Annali dell'Istituto Superiore di Sanità
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The impact of pictorial health warnings (PHW) on tobacco packages: the first quasi-experimental field trial after the implementation of the law in Italy
No full textBackground. The aim of the study was to evaluate in the Italian smokers, the effects of implementation of the law about Pictorial Health Warnings (PHWs) on tobacco products. Methods. A quasi-experimental longitudinal design was conducted between 2016 and 2017. The data were collected before (pre-PHW/Wave 1) and after (post-PHW/Wave 2) the implementation of the law. The adopted questionnaire included impact of advertisement (Label Impact Index, LII), quitting behavior and knowledge of tobacco related diseases.Results. 455 respondents completed both the Waves. 7.7% of smokers declared to have stopped smoking in Wave 2 and 29% of these declared the PHWs as one of the reasons to quit. The knowledge of tobacco related diseases was significantly (p <0.001) increased from Wave 1 to Wave 2 (58% versus 72%), similarly the LII (mean = 26.9, SD = 16.7 and mean = 40.4, SD = 16.2).Conclusion. Tobacco addiction is a problem that needs to be addressed from different angles. PHWs confirm their complementary role as a support for smokers along with other strategies such as text warnings and the tobacco quit line of the Istituto Superiore di Sanità (Italian National Institute of Health) reported on the packages. Nonetheless, over the years these measures have been not enough and policy makers should consider more strategies synergistically acting in the fight against tabagism.
Narrating and remembering as practices of care, community, and commitment in asbestos contaminated contexts
Get PDFIn contexts of social and environmental disasters, practices of memory and narration can become actions implemented by the affected groups to cope with the suffering related to the disaster experience, to mobilise in the name of social justice, and to favour those dynamics by which the survivors develop their sense of being part of a community. This article is based on qualitative data collected through an anthropological study based on ethnographic fieldwork conducted in Italy and Brazil. It discusses the practices by which the survivors of the impact of asbestos-related disaster on their lives make sense of their suffering experience and engage in a grassroots health-based movement. Attention is paid on the social aspects of the health impact of asbestos exposure, and the role of the affected communities in the elaboration of their own paths of care by remembering and communicating the disaster is considered
Multiple chemical sensitivity: pursuit of a scientific consensus, need for a public health response
Get PDFOn the international scene, the Multiple Chemical Sensitivity (MCS) is defined, by several experts, as a multisystem syndrome that develops following chronic exposures to low doses of common chemical contaminants. Its general characteristics are, however, the object of conflicting opinions and a source of debate and research aimed at the correct nosological and therapeutic framework. In the face of a potentially debilitating trend, both in the work and in the economical and social sphere, the scientific community has not found an agreement. This problem leads some patients and their associations to periodically claim some requests. The syndrome is also taken into consideration at a political level, especially due to the close connection with the problems related to environmental pollution and to any necessary measures in the field of control and prevention. For these reasons we believe it is appropriate for a widespread surveillance network to be set up in Italy, capable of intercepting possible cases, analyzing them at a multidisciplinary level, and following their evolution
Revisiting problems and solutions to decrease Mycobacterium tuberculosis pyrazinamide false resistance when using the Bactec MGIT 960 system
Get PDFPyrazinamide (PZA) is a first-line key drug used in combination with other agents for the treatment of tuberculosis (TB). Phenotypic and molecular assays for testing susceptibility of Mycobacterium tuberculosis (Mtb) to PZA have been developed, with the assay in liquid medium at acidic pH in the Bactec MGIT 960 (M960) system being routinely used in the mycobacteriology laboratories. However, false resistance to PZA by this method was reported to occur by several investigators, mostly due to high Mtb inoculum, which may impair drug activity by increasing the pH of the medium. In this study, a revision of the literature on the issue of false resistance in the M960 PZA assay was performed. In the reports examined, all improvements of the M960 test proposed to decrease false resistant results were based on the use of reduced inoculum densities of Mtb cells, to be easily translated into laboratory practice
Are touch screen technologies more effective than traditional educational methods in children with autism spectrum disorders? A pilot study
Get PDFApplied Computer technologies can address the needs of individuals with autism spectrum disorders (ASD). Data on the efficacy of assistive technology in ASD is limited, and its effectiveness in supporting and facilitating skill acquisition in this specific population must be still demonstrated. 63 Italian ASD subjects underwent learning activities administered by cardboards or a touch screen support. The support preference was evaluated in a choice trial, and quantitative analysis was performed on items regarding communication and challenging behaviours. Touch devices are attractive especially for males without intellectual disability and a lower communication and cooperation behaviours with the use of touch screen compared with paper support was shown depending on activities. Overall, our data do not confirm the hypothesis that touch screen presentation improves activity completion and behavioural performance for each individual with ASD. Data discourage an indiscriminate use of these devices and suggest analysing with more attention the core ingredients that should shape digital devices when used for people on ASD.
Understanding mechanisms of cancer initiation and development supports the need for an implementation of primary and secondary cancer prevention
Get PDFThe burden of cancer is increasing worldwide, with a continuous increase of the annual total cases. Although mortality rates due to cancer are declining in developed countries, the total number of cancer deaths continues to rise due to the increase in the number of aged people. Three main causes of cancer have been described, represented by environmental factors, hereditary factors and random factors related to defects originated during cell replication. The frequency of cancers is very different for the various tissues and there is great debate on the extent of the specific contribution of environmental factors and random factors (due to “bad luck”) to cancer development. However, there is consensus that about 50% of all cases of cancer are related to environment and are preventable. Although a part of cancers is related to intrinsic mechanisms non preventable of genetic instability, it is evident that implementation of primary and secondary prevention measures is the only affordable strategy to meet from a medical and economic point of view the tremendous pressure created on healthcare structures by the increased cancer burden. It is time to bypass the paradox of disease prevention: celebrated in principle, resisted in practice
Communication and basic health counselling skills to tackle vaccine hesitancy
Get PDFIntroduction. The Italian law 119/2017 mandates ten childhood vaccinations to allow population aged 0-16 attend educational places and state school. This law enforcement is due to low coverage rates for some vaccine-preventable diseases and a complex phenomenon as known as vaccine hesitancy.Methods. Within a broad e-learning course programme promoted by the Istituto Superiore di Sanità to public health professionals, a specific training module was developed on communication and basic health counselling skills which represent relevant resources to let healthcare workers effectively address vaccine hesitancy in the population.Results. We indicated recommended communication approaches and basic health counselling skills to be applied by public health professionals according to the specific target population with vaccine deficit, that means people not at all or partially reached by vaccinations.Discussion and conclusions. Public health professionals are called to know, acquire, use, and adapt basic health counselling skills to effectively address vaccine hesitancy diversely affecting different groups of population
Adolescents self-reported sleep quality and emotional regulation: a discordant twin study
Get PDFAim. This study explores the association between sleep quality and emotional regulation, and investigates the genetic and environmental bases of this association. Methods. Three-hundred-eighty-two adolescent twins, from the Italian Twin Registry, and their parents filled the Youth Self-Report and Child Behavior Checklist questionnaires, from which the construct of Effortful Control (EC) was derived as a measure of emotional regulation. Twins were identified as “good” or “non-good” sleepers based on answers to the Sleep Disorders Questionnaire. EC levels were compared between samesex sleep discordant twins.Results. A significant association was detected between EC scores and sleep quality. When controlling for shared (fetal or early life) environmental factors and genetic background in the discordant twin analysis, this association weakened in dizygotic twins and disappeared in monozygotic twins.Conclusion. Results support the association between sleep quality and EC in adolescence; furthermore, they suggest that sleep quality and emotional regulation may depend on common genetic or environmental factors.
Organ donor families should be free to meet their recipients under controlled conditions if both sides wish, Italian National Committee for Bioethics says
Get PDFn 27 September 2018 the Italian Committee for Bioethics (ICB) adopted an opinion regarding the possibility of an exception to the anonymity obligation when both parties agree and have signed an appropriate informed consent form. According to the IBC any contact between the donor’s family and recipient must be managed by a third-party body pertaining to the National Health Service, established to guarantee strict control over the expression of consent in order to avoid any risk of inappropriate behaviour. The paper traces how Reg and Maggie Green, on holiday from California, donated the organs of their seven-year old son, Nicholas, to seven Italians after he had been shot in a carjacking on the Salerno-Reggio Calabria autostrada in 1994. Reluctant as a foreigner to propose a change in Italian law that effectively prevents the two sides from contacting each other, Reg Green held back for 22 years until, at age 87, he began a public campaign to voice his concern that the law was hurting transplant families rather than helping them