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

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

Hepatitis B Immunization in Health Care Workers: Needs and Opportunities

[No abstract available

Alcuni dubbi interpretativi su talune previsioni contenute nel disegno di revisione costituzionale del Governo Renzi in ordine alle garanzie costituzionali

Il contributo si propone di analizzare il progetto di revisione costituzionale in corso di discussione nella XVII legislatura, con particolare riferimento al tema delle garanzi

Cartel Formation with Quality Differentiation

Research on collusion in vertically differentiated markets is conducted under one or two potentially restrictive assumptions. Either there is a single industry-wide cartel or costs are assumed to be independent of quality or quantity. We explore the extent to which these assumptions are indeed restrictive by relaxing both. For a wide range of coalition structures, profit-maximizing cartels of any size price most of their lower quality products out of the market as long as production costs do not increase too much with quality. If these costs rise sufficiently, however, then market share is maintained for all product variants. All cartel sizes may emerge in equilibrium when exclusively considering individual deviations, but the industry-wide cartel is the only one immune to deviations by coalitions of members. Overall, our findings suggest that firms have a strong incentive to coordinate prices when the products involved are vertically differentiated

An Overview on ERAP Roles in Infectious Diseases

Endoplasmic reticulum (ER) aminopeptidases ERAP1 and ERAP2 (ERAPs) are crucial enzymes shaping the major histocompatibility complex I (MHC I) immunopeptidome. In the ER, these enzymes cooperate in trimming the N-terminal residues from precursors peptides, so as to generate optimal-length antigens to fit into the MHC class I groove. Alteration or loss of ERAPs function significantly modify the repertoire of antigens presented by MHC I molecules, severely affecting the activation of both NK and CD8+ T cells. It is, therefore, conceivable that variations affecting the presentation of pathogen-derived antigens might result in an inadequate immune response and onset of disease. After the first evidence showing that ERAP1-deficient mice are not able to control Toxoplasma gondii infection, a number of studies have demonstrated that ERAPs are control factors for several infectious organisms. In this review we describe how susceptibility, development, and progression of some infectious diseases may be affected by different ERAPs variants, whose mechanism of action could be exploited for the setting of specific therapeutic approaches

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

ENDOPLASMIC RETICULUM AMINOPEPTIDASE 2 HAPLOTYPES PLAY A ROLE IN MODULATING SUSCEPTIBILITY TO HIV-1 INFECTION

Background: The endoplasmic reticulum aminopeptidase type 2 (ERAP2) undergoes haplotype-specific alternative splicing which results in the production of either full-length (FL, from haplotype A ) or alternatively spliced (AS, from haplotype B) mRNA Resistance to HIV infection in a cohort of Italian sexually HIV-exposed seronegative individuals (HESN) is recently associated with a variant in ERAP2 that tags haplotype A. As the protein product of this gene trims peptides loaded on MHC class I, shaping the quality of viral peptides that are presented to CD8+T cells, we further analysed its role in HIV-1-susceptibility. Methodology: ERAP2 was genotyped in a cohort of 104 Spanish HESN individuals exposed to HIV through injection drug use (IDU-HESN). In parallel PBMCs isolated from 139 healthy controls (HC) grouped according to their ERAP2 genotype were infected with HIV-1 and analysed for: 1)expression levels of mRNA specific for ERAP2 and for 84 genes involved in the antigen presentation pathway; 2) MHC class I MFI on CD45 Ba-L cells; 3)susceptibility to HIV-1 infection; 4) ERAP2 protein expression. Finally, we analyzed the co-segregation of HLA-B*57 with ERAP2 haplotype in a previously described cohort of Italian sexually-exposed HESN. Results: Genotype analysis in IDU-HESN mirrored the previous association between ERAP2 haplotype A and protection from HIV infection; meta-analysis with the Italian cohort yielded a p value of 7.6 x10 Cosegregation analysis indicated that the HLA-B*57 allele is significantly more common among HESN homozygous for haplotype A(homo A) compared to non-homo A (p=0.01), suggesting genetic interaction. Data obtained in HC showed that following in vitro HIV infection the expression of mRNA for ERAP2-FL and a number of genes involved in antigen processing and presentation as well as of MHC class I on the surface of CD45+ cells are significantly increased in homo A cells; notably, homoA peripheral blood mononuclear cells, but not isolated CD4 cells, were less susceptible to HIV-1 infection. Only the expression of ERAP2-FL could be detected by western blot analyses. Conclusions: haplotype A of ERAP2 confers resistance to HIV infection independently of the route of exposure; such variation possibly affects MHC presentation and immune response

La reintroduzione dell'insegnamento scolastico dell'educazione civica da parte della legge n. 92/2019, con a fondamento la conoscenza della Costituzione. Tra buone intenzioni e false partenze

Il lavoro si sofferma sulla legge recentemente approvata dal Parlamento italiano (legge n. 92/2019), contenente l’introduzione – o, se si preferisce, la reintroduzione – dell’insegnamento scolastico dell’educazione civica. Dopo aver tracciato un breve quadro delle esperienze straniere in materia di educazione alla cittadinanza e aver ripercorso l’evoluzione dell’insegnamento dei contenuti civici nel nostro Paese, il lavoro propone un esame della nuova disciplina, evidenziando in particolare la centralità del rilievo della Costituzione. Un dubbio viene, peraltro, sollevato, con riferimento ai termini per l’applicazione della nuova normativa