In salute in Sapienza

Background and objective: The growing impact of chronic degenerative pathologies (such as cardiovascular disease, type 2 diabetes and Alzheimer’s disease) requires and pushes towards the development of new preventive strategies to reduce the incidence and prevalence of these diseases. Lifestyle changes, especially related to the Mediterranean Diet (MD), have the potential to modify disease outcomes and ultimately costs related to their management. The Mediterranean dietary pattern (MDP) is a useful tool in the primary and secondary prevention of cardiovascular diseases, and its adoption has significantly beneficial public health implications. The rise in chronic diseases, stresses the need to retain a healthy workforce. Many chronic diseases are linked to unhealthy lifestyles and stress. Fortunately, in many cases the severity chronic disease can be altered and improved by appropriate nutrition, increased physical activity, smoking cessation and reduced alcohol consumption. Unfortunately, high level of stress and unhealthy lifestyles are very common among university employees and students. This calls for appropriate action focusing on improving and maintaining university employees and students’ health. Settings such as the workplace and the university, in particular, have been established as one of the priority settings for health promotion into the 21st century, as they can reach a great range of people of diverse backgrounds. Therefore, the proposed project examined university employees’ and students’ health and well-being, with the overall aim to improve and promote health in “Sapienza” University of Rome. Material and methods: Phase 1: The first part of the project followed a cross-sectional design. In order to identify areas of health-promotion and prevention, employee and student health were assessed through a self-administered questionnaire. Both groups participated in survey based on existing and validated instruments: Socio-demographic factors; Food Frequency Questionnaire (FFQ); Questionnaire on alcohol consumption (Audit c); Questionnaire on smoking habit and tobacco consumption (e.g. Fagerström Test); Questionnaire for the evaluation of physical activity (IPAQ); Questionnaire on the health related quality of life (SF-12). The project provides the establishment of a pilot center of preventive medicine and health care and it was created an ad hoc website dedicated to these issues. It could be visualized on the following link: https://dspmi.uniroma1.it/strutture/progetto-preveniamo In progress: Phase 2: based on the results of the first part target-oriented workplace and university health promotion efforts will be developed. Phase 3: it will involve the evaluation and monitoring of the project. Evaluation and monitoring is an important in ensuring the ongoing development of the project as well as safeguarding that goals, objectives and strategies are being met. Evaluation will take place through questionnaires. Results: On 760 University people, the mean score was 5 (SD 1.71; range:0-10). The majority of the students/employees (n.632; 83.2%) showed a score < 6.99, indicating that they do not respect the rules of the MD; on the contrary, only 128 (16.8%) exceeded a score of 7, and therefore adhered in varying degrees. In detail, no one reached the maximum score of 12 and no one of 11. The maximum score gained was 10 for only 2 people (0.3%). By binary logistic regression, resulted that the likelihood of adhering to healthy eating habits increase in older people and to be an employee could reduce the likelihood of adhering to the Mediterranean dietary pattern. About 23.1% declared to smoke cigarettes, 52.2% in the last 7 days never performed vigorous physical activities and 21.2% never performed moderate physical activities. A percentage of 45% of the sample in the last 7 days walked for at least 10 minutes every day. Only 5.5% of the sample answered “excellent” to the question on own health perception, 29.7% declared “very good”, 50.1% “good”, 13.3% “not very good”, 1.3% poor. Most of the sample (n. 256; 33.7%) consumes alcoholic beverages 2-4 times a week and for n.151 (19.9%) was happened to drink more than six glasses once a month. Conclusions This study is a good starting point for carrying out larger study, with repeated health promotion interventions over time and long-term efficacy evaluation

Risk factors from HBV infection among blood donors: A systematic review

Abstract Objective To perform a systematic review of the scientific literature to identify risk factors associated with hepatitis B viruses (HBV) infection among blood donors. Methods The literature search was carried out on PubMed and Scopus databases using the keywords "risk factors" "HBV infection" and "blood donors". No date or language restrictions were applied to the search. This literature review was completed in March 2014. The selection process and the reporting of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. The Newcastle Ottawa scale was using to evaluate the quality of each single primary study. Results Out of 172 records resulted in the search, 5 papers were included in the final analysis because they are within acceptance criteria. Two of the selected studies were cross-sectional and three of them were case-control studies. Significant association resulted with some demographic and behavioral risk factors, such as marital status, dental treatment/procedure history, no stable relationship or multiple partners and family history of HBV infection. Conclusions The systematic review performed encourages to conduct further research among blood donors in order to fully understand risk factors among donors in more extensive thus to provide valuable information about surveillance

Hepatitis B Immunization in Health Care Workers: Needs and Opportunities

[No abstract available

Economic evaluation of HBV vaccination: a systematic review of recent publications (2000-2013).

Aim: To conduct a systematic review of the economic evaluations (EE) of HBV vaccination, taking also into account the studies published in the new millennium. Methods: An extensive scientific literature review was conducted using two electronic medical journal databases: Scopus and PubMed engines for published studies on EE of HBV vaccination. Results: 22 articles were reviewed, 9, 5 and 8 cost-effectiveness, cost-benefit and cost-utility analysis, respectively. Studies were mainly concerning EE of universal vaccination (UV), mostly with regards to low or low-medium income countries. For high income countries, EE were focused on the possible implementation of HBV vaccination in particular settings, such as diabetic, renal and other chronic conditions care, as well as infectious diseasesUV has usually a very good cost-effectiveness ratio (80%), ranging from cost-saving (China) or few Euro per LY/QALY gained (in Thailand, and Vietnam) to 630.00$/ QALY in USA (Asian and Pacific Islands) Moreover, EE of HBV vaccination are favorable in the infectious diseases field as well as for chronic conditions. In relation to diabetes the studies gave controversial results. Conclusion: This systematic review highlighted the importance of introducing HBV vaccination not only for infant UV program but also for other settings in which patients are people affected by communicable and non-communicable diseases

Smoking cessation interventions in nurses and other health care workers

Introduction: Tobacco smoking can be considered an old and a new challenge for public health. The aim of this review was to analyse different smoking cessation interventions aiming at health care workers.Methods: A literature search of electronic journal databases for studies on smoking cessation interventions among health care workers was performed according to PRISMA criteria, using the MEDLINE and Scopus databases.Results: Smoking restriction policies shouldn’t be considered as actual interventions, being ineffective, unpopular and reducing willingness to quit smoking in many subjects. Even though pharmacological therapies based on bupropion SR and transdermal nicotine patches grant significant results on the short-term (weeks and months), smoking recurrence rates are high and individualised interventions should be preferred or integrated since they seem to grant better results on the longterm (years).Conclusions: There is evidence that smoking cessation interventions among health care workers can be effective. This is of particular interest both for reducing tobacco smoking prevalence among this type of workers and for helping them to be useful model for the general population

How much do needlestick injuries cost? a systematic review of the economic evaluations of needlestick and sharps injuries among healthcare personnel

objective. To provide an overview of the economic aspects of needlestick and sharps injury (NSI) management among healthcare personnel (HCP) within a Health Technology Assessment project to evaluate the impact of safety-engineered devices on health care methods. A systematic review of economic analyses related to NSIs was performed in accordance with the PRISMA statement and by searching PubMed and Scopus databases (January 1997–February 2015). Mean costs were stratified by study approach (modeling or data driven) and type of cost (direct or indirect). Costs were evaluated using the CDC operative definition and converted to 2015 International US dollars (Int$). results. A total of 14 studies were retrieved: 8 data-driven studies and 6 modeling studies. Among them, 11 studies provided direct and indirect costs and 3 studies provided only direct costs. The median of the means for aggregate (direct + indirect) costs was Int$747 (range, Int$199–Int$1,691). The medians of the means for disaggregated costs were Int$425 (range, Int$48–Int$1,516) for direct costs (9 studies) and Int$322 (range, Int$152–Int$413) for indirect costs (6 studies). When compared with data-driven studies, modeling studies had higher disaggregated and aggregated costs, but data-driven studies showed greater variability. Indirect costs were consistent between studies, mostly referring to lost productivity, while direct costs varied widely within and between studies according to source infectivity, HCP susceptibility, and post-exposure diagnostic and prophylactic protocols. Costs of treating infections were not included, and intangible costs could equal those associated with NSI medical evaluations. conclusions. NSIs generate significant direct, indirect, potential, and intangible costs, possibly increasing over time. Economic efforts directed at preventing occupational exposures and infections, including provision of safety-engineered devices, may be offset by the savings from a lower incidence of NSIs

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

No effects of oral vitamin D supplementation on non-alcoholic fatty liver disease in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common hepatic disorder worldwide, reaching prevalence up to 90 % in obese patients with type 2 diabetes (T2D), and representing an independent risk factor for cardiovascular mortality. Furthermore, the coexistence of T2D and NAFLD leads to higher incidence of diabetes’ complications and additive detrimental liver outcomes. The existence of a close association between NAFLD and hypovitaminosis D, along with the anti-inflammatory and insulin-sensitizing properties of vitamin D, have been largely described, but vitamin D effects on hepatic fat content have never been tested in a randomized controlled trial. We assessed the efficacy and safety of 24-week oral high-dose vitamin D supplementation in T2D patients with NAFLD. Methods: This randomized, double-blind, placebo-controlled trial was carried out at the Diabetes Centre of Sapienza University, Rome, Italy, to assess oral treatment with cholecalciferol (2000 IU/day) or placebo in T2D patients with NAFLD. The primary endpoint was reduction of hepatic fat fraction (HFF) measured by magnetic resonance; as hepatic outcomes, we also investigated changes in serum transaminases, CK18-M30, N-terminal Procollagen III Propeptide (P3NP) levels, and Fatty Liver Index (FLI). Secondary endpoints were improvement in metabolic (fasting glycaemia, HbA1c, lipids, HOMA-IR, HOMA-β, ADIPO-IR, body fat distribution) and cardiovascular (ankle-brachial index, intima-media thickness, flow-mediated dilatation) parameters from baseline to end of treatment. Results: Sixty-five patients were randomized, 26 (cholecalciferol) and 29 (placebo) subjects completed the study. 25(OH) vitamin D significantly increased in the active treated group (48.15 ± 23.7 to 89.80 ± 23.6 nmol/L, P < 0.001); however, no group differences were found in HFF, transaminases, CK18-M30, P3NP levels or FLI after 24 weeks. Vitamin D neither changed the metabolic profile nor the cardiovascular parameters. Conclusions: Oral high-dose vitamin D supplementation over 24 weeks did not improve hepatic steatosis or metabolic/cardiovascular parameters in T2D patients with NAFLD. Studies with a longer intervention period are warranted for exploring the effect of long time exposure to vitamin D

Reliability of the telephone-administered International Physical Activity Questionnaire in an Italian pilot sample

Background: the International Physical Activity Questionnaire (IPAQ) is an instrument for crossnational monitoring of physical activity and inactivity. The aim of the study was the reliability evaluation of the Italian telephone-administered IPAQ version in Rome. Methods: the IPAQ short form (IPAQ-SF), consisting of 7 items, was administered. The responses, used to compute Metabolic Equivalent Task (MET in minutes per week), were processed to analyze the internal consistency. Standardized Cronbach’s alpha was used for reliability estimation. Results: a total of 133 adults (51 males and 82 females) participated in the study, with a mean age of 51 years (SD=19). The mean MET was 4 130, corresponding to good physical activity levels. The standardized Cronbach’s alpha on 6 items, concerning time spent on vigorous and moderate activity and walking, was 0.614. Conclusions: according to the findings from other countries, the Italian IPAQ-SF has acceptable measurement properties, as good as other established self-reports. The IPAQ-SF has a questionable reliability as previously reported, but the results of the present pilot study are promising and suggest that these instruments can be used to compare population estimates of physical activity