Annali dell'Istituto superiore di sanita最新文献

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.