Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy

Background Solar UV radiation (sUVR) is one of the main carcinogen exposures in occupational settings, and UV-induced skin cancers are the most frequent tumours in fair-skinned individuals worldwide. Objectives According to this premise, we should expect a high number of occupational skin cancers reported to the national workers' compensation authorities each year, also considering that the incidence of skin cancers has been constantly increased in recent years Methods We examined the data on reported non-melanoma skin cancers (NMSC) and actinic keratoses (AK) to the Italian National Workers Compensation Authority (INAIL) from 2012 to 2017, and we compared the number of reported skin cancers for outdoor workers with the expected numbers, obtained from currently available NMSC incidence rates for the Italian population applied to the occupational sUVR-exposed workers estimated with the CAREX methodology in Italy in 2005. Results The cases of NMSC reported each year to INAIL in Italy are 34 per year on average, while for AK the mean number of reported cases is of only 15/year. We estimated a number of expected NMSC cases in Italy for solar UV-exposed workers ranging between 432 and 983, representing a proportion between reported vs. expected skin cancers of only 3.5-6.2%. Conclusions Our study clearly shows that occupational skin cancers in Italy are largely underreported, and, accordingly, urgent initiatives should be taken to raise appropriate awareness to the problem of occupational sUVR-induced skin cancers, so that adequate preventive measures can be implemented rapidly

Changes in Dietary Intake and Adherence to the NU-AGE Diet Following a One-Year Dietary Intervention among European Older Adults—Results of the NU-AGE Randomized Trial

Background: The Mediterranean Diet has been proposed as an effective strategy to reduce inflammaging, a chronic low grade inflammatory status, and thus, to slow down the aging process. We evaluated whether a Mediterranean-like dietary pattern specifically targeting dietary recommendations of people aged over 65 years (NU-AGE diet) could be effective to shift dietary intake of older adults towards a healthful diet. Methods: Adults aged 65–80 years across five EU-centers were randomly assigned to a NU-AGE diet group or control group. The diet group followed one year of NU-AGE dietary intervention specifying consumption of 15 food groups plus the use of a vitamin D supplement. Participants in the diet group received counselling and individually tailored dietary advice, food products and a vitamin D supplement. Dietary intake was assessed by means of seven-day food records at baseline and one-year follow-up. A continuous NU-AGE index (0–160 points) was developed to assess NU-AGE diet adherence. Results: In total 1296 participants were randomized and 1141 participants completed the intervention (571 intervention, 570 control). After one year, the diet group improved mean intake of 13 out of 16 NU-AGE dietary components (p < 0.05), with a significant increase in total NU-AGE index (difference in mean change = 21.3 ± 15.9 points, p < 0.01). Conclusions: The NU-AGE dietary intervention, based on dietary recommendations for older adults, consisting of individual dietary counselling, free healthy foods and a vitamin D supplement, may be a feasible strategy to improve dietary intake in an aging European population

Mediterranean-style diet improves systolic blood pressure and arterial stiffness in older adults: Results of a 1-year European multi-center trial

We aimed to determine the effect of a Mediterranean-style diet, tailored to meet dietary recommendations for older adults, on blood pressure and arterial stiffness. In 12 months, randomized controlled trial (NU-AGE [New Dietary Strategies Addressing the Specific Needs of Elderly Population for Healthy Aging in Europe]), blood pressure was measured in 1294 healthy participants, aged 65 to 79 years, recruited from 5 European centers, and arterial stiffness in a subset of 225 participants. The intervention group received individually tailored standardized dietary advice and commercially available foods to increase adherence to a Mediterranean diet. The control group continued on their habitual diet and was provided with current national dietary guidance. In the 1142 participants who completed the trial (88.2%), after 1 year the intervention resulted in a significant reduction in systolic blood pressure (−5.5 mm Hg; 95% CI, −10.7 to −0.4; P=0.03), which was evident in males (−9.2 mm Hg, P=0.02) but not females (−3.1 mm Hg, P=0.37). The −1.7 mm Hg (95% CI, −4.3 to 0.9) decrease in diastolic pressure after intervention did not reach statistical significance. In a subset (n=225), augmentation index, a measure of arterial stiffness, was improved following intervention (−12.4; 95% CI, −24.4 to −0.5; P=0.04) with no change in pulse wave velocity. The intervention also resulted in an increase in 24-hour urinary potassium (8.8 mmol/L; 95% CI, 0.7–16.9; P=0.03) and in male participants (52%) a reduction in pulse pressure (−6.1 mm Hg; 95% CI, −12.0 to −0.2; P=0.04) and 24-hour urinary sodium (−27.1 mmol/L; 95% CI, −53.3 to −1.0; P=0.04). In conclusion, a Mediterranean-style diet is effective in improving cardiovascular health with clinically relevant reductions in blood pressure and arterial stiffness

Defining and averting syndemic pathways in aquaculture: a major global food sector

Aquaculture now provides half of all aquatic protein consumed globally—with most current and future production occurring in low- and middle-income countries (LMICs). Concerns over the availability and application of effective policies to deliver safe and sustainable future supply have the potential to hamper further development of the sector. Creating healthy systems must extend beyond the simple exclusion of disease agents to tackle the host, environmental, and human drivers of poor outcomes and build new policies that incorporate these broader drivers. Syndemic theory provides a potential framework for operationalizing this One Health approach.</jats:p

Changing patterns in diagnostic strategies and the treatment of blunt injury to solid abdominal organs

Background: In recent years there has been increasing interest shown in the nonoperative management (NOM) of blunt traumatic injury. The growing use of NOM for blunt abdominal organ injury has been made possible because of the progress made in the quality and availability of the multidetector computed tomography (MDCT) scan and the development of minimally invasive intervention options such as angioembolization. Aim: The purpose of this review is to describe the changes that have been made over the past decades in the management of blunt trauma to the liver, spleen and kidney. Results: The management of blunt abdominal injury has changed considerably. Focused assessment with sonography for trauma (FAST) examination has replaced diagnostic peritoneal lavage as diagnostic modality in the primary survey. MDCT scanning with intravenous contrast is now the gold standard diagnostic modality in hemodynamically stable patients with intra-abdominal fluid detected with FAST. One of the current discussions in the l erature is whether a whole body MDCT survey should be implemented in the primary survey. Conclusions The progress in imaging techniques has contributed to NOM being currently the treatment of choice for hemodynamically stable patients. Angioembolization can be used as an adjunct to NOM and has increased the succe

The synergistic impacts of anthropogenic stressors and COVID-19 on aquaculture: a current global perspective

The rapid, global spread of COVID-19, and the measures intended to limit or slow its propagation, are having major impacts on diverse sectors of society. Notably, these impacts are occurring in the context of other anthropogenic-driven threats including global climate change. Both anthropogenic stressors and the COVID-19 pandemic represent significant economic challenges to aquaculture systems across the globe, threatening the supply chain of one of the most important sources of animal protein, with potential disproportionate impacts on vulnerable communities. A web survey was conducted in 47 countries in the midst of the COVID-19 pandemic to assess how aquaculture activities have been affected by the pandemic, and to explore how these impacts compare to those from climate change. A positive correlation between the effects of the two categories of drivers was detected, but analysis suggests that the pandemic and the anthropogenic stressors affect different parts of the supply chain. The immediate measurable reported losses varied with aquaculture typology (land vs. marine, and intensive vs. extensive). A comparably lower impact on farmers reporting the use of integrated multitrophic aquaculture (IMTA) methods suggests that IMTA might enhance resilience to multiple stressors by providing different market options under the COVID-19 pandemic. Results emphasize the importance of assessing detrimental effects of COVID-19 under a multiple stressor lens, focusing on areas that have already locally experienced economic loss due to anthropogenic stressors in the last decade. Holistic policies that simultaneously address other ongoing anthropogenic stressors, rather than focusing solely on the acute impacts of COVID-19, are needed to maximize the long-term resilience of the aquaculture sector.publishe

Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status : the NU-AGE 1-year dietary intervention across five European countries

Objective Ageing is accompanied by deterioration of multiple bodily functions and inflammation, which collectively contribute to frailty. We and others have shown that frailty co-varies with alterations in the gut microbiota in a manner accelerated by consumption of a restricted diversity diet. The Mediterranean diet (MedDiet) is associated with health. In the NU-AGE project, we investigated if a 1-year MedDiet intervention could alter the gut microbiota and reduce frailty. Design We profiled the gut microbiota in 612 non-frail or pre-frail subjects across five European countries (UK, France, Netherlands, Italy and Poland) before and after the administration of a 12-month long MedDiet intervention tailored to elderly subjects (NU-AGE diet). Results Adherence to the diet was associated with specific microbiome alterations. Taxa enriched by adherence to the diet were positively associated with several markers of lower frailty and improved cognitive function, and negatively associated with inflammatory markers including C-reactive protein and interleukin-17. Analysis of the inferred microbial metabolite profiles indicated that the diet-modulated microbiome change was associated with an increase in short/branch chained fatty acid production and lower production of secondary bile acids, p-cresols, ethanol and carbon dioxide. Microbiome ecosystem network analysis showed that the bacterial taxa that responded positively to the MedDiet intervention occupy keystone interaction positions, whereas frailty-associated taxa are peripheral in the networks. Conclusion Collectively, our findings support the feasibility of improving the habitual diet to modulate the gut microbiota which in turn has the potential to promote healthier ageing.Peer reviewe

Harnessing the diversity of small-scale actors is key to the future of aquatic food systems

Small-scale fisheries and aquaculture (SSFA) provide livelihoods for over 100 million people and sustenance for ~1 billion people, particularly in the Global South. Aquatic foods are distributed through diverse supply chains, with the potential to be highly adaptable to stresses and shocks, but face a growing range of threats and adaptive challenges. Contemporary governance assumes homogeneity in SSFA despite the diverse nature of this sector. Here we use SSFA actor profiles to capture the key dimensions and dynamism of SSFA diversity, reviewing contemporary threats and exploring opportunities for the SSFA sector. The heuristic framework can inform adaptive governance actions supporting the diversity and vital roles of SSFA in food systems, and in the health and livelihoods of nutritionally vulnerable people—supporting their viability through appropriate policies whilst fostering equitable and sustainable food systems.Additional co-authors: Caroline E Ferguson, Nicole Franz, Christopher D. Golden, Benjamin S. Halpern, Lucie Hazen, Christina Hicks, Derek Johnson, Sangeeta Mangubhai, Rosamond L. Naylor, Melba Reantaso, U. Rashid Sumaila, Shakuntala H. Thilsted, Michelle Tigchelaar, Colette C. C. Wabnitz & Wenbo Zhan

Defining and averting syndemic pathways in aquaculture: a major global food sector

Aquaculture now provides half of all aquatic protein consumed globally—with most current and future production occurring in low- and middle-income countries (LMICs). Concerns over the availability and application of effective policies to deliver safe and sustainable future supply have the potential to hamper further development of the sector. Creating healthy systems must extend beyond the simple exclusion of disease agents to tackle the host, environmental, and human drivers of poor outcomes and build new policies that incorporate these broader drivers. Syndemic theory provides a potential framework for operationalizing this One Health approach