Promozione della salute e strategie di educazione nutrizionale

Le abitudini alimentari fanno parte integrante della cultura di ogni popolo e contribuiscono in maniera rilevante a una migliore comprensione del comportamento umano. La mancanza di conoscenze corrette in tema di nutrizione è spesso responsabile di rilevanti problemi sanitari. I regimi nutrizionali attuali sono, infatti, perlopiù sbilanciati perché ricchi di grassi, zuccheri e sale, e poveri in carboidrati complessi, frutta e verdura. L’educazione nutrizionale mira a formare il «comportamento alimentare» e non va, pertanto, ricondotta al semplice concetto di dieta. Il comportamento alimentare, dal canto suo, costituisce una vera e propria rappresentazione esterna dell’individuo con i suoi punti di forza e le sue debolezze, con le sue convinzioni e la sua storia familiare e personale. L’educazione nutrizionale ha, dunque, l’obiettivo di sviluppare l’autonomia decisionale degli individui per metterli nelle condizioni di adottare in maniera permanente, volontaria e consapevole, scelte alimentari corrette per tutto l’arco della loro vita. Dal momento che i comportamenti alimentari sono influenzati da fattori sociali e culturali, l’educazione alimentare andrebbe impartita già a partire dalle scuole elementari. Educatori professionali e insegnanti dovrebbero illustrare agli alunni e ai loro genitori i vantaggi derivanti da un’alimentazione bilanciata e le conseguenze della malnutrizione. I servizi di ristorazione scolastica, in particolare, dovrebbero provvedere alla distribuzione di pasti completi e, soprattutto, equilibrati

Knowledge, attitudes and practices towards patients with HIV/AIDS in staff nurses in one university hospital in Sicily

Background: nurses’ knowledge, attitudes and practices towards patients with HIV/AIDS are of ongoing interest, especially in developing countries. Nothing or very little is known about Italian nurses. Methods: HIV/AIDS knowledge, attitudes and behaviours of the nurses (n=107) from one university hospital inCatania,Sicily, were documented. Comparisons among nurses belonging to different Operative Units (O.U.) were conducted by the chi-square test (P<0.05). Results: although HIV was nurses’ main concern in regard to contracting infections in the workplace (54%), the vast majority of them (98%) had never refused an HIV/AIDS patient care assignment. Moreover, despite their concern of being more at risk of contracting HIV than the general population (41%), a not negligible percentage of nurses did not use gloves routinely (21%) and only a few treated all patients as potentially HIV-positive (9%). The vast majority of the respondents knew the meaning of AIDS (87%) and of a positive serological test (78%). On the contrary, a relatively low percentage of them knew what is the ‘window period’ (62%) and were acquainted with HIV pathophysiology (65%). No statistically significant differences in terms of risk perception were found between nurses who had previously attended an HIV/AIDS workshop, lecture or specific course (43%) and nurses who did not (57%). Level of knowledge was positively associated to age (P=0.000) and to education (P=0.016), and it was found higher in nurses working in a O.U. of Infectious Diseases. Conclusions: data from our study show that also in developed countries, such as Italy, nurses could have some misconceptions and concerns about HIV/AIDS. The importance of examining the impact of continuing education on nurses’ preparedness to care for patients with HIV/AIDS and to prevent the risks of occupational HIV transmission is discussed.&nbsp

Severe ocular involvement in a newborn with Langerhans Cell Histiocytosis

Abstract Langerhans Cell Histiocytosis (LCH) is a rare proliferative disease of the mononuclear phagocyte system, characterised by tissue infiltration of CD1a + CD207+ histiocytes. The clinical presentation is variable, ranging from unifocal asymptomatic bone involvement to life-threatening multisystem disease, requiring aggressive therapeutic approaches. Intraocular involvement is uncommon and associated to poor visual and general prognosis. We report a case of LCH in a newborn with severe ocular and multisystem risk-organ involvement, unresponsive to several lines of chemotherapy. Off-label administration of vemurafenib led to dramatic improvement at systemic level; however, chronic sequelae of ocular involvement resulted in poor visual prognosis. Intraocular LCH involvement may be asymptomatic and clinical signs delayed, leading to severe complications, especially in newborns and young children. Screening for ocular involvement is essential for early treatment initiation, which can possibly improve the visual outcome. Vemurafenib is effective on systemic involvement, and its role in ocular LCH needs to be evaluated

Cardiology Rehabilitation wards: Isolation of Staphylococcus capitis. A risk of infection to be kept under control

Odděleni kardiovaskularni rehabilitace se specializuji na rehabilitaci nemocných po kardiochirurgickem výkonu nebo po akutnim infarktu myokardu. Nemocnicni infekce jsou velmi castou a zavažnou komplikaci provaděne lecby. V poslednich dvou desetiletich se nicmeně ukazalo, že hlavni přicinou připadů infekce a sepse na jednotkach kardiologicke pece jsou koagulaza-negativni stafylokoky (CoNS), mezi nimiž významne misto zaujima bakterie Staphylococcus capitis. Popisujeme nase zkusenosti z izolaty S. capitis od pacienta, který byl hospitalizovan s kardiovaskularnim onemocněnim a s bercovými vředy. © 2019, CKS

Plasmid-mediated multiple antibiotic resistance of Escherichia coli in crude and treated wastewater used in agriculture.

A total of 273 Escherichia coli isolates from raw and treated municipal wastewaters were investigated to evaluate the frequency and persistence of antibiotic resistance and to detect the occurrence of conjugative R plasmids and integrons. The highest resistance rates were against ampicillin (22.71%), tetracycline (19.41%), sulfamethoxazole (16.84%) and streptomycin (14.28%). Multiple antibiotic resistance was present in 24.17% of the isolates. Several multiple antibiotic-resistant isolates proved to be able to transfer en bloc their resistance patterns by conjugative R plasmids with different molecular sizes and restriction profiles. Class 1 integrons of 1 or 1.5 kbp were found in 5 out of 24 representative multiresistant E. coli isolates. Although wastewater treatments proved to be effective in eliminating Salmonella spp. and in reaching WHO microbiological standards for safe use of wastewater in agriculture, they were ineffective in reducing significantly the frequency of plasmid-mediated multiple antibiotic resistance in surviving E. coli. Since multiple antibiotic-resistant bacteria carrying integrons and conjugative R plasmids can constitute a reservoir of antibiotic-resistance genes in wastewater reclaimed for irrigation, risks for public health should be considered. Bacterial strains carrying R plasmids and integrons could contaminate crops irrigated with reclaimed wastewater and transfer their resistances to the consumers' intestinal bacteria

Persistent oral and urinary Candida spp. carriagein Italian HIV-seropositive asymptomatic subjects

The aim of the present study was to ascertain frequency and persistence of Candida spp. oral and urinary carriage in asymptomatic, HAART-naive HIV-seropositive subjects who had not undergone therapy with antimycotic drugs, and whose CD4+ lymphocyte count was greater than 200/?l. Oral carriage was the most common Candida spp. carriage (63.0% of the subjects), while candiduria was more rarely observed (6.5%). C. albicans was recovered from the majority of the subjects examined (56.5%), followed by C. krusey (4.3%), C. tropicalis (2.2%) and C. dubliniensis (2.2%). C. albicans was also isolated from two urinary carriers (4.3%) and C. glabrata from another one (2.2%). The same C. albicans clone was repeatedly isolated from 14 out of 15 oral carriers while the same clone of C. dubliniensis was repeatedly isolated from one carrier, as shown by the persistence of RAPD fingerprint of serial isolates during one year of follow-up. Since persistence of Candida spp. carriage may influence the development of clinical candidiasis in immunocompromised hosts, monitoring of the carrier status could be useful for preventing clinical thrush in HIV-seropositive subjects

Antimicrobial potential of Sicilian honeys against commensal Escherichia coli and pathogenic Salmonella serovar Infantis

Introduction. The purpose of this study was to investigate the antibacterial effect of 71 locally produced honeys from different botanical sources collected from apiarist?s open markets in Sicily. Methods. Antimicrobial activity was determined against Escherichia coli (ATCC 25922) and Salmonella serovar Infantis (ATCC 1523) by an agar-diffusion assay from the estimation of the diameter of the inhibition zone produced by the honeys. Statisti- cally significant differences (P inf. .000) regarding inhibition were observed for the honeys tested. Results. The chestnut and polyfloral honey samples exhibited the largest and highest inhibition (diameter of the inhibition zone > 25 mm) against both E. coli and S. Infantis. The honey of oregano origin showed intermediate or low activity against E. coli and S. Infantis, respectively. Prickly pear and erica honeys showed no antimicrobial activity against the two reference strains. Discussion. The results may partially suggest the usefulness of the Sicilian honeys on treating multi-resistant enterobacteria. In light of the enormous potential for application of honey in the clinical practice, it is important that research continues not only into those honeys well recognized as antimicrobial, but also into other locally produced and yet untested honeys

Variabili socio-demografiche, sanitarie e psicologiche dello stress lavorativo

Obiettivo principale del presente studio è individuare e valutare in ottica interdisciplinare le principali variabili che possono influenzare il malessere lavorativo, utilizzando strumenti diagnostici adatti a misurare in modo attendibile e valido sul piano sia psicometrico che clinico le variabili osservabili in ambito organizzativo. È stato esaminato un campione di 243 persone, dipendenti di aziende sanitarie e scolastiche. I risultati evidenziano come i disturbi psicofisici generalmente prevalenti siano quelli del sonno; le percezioni di stress direttamente riferite al lavoro riguardano le preoccupazioni inerenti la mansione e la sensazione di non avere più energie sufficienti per svolgere adeguatamente il proprio lavoro. Alcune significative differenze sono state riscontrate relativamente al genere e all’ambito di lavoro (maggiore stress emotivo è riportato nei lavoratori della sanità rispetto a quelli della scuola). Cambiamenti nello stile di vita, dieta, variazioni di peso sono correlati con l’incremento dello stress. Specifici aspetti di stress sul lavoro predicono significativamente lo stress complessivo, mentre altri sembrano dipendere da diversi fattori extralavorativi. Analisi di approfondimento qualitativo consentono di valutare il profilo dei lavoratori che hanno uno stress superiore al limite della norma. I risultati potranno essere utili al fine di formulare specifici piani organizzativi mirati alla riduzione delle variabili fisiche e psicologiche che incidono sullo stress lavorativo, mediante attività di risk-management da usare per la diagnosi e la gestione organizzativa. The main objective of this study is to detect and evaluate, in interdisciplinary perspective, the key variables that can affect work uneasiness, using diagnostic tools suitable for measuring both the psychometric and the clinically relevant variables observable in the organizational context. The sample of the study is composed of 243 subjects, working both in health and school organizations. The results show that the psychophysical disorders generally prevalent regard sleep; stress perceptions directly related to work regard job-related concerns and the feeling of not having enough energy to properly carry out work. Significant differences have been reported pertinent to gender and work context (more emotional stress was reported in healthcare workers than in the school). Lifestyle changes, diet, weight alterations are correlated with increased stress. Specific aspects of work stress significantly predict overall stress, while others seem to depend on different non-working factors. Qualitative in-depth analyses allow assessing the profile of the workers who have a higher stress compared with the norms. The results may be useful in order to formulate specific organizational strategies aimed at reducing physical and psychological variables affecting work stress, through risk management activities useful for diagnosis and organizational planning

Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study

Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis®μ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis®μ were also analyzed by real-time PCR. Legionella presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolis®μ did not yield Legionella in any enrolled HF. However, molecular investigation using Coriolis®μ resulted in eight HF testing positive for Legionella in the air. Comparison of Legionella air and water contamination indicated that Legionella water concentration could be predictive of its presence in the air. Furthermore, a molecular study of 12 L. pneumophila strains confirmed a match between the Legionella strains from air and water samples by SBT for three out of four HF that tested positive for Legionella by at least one of the culturable methods. Overall, our study shows that Legionella air detection cannot replace water sampling because the absence of microorganisms from the air does not necessarily represent their absence from water; nevertheless, air sampling may provide useful information for risk assessment. The liquid impingement technique appears to have the greatest capacity for collecting airborne Legionella if combined with molecular investigation