Annali dell'Istituto Superiore di Sanità
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Urban mobility and health: a multicentric survey conducted in some Italian cities
Get PDFIntroduction. Urban and transport planning, environmental exposures, physical activity and human health are strictly linked. The aim of this study was to analyze the determinants of sustainable and active mobility in 4 Italian provinces.Materials and methods. An online multiple-choice survey was administered via Google Form between October 2019 and February 2020.Result: 605 people answered the questionnaire, reporting their mobility practices. The home location did not seem to influence mobility behaviours, with the exception of the greater use of public transport for those who did not live in the province capital. Working or studying in central areas was associated with less use of the car, while not working or
studying in the province capital was associated with less use of the motorbike. Women use cars more, and motorcycles/bicycles less. Age and educational level did not seem to influence mobility practices, while being a student compared to a worker was related to greater use of public transport and tendency to walk to the work/study place as well asnto lesser car use.Discussion. It is essential that all cities adopt solutions to encourage healthy mobility. The positive relationship between BMI and car use, between good food score and bike use and between frequent light physical activity and healthy mobility indicators confirmed that risk factors are often interconnected and that improving even one single habit could have a positive effect on the others as well.Conclusion. An urgent paradigm shift is needed to transform urban areas from agglomerations oriented on motorized transport to ones that rely on active and sustainable mobility, in order to turn cities into places generating wellness and health
Proportionate mortality among workers exposed to hardwood dust in Italy
Get PDFAims. The main aim of this study is to estimate the impact on workers’ health caused by hardwood dust exposure in selected industrial sectors in Italy.Methods. Proportionate mortality ratios (PMR) by cancer site were calculated by linking the information on occupational exposure to carcinogens from the Italian national registry (SIREP, 1996-2018) to the national mortality archives (ISTAT, 2005-2018), assuming a Poisson distribution of the data.Results. An elevated proportion of deaths from sino-nasal cancer was found in male exposed workers (PMR=4.25, CI 95%=1.37-13.23). Increased proportions of deaths were also found from stomach cancer in both genders (PMR=3.14, CI 95%=1.41-7.00 women; PMR=1.64, CI 95%=1.22-2.19 men).Conclusions. Although hardwood dust is a known human carcinogen, there are still many high-risk occupational exposure settings. Epidemiological surveillance and continuous monitoring of workers is highly recommended in order to ensure compliance with regulatory obligations and limit the burden of associated mortality causes
Culturally sensitive lifestyle intervention to prevent type 2 diabetes among Somalis in Finland: a pilot study using JA CHRODIS Recommendations and Criteria
Get PDFIntroduction. Somalis, particularly women, have high risk for type 2 diabetes (T2D). We designed and piloted a culturally tailored lifestyle intervention model to prevent T2D among Somalis.
Methods. The pilot was designed using the JA CHRODIS Recommendations and Criteria, with special emphasis on target group empowerment. Intervention consisting of risk identification and group and digital lifestyle counselling was created based on the existing Stop Diabetes-model. The 12-week intervention was conducted in the mosque.
Results. Of those at T2D risk, 24 participants (73%) agreed to participate in the lifestyle counselling. Mean participation rate in the group sessions was 50% and 76% of the participants used the mobile application. A statistically significant increase in vegetable intake was seen after the intervention. A non-significant increasing tendency was seen in all parameters of physical activity. All respondents considered counselling meetings very useful or useful.
Discussion. The piloted model proved to be feasible in providing prevention interventions to an underserved population group. Key success factor was active involvement of the target community
Ecological meta-analytic study of kidney disease in Italian contaminated sites: Kidney disease in Italian contaminated sites
No full textIntroduction. Environmental heavy metals exposure has been associated with kidney disease. There is also some evidence that exposure to solvents may be a risk factor for kidney disease. We estimated the risk of hospitalization for “kidney diseases” (ICD-9 580-586) and chronic kidney disease (CDK) (ICD-9 585) in residents in thirty-four Italian National Priority Contaminated Sites (NPCSs) polluted by heavy metals.
Methods. Random-effects model meta-analyses of SHR computed for each NPCS was performed for all the NPCSs together, and separately, according to the presence/absence of selected industrial activities (petrochemical/refinery and steel plants), and the presence/absence of solvents contamination.
Results. Pooled SHRs of overall NPCSs were in excess in both genders. Statistically significant excesses were found for CKD in both genders, and for “kidney diseases” in females, residing in NPCSs with the combined presence of heavy metals and solvents contamination. The pooled SHRs for CKD and “kidney diseases” were not statistically significant in excess in NPCSs with petrochemical/refinery and steel plants, and only petrochemical/refinery plants.
Conclusions. The results are suggestive of a possible kidney disease risk in population living in the above-mentioned NPCSs. Epidemiological surveillance and remediation actions in these areas are recommended
The Italian National Faecal Microbiota Transplantation Program: a coordinated effort against C. difficile infection
No full textClostridioides (previously Clostridium) difficile infection (CDI) is a common cause of antibiotic-associated diarrhea, whose symptoms range from mild diarrhea to life-threateningpseudomembranous colitis. CDI is characterized by significant recurrence rate followinginitial resolution and recurrent C. difficile infection (rCDI) represents an onerous burdenfor the healthcare systems. Conventional antibiotic‐based approaches are generally usedfor the treatment of rCDI but the effective therapy remains elusive. Recently, the faecalmicrobiota transplantation (FMT) has emerged as an alternative therapeutic strategyagainst rCDI, with high treatment success rate. In 2018, the Italian National FMT Programwas launched, with the aim to provide high quality standards in FMT applicationto adults with rCDI not responding to antibiotic therapy. Here, we sketch out the keycharacteristics and the progress of the Italian National FMT Program during the COVID-19 pandemic
New perspectives inperinatal mental health models: facing challenge for italian health services. Preface
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Quality of care for people with chronic diseases: engaged in collaboration, achieving results. Preface
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Measurable residual disease in multiple myeloma and in acute myeloid leukemia, an evolving topic
Get PDFMinimal or measurable residual disease (MRD) is a term that refers to the submicroscopic tumor disease persisting after therapy. Sensitive immunophenotypic and molecular techniques are used to detect the small amount of residual tumor cells, conferring a detection capacity clearly more sensitive of common cytomorphologic techniques. MRD evaluation now represents an important tool in the study of solid tumors and of hematological malignancies. Concerning hematological malignancies, MRD evaluation was particularly developed in the study of multiple myeloma and acute myeloid leukemia,representing in these diseases a precious biomarker to quantify response to treatment, to evaluate the chemosensitivity/chemoresistance of the disease and to have a prognostic prediction on disease outcome. The finding that MRD evaluation may have a prognostic value, predicting the risk of relapse, stimulated interest in the introduction of MRD in clinical trials, either as a clinical endpoint or as a tool to guide treatment decisions. However, the clinical use of MRD requires a standardization of the techniques used for its detection, the use of multiple techniques and the development of a consistent accuracy and reproducibility. Finally, prospective clinical trials are required to assess thereal clinical benefit potentially deriving from the introduction of MRD evaluation into clinical studies
The healthcare professionals’ support towards organ donation. An analysis of current practices, predictors, and consent rates in Apulian hospitals
Get PDFIntroduction. The paper investigates the critical care staff’s support towards organ donation by analysing how their attitude, knowledge, confidence, engagement, and training can act as predictors of donation consent rates. Our study focused on hospitals in the Apulia Region, Italy.Material and methods. The study employs a quantitative methodology based on a survey of healthcare professionals. The rate of consent to organ and tissue donation at the hospital level, given as a ratio of the permissions received to the proposals performed, was extracted from GEDON software related to the year 2019 report. For each Apulian participating hospital, we calculated a median score for each of the five predictors (namely, attitude, knowledge, confidence, engagement, and training) and investigated the association with hospital consent rates.Results. The results highlight that the engagement of the intensive care units’ healthcare personnel stands as the only influential predictor of the consent rate.Discussion. In Italy’s Apulia Region, efforts are needed to increase consent rates for organ donation. Strategies should concentrate on continuous support, as well as specific training of hospital staff involved in the donation process