Air pollution: a study of citizen's attitudes and behaviors using different information sources

Background: From November 2015 to January 2016, the routine air monitoring showed a peak of air pollution (in particular of PM10) that caused alarm in many Italian cities and was widely reported by mass media. After some weeks from this alarm, we tried to evaluate the citizen awareness and interest towards air pollution together with their positive behaviors, using different information sources. Methods: From September 2015 to March 2016, in parallel with the number of exceedances of the PM10 in Italy we evaluated the press coverage, the average monthly searches on Google and the interest on Twitter. Moreover, a qualitative content analysis on daily newspapers was conducted and a self-compiled questionnaire on the attitudes and behaviors about environmental issues and their determinants was administered to 598 parents involved in the project MAPEC_LIFE (LIFE12 ENV/IT/00614). Results: The media coverage of the theme of air pollution was very high from the end of 2015 to the beginning of 2016, as well as internet searches and twitter messages. Our qualitative analysis highlighted that only a small portion of articles included information about positive behaviors and environmental awareness. Despite the high media coverage and the satisfactory self-perceived knowledge, the majority of respondents judged negatively the received information (as untrue and incomplete) and declared a limited adoption of pro-environmental behaviors.  Conclusion: The parallel study of mass media information and people’s attitudes and behaviors seem to indicate that the high media coverage was not followed by a very high motivation towards pro-environmental behaviors

Improving awareness of health hazards associated with air pollution in primary school children: Design and test of didactic tools

One of the objectives of the MAPEC-Life project is raising children’s awareness on air quality and its health effects. To achieve this goal, we designed didactic tools for primary school students, including leaflets with more information for teachers, a cartoon, and three educational videogames. The tools were then tested with 266 children who attended six primary schools in four Italian cities. A control group of 51 children received only explanations from teachers. An improvement in knowledge after using the audiovisual package was demonstrated, with higher efficacy compared with the control group. In addition, the use of videogames was greatly appreciated

VALUTAZIONE DEL DANNO PRIMARIO ED OSSIDATIVO AL DNA IN LINFOCITI SALIVARI PER IL MONITORAGGIO DEGLI EFFETTI BIOLOGICI PRECOCI CAUSATI DALL’INQUINAMENTO ATMOSFERICO NEI BAMBINI: STUDIO MAPEC

VALUTAZIONE DEL DANNO PRIMARIO ED OSSIDATIVO AL DNA IN LINFOCITI SALIVARI PER IL MONITORAGGIO DEGLI EFFETTI BIOLOGICI PRECOCI CAUSATI DALL’INQUINAMENTO ATMOSFERICO NEI BAMBINI: STUDIO MAPEC Samuele Vannini (1) - Sara Levorato (1) - Elisabetta Ceretti (2) - Milena Villarini (1) - Silvia Bonetta (3) - Cristina Fatigoni(1) - Annalaura Carducci (4) - Tania Salvatori (1) - Maria Rosaria Tumolo (5) - Alessio Perotti (6) - Silvia Bonizzoni (7) - Alberto Bonetti (8) - Massimo Moretti (1) - Umberto Gelatti (2) Dipartimento di Scienze Farmaceutiche, Università degli Studi di Perugia, Perugia, Italia (1) - Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, Brescia, Italia (2) - Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Torino, Italia (3) - Dipartimento di Biologia, Università degli Studi di Pisa, Pisa, Italia (4) - Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Lecce, Italia (5) - Dipartimento di Bioscienze, Università del Studi di Parma, Parma, Italia (6) - Ufficio Minori, Comune di Brescia, Brescia, Italia (7) - Centro Servizi Multisettoriale e Tecnologico, Csmt Gestione S.c.a.r.l., Brescia, Italia (8) Il particolato è l’inquinante atmosferico che provoca i maggiori danni alla salute umana in Europa (Agenzia Europea dell’Ambiente; www.eea.europa.eu). Tra le prime 30 città più inquinate del continente, oltre la metà sono italiane, in particolare quelle situate nella pianura Padana, con concentrazioni di PM10, PM2,5 e NOx ben al di sopra dei valori di riferimento europei. Studi epidemiologici hanno rilevato un’associazione positiva tra esposizione ad inquinamento atmosferico, soprattutto al PM, ed incidenza e mortalità per diverse malattie cronico-degenerative, come cancro al polmone, malattie cardiovascolari e diabete. I bambini, in particolar modo, risultano esposti ad un elevato rischio per quanto riguarda gli effetti a breve e lungo termine dell’inquinamento atmosferico. Dati recenti suggeriscono che alcune alterazioni genetiche che si verificano nella prima infanzia posso incrementare il rischio di malattie cronico-degenerative in età adulta. L’obiettivo dello studio MAPEC (Monitoring Air Pollution Effects on Children for supporting Public Health policy) è quello di valutare l’associazione tra inquinamento atmosferico e biomarcatori di effetti genotossici precoci nei bambini, e di proporre un modello per la stima del rischio globale causato dagli inquinanti atmosferici. Lo studio ha previsto il reclutamento di circa 1.000 bambini, di età compresa tra 6-8 anni, in cinque città italiane (200 bambini per città) caratterizzate da diverse concentrazioni di inquinanti atmosferici: Brescia, Torino, Pisa, Perugia e Lecce. Campioni di saliva sono stati raccolti in due differenti stagioni, inverno e primavera, caratterizzate da differenze qualitative e quantitative degli inquinanti atmosferici (1.000 × 2 = 2.000 campioni). Nei linfociti salivari è stato valutato il danno primario e ossidativo al DNA mediante il test della microgel elettroforesi su singole cellule (comet assay). Alla conferenza verranno presentati i risultati preliminari relativi al campionamento invernale

Lifestyles and socio-cultural factors among children aged 6-8 years from five Italian towns: The MAPEC-LIFE study cohort

Background: Lifestyles profoundly determine the quality of an individual’s health and life since his childhood. Many diseases in adulthood are avoidable if health-risk behaviors are identified and improved at an early stage of life. The aim of the present research was to characterize a cohort of children aged 6–8 years selected in order to perform an epidemiological molecular study (the MAPEC_LIFE study), investigate lifestyles of the children that could have effect on their health status, and assess possible association between lifestyles and socio-cultural factors. Methods: A questionnaire composed of 148 questions was administered in two different seasons to parents of children attending 18 primary schools in five Italian cities (Torino, Brescia, Pisa, Perugia and Lecce) to obtain information regarding the criteria for exclusion from the study, demographic, anthropometric and health information on the children, as well as some aspects on their lifestyles and parental characteristics. The results were analyzed in order to assess the frequency of specific conditions among the different seasons and cities and the association between lifestyles and socio-economic factors. Results: The final cohort was composed of 1,164 children (50.9 boys, 95.4% born in Italy). Frequency of some factors appeared different in terms of the survey season (physical activity in the open air, the ways of cooking certain foods) and among the various cities (parents’ level of education and rate of employment, sport, traffic near the home, type of heating, exposure to passive smoking, ways of cooking certain foods). Exposure to passive smoking and cooking fumes, obesity, residence in areas with heavy traffic, frequency of outdoor play and consumption of barbecued and fried foods were higher among children living in families with low educational and/or occupational level while children doing sports and consuming toasted bread were more frequent in families with high socio-economic level. Conclusions: The socio-economic level seems to affect the lifestyles of children enrolled in the study including those that could cause health effects. Many factors are linked to the geographical area and may depend on environmental, cultural and social aspects of the city of residence

The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the "Delirium Day 2015"

Backround: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. Aim: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. Methods: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score ≥ 4: possible delirium; scores 1-3: possible cognitive impairment). Results: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score ≥ 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. Discussion: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. Conclusion: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Eye model for floaters’ studies: production of 3D printed scaffolds

Floaters are aggregates of collagen that form inside the vitreous body. They originate by liquefaction of the vitreous and result in visual field distortions. In some cases, the patient discomfort is so severe that surgical removal is required, with the risk of consequent complications. However, floaters have yet to be fully studied and understood in the way and time they originate. The introduction of 3D printing boosted the development of new tools for scientific research such as bio-models. Bio-model applications range from surgical training to implants fabrication. Several models are also bioprinted as rigid scaffolds or bio inks containing living cells. Medical implants are often produced by Stereolithography (SLA) to build complex geometries and meet the desired mechanical properties with high-dimensional accuracies. This paper focuses on the optimization of the printing parameters of an SLA structure to obtain a scaffold with the required characteristic for a proper 3D cell culture and investigation. The model will be the starting point for a future study regarding the etiology and formation mechanism of eye floaters in cell culture. The studied 3D printing parameters are layer thickness, exposure time, and light blocker content added to a biocompatible resin. Due to the final application, the main required property of the scaffold is transparency that allows visual inspection under optical microscope. The selected samples showed a good biocompatibility and visibility under optical microscope, both promising results for long-term cell cultures