Annali di igiene : medicina preventiva e di comunita最新文献

Introduction: According to the European Food Safety Authority (EFSA), novel food is defined as food that had not been consumed to a significant degree by humans in the EU before May 15th 1997, when the first regulation of novel food came into force. This study investigates the consumption of insect-based novel food in Italy, where cultural aversions and particular disgust are major barriers to acceptance.

Methods: A cross-sectional study was conducted using a three-sections questionnaire shared through social media platforms (Facebook, Instagram, WhatsApp). The questionnaire explored socio-demographic characteristics, prior knowledge of novel food, willingness to consume insect-based food, and the impact of packaging on consumer choices. Frequencies for different items were calculated and reported in tables and charts.

Results: The sample showed that the majority of respondents were female (56.3%) and aged 26-35 years (24.8%). Most participants were from Southern Italy (61.8%) and had a high school diploma (45.6%). However, the majority of novel food consumers appears to be male, less than 35 years-old and born in Northern Italy. Disgust is the main obstacle towards the consumption of insects (n=261, 78.4%) while, conversely, curiosity was also significant (72.9%). Packaging had a considerable influence on consumer choices: 74.1% were willing to try chips made from cricket flour, while only 15.0% were willing to try whole insects.

Conclusion: Despite strong cultural barriers, strategies such as improved information and appealing packaging could increase acceptance of insect-based foods in Italy, particularly among younger, educated consumers.

Background: The training of healthcare professionals requires continuous innovation in teaching methodologies to foster the development of professional skills. The use of simulation in critical care is a proven effective technique, allowing students to acquire and consolidate the necessary knowledge to plan and implement nursing care in clinical practice. Interactive teaching strategies aim to increase student engagement and motivation in order to improve the learning process, decision-making, and critical thinking. New technologies that leverage gamification provide further advancements in interactive learning and represent a valuable and promising tool for training in various healthcare contexts. This study aims to analyze and compare two simulated teaching methodologies, Role Playing and Action Maze, and assess their effectiveness in terms of the acquisition of specific knowledge in the critical care field and the level of satisfaction among nursing students.

Materials and methods: A Randomized Field Trial was conducted. A total of 130 third-year nursing students from the Sapienza University of Rome were enrolled in the study, with 60 students from course D and 70 students from course X. An initial lecture was given on nursing care for critical patients. At the end of the lecture, a custom-designed questionnaire was administered to evaluate the knowledge acquired. The students were then randomly allocated into two groups: one group was assigned to Role Playing, and the other to Action Maze. At the end of the two simulated teaching activities, the questionnaire was administered again to assess changing in knowledge. Additionally, two validated scales, the Educational Practice Questionnaire Student Version and the Simulation Design Scale Student Version, were administered to assess student satisfaction and perception regarding the simulation techniques performed.

Results: The Wilcoxon signed-rank test with Z=-2.1 and p=0.03, performed on the correct post-intervention responses, was significant with a p-value of <0.05 for the Action Maze group compared to the Role Playing group. The Simulation Design Scale Student Version scale showed a p-value of <0.05 for both the "teaching methodology" and "importance of elements" sections. The Educational Practice Questionnaire Student Version scale showed a p-value of 0.076 for the evaluation of the "importance of elements" section.

Conclusions: The results of the study indicated that the Action Maze simulation teaching methodology was more effective, both in terms of knowledge acquisition and student satisfaction, compared to the Role Playing methodology. Further comparative studies are recommended to evaluate the effectiveness of the Action Maze compared to other simulated teaching methods.

Background: Surgical waiting lists pose a major challenge for public healthcare systems, affecting access to care and the perceived quality of services. However, there is no standardized method for assessing the efficiency and management of waiting lists.

Study design: This study proposes a model based on Key Performance Indicators (KPIs) to measure the Waiting List sustainability of surgical waiting lists, evaluating their balance, attractiveness, efficiency, and timeliness.

Methods: Three main KPIs were defined and applied to both hypothetical and real datasets, analyzing data collected at the IRCCS Istituto Ortopedico Rizzoli from January 2024 to September 2024. Statistical analysis was conducted using Excel, calculating ratios between enrolled, admitted, canceled, and overdue patients on the waiting list.

Results: The analysis showed that some hospital departments have a balanced management of waiting lists, while others exhibit critical issues, with high rates of overdue or canceled patients. The graphical representation of the indicators helped identify areas for improvement in resource management.

Conclusions: The adoption of standardized KPIs could serve as a valuable tool for monitoring and optimizing waiting lists, supporting strategic decisions to enhance access to healthcare services.

Background: Psychological distress and substance use is a global public health problem. Understanding the mental distress and substance use regarding female sex workers is crucial which is noticeably lacking in India. The authors of this study investigate the prevalence of psychological distress and substance use among female sex workers in Sonagachi.

Methods: Using convenience sampling 149 participants were invited to participate. Tools included socio-demographic proforma, alcohol use disorder identification test to assess the risk of alcohol consumption and patient health questionnaire used to assess anxiety and depression.

Results: Overall, 52.4% reported psychological distress and 66.1% of participants were found to use substances. The factors associated with psychological distress are marital status, education level and number of children. Education, sex under the influence of substances, and number of years working predicted a higher likelihood of substance use such as tobacco, cannabis and alcohol. Additionally, psychological distress was more significant among women who were married, worked for more than 5 years, were forced to enter the sex trade and used condoms inconsistently.

Conclusion: Education, sex under the influence of alcohol, number of years working, marital status, age of working, reason for sex work and condom use emerged as significant predictors of use of tobacco and cannabis, risk of alcohol consumption and psychological distress.

Background: It has been observed that women vaccinated against coronavirus disease 2019 (COVID-19) may show axillary lymphadenopathy at screening mammogram, which may become suspicious for malignancy, leading to an increased recall rate for further diagnostic evaluations and a higher number of false-positive results, as well as considerable emotional distress for the women involved.

Study design: The study aimed to assess the incidence of doubt/positive results in the 1st level mammogram among women who received a COVID-19 vaccine within 4 weeks before mammogram, compared to unvaccinated women. Further aims included the analysis of the distribution of doubt/positive 1st level screening mammogram results according to different women-related and diagnostic work-up-related characteristics, and the evaluation of the incidence of false-positive results observed at the 2nd level.

Methods: The cohort study was carried out by retrospectively reviewing electronic data records related to the breast screening program of the Local Health Authority of Bologna in 2021 concerning women between 45 and 74 years old. Excluded were the women outside the age range, with prior breast cancer history, or receiving COVID-19 vaccination more than 4 weeks before the mammogram.

Results: A total of 43,856 (mean age 56.6 ± 8.7) women met the study's inclusion criteria. Among all enrolled women, the recall rate was 5.5% (N=2,394). There were no statistically significant differences in doubt/positive results between vaccinated within 4 weeks before the mammogram and unvaccinated women (5.5% versus 5.4%, p=0.649). However, those who received the Pfizer vaccine showed a significantly higher rate of doubt/positive results.

Conclusions: Healthcare professionals' awareness of vaccine records and educating patients about rare adverse effects can help prevent unnecessary biopsies, interventions, and changes in patient management. Further research is needed to confirm our findings.

Background: Nasopharyngolaryngoscopes reprocessing is often suboptimal and breaches in reprocessing protocols are commonly reported. Single-use sheaths help in reducing endoscope contamination. The aim of the study is to compare costs related to disposable instruments reprocessing and the single-use sheaths alternative.

Research design and methods: A cost-minimization analysis to compare fiberoptic nasopharyngolaryngoscopy instruments reprocessing with disposable sheaths use was performed through the micro-costing approach with data from teaching hospital and costs in euros referred to 2022, following the Consolidated Health Economic Evaluation Reporting Standards.

Results: In the base-case scenario, using disposable sheaths costs € 2,600 less than using cleaning and sterilization procedures. The analysis of direct medical costs, which included personnel, equipment and operating costs, and consumables, revealed higher costs related to personnel for the cleaning and sterilization alternative. Sensitivity analysis further supported the robustness of the cost-saving findings, with variations in disposable sheaths cost and sterilization kits demonstrating significant impacts on the cost difference between the two alternatives.

Conclusions: Based on the study findings, this economic analysis shows that using disposable sheaths covering nasopharyngolaryngoscopes is an appropriate cost-saving strategy. Further studies on a larger scale are needed to confirm these encouraging results.

Background: Seafarers experience unique challenges related to their profession, including risks for mental health. The present study explored the correlates of depression among seafarers in India.

Methods: Following ethics clearance, this cross-sectional study was conducted at an international shipping company in Mumbai, India. Using time-bound convenience sampling, 105 multi-state seafarers were recruited following verbal consent. The Beck Depression Inventory and Work-Related Quality of Life scale were used to screen for the study outcomes. Data analysis was performed using Jamovi 2.0. Descriptive statistics and Chi-square tests were used to assess associations, and logistic regression was performed to identify correlates of depression.

Results: Of 105 seafarers, the majority (98.1%) were male, most were married (80%), and were aged between 18-35 years (56.2%). About 42.9% had an income of INR 3 lakh (≈$3604) and above monthly. An overwhelming majority had mild mood disturbances, which was found among 90.5% and 8.6% reported depression. Seafarers who engaged in regular physical activity and had higher monthly incomes had higher Work-Related Quality of Life. A significant association was found between depression and isolation (p=0.031) as well as with Work-Related Quality of Life (p=0.012). On logistic regression, we found that the number of hours of work per day, experiencing isolation and Work-Related Quality of Life, significantly predicted depression.

Conclusions: The existing burden and treatment gap for mental health morbidity among seafarers needs to be addressed. To address early indications of mental health conditions among seafarers, implementing mental health screening and offering counseling services on board may be the way forward.

Background: Hospitals are among the most resource-intensive infrastructures, consuming significant amounts of energy, water, and materials while contributing 5.2% of global carbon dioxide emissions. Despite growing awareness and international commitments, hospitals face financial, structural, and operational barriers in implementing sustainability strategies.

Study design: The study assesses the maturity of healthcare stakeholders regarding environmental sustainability, exploring key drivers, barriers, and strategies for integrating sustainability into healthcare facilities.

Methods: A national web-based survey was conducted within the Joint Research Partnership Healthcare Infrastructures between November 2022 and January 2023, gathering 30 responses from 32 partners (94% participation rate). The analysis focuses on the environmental sustainability dimension, using descriptive statistics to identify trends, challenges, and best practices.

Results: Healthcare stakeholders selected the most relevant Sustainable Development Goals for hospitals. Sustainability is widely recognized as a priority, yet resource allocation emerges as marginal. The most frequently cited constraint for improving environmental sustainability was financial constraints (n=27/30). Indeed, some hospitals are implementing energy-efficient retrofitting, high-efficiency thermal power plants, and sustainability building certification. The adoption of Building Energy Management Systems and retrofit interventions to maximise energy efficiency suggests increasing interest in sustainability performance measurement.

Conclusions: Despite growing awareness, financial and regulatory support must be strengthened to facilitate hospital sustainability investments. Early integration of sustainability principles, access to public and private models and multi-stakeholder collaboration are crucial. Future research and action should foster multi-stakeholders approaches, develop sector-specific sustainability frameworks and assess the long-term impact of sustainability initiatives in healthcare.

Background: Tuberculosis is one of the leading causes of death from infectious diseases in the world, with approximately 25% of the global population having latent tuberculosis infection. Secondhand smoke exposure has been recognised as a significant risk factor in the development of active Tuberculosis in individuals with latent tuberculosis infection.

Study design and methods: This study used the Systematic Literature Review method based on PRISMA guidelines. Relevant articles published between 2014-2024 were identified through PubMed, ProQuest, and Scopus databases using related keywords. A total of 13 articles met the inclusion criteria for analysis.

Results: Secondhand smoke exposure significantly increases the risk of latent tuberculosis infection conversion to active Tuberculosis, with a stronger effect in vulnerable groups such as children and individuals who are in close contact with active Tuberculosis patient and live in the same household with heavy smokers. This risk of exposure to secondhand smoke follows a dose-response pattern, where longer duration and higher intensity of exposure directly increase the likelihood of Tuberculosis activation in individuals with latent tuberculosis infection. The biological mechanisms involve immune suppression and lung damage caused by toxic particles in the tobacco smoke, which weaken the body's defenses against Mycobacterium tuberculosis and facilitate the progression of latent tuberculosis infection to active Tuberculosis. Therefore, reducing exposure to secondhand smoke is important to mitigate its impact on active Tuberculosis progression.

Conclusion: Secondhand smoke exposure has been consistently shown to increase the risk of developing active Tuberculosis in individuals with latent tuberculosis infection. To support the global Tuberculosis elimination programme, concerted efforts are needed to reduce exposure to secondhand smoke, especially in individuals with latent tuberculosis infection.