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Tobacco, heated tobacco products, e-cigarette, alcohol, cannabis and other psychotropic substances. Polysubstance use during the COVID-19 pandemic in Italy. 烟草、加热烟草制品、电子烟、酒精、大麻和其他精神药物。意大利COVID-19大流行期间的多物质使用。
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_08
Cosimo Campagni, Giuseppe Gorini, Andrea Amerio, Sonia Cerrai, Silvano Gallus, Alessandra Lugo, Luisa Mastrobattista, Claudia Mortali, Anna Odone, Chiara Stival, Giulia Carreras

Objective: Psychoactive substance use is largely found to involve multiple substances. In recent years, the COVID-19 pandemic has changed psychoactive substance use patterns. Aim of this study is to investigate profiles of polysubstance and their pattern during and after the COVID-19 pandemic.

Methods: We collected information on alcohol consumption, use of tobacco, cannabis and other psychotropic substances, and nicotine-containing electronic devices (NCEDs; i.e., heated tobacco products and electronic cigarettes) on representative samples of the Italian adult population in five surveys from 2020 to 2023 (3,000≤n≤6,600). We used a Latent Class Analysis model to identify substance use profiles and their associated variables in each time period.

Results: We initially identified two profiles, "light users", characterized by a low use of tobacco and NCEDs (3%-20%) and a 40% at-risk alcohol consumption, and "polysubstance users", characterized by a large use of all psychoactive substances. After the 2020 COVID-19 lockdown, we also found the "dual users" profile, which show a large use of tobacco (90%) and NCEDs (50%), and also alcohol (50%). Being "dual users" and "polysubstance users" were associated with younger age and high economic status, with strengths of association less pronounced during lockdown but more marked immediately thereafter. Moreover, reporting anxiety or depressive symptoms as well as using psychotropic drugs were strongly associated with both profiles, especially in the last two years.

Conclusions: Heterogeneity of polysubstance users and their socio-demographic characteristics need to be considered to design tailored prevention interventions, with special attention to the new "dual users" profile, which confirmed the increasing trend in NCED use.

目的:精神活性物质的使用在很大程度上涉及多种物质。近年来,COVID-19大流行改变了精神活性物质的使用模式。本研究的目的是调查COVID-19大流行期间和之后的多物质特征及其模式。方法:我们收集了有关饮酒、使用烟草、大麻和其他精神药物以及含尼古丁电子设备(nced)的信息;(即加热烟草制品和电子烟)在2020年至2023年的五次调查中对意大利成年人口的代表性样本进行了研究(3,000≤n≤6600)。我们使用潜在类别分析模型来确定每个时间段的物质使用概况及其相关变量。结果:我们最初确定了两种情况,“轻度使用者”,其特点是烟草和非尼古丁类药物的使用很少(3%-20%),40%的危险饮酒,以及“多物质使用者”,其特点是大量使用所有精神活性物质。在2020年COVID-19封锁之后,我们还发现了“双重用户”的概况,其中显示大量使用烟草(90%)和非尼古丁类药物(50%),也大量使用酒精(50%)。“双重使用者”和“多种物质使用者”与年龄较小和经济地位较高相关,这种关联的优势在封锁期间不太明显,但在封锁之后立即更加明显。此外,报告焦虑或抑郁症状以及使用精神药物与这两种情况密切相关,特别是在过去两年中。结论:需要考虑多物质使用者的异质性及其社会人口特征,以设计量身定制的预防干预措施,特别注意新的“双重使用者”概况,这证实了NCED使用的增加趋势。
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引用次数: 0
Recommendations for preventing sentinel events: results of a national cross-sectional survey in Italy. 预防哨点事件的建议:意大利全国横断面调查的结果。
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_09
Emanuele Sebastiani, Massimo Maurici, Michele Tancredi Loiudice, Domenico Mantoan

Introduction: In 2005, the Italian Ministry of Health entrusted the National Agency for Regional Healthcare Services (Agenzia Nazionale per i Servizi Sanitari Regionali, AGENAS) with the task of monitoring the implementation of recommendations to prevent sentinel events, which are serious adverse events that can compromise patient safety. The aim is to provide Regions and healthcare facilities with a standardised method for managing these events. Currently, there are nineteen recommendations developed with the support of regional experts and other stakeholders.

Objective: This study assessed the applicability and implementation of these recommendations in Italy, also comparing data on the most frequently reported sentinel events.

Materials and methods: The study, conducted from March to October 2023, involved all acute care, rehabilitation, and post-acute long-term care facilities, both public and private. A questionnaire was used to gather information on the applicability and implementation of the recommendations as of December 31, 2022. The data were analysed using the statistical software Jamovi.

Results: 34.7% of the facilities found no recommendations applicable, while 18.4% considered all 19 recommendations. Regarding implementation, 35.5% did not implement any recommendations, while 11.3% implemented all 19. In particular, Recommendation 4 ("Prevention of patient suicide in hospital") was not implemented by 16% of the facilities.

Conclusions: The applicability of the recommendations varies depending on the type of facility. The implementation rate is influenced by the diversity of participating facilities. The low implementation of Recommendation 4 suggests a need for further investigation to understand the challenges faced.

简介:2005年,意大利卫生部委托国家区域卫生保健服务局(AGENAS)监测建议的执行情况,以预防可能危及患者安全的严重不良事件——哨点事件。其目的是为各区域和卫生保健机构提供管理这些事件的标准化方法。目前,在区域专家和其他利益攸关方的支持下制定了19项建议。目的:本研究评估了这些建议在意大利的适用性和实施情况,并比较了最常报道的哨点事件的数据。材料和方法:该研究于2023年3月至10月进行,涉及所有公立和私立的急性护理、康复和急性后长期护理机构。使用问卷收集截至2022年12月31日建议的适用性和实施情况的信息。使用统计软件Jamovi对数据进行分析。结果:34.7%的医院认为不适用建议,18.4%的医院认为19条建议都适用。在执行方面,35.5%的人没有执行任何建议,11.3%的人执行了全部19项建议。特别是,建议4(“预防病人在医院自杀”)没有被16%的医疗机构执行。结论:建议的适用性因设施类型而异。执行率受参与设施多样性的影响。建议4的低执行率表明需要进一步调查,以了解所面临的挑战。
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引用次数: 0
Pandemic impact on training and mental health of medical residents: an Italian multicentre prospective study. 流行病对住院医生培训和心理健康的影响:一项意大利多中心前瞻性研究
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_07
Giuseppina Lo Moro, Gianmarco Giacomini, Giacomo Scaioli, Cecilia Acuti Martellucci, Davide Alba, Laura Brunelli, Silvio Brusaferro, Maria Elena Flacco, Walter Mazzucco, Lorenzo Fronticelli Baldelli, Paolo Leombruni, Fabrizio Bert, Roberta Siliquini

Objective: To describe the mental health of Italian medical residents during COVID-19 pandemic and explore the impact of personal and work-related changes on their mental health.

Methods: A multicentre prospective study was conducted on a sample of Italian residents across five timepoints (February-October 2021). Mental health outcomes (symptoms of post-traumatic stress disorder, PTSD, depression, anxiety, poor sleep quality) were assessed. Regressions analysed the association between pandemic-related personal and professional changes and the mental health outcomes.

Results: Participants were 451. From February to October 2021, the prevalence of symptoms ranged from 21.6% to 12.7% (PTSD), 29.8% to 16.2% (depression), 36.2% to 28.8% (anxiety), 15.2% to 5.7% (sleep). Several work-related changes were significantly associated with symptoms, e.g. a perceived negative training change was associated with all outcomes; increased working hours with PTSD, depression, and anxiety; reallocation to tasks far from expertise area with PTSD.

Conclusions: Residents reported a relevant frequency of mental issues. Many work-related changes were associated with poor mental health.

目的:了解新冠肺炎大流行期间意大利医疗居民的心理健康状况,探讨个人和工作变化对其心理健康的影响。方法:对五个时间点(2021年2月至10月)的意大利居民样本进行了多中心前瞻性研究。评估心理健康结果(创伤后应激障碍、PTSD、抑郁、焦虑、睡眠质量差的症状)。回归分析了与大流行相关的个人和职业变化与心理健康结果之间的关系。结果:参与者451人。从2021年2月至10月,症状的患病率为21.6%至12.7% (PTSD), 29.8%至16.2%(抑郁),36.2%至28.8%(焦虑),15.2%至5.7%(睡眠)。一些与工作相关的变化与症状显著相关,例如,感知到的负面培训变化与所有结果相关;患有创伤后应激障碍、抑郁和焦虑的人工作时间增加;重新分配到远离PTSD专业领域的任务中。结论:居民报告了与心理问题相关的频率。许多与工作有关的变化与心理健康状况不佳有关。
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引用次数: 0
The Italian National Vaccine Prevention Plans, 1999/2020-2023/2025: challenges and obstacles to vaccine coverage goals. Commentary. 意大利1999/2020-2023/2025年国家疫苗预防计划:实现疫苗覆盖目标的挑战和障碍。评论。
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_02
Carlo Signorelli, Fabrizio Oleari, Donato Greco, Giuseppe Ruocco, Ranieri Guerra, Giovanni Rezza, Francesco Vaia, Maria Rosaria Campitiello, Gaetano Maria Fara

Five consecutive national vaccination plans (from 1999 to 2025) were revised, outlining their objectives, challenges, and results. Vaccination coverage for children consistently approached target levels, though regional differences emerged. In contrast, coverage for adolescents, the elderly, and vulnerable groups, consistently fell short of targets. While vaccination policies in Italy over the past 25 years were ambitious and well-planned, success was primarily limited to newborns immunization, thanks to effective organizational activities. Failure to achieve goals for other population groups was partly due to inconsistent implementation of regional vaccination prevention plans.

修订了连续五个国家疫苗接种计划(1999年至2025年),概述了其目标、挑战和结果。尽管出现了区域差异,但儿童疫苗接种覆盖率始终接近目标水平。相比之下,青少年、老年人和弱势群体的覆盖率一直达不到目标。虽然意大利过去25年的疫苗接种政策雄心勃勃且计划周密,但由于有效的组织活动,成功主要限于新生儿免疫接种。未能实现其他人口群体的目标,部分原因是区域疫苗接种预防计划的执行不一致。
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引用次数: 0
Serious games in child and adolescent health education campaigns: a systematic review. 儿童和青少年健康教育运动中的严肃游戏:系统回顾。
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_06
Angela Ancona, Francesco Corea, Camilla Lombardo, Donatella Gentili, Antonio Mistretta

Background: The use of playful tools to promote children's and adolescents' health in schools is growing. Educational games are proven tools for promoting virtuous behaviours. This systematic review explores the significance of serious games in promoting health education among young audiences, particularly about hand, oral and respiratory hygiene, immunisation, antimicrobial resistance (AMR) and sexually transmitted infections.

Methods: This study was conducted in March 2023 on PubMed, Scopus, Web of Science and Embase using the population, exposure, outcome, and study design framework (PEOS). Articles in English and Italian were published within the past decade regarding campaigns with educational games on hygiene for students aged 3 to 19 years who do not have chronic conditions or disabilities. Final screening resulted in including the study of 40 articles of the 1,577 records initially extracted.

Results: The results indicate that play positively influences the quality of learning. Serious games have been demonstrated to have a high potential in child and adolescent health education campaigns.

Conclusions: Games can effectively engage young individuals, promote healthy behaviors, prevent diseases and enhance health literacy. As serious games continue to evolve, further research and collaboration are needed to utilize their full potential to improve children's and adolescents' health and well-being worldwide.

背景:越来越多的学校使用好玩的工具来促进儿童和青少年的健康。教育游戏被证明是促进良好行为的工具。本系统综述探讨了严肃游戏在促进年轻受众健康教育方面的意义,特别是关于手部、口腔和呼吸卫生、免疫、抗菌素耐药性(AMR)和性传播感染的教育。方法:本研究于2023年3月在PubMed、Scopus、Web of Science和Embase上使用人群、暴露、结果和研究设计框架(PEOS)进行。在过去十年中,以英语和意大利语发表了关于为3至19岁无慢性疾病或残疾的学生开展卫生教育游戏运动的文章。最后的筛选结果包括了最初提取的1577份记录中的40篇文章的研究。结果:游戏对学习质量有正向影响。严肃游戏已被证明在儿童和青少年健康教育运动中具有很大的潜力。结论:游戏可以有效地吸引年轻人,促进健康行为,预防疾病,提高健康素养。随着严肃游戏的不断发展,需要进一步的研究和合作,以充分利用其潜力,改善全世界儿童和青少年的健康和福祉。
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引用次数: 0
The European legislation on the restriction on intentionally added microplastics. Commentary. 欧洲关于限制故意添加微塑料的立法。评论。
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_01
Tiziana Catone, Silvia Alivernini, Leonello Attias, Maria Antonietta Orrù

The potential impacts of microplastics pollution on the environment and possibly human health have raised concerns in various parts of the world. Once in the environment, microplastics do not biodegrade and cannot be removed. Several Member States have adopted or proposed specific measures. However, a patchwork of national restrictions can hinder the functioning of the internal market and therefore requires harmonization at Union level. The European Commission, on 9 November 2017, requested the European Chemicals Agency to prepare possible proposals for restrictions regarding oxo-plastics and intentionally added microplastic particles. On 25 September 2023, the restriction on microplastics intentionally added was published on the Official Journal of the European Union. By the end of 2024 it is envisaged the publication of a Guidance on the application of the microplastic restriction under Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH).

微塑料污染对环境和人类健康的潜在影响已引起世界各地的关注。微塑料一旦进入环境,就不会被生物降解,也无法被清除。一些会员国已经采取或提议采取具体措施。然而,各国限制措施的拼凑会阻碍内部市场的运作,因此需要在欧盟层面进行协调。欧盟委员会于 2017 年 11 月 9 日要求欧洲化学品管理局就限制氧化塑料和有意添加的微塑料颗粒编制可能的提案。2023 年 9 月 25 日,《欧盟官方公报》公布了对有意添加的微塑料的限制。预计到 2024 年底,将根据《化学品注册、评估、许可和限制》(REACH)发布关于微塑料限制的应用指南。
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引用次数: 0
Efficacy of sodium oxybate plus disulfiram for the maintenance of alcohol abstinence in treatment-resistant patients with alcohol use disorder: a multicentre retrospective study. 一项多中心回顾性研究:氧化钠加双硫仑对酒精使用障碍难治性患者戒酒的疗效
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_03
Fabio Caputo, Caterina Trevisan, Teo Vignoli, Angelo Giovanni Icro Maremmani, Franco Montesano, Gianfranco Carboni, Lisa Lungaro, Anna Costanzini, Giacomo Caio, Gianni Testino, Stefano Volpato, Roberto De Giorgio

Introduction: Disulfiram (DF), acamprosate, naltrexone, baclofen and sodium oxybate (SO) are currently the medications approved for the treatment of alcohol use disorder (AUD). In this context, combined pharmacological interventions and sex differences are an interesting area in the treatment of non-responder AUD patients.

Aim: To evaluate the efficacy of SO in combination with DF in maintaining alcohol abstinence in patients with AUD who failed to achieve abstinence either with SO or DF alone.

Methods and results: 126 detoxified AUD patients, previously treated with only SO or DF, were retrospectively enrolled from 2018 to 2022. At the end of treatment, a higher number of females than males (74.1% vs 66.3%: p=0.03) maintained continuous abstinence from alcohol, and all the females responded completely or partially to the treatment.

Conclusions: This study shows that the combination of SO and DF may be considered a further pharmacological opportunity for AUD patients (particularly in females) who do not respond to mono-therapy.

简介:双硫仑(DF)、阿坎普罗酸、纳曲酮、巴氯芬和氧化钠(SO)是目前批准用于治疗酒精使用障碍(AUD)的药物。在这种情况下,联合药物干预和性别差异是治疗无反应AUD患者的一个有趣的领域。目的:评价SO联合DF对单用SO或DF均不能戒酒的AUD患者维持酒精戒断的疗效。方法和结果:从2018年到2022年,回顾性纳入126例先前仅接受SO或DF治疗的解毒AUD患者。治疗结束时,女性持续戒酒的人数高于男性(74.1% vs 66.3%: p=0.03),所有女性对治疗均有完全或部分反应。结论:本研究表明,对于单药治疗无效的AUD患者(尤其是女性患者),SO和DF联合用药可能被认为是进一步的药理学机会。
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引用次数: 0
Evaluation of four common electronic mosquito repellers on Aedes albopictus and Culex pipiens. 四种常用电子驱蚊剂对白纹伊蚊和淡库蚊的驱蚊效果评价。
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_04
Luciano Toma, Fabio Lo Castro, Francesco Severini, Roberta Pozzi, Francesca Casale, Michela Menegon, Marco Di Luca, Massimiliano De Luca, Paolo Sperandio, Sergio Iarossi

Introduction: Mosquitoes represent a way of spreading infectious diseases, as vectors of pathogens. Many types of ultrasonic devices have recently been promoted as effective and suitable alternatives to the use of biocides known as toxic to humans and environment.

Materials and methods: Four ultrasonic mosquito repellers have been analysed and tested on females of two species, Culex pipiens and Aedes albopictus, in laboratory conditions. The behavior of the mosquitoes of reaching the attractant, with the repellers both at ON and OFF, was observed.

Results: The total mean number of Cx. pipiens interested to attractant when the repellers were ON was 2.8 versus 2.9 at OFF. The total mean number of Ae. albopictus interested to attractant when the repellers were ON was 5.5 versus 6.1 at OFF.

Conclusions: The repellence efficacy resulted not significant (P>0.05) in all the electronic ultrasound repellers tested. The number of mosquitoes of both species, displaying the attractant's search behavior appeared independent from the switch ON/OFF mode. Open questions remain: the need of conducting further research to establish a relationship between ultrasonic emission and mosquito effective disturbance.

蚊子作为病原体的载体,是传染病传播的一种方式。最近,许多类型的超声波装置被推广为对人类和环境有毒的杀菌剂的有效和合适的替代品。材料与方法:在实验室条件下,对四种超声波驱蚊剂对淡库蚊和白纹伊蚊两种雌蚊进行了分析和试验。观察了驱蚊剂开、关两种状态下,蚊虫到达引诱剂的行为。结果:Cx细胞总平均数目;驱蚊剂开启时,对引诱剂的兴趣为2.8,关闭时为2.9。Ae的总平均数量。当驱蚊剂打开时,白纹伊蚊对引诱剂的兴趣为5.5,而在关闭时为6.1。结论:所有电子超声驱避剂的驱避效果均无显著性差异(P < 0.05)。显示引诱剂搜索行为的两种蚊子数量与打开/关闭模式无关。超声发射与蚊虫有效干扰之间的关系有待进一步研究。
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引用次数: 0
Dementia among migrants in Italy: a qualitative study of the ImmiDem project. 意大利移民中的痴呆症:对imidem项目的定性研究。
Pub Date : 2024-10-01 DOI: 10.4415/ANN_24_04_05
Annachiara Di Nolfi, Angela Giusti, Marco Canevelli, Nicola Vanacore, Simone Pomati, Ilaria Cova, Antonio Ancidoni, Francesca Marchetti, Francesca Zambri

Introduction: In recent years, the number of migrants referred to centres for cognitive disorders and dementias has increased. The aim of this study was to provide information on the provision of care for migrants with dementia through the perceptions and experiences of the professionals and caregivers involved.

Methods: The study is an exploratory qualitative research. Between 2020 and 2021, three focus group, involving caregiver and professionals were organized.

Results: The study explored several areas of care provision including needs, cultural representation of dementia, strengths and weaknesses and opportunities for improvement in care provision.

Discussion and conclusions: The perceptions of people directly involved in dementia care provide critical insights into the functioning of the care system, capturing nuances that standard care practices may overlook. Disorientation between services, language barriers and cultural representations of the disease are the main obstacles to continuity of care. A more holistic approach, which also addresses the emotional and social implications of dementia, is essential in ensuring equitable, timely and culturally sensitive care.

导言:近年来,转介到认知障碍和痴呆症中心的移民人数有所增加。本研究的目的是通过专业人员和护理人员的感知和经验,为患有痴呆症的移民提供护理信息。方法:本研究为探索性质的研究。在2020年至2021年期间,组织了三个焦点小组,涉及护理人员和专业人员。结果:该研究探讨了护理提供的几个领域,包括需求、痴呆症的文化表征、优势和劣势以及改善护理提供的机会。讨论和结论:直接参与痴呆症护理的人的看法为护理系统的运作提供了重要的见解,捕捉了标准护理实践可能忽略的细微差别。服务之间的定向障碍、语言障碍和疾病的文化表征是连续性护理的主要障碍。采取更全面的方法,同时处理痴呆症的情感和社会影响,对于确保公平、及时和具有文化敏感性的护理至关重要。
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引用次数: 0
Regulation of gene transcription in Escherichia coli O157:H7 in response to a natural derivate peptide of esculentin-1a used in combination with essential oils from plants of the Cymbopogon genus. 埃希氏大肠杆菌 O157:H7 中基因转录的调控--埃希氏素-1a 的天然衍生物肽与 Cymbopogon 属植物的精油结合使用的反应。
Pub Date : 2024-07-01 DOI: 10.4415/ANN_24_03_04
Raffaella Scotti, Eleonora Spinozzi, Roberta Gabbianelli

Introduction: We analyzed the expression of several genes implicated in the pathogenicity of Escherichia coli O157:H7, treating bacteria with Esc(1-21), a derivative of peptide esculentin-1 in combination with three essential oils obtained from plants from the Cympopogon genus.

Methods: We used the checkerboard assay to determine the antimicrobial activity of the combinations. We analyzed the expression of some genes implicated in the pathogenicity and quorum sensing system of E. coli O157:H7 by real-time RT-PCR technique.

Results: Treatment of the bacteria with the peptide combined with oils had an efficacious antimicrobial activity. The analysis of gene expression showed that all used combinations regulate positively the espAD and ler genes, located in the pathogenicity island, named the locus of enterocyte effacement. None of the combinations affects the quorum sensing genes: lsrABCFKR and qseBC.

Conclusions: This study demonstrates that the use of essential oil/peptide combinations can be effective in fighting microbial infections.

简介我们分析了与大肠杆菌 O157:H7 致病性有关的几种基因的表达情况,用 Esc(1-21)处理细菌,Esc(1-21)是多肽埃斯库伦汀-1 的衍生物,它与从香蒲属植物中提取的三种精油结合使用:方法:我们使用棋盘试验来确定组合物的抗菌活性。我们通过实时 RT-PCR 技术分析了与大肠杆菌 O157:H7 致病性和法定量传感系统有关的一些基因的表达情况:结果:用多肽与油类组合处理细菌具有有效的抗菌活性。基因表达分析表明,所有使用的组合都对位于致病性岛(即肠细胞损伤位点)的 espAD 和 ler 基因有正向调节作用。所有组合都不会影响法定量感应基因:lsrABCFKR 和 qseBC:本研究表明,使用精油/肽组合可有效对抗微生物感染。
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引用次数: 0
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