Annali dell'Istituto superiore di sanita最新文献

Ann Ist Super Sanità 2024 | Vol. 60, No. 4: 252-257 DOI: 10.4415/ANN_24_04_03 In the originally published version of this manuscript, an error occurred in the reporting of the dosage of disulfiram (DF) (Methods section, page 253). The correct sentence should read:"All patients failed to achieve abstinence either with SO (101 patients) or DF (25 patients) alone, so they were treated with oral doses of SO (50-100 mg/kg of body weight, tid), and DF (200 mg daily) in combination for 12 weeks"instead of:"All patients failed to achieve abstinence either with SO (101 patients) or DF (25 patients) alone, so they were treated with oral doses of SO (50-100 mg/kg of body weight, tid), and DF (250 mg daily) in combination for 12 weeks."We apologize for this error and any confusion it may have caused.

Introduction: In health impact assessment, relative excess measures of effect are used in combination with exposure and outcome data to estimate the health impacts under an alternative exposure scenario. The aim of this study is to propose: a classification of relative excess measures of effect functional for health impact assessment; a standard and general framework for calculating health impacts; different approaches when using data at different spatial resolutions.

Methods and results: A classification of the relative excess measures of effect was presented, introducing a new measure. A standard framework for calculating attributable and preventable cases based on the nature of the exposure and the imagined change in exposure was described. The marginal and conditional approaches to calculate health impacts using data at different spatial resolutions were illustrated.

Conclusions: The proposed methods and frameworks are designed to be applicable to a range of different situations. As health impact assessment continues to evolve, the insights and tools provided in this paper could help guide effective and equitable assessments, ultimately contributing to better public health decisions and outcomes.

Introduction: The use of antibiotics in food-producing animals for infections treatment, metafilaxis and, although not allowed in Europe, as growth enhancer is responsible for the presence of antibiotic residues in animal derived foodstuffs. For this reason, it is very important to perform a monitoring.

Methods and results: Muscle samples from bovine, pig, poultry, turkey and fish, as well as bovine milk and hen's egg samples, deriving from 444 farms of both Umbria and Marche regions (Italy) were analyzed by well-established and validated analytical methods in order to evaluate the presence or not of antibiotic residues (penicillins, quinolones, tetracycline and sulphonamides). The samples were collected during 2012-2021 period of time. In total, 15/2,354 samples resulted positive to the analyses. The amount of antibiotics found in the 15 samples resulted below the maximum residue limit fixed by EU Regulation 37/2010 and for this reason considered compliant.

Conclusions: Despite irregular samples were not found, the presence of antibiotic residues in foodstuff represents a risk for public health as they are responsible for the selection of resistant strains contributing to antimicrobial resistance problem spread. In the present work, this aspect was evaluated in relation to the results obtained from the analyzed samples coming from Umbria and Marche regions.

Background: 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 correlations between 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 state examination (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 order to get a more reliable model.

Background: 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.

Objective: To describe breastfeeding and associated factors in a large representative sample of children aged 0-2 years in Italy.

Materials and methods: Data from the 2022 Italian surveillance of children aged 0-2 years, comprised of 35,550 mothers, were analysed to estimate rates of EBF (exclusive breastfeeding), any breastfeeding (BF) and never breastfed (NBF). Logistic regression was used to investigate the association of EBF, BF and NBF with potential predictors.

Results: EBF among children aged 2-3 months varied from 36.4% in the South Italy to 54.0% in the North, decreasing respectively to 19.6% and 35.8% at 4-5 months. At 12-15 months BF ranged between 29.2% (South) and about 40% (Centre and North). Women with Italian citizenship, having a lower educational level, those who never attended antenatal classes (AC), and those residing in the South were significantly less likely to exclusively breastfeed or to breastfeed after the first year of life of the child.

Conclusions: The data underscore the gap between recommendations and actual breastfeeding practices, offering the first national perspective that highlights territorial disparities. The findings emphasize the need for targeted interventions, particularly in light of identified regional and socio-economic differences.

Background: 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 innovation in 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 of this 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). Among those 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.

Objectives: 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 anonymous online 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 workers and 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.

Since their institution, Ethics Committees (ECs) dedicated to the ethical evaluation of research protocols have been traditionally entrusted with the role of finding a delicate balance between protecting research participants' rights and avoiding the hampering of scientific progress. In Europe, these bodies have evolved significantly over time, shaped by a dynamic regulatory framework culminating in Regulation (EU) 536/2014, which has been fully applied since 2022. Focusing on the Italian scenario, a decade after the adoption of the Regulation (2014-2024), this paper is aimed at shedding light on the extent to which the evolution of the pertinent normative framework has affected ECs' space for reflection within the ethics review process of clinical trials, essential to protect the rights of research participants. Although focused on the Italian scenario, the analysis holds relevance for the broader European context, since the Regulation is unique and developments in a single Member State may impact the others.

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.