Socioeconomic deprivation status and air pollution by PM10 and NO2: an assessment at municipal level of 11 years in Italy

The aim of this observational study was to assess the relationship between environmental risk factors and some aspects of social economic status (SES) of the population in different Italian municipalities. Nitrogen dioxide (NO2) and particulate matter (PM10) annual means were extracted from ISPRA-BRACE (environmental information system of 483 Italian municipalities, 6% of the total amount of administrative units) from 2002 to 2012. As an indicator of sociodemographic and SES data, we collected the following: resident population, foreign nationality, low level of education, unemployment, nonhome ownership, single-parent family, and overcrowding. Low educational level, unemployment, and lack of home ownership were indirectly associated with the higher mean values of NO2 at the statistically significant level (). Major resident population and rental housing percentage determined higher levels of PM10. Northern regions showed similar results compared to the national level, with the exception of foreign residency that showed direct correlation with the increase of PM10. The central regions showed a direct relationship between NO2 and PM10 levels and higher educational levels and between NO2 levels and percentage of single-parent family. In the southern areas, higher NO2 levels were correlated with a higher rental housing percentage, as well as higher PM10 levels with a higher percentage of unemployment and lower housing density. The study shows high heterogeneity in the findings but confirms the relationship between high educational level and employment with the increased concentration of pollutants. The higher rental housing percentage may increase the pollutants’ levels too. The housing density does not seem to be in relationship with NO2 and PM10 at the national level. The analysis stratified by geographical areas showed that the direction of the correlations was different over time as the analysis was at a national level. The study represents an example of how data from national information systems can provide a preliminary evaluation and be a comparative tool for policy-makers to assess environmental risk factors and social inequalities

Prevedil – the development of a mobile application for the prevention of workplace injury

This research protocol is concerning the development of a mobile application for the prevention of workplace injury and work-related pathologies through the design and use of multimedia and interactive learning tools in offline. The design idea aims at protecting the health through the winning approach of two apparently distant thematic areas, namely modern technologies and prevention. From this mixture, we are projecting to make a resolution product or, at the very least, a contributor to hinder one of the major woes of our day: accidents at work. Our challenge is to correct behavioral models and little virtuous attitudes (deriving from cultural, social, familial factors, etc.) related to work procedures, using the new technology communication systems to promote health culture and Safety in workplaces and the dissemination of good operating practices and guidelines aimed at increasing awareness, perception of risks and critical thinking

Balneotherapy for osteoarthritis: a systematic review

: This systematic review is aimed to evaluate the effects of balneotherapy with thermal mineral water for managing the symptoms and signs of osteoarthritis located at any anatomical site. The systematic review was conducted according to the PRISMA Statement. The following databases were consulted: PubMed, Scopus, Web of Science, Cochrane Library, DOAJ and PEDro. We included clinical trials evaluating the effects of balneotherapy as a treatment for patients with osteoarthritis, published in English and Italian language, led on human subjects. The protocol was registered in PROSPERO. Overall, 17 studies have been included in the review. All of these studies were performed on adults or elderly patients suffering from osteoarthritis localized to knees, hips, hands or lumbar spine. The treatment assessed was always the balneotherapy with thermal mineral water. The outcomes evaluated were pain, palpation/pressure sensibility, articular tenderness, functional ability, quality of life, mobility, deambulation, ability to climb stairs, medical objective and patients' subjective evaluation, superoxide dismutase enzyme activity, serum levels of interleukin-2 receptors. The results of all the included studies agree and demonstrated an improvement of all the symptoms and signs investigated. In particular, pain and quality of life were the main symptoms evaluated and both improved after the treatment with thermal water in all the studies included in the review. These effects can be attributed to physical and chemical-physical properties of thermal mineral water used. However, the quality of many studies resulted not so high due and, consequently, it is necessary to perform new clinical trial in this field using more correct methods for conducting the study and for processing statistical data

Reliability and use of Copenhagen Burnout Inventory in italian sample of university professors

Academics often have to face with burnout syndrome at work. This cross-sectional study evaluates the reliability of the Italian version of the Copenhagen Burnout Inventory (CBI) in a sample of Academics of Sapienza University of Faculty of Medicine and Pharmacy, through an online questionnaire composed of the CBI, SF12 Health Survey, and Positivity Scale. Univariate, bivariate, multivariate analyses, and Cronbach α coefficients of CBI were performed. Ninety-five participants completed the questionnaire (response rate 85%). Cronbach’s α of the three domains were high (0.892, 0.868, and 0.836). Women, younger and part time professors reported higher score in personal (p = 0.025; 0.060) and work burnout. In multivariate analysis decreasing age (β = −0.263; p = 0.001); being a professor in environmental technicians (β = −0.120; p = 0.098); and low mental (β = −0.263; p = 0.020), physical (β = −0.319; p ≤ 0.001) and positivity scores (β = −0.237; p = 0.031) predict significantly higher personal burnout. Low physical (β = −0.346; p < 0.001) and mental (β = − 0.249; p = 0.013) positivity (β = −0.345; p = 0.001) scores; fewer years of work (β = −0.269; p ≤ 0.001); and being a medical or nursing professor (β = 0.169; p = 0.016) predicts high work burnout. Low MCS predicts a high level of student burnout. Results suggest that the Italian version of the CBI is a reliable instrument. Further research should focus on the prevalence of burnout in academics

Knowledge and perception about climate change among healthcare professionals and students: A cross-sectional study

Aim: The aim of this study was to assess knowledge on Climate Change (CC) and related consequences among students and professionals of healthcare setting. Methods: A cross-sectional study involving 364 people was conducted. The survey was performed at Sapienza University (Rome) using questionnaire previously developed and validated by the same research group. Results: Findings indicate awareness about CC and its effects and correct identification of practices that could help to mitigate its repercussions. The majority of the participants believed that CC had an impact on the health of humans (96.7%), animals (99.5%) and on the environment (99.7%). Results from the multivariate analysis regarding overall knowledge, show an increased odd in professionals (OR=2.08; 95%CI=1.02-4.26), individuals from the North (OR=3.34; 95%CI=1.37-8.15) and from the Center (OR=2.07; 95%CI=1.17-3.66). Regarding factors able to modify Earth's climate, correct answer had higher odds of being chosen by professionals (OR=2.83; 95%CI=1.41–5.70), and from individuals from South/Islands than by the ones from the Center (OR=0.65; 95%CI=0.40-1.06). The main sources of information resulted to be TV and school/university. Conclusions: These new evidences could guide policymakers on increasing the awareness of the population about this fundamental subject. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Knowledge and perception about climate change among healthcare professionals and students: A cross-sectional study

Aim: The aim of this study was to assess knowledge on Climate Change (CC) and related consequences among students and professionals of healthcare setting. Methods: A cross-sectional study involving 364 people was conducted. The survey was performed at Sapienza University (Rome) using questionnaire previously developed and validated by the same research group. Results: Findings indicate awareness about CC and its effects and correct identification of practices that could help to mitigate its repercussions. The majority of the participants believed that CC had an impact on the health of humans (96.7%), animals (99.5%) and on the environment (99.7%). Results from the multivariate analysis regarding overall knowledge, show an increased odd in professionals (OR=2.08; 95%CI=1.02-4.26), individuals from the North (OR=3.34; 95%CI=1.37-8.15) and from the Center (OR=2.07; 95%CI=1.17-3.66). Regarding factors able to modify Earth's climate, correct answer had higher odds of being chosen by professionals (OR=2.83; 95%CI=1.41–5.70), and from individuals from South/Islands than by the ones from the Center (OR=0.65; 95%CI=0.40-1.06). The main sources of information resulted to be TV and school/university. Conclusions: These new evidences could guide policymakers on increasing the awareness of the population about this fundamental subject. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.   Author contributions: Conceptualization, G.L.T. and A.D.C..; Methodology, G.L.T. and A.M..; Formal Analysis, A.D.P.B., C.S., R.A.C., D.B.; Investigation, A.D.P.B., C.S., R.A.C., D.B.; Data Curation, A.D.P.B., C.S.; Writing – Original Draft Preparation, R.A.C., D.B.; Writing – Review & Editing, R.A.C., D.B., A.M..; Supervision, G.L.T..; Project Administration, G.L.T.   Conflicts of interest: None declare

Preventive medicine center and health care for students of medicine and health professions at the Sapienza University of Rome: a research protocol

This project aims to develop a Center of Preventive Medicine and Health Care for the students of Medicine and Health profession at Sapienza University of Rome. At the beginning of the university career students, both residents and nonresident s, have to face several difficulties such as: starting smoking or the increase in cigarette consumption ; the independent management of their own health (especially for non residents consequently to the distance of the family doctor) ; unhealthy diet; tuberculosis (TB) biological risk during their university training. These aspects , especially if present at the same time, act as a source stress and adversely affect the quality of life and the academic performance. Specific aims of the project will be: implementing an ambulatory of Preventive Medicine; implementing a virtual ambulatory of general medicine; creating a website on the problems mentioned above. Data collected will be computerized to keep an electronic health record (HER) and to use the information for the purposes of scientific research. The Centre will act in close relationship with the Central Administration, with the Headmasters of the Medical Faculties, and in close collaboration with the Center of Occupational Medicine of Sapienza University

Temporal pattern of Klebsiella pneumoniae carbapenemase (KPC) on surfaces of an intensive care unit of a large hospital

Background:Carbapenem-resistant Enterobacteriaceae are an increasing cause of healthcare-associated infections worldwide. Patients with infections caused by Klebsiella pneumoniae resistant to carbapenems (KPC) have significant increases in both all-cause mortality and 30-day mortality. The aims of this study was to investigate the prevalence of KPC on environmental samples collected during and after an outbreak caused by KPC in an intensive care unit (ICU) of a teaching hospital. Methods:Between 2010 and 2014 we conducted a total of 132 environmental monitoring campaigns from different critical surface of ICU ward in a Teaching Hospital Policlinico Umberto I. Samples were collected on surfaces in patient rooms and health care area. All samples were cultured and K. pneumoniae isolates were identified by standard microbiological techniques. The presumptive colonies were confirmed and tested for antibiotic resistance by an automated system. K. pneumoniae resitant to carbapenems were tested for carbapenemase production by modified Hodge test. Results:A total of 2526 environmental samples were collected from November 2010 to July 2014. Of those, 111 resulted positive for K. pneumoniae while KPC were 95 (85.6% of all K. pneumoniae, 3.8% of total samples). KPC was recovered in all patient rooms with similar proportion (5.1-5.6%) with the exception of patient 6 bed room where it was lower (2.4%). The pathogen was not recovered in rooms dedicated to healthcare personnel and doctors. Among surfaces, the highest proportion of KPC resulted onbedrail (6.8%), more than double than other surfaces. Washbasins had nearly half of samples KPC positive (1.2%). Conclusions:Despite previous studies suggested that environment plays a minor role in the transmission of carbapenem-resistant enterobacteriaceae, our data highlighted that surfaces represents a significant reservoir for KPC possibly supporting transiently contamination of hands of healthcare workers in our ICU. Our results confirm that KPC are more likely found on surfaces closer to the patient than on those situated further away

Legionella control in the water system of antiquated hospital buildings by shock and continuous hyperchlorination: 5 years experience

To control the presence of Legionella in an old hospital water system, an integrated strategy of water disinfection-filtration was implemented in the university hospital Umberto I in Rome. Due to antiquated buildings, hospital water system design and hospital extension (38 buildings), shock hyperchlorination (sodium hypochlorite, 20-50 ppm of free chlorine at distal points for 1-2 h) followed by continuous hyperchlorination (0.5-1.0 mg/L at distal points) were adopted, and microbiological and chemical monitoring of the water supply was carried out in the university hospital (December 2006-December 2011). Overall, 1308 samples of cold 45°C (17.8%) water were collected, determining residual free chlorine (0.43 ± 0.44 mg/L), pH (7.43 ± 0.29) and trihalomethanes (8.97 ± 18.56 μg/L). Legionella was isolated in 102 (9.8%) out of 1.041 water samples without filters (L. pneumophila sg 1 17.6%, L. pneumophila sg 2-14 28.4%, L. non pneumophila 53.9%), and in none of the 267 samples with filters. Legionella was recovered in 23 buildings out of 38 and 29 samples (28.4%) exceeded 103 cfu/L. When considering the disinfection treatment Legionella was isolated: before shock hyperchlorination (21.1%), 15 days after shock hyperchlorination (7.8%), 30 days after shock hyperchlorination (3.5%), during continuous hyperchlorination (5.5%) and without continuous hyperchlorination (27.3%). Continuous hyperchlorination following the shock treatment achieved >70% reduction of positive samples, whereas no continuous hyperchlorination after shock treatment was more frequently associated to Legionella isolation (OR 6.41; 95% CI 3.10-13.26; p 0.5 < 1.0 mg/L) deteriorated water quality (organoleptic and chemical). However, shock and continuous hyperchlorination remains a valid-term option in old buildings with no water system rational design, managing problems due to hospital extension and absence of a proper hot water recirculation system