Annali dell'Istituto Superiore di Sanità
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At the heart of life: the Italian National Transplant Centre\u27s enduring commitment
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Assessing brain vascular impairment, white matter lesions and ApoE status as predictors of behavioral and psychological symptoms of dementia (BPSD) in a multicentre sample of patients with Alzheimer’s disease: a multidisciplinary retrospective study
Full text linkBackground. Understanding pathogenetic background and risk factors is the primary step to a better behavioral and psychological symptoms of dementia (BPSD) management. To this aim, this exploratory study is designed to sketch some indicative correlationsbetween BPSD severity and vascular, genetic and cognitive variables.Methods. A retrospective cross-sectional study conducted on medical reports of 135 Alzheimer Dementia (AD) patients from two memory clinics. Each subject underwent clinical examination and brain Magnetic Resonance Imaging (MRI), mini mental stateexamination (MMSE) and behavioral assessment using the neuropsychiatric inventory (NPI). This real-world cross-sectional study aimed to correlate the load of white matter lesions and global vascular compromise with clinical assessment. In addition, apolipoprotein E (ApoE) genotype was checked in 92 patients. Data were analysed performing Spearman correlation and principal component analysis (PCA).Results. BPSD severity was independent from cognitive impairment, vascular impairment, white matter lesions and ApoE status.Conclusions. Our results do not confirm the possible role for vascular impairment in BPSD severity as previously reported. Studies focusing on different biological features in relation to other structural, psychosocial and environmental factors are needed in orderto get a more reliable model
Health promotion at the beach: lessons learned from the “safe beaches” education project
Full text linkBackground. During summer, beach authorities are charged with ensuring the safety of beach visitors, which includes promoting safe behaviour via educational efforts. The purpose of this study was to describe the processes of development and implementation of a promotional project for beach safety.Methods. A multidisciplinary task force developed the informational material and the content to be provided following the principles of the Health Belief Model (HBM). The health promotion addressed a wide range of topics and was delivered at 65 bathing facilities along the Lazio coast (Central Italy) from June 2, 2023, to September 10, 2023. To evaluate the feedback of the promotion activities, the attendees were asked to answer a post-event self-evaluation survey.Results. 1,032 people responded to the questionnaire about satisfaction and utility levels. Participants’ overall satisfaction scores (98% rated “excellent” or “good”) and utility (88%) were high, with higher satisfaction levels for the women, those with higher education, and Italian citizens. Most participants reported that the material was easy to understand; the contents were comprehensive; and the healthcare professionals were prepared, engaging, and available.Conclusions. This project showed that approaching the summer visitors in the place time is a feasible and well-accepted strategy for summer health-related education
Awareness of digital tomosynthesis and attitudes towards breast cancer early diagnosis in women at first screening: findings from the IMPETO trial survey
Full text linkBackground. The European guidelines on breast cancer and diagnosis recommend digital mammography (DM) or digital breast tomosynthesis (DBT) for screening asymptomatic women with an average risk of breast cancer. The research project innovationin mammography: tomosynthesis pathways (IMPETO) includes an interventional randomised trial conducted in Tuscany, Italy, aiming to assess the feasibility and impact of DBT in screening. Limited evidence exists on women’s preferences and acceptability ofthis new technology. To address this gap, as part of the IMPETO trial, a questionnaire was administered to 441 women aged 45 at their first inclusion in the screening programme, to investigate women’s awareness of tomosynthesis and their attitudes toward early diagnosis.Methods. This cross-sectional study was nested within the IMPETO trial, whose participants were randomly sampled. From October 2021 to February 2022 all women who participated in the face-to-face enrolment for the IMPETO trial were asked to fill out a structured questionnaire collecting socio-demographic information and assessing awareness of tomosynthesis, breast density, attitudes toward breast cancer early diagnosis, and sources of information on breast health. Multiple logistic regression was performed to identify predictors of tomosynthesis awareness and attitudes toward early diagnosis.Results. Out of the 441 women surveyed, only 12% knew what tomosynthesis was and this awareness was positively associated with prior mammography experience (OR=2.092; 95% CI: 1.036-4.11). More than half of the participants (56.7%) had undergone mammography before joining the screening programme. Education attainment emerged as a significant predictor, with women holding a secondary degree being more likely to undergo mammography before age 45 (OR=2.18; 95% CI: 1.04-4.56). Amongthose who had undergone mammography before 45, 38.8% were advised by their gynaecologist, 27.6% made the decision independently, and 13.6% followed the advice of their general practitioner.Conclusion. This study highlights the need for improved education on screening appropriateness and associated risks and the importance of tailored communication to reduce knowledge differences across educational levels without increasing inappropriate use
Exploring perceptions of vaccine safety: an Italian national survey on different COVID-19 vaccine formulations
Full text linkObjectives. COVID-19 vaccines have proven effective and safe, enabling the resumption of normal life. However, misinformation has hindered vaccination efforts. This study aimed to investigate perceptions of vaccine safety among Italians through an anonymousonline survey. Study design. An anonymous online survey was conducted from April to July 2022 and disseminated through social platforms, among adult individuals living in Italy.Results. A total of 1,329 individuals participated. Younger individuals and healthcare professionals showed greater trust in vaccines. Education level was significantly associated with perceived vaccine safety. Most respondents, including many healthcare workersand highly educated individuals, believed vaccines to be safe, with confidence levels of 39.5% for mRNA, 32.9% for viral vector, and 39% for protein subunit vaccines. Younger age and trust in institutions were linked to higher confidence in all vaccine types.Conclusions. These findings may be useful to further investigate the drivers of vaccine safety perceptions and their relationship with vaccine hesitancy and may help to develop more effective communication campaigns in the future
EpiCHILD assessment tool: identifying exposure to witnessed violence in children and adolescents
Full text linkIntroduction. Witnessed domestic violence is a widespread yet underrecognized form of childhood trauma, with serious consequences for the emotional, behavioral, and physical development of children and adolescents. In Italy, nearly half of domestic violence incidents occur in the presence of children, yet standardized tools for identifying affected minors remain scarce.Objectives. This study presents the EpiCHILD assessment tool, designed to support the early identification of psychophysical vulnerabilities in children exposed to domesticviolence and to guide targeted prevention and care strategies.Methods. Developed within the ESMiVA study, EpiCHILD is a multidimensional electronic questionnaire composed of nine sections, incorporating validated instruments forPTSD (ITQ-CA), depression (CDI-2), and psychosocial functioning (SDQ-Ita). Administered by trained professionals in clinical and social service settings, the tool is GDPRcompliant and allows for flexible, child-centered use.Conclusions. EpiCHILD enables systematic screening and early detection of children at risk due to violence exposure. It standardizes data collection across sectors and laysthe groundwork for future research on the biological impact of trauma, including potential epigenetic markers, representing an innovative contribution to precision preventio
Smoking cessation in the management of Chronic Obstructive Pulmonary Disease (COPD): narrative review and recommendations
Full text linkBackground. The percentage of smokers who develop COPD (chronic obstructive pulmonary disease) peaks at 40-50% in most recent publications.Summary. Tobacco smoke remains the main cause of COPD, though smoking-related limitation of the flow is rather subjective. For patients who keep on smoking, general practitioners (GPs) and pulmonologists should be able to offer smoking cessation programs as an important part of COPD treatment. This narrative article aims to provide the scientific basis to help healthcare professionals develop this therapy; with this aim in mind, the authors have analyzed the most recent literature.Key messages. Only 3% of smokers who try to quit without availing themselves of any support succeed. Effective smoking cessation methods are Counselling and Pharmacotherapy, which, combined together, are credited with a 24% success rate. Although there are no therapeutic novelties with strong scientific evidence for smoking cessation, it is however advisable to keep the literature updated to new devices and new digital therapies
Tackling the challenge of cardiovascular diseases and diabetes across Europe: a joint action by more than 300 public health professionals
Full text linkCardiovascular diseases (CVD) and diabetes pose significant health challenges in Europe, affecting millions and burdening healthcare systems. The recent EU4Health Programme places reducing the burden of non-communicable diseases (NCD) at the forefront, through a Joint Action focused on CVD and diabetes (JACARDI, Joint Action on CARdiovascular diseases and DIabetes). This initiative unites 21 European countries, including Ukraine, and over 300 experts. Employing an innovative approach and standardised methodology, JACARDI implements 142 pilot projects covering the entire“patient” journey. Particular focus will be given to improvement of data availability and quality. Additionally, JACARDI will emphasise transversal and intersectional aspects, such as health equity, determinants of health, and social, cultural, and ethnic diversity, while pioneering gender-transformative leadership. Committed to evidence-based interventions, JACARDI aims to harmonise strategies and disseminate knowledge for enhanced CVD and diabetes prevention and management. The goal is to identify effective strategies for wider implementation, fostering cross-national collaboration and fortifying Europe’s health resilience
Driving under the influence of alcohol and alcohol use disorder: the relevance of early identification from an Italian retrospective outpatient study
Full text linkIntroduction. Worldwide, almost 1.2 million people drive under the influence of alcohol. However, early identification of alcohol use disorder (AUD) in subjects driving under the influence (DUI) of alcohol is seldom achieved.Aim. The aim of our retrospective study is to investigate the presence of AUD in a population of DUI subjects who had their driving license suspended, and if they were following a specific rehabilitation program.Methods and results. 750 subjects were retrospectively enrolled from 2018 to 2021. DSM-V to assess AUD was used. Forty-eight (6.4%) subjects presented a diagnosis of AUD, after one month they showed a statistically significant reduction of carbohydratedeficient transferrin (CDT) (p<0.0001); however, none were following a program for the treatment of AUD.Conclusions. This outpatient setting may be considered a place of primary and secondary prevention where DUI subjects with a diagnosis of AUD may be entrusted to a Centre in order to follow rehabilitation treatment
The “Investigating and translating genomic evidence for public health response to SARS-CoV-2 (INSIDE SARS-CoV-2)” project – Network of excellence
Full text linkThe “Investigating and translating genomic evidence for public health response to SARSCoV- 2 (INSIDE SARS-CoV-2)” project is part of the initiative “Joint science and technology cooperation call for joint project proposals for the years 2021-2023” promoted by the Italian Ministry of Foreign Affairs and International Cooperation (MAECI) and the Republic of India. To start the project activities, the pandemic response and the epidemiological situation in Italy and in India, together with the genomic surveillance strategies for SARS-CoV-2 virus in the two countries, are here described