The Italian national trends in smoking initiation and cessation according to gender and education

Objectives. This study aims to assess the trend in initiation and cessation of smoking across successive birth cohorts, according to gender and education, in order to provide useful suggestion for tobacco control policy. Study design. The study is based on data from the ?Health conditions and resort to sanitary services? survey carried out in Italy from October 2004 to September 2005 by the National Institute of Statistics. Through a multisampling procedure a sample representative of the entire national territory was selected. Methods. In order to calculate trends in smoking initiation and cessation, data were stratified for birth cohorts, gender and edu- cation level, and analyzed through the life table method. Results. The cumulative probability of smoking initiation, across subsequent generations, shows a downward trend followed by a plateau. This result highlights that there is not a shred of evidence to support the hypothesis of an anticipation in smok- ing initiation. The cumulative probability of quitting, across subsequent generations, follows an upward trend, highlighting the growing tendency of smokers to become an ?early quitter?, who give up within 30 years of age. Conclusion. Results suggest that the Italian antismoking approach, for the most part targeted at preventing the initiation of smoking emphasising the negative consequences, has an effect on the early smoking cessation. Health policies should reinforce the existing trend of ?early quitting? through specific actions. In addition our results show that men with low education exhibit the higher probability of smoking initiation and the lower prob- ability of early quitting, and therefore should be targeted with special attention

Does living in previously exposed malaria or warm areas is associated with a lower risk of severe COVID-19 infection in Italy?

Incidence of Covid-19 positivity (21/2/2020-28/3/2020) in provinces of 4 Italian regions whose territory was described as previously exposed to Malaria was compared with those of other provinces of the same regions. The climate of such provinces was compared with the climate of the other provinces in some regions. Previously malarial areas show a lower risk than other provinces of the same regions: Mantua (Lombardy) RR=0.94 (CI95%0.89-0.99); Venice-Rovigo (Veneto) RR=0.61 (CI95%0.58-0.65); Ferrara-Ravenna (Emilia-Romagna) RR=0.37 (CI95%0.35-0.41); CagliariOristano-SouthSardinia (Sardinia) RR=0.25 (0.17-0.31). The maximum temperature in March 2020 in those provinces was higher in mean 1.5° for other provinces. The lower frequency of COVID-19 in the provinces previously exposed to Malaria of four Italian regions does not reveal a causal link. The phenomenon has emerged independently in all the regions investigated. People born between the 1920s and 1950s were those most exposed to malaria years ago and today are the most exposed to the severest forms of COVID-19. A warmer climate seems to be associated with a lower risk of COVID, in line with the evidence highlighted in equatorial states where a lower lethality of the virus has emerged, however this regardless of the presence of Malaria. This may suggest that climate and not Malaria is the real risk factor, though further studies need to determine the role of the association climate / COVID

A Multi-Source Harvesting System Applied to Sensor-Based Smart Garments for Monitoring Workers’ Bio-Physical Parameters in Harsh Environments

This paper describes the development and characterization of a smart garment for monitoring the environmental and biophysical parameters of the user wearing it; the wearable application is focused on the control to workers’ conditions in dangerous workplaces in order to prevent or reduce the consequences of accidents. The smart jacket includes flexible solar panels, thermoelectric generators and flexible piezoelectric harvesters to scavenge energy from the human body, thus ensuring the energy autonomy of the employed sensors and electronic boards. The hardware and firmware optimization allowed the correct interfacing of the heart rate and SpO2 sensor, accelerometers, temperature and electrochemical gas sensors with a modified Arduino Pro mini board. The latter stores and processes the sensor data and, in the event of abnormal parameters, sends an alarm to a cloud database, allowing company managers to check them via a web app. The characterization of the harvesting subsection has shown that ≈ 265 mW maximum power can be obtained in a real scenario, whereas the power consumption due to the acquisition, processing and BLE data transmission functions determined that a 10 mAh/day charge is required to ensure the device’s proper operation. By charging a 380 mAh Lipo battery in a few hours by means of the harvesting system, an energy autonomy of 23 days was obtained, in the absence of any further energy contribution

Survey of Low Birthweight and Extremely Low Birthweight Events in a High Environmental Risk Area of Apulia, Italy

The association between environmental conditions and pregnancy outcome has been under investigation for a long time, but results appear to be inconclusive regarding damage to either the newborn or the mother. The aim of this study was to evaluate the distribution of hospitalization of newborns with low birthweight (< 2500 g) and extremely low birthweight (< 1000 g) in the geographical area of Taranto, Italy, which is characterized by high environmental risk because of industrial pollution. We analyzed the database of hospital discharge forms for the years 2001–2013 regarding hospital admission of newborns in the region of Apulia. The relative risk (RR) of hospitalization, adjusted for the deprivation index, was estimated using the Besag–York–Molliè Bayesian model. The city of Taranto, which has the highest environmental risk, had the highest RR for newborns with low birthweight (1.47, 95% uncertainty interval 1.38–1.56). Other geographical areas with high environmental pollution had higher RRs for low birth weight compared with the regional average. We found no geographical distribution pattern of extremely low birthweight that would suggest an association with environmental pollution

Survey of Low Birthweight and Extremely Low Birthweight Events in a High Environmental Risk Area of Apulia, Italy

AbstractThe association between environmental conditions and pregnancy outcome has been under investigation for a long time, but results appear to be inconclusive regarding damage to either the newborn or the mother. The aim of this study was to evaluate the distribution of hospitalization of newborns with low birthweight (< 2500 g) and extremely low birthweight (< 1000 g) in the geographical area of Taranto, Italy, which is characterized by high environmental risk because of industrial pollution. We analyzed the database of hospital discharge forms for the years 2001–2013 regarding hospital admission of newborns in the region of Apulia. The relative risk (RR) of hospitalization, adjusted for the deprivation index, was estimated using the Besag–York–Molliè Bayesian model. The city of Taranto, which has the highest environmental risk, had the highest RR for newborns with low birthweight (1.47, 95% uncertainty interval 1.38–1.56). Other geographical areas with high environmental pollution had higher RRs for low birth weight compared with the regional average. We found no geographical distribution pattern of extremely low birthweight that would suggest an association with environmental pollution

Malignant cancer mortality in Province of Taranto (Italy). Geographic analysis in an area of high environmental risk

Background. A geographic analysis of the causes of death is an important tool for assessing the effectiveness of Public Health initiatives. The aim of this study is to analyse the causes of death between 2000 and 2004, to discover any excess mortality from can- cer in Province of Taranto, an area at high environmental risk. Methods. Mortality data from cancer were selected from the Puglia Regional Nominative Causes of Death Registry. Crude and standardized rates and Standardized Mortality Ratios (SMR) were calculated for the five Provinces of the Puglia Region, their capital cities and in four concentric rings around the industrial area located in Province of Taranto. Results. Even if the highest death rate for all tumours resulted in the Province of Lecce (24.9 x 10,000), in the cities of Lecce and Bari (29 x 10,000), the distribution of the SMRs in Province of Taranto showed an excess of mortality (+10%) in the ring next to industrial area. For lung cancer the highest rate was reported in city of Taranto (6 x10,000) and the highest risk (+24%) in the ring next to industrial area. Moreover, in this area 9 (70%) of the 13 considered malignant tumours types presented an excess of mortality. Conclusion. The results uphold the data reported in the pub- lished literature. It is fundamental to intensify research into other risk factors (exposure at work and aberrant lifestyles). Moreover, there is an increasing need for a Regional Cancer Register

A follow-up on psychiatric symptoms and post-traumatic stress disorders in Tuareg refugees in Burkina Faso

Introduction: The aim of this study was to carry out a 2-year follow-up of refugees in a camp in Burkina Faso who had been interviewed previously. We also aimed to verify whether the general conditions in which they lived (e.g., protection by international organizations and the conclusion of negotiations and new hope of returning to Mali and reunification with surviving family members) would affect their mental health state. Methods: This is a cross-sectional study repeated over time on a cohort of refugees. People living in the Subgandé camp who had participated in the first survey in 2012 were identified using informational chains and approached for follow-up. Those who agreed were interviewed using the Short Screening Scale for post-traumatic stress disorder (PTSD) and the K6 scale, French versions, to measure general psychopathology and the level of impairment. Results: The second survey shows a dramatic decrease in psychopathological symptoms (positivity at K6 scale). Improvement was also conspicuous in the frequency of people with stress symptoms (positivity at Short Screening Scale for PTSD and simultaneous positivity to K6 scale). The frequency of people screened positive at the Short Screening Scale for PTSD had also decreased, but the level of improvement was not pronounced. Conclusion: Our findings confirm that when physical conditions improve, psychological symptoms can also improve. Although in the studied sample psychological factors, such as the hope of returning to their own land and thus the possibility of maintaining ethnic cohesion, may have played a role, future research carried out with a proper methodology and sufficient resources to identify protective factors is needed

Broad Spectrum project: Factors determining the quality of antibiotic use in primary care: An observational study protocol from Italy

Introduction The overuse of antibiotics is causing worldwide spread of antimicrobial resistance (AMR). Compared with other countries, Italy has both high antibiotic consumption rates and high rates of AMR. Due to the fact that around 90% of antibiotics are prescribed by general practitioners (GPs), this study aims to measure the impact of knowledge, attitudes and sociodemographic and workplace-related factors on the quality of antibiotic prescriptions filled by GPs in the Italian Region of Sardinia. Methods and analysis Knowledge, attitude, sociodemographic and workplace-related factors deemed to influence physicians prescribing behaviour will be evaluated in a cross-sectional study conducted among all GPs of the Italian Region of Sardinia (n=1200). A knowledge and attitudes questionnaire (Knowledge and Attitudes on Antibiotics and Resistance - Italian version: ITA-KAAR) accompanied by a sociodemographic form will be linked to drug prescription data reimbursed by the National Health System. European Surveillance of Antibiotic Consumption quality indicators for outpatient antibiotic use will be calculated from drug prescription records. Every GP will be deemed to have demonstrated an adequate quality of prescriptions of antibiotics if half of the indicator score plus one is better than the median of the region. A multivariate Poisson regression model with robust variance estimation will be used to evaluate the impact of the determinants of antibiotic prescriptions on the actual prescribing quality of each physician. Ethics and dissemination The project has been approved by the ethics committee of the Regional Health Trust of Sardinia (176/2019/CE, 24 September 2019). The results will be useful to inform evidence-based interventions to tackle irrational antibiotic use in the community

Prognostic prediction of the immunohistochemical expression of p16 and p53 in cutaneous melanoma: a comparison of two populations from different geographical regions

p16INK4a and p53 are tumor-suppressor genes frequently altered in various malignancies, including cutaneous melanoma. The purpose of the study was to establish the prognostic value of immunohistochemical expression of p16INK4a and p53 in sporadic cutaneous melanoma (CM) in two regions with a high-risk for melanoma in Italy and Ecuador. Immunohistochemical staining of p16 and p53 was performed in samples of primary CM from 82 patients with Stage I and II melanoma according to the American Joint Committee on Cancer (AJCC) staging system. Survival differences between categories of p16 or p53 expression were analyzed using the product-limit procedure (Kaplan-Meier method, log-rank test). Clinical variables (gender, age, tumor location, Clark’s level, thickness) were correlated with survival and p16 or p53 expression. p16 nuclear immunoreactivity was observed in 85% of Italian patients compared to 48.7% of Ecuadorians; a small number of cases showed p53 immunoreactivity in both populations. Only nuclear p16 expression exhibited a significant correlation with survival (Italians p=0.001, Ecuadorians p=0.017) but did not appear to correlate with any clinicopathological parameter. No significant difference was observed in survival with regard to p53 expression or cytoplasmic p16. Our results demonstrate that nuclear expression of p16 can be considered a molecular prognostic factor in patients with sporadic CM and indicate its importance as a clinical marker

Social and Behavioral Rhythms is Related to the Perception of Quality of Life in Old Adults

Introduction: The purpose is to verify in old adults if social and behavioral rhythms (SBRs) are correlated with a positive perception of the quality of life (QoL). Social and behavioral rhythms and related circadian biorhythms are known as central points in the pathophysiology of bipolar disorders. A secondary aim is to see if a similar relationship can be found in Major Depressive Disorder (MDD) in old adults. Sample: 141 people aged ≥65 years (58.9% Female). Methods: Each subject was evaluated using the Social and Behavioral Rhythms Scale (in which higher scores show more dysfunctional SRBs); SF-12 for QoL and a screening tool for depressive symptoms. They underwent a medical evaluation and blood level assays including cholesterol and triglycerides. The medical diagnoses including MDD were taken into account. Results: The Social and Behavioral Rhythms Scale score correlated inversely with SF-12 score (p&lt;0.001) and positively with PHQ9 (p&lt;0.0001). People with MDD had a higher score on social rhythms than controls without (p&lt;0.01). The study highlighted, for the first time, that social and behavioral rhythms have a role in old adults living in the community. Conclusion: Further longitudinal studies with a sufficient number of individuals will be required to confirm these data and clarify causal links of the association