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Background: During the COVID-19 pandemic, several outbreaks have been recorded worldwide in industrial slaughterhouses and meat-processing plants. Competent Italian health authorities at regional and provincial levels agreed on a risk-oriented control plan., Methods: Advocacy actions were activated, targeting meat plant managers and related food business operators. A questionnaire focused on the inventoried risk factors from literature was developed and administered voluntarily to interested stakeholders. In addition, an outbreak questionnaire was proposed to the prevention department of local health units., Results: From 2021 to 2022, 333 advocacy and 24 outbreak questionnaires on 4,765 inventoried plants were collected. The lack of awareness in updating the Risk Assessment Document for COVID-19, non-instrumental body temperature checks at the entrance, working force from different subcontractors, poor hygiene in shared places, and insufficient ventilation were the main critical points recorded., Conclusions: Results provide a post hoc review with an eye toward future zoonotic pandemics.

Abstract: Coratella, G, Beato, M, Bertinato, L, Milanese, C, Venturelli, M, and Schena, F. Including the eccentric phase in resistance training to counteract the effects of detraining in women: a randomized controlled trial. J Strength Cond Res 36(11): 3023-3031, 2022-The current study compared the effects of concentric-based (CONC), eccentric-based (ECC), and traditional concentric-eccentric (TRAD) resistance training on muscle strength, mass, and architecture and the postdetraining retention of the training-induced effects in women. Sixty women were randomly assigned to unilateral volume-equated CONC, ECC, or TRAD knee extension training or control ( N = 15 per group). Before training, after an 8-week intervention period, and after an 8-week detraining period, isokinetic concentric, eccentric, and isometric torque were measured. In addition, thigh lean mass was assessed by dual X-ray absorptiometry and vastus lateralis thickness, pennation angle, and fascicle length by ultrasound. After training, concentric and isometric torque increased ( p < 0.05) similarly in all groups, whereas eccentric torque increased more in ECC than that in CONC (+13.1%, effect size (ES): 0.71 [0.04-1.38]) and TRAD (+12.6%, ES: 0.60 [0.12-1.08]). Thigh lean mass increased in ECC (+6.1%, ES: 0.47 [0.27-0.67]) and TRAD (+3.1%, ES: 0.33 [0.01-0.65]). Vastus lateralis thickness and pennation angle increased ( p < 0.05) similarly in all groups, whereas fascicle elongation was visible in ECC (+9.7%, ES: 0.92 [0.14-1.65]) and TRAD (+7.1%, ES: 0.64 [0.03-1.25]). After detraining, all groups retained ( p < 0.05) similar concentric torque. ECC and TRAD preserved eccentric torque ( p < 0.05), but ECC more than TRAD (+17.9%, ES: 0.61 [0.21-1.21]). All groups preserved isometric torque ( p < 0.05), but ECC more than CONC (+14.2%, ES: 0.71 [0.04-1.38]) and TRAD (+13.8%, ES: 0.65 [0.10-1.20]). Thigh lean mass and vastus lateralis fascicle length were retained only in ECC ( p < 0.05), pennation angle was preserved in all groups ( p < 0.05), and thickness was retained in CONC and ECC ( p < 0.05). Including the eccentric phase in resistance training is essential to preserve adaptations after detraining., (Copyright © 2021 National Strength and Conditioning Association.)

Background: This study assessed whether anthropometry, physical fitness and sport-specific sprint performance vary across the three groups of sitting volleyball (SV) athletes (athletes with a disability (VS1), athletes with a minimal disability (VS2) and able-bodied SV athletes (AB)) in order to explore the validity of the current system of classification. This study also investigated how the anthropometric and physical fitness characteristics of athletes relate to their sprint performance., Methods: Thirty-five SV male athletes aged 37.4 ± 10.8 years and practicing SV at a national/international level volunteered for this study. Testing consisted in the evaluation of linear anthropometry, physical fitness (body composition by-means of dual-energy X-ray absorptiometry and upper-body strength) and sprint performance (5-meter sprint tests, agility test and speed and endurance test)., Results: Athletes in the three groups differed in fat mass percentage (%FM) which was higher in VS1 versus AB at the sub-total level (+9%), in the arms (+15%) and in the non-impaired leg (+8%) regions. Greater hand span, greater length of the impaired lower leg, lower %FM at both the sub-total and regional level and a higher level of strength in the upper body are all associated with better performances in the considered sprint tests ( P  < 0.05 for all). These results do not confirm the validity of the current system of classification of athletes adopted in SV. Professionals dealing with SV athletes should include specific exercises aimed at improving whole-body and regional body composition and the strength of the trunk and upper limbs in their training programs., Competing Interests: The authors declare there are no competing interests., (©2022 Cavedon et al.)

Excimer Laser Coronary Atherectomy (ELCA) is a well-established therapy that emerged for the treatment of peripheral vascular atherosclerosis in the late 1980s, at a time when catheters and materials were rudimentary and associated with the most serious complications. Refinements in catheter technology and the introduction of improved laser techniques have led to their effective use for the treatment of a wide spectrum of complex coronary lesions, such as thrombotic lesions, severe calcific lesions, non-crossable or non-expandable lesions, chronic occlusions, and stent under-expansion. The gradual introduction of high-energy strategies combined with the contrast infusion technique has enabled us to treat an increasing number of complex cases with a low rate of periprocedural complications. Currently, the use of the ELCA has also been demonstrated to be effective in acute coronary syndrome (ACS), especially in the context of large thrombotic lesions., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: To investigate the impact of fast-start, steady or slow-start strategies of the running fraction in sprint triathlon on oxygen consumption, perception of fatigue and blood lactate., Design: Thirteen male triathletes (age; 36.4 ± 10.8 yy, height 174.8 ± 7.9 cm, body mass 70.6 ± 11.1 kg; V'O 2max 62.4 ± 8.9 ml min -1  kg -1 ; mean ± SD) attended the laboratory five times in order to complete two incremental tests and three subsequent cycle-run sessions., Methods: Three experimental randomized sessions with different effort distribution were compared. The intensities of the 1st running kilometer were set at 95%, 100% and 105% of the second ventilatory threshold for slow, continuous and fast start protocol respectively. Measurement of ventilatory variables, blood lactate and ratings of perceived exertion were collected throughout all sessions., Results: A meaningful difference was found between the slow versus fast start protocol in V'O 2 (SE = 0.58, P = 0.0005), BLa - (SE = 0.21, P = 0.0097), HR (SE = 1.23, P = 0.0011) and RPE (SE = 2.83, P = 0.0047) values. No differences in-between protocols were found at the end of the running bout whatever the condition., Conclusions: Differences in physiological parameters were found between protocols during the first kilometer, not at the end of exercise. The fast start appears to be more correct and useful for performance in racing setting and may be used as a strategy without impacting the remaining running bout in ecological setting., (Copyright © 2021 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background: Italy and especially Lombardy region was the first European Country hit by the covid 19 pandemic, without a proper preparedness plan. Italy's health-care service is a regionally based National Health Service (NHS) that provides universal coverage, largely free of charge at the point of service. Aim of this paper is to analyse the national and especially the regional strategies put in place to face the pandemic, focusing on the impact of the overlap of the political and health competences among national and regional authority., Methods: Italian hygiene and preventive medicine society (SITI) realized a questionnaire submitted to National Institute for Health and regional stakeholder to investigate the response to the epidemic analysing the strategies and actions put in place both by the national and regional governments and the regional health authorities., Results: The national survey highlighted several critical points in the management of the covid 19 pandemic in the different regional contexts such as lack of personnel in preventive departments and preparadness., Conclusions: Lessons learnt during the pandemic should shape the future of the Italian health service. (www.actabiomedica.it).

Objective: Nose and nasopharyngeal swab is the preferred and worldwide-accepted method to detect the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) within the nose and nasopharynx. This method may be linked with possible difficulties, such as patient's discomfort or complications. This article shows a pilot study of SARS-CoV-2 detection with nasal and nasopharyngeal lavage fluids (level of evidence: 3)., Methods: Nasal lavage fluid was collected from patients who were submitted to SARS-CoV-2 screening test, due to a preceding positive rapid antigen test. A control group was enrolled among health care professionals whose nasopharyngeal swab tested negative. Nasal lavages were performed using isotonic saline solution injected through a nasal fossa. Both lavage fluid and traditional nasopharyngeal swab were analyzed by real-time (RT) PCR and antigenic test., Results: A total of 49 positive subjects were enrolled in the study. Results of the analysis on lavages and nasopharyngeal swabs were concordant for 48 cases, regardless of the antigenic and molecular test performed. RT-PCR resulted weakly positive at swab in one case and negative at lavage fluid. Among the control group (44 subjects), nasopharyngeal swab and lavage fluid analyses returned a negative result. Sensitivity of the molecular test based on nasal lavage fluid, compared to traditional nasal swab, was 97.7%, specificity was 100%, and accuracy was 98.9%, with high agreement (Cohen's κ, 0.978)., Conclusion: Nasal and nasopharyngeal lavages resulted to be highly reliable and well tolerated. A larger series is needed to confirm these results. This approach may potentially represent a valid alternative to the traditional swab method in selected cases., Level of Evidence: 3., Competing Interests: All authors declare that they have no conflict of interest., (© 2021 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Malignant melanoma, an aggressive form of skin cancer, has a low five-year survival rate in patients with advanced disease. Immunotherapy represents a promising approach to improve survival rates among patients at advanced stage. Herein, the aim of the study was to design and produce, by using engineering tools, a novel oncolytic adenovirus AdV-D24- inducible co-stimulator ligand (ICOSL)-CD40L expressing potent co-stimulatory molecules enhancing clinical efficacy through the modulation of anti-cancer immune responses. Firstly, we demonstrated the vector's identity and genetic stability by restriction enzyme assay and sequencing, then, by performing in vitro and in vivo pre-clinical studies we explored the anti-cancer efficacy of the virus alone or in combination with anti PD-1 inhibitor in human melanoma cell lines, i.e., MUG Mel-1 and MUG Mel-2, and in immunocompetent C57BL/6 melanoma B16V mouse model. We showed that both monotherapy and combination approaches exhibit enhanced anti-cancer ability and immunogenic cell death in in vitro settings. Furthermore, AdV-D24-ICOSL-CD40L combined with anti PD-1 revealed a fall in tumor volume and 100% survival in in vivo context, thus suggesting enhanced efficacy and survival via complementary anti-cancer properties of those agents in melanoma therapy. Collectively, the novel oncolytic vector AdV-D24-ICOSL-CD40L alone or in combination with anticancer drugs, such as check point inhibitors, may open novel therapeutic perspectives for the treatment of melanoma.

Introduction: The Istituto Superiore di Sanità (ISS) has been asked for rapid technical and scientific advice to the State and Regions during Sars-CoV-2 pandemic preparedness., Methods: An ad hoc Working Group on Scientific Literature updates (WG SL) was set up at ISS (March-May 2020) to screen pre-prints and peer reviewed papers from arXiv, medRxiv, bioRxiv, and Pubmed to provide a real time knowledge and empirical evidence addressed to health-workers., Results: The WG SL screened a total of 4,568 pre-prints and 15,590 peer reviewed papers, delivered as daily summary report of pre-print selection for ISS President activity in the National Scientific Technical Committee framework and a weekly open access publication (COVID Contents) on peer-reviewed papers of interest for health professionals, monitored by a satisfaction questionnaire., Conclusions: Promoting heath literacy, with a cross-cutting approach is a powerful heritage of Public Health Institutes and a proven effective non pharmacological intervention.

Background: Digital health (DH) is nowadays fundamental for physicians. Despite the improvement of information and communications technology (ICT), Italian medical doctors' (MDs) education system seems inadequate in this area. Moreover, due to the COVID-19 pandemic, societies are waking up to their limitations. The aim of this paper is to analyze the Italian status quo in DH., Methods: The Italian Young Medical Doctors Association (Segretariato Italiano Giovani Medici - SIGM) proposed a web-based survey to assess DH awareness and previous knowledge among young doctors. Investigated areas were: big data, -omics technology and predictive models, artificial intelligence (AI), internet of things, telemedicine, social media, blockchain and clinical-data storage., Results: A total of 362 participants answered to the survey. Only 13% had experience in big data during clinical or research activities, 13% in -omics technology and predictive models, 13% in AI, 6% had experience in internet of things, 22% experienced at least one telemedicine tool and 23% of the participants declared that during their clinical activities data collection was paper-driven., Conclusions: Three categories of MDs, high-tech, low-tech and no-tech, can be identified from the survey-based investigation. Our survey's results indicate an urgent need for integration of pre- and post-graduation training in digital health to provide adequate medical education.

In this review, we discuss the use of oncolytic viruses and checkpoint inhibitors in cancer immunotherapy in melanoma, with a particular focus on combinatory therapies. Oncolytic viruses are promising and novel anti-cancer agents, currently under investigation in many clinical trials both as monotherapy and in combination with other therapeutics. They have shown the ability to exhibit synergistic anticancer activity with checkpoint inhibitors, chemotherapy, radiotherapy. A coupling between oncolytic viruses and checkpoint inhibitors is a well-accepted strategy for future cancer therapies. However, eradicating advanced cancers and tailoring the immune response for complete tumor clearance is an ongoing problem. Despite current advances in cancer research, monotherapy has shown limited efficacy against solid tumors. Therefore, current improvements in virus targeting, genetic modification, enhanced immunogenicity, improved oncolytic properties and combination strategies have a potential to widen the applications of immuno-oncology (IO) in cancer treatment. Here, we summarize the strategy of combinatory therapy with an oncolytic vector to combat melanoma and highlight the need to optimize current practices and improve clinical outcomes.

Background: Physical activity (PA) (e.g., sport, physical education) promotes the psychophysical development of children, enhances health and wellbeing, offers opportunities for enjoyable experiences, and increases self-efficacy., Methods: In the DEDIPAC framework, we conducted a naturalistic, cross-sectional study to evaluate the effects of a school-based, long-term intervention on fitness (i.e., cardiovascular endurance, muscular strength, flexibility, speed, and finger dexterity), body mass index (BMI), PA levels, sedentary levels, enjoyment, and physical self-efficacy in primary school children. A group of Italian children (41 boys and 39 girls, aged 10-11 years) involved in the project-named "Più Sport @ Scuola" (PS@S)-was compared with a group of children (41 boys and 39 girls) of the same age not involved in the project., Results: After a four-year long attendance to the PS@S project, participants reported higher scores of cardiovascular endurance, muscular strength, enjoyment, and physical self-efficacy compared to children not involved in the project. Correlation analysis results showed that muscular strength scores correlated positively with BMI, PA levels, and enjoyment. Flexibility of the upper body was positively related to physical self-efficacy, and negatively related to speed and BMI., Conclusions: Findings suggest that the PS@S project enhanced fitness level, enjoyment, and physical self-efficacy of children., Competing Interests: The authors declare there are no competing interests.

Background: The sympatho-adrenergic activation during exercise is implicated in many cardiovascular respiratory and metabolic adaptations which have been thought to partially explain the different levels of performance observed between trained and untrained subjects. To date, no evidence exists about the association between competition performance and markers of "acute stress response". We designed this study to investigate; (i) the acute sympatho-adrenergic activation during endurance exercise in recreational runners by measuring plasma levels of free metanephrine (MN) and normethanephrine (NMN) before and after a half-marathon run; (ii) the association between the metanephrines levels and the running time., Methods: 26 amateur runners (15 males, 11 females) aged 30 to 63 years were enrolled. The quantification of MN and NMN was performed by LC-MS/MS. Anthropometric ergonomic and routine laboratory data were recorded. Statistical analyses included paired T -test, univariate and multivariate regressions., Results: The post-run values of MN and NMN displayed a nearly 3.5 and 7 fold increase respectively compared to the baseline values ( p < 0.0001 for both). NMN pre-run values and pre/post run delta values showed a significant direct and inverse association ( p = 0.021 and p = 0.033, respectively) with running performance. No correlations were found for MN values., Conclusion: NMN is a reliable marker of sympatho-adrenergic activation by exercise and can predict endurance performance in the individual athlete. Adaptation phenomenon occurring not only in the adrenal medulla might represent the biological mechanism underlying this association. Further studies on sympatho-adrenergic activation, competition performance and training status should contemplate the measurement of these metabolites instead of their unstable precursors., Competing Interests: CONFLICTS OF INTEREST The authors have no conflicts of interest to declare.

Health literacy can be defined as the knowledge, motivation and competence to access, understand, appraise and apply information to make decisions in terms of healthcare, disease prevention and health promotion. Health literacy is a European public health challenge that has to be taken seriously by policy-makers. It constitutes an emerging field for policy, research and practice. However, recent research has shown that health literacy advancement is still at its infancy in Europe, as reflected in the scarce scientific health literacy literature published by European authors. From a total of 569 articles published until 2011 on this subject, the first author of only 15% of them is from Europe. This article conveys recommendations of different European stakeholders on how to accelerate the health literacy agenda in Europe. A general introduction on the current status of health literacy is provided, followed by two cases applying health literacy in the areas of prevention of communicable diseases and promotion of digital health. The current EU strategies integrating health literacy are listed, followed by examples of challenges threatening the further development of health literacy in Europe. Recommendations as to how European stakeholders involved in research, policy, practice and education can promote health literacy are given. It is vital that the European Commission as well as European Union Member States take the necessary steps to increase health literacy at individual, organizational, community, regional and national levels., (© The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

In order to investigate the current and past activity of phlebovirus and flavivirus in Kosovo, a seroprevalence study among 200 blood donors was performed. Positive results were obtained for the phleboviruses TOSV and SFNV, and for a flavivirus of the Japanese Encephalitis group. No positive results for TBEV were observed., (© 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.)

This study presents the initial results of a collaborative project aimed at the evaluation of Toxoplasma seroprevalence in a population of Kosovar pregnant women. The serum samples of 334 pregnant women were tested to detect IgG, IgM, IgG avidity for toxoplasmosis. Data regarding age, occupation, area of origin and education were also obtained for the pregnant women examined; 97/334 (29.4%) resulted positive for IgG antibodies, four of whom (4.1%) were also positive for IgM, (1.2% of the total population examined). All four IgM-positive pregnant women also demonstrated low avidity tests. The rate of IgG seroprevalence found in our study was lower than that observed in various European countries, especially those of western Europe. Conversely, the percentage of recent infections was higher than expected. The higher rate of infections could be the result of a recent toxoplasmosis epidemic in Kosovo, most likely due to the altered hygienic conditions caused by the forced transfer of the ethnic-Albanian population from an area of low (Serbia) to high (Kosovo) toxoplasmosis prevalence.

The serological status of hepatitis viruses and other infectious diseases in the 66 dialysed patients of one haemodialysis unit in Kosovo were studied, comparing the data with a large group of blood donors and out-patients. All dialysed patients were hepatitis A virus (HAV) positive. Prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (anti-HBs), and hepatitis B core antibodies (anti-HBc) was 14 of 66, 21% (95% confidence interval (CI): 12-33%), 5 of 66, 8% (95%CI: 5-22%), and 50 of 66, 76% (95%CI: 64-85%), respectively. Antibodies to hepatitis C virus (anti-HCV) prevalence was 57 of 66, 86% (95%CI: 76-94%). No human immunodeficiency virus (HIV) positive case was found. Prevalence of past herpes simplex virus type 2 (HSV-2) infection was 29% (95%CI: 18-41%). Two patients (3%, 95%CI: 0-10%) were positive for Treponema pallidum and 18% (95%CI: 10-30%) were human herpesvirus 8 (HHV-8) antibody positive. Four hundred and fifty-two subjects were recruited for comparison. Markers of past HAV infection was associated with haemodialysis (Fisher s exact test p-value=0.037). Dialysed patients were at a higher risk of being HBsAg positive than others: the sex- and age-adjusted odds ratio (OR) was 5.18 (95%CI: 1.87-14.32). Anti-HBc positivity was strongly associated with haemodialysis: the sex- and age-adjusted OR was 6.43 (95%CI: 3.22-12-85). Anti-HCV positivity was 86% and 1% in presence and absence of haemodialysis, respectively. The Fisher s exact test for association proved a strong association between haemodialysis and HCV (p-value<0.0001). The OR for association between haemodialysis and HSV-2 positivity was 3.20 (95%CI: 1.46-7.00). Significant associations were also observed between haemodialysis status and antibodies to Treponema pallidum (Fisher s exact test p-value=0.044). In Kosovo, the prevalence of viral hepatitis infection and other viral infections and Treponema pallidum among dialysed patients is high, indicating major ongoing nosocomial transmission.

Since the 1998 civil warcholera outbreaks and waterborne infections have been a major cause of morbidity and mortality during the rainy season in Guinea Bidsau. Our survey aims at: (1) describing the distribution, characteristics and use of water sources and sewage facilities in a central area of the capital city of Bissau; (2) determining the microbiological quality of drinking water during the rainy season. After mapping of the Cuntum 3 study area, water sources' and latrines' location, characteristics and use were determined by visual inspection and interviews with householders. Microbiological analyses were peformed from water sources for evaluation of total Coliforms, E. coli, Enterococcus faecalis. Twelve water sources (9 wells, 3 taps) and 15 latrines were identified and used by 444 inhabitants. Water sources and latrines were at less than 5 meters distance apart. Wells were self-built, hand-dug, shallow (4-6 meters), unprotected. Taps were located outdoor. Latrines were self-built, open air, unprotected. None of the houses had a bathroom. Maintenance of wells, taps and latrines is not performed on regular basis and well's handling habits are not safe. Well and tap water showed heavy faecal contamination with more than 1000 CFU/100 ml. The contamination of drinking water in Bissau due to poor construction, maintenance and improperuse ten years after the civil war, demonstrates the need to allocate resources after conflicts in the area of water and sanitation. Both should be included as a priority in post-conflict reconstruction programs in order to reduce cholera outbreaks and diarrhoea related mortality.

The objective of this study was to evaluate the seroprevalence of infection with HIV, herpes simplex virus type 2 (HSV-2), and Treponema pallidum (TP) in a Kosovarian population. A cross-sectional study was performed in Peja, Kosovo, from January to March 2005, among 1285 persons recruited at the Peja Hospital. The seroprevalence of HIV, HSV-2, and TP was evaluated, and the viral correlates for each infection were analysed. No HIV-positive cases were found. The seroprevalence of HSV-2 was 20.2%. The factors significantly associated with HSV-2 infection at the multivariate analysis were: female gender (adjusted OR, 1.73; 95% CI 1.24-2.41) and being married (adjusted OR, 1.46; 95% CI 1.06-2.01). Three persons (0.2%) had a positive serology for TP. The only risk factor associated with TP infection was age = 50 y. Our results show a low seroprevalence of HIV infection and TP, and a high seroprevalence of HSV-2 in Kosovo. These findings suggest the need for appropriate surveillance systems, prevention programmes, and information aimed at controlling the spread of HIV and other sexually transmitted infections in this area. Moreover, the circulation of infections acquired through sexual contact may facilitate an increase in the sexually transmitted HIV epidemic in the near future.

Objectives: To determine (i) the extent of malnutrition and the risk factors for severe malnutrition in Guinea Bissau, a post-conflict country experiencing long-term consequences of civil war; and (ii) the feasibility and effectiveness of a short-term intervention characterized by outpatient treatment with locally produced food for the treatment of severe malnutrition during the rainy season., Design and Setting: Social, clinical, nutritional information were collected for children reaching the paediatric outpatient clinic of the Hospital 'Comunità di Sant'Egidio' in Bissau, Guinea Bissau, from 1 July to 12 August 2003. Severely malnourished children (weight-for-age <-3sd) in poor health status were admitted for daily nutritional and pharmacological treatment until complete recovery. Social and health indicators were analysed to define risk factors of severe malnutrition., Results: In total, 2642 children were visited (age range: 1 month-17 years). Fever, cough and dermatological problems were the main reasons for access. Social data outlined poor housing conditions: 86.4 % used water from unprotected wells, 97.3 % did not have a bathroom at home, 78.2 % lived in a mud house. Weight-for-age was <-2sd in 23.0 % of the children and <-3sd in 10.3 %; thirty-seven children (1.4 %) were severely malnourished and admitted for day care. All recovered with a weight gain of 4.45 g/kg per d, none died or relapsed after 1 year. Severely malnourished children were mainly infants, part of large families and had illiterate mothers., Conclusion: Short-term interventions performed in post-conflict countries during seasons of high burden of disease and malnutrition are feasible and successful at low cost; day-care treatment of severe malnutrition with locally produced food is an option that can be tested in other settings.

Aims: This article describes management and outcomes of an academic pathway for the transition from Medical Assistant Diploma to Bachelor Science of Nursing (BSN) of Padua University for a group of Romanian nurses., Methods: The course, repeated for two academic years, (2004-05, 2005-06), was 15 months long and it was performed mainly in Timisoara. It was managed by a partnership of public and private Italian and Romanian institutions., Results: Forty-three nurses attended to the full course and 42 obtained the BSN with good results. Lectures were delivered locally and via long distance courses. Students attended Italian wards for their practical training., Conclusion: This project was performed in the framework of an international cooperation project for academic nursing knowledge diffusion in East-European countries, and for recognition and integration of nursing studies.

Health-care-associated infection (HAI) is a major issue of patient safety with a substantial impact on morbidity, mortality, and use of additional resources worldwide. In April 2004, the WHO Regional Office for Europe organised the first international consultation to address the issue of HAI in eastern and central Europe. The main objectives of the consultation were to identify the primary needs and obstacles for the prevention and control of HAI at country level, to design the essential components of an international strategy to effectively address the issue of HAI, and to identify specific priorities and recommendations for interventions by the WHO and other international institutions. An update on HAI activities and related networks throughout Europe, together with the outcome of the meeting, are presented, with special emphasis on future considerations for a European WHO strategy on HAI prevention.

This review describes the HIV prevention strategies adopted since 1990 by the Italian Ministry of Health and Ministry of Education, coordinated by the National Health Institute, for use in Italian schools. It sets out reasons for believing that action in schools is essential in containing the spread of the HIV epidemic and presents teaching materials prepared for school use. An analysis is made of the IV national HIV information campaign, in which the Ministry of Health trained 4,000 middle and senior schools principals. The prospects for continuing the work with these 4,000 principals in the V information campaign, are also reported.

A course for regional trainers was organized by the Working Group for HIV training (PFH) and held in Rome. This course has motivated the participants and has given them the ability to organize similar training activities at local level. The training methodology, the evaluation methods and the objectives used in the course are described. An investigation has been carried out by the Working Group of PFH to evaluate the training activity of the participants at the regional level. The results show that 17 out of the 25 participants have been able to organize a total number of 53 peripheral courses and train 2144 health workers. The training methodology and the evaluation method utilized at the different local levels have followed the ones used in the central course.

Red cell Na-Li countertransport was measured in 78 normal subjects, 64 patients with essential hypertension, and 67 patients with hyperlipidemias. Both hypertensive and hyperlipidemic patients had elevated Na-Li countertransport compared to normal controls (p less than 0.001). Subjects with hyperlipidemia and hypertension had higher countertransport (p less than 0.02) than patients with only hyperlipidemia. Normotensive hyperlipidemic subjects had higher countertransport than normotensive and normolipidemic controls (p less than 0.02). This suggest that hypertension and high plasma lipids can influence independently the Na-Li countertransport. In another group of 52 normotensive subjects, Na-Li countertransport was positively correlated with serum total and free (unesterified) cholesterol, phospholipids and triglycerides. No correlations were found with HDL-cholesterol or HDL-phospholipids. A very high positive correlation was found between Na-Li countertransport and plasma acetylcholinesterase (p less than 0.005). These findings suggest that plasma lipids, probably through membrane lipids, can affect the maximal rate of the Na-Li exchange in red cells. The relationship between plasma or membrane lipids and cation transport should be further studied in erythrocytes and other cells.

Two groups of individuals, 26 normotensive normolipemic and 37 normotensive hyperlipemic, all without family history of hypertension have been selected in attempt to demonstrate whether Li-Na countertransport of erythrocytes is influenced by plasma and membrane lipid composition. The maximal rate of Li-Na countertransport was elevated in hyperlipemics (0.344 +/- 0.168 vs 0.220 +/- 0.074 mmol/l erythrocytes/h). This difference is highly significant. Hyperlipemics had different composition of membrane lipids than normals. The most important variations were: increase of palmitic, palmitoleic and total saturated fatty acids (SFA) as well as increase of cholesterol/phospholipids ratio (C/PL); in contrast, hyperlipemics had a reduced amount of linoleic acid and total unsaturated fatty acids (UFA) as well as total polyunsaturated fatty acids (PUFA). Consequently, UFA/SFA and PUFA/SFA ratios were lower than in normals. Li-Na countertransport was negatively correlated with the amount of PUFA (P less than 0.02), whereas it was positively correlated with the following parameters: oleic/linoleic ratio (p less than 0.02), monounsaturated fatty acids/polyunsaturated fatty acids ratio (p less than 0.03) as well as with the SFA + monounsaturated fatty acid/PUFA ratio (p less than 0.03). These findings suggest that the V max of Li-Na countertransport in erythrocytes is influenced by the lipid composition of the membrane.