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The "Urbino Charter" is a document aimed at promoting the wellbeing of the working person that the Olympus Observatory of the University of Urbino Carlo Bo and the Rubes Triva National Foundation, a joint body in the field of environmental hygiene, presented in Bilbao at a public conference in March 2023. The Charter has the objective of stimulating reflection on the issues related to prevention while drawing attention to the essential values for the effective protection of workers' health, safety and well-being. This commentary has the aim of presenting the 10 statements of the Chart, from a perspective of Occupational health and safety. [ABSTRACT FROM AUTHOR]

Background. Work-related stress represents a major health problem within most work environments and its rates of incidence are increasing as time goes by. Work-related stress is both detrimental for workers’ psychophysical health and costly to societies. Besides the direct medical costs that represent only a fraction of the total cost, data is either lacking or unreliable to properly estimate the economic impact of occupational stress. Methods. This paper reviews international studies and organisational reports in order to highlight occupational stress economic impact on an international level. Results. The study shows that work-related stress imposes an undeniable financial burden on worldwide societies. Findings show estimations that vary from € 54 million up to € 280 billion depending on the country. Results suggest that productivity loss due to absenteeism and presenteeism has a greater economic impact compared to the medical expenses. Discussion. Generally speaking, the costs of work-related stress, also according to Europe, impact both on employers and welfare systems, and from the point of view of prevention we should work hard to improve stress-management strategies. Conclusions. The discussion around this matter should be emphasized in order to properly address occupational stress and make implications for job redesign under the perspective that promoting and protecting workers’ mental well-being will benefit the individual and allow cost containment benefitting the collective as well. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is an ever-increasing disease and is defined as a "social disease" due to the significant economic damage it causes to the affected individuals and the community involved in its care. This paper presents the process of certification of diabetic disease and the application for invalidity in order to obtain welfare and economic benefits provided by law; it, also, describes the prescription process and the appropriateness of therapeutic prescription for the diabetic patient in terms of clinical-prescriptive appropriateness and economic-prescriptive appropriateness. Finally, it reports on the side effects of the most common antidiabetics, the off-label use of metformin and the physician's responsibilities in the light of the Gelli-Bianco law. [ABSTRACT FROM AUTHOR]

Background. Alcohol, drug consumption and polysubstance use are some of the most important causes of illnesses and mortality among adolescents, who have been identified as common users of these substances. Aim of this study was to assess and describe the current scenery of alcohol and other drugs consumption habits among a wide sample of Italian high school and university students. Methods. A cross-sectional study was carried out using an online survey. The questionnaire was developed and administered via an internet forum for middle school, high school and university students named "Skuola.net". The statistical analysis included descriptive statistics, univariate and multivariate analysis. Additive interactions were assessed by calculating the synergy index. Results. A total of 11,379 Italian students answered the questionnaire. The prevalence of alcohol drinkers was 34.2%; among these, 17.8% of the individuals showed unhealthy drinking behaviors (frequency of alcohol use of four times or more per week); 10.3% of individuals declared daily assumption of six or more glasses of alcohol. Concerning drugs, 15.7% of the responders classified themselves as illicit drug users, with cannabis getting the highest prevalence rates (6.9%). Finally, concerning alcohol, a synergistic effect was recorded for male and adult individuals (SI = 1.04); while concerning illicit drugs, a synergistic effect was found between male gender and older age (SI = 1.42), and between university students and male gender (SI = 1.10). Conclusions. This study gives an overview about the attitudes of a wide sample of Italian students concerning alcohol and drugs habits. These results are in line with evidences from the scientific literature and will be helpful for developing future prevention strategies towards this target population. [ABSTRACT FROM AUTHOR]

Working night shifts has been associated with negative mental health consequences such as depression, anxiety, and sleep problems. The objectives of this study were to determine the lifestyle behaviors (prevalence of nicotine, caffeine, cannabis, sleep-promoting medication, and alcohol use) and the association between job stress, sleep quality, anxiety, and depression among registered nurses working night shifts in the Canadian province of Saskatchewan in the COVID-19 era. Twenty-two registered nurses ranging from ages 25-65 that work permanent or rotating night shifts participated in an online survey from April 11th to July 15th, 2022. The results showed a strong positive association between sleep disturbance, and depression r (19) = 0.50, [p = 0.029, 95% CI, 0.06, 0.78]. A positive correlation was found between higher levels of reported anxiety and sleep disturbance r (19) = 0.69, [p = 0.001, 95% CI, 0.34, 0.87]. There was a positive correlation between depression and occupational exhaustion r (17) = 0.56, [p = 0.021, 95% CI, 0.10, 0.82]. Anxiety was significantly related to occupational exhaustion r (17) = 0.65, [p = 0.005, 95% CI, 0.24, 0.86] and depersonalization r (17) = 0.52, [p = 0.005, 95% CI, 0.06, 0.80], but not significantly related to personal accomplishment r (17) = -0.34, [p = 0.185, 95% CI, -0.70, 0.17]. In conclusion, a sample of Canadian nurses working night shifts in the province of Saskatchewan during the COVID-19 pandemic showed a significant positive relationship among sleep disturbance, anxiety, and depression. Furthermore, most nurses reported using at least one or more of the following substances: sleep-promoting medication, nicotine, alcohol, and cannabis. [ABSTRACT FROM AUTHOR]

Background. In the workplace, it is increasingly important to promote interventions to improve the work environment that can combine compliance with regulations related to worker health and safety protection with health promotion interventions. The objective of our study is to investigate the status of the implementation of various health management measures through questionnaires submitted to Occupational Physicians (OPs) and Prevention and Protection Service Managers (PPSMs). Methods. This study was conducted between September 2022 and November 2022. Healthcare professionals were invited to voluntarily answer the questions, administered through a Google form, of a standardized questionnaire (Cronbach's alpha=0.887) based on the study made by Hoge et al. (2019): the first part collected demographic information and the other four were relating to the state of implementation of interventions attributable to the Total Worker Health® approach. Results. 89 OPs and PPSMs were involved. The univariate and multivariate analysis shows that, overall, women and PPSMs have a higher degree of dissatisfaction related to various health management measures within companies; most workers are fairly satisfied with health and safety protection in the workplace; finally, according to healthcare professionals, aspects of primary prevention and work management/organization would need to be improved. Conclusions. This study shows that in Italian companies there is often no full application of Total Worker Health® principles. The affirmation of this approach, awareness should be raised, first and foremost, among employers, but also among prevention figures and consultants about all the benefits of Total Worker Health®: one among all, an 'economic' advantage. [ABSTRACT FROM AUTHOR]

Background. The aim of the paper was to perform an Italian version of the International Questionnaire of Physical Activity in the Elderly: IPAQ-EIT. Methods. Adults with age over 64 years with normal neurological status and without difficulty in ambulation were enrolled in opportunistic way and on voluntary basis in different Italian regions. Two independent researchers have translated the English version independently. The final IPAQ-EIT version was submitted twice, with an interval of one day between each administration (T0 and T1). McNemar's Test was used to assess the agreement between qualitative variables; Wilcoxon Signed Ranks Test and Spearman correlation coefficients were used for continuous data. Cronbach's alpha was used as a measure of the internal consistency. Results. Thirty-three questionnaires were collected at T0 and T1. 100% of response rate was obtained. The Cronbach's alpha at T0 was α= 0.79 and at T1 α= 0.84. The Spearman's coefficient reported significant associations (p<0.001) between the two administrations for all items. The test-retest analysis for two paired samples underlined for all items not significant differences. Conclusions. The IPAQ-EIT short form shown an acceptable consistency, feasibility to administer and easy to combine with other questionnaires. It is an additional valid measuring tool for physical activity levels in the elderly. [ABSTRACT FROM AUTHOR]

The present research focuses on the delicate and complex process of senilization of the population, being one of the most important anthropological and social problems of our time. These considerations lead us to examine not so much the aging process itself, but the relationship between the third age and society, focusing on the factors that promote or inhibit well-being and the relative perceptions that emerged in the sample. In this sense, an online questionnaire was administered, by email and by telephone message, over a period of approximately 10 months starting from March 2021 until December 2021. The questionnaire included multiple choice questions that produced clear data and simple analysis, arriving at an accurate analysis (qualitative and quantitative), on the topics of interest: the role of nutrition and sport in the over 65s, not only by the subjects in question, but also the considerations and perceptions of subjects belonging to different age groups with reference to the topics of interest relating to the third age. The sample results, allow us to identify the appropriate intervention strategies and policies useful for eradicating the stereotype that accompanied the concept of old age until a few years ago, making it synonymous with illness, loneliness, fragility and uselessness. Finally, today, we have freed ourselves from the role of "sedentary elderly" and motor activity in the third age is increasingly widespread and relevant as can be seen from the data analysis. This research is the result of a program that has been in place for several years now to combat the hypokinesis diseases, through physical movement and particularly by examples of appropriate lifestyles. This initiative was conceived and implemented by C.I.S.C.O.D. (Comitato Italiano Sport Contro Droga) and CO.NA.P.E.F.S. (Collegio Nazionale Professori Educazione Fisica e Laureati in Scienze Motorie), two C.O.N.I. well-deserving associations, and carried out as part of a larger "Survey on nutrition and culture over 65" project, proclaimed by Sport & Salute S.p.A. [ABSTRACT FROM AUTHOR]

Background. Climate change (CC) is the greatest threat to the health of the planet. The scientific community has established its connection to human activities and its role in emerging and premature diseases. Our study helps to understand how students of various backgrounds and academic fields retrieve information on CC and highlights the knowledge on the main causes and consequences of global warming and on the role of healthcare workers in the fight towards this threat. Methods. A cross-sectional study was performed through an online questionnaire administered to university students between January and December 2020. Univariable analyses were performed, Chi-square was calculated and multivariable analysis was used to investigate the relationship between the answers and socio-demographic variables. Statistical significance was set at a p-value of less than 5%. Results. More than 80% of the sample correctly identifies as major consequences of CCs the increase in Earth's temperature (95.0%), melting of ice caps (89.4%), rising sea levels (81.8%), and the more frequent occurrence of climate-related natural disasters. Across courses of study, the frequency on how CC is addressed differs (p<0.001): 31.5% of the students from the medical field reported the topic to be taught in class, compared to 49.0% from humanities and 63.4% from science and technology. Conclusion. The study shows that medical students are less prepared and less aware of the consequences and causes of CC than students in other faculties. Since CC will play a role in every aspect of patients' lives, barriers to health care will have to be overcome through the knowledge and skills acquired during undergraduate courses. [ABSTRACT FROM AUTHOR]

Context. In Europe, during an era of globalization in which traveling and studying abroad is becoming easier and more affordable, an open question remains on whether different European medical schools educate students with a dissimilar level of preparedness and/ or satisfaction. Objective. To develop and validate the EUropean Students' Preparedness and Satisfaction Questionnaire (EUSPSQ), a standardized European tool to assess preparedness and satisfaction in medical education. Materials and methods. 30 participants belonging to the 5th and 6th year of two different European medical schools (Sapienza University of Rome and Universidad Complutense de Madrid) participated in the validation of the study. A standard validation protocol that included item development, test-retesting, and a series of statistical validation analyses, was used. Feasibility, test-retest reliability, inter-item reliability were assessed quantitatively. Face validity was evaluated qualitatively by an expert professor in the field. Results. Test-retest and inter-item reliability were considered satisfactory for all the parts of the questionnaire. Part III and IV presented lower Cohen's kappa values, probably as a consequence of their inherent subjectivity. When one item in Part III was removed, the Cronbach's alpha values of both initial and 48h answers considerably increased (-0.355 to 0.713 and -0.202 to 0.808 respectively). We therefore decided to eliminate the question from the EUSPSQ. Internal and external validity were considered appropriate. The questionnaire was also feasible and viable to complete. Discussion. Preliminary findings indicate that the EUSPSQ can be a valid, viable and reliable questionnaire to measure preparedness and satisfaction of 5th and 6th year medical students across different European Universities. [ABSTRACT FROM AUTHOR]

Objectives: To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (JIA) cohort and to evaluate how therapeutic advances have changed the course of the uveitis. Methods: Analysis of a retrospective cohort study of consecutive JIA pediatric patients including JIA-associated uveitis (JIA-U) and comparison with a previous study in the same uveitis center assessed before the wide-spread of biological therapy. Results: The total of 49 JIA patients were analyzed, of whom 18 JIA-U, compared with a JIA-U past cohort of 66 patients. Systemic corticosteroids were used significantly less in the current JIA-U group (p = 0.008) than in the past one. JIA-U present cohort was on therapy more frequently with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) than the past group (p = 0.039), mostly treated with methotrexate (93.3%). Furthermore, a larger use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) was described in the current JIA-U group (p = 0.005) also associated with csDMARDs (p = 0.003). Adalimumab was used more (72.7%) in the present JIA-U cohort compared to a larger treatment with infliximab (61.5%) in the past (p = 0.005). Higher number of uveitis recurrences was observed in the previous cohort compared to the current one (p = 0.005). Fewer complications were described in this study than in the previous: posterior synechiae (p = 0.007), cataract (p < 0.001), band keratopathy (p < 0.001), and elevated intraocular pressure (IOP) (p = 0.047). Conclusion: Current therapies reduced the uveitis recurrences and ocular complications including cataract due also to the lower use of corticosteroids. The new close collaboration with the pediatric rheumatologic center in the same University has contributed to the care improvement and decrease of uveitis complications. [ABSTRACT FROM AUTHOR]

Neotropical birds are mostly parasitized by immature ticks and act as reservoir hosts of tick‐borne pathogens of medical and veterinary interest. Hence, determining the factors that enable ticks to encounter these highly mobile hosts and increase the potential for tick dispersal throughout migratory flyways are important for understanding tick‐borne disease transmission. We used 9682 individual birds from 572 species surveyed across Brazil and Bayesian models to disentangle possible avian host traits and climatic drivers of infestation probabilities, accounting for avian host phylogenetic relationships and spatiotemporal factors that may influence tick prevalence. Our models revealed that the probability of an individual bird being infested with tick larvae and nymphs was lower in partial migrant hosts and during the wet season. Notably, infestation probability increased in areas with a higher proportion of partial migrant birds. Other avian ecological traits known to influence tick prevalence (foraging habitat and body mass) and environmental condition that might constrain tick abundance (annual precipitation and minimum temperature) did not explain infestation probability. Our findings suggest that migratory flyways harbouring a greater abundance of migrant bird hosts also harbour a higher prevalence of immature ticks with potential to enhance the local transmission of tick‐borne pathogens and spread across regions. [ABSTRACT FROM AUTHOR]

Objective. The nursing coordinator plays a crucial role within health organizations. She/he represents the connection between organizational needs, clinical-care needs and company objectives. In order to be a nurse manager one must have acquired managerial characteristics, including strategic, relational and operational skills. Study design. In this regard, a wide-ranging review was carried out in order to analyze the managerial qualities by the nursing coordinators. Materials and Methods. The main scientific databases were consulted, such as PubMed, Scopus and Cochrane Library, analyzing all the systematic reviews present in the literature, published in English and Italian in the last ten years. 10 reviews were included in the article. Quality assessment of systematic reviews included in the research were evaluated using the AMSTAR checklist. Results. The coordinating nurse is the one who guides and directs the activities of other people in order to achieve company's objectives. Empowerment and leadership are the main qualities that a coordinator must possess. They represent essential characteristics for the creation of a work environment that guarantees high quality care. Conclusions. The coordinating nurse has a crucial role in this: she/he represents the focal point for the motivation of the group. Establishing a possible program of continuing education activities in healthcare directed to healthcare professionals can be an important way for reinforcing leadership aptitude. [ABSTRACT FROM AUTHOR]

Aim. To develop and test the effectiveness of an E-learning program for promoting physical activity (PA) and wellness among nurses. Background. Restrictions during the coronavirus (COVID-19) pandemic drastically changed many people's lives. Maintaining a healthy lifestyle is an everyday challenge faced by the general population. Nurses are one of the health care professionals who are typically well-educated in taking care of patients. There are studies that show that night shifts, extended shifts, and obesity have a correlation with the prevalence of acute low back pain among female nurses. PA is the key factor in the prevention and treatment of many chronic diseases, resulting in an improvement in the quality of Life. The impact of social media and technology on our lives is undeniable in the modern era. Design. This study will be a single-centre, single-blind, randomized controlled trial executed on an E-learning platform to provide the control and intervention groups with a distance learning program. Participants will be randomly assigned to either the control or intervention group. Participants in the control group will only sign up for module 1 of the PA modules, which only comprises information on PA and health promotion. On the other hand, the participants in the intervention group are expected to carry out 3 modules of exercises at home three days a week for a total duration of 8 weeks. The exercises will be performed at moderate intensity (5-6 on the Borg CR10 Scale). Ethical issues. This trial will comply with the declaration of Helsinki 1975, as revised in 2000. Informed written consent will be obtained from the participants. The Sapienza University of Rome, institutional ethics committee and review board approval will be requested for this study. Conclusion. Establishing an online PA program with good quality, such as a high level of convenience in access and use, simplified, easy to practice, and made available on social media, can minimize the difficulties faced previously in the implementation of an online PA program for nurses, and may enhance the health and wellbeing of many nurses in healthcare institutions. [ABSTRACT FROM AUTHOR]

Gelli-Bianco law (Law no. 24/2017) intervenes both in order to divide healthcare liability between the healthcare professional and the facility in which he/she exercises and to incentivize the latter to adopt an organizational model suitable for managing the risk associated with the provision of any healthcare service, including the information for consent. In fact, the healthcare facility must guarantee clear, complete and adequate information on the specific case, which, therefore, cannot consist of standard forms to be signed by the patient, under penalty of a flawed consent to treatment and consequent healthcare liability in the event of an adverse event. The regulation mandates that safety must be guaranteed through proper prevention tools and health care risk management, in conjunction with the most effective use of structural, technological and organizational resources available. It further spells out the obligation of health care professionals to contribute to risk prevention while administering health care procedures. For this reason, the consent information constitutes a source of risk for the responsibility of the healthcare provider and the Facility and it must necessarily be managed. Risk Management is the management tool that can allow the healthcare facility to improve the quality and safety of the services provided, optimizing the risk of adverse events through proper monitoring of the same. This paper will be published, following a special agreement, on the two journals "Igiene e Sanità Pubblica" and "La Clinica Terapeutica", in Italian and in English, in order to increase the diffusion to a wider audience. [ABSTRACT FROM AUTHOR]

Background. Adequate training in tobacco, nicotine dependence and treatment is lacking in Medical School education. With the rise in popularity of electronic alternatives to cigarettes, future physicians should also be provided with the more recent scientific evidence on these products during their undergraduate studies. We introduced an e-learning course for Medical School students and assessed its effectiveness of increasing knowledge on these topics. Methods. We developed 16 didactic modules divided in 3 courses: tobacco dependence (TDI), treating tobacco dependence (TDII) and electronic products and tobacco control (TDIII). The course was offered to 4th, 5th, and 6th year Medical School students in Italy. To assess learning outcomes, we examined the pre- to post-changes in knowledge scores associated with each course. Paired and independent samples t-tests were performed overall, and among smokers and nonsmokers separately. Results. A total of 1318 students completed at least one of the courses; 21% were self-reported smokers. A significant increase in knowledge was observed at the end of TDI (pre-course: 52.1±15.9, post-course: 79.9±13.5, p<0.001), TDII (pre-course: 52.5±13.0, post-course: 66.5±12.0, p<0.001) and TDIII (pre-course: 52.2±15.3, post-course: 76.1±17.7, p<0.001). Smokers showed significantly lower improvements compared to non-smokers. Conclusions. The e-learning course was effective in increasing knowledge about tobacco dependence, treatments, and electronic nicotine products in advanced medical students. Given the fundamental role for healthcare practitioners in encouraging and assisting people in quitting smoking, e-learning may be a useful tool in providing up-todate and standardized training in the area during Medical School. [ABSTRACT FROM AUTHOR]

Purpose: Labour market marginalisation (LMM), i.e. long-term unemployment (LTU), long-term sickness absence (LTSA) and disability pension (DP), among young individuals with common mental disorders (CMDs) are a challenge for the welfare system, and refugees and non-refugee migrants seem particularly vulnerable. The aim was to investigate the risk of LMM in young adults with CMDs among refugees and non-refugee migrants compared to Swedish-born individuals and the role of country of birth, duration of residence and age at arrival. Methods: A prospective cohort study was conducted including young adults (19–30 years) with inpatient or specialised outpatient healthcare due to CMDs and/or antidepressant prescriptions during 2009 (N = 69,515). Cox regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals for the risk of LMM during 2010–2013. Results: Both refugees and non-refugee migrants had a higher risk of LTU compared to Swedish-born individuals (HR refugees: Africa: 2.4; Asia: 2.2; Europe outside EU25: 1.6; South America: 1.4) with highest estimates in refugees from Afghanistan and Syria. Refugees from Africa and Asia had a lower risk of LTSA compared to Swedish-born individuals (HR: 0.6 and 0.7, respectively), particularly refugees from Afghanistan and Iraq. Especially among refugees, a longer duration of residence and a younger age at arrival were associated with a lower risk of LTU. Conclusions: The risk of LTU among refugees and non-refugee migrants was higher and the risk of LTSA was lower, compared to Swedish-born individuals. Duration of residence and age at arrival had an influence on the risk of LTU, particularly among refugees. [ABSTRACT FROM AUTHOR]

Background. During the most difficult phases of the Covid-19 health emergency, when access to the usual work location was not allowed due to the constraints related to the pandemic, Smart Working enabled business continuity in the face of the ongoing health emergency. Modern technology serves a new way of working, allowing workers to effectively manage their professional and personal spheres in a world that increasingly requires them to optimize their time. The main objective of this research is to validate a Smart Working questionnaire administered to healthcare workers. Methods. The questionnaire, reported in Annex I, consisting of 30 questions and submitted electronically through Google Forms, was administered in Italian to healthcare personnel of the Teaching hospital Umberto I and Sapienza University of Rome between September and October 2020. The questionnaire analyzed the characteristics of the sample and investigated the perception and attitude of healthcare personnel towards seven different aspects of Smart Working. A descriptive analysis of the sample examined and an internal consistency analysis was performed through the use of the SPSS (Statistical Package for Social Science) program version 25.0. Cronbach’s alpha statistical indicator, which measures reproducibility over time, reliability, and homogeneity of questions, was used for the analysis. Results. A total number of 53 health care providers answered the online questionnaire. The majority of the respondents were female (60.4%); 73.6% of respondents reported having a college degree or a higher educational level. The analysis showed an overall standardized Cronbach’s Alpha of 0.709, which corresponds to a good reliability. In the items analysis, the alpha value ranged from a minimum of 0.652 to a maximum of 0.756. Conclusions. The present tool is adequate to investigate attitudes towards Smart Working among healthcare workers. [ABSTRACT FROM AUTHOR]

Background. In 2015, 37% of Italian adolescents reported to have smoked in the past month. The study aimed to evaluate smoking behaviour on the school premises and to study the influence of the school environment on student smoking. Methods. Around 900 junior high-school students, aged 11-13 years old completed an online survey in November 2016 and May 2017. Descriptive statistics, univariate analyses and binary logistic regression were performed to analyse data. Results. Between 40 - 50% of students indicated that students and staff smoke on the school premises. Students who witnessed students (OR: 3.48 (2.20 - 5.50)) and school employees (OR: 3.17 (1.97 - 5.10)) smoking were more likely to be a smoker. Conclusion. Although laws making it illegal to smoke on the school ground are in place, in Italy, its enforcement is sloppy. To tackle adolescent smoking effectively, policymakers are advised to enforce smoking restrictions and to verify these are respected. [ABSTRACT FROM AUTHOR]

Having regard to the increasing attention to the issue of safety and health of patients and workers by low, the hypothesis that this topic will be the growing trend in the next years does not seem to be manifestly unfounded. For this reason, it is wise for healthcare professionals to already be aware that any violation of the interests underlying the legislation in question entails a ruling on civil and/or criminal liability. It is therefore necessary to identify the most suitable means to prevent undue harm occurring, partly to exempt healthcare professionals and hospitals from compensation costs, thereby providing them with recourse to insurance coverage. Healthcare facility organisations must adopt Risk Management techniques as a tool to simultaneously guarantee the effectiveness of health services (in this case), the efficiency of the management economy, and finally compliance with all legally required precautions. This will relegate the occurrence of an adverse event to remote and unpredictable hypotheses, thus guaranteeing useful recourse to insurance coverage to compensate any harm that does occur. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose. Retinal Vein Occlusion (RVO) is a thrombotic process affecting retinal veins. The purpose of this research is to study demographic characteristics and prevalence of cardiovascular comorbidities among subjects affected by RVO. In addition, authors explore the role of each variable in determining occlusion type and severity. Subjects, materials and methods. This was a prospective observational study recruiting subjects affected by RVO and secondary macular edema. Exclusion criteria included pre-existing macular edema, recent ocular surgery (<6 months), pregnancy, diagnosis other than RVO, diabetes mellitus type I, any systemic pathology that significantly reduced life expectancy. Each participant was studied through a comprehensive medical history, cardiovascular assessment, blood testing, ocular exam, and macular OCT imaging. Results. A total of 145 eyes, 145 participants, thereof 80 males (55%) and 65 females. (45%) Mean age: 62.5 ± 14.3 SD. 61 eyes (42%) were affected by CRVO and 84 eyes (58%) by BRVO. No statistically significant differences were noted between genders. Hypertension was very prevalent (63%). Dyslipidemia was more associated with BRVO (p = 0.044). Subjects with hypertension had a mean central macular thickness (CMT) of 643 µm against a mean of 489 µm of those without hypertension. (p < 0.05). No other variable was associated with macular edema severity. Conclusions. Older age and hypertension are strong risk factors for RVO. Dyslipidemia was strongly associated with BRVO. (p=0.044) Hypertension was not only associated with RVO incidence, but also with its severity. In fact, hypertensive subjects had significantly worse macular edema. [ABSTRACT FROM AUTHOR]

Introduction. Uveal melanoma is the most common intraocular tumor in the adult population. It can affect any part of the uveal tract: the iris, ciliary body, and choroid. Historically, enucleation has been the mainstay of treatment for primary melanoma. In the last decade, however, radiotherapy has acquired an increasingly important role and has now become our first-line modality. However, it is still widely debated what is the most effective radiotherapy technique for this tumor. Purpose to perform a literature review on the utility of radiotherapy for primary ocular melanoma and determine the most effective radiotherapy technique. Materials and Methods. We included all systematic and narrative reviews on the topic, published between September 2007 and November 2017 on PubMed and SCOPUS. Two independent reviewers assessed the eligibility criteria for each article using the PRISMA checklist. The methodological quality of narrative and systematic reviews was evaluated with the INSA and AMSTAR checklists, respectively. Results. Our study analyzed a total of 23 studies, including 18 narrative reviews and 5 systematic reviews. Radiotherapy with Brachytherapy, Proton Therapy, SRS/SRT with gamma knife and cyber knife, are the most common choices for the treatment of primary ocular melanoma. These techniques allow for excellent lesion spread control, eye, and vision conservation, and improve overall patients' quality of life. Among the narrative reviews, the highest INSA score was 5/7, the lowest 2/7, the mean was 3.83/7 and median was 4/7. Among the systematic reviews, the highest AMSTAR score was 9/12, the lowest 4/12, the mean 5.6/7 and median 4/7. Conclusion. The number of studies available on this topic is scarce. Among those published, the methodological quality is modest, as assessed with the INSA and AMSTAR checklists. As a result, we are not able to determine what the most effective radiotherapy technique is. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Several tapered stems with similar geometry and extensive hydroxyapatite coating have recently been introduced. It is not clear, however, whether they share the same design or whether they exhibit any difference that might affect their clinical performances. In this study, we analysed five tapered stems fully coated with hydroxyapatite to establish whether they exhibit similar geometric features and may therefore be used indifferently when a cementless stem is indicated.Methods: The length of the stem, the coronal and sagittal diameters, the length of the stem shoulder and the metadiaphyseal angle were measured. The ratio between the proximal and distal coronal diameters of the stem and that between the proximal and distal cross-sectional areas were calculated as a flare index and tapered index, respectively.Results: The proximal coronal diameter ranged between 24.9 and 28 mm in the smaller size and between 34 and 38.4 mm in the largest sizes. The proximal sagittal diameter ranged between 10.2 and 11.8 in the smallest size and between 14.4 and 17.2 in the largest. A significant difference was found between stems of different brands in the flare index, tapered index, length of stem shoulder and metadiaphyseal angle.Conclusions: Lookalike tapered stems with extensive HA coating actually exhibit significant differences in several geometric features potentially affecting their clinical performances. As a result, these stems should not be used indifferently, but rather they should be selected on the basis of the femoral morphology of the operated patient. [ABSTRACT FROM AUTHOR]

Background and aim. Healthcare workers and Biomedical students are continuously exposed to biological risk in their clinical practice. The objective of this study was to evaluate the validity and reliability of an Italian questionnaire on the knowledge and perception of biological risk in Biomedical students at the beginning of their professional training. Material and methods. An electronic questionnaire was administered to students attending the second semester of the first year of Biomedical Courses at Sapienza University of Rome. The questionnaire consists of 40 questions divided into five sections collecting sociodemographic data, health status and level of knowledge and perception of biological risk. The statistical analysis was performed with Statistical Package for Social Sciences (SPSS) version 25. Results. A total of 309 individuals answered the online questionnaire, with a response rate of 83.5%. The analysis of internal consistency was performed by two dichotomous variables that measured the knowledge level on hygiene behaviour and gloves use. The analysis showed a standardized Cronbach's alpha equal to 0.765, corresponding to a good reliability. A better reliability was found out among physiotherapy and medical students, with a Cronbach's alpha equal to 0.944 and 0.881, respectively. Regarding vaccines, 97.7% of the sample was given a Hepatitis B vaccination and 98.7% of students consider vaccinations essential for healthcare workers. Conclusion. Results of Cronbach's alpha showed a good reliability of the questionnaire. First-year Biomedical students may be exposed to occupational biological risk mainly because of their inexperience. A training educational path should be implemented in order to acquire competences, knowledge, attitudes and practical skills, correct behaviors and a personal and professional responsibility. [ABSTRACT FROM AUTHOR]

Background. stroke is the most common cardiovascular disorder after heart disease and one of the major causes of death and disability. Mediterranean diet has proven to be an effective means to prevent cardiovascular diseases and may contribute to the prevention of stroke. This overview aims to analyze all reviews that examine the association between Mediterranean diet pattern and stroke. Methods. we conducted a literature search on PubMed and Scopus databases, using the keywords "Mediterranean diet" and "Stroke". All studies were selected evaluating the association between the Mediterranean diet and the prevention of stroke and only systematic reviews, meta-analysis and narrative reviews were included. Results. 25 eligible articles were included (16 narrative reviews, 9 systematic reviews, 6 systematic reviews with meta-analyses). The authors stated that Mediterranean diet may be a useful means of preventing stroke, especially the 6 meta-analyses highlighted that high adherence to Mediterranean diet was protective against stroke, with a relative risk ranging from 0,64 (95% CI 0,48-0,88) to 0,90 (95% CI 0,87-0,93). Moderate adherence has not shown significant results. Conclusions. a high adherence to the Mediterranean diet is inversely associated with stroke risk, and can modify the costs of its management, therefore the prevention policies should implement adherence to this healthy diet. [ABSTRACT FROM AUTHOR]

Background: Colonic J pouch reconstruction has been found to be associated with a lower incidence of anastomotic leakage than straight anastomosis. However, studies on this topic are underpowered and retrospective. This randomized trial evaluated whether the incidence of anastomotic leakage was reduced after colonic J pouch reconstruction compared with straight colorectal anastomosis following anterior resection for rectal cancer. Methods: This multicentre RCT included patients with rectal carcinoma who underwent low anterior resection followed by colorectal anastomosis. Patients were assigned randomly to receive a colonic J pouch or straight colorectal anastomosis. The main outcome measure was the occurrence of major anastomotic leakage. The incidence of global (major plus minor) anastomotic leakage and general complications were secondary outcomes. Risk factors for anastomotic leakage were identified by regression analysis. Results: Of 457 patients enrolled, 379 were evaluable (colonic J pouch arm 190, straight colorectal arm 189). The incidence of major and global anastomotic leakage, and general complications was 14·2, 19·5 and 34·2 per cent respectively in the colonic J pouch group, and 12·2, 19·0 and 27·0 per cent in the straight colorectal anastomosis group. No statistically significant differences were observed between the two arms. In multivariable logistic regression analysis, male sex (odds ratio 1·79, 95 per cent c.i. 1·02 to 3·15; P = 0·042) and high ASA fitness grade (odds ratio 2·06, 1·15 to 3·71; P = 0·015) were independently associated with the occurrence of anastomotic leakage. Conclusion: Colonic J pouch reconstruction does not reduce the incidence of anastomotic leakage and postoperative complications compared with conventional straight colorectal anastomosis. Registration number NCT01110798 (http://www.clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

Background. The nicotine market has rapidly evolved with the emergence of newer forms of smoking device that have been expanded worldwide, such as electronic cigarettes (eCig) which heat a solution (e-liquid) to create vapour and heat-not-burn (HNB) tobacco products, which heats tobacco at a temperature below the point of combustion. Their use is increasing at an alarming rate; it is believed it will surpass the use of traditional cigarettes in next 5 years, mostly among neversmokers and young people. Objective. There are not many studies investigating knowledge and behaviour about heat tobacco products (HTP) among teenagers, so the aim of this study is to validate the SECRHET questionnaire (Smoking E-CigaRette and HEat-noT-burn products) on knowledge and behaviour on cigarette and HTP among youth. Methods. The study was conducted in February and March 2019 inside Sapienza University of Rome and high school Giulio Cesare of Rome. A self-administered anonymous questionnaire was performed to investigate smoking habits and measures knowledge about HTP among Italian teenagers. Outcomes. A sample of 60 students took part in the validation of the questionnaire. The overall Cronbach's alpha was 0,635, corresponding to a sufficient reliability. Conclusion. There is little or no data on consumption or perceptions of HTP products among youth and evidence suggests the usefulness of a standardized and validated questionnaire available to monitoring of awareness, interest in trying and prevalence of use of these novel products among young people. [ABSTRACT FROM AUTHOR]

Purpose. Hypokinesia is the fourth cause of endemic death in the world. The prevalence of obesity, caused by hypokinesia, in the world continues to increase and it is the main risk factor of chronic diseases. Our aim was to evaluate the effectiveness of curves program and High- Intensity Interval Training (HIIT) in healthy women. Methods. The study design is a non-randomized clinical trial. Eighty women with age between 30 to 40 years (who train 3/4 times a week) participated over a period of six months. They were allocated into a "Curves" program group (n = 40) and a "High-Intensity Interval Training" group (n = 40). BMI, body fat, the fat mass percentage was calculated by OMRON body fat 306 TM at baseline and the end of the intervention. Results. the results between high-intensity interval training and curves show that curves scores were significantly lower among Interval training. after 6 months the most impact was on "Abdomen loss "in Curves Group Mean(SD) = -4.48(1.70). According to the multivariate analysis, we can say that for all the dependent variables Weight loss -0.320 (<0.001), Trunk loss -0.376 (<0.001), Abdomen loss -0.276 (<0.001), Hip loss -0.302 (<0.001), Lower arm loss -0.248 (0.003) and Fat mass loss -0.153 (0.061) the curves group shows significant results in comparison with the high-intensity interval training group (p < 0.001) while the civil status is significantly associated with only "Upper arm loss" variable (ß = -0.357; p <0.001). Conclusions. This "Curves" program improved strength muscles, loss of fat and fat mass reduction more than High Intensity Interval Training. [ABSTRACT FROM AUTHOR]

Background and aim. Climate Change (CC) is a worldwide concern with important consequences for Public Health. A more sustainable and responsible way of living is necessary in order to reduce CC consequences, and adequation to this is directly related to risk perception and knowledge about the phenomenon. The aim of this study was to validate a questionnaire to measure the knowledge of Italians on CC and its consequences. Material and methods. The questionnaire was administered online to high school students, their parents and teachers that were participating to a meeting at Sapienza University. The questionnaire contained a sociodemographic section and 19 questions on causes and consequences of CC and ways to fight it. The statistical analysis was performed with Statistical Package for Social Sciences (SPSS) version 25. Results. Sixty-four individuals answered the online questionnaire. The analysis of internal consistency was performed by 12 dichotomous variables that measured the knowledge level on CC. The analysis showed a standardized Cronbach's alpha equal to 0.39, corresponding to a low reliability. When females were excluded, the alpha value rose to 0.497, and ascended to the reliable value of 0.639 when refining the selection of the included questions. Conclusion. The Cronbach's alpha value found showed a low reliability but achieves acceptable levels when considering only males and excluding some of the initial questions. Future studies should be performed in order to highlight the reliability of this tool to assess the knowledge about CC among the population. [ABSTRACT FROM AUTHOR]

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Aims. The aim of the study was to investigate the frequency, type, causes and consequences of violence and aggression experienced by Emergency Department workers during their interactions with patient, their relatives or companions and whether the phenomenon of violence at work is a specific risk factor predicting stress and possible stress related pathologies in emergency health workers. The study proposes a model of effective intervention for the prevention and management of violence and stress. Methods. A cross-sectional retrospective study was performed with a sample of 323 healthcare workers at Department of Emergency and Acceptance of Level II and the Psychiatric Services of Diagnosis and Care of the University Hospital Policlinico Umberto I, in Rome, Italy, between June 2016 and February 2017. Data collection was conducted by a psychiatrist by means of a questionnaire method administered to each participant and by carrying out individual interviews. The two questionnaires used, both the Health Violence Questionnaire (QVS) and the Workers' Stress Perception Questionnaire (SPQR) were designed ad hoc, after some test sessions intended for the creation of their content. Results. Eighty-seven percent of emergency healthcare workers experienced workplace violence by patients or their relatives. More than half of healthcare workers reported multiple consequences on their emotional sphere, in particular female healthcare professionals and all those who have suffered frequent incidents of violence. Regarding the effects on lifestyle, one third reported an increase in consumption of tobacco, food and sleep disorders and changes from social relationships to social isolation and avoidance of some places. More than one third of healthcare workers reported consequences on their well-being and health, especially the female workers. Distress was associated with frequent workplace violence. Healthcare workers who experienced frequent violence indicated lack of support from hospital administration and ED management as barriers to reporting workplace violence. Conclusions. The study confirms the diffusion of the workplace violence by patients and/or their relatives against the emergency healthcare professionals, related to the gender, the professional qualification, the role in the organization and the workplace. Almost all male and female healthcare workers reported they had suffered the effects on lifestyle, working habits and wellbeing and health following the workplace violence. Precipitating factors to violent incidents identified by healthcare professionals are consistent with the research literature. Commitment from hospital administrators, ED managers and hospital security is necessary to facilitate improvement and ensure a safer workplace for ED healthcare workers. Our study emphasizes the importance of analyzing, in addition to general job demands, the specific job demands such as the phenomenon of violence, considered a key risk factor, predictor of stress and possible mental disorders in healthcare workers operating in high-risk environments. This study confirms the importance of application of the modified model by Brough and Biggs of integrated multidimensional intervention on the prevention and management of workplace violence and work stress and shall be implemented on all three levels: individual, organizational and situational. The study also highlights the need to implement support strategies for the victims of violence. [ABSTRACT FROM AUTHOR]

Introduction. The AHRQ Quality Indicators (QIs) were created in order to both identify the performance and to track the improvement of patient safety. Patient Safety Indicator 12 (PSI12) is relative to the risk of Post Operatory Pulmonary Embolism or Deep Venous Thrombosis (PO DVT/PE). This pilot study has three main objectives. Firstly, to perform an analysis of the performance of different hospital wards by using administrative data; secondly, to analyze defects in the process that led to the occurrence of the adverse event; thirdly, reviewing the single PO DVT/PE. Methods. Data were extracted from a Hospital Information data flow (SIO) and compared to Clinical Discharge Record. PSI12 estimates were computed before and after the screening. Control Charts allowed the static analysis of performance between different hospital wards in 2014. The Ishikawa diagram was drawn for the analysis of the underlying causal process. Results. The number of PSI12 cases provided by DRGs through SIO data flow decreased from 45 to six after the comparison with the correspondent clinical records. Four clinical records provided full information allowing the analysis of process. The Ishikawa Diagram identified the defects in the process of prophylaxis that resulted into a PO DVT/PE. Discussion. The clinical records screening revealed a lower incidence of PO DVT/PE with respect to the DRGs statistics. Overall the PO DVT/PE occurrence in 2014 fell into the control limits, although the result could be undermined by the low quality of clinical records compilation. The failure in the prophylaxis procedure was imputable to pitfalls in the health care management and to the individual attitude towards patient safety procedures. In conclusion, the reliability and validity of administrative data in monitoring quality and safety are worthy to be explored in the context of further validation studies. [ABSTRACT FROM AUTHOR]

Challenging times [ABSTRACT FROM AUTHOR]

Little is known about the Covid-19 transmission through ocular tissue, and more research needs to be carried out in order to confirm its ability to infect ocular tissue and its pathogenic mechanisms. Covid-19 may be detected in the tears and conjunctival secretions in novel coronavirus pneumonia patients with conjunctivitis. This case report shows a severe viral conjunctivitis in a patient diagnosed with Covid-19 on the Diamond Princess ship, characterized by both red, irritated and swollen eyes, with transparent serous secretions, conjunctival chemosis, pseudomembranes of fibrin and inflammatory cells on the tarsal conjunctiva accompanied by preauricular lymph nodes and enlarged submaxillaries. [ABSTRACT FROM AUTHOR]

BACKGROUND: Due to improvements in breast cancer diagnosis and treatment, the healthcare system faces a growing number of cancer survivors. Breast cancer survivors experience many difficulties when returning to work, including discrimination at work and lack of support by employers and colleagues. OBJECTIVE: To point out the knowledge in literature up to date about return to work (RTW) after breast cancer, the factors influencing it and the interventions to facilitate it. METHODS: A literature search was conducted in January 2017 using the databases Medline (PubMed) and Scopus. Studies were included if they analyzed the problem of RTW in women treated for breast cancer. RESULTS: Twenty-six articles met the inclusion criteria. The studies were divided into four themes: factors facilitating or impeding RTW; interventions to enhance RTW; lived experiences of RTW; economic aspects related to cancer survivors and RTW. CONCLUSIONS: The heterogeneity of the interventions suggests the need for a better definition of the concept of RTW. To compare interventions, studies should use a rigorous approach and better outcome measures should be identified to evaluate RTW. [ABSTRACT FROM AUTHOR]

Backgrounds: Imbalance in elderly is a common problem strictly related to fall.Aims: This study investigates the possibility that a new protocol based on the focal mechanical muscle vibration may improve balance and stability in elderly.Methods: Pre-post non-randomized clinical trial has been used. Patients referring postural disequilibrium with negative vestibular bed-side examinations have been treated with focal muscle vibration applied to quadriceps muscles and evaluated before and immediately after therapy and after 1 week and after 1 month with postural stabilometric examination and with an inertial measurement units during the time up and go test.Results: Stabilometric analysis showed statistically significant differences in both the area (p = 0.01) and sway (p < 0.01) of the center of pressure during the close eyes tests. Moreover, the global time of the time up and go test was reduced (p < 0.05) and the rotation velocity was increased (p < 0.01).Conclusions: The findings confirm the beneficial role of focal muscle vibration in elderly patients improve postural stability and mobility. [ABSTRACT FROM AUTHOR]

Background: There is limited knowledge regarding psychiatric healthcare utilization around the time of granting disability pension (DP) due to common mental disorders (CMD) among immigrants and if this is related to social insurance regulations. The aim was to evaluate patterns of psychiatric healthcare utilization before and after DP due to CMD among immigrants and natives. A second aim was to evaluate if such patterns differed before and after changes in social insurance regulations in Sweden in 2008. Methods: All 28 354 individuals living in Sweden with incident DP due to CMD, before (2005-06; n = 24 298) or after (2009-10; n = 4056) changes in regulations of granting DP, were included. Patterns of psychiatric in- and specialized outpatient healthcare utilization during a 7- year window around DP granting were assessed by Generalized Estimating Equations estimating multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results: Prevalence rates of psychiatric inpatient care were comparable among immigrants and natives, lower in non-Western immigrants (Africa, Asia and South-America). Three years after DP, non-Western immigrants in comparison to natives and Western immigrants had a stronger decrease in inpatient psychiatric healthcare: OR 0.48 (CI 0.38-0.62), 0.76 (0.70-0.83) and 1.01 (0.76-1.34), respectively. After 2008, a strong reduction in outpatient psychiatric healthcare after DP granting was observed, similarly in immigrants and natives. Conclusions: Non-Western immigrants showed a different pattern of inpatient specialized healthcare after DP granting in comparison to natives. After changes in social insurance regulations, the decline in outpatient psychiatric healthcare following DP granting was comparable in immigrants and natives. [ABSTRACT FROM AUTHOR]

Introduction. The error in medicine is always the subject of debate in the scientific debates. The purpose of this study is to evaluate the degree knowledge, attitudes and behaviors of health workers towards the error in the health sector. Methods. A survey was carried out involving 435 health professionals working in health facilities of the Lazio region, of which 312 females (71%) and 123 males (28%) with an age between 21 and 68 years. A structured questionnaire was administered for investigating the experiences and opinions about the errors found in medical practice, the causes underlying them and the mistakes that should never be committed. Data were collected, stratified by sex, age, marital status, year of graduation, years of service and the workplace (medical or surgical). The statistical significance was set at p=0.05. Results. The 5 errors found more frequently in the clinical practice by health professionals were as follows: errors related to the request for examination (60.9%); errors in the collection of samples (37.5%); errors relating to the delivery of the reports (35.2%); errors due to reporting of examinations (31.7%); errors of history (29.2%). The five cases considered to be the most frequently responsible for such errors were: disorganization (52%); fast (46.4%); tiredness due to excessive workloads, stress (44.6%); negligence and carelessness (41.6%); inattention (41.1). With regard to the errors that you should never commit they were more frequently: exchange of patient or misidentification of the patient (49.2%); administration errors of therapies or medications (47.6%); errors related to surgery (41.6%); errors of prescription therapies or medications (39.3); errors in the reporting of exams (33.6%). Conclusions. The results of this study shows the importance of a culture of error in medicine among healthcare professionals, those who have already gained practical experience in health care and therefore better able to perform a critical analysis and evaluation of the errors that occur every day. The continuous training of health professionals is fundamental for promoting patient safety and quality in the healthcare sector. [ABSTRACT FROM AUTHOR]

Introduction: Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk.Purpose: The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls.Methods: Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h “weighted” Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements.Results: Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P < 0.01) and average real variability (P < 0.05) of systolic blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P < 0.001). A positive correlation of serum calcium and parathyroid hormone with 24-h-average real variability of systolic BP was observed in the entire primary hyperparathyroidism patients group (P = 0.04, P  = 0.02; respectively).Conclusion: Systolic blood pressure variability is increased in normotensive patients with primary hyperparathyroidism and is reduced by parathyroidectomy, and may potentially represent an additional cardiovascular risk factor in this disease. [ABSTRACT FROM AUTHOR]

Background: In several countries, immigrants have higher disability pension (DP) rates than natives. Reasons for this are poorly understood. The aim of this study was to investigate if the risk of diagnosis-specific DP differed in first, second, and second/intermediate generation immigrants compared to natives, in general and across regions of birth, and stratified by age.Methods: A population-based prospective cohort study of all 3,507,055 individuals aged 19-50 years and living in Sweden in 2004 with a 6-year follow-up period. Hazard ratios (HR) and 95% confidence intervals (CI) for mental and somatic DP were estimated by Cox regression for first, second, and second/intermediate generation immigrants compared to natives, across regions of birth and stratified by age.Results: After multivariate adjustment, HRs for both mental and somatic DP were higher at follow-up in the first generation compared to natives: mental HR 1.17 (CI 1.12-1.22) and somatic 1.15 (1.09-1.22) for individuals <35 years; 1.74 (1.69-1.79) and 1.70 (1.66-1.74) ≥35 years (median), respectively. Immigrants born in Europe outside EU25, and countries outside Europe had particularly elevated HRs. Also in the second generation, HRs were higher in mental 1.29 (1.21-1.37) and somatic DP: 1.30 (1.19-1.42) in those <35 years; and 1.18 (1.10-1.27); and 1.10 (1.03-1.17) for those ≥35 years, respectively. Among second generation immigrants there were no strong differences in HRs between regions of birth.Conclusions: Compared to natives, the risk of DP was higher in first and second generation immigrants. Higher estimates were seen for immigrants from Europe outside EU25 and from the rest of the world in the first generation. No considerable differences in estimates regarding mental or somatic DP diagnoses were found. [ABSTRACT FROM AUTHOR]

Healthcare workers, since the beginning of the COVID-19 pandemic, have been universally recognized as especially susceptible, with infection risks higher than the general population. Therefore, it is important to apply infection prevention and control measures in healthcare institutions to limit infections associated with the provision of healthcare services. In this contest, contact tracing, in fact, is an essential public health measure to fight the COVID-19 pandemic, with active case finding and testing, and physical distancing. Globally, new weekly cases and deaths are decreased, but WHO emphasizes that cases and deaths should be interpreted with caution because several countries have been progressively changing COVID-19 testing strategies, resulting in lower overall numbers of tests performed and consequently lower numbers of cases detected. Health personnel, therefore, work at a highrisk department and this has been associated with a 2.13 times higher risk of COVID-19 compared to the general departments of any hospital and, if the healthcare workers had inability to continue working and if there was the possibility of hospitals turning into sources of infection, it could be an interruption in healthcare services. A coordination with the system of surveillance is important that remains in the hospital in order to fight COVID-19 and help restructure the response in the light of detected transmission and guarantee safe hospital care. [ABSTRACT FROM AUTHOR]

Hand functioning is often impaired in patients with Systemic sclerosis. Neuromuscular Taping is a novel application of tape able to improve functioning. The aim of this study was to evaluate the possible role of this application in the hand functionality of patients with Systemic sclerosis. Women with a diagnosis of SSc has been recruited and evaluated using different scales before and immediately after NMT application and after one, three and six months. Fifty-three women has been evaluated and Cochin Hand Functional Disability scale, Hand Mobility in Sclerodermia, Modified Rodnan Skin Score and Dreiser Algo - Functional Index scores showed statistical significant differences during all the period; moreover a reduction of pain and Raynaud Phenomenon's and an improvement of finger flexion has been observed. Application of NMT in patients with Systemic sclerosis have showed beneficial effect and future studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Background: Higher survival rates for breast cancer patients have led to concerns in dealing with short- and long-term side effects. The most common complications are impairment of shoulder functions, pain, lymphedema, and dysesthesia of the injured arm; psychological consequences concern: emotional distress, anxiety, and depression, thereby, deeply impacting/affecting daily living activity, and health-related quality of life.Objective: To perform a systematic review for assessing the efficacy or effectiveness of interventions aiming at improving health-related quality of life, return to daily activity, and correct lifestyles among breast cancer patients.Methods: A literature search was conducted in December 2016 using the databases PubMed and Scopus. Search terms included: (counseling) AND (breast cancer) AND (quality of life). Articles on counseling interventions to improve quality of life, physical and psychological outcomes were included.Results: Thirty-five articles met the inclusion criteria. The interventions were grouped in five main areas: concerning lifestyle counseling interventions, related to combined interventions (physical activity and nutritional counseling), physical therapy, peer counseling, multidisciplinary approach, included psychological, psycho-educational interventions, and cognitive-behavior therapy (CBT). Exercise counseling as well as physical therapy are effective to improve shoulder mobility, healing wounds, and limb strength. Psychological therapies such as psychoeducation and CBT may help to realize a social and psychological rehabilitation.Conclusion: A multidisciplinary approach can help in sustaining and restoring impaired physical, psychosocial, and occupational outcomes of breast cancer patients. [ABSTRACT FROM AUTHOR]

The eradication of tuberculosis, brucellosis and leucosis in cattle has not yet been achieved in the entire Italian territory. The region of Lazio, Central Italy, represents an interesting case study to evaluate the evolution of costs for these eradication programmes, as in some provinces the eradication has been officially achieved, in some others the prevalence has been close to zero for years, and in still others disease outbreaks have been continuously reported. The objectives of this study were i) to describe the costs for the eradication programmes for tuberculosis, brucellosis and leucosis in cattle carried out in Lazio between 2007 and 2011, ii) to calculate the ratio between the financial contribution of the European Union ( EU) for the eradication programmes and the estimated total costs and iii) to estimate the potential savings that can be made when a province gains the certification of freedom from disease. For the i) and ii) objectives, data were collected from official sources and a costing procedure was applied from the perspective of the Regional Health Service. For the iii) objective, a Bayesian AR(1) regression was used to evaluate the average percentage reduction in costs for a province that gained the certification. The total cost for the eradication programmes adjusted for inflation to 1 January 2016 was estimated at 18 919 797 euro (5th and 95th percentiles of the distribution: 18 325 050-19 552 080 euro). When a province gained the certification of freedom from disease, costs decreased on average by (median of the posterior distribution) 47.5%, 54.5% and 54.9% for the eradication programmes of tuberculosis, brucellosis and leucosis, respectively. Information on possible savings from the reduction of control costs can help policy makers operating under budget constraints to justify the use of additional resources for the final phase of eradication. [ABSTRACT FROM AUTHOR]

Aim The aim of this study is to evaluate the level of Health-Related Quality of Life (HRQoL) and its determinants among migrants in irregular situations in Italy. Methods This cross-sectional study was held in Rome in 2014. HRQoL was assessed through SF-12 questionnaire and physical (PCS) and mental component scores (MCS) were calculated; socio-demographic information and medical conditions were collected. Bivariate and multivariate analyses were performed to assess the impact of demographic and pathological variables on the HRQoL. Results The median PCS among the 200 migrants enrolled was 46.5 and the median MCS was 37.9, some points below the Italian average. The multivariate analysis revealed a negative association between PCS and age (P < 0.01), respiratory (P: 0.03) and Poverty-Related Diseases (PRDs) (P < 0.01). MCS, on the other hand, resulted negatively associated with neuropsychiatric diseases (P: < 0.01) and PRDs (P < 0.01). Conclusion Although multivariate analyses revealed that gender acts as an effect modifier the negative association between PRDs and the two dimensions of HRQoL is confirmed in both genders. This suggests a great impact of socio-economic status on the HRQoL. Public health could contribute to improve the HRQoL of migrants only taking into account social aspects of diseases and tailoring intervention on the specific needs of migrants. [ABSTRACT FROM AUTHOR]