Annali dell'Istituto Superiore di Sanità
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Hypochondria, or, the awareness of death that goes against the cure
Get PDFFifteen years after the publication of G. Braddock’s paper “Epicureanism, death, and the good life” in Philosophical inquiry the time has come to think of what actually prevents Epicureanism from taking root in Western societies, thereby facilitating our relationship with disease and care: hypochondria. In this commentary I analyse the philosophical problem of hypochondria overturning Heidegger’s idea that awareness of death is positive and calling for medical therapies that, through the help of psychology, would act on the causes and elimination of hypochondria
Gender-related differences in lifestyle may affect health status
Get PDFConsistent epidemiological and clinical evidence strongly indicates that chronic noncommunicable diseases are largely associated with four lifestyle risk factors: inadequatediet, physical inactivity, tobacco use, and excessive alcohol use. Notably, obesity, a worldwide-growing pathological condition determined by the combination between inadequate diet and insufficient physical activity, is now considered a main risk factor for most chronic diseases. Dietary habits and physical activity are strongly influenced by gender attitudes and behaviors that promote different patterns of healthy or unhealthy lifestyles among women and men. Furthermore, different roles and unequal relations between genders strongly interact with differences in social and economic aspects as well as cultural and societal environment. Because of the complex network of factors involved in determining the risk for chronic diseases, it has been promoting a systemic approach that, by integrating sex and gender analysis, explores how sex-specific biological factors and gender-related social factors can interact to influence the health status
Gender disparity in addiction: an Italian epidemiological sketch
Get PDFIntroduction. Gender disparity in different fields of addiction such as tobacco smoking, alcohol use, drugs of abuse consumption and doping practice has been investigated in Italian population. Methods. We used the surveys and studies carried out for the above reported issues in recent years as revised by the “National Observatory on Tobacco smoke, Drugs of abuse, Alcohol and Doping” at Istituto Superiore di Sanità. Results. Concerning tobacco habit, the trend of smoking women has been in constant decrease from a 19.7% in 2010 to a 16.9% in 2015, differently from men who passed from a 23.9% in 2010 to a 25.1% in 2015 with a slight increase in the habit. With respect to alcohol, in the last five years an increasing trend of consumption has been observed in 18-24 years old women, with 53% drinking women in the age range of 18-19 years overcoming the 50.4% general female population. Generally speaking, a one to four ratio can be underlined in the percentage of elderly women with a risky alcohol consumption with respect to men, while in case of adolescents and young adults gender disparity is not so pronounced. Drug abuse still remains a prevalent male phenomenon. However, an increase in cannabis users for both genders has been reported with a prevalence of “once in the life” around 20%, although more pronounced in females (+2.66 percentage points for females vs +0.93 percentage points in male). With respect to cocaine, the secondmost consumed drug, a reduction in consumption has been recently observed mainly in female population (-42.1%) than in men one (-27.5%). Finally, there are significant gender differences in doping attitude and/or in doping profiling. First of all, males seem to be more exposed to doping than females The prohibited substances most frequently used by females athletes are “Diuretics and Masking Agents” (38.3% positive female vs 14% males) compared to males athletes who use mostly anabolic agents (20.1% males vs 11.2% females). Conclusions. Results presented for the different fields of addiction show that a gender disparity is apparent and that females are less prone in having an addiction behaviour, although the young generation seems to increase that tendency
Assent, consent and paediatric bioethics
Get PDFIn the ethics of relations between physicians and paediatric patients the question of autonomy and its corollary, consent, is crucial. While the importance attached to autonomy in the clinical setting is not the same as that accorded in research, it nonetheless assumes greater relevance when minors are involved, and a careful case-by-case assessment becomes obligatory
Climate change and agricultural workers’ health in Ecuador: occupational exposure to UV radiation and hot environments
Get PDFClimate change is a global concern but little is known about its potential health effects in workers from non-industrialized countries. Ecuadorian workers from the coast (hot environments) and Andean region (elevated UV radiation) might be at particular risk of such effects. In the Andean region, measurements of UV index show maximum levels exceeding 11, a level considered being extreme according to the WHO. Also, an increased incidence of skin cancer was reported the last decennium, this being the second most common cancer type in men and women. In the coast, a high reported prevalence of kidney disease in agricultural workers is suggested to be related to exposure to hot temperatures. The scarce data available on occupational health in Ecuadorian agricultural workers raise the need for further investigation. Data worldwide shows an increasing prevalence of UV radiation- and heat stress-related illnesses in agricultural workers and urges the adoption of preventive measures
Impact of climate change on occupational exposure to solar radiation
Get PDFOccupational exposure to solar radiation may induce both acute and long-term effects on skin and eyes. Personal exposure is very difficult to assess accurately, as it depends on environmental, organisational and individual factors. The ongoing climate change interacting with stratospheric ozone dynamics may affect occupational exposure to solar radiation. In addition, tropospheric levels of environmental pollutants interacting with solar radiation may be altered by climate dynamics, so introducing another variable affecting the overall exposure to solar radiation. Given the uncertainties regarding the direction of changes in exposure to solar radiation due to climate change, compliance of outdoor workers with protective measures and a proper health surveillance are crucial. At the same time, education and training, along with the promotion of healthier lifestyles, are of paramount importance
Characterization of spotted fever group Rickettsiae in ticks from a city park of Rome, Italy
Get PDF Background: Ticks are vectors and important reservoirs for microbial agents that cause disease in humans and animals. Among these pathogens, the members of Rickettsia species play an important role in public health.Aim and Methods: One hundred twenty-nine ticks belonging to four tick species (Ixodes ricinus, Rhipicephalus turanicus, Dermacentor marginatus, and Haemaphysalis punctata) were collected at different sites of the Insugherata Natural Reserve, localized in the urban area of Rome, Italy. Questing ticks were tested by PCR for Rickettsia spp., amplifying partial gene of ompA.Results: Forty-six ticks were found to be infected with Rickettsia species. Five SFG rickettsiae were identified: three human pathogens Rickettsia conorii, Rickettsia massiliae and Rickettsia aeschlimannii, and two putative new strains Rickettsia sp. strain RM1 and Rickettsia sp. strain RM2. The phylogenetic analysis of partial gene sequences of ompA, gltA, and 17-kd antigen showed that they clustered with several rickettsiae with unidentified pathogenicity. However, Rickettsia sp. strain RM1 and Rickettsia sp. strain RM2 clustered in a statistically supported clade with R. massiliae, and R. monacensis, respectively.Conclusion: Our findings suggest that Rickettsia species other than R. conorii are implicated in human disease in Italy
Appropriateness of clinical and organizational criteria for intra-articular injection therapies in osteoarthritis. A Delphi method consensus initiative among experts in Italy
Get PDFObjective.The aim of the study was to identify the main aspects involved in patient selection, the choice of therapeutic agents and the safety profile, as well as the medico-legal and organizational aspects of intra-articular injection therapies for osteoarthritis. Methods. A committee of 10 experts from Italian universities, public hospitals, territorial services, research institutes and patient associations was set up. Fifty-two clinicians from a large number of Italian medical centers specialized in intra-articular injection therapy took part in a Delphi process aimed at obtaining consensus statements among the participants. Results. Large consensus was obtained for statements grouped under the following main themes: treatment indications; drug/medical device choice; treatment efficacy; and appropriate setting. Conclusions. The consensus statements developed by a large number of experts may be used as a practical reference tool to help physicians treat osteoarthritis patients by means of intra-articular injection therapies