| | - R Guerrieri
- Department of Crop Systems, Forestry and Environmental Sciences, University of Basilicata, viale dell'Ateneo Lucano 10, 85100 Potenza, Italy
| | - F Magnani
- Department of Fruit and Trees, University of Bologna, via Fanin 46, 40127 Bologna, Italy
| | - J Pe Uelas
- Global Ecology Unit, Center for Ecological Research and Forestry Applications (CREAF), Center for Ecological Research and Forestry Applications, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - S Raddi
- Department of Agricultural and Forest Economics, Engineering, Sciences and Technologies, University of Florence, Via S. Bonaventura, 13 50145 Firenze, Italy
| | - M Borghetti
- Department of Crop Systems, Forestry and Environmental Sciences, University of Basilicata, viale dell'Ateneo Lucano 10, 85100 Potenza, Italy
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Affiliation(s)
- C Pichot
- INRA, Unité de Recherches Forestières Méditerranéennes, Avenue Vivaldi, 84000 Avignon, France.
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