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

Meat intake and non-Hodgkin lymphoma: a meta-analysis of observational studies

Purpose: High intake of meat has been inconsistently associated with increased risk of NonHodgkin Lymphoma (NHL). We carried out a meta-analysis to summarise the evidence of published observational studies reporting association between red meat and processed meat intake and NHL risk. Methods: Analytical studies reporting relative risks with 95% confidence intervals (95% CI) for the association between intake of red and/or processed meat and NHL or major histological subtypes were eligible. We conducted random-effects meta-analysis comparing lowest and highest intake categories and dose-response meta-analysis when risk estimates and intake levels were available for more than three exposure classes. Results: Fourteen studies (4 cohort and 10 case-control) were included in the meta-analysis, involving a total of 10121 NHL cases. The overall relative risks of NHL for the highest versus the lowest category of consumption were 1.14 (95%CI: 1.03, 1.26) for red meat and 1.06 (95%CI: 0.98, 1.15) for processed meat. Significant associations were present when the analysis was restricted to case-control studies but not when restricted to cohort studies. No significant associations were found for major NHL etiological subtypes. Dose response meta-analysis could be based only on 8 studies that provided sufficient data and, compared to no meat consumption, the overall NHL relative risk increased not linearly with increased daily intake of red meat. Conclusion: The observed positive association between red meat consumption and NHL is mainly supported by the effect estimates coming from case-control studies and is affected by multiple sources of heterogeneity. This meta-analysis provided mixed and inconclusive evidences on the supposed relationship between red and processed meat consumption and NHL

Epidemiologia delle infezioni da amebe a vita libera

Le amebe a vita libera (spesso conosciute come Free-Living Amoebae, FLA) sono protozoi presenti in tutte le matrici ambientali a diffusione cosmopolita. L’etichetta di organismi “a vita libera” deriva dal fatto che il loro serbatoio è l’ambiente acquatico naturale, e quello realizzato dall’uomo è un habitat secondario favorevole. Sono protozoi unicellulari che possono vivere all’interno di un ospite in condizioni di parassitismo facoltativo o avere un’esistenza autonoma. Per tale proprietà sono anche definite amebe anfizoiche. In particolare, anche se in realtà è Acanthamoeba spp. il protozoo più frequentemente rilevabile nell’ambiente, amebe a vita libera sono state isolate da suolo, sedimenti, polveri, aria, acque naturali e reflue, dolci, marine, termali, e sono state anche rilevate in acque confezionate, potabilizzate e sottoposte a trattamenti di disinfezione (acque destinate al consumo umano e di piscina) e in biofilm. Numerose specie di amebe a vita libera sono state segnalate in torri di raffreddamento, impianti di climatizzazione, deumidificatori, unità di dialisi, riuniti dentistici, apparecchi per il trattamento domestico dell’acqua e su lenti a contatto. Individuate nell’uomo e in animali a sangue caldo e freddo, in soggetti malati sono state isolate da ferite, dalla cornea, dai polmoni e dal sistema nervoso centrale, anche se la loro presenza è stata dimostrata anche in individui sani. La loro distribuzione e diversità nell’ambiente sono fortemente influenzate da temperatura, umidità, pH, disponibilità di nutrienti e appare chiara l’esistenza di un loro andamento stagionale. In condizioni ambientali ostili le amebe producono cisti che excistano solo in condizioni favorevoli liberando trofozoiti. Sopravvivenza e moltiplicazione sono anche associate sia alla presenza di batteri, soprattutto Gram-negativi, sia alla concentrazione degli stessi batteri. Infatti, con rapporti di concentrazione ameba: batteri di 1:104, lo sviluppo dei protozoi è inibito. Per il basso numero di infezioni riscontrate, le amebe non hanno mai rappresentato un argomento sanitario di interesse prioritario, anche se la mancanza di farmaci efficaci e l’esito quasi sempre fatale delle malattie indotte da alcune specie, le hanno sempre rese oggetto di interesse e di studio. Negli ultimi decenni tuttavia, un’attenzione particolare è stata loro rivolta per il ruolo che rivestono come veicolo di trasmissione di microrganismi patogeni presenti nell’ambiente idrico. Infatti, circa un quarto degli isolati di origine ambientale, clinica o derivanti da lenti a contatto contengono microrganismi endosimbionti, definiti Amoeba-Resistant Microorganisms (ARM), microrganismi resistenti alle amebe, che sono in grado di mantenere la loro vitalità a livello intracellulare. Le amebe fungono così da riserva per altri microrganismi, proteggendoli da fattori ambientali ostili e fornendo condizioni favorevoli alla loro replicazione. Per questa circostanza, nel 2017, presso la III Sezione del Consiglio Superiore di Sanità, presieduta dalla Prof.ssa Anna Teresa Palamara, e coordinata dalla Dott.ssa Anna Gaspardone, è stato istituito un Gruppo di Lavoro il cui compito è stato quello sia di approfondire gli aspetti sanitari associati alle amebe a vita libera rilevabili nelle acque, sia di valutare la rilevanza del problema in un’ottica di salvaguardia della salute. A seguito delle attività del Gruppo di lavoro è stato quindi predisposto il documento condiviso e di seguito presentato che produce informazioni sulle caratteristiche tassonomiche ed ecologiche di questi organismi, sulle loro possibili implicazioni di carattere sanitario, sul loro adattamento nelle reti di distribuzione idrica e sulle dinamiche di interazione con gli altri microrganismi. Inoltre, il volume fornisce un indirizzo metodologico univoco e specifiche raccomandazioni per minimizzare il rischio associato alla presenza di amebe nell’ambiente idrico, nonché, in Appendice, metodi analitici colturali e molecolari per la ricerca di questi organismi nelle acque

Factors influencing persistence of Legionella pneumophila serogroup 1 in laboratory cocultures

Background: Risk for infections from Legionella pneumophila for immunocompromised individuals increases greatly when this species is present within the biofilm of the water distribution systems of hospitals or other health facilities. Multiplication and persistence of Legionella may dependent also upon planktonic growth in alternative to sessile growth. Here we compared the persistence of L. pneumophila serogroup 1 in experimental planktonic co-cultures subsided with iron, Pseudomonas aeruginosa and other non Legionella bacteria (quantified as Heterotrophic Plate Count, HPC at 37°C), isolated from drinking water sources of a large hospital. Results: Concentrations of L. pneumophila showed a decreasing pattern with incubation time in all co-cultures, the degree of reduction depending on the experimental treatment. In co-cultures with added P. aeruginosa, no L. pneumophila was detectable already after 4 days of incubation. In contrast in co-cultures without P. aeruginosa, HPC but not iron were significant factors in explaining the pattern of L. pneumophila, although the HPC effect was different according to the incubation time (HPC x time interaction, p < 0.01). Conclusions: Our results highlight the need of controlling for both HPC and metal constituents of the water systems of buildings used by individuals at particular risk to the effects of Legionella exposure

Validation of a questionnaire about knowledge and perception of biological risk among biomedical students of Sapienza University of Rome

Background and aim. Healthcare workers and Biomedical students are continuously exposed to biological risk in their clinical practice. The objective of this study was to evaluate the validity and reliability of an Italian questionnaire on the knowledge and perception of biological risk in Biomedical students at the beginning of their professional training. Material and methods.An electronic questionnaire was administered to students attending the second semester of the first year of Biomedical Courses at Sapienza University of Rome. The questionnaire consists of 40 questions divided into five sections collecting sociodemographic data, health status and level of knowledge and perception of biological risk. The statistical analysis was performed with Statistical Package for Social Sciences (SPSS) version 25. Results. A total of 309 individuals answered the online questionnaire, with a response rate of 83.5%. The analysis of internal consistency was performed by two dichotomous variables that measured the knowledge level on hygiene behaviour and gloves use. The analysis showed a standardized Cronbach’s alpha equal to 0.765, corresponding to a good reliability. A better reliability was found out among physiotherapy and medical students, with a Cronbach’s alpha equal to 0.944 and 0.881, respectively. Regarding vaccines, 97.7% of the sample was given a Hepatitis B vaccination and 98.7% of students consider vaccinations essential for healthcare workers. Conclusion. Results of Cronbach’s alpha showed a good reliability of the questionnaire. First-year Biomedical students may be exposed to occupational biological risk mainly because of their inexperience. A training educational path should be implemented in order to acquire competences, knowledge, attitudes and practical skills, correct behaviors and a personal and professional responsibility

Seasonal and pandemic influenza: the role of communication and preventive strategies

Appropriate, timely, and data-driven health information is a very important issue in preventive strategies against influenza. Intui- tively, a link between willingness to be vaccinated against seasonal influenza and against pandemic influenza exists, given the similarities in decision-making for this vaccine. International and national literature reviews suggest that progress has been made in order to incorporate and disseminate crisis risk communication principles into public health practice, as such investments in public health could be important for building capacity and practice which aid in the realization of countermeasures in response to a future pandemic and epidemic situation. This study emphasizes the lack of perception by Health Care Workers (HCWs) of the importance of being immunized against seasonal and pandemic influenza and the doubts concerning safety. In the future, particular efforts are needed during vaccination campaigns, to provide more information to HCWs and the general population regarding role and safety of such vaccines

Malpractice and patient safety descriptors: an innovative grid to evaluate the quality of clinical records

Introduction: The medical record contains all the health information related to the patient’s clinical condition and its evolution during hospitalization. It was defined by the Italian Ministry of Health in 1992 as "The information tool designed to record all relevant demographic and clinical information about a patient during a single episode of hospitalization". The documents and information in a Medical Record must meet the following criteria: traceability, clarity, accuracy, authenticity, pertinence and completeness. The objectives of our study was to develop a tool capable of assessing the quality of the clinical record and pointed the critical point at the Organizational, Technical - Professional, Managerial level. Methods: To evaluate the quality of the medical documentation, we created an assessment grid composed of 4 sections with a total of 92 criteria. This grid was tested on 200 medical records that were randomly selected from 25 (18 medical and 7 surgical) wards of a teaching hospital in Rome. Results: The grid contains 4 sections. The first part regards administrative and clinical data; the second assesses the quality of hospital stay and surgical/invasive procedures; the third part is concerned with the discharge of the patient and the fourth aims to identify the presence of advisory reports given to the patient. This grid has been validated to verify internal consistency with Cronbach's Alpha = 0,743. Conclusions: Medical records were analyzed using a validated tool with grids to identify critical issues in care activities. Weaknesses in the system were identified in order to improve planning. The sample testing also in terms of ‘self-assessment' represents a tool to introduce activities to improve safety and quality of care, greatly reducing the costs of litigation

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 &lt; 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

Pseudo-outbreak of Mycobacterium gordonae in a teaching hospital: importance of strictly following decontamination procedures and emerging issues concerning sterilization

Aim of this study was to investigate a pseudo-outbreak of Mycobacterium gordonae analyzing isolates detected from clinical and environmental samples. Mycobacterium gordonae was detected in 7 out of 497 broncho-alveolar lavage (BAL) samples after bronchoscopy procedure in patients admitted to a teaching hospital between January and April 2013. During this pseudo-outbreak clinical, epidemiological, environmental and molecular investigations were performed. None of the patients met the criteria for non-tuberculous mycobacterial (NTM) lung disease and were treated for M. gordonae lung disease. Environmental investigation revealed M. gordonae in 3 samples: in tap water and in the water supply channel of the washer disinfector. All the isolates were subjected to genotyping by pulsed-field gel electrophoresis (PFGE). The PFGE revealed that only patients' isolates presented the same band pattern but no correlation with the environmental strain was detected. Surveillance of the outbreak and the strict adherence to the reprocessing procedure and its supplies resulted afterwards in no detection of M. gordonae in clinical respiratory samples. Clinical surveillance of patients was crucial to establish the start of NTM treatment. Regular screening of tap water and endoscopic equipment should be adopted to compare the clinical strains with the environmental ones when an outbreak occurs

Vamos fazer da nossa vida uma obra de arte?

This article presents an educational research as an investigative way developed together with many people. We have counted with the narrative of some female popular educators in order to share a professional development experience carried out in the city of Campinas-SP, in the period between 2003-2004. We tried to show how teacher’s education and the work developed by them in a literacy program for young and adults had an impact in the life of all the people involved in the process. The importance of the experience can be seen through the narratives, which are full of the understanding of these educators about themselves and the work developed together with educators and students, all of them producers of a new and different comprehension of the lived experience.  Educators’ attitude manifested in their narratives, as writers, and in their life choices indicates that the emancipatory conception of knowledge production, as experienced in the Popular Education allows the development of people’a intelligence and creative energy. The new meaning of life as a work of art, unfinished and open, can be seen by the writings of the subjects involved in this program: educators and researchers.  Key-words: Knowledge Production, Educators development, Popular Education  Apresentamos nesse artigo uma pesquisa educacional como caminho investigativo trilhado na companhia de muitas pessoas.  Recorremos às narrativas de algumas educadoras populares para compartilhar uma experiência de formação realizada na cidade de Campinas-SP, no período compreendido entre os 2003-2004. Procuramos abordar a formação e o trabalho realizado nos grupos de alfabetização de jovens e adultos, como vivência significativa na vida de todos os participantes do processo. A relevância da experiência pode ser apreendida através das narrativas, impregnadas da compreensão que as educadoras têm de si e do trabalho que desenvolvem em parceria com formadores e educandos, todos sujeitos produtores de uma outra e nova interpretação do vivido. A atitude autoral presente nas narrativas e nas opções de vida evidenciam que a concepção emancipatória da produção do conhecimento experimentada na Educação Popular favorece o desenvolvimento da inteligência e das energias criativas das pessoas. A re-significação da vida como uma obra de arte, inconclusa e aberta, pode ser vislumbrada através dos registros dos sujeitos: educadoras e pesquisadores.  Palavras-chave: Produção do Conhecimento, Formação de Educadores, Educação Popular.