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Purpose The aim of the study was to evaluate the caffeinated Energy Drinks (EDs) consumption among a large sample of Italian undergraduates and its association with some of the major lifestyle risk factors. Methods Students attending twelve public Italian universities were involved between October 2021 and May 2022. Information on socio-demographic characteristics, ED consumption, and on health-related behaviors of participants was collected by the use of a web-based questionnaire. Results A total of 2165 students participated in the study and 15.2% of them reported having used caffeinated EDs in the last six months, mainly once a month (41.5%). In comparison with non-users, ED users showed a higher proportion of males (p p = 0.003), came mainly from Northern universities (p = 0.004) and life sciences degree courses (p p = 0.003), more particular dietary regimens (p p p p = 0.003), and higher proportion of smokers (p p = 0.005). ED use was negatively related with female gender (OR 0.546; 95% CI 0.374–0.798), the Mediterranean diet (OR 0.587; 95% CI 0.362–0.951) and coming from the center of Italy (OR 0.500; 95% CI 0.275–0.909) and positively associated with tobacco smoke (OR 1.712; 95% CI 1.176–2.492) and participation in a team sport (OR 1.686; 95% CI 1.051–2.707). Conclusion These findings could encourage figures engaged in education to increase the students’ awareness on this issue in order to prevent the excessive use of EDs and associated unhealthy behaviors, especially in the most interested subgroups.

Working memory (WM) is a multicomponent system that supports cognitive functioning. It has been linked to a wide variety of outcomes including academic success and general well-being. The present study examined the relations between adherence to the Mediterranean diet (MD) and WM among Italian children, adjusting for important parent characteristics and children's lifestyle habits. Data for this study was obtained from 106 children attending primary school in Imola (Italy) who were part of the I-MOVE study emphasizing school-based physical activity. Children's adherence to the MD was calculated using the KIDMED index (KI) based on the ZOOM-8 questionnaire. Physical activity (PA) levels were assessed using an actigraph accelerometer and WM using the backward digit span test. Univariate regression was used to select significant child-level and family measures associated with WM, which were then tested in a single multivariate regression model. Older age is positively associated with higher WM (β = 0.36; 95% CI 0.25, 0.47). Dietary adherence (KI) (β = 0.07; 95% CI 0.01, 0.14) and engagement in organized PA outside school hours (β = 0.58; 95% CI 0.09, 1.10) are positively related to WM. Among the family measures, father's education was positively associated with WM for high school education and for university vs. middle school or lower, respectively.Adherence to the MD was associated with better WM capacity in primary school children. These findings can be used to guide policymakers in designing health promotion programs and instituting policies emphasizing healthy nutrition to improve physical health and boost cognitive functioning.• The development of working memory involves the entire childhood with a rapid spurt between 2 and 8 years of age. • Working memory plays a critical role in children's learning and academic performance and underlies higher-order cognitive abilities.• Adherence to the Mediterranean Diet was associated with higher working memory capacity in primary school children. • Health promotion interventions based on PA and sound nutrition involving children benefit not only physical and mental health, but also cognitive health.

The acquisition of healthy dietary and exercise habits during childhood is essential for maintaining these behaviors during adulthood. In early childhood, parents have a profound influence on a child’s lifestyle pursuits, serving as both role models and decision-makers. The present study examines family factors as potential contributors to healthy lifestyle habits and their child’s overall diet quality among a sample of primary school children. A secondary aim is to evaluate several aspects of diet quality using the Mediterranean adaptation of the Diet Quality Index-International (DQI-I). This cross-sectional study involved 106 children enrolled in a primary school located in Imola, Italy. Data were collected from October to December 2019 using an interactive tool used to assess parent characteristics, children’s lifestyle, food frequency (ZOOM-8 questionnaire), and actigraph accelerometers to capture children’s physical activity and sedentary behavior. Adherence to the Mediterranean Diet (expressed by KIDMED Index) was positively associated with fathers’ educational level, parental sport participation, and the parent’s overall nutritional knowledge. Higher mothers’ educational level was inversely associated with children’s leisure screen time. Parents’ nutritional knowledge was positively related to children’s average daily minutes of organized sport activities. The better score for DQI-I was for consumption adequacy, followed by variety and moderation. The lowest score was for overall balance. The present study reinforces the importance of family factors in young children’s lifestyle choices, particularly their dietary, leisure time, and exercise habits.

Objectives: The aim of this study was to analyze the consumption of dietary supplements (DSs) and related sociodemographic characteristics or behaviors in Italian undergraduates. Methods: A questionnaire-based, cross-sectional study was carried out between October 2021 and May 2022 involving undergraduates from 12 public universities. The use of DSs in the previous 6 mo, the aim and reason for use, the purchasing channel, and related adverse effects were explored and compared by sex. A logistic regression was performed to highlight possible associations between sociodemographic, anthropometric, and behavioral characteristics of participants and supplement consumption. Results: The use of DSs was reported by 71.5% of the 2165 respondents. Supplementation was related to sex (odds ratio [OR] 0.690; 95% confidence interval [CI], 0.516-0.924, for men), vegetarian or vegan (OR 4.814; 95% CI, 1.669-13.887) and other particular diet regimens (OR 1.819; 95% CI, 1.282-2.580), sport (OR 1.688; 95% CI, 1.116-2.553), and type of sport (OR 0.629; 95% CI, 0.423-0.936, for team sports). Women were more likely to use DSs following a doctor's prescription and to buy them in a pharmacy (P < 0.001) but reported more adverse effects (P=0.018) than men. The main aim pursued was general health; proteins, amino acids, and non-caffeinated energy supplements were consumed to improve physical performance and caffeinated energy supplements for mental performance. Conclusions: Diet supplementation was common in the sample examined, especially in women, and associated with particular dietary regimens and sports, especially individual sports. Female consumers follow specialists' indications more than males. These results highlight the need for educational interventions about diet supplementation for this category of users.

Background: Healthy eating and active lifestyle habits are essential for a child’s development, wellbeing, and health. School setting and family environment play a crucial role in shaping these habits and this could be reflected in different behavior patterns during weekdays and weekends. Methods: We investigated primary school children’s lifestyle habits through a cross-sectional analysis of 428 Italian primary school children, with a mean age of 8.99 years (±1.43). Data were collected from May to June 2017 using a weekly diary to assess children’s lifestyles. Results: Children who eat their morning snack and lunch at school three or more times during the weekdays were 5.47 times more likely (95% CI 3.02, 10.2) to consume adequate snacks and 7.79 times more likely (95% CI 4.43, 14.5) to have adequate meals than those who did not. Conclusion: Consumption of vegetables, lunch, and snacks are significantly more adequate during the weekdays as compared to the weekends. Physical activity levels did not differ between weekdays and weekends. Moreover, children spent more time engaged in physical activities than in front of a screen during both the weekdays and the weekends. The present results are good indicators of the importance of the school canteen in defining correct eating habits. Family-based and school-based interventions could represent valuable integrative strategies for promoting a healthy lifestyle in children.

Tattooing and piercing may lead to health complications. The present multicenter cross-sectional study aimed to assess awareness and knowledge of health risks related to body art and to identify their possible determinants among a large sample of undergraduates in Italy. A web-based questionnaire collecting information on socio-demographic characteristics, awareness, knowledge, and some potential predictors was administered to undergraduates attending twelve Italian universities. The level of knowledge was expressed as the number of correct answers (0–11 for tattooing, 0–14 for piercing). A total of 2985 participants (mean age 23.15 ± 3.99, 73.9% F) participated in the study. Although 95.4% of the respondents were aware of possible health consequences of body art, a low level of specific knowledge was registered for both tattooing (mean number of correct answers 5.38 ± 2.39) and piercing (5.93 ± 3.12) consequences. Lower knowledge was associated with the attendance of non-life science course and with lower duration of academic education for both tattoo and piercing. Lower knowledge of tattooing risks was related with commuter status, while lower knowledge of piercing risks was associated with lower father’s education. These findings highlight the need to enhance information campaigns targeted to youths to increase their awareness of possible health risk of body art.

Background: tattooing and piercing are increasingly common, especially among youths. However, several health complications may be associated with these practices if basic hygiene rules are not respected. This multicenter study was aimed at exploring tattoo and piercing experiences reported by a large sample of Italian undergraduate students through a public health perspective. Methods: tattooed and/or pierced students attending 12 Italian universities were asked to complete a web-based questionnaire regarding their body art experience. Results: out of 1472 respondents, 833 (56.6%) were tattooed and 1009 (68.5%) were pierced. The greatest proportion of tattooed students (93.9%) got her/his first tattoo in a tattoo studio, while most of the pierced were serviced in a jewelry store (48.0%). The pierced ones were less informed on health issues related to the procedure (56.0% versus 77.8% of tattooed p < 0.001), and tattooists were reportedly more attentive to hygiene rules (instrument sterilization 91.5% versus 79.1% of piercers, p < 0.001; use of disposable gloves 98.2% versus 71% of piercers, p < 0.001). Conclusions: educational interventions for both professionals and communities are needed to improve the awareness and the control of health risks related to body art throughout the Italian territory.

Municipal tap water is increasingly treated at the point of use (POU) to improve the acceptability and palatability of its taste. The aim of this study was to assess the bacteriologic and nutritional characteristics of tap water treated at the point of use in residential healthcare facilities for the elderly. Two types of POU devices were used: microfiltered water dispensers (MWDs) and reverse-osmosis water dispensers (ROWDs). All samples of water entering the devices and leaving them were tested for the bacteriological parameters set by Italian regulations for drinking water and for opportunistic pathogens associated with various infections in healthcare settings, in addition, the degree of mineralization of the water was assessed. The results revealed widespread bacterial contamination in the POU treatment devices, particularly from potentially pathogenic species. As expected, the use of ROWDs led to a decrease in the saline content of the water. In conclusion, the use of POU treatment in healthcare facilities for the elderly can be considered advisable only if the devices are constantly and carefully maintained.

Monitor school meals and students’ appreciation, promoting awareness about food use/waste, in relationship with breakfast and morning snacks. Determine approval rating, and measure food waste in school, to develop strategies for management and education about prevention and reduction of food waste. Methods To control the food waste in school, it was developed a collaboration between healthcare (SIAN, Bologna’s USLgency), education (school) and society (parents, scholastic foodservice and administration). Two surveys were prepared about the appreciation and consumption of provided meals, breakfast and morning snacks, and a hundred 3rd and 4th grade children participated. Bread and fruit leftovers were used as snacks or given to charity. Each phase of the project was video taped to show participation of all parties. The results were discussed with all the participants while planning for following school years. Results 2069 nutritional profiles were examined (breakfast, snack, and lunch). The consumption of first (pasta) and second (meat or fish) courses was 3/4, while vegetables, breads, and fruits, was 1/2. Those who had a proper breakfast and/or morning snack tended to eat a greater quantity of food for lunch. Some differences emerged between the two schools involved. In one school there was significantly higher meal consumption, with a two-fold difference for vegetables, second dishes and fruits. The difference between schools with equal socio- economic status, seemed to be due to the active and authoritative teachers. Conclusions The surveys were simple and well accepted by the children. They actively participated with enthusiasm, and they were awarded with the title of ‘‘little tasters’’. The joint planning between the education, healthcare, and social components will continue: it will start a project for all the schools of Bologna to promote the consumption of proper snacks (fruits), and to monitor food waste, in order to guide both nutritional education interventions. Key messages: Scholastic food service is a very important occasion to promote nutritional education and an healthy diet. To succeed, is fundamental the active involvement of children, teachers, parents, scholastic foodservice and healthcare, to balance between offering healthy food and maximizing customer satisfaction.

A comparison was made between the microbial quality of drinking water obtained from Microfiltered Water Dispensers (MWDs) and that of municipal tap water. A total of 233 water samples were analyzed. Escherichia coli (EC), enterococci (ENT), total coliforms (TC), Staphylococcus aureus, Pseudomonas aeruginosa and heterotrophic plate count (HPC) at 22 °C and 37 °C were enumerated. In addition, information was collected about the principal structural and functional characteristics of each MWD in order to study the various factors that might influence the microbial quality of the water. EC and ENT were not detected in any of the samples. TC were never detected in the tap water but were found in 5 samples taken from 5 different MWDs. S. aureus was found in a single sample of microfiltered water. P. aeruginosa was found more frequently and at higher concentrations in the samples collected from MWDs. The mean HPCs at 22 °C and 37 °C were significantly higher in microfiltered water samples compared to those of the tap water. In conclusion, the use of MWDs may increase the number of bacteria originally present in tap water. It is therefore important to monitor the quality of the dispensed water over time, especially if it is destined for vulnerable users.

Three microfiltered water dispensers (MWDs) for domestic use were bacteriologically monitored over a period of 1 year to evaluate their hygienic status and to compare the ability of two disinfectants (peracetic acid and hydrogen peroxide) to ensure adequate bacteriological quality of the dispensed water. To this end, two dispensers were purposely contaminated with a strain of Pseudomonas aeruginosa of environmental origin. A total of 324 samples of input and output water were analyzed. Heterotrophic plate count (HPC) bacteria at 22 degrees C and 36 degrees C, total coliforms (CT), Escherichia coli (EC), enterococci (ENT), P. aeruginosa and Staphylococcus aureus were enumerated. Throughout the study period, the supply water was always of excellent bacteriological quality. All water samples taken from the MWDs complied with the legal requirements for drinking water: CT, EC, ENT and S. aureus were all consistently absent. P. aeruginosa was never isolated from the uncontaminated dispenser. However, an increase in HPCs up to levels of 10(3)-10(4) cfu/mL was found in the dispensed water. Under the present operative conditions, hydrogen peroxide was seen to be more effective than peracetic acid in controlling bacterial contamination in the water circuits. Periodic disinfection with hydrogen peroxide made it possible to obtain water with HPC levels conforming to Italian regulations for drinking water (or =100 cfu/mL) as well as to the levels recommended by the American Dental Association (ADA) (or =200 cfu/mL). Furthermore, in the contaminated circuits, H(2)O(2) disinfection led to a reduction in the concentrations of P. aeruginosa to only a few colony forming units/100 mL or to a complete, albeit temporary, disappearance of the microorganism. In conclusion, hydrogen peroxide at 3% can be proposed as a suitable product for periodic disinfection of domestic MWDs, taking into consideration also its low cost and easy availability.

A study was carried out to assess the efficiency of filtration in reducing microbial contamination in municipal secondary effluent. After primary and secondary treatments, the wastewater underwent filtration through sand/hydroanthracite filters. A total of 20 samplings were made, each consisting of two instant samples (secondary effluent and filtered effluent). Each of the 40 samples was tested for: total and faecal coliforms, Escherichia coli, enterococci and somatic coliphages. The mean concentrations detected in the secondary effluent were in the order of 5 log for the total and faecal coliforms, 4 log for enterococci and Escherichia coli, and approx. 3 log for the coliphages. The filtration showed a higher efficacy in the reduction of faecal coliforms, Escherichia coli and in particular total coliforms. The results obtained for enterococci and coliphages were significantly lower. Filtration alone was not enough to reduce the bacterial indicators to within Italian legal limits, and showed a poor capacity to abate coliphages. However, by performing the filtration before disinfection, secondary effluents require a lower dose of disinfectant. This results in less pollution of surface waters from by-products and a consequent reduction in the chemical risk for the general population. Copyright © Source Interlink Media.

Background This study aimed to assess whether a school-based physical education intervention was effective in improving physical abilities and influencing daily physical activity habits in primary school children. The possible effect on body mass index (BMI) was also considered. Methods Twenty-six 3rd-grade classes were randomly selected stratifying by geographic location (city, plain, hills) and were assigned either to an intervention (127 boys; 120 girls) or to a traditional (129 boys; 121 girls) physical education program. At baseline (age: 8-9 years) and after a 2-year follow-up (age: 10-11 years), information was collected about sport participation and daily activity habits using a self-administered questionnaire. Height, weight, and BMI were measured and physical performance was assessed by means of standardized tests. Results The enhanced program of physical education was effective in improving physical abilities of children and determining a decrease (boys: 10%; girls: 12%) in daily sedentary activities (preintervention versus postintervention, p

The quantity of Aeromonas spp. and Aeromonas hydrophila was determined in samples of fresh surface water, brackish, and seawater with different degrees of pollution, and their presence was compared with the classical indicators of water fecal pollution. Aeromonas spp. were isolated from all the water samples examined and their number, like that of Aeromonas hydrophila, was always higher than, and in some cases correlated with, that of fecal coliforms. The results obtained seem to confirm the opinion already expressed by other researchers regarding the importance of monitoring the presence of these bacteria to obtain more complete information on the degree of contamination of surface water.

The effectiveness of a full scale membrane bioreactor (MBR) in the removal of bacteriophages and bacterial fecal indicators from municipal wastewater was compared with that obtained by conventional activated sludge process (CASP). Somatic coliphages (SOMCPH) and F-RNA specific bacteriophages (FRNAPH) were always detected in the pre-treated effluent (mean: 6Log10), while phages infecting Bacteroides fragilis were not always present (mean: 3.9Log10). The MBR process was able to achieve respectively 2.7 and 1.7 Log10 higher reductions of SOMCPH and FRNAPH compared to CASP (significant differences: P

A cross-sectional study was carried out to analyse, through a limited number of fitness tests, the main conditioning and coordinative abilities in children aged 8-9 years, and their relationship with gender, anthropometric variables and physical activity habits. The height and weight of 256 boys and 241 girls were measured and information about physical activity habits was collected using a self-administered questionnaire. Physical performance was assessed by means of a few standardised tests: 'sitreach', medicine-ball forward throw, standing long jump, 20 m running speed, and forward roll test. In both boys and girls, body weight and body mass index (BMI) were positively correlated with the medicine-ball throw performances and negatively correlated for the standing long jump and speed tests, while no association was found with tests measuring back flexibility and total body coordination. Daily physical activity and participation in sport were not significantly correlated with body weight and BMI, but were positively associated with children's motor performance. The standardised fitness tests selected in the current study have been found to be suitable to identify fitness levels of primary school children. Thanks to their limited number and ease of measurement, they can be used in any school context to classify children and for monitoring the effects of targeted interventions promoting physical activity.

The microbial removal efficacy of membrane bioreactor (MBR) technology in a full-scale municipal wastewater treatment plant was evaluated. Total and faecal coliforms, thermo-tolerant coliforms, Escherichia coli, enterococci, somatic coliphages, F-RNA specific bacteriophages and bacteriophages infecting Bacteroides fragilis (BFRPH) were used as bacterial and viral indicators. Reclamation and reuse of MBR effluent were considered. The average Log10 reductions of the bacterial indicators range from 6 Log10 for enterococci to 7 Log10 for E. coli and faecal coliforms. The average removal of FRNA coliphages was similar to that of enterococci. Complete removal of BFRPH was observed. Log10 reductions of somatic coliphages were significantly lower than those of all other indicators. Somatic coliphages appear to be better indicators of the microbial removal efficiency of the MBR system than faecal bacterial indicators. The quality of the MBR permeate conforms largely with the microbiological standards for urban (e.g. street cleaning, vehicle washing) and agricultural reuse.

The abilities of peracetic acid and hydrogen peroxide to remove or reduce Pseudomonas aeruginosa and Stenotrophomonas maltophilia in output water from microfiltered water dispensers (MWDs) were investigated. Two MWDs were inoculated with strains of P. aeruginosa and S. maltophilia isolated from water. Dispensers A and B were disinfected with 10% (v/v) peracetic acid (PAA) and 3% (v/v) hydrogen peroxide (HP) respectively. Each dispenser was disinfected three times at monthly intervals with contact times of 10, 30 and 40 min. Water dispensed by the MWDs was collected immediately before and after each treatment and then twice weekly for the remaining period. Once a week a sample of the tap water entering the dispensers was tested. P. aeruginosa and S. maltophilia were enumerated in the 90 samples collected during 6 months. In the output water from the dispensers before the first treatment, the number of the bacteria was 3 to 4 log cfu/100 mL. Treatment with PAA greatly reduced the numbers of P. aeruginosa and S. maltophilia in the dispensed water initially. However, by 2 days after treatment, the numbers increased and remained high. In the case of disinfection with HP for 40 min, P. aeruginosa was not detected in most of the samples (73.7%). Numbers of S. maltophilia decreased with increasing time after treatment.

Numerous studies have shown that the water discharged from dental unit waterlines (DUWLs) contains high densities of bacteria, especially non-fermenting Gram negative bacteria. The aim of the present study was to investigate how the material (polyethylene-PE and polytetrafluorethylene-PTFE) and size (1.6 and 4.0 mm) of 4 waterlines in a pilot plant influence the level of contamination in the output water. The water contamination was assessed by analyzing the trend of the heterotrophic plate counts at 22 degrees C as a function of time and by testing for non-fermenting Gram negative bacteria. In all waterlines, the bacterial density increased exponentially during the first months and thereafter remained between 10(4) and 10(6) cfu/ml. However, the plate count at 22 degrees C was lower in the water from PTFE tubes and from larger size tubes. Comamonas acidovorans, Pseudomonas aeruginosa and Pseudomonas fluorescens were isolated. Pseudomonas aeruginosa, responsible for infections associated with dental practice, was never isolated in the output water from PTFE tubes. In order to control bacterial contamination the results suggest the use of waterlines made of PTFE on account of their ability to inhibit the colonization and growth of Pseudomonas aeruginosa.

The investigation was carried out by evaluating the microbiological characteristics of the water before and after treatment with Er:YAG laser and turbine. The study was carried out in 2 dental surgeries. In both cases the laser and dental units were served by two independent circuits, fed by the same potable tap water. Samples were taken from the water supplying and the water leaving the turbine and laser before and after treatment on the same patient. Total heterotrophic plate count was measured at 36 degrees C and at 22 degrees C, and the presence of Staphylococcus species and non-fermenting Gram negative bacteria was investigated. Bacterial contamination was found within the circuit, especially in the laser device. Pseudomonas aeruginosa was detected in only 1 sample of supply water, in 11.1 % and in 19.4 % of the samples from the turbine and the laser respectively. No evidence of Staphylococcus aureus was found. The contamination of supply water was low, whereas that of the water leaving the handpieces of the 2 devices was high, especially in the laser. Attention should be paid to the control of the water leaving laser devices, given the increasingly wide use of such instruments in dental treatment exposed to risk of infection.

The aim of the study was to assess the efficiency of low doses of peracetic acid against viral and bacterial indicators in wastewater and to evaluate if the treatment allows regulatory requirements to be satisfied. A total of 31 samplings were carried out, each involving the collection of secondary effluent and of effluent disinfected with 1.2 or 1.5 mg l(-1) of peracetic acid (contact time 20 minutes). In each sample were measured: somatic coliphages, F-specific RNA bacteriophages, Escherichia coli, total and faecal coliforms, enterococci. Peracetic acid disinfection showed significant differences between the reductions of the microorganisms tested: E. coli showed the highest reduction (1.78 and 2.43 Log respectively with 1.2 and 1.5 mg l(-1) of peracetic acid) and phages the lowest (ranging between 0.52 and 0.60 Log). Only a concentration of 1.5 mg l(-1) of peracetic acid would enable the effluent to be discharged into surface waters in compliance with Italian regulations. The variability of microbial resistance against the peracetic acid disinfection treatment, underlines the importance of assessing disinfection efficiency by using more than one indicator microorganism. The detection of E. coli could be usefully accompanied by tests for more resistant microorganisms such as enterococci or coliphages. In conclusion, peracetic acid can be used for the disinfection of effluents even at low doses, with the advantage of reducing costs and preventing the formation of significant amounts of genotoxic by-products.

A prospective surveillance study of legionnaires disease and an environmental survey of Legionella species were performed simultaneously in a general hospital. During a period of 3 years, 705 patients with pneumonia were screened with a Legionella urinary antigen test, and pneumonia was confirmed by culture and serological tests. Twelve cases of legionnaires disease were identified, none of which were hospital acquired, despite the fact that 60% of hospital water samples were contaminated with Legionella pneumophila at a concentration of more than 103 colony-forming units/L. The probable source of infection was identified for only 2 community-acquired cases. The results show that environmental contamination alone is not able to predict the risk of legionnaires disease. If no cases are present, monitoring of hospital water systems is of little significance; clinical surveillance is much more important.

Objective.To evaluate the effectiveness of different disinfection treatments in a spa water system contaminated byLegionella pneumophilaand associated with a case ofLegionellapneumonia.Design.During an 18-month period, the spa water was analyzed by taking samples from the well, the recirculation line, and the final distribution devices (nebulizers and nasal irrigators). Various attempts were made to eradicateLegionellaorganisms by chemical and thermal shock. The final protocol consisted of heat shock treatment at 70°C-75°C for 3 hours, 2 nights per week, followed by a lowering of the water temperature to 30°C ± 1°C for use in the plant. In addition, 3 times a week superheated steam (at a pressure of 1 atmosphere) was introduced for 1 hour into the nebulization machines.Setting.A spa at which sulfurous water was used for hydrotherapy by means of aerosol and nasal irrigation.Patient.A 74-year-old woman with legionnaires disease.Results.After the case of infection occurred,L. pneumophilawas isolated from the recirculation line at a concentration of 400,000 cfu/L and from the nebulizers and nasal irrigators at levels ranging from 3,300 to 1,800,000 cfu/L. The colonizing organisms consisted of a mixture ofL. pneumophilaserogroup 1 (12%) and serogroup 5 (88%). The shock treatment with chlorine dioxide and peracetic acid resulted in the eradication ofLegionellaorganisms from the recirculation line but not from the water generated from the final distribution devices. After the restructuring of the plant and the application of thermal shock protocol, an evaluation after 12 months revealed no evidence ofLegionellacontamination.Conclusion.To preventLegionellacolonization, disinfection treatment is effective if associated with carefully selected materials, good circuit design, and good maintenance practices.

Tests for Escherichia coli and E. coli O157 were carried out on meat samples collected from randomly chosen stores throughout the city of Bologna and suburban areas. The samples consisted of 25 g of loose minced beef, sometimes already shaped into meatballs or hamburgers, some of which were mixed with vegetables. The meat was purchased from retail outlets, open market stalls, and supermarket chains during 25 sampling visits from October 2000 to December 2001. For E. coli detection, Tryptone soya broth (TSB) supplemented with novobiocin and C-EC agar were used. Immunomagnetic separation with SMAC-BCIG-CT agar and chromogenic E. coli O 157 agar, API 20E system and agglutination latex test were used to detect E. coli O157; Vero cell assay and polymerase chain reaction (PCR) were used to assess toxin production and the presence of virulence genes. E. coli were detected in 45 (30.2%) of the 149 samples examined, mainly in the hamburger samples mixed with vegetables and in the loose minced beef. E. coli O157 was found in one sample of hamburger and two samples of hamburger mixed with vegetables (2%) collected from three different butcher's stores between July and October. All the strains of E. coli O157 and most cases of E. coli were found in meat from small retailers. The three strains of E. coli O157 were positive for verocytotoxin production. PCR analysis revealed genes coding for vt2 and one strain possessed the gene for eae A. Chromogenic E. coli O157 agar was found to be more selective and differential, allowing easier identification of suspected colonies with mixed flora and producing less false-positive colonies.

Objectives: monitor school meals and students’ appreciation of the different food preparations, promoting their awareness about food use/waste, also in relationship with breakfast and morning snacks. Test tools, determine approval rating, and measure food waste in school canteens in order to develop effective strategies for management and education about prevention or reduction of food waste. Methods: a movement started by parents and teachers, who were worried about excessive food waste in schools, saw the development of an active collaboration between healthcare (SIAN, Bologna’s USL Agency), education (school) and society (parents of the involved classes, company for the scholastic foodservice and local administration). Two questionnaires were prepared, one about the appreciation and consumption of provided meals, and the other about the consumption of breakfast and morning snacks. Between March and May in 2015, a hundred 3rd and 4th grade children filled out the questionnaires at the end of the provided meal, with the help of teachers and UO Hygiene Food and Nutrition’ dietitians as observers. Leftover bread and fruits that were still edible were used as afternoon snacks or rescued for charity. Each phase of the project was recorded on videotape in order to prove the main involvement of all parties mentioned. The analyzed results were reported to all the participants of the project and were discussed jointly, beginning the planning for following school years. Results: during more than 30 days, 2069 nutritional profiles were examined (breakfast, morning snack, and lunch). From these data, it could be seen that about 3⁄4 of the first and the second courses were eaten, while side dishes’, breads’, and fruits’, consumption was at about half. Those who had a proper breakfast and/or morning snack ate, on average, a greater quantity of first and second dishes, and also side dishes and fruits. Interestingly, some differ- ences emerged between the two schools involved in the project. In one of the two schools a significantly higher meal consumption (as well as breakfast and morning snacks) was recorded, reaching a two-fold difference for both second dishes (80% vs 40%) and fruits (70% vs 35%). The active and authoritative teaching style of teachers during meals seems to be the basis for the observed difference between schools with equal socioeconomic status. Conclusions: the questionnaires used turned out to be simple and well accepted by the children, who participated with enthusiasm. A strong point of the project was making them active parts of the process and awarding them with the title of “little tasters”. The project allowed all the participants (teachers, students, parents, scholastic foodservice, local administration and ASL) to see the factors that impact on the acceptance of food choice, and the waste of uneaten food at scholastic foodservices. It has been decided to continue with joint planning between the education, healthcare, and social components, and a project for all the schools of Bologna is now at an advanced stage of planning. This project aims to promote the consumption of proper snacks, by offering fruits as a snack, and to create a system to monitor food waste that can be useful to guide both nutritional education interventions, and food choices offered by scholastic foodservices, which are focusing more and more on reaching a balance between offering healthy food and maximizing customer satisfaction.