Poor weight control, alcoholic beverage consumption and sudden sleep onset at the wheel among Italian truck drivers: A preliminary pilot study.

Objectives: The aim of this study was to investigate the prevalence of obesity, alcoholic beverage consumption, unhealthy alcohol use and sudden sleep onset at the wheel among Italian truck drivers. In addition to prevalence rates, this study also aimed at investigating potential predictors for sudden-onset sleepiness and obesity. Material and Methods: A sample of truck drivers was extracted from the database of the High Risk Professional Driver Study. Data concerning demographics, anthropometry, medical information and working conditions were collected using anonymous questionnaires. Logistic regression analyses were performed to assess the association of the reported body mass index (BMI), alcohol consumption and sudden sleep onset with working conditions and general lifestyle factors. Results: Three hundred and thirty-five questionnaires were collected. According to their BMI, 45% of the participants were overweight and 21.4% of them were obese. Twenty-four point two percent declared they drank alcoholic beverages during working hours or work breaks and 21.3% of the drivers had an Alcohol Use Disorders Identyfication Test Consumption (AUDIT C) score ≥ 5 (the threshold value for unhealthy alcohol use). Forty-one point six percent of the interviewees experienced one episode of sudden sleep onset at the wheel per month (5.5% per week and 0.9% daily). Predictive factors for obesity were: length of service (odds ratio (OR) = 1.09, confidence interval (95% CI): 1.04–1.15, p 55 years old (OR = 5.22, 95% CI: 1.29–21.1, p = 0.020), driving more than 50 000 km per year (OR = 2.89, 95% CI: 1.37–6.11, p = 0.006) and the Chalder Fatigue Questionnaire (CFQ) score > 11 (adjusted OR = 2.97, 95% CI: 1.22–7.21, p = 0.016). Conclusions: This study strongly emphasizes the need for intervention in order to reduce and prevent important risk factors for the sake of road safety and truck drivers' health

Mental health during the COVID-19 quarantine in five countries

University Cooperativa of Colombia, Colombia, University of Pavia, ItaliaIntroduction. In the current COVID-19 pandemic governments and health entities urgently responded to the biological threat developing diagnostic tests, treatments, vaccines, additionally the economic concerns were approached, however there is little effort directed to the mental health, which is part of the holistic concept of health, and from where interventions for the prevention of contagion and coping with the disease and its consequences can be focused. The present study sought to describe, compare, and analyze the association of the perceived stress, coping strategies, emotional regulation, hopelessness, impact of the event, psychological distress, suicidality, as components of mental health, and sociodemographic characteristics during the quarantine in various countries in Europe and Latin America. Material and methods. Multicentric and epidemiological study approved by the Ethics Committee of the Universidad Cooperativa de Colombia. Convenience online snowball sampling of general population and university students. The questionnaire contained the informed consent, sociodemographic data, and the Impact of Event Scale-Revised, Perceived Stress Scale, Coping Orientations to Problems Experienced, Emotion Regulation Questionnaire, Symptom Check-List-90 Revised, Beck's Hopelessness Scale, and Okasha Suicidality Scale. Data were collected between April and June 2020. Statistical analysis: Internal consistency of scales was estimated by Cronbach's alpha. Normality of distribution was assessed by Kolmogorov-Smirnov tests. Univariate (Kruskal-Wallis test, Spearman correlation) and multivariate analyses (Generalized Linear Models) were performed using STATA 16. Results. 1.179 participants (27.48% male) aged between 15 to 76 years (M=33.52, SD=13.4) from Colombia (N=356), Brazil (N=364), Mexico (N=202), Italy (N=166), and Spain (N=91). The majority are students and workers, whit high level of education, and living with family during the quarantine. There are significant differences in the medians of all variables among countries and sociodemographic characteristics showing greater psychological affectation in young people, students, women, and inhabitants of Brazil, Italy and Spain. Most variables correlate with each other in a statistically significant way as theoretically expected. Conclusions. Due to the complexity of the pandemic, there are differences in terms of contagion containment measures, restrictions, laws and sanctions, government and health authorities’ management, type of information disseminated by media, resources available for diagnoses, treatments and aid, number of infections and deaths, job and economic losses, that significantly affect the impact in mental health worldwide. The results of the present research contribute to the understanding of mental, emotional and behavioral reactions of people across different countries and according to sociodemographic characteristics and underline the urgency of monitoring mental health in vulnerable groups, in order to design specific prevention and intervention programs

Sănătatea mintală în timpul carantinei COVID-19 în cinci țări

Introduction. As part of the holistic concept of health, mental health can be focused on prevention of contagion and coping with the disease and its consequences in the context of the current COVID-19 pandemic. The present study describes, compares, and analyzes the association of the impact of the event, perceived stress, coping strategies, emotional regulation, and sociodemographic characteristics during the quarantine in various countries. Material and methods. This research is a multicentric and epidemiological study with a convenience online snowball sampling of the general population and university students. Results. 1.179 participants from Colombia, Brazil, Mexico, Italy, and Spain responded to the survey. Most of them included students and workers, with a high educational level and living with family during the quarantine. There are significant differences in the medians of all variables among countries and sociodemographic characteristics. The variables positively and significantly associated with the impact of the event during quarantine included the perceived stress, the coping strategies of alcohol/drug use, planning and active coping, focus on emotions and vent, the emotional regulation strategy expressive suppression, and living in Italy. Conclusions. These results have contributed to the understanding of mental, emotional, and behavioral response to quarantine, as well as underline the urgency of monitoring mental health among the vulnerable groups, in order to design specific prevention and intervention programs.Introducere. Ca parte a conceptului holistic de sănătate, în actuala pandemie COVID-19, sănătatea mintală presupune prevenirea contagiunii și gestionarea bolii și a consecințelor acesteia. Prezentul studiu descrie, compară și analizează asocierea impactului evenimentului, stresului perceput, strategiilor de adaptare, reglării emoționale și a caracteristicilor sociodemografice în timpul carantinei în diferite țări. Material si metode. Studiu epidemiologic multicentric, cu o eșantionare convențională de tipul „bulgări de zăpadă” online a populației generale și a studenților universitari. Rezultate. A fost realizat un sondaj la care au participat 1.179 de respondenți din Columbia, Brazilia, Mexic, Italia și Spania. Majoritatea dintre ei sunt studenți și muncitori, cu un nivel ridicat de educație, care au locuit cu familia în timpul carantinei. Există diferențe semnificative între medianele tuturor variabilelor între țări și caracteristici sociodemografice. Variabilele asociate pozitiv și semnificativ, cu impactul evenimentului în timpul carantinei, includ: stresul perceput, consumul de alcool/droguri, planificarea și gestionarea activă, concentrarea asupra emoțiilor, strategia de reglare emoțională, suprimarea expresivă și locuirea în Italia. Concluzii. Aceste rezultate contribuie la înțelegerea reacțiilor mintale, emoționale și comportamentale în timpul carantinei și relevă necesitatea monitorizării urgente a sănătății mintale în grupurile vulnerabile în scopul proiectării unor programe specifice de prevenire și de intervenție

Health impact of the emissions from a refinery: case-control study on the adult population living in two municipalities in Lomellina, Italy

Background: In the municipalities of Sannazzaro de’ Burgondi and Ferrer Erbognone (District of Lomellina, Pavia, Lombardy, Italy), an oil refinery is operating since 1963. In 2008, the company running the plant (eni S.p.A.) asked the competent bodies the permission for building a new facility (“EST”). The present work is aimed at evaluating the ante-operam health impacts of the existing facility refinery. Methods: A case-control study design was implemented. Cases were subjects admitted to hospital in 2002-2014 due to acute respiratory, cardiovascular or gastrointestinal conditions. Controls were selected among those who had not been hospitalised in that timespan. Cases and controls had to be alive at enrolment, aged 20-64 years, and were frequency-matched by age, gender and municipality. Data were extracted from the health insurance registry and from Hospital Discharge Records (ATS Pavia). Enrolled subjects were asked to complete a mailed survey. Environmental exposure was the fallout of refinery emissions (PM10) at participants’ homes, as predicted by an AERMOD model. Results: 541 respondents (125 cases, 416 controls) were included in the analyses. Response bias was excluded. Individual PM10 exposure was not significantly different between cases and controls, while it was significantly associated with municipality (being higher in Sannazzaro). The crude effect estimate of PM10 over case/control status indicated a not-significant excess of hospitalisation with the increase in PM10 exposure. Multivariate analyses confirmed those results. Conclusion: Findings indicate a possible excess of hospitalisation risk in most exposed people, but the effect is not statistically significant and may be affected by bias

QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy

BACKGROUND: Several antipsychotic agents are known to prolong the QT interval in a dose dependent manner. Corrected QT interval (QTc) exceeding a threshold value of 450 ms may be associated with an increased risk of life threatening arrhythmias. Antipsychotic agents are often given in combination with other psychotropic drugs, such as antidepressants, that may also contribute to QT prolongation. This observational study compares the effects observed on QT interval between antipsychotic monotherapy and psychoactive polytherapy, which included an additional antidepressant or lithium treatment. METHOD: We examined two groups of hospitalized women with Schizophrenia, Bipolar Disorder and Schizoaffective Disorder in a naturalistic setting. Group 1 was composed of nineteen hospitalized women treated with antipsychotic monotherapy (either haloperidol, olanzapine, risperidone or clozapine) and Group 2 was composed of nineteen hospitalized women treated with an antipsychotic (either haloperidol, olanzapine, risperidone or quetiapine) with an additional antidepressant (citalopram, escitalopram, sertraline, paroxetine, fluvoxamine, mirtazapine, venlafaxine or clomipramine) or lithium. An Electrocardiogram (ECG) was carried out before the beginning of the treatment for both groups and at a second time after four days of therapy at full dosage, when blood was also drawn for determination of serum levels of the antipsychotic. Statistical analysis included repeated measures ANOVA, Fisher Exact Test and Indipendent T Test. RESULTS: Mean QTc intervals significantly increased in Group 2 (24 ± 21 ms) however this was not the case in Group 1 (-1 ± 30 ms) (Repeated measures ANOVA p < 0,01). Furthermore we found a significant difference in the number of patients who exceeded the threshold of borderline QTc interval value (450 ms) between the two groups, with seven patients in Group 2 (38%) compared to one patient in Group 1 (7%) (Fisher Exact Text, p < 0,05). CONCLUSIONS: No significant prolongation of the QT interval was found following monotherapy with an antipsychotic agent, while combination of these drugs with antidepressants caused a significant QT prolongation. Careful monitoring of the QT interval is suggested in patients taking a combined treatment of antipsychotic and antidepressant agents

“Wake-up time activation” in older adults: first randomized experimental clinical trial

Balance main rely on vestibular, proprioceptive and visual apparatus integrity. In elderly, postural control fails also due to deficit of sensory functions, atrophy of the musculoskeletal system and neuronal reduction. Deterioration of these functions finally lead to abnormality in performing voluntary muscle movements, subjective feeling of vulnerability, insecurity and depression. Besides, physical inactivity (hypokinesia) is a major risk factor for developing coronary artery disease and stroke, contributing to obesity, high blood pressure, hypercholesterolemia and diabetes. For these reasons, especially in elderly, it is important to include physical activity as part of a regular routine. Aim of this randomized controlled trial was to demonstrate that daily subministration of “Wake-up Time Activation” protocol allow individual recovery of balance and tensile properties of periarticular and intra-articular structures, so preventing morning stiffness and reduction of the Range Of Motion (R.O.M.), mainly in the Vertebral Columna. Therefore, we propose to 50 Healthy individuals (age 45-86) of both sexes a peculiar sequence of movements that allow individual recovery of balance and tensile properties of periarticular and intra-articular structures, so preventing morning stiffness and reduction of the Range Of Motion (R.O.M.), mainly in the Vertebral Columna. To verify the effectiveness of this exercises, we scientifically detected, by mean of validated test and instruments, different parameters at tifferent time, for each individual, for two months. Tests were detected at T0 (before starting daily exercises), T1 (after one month of daily exercises), T2 (at the end of the second month of exercises). At each time, on every person, we performed: Cervical Test, Spinal motility, Pelvic motility (mobility); Standing one leg Test (balance); Get up and Go (reactivity); SF-36 (mood/depression); Paint Rating Scales (joint pain). Statistical analysis of obtained results, discussed in detail in the Postrer, scientifically demonstrate that performing of “Wake-up Time Activation” protocol of adapted fisical activity lead to immediate and persistent back pain reduction, articular R.O.M. increase, recovery of balance and coordination, improved autonomy and mood, also in elderly

Estrés percibido y estrategias de afrontamiento durante el confinamiento por COVID-19 en cinco países

Several studies have shown how mental health could be affected during the COVID-19 pandemic, which led us to wonder about the psychological impact that the initial period of lockdown could have. We conducted a multicentric study that sought to describe, compare, and analyze the association between perceived stress, coping strategies and sociodemographic characteristics in a snowball-style convenience sample of 1169 participants from Colombia, Brazil, Mexico, Italy, and Spain who responded to an online survey. There were differences in perceived stress and coping strategies between countries and depending on sociodemographic characteristics. The variables positively associated with perceived stress were the coping strategies alcohol-drug use, focus on emotions and venting, being a woman, and living in Brazil, Italy, and Spain. The variables negatively associated with perceived stress were planning and active coping, positive reinterpretation, being over 45 years old, and being a worker. These results contribute to understanding the stress responses to lockdown and help identify vulnerability factors in order to design prevention and intervention programs.  Varios estudios han demostrado cómo la salud mental pudo verse afectada durante la pandemia de COVID-19, lo que nos llevó a preguntarnos sobre el impacto psicológico que podría tener el período inicial de confinamiento. Llevamos a cabo un estudio multicéntrico que buscó describir, comparar y analizar la asociación entre el estrés percibido, las estrategias de afrontamiento y las características sociodemográficas en una muestra de conveniencia tipo bola de nieve de 1169 participantes de Colombia, Brasil, México, Italia y España que respondieron un cuestionario en línea. Se encontraron diferencias en el estrés percibido y las estrategias de afrontamiento entre países y según características sociodemográficas. Las variables asociadas positivamente con el estrés percibido fueron las estrategias de afrontamiento consumo de alcohol y drogas, centrarse en las emociones y desahogo, ser mujer y vivir en Brasil, Italia y España. Las variables asociadas negativamente con el estrés percibido fueron planificación y afrontamiento activo, reinterpretación positiva, ser mayor de 45 años y ser trabajador. Estos resultados contribuyen a comprender las respuestas de estrés al confinamiento y ayudan a identificar factores de vulnerabilidad para diseñar programas de prevención e intervención.

A multinational consensus on dysphagia in Parkinson's disease: screening, diagnosis and prognostic value

Background Parkinson's disease (PD) is a neurodegenerative disorder characterized by a combination of motor and non-motor dysfunction. Dysphagia is a common symptom in PD, though it is still too frequently underdiagnosed. Consensus is lacking on screening, diagnosis, and prognosis of dysphagia in PD. Objective To systematically review the literature and to define consensus statements on the screening and the diagnosis of dysphagia in PD, as well as on the impact of dysphagia on the prognosis and quality of life (QoL) of PD patients. Methods A multinational group of experts in the field of neurogenic dysphagia and/or PD conducted a systematic revision of the literature published since January 1990 to February 2021 and reported the results according to PRISMA guidelines. The output of the research was then analyzed and discussed in a consensus conference convened in Pavia, Italy, where the consensus statements were drafted. The final version of statements was subsequently achieved by e-mail consensus. Results Eighty-five papers were used to inform the Panel's statements even though most of them were of Class IV quality. The statements tackled four main areas: (1) screening of dysphagia: timing and tools; (2) diagnosis of dysphagia: clinical and instrumental detection, severity assessment; (3) dysphagia and QoL: impact and assessment; (4) prognostic value of dysphagia; impact on the outcome and role of associated conditions. Conclusions The statements elaborated by the Consensus Panel provide a framework to guide the neurologist in the timely detection and accurate diagnosis of dysphagia in PD

Consensus on the treatment of dysphagia in Parkinson's disease

Background: Dysphagia is common in Parkinson's disease (PD). The effects of antiparkinsonian drugs on dysphagia are controversial. Several treatments for dysphagia are available but there is no consensus on their efficacy in PD. Objective: To conduct a systematic review of the literature and to define consensus statements on the treatment of dysphagia in PD and related nutritional management. Methods: A multinational group of experts in the field of neurogenic dysphagia and/or Parkinson's disease conducted a systematic evaluation of the literature and reported the results according to PRISMA guidelines. The evidence from the retrieved studies was analyzed and discussed in a consensus conference organized in Pavia, Italy, and the consensus statements were drafted. The final version of statements was subsequently achieved by email consensus. Results: The literature review retrieved 64 papers on treatment and nutrition of patients with PD and dysphagia, mainly of Class IV quality. Based on the literature and expert opinion in cases where the evidence was limited or lacking, 26 statements were developed. Conclusions: The statements developed by the Consensus panel provide a guidance for a multi-disciplinary treatment of dysphagia in patients with PD, involving neurologists, otorhinolaryngologists, gastroenterologists, phoniatricians, speech-language pathologists, dieticians, and clinical nutritionists