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Adolescence is a critical period for engaging in health risk behaviors. Migrant adolescents may face unique challenges due to acculturation stress. This study aims to monitor substance use and problem gambling among migrant adolescents living in Italy. Data from the 2017/18 Health Behavior in School-Aged Children survey in Italy were analyzed. The 18,794 participants included 15-year-olds, categorized as native or migrants, with ethnic backgrounds from Western, Eastern European, or non-Western/non-European countries. Girls had higher smoking rates, while boys exhibited higher prevalence of alcohol-related risk behaviors, cannabis use, and gambling. Boys from Eastern European countries displayed a greater risk of drunkenness (OR: 1.58, 95% CI: 1.06–2.37), particularly in the first generation, while those from Western countries showed a higher risk of multiple substance use (OR: 1.44, 95% CI: 1.05–1.96). Girls from Eastern European and non-Western/non-European countries had a lower risk of alcohol consumption (OR: 0.50, 95% CI: 0.29–0.85; OR: 0.55, 95% CI: 0.33–0.91, respectively). Finally, boys, especially those from Eastern European and non-Western/non-European countries, had a significantly higher risk of problem gambling (OR: 1.83, 95% CI: 1.04–3.22; OR: 2.10, 95% CI: 1.29–3.42, respectively). This disparity was more pronounced in the first generation, possibly due to acculturation challenges and socio-economic factors. Risk behaviors in adolescents are influenced by complex interplays of gender, cultural factors, and migration generation. Preventive strategies should consider these factors to effectively address substance use and gambling in this heterogeneous population. [ABSTRACT FROM AUTHOR]

Parental and peer support seems to be a favourable determining factor in the acculturation process among young immigrants. We aimed to assess the level of perceived support among first- and second-generation adolescent immigrants and compare it to that perceived by the adolescents from the host population. Using Italian HBSC survey data collected in 2013-2014, first- and second-generation immigrants aged 11, 13 and 15 years were classified according to their ethnic background as being from Western countries, Eastern European countries, or from non-Western/non-European countries. The domains of teacher, classmate, family, and peer support was measured through multidimensional, standardised, validated scales. Analyses were run on a 47,399 valid responses (2195 from Western countries, 2424 from Eastern European countries, and 2556 from non-Western/non-European countries). Adolescent immigrants from Eastern European countries and non-Western/non-European countries reported significantly lower support than their peers from the host population in all explored domains. Girls perceived a lower level of classmate and family support compared to boys across all ethnic backgrounds. We observed two different immigration patterns: the Western pattern, from more affluent countries, and the Eastern pattern. Among the latter, second-generation immigrants showed the lowest level of support in all domains. Increasing family connections and developing peer networks should favour the acculturation process among adolescent immigrants. [ABSTRACT FROM AUTHOR]

Background A huge amount of literature suggests that adolescents' health-related behaviors tend to occur in clusters, and the understanding of such behavioral clustering may have direct implications for the effective tailoring of health-promotion interventions. Despite the usefulness of analyzing clustering, Italian data on this topic are scant. This study aimed to evaluate the clustering patterns of health-related behaviors. Methods The present study is based on data from the Health Behaviors in School-aged Children (HBSC) study conducted in Tuscany in 2010, which involved 3291 11-, 13- and 15-year olds. To aggregate students' data on 22 health-related behaviors, factor analysis and subsequent cluster analysis were performed. Results Factor analysis revealed eight factors, which were dubbed in accordance with their main traits: 'Alcohol drinking', 'Smoking', 'Physical activity', 'Screen time', 'Signs & symptoms', 'Healthy eating', 'Violence' and 'Sweet tooth'. These factors explained 67% of variance and underwent cluster analysis. A six-cluster κ-means solution was established with a 93.8% level of classification validity. The between-cluster differences in both mean age and gender distribution were highly statistically significant. Conclusions Health-compromising behaviors are common among Tuscan teens and occur in distinct clusters. These results may be used by schools, health-promotion authorities and other stakeholders to design and implement tailored preventive interventions in Tuscany. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between adolescent at-risk or problem gambling (ARPG) and medicine used to treat nervousness in a large-scale nationally representative sample of Italian adolescents.Study Design: Data from the 2013/2014 Health Behaviour in School-aged Children Survey was used for cross-sectional analyses (a sample of 20,791 15-year-old students). Self-administered questionnaires were completed by a representative sample of high-school students. Respondents' ARPG, use of medicine for nervousness and potential confounding factors were assessed. Multilevel logistic regression analyses were used to test the association between medicine use to treat nervousness and ARPG.Results: The overall prevalence of adolescents reporting medicine use for nervousness in the last month was 6.3%. The odds of ARPG were 3 times higher among adolescents who used medicine for nervousness compared to that among adolescents who did not take such medicine (OR 2.96, 95% CI 2.07-4.25). Importantly, the association between medicine used to treat nervousness and ARPG did not vary significantly when viewed in light of psychological symptoms.Conclusions: Medicine use to treat nervousness is associated with increased risk of gambling-related harm. [ABSTRACT FROM AUTHOR]

Background Psychosomatic health complaints a re significant indicators of adolescent well-being. The aim of this study is to describe the full set of interactions between health complaints and the presence of subjective resources, represented by the quality of relationships with parents and peers and by a positive school perception, in a population of 15-year-old adolescents. Smoking and alcohol consumption were also included in the analyses. Methods Bayesian networks were built for males and females separately, in order to understand the interactions among all considered variables in a representative sample of 16 018 Italian adolescents participating in the Health Behaviour in School-Aged Children survey 2009-10. Results The resulting networks show that school is the crucial node linking adolescents' well-being with parents and peer relationships, as well as with smoking and alcohol consumption. Conclusions Adolescents' well-being, as well as the prevalence of typical risk behaviours, such as smoking and alcohol consumption, is mediated by the adolescents' academic stress. Therefore, public health interventions, to be effective, should consider addressing the school environment by making it a more inclusive environment promoting critical thinking and sense of belonging rather than just focusing on personal behaviours. [ABSTRACT FROM AUTHOR]

Background We aimed to determine the extent to which three core variables (school environment, peer group and family affluence) were associated with unhealthy behaviours and health outcomes among Tuscan adolescents. The unhealthy behaviours considered were smoking, alcohol consumption, sedentary lifestyle and irregular breakfast consumption; health outcomes were classified as self-reported health, multiple health complaints and life satisfaction. School environment was measured in terms of liking school, school pressure, academic achievement and classmate support; peer groups were evaluated in terms of the number of peers and frequency of peer contact. Family affluence was measured on a socioeconomic scale. Methods Data were taken from the Tuscan 2009/10 survey of "Health Behaviour in School-aged Children", a WHO cross-national survey. A binary logistic multiple regression (95% confidence intervals) was implemented. Results The total sample comprised 3291 school students: 1135 11-year-olds, 1255 13-year-olds and 901 15-year-olds. Peer group and school environment were associated with unhealthy behaviours such as smoking, alcohol consumption and sedentary lifestyle. Family affluence proved to have less impact on unhealthy behaviours, except in the case of adolescents living in low-income families. Poor health outcomes were directly related to a negative school environment. Regarding the influence of family affluence, the results showed higher odds of life dissatisfaction and poor self-reported health status in medium-income families, while low-income families had higher odds only with regard to life dissatisfaction. A consistent pattern of gender differences was found in terms of both unhealthy behaviours and health outcomes. Conclusions Unhealthy behaviours are strongly related to the school environment and peer group. A negative school environment proved to have the strongest relation with poor health outcomes. [ABSTRACT FROM AUTHOR]

Background: Parents are responsible not only for the genetic structure of their children, but also for passing onto them their behaviours and attitudes toward life. The aim of this study was to analyse the connection between school-age children's obesity and that of their parents as well as between child obesity and parents' educational level, as a proxy indicator of the socio-economic status (SES) of families in Tuscany.Methods: The children sample was selected from "OKkio alla Salute 2010" (a cross sectional survey carried out by the Italian Institute of Health) and consisted of 1,751 (922 males and 855 females) 8-9 year-old school children. Weight and height were measured by ad hoc trained personnel, and Body Mass Index (BMI) categories were calculated using Cole et al.'s cut-off. Parents' weight, height and educational level were collected by a self-administered questionnaire. The educational levels were classified as high, medium and low.Results: The prevalence of obese children increased along the parents' BMI category: from 1.4% for underweight mothers to 30.3% for obese mothers and from 4% for under-normal-weight fathers to 23.9% for obese fathers (p < 0.001). An inverse relationship was observed between the parents' educational level and child obesity, the lowest educational level corresponding to the highest prevalence of obese children: 9.3% for mothers with a low educational level compared to 5.8% for mothers with a high educational level (p = 0.15); similarly, the corresponding prevalence for fathers was 9.5% compared to 4.5% (p = 0.03).Conclusion: Parents' obesity and the cultural resources of the family, particularly the father's, seem to influence the prevalence of overweight and obesity in Tuscan children. [ABSTRACT FROM AUTHOR]

Wildfires have affected global forests and the Mediterranean area with increasing recurrency and intensity in the last years, with climate change resulting in reduced precipitations and higher temperatures. To assess the impact of wildfires on the environment, burned area mapping has become progressively more relevant. Initially carried out via field sketches, the advent of satellite remote sensing opened new possibilities, reducing the cost uncertainty and safety of the previous techniques. In the present study an experimental methodology was adopted to test the potential of advanced remote sensing techniques such as multispectral Sentinel-2, PRISMA hyperspectral satellite, and UAV (unmanned aerial vehicle) remotely-sensed data for the multitemporal mapping of burned areas by soil–vegetation recovery analysis in two test sites in Portugal and Italy. In case study one, innovative multiplatform data classification was performed with the correlation between Sentinel-2 RBR (relativized burn ratio) fire severity classes and the scene hyperspectral signature, performed with a pixel-by-pixel comparison leading to a converging classification. In the adopted methodology, RBR burned area analysis and vegetation recovery was tested for accordance with biophysical vegetation parameters (LAI, fCover, and fAPAR). In case study two, a UAV-sensed NDVI index was adopted for high-resolution mapping data collection. At a large scale, the Sentinel-2 RBR index proved to be efficient for burned area analysis, from both fire severity and vegetation recovery phenomena perspectives. Despite the elapsed time between the event and the acquisition, PRISMA hyperspectral converging classification based on Sentinel-2 was able to detect and discriminate different spectral signatures corresponding to different fire severity classes. At a slope scale, the UAV platform proved to be an effective tool for mapping and characterizing the burned area, giving clear advantage with respect to filed GPS mapping. Results highlighted that UAV platforms, if equipped with a hyperspectral sensor and used in a synergistic approach with PRISMA, would create a useful tool for satellite acquired data scene classification, allowing for the acquisition of a ground truth. [ABSTRACT FROM AUTHOR]

Background: There are very few studies on the frequency of breakfast and snack consumption and its relation to fruit and vegetable intake. This study aims to fill that gap by exploring the relation between irregular breakfast habits and snack consumption and fruit and vegetable intake in Tuscan adolescents. Separate analyses were conducted with an emphasis on the potentially modifying factors of sex and age.Methods: Data was obtained from the 2010 Tuscan sample of the Health Behaviour in School-aged Children (HBSC) study. The HBSC study is a cross-sectional survey of 11-, 13- and 15-year-old students (n = 3291), selected from a random sample of schools. Multivariate logistic regression was used for analyzing the food-frequency questionnaire.Results: A significant relation was found between low fruit and vegetable intake and irregular breakfast habits. Similarly, low fruit intake was associated with irregular snack consumption, whereas vegetable intake did not prove to be directly related to irregular snack consumption. Different patterns emerged when gender and age were considered as modifying factors in the analyses. A statistically significant relation emerged only among female students for irregular breakfast habits and fruit and vegetable intake. Generally, older female participants with irregular breakfast habits demonstrated a higher risk of low fruit and vegetable intake. Age pattern varied between genders, and between fruit and vegetable consumption.Conclusions: Results suggest that for those adolescents who have an irregular consumption of breakfast and snacks, fruit intake occurs with a lower frequency. Lower vegetable consumption was associated with irregular breakfast consumption. Gender and age were shown to be moderators and this indicated the importance of analyzing fruit and vegetable intake and meal types separately. This study also confirmed that health-promotion campaigns that aim to promote regular meal consumption and consumption of fruits and vegetables need to take into account gender and age differences in designing promotional strategies. Future research should identify evidence-based interventions to facilitate the achievement of the Italian guidelines for a healthy diet for fruit, vegetables and meals intake. [ABSTRACT FROM AUTHOR]

Aim: The primary aim of the present study was to examine the association between immigrant generation, family sociodemographic characteristics, and problem gambling severity in a large-scale nationally representative sample of Italian youth.Method: Data from the 2013-2014 Health Behaviour in School-aged Children (HBSC) Survey were used for cross-sectional analyses of adolescent problem gambling. Self-administered questionnaires were completed by a representative sample of 20,791 15-year-old students. Respondents' problem gambling severity, immigrant status, family characteristics (family structure, family affluence, perceived family support) and socio-demographic characteristics were individually assessed.Findings: Rates of adolescent at-risk/problem gambling were twice as high among first generation immigrants than non-immigrant students; the odds of being at-risk/problem gamblers were higher among first-generation immigrants than adolescents of other immigrant generations or non-immigrant. Not living with two biological or adoptive parents appears to be a factor that increases the risk of becoming a problem gambler in first generation immigrants.Conclusions: Immigrant status and family characteristics may play a key role in contributing to adolescent problem gambling. [ABSTRACT FROM AUTHOR]

Introduction: The 2021/2022 influenza season was not characterised by a well-defined incidence peak. As reported by the Italian National Institute of Health, a high value of incidence of influenza cases was recorded in week 13, but it was still lower than in other influenza seasons. This abnormal circulation was probably due to relaxation of the COVID-19 pandemic restriction measures, such as social distancing, smart-working, home leaning and the use of masks, which greatly reduced the circulation of respiratory-transmitted viruses, including human respiratory syncytial virus (HRSV). The symptoms of SARS-CoV-2 and influenza are quite similar, sharing the human-to-human transmission route via respiratory droplets., Methods: The aim of this study was to estimate the rate of coinfection with influenza viruses and/or HRSV in SARS-CoV-2-positive subjects (N = 940) in a population of central Italy during the 2021/2022 season., Results: A total of 54 cases of coinfection were detected during the study period, 51 cases (5.4%) of SARS-CoV-2 and influenza virus and three cases (0.3%) of SARS-CoV-2 and HRSV coinfection., Conclusions: These results highlight the importance of continuous monitoring of the circulation of influenza virus and other respiratory viruses in the context of the COVID-19 pandemic., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results., (©2024 Pacini Editore SRL, Pisa, Italy.)

Background: Overweight has been associated with several social and phycological problems and is perceived as one of the major health care challenges to focus on in the future. The purpose of the study is to investigate the correlations among nutritional status, assessed by the Body Mass Index, the perception of one's own health status and Life Satisfaction, detected in Italian adolescents living in Tuscany Region, and to investigate the influence of gender on them., Methods: A statistically representative sample of 2760 Tuscan adolescents aged 11, 13 and 15 was involved in the 2018 Health Behaviours at School-aged Children survey. The participants were divided into three nutritional status class: underweight, normal weight and overweight (overweight + obese)., Results: The results show that there is a statistically significant difference in all categories between boys and girls aged 13 and 15 years; in girls aged 11 and 13 years, the Life Satisfaction of the overweight group is statistically lower than that of normal and underweight groups; Self-Rated Health is statistically lower in all age groups for overweight individuals compared to normal weight children, except for 11-year-old females., Conclusions: Viewing the psychosocial problems related to overweight, more attention and care must be placed on adolescents to ensure their healthier development., Competing Interests: The authors declare no conflict of interest., (©2024 Pacini Editore SRL, Pisa, Italy.)

Adolescence is a critical moment in life; people become individuals, create new relationships, develop social skills and learn behaviours that they will use for the rest of their lives. During this phase, adolescents establish patterns of behaviour that can protect their health. This study aims to 1. assess the presence of psychological disorders in adolescents of both genders, 2. determine their relation to socio-economic differences based on the Family Affluence Scale (FAS), and 3. assess trends from 2006 to 2018. Data were collected from the Italian Health Behaviour in School-aged Children survey given to a representative sample of Tuscan adolescents aged 11-15 years. Participants ( n . 12,550) filled out questionnaires to assess whether psychological symptoms such as feeling low, irritability, nervousness, or sleeping difficulties manifested weekly or more often over the past six months. For the study we utilized a cross-sectional survey method and linear regression to examine the association between psychological symptoms (dependent variable measured on an interval scale (0-16)), gender and FAS. We conducted similar analyses using logistic regressions for each of the four symptoms. An increase in psychological symptoms in both genders was revealed between 2006 and 2018, with a statistically significant presence in females: 0.29 (95% Confidence Interval [CI], 0.17 to 0.41), 1.43 (95% CI, 1.37 to 1.48) and 1.43 (95% CI, 1.34 to 1.52) in low-, medium- and high-affluence families, respectively; whereas males presented 0.14 (95% CI, 0.01 to 0.27), 0.71 (95% CI, 0.65 to 0.77) and 0.31 (95% CI, 0.22 to 0.39), respectively. The probability of a predictive episode of psychological symptoms (feeling low, irritability, nervousness, sleeping difficulties) occurring weekly, or more, often was greatly increased in females of all socioeconomic classes. These findings suggest that the increase in psychological disorders in adolescents should be considered a public health problem and further investigated through longitudinal studies and continuous monitoring of health trends.

In March 2020, the first pandemic caused by a coronavirus was declared by the World Health Organization. Italy was one of the first and most severely affected countries, particularly the northern part of the country. The latest evidence suggests that the virus could have been circulating, at least in Italy, before the first autochthonous SARS-COV-2 case was detected in February 2020. The present study aimed to investigate the presence of antibodies against SARS-CoV-2 in human serum samples collected in the last months of 2019 (September-December) in the Apulia region, Southern Italy. Eight of 455 samples tested proved positive on in-house receptor-binding-domain-based ELISA. Given the month of collection of the positive samples, these findings may indicate early circulation of SARS-CoV-2 in Apulia region in the autumn of 2019. However, it cannot be completely ruled out that the observed sero-reactivity could be an unknown antigen specificity in another virus to which subjects were exposed containing an epitope adventitiously cross-reactive with an epitope of SARS-CoV-2.

Introduction: The Italian "Health Behaviour in School-aged Children" (HBSC) is a national surveillance system that collects data on health and well-being among adolescents aged 11, 13 and 15 years attending school. It is part of the HBSC Research Network, an international alliance of researchers from 45 European and North American countries and regions started in 1982., Methods: All countries and regions participating in HBSC must adhere to a common international standard protocol developed and systematically updated by the entire HBSC Network. Data collection occurs every four years. Italy joined the international Network in 2000 and, to date, five waves (in 2002, 2006, 2010, 2014 and 2018) have been carried out. From 2010 the Italian HBSC is representative at regional level and in 2017 the base of the "Surveillance system for risk behaviours in 11-17 year-olds" became part of the Prime Ministerial Decree "Identification of surveillance systems and registries of mortality, tumours and other diseases". Cluster sampling is used, with school class as primary sampling unit, and two validated questionnaires are used to collect the information., Results: In 2018, the Italian HBSC involved 3,608 classes and 58,976 students. The average response rates were 86% of sampled classes and 97% of students achieving a national and regional representative sample for youths of all age groups (19,504 eleven-year-old, 20,554 thirteen-year-old and 18,918 fifteen-year-old). The national coordination group prepared a standardized format for disseminating the results locally and indicating areas for intervention A national report and some articles have been published. The next round, which will take place in the 2021-2022 school year, will also involve a representative sample of students of grade four of secondary schools (adolescents aged 17 years) and use on line questionnaires., Conclusions: Over 3 decades at international and 2 decades at national level 35 years have demonstrated that HBSC methodology and its results are useful for monitoring and deepening the knowledge on the most critical issues of adolescents' well-being., Competing Interests: Conflicts of interest None declared., (©2021 Pacini Editore SRL, Pisa, Italy.)

In Italy, the influenza season lasts from October until April of the following year. Influenza A and B viruses are the two viral types that cocirculate during seasonal epidemics and are the main causes of respiratory infections. We analyzed influenza A and B viruses in samples from hospitalized patients at Le Scotte University Hospital in Siena (Central Italy). From 2015 to 2020, 182 patients with Severe Acute Respiratory Infections were enrolled. Oropharyngeal swabs were collected from patients and tested by means of reverse transcriptase-polymerase chain reaction to identify influenza A(H3N2), A(H1N1)pdm09 and B. Epidemiological and virological surveillance remain an essential tool for monitoring circulating viruses and possible mismatches with seasonal vaccine strains, and provide information that can be used to improve the composition of influenza vaccines.

Objective: The aim is to describe dietary habits and their association with socio-demographic characteristics in a large nationally representative sample of Italian adolescents aged 11, 13 and 15 years., Materials and Methods: Data from the 2018 Italian Health Behaviour in School-aged Children (HBSC) survey on 58,976 adolescents were analysed to determine eating habits. Logistic regression was used to investigate the association between incorrect dietary habits and potential predictors., Results: 38.3% of boys and 48.1% of girls skipped breakfast and 54.1% did not consume fruit and/or vegetables daily. 15.9% of boys and 11.3% of girls drank carbonated-sugary beverages at least once a day. Incorrect dietary habits were more common among boys, adolescents with lower socio-economic conditions, residents in Southern Italy and those spending more time watching TV. Italian adolescents were more likely to have incorrect dietary habits compared with those from most other countries involved in 2018 HBSC., Conclusions: Action is needed to improve dietary habits among adolescents.

Background and Objective : Participation in organised out-of-school leisure-time activities (OLTAs) has been shown to have a positive impact on community health practices and to lessen inequities in social and environmental opportunities among youths. According to the social capital theory, OLTAs foster bridging ties that allow individuals to forge new, wider-ranging social connections, increasing social integration and opportunities for identity-related exploration. This study aimed to describe participation in different types of OLTAs and its association with perceived life satisfaction, physical activity, tobacco use, alcohol consumption, and drunkenness in a representative sample of youths. Methods: A representative sample of 11-, 13- and 15-year-old students ( n = 47,799) was recruited throughout all Italian regions within the Italian 2013/2014 Health Behaviours in School-aged Children (HBSC) study. Data were collected according to the HBSC study protocol. Participants were compared on outcomes according to OLTA participation type (i.e., non-sport, sport-only, and mixed vs. no-OLTA). In accordance with the study sampling procedures, hierarchical logistic regression models were used. Results: Participation in OLTAs was significantly associated with high life satisfaction in all ages (sport-only: odds ratio (OR) = 1.67, 1.48 and 1.55 for 11- 13- and 15-year-olds; mixed: OR = 1.95, 1.60 and 1.45, respectively). Youths participating in OLTAs were more likely to meet physical activity recommendations and report lower rates of tobacco use and drunkenness. Conclusions: Participation in OLTAs showed a favourable impact on health behaviours. Thus, community organisations and clubs, whether supported by public investments, could contribute to the enhancement of beneficial health practices, by engaging and serving the community as a whole and further reducing inequities in both social and environmental opportunities., Competing Interests: All authors declare that they have no competing interests.

Objectives: to evaluate smoking prevalence in adolescents by Italian region from the Health Behaviour Study in School-aged Children (HBSC) of 2014 and to correlate it with the presence, in the 2014-2018 Regional Prevention Plans (PRPs), of school-based smoking prevention interventions., Setting and Participants: the 2014 HBSC surveillance system provided data on 48,000 adolescents aged 11, 13, and 15 years; Ministry of Health provided data for each PRP on interventions with a tobacco control component and, among them, school-based smoking prevention interventions., Main Outcome Measures: weekly smoking prevalence; proportion of school-based smoking prevention interventions out of prevention interventions with tobacco control measures., Results: regions with the highest weekly smoking prevalence were Sardinia and Apulia for all age groups, Abruzzo for 11- and 15-year-old children, Basilicata for 15-year-old children, Bolzano for girls aged 13 years old; Liguria for females, Molise, Calabria, and Veneto for males. In the regions with the highest prevalence of smoking in 2014, in girls aged 11 and 13 years (Sardinia, Apulia, Basilicata, Liguria, Bolzano), a greater proportion of school-based smoking prevention interventions to be developed in the period 2014-2018 have been recorded., Conclusions: smoking prevalence in Italian adolescents is high, especially in 15-year-old children. Implementing policies recommended by the World Health Organization - Framework Convention on Tobacco Control (higher tobacco taxes, anti-tobacco mass media campaigns, plain tobacco package) could work synergistically with school-based interventions in order to decrease tobacco initiation among adolescents in Italy.

Objectives: The aim of this work was to study whether and to what extent selected connectedness variables (perceived family, peer, and school support) are protective factors against low life satisfaction and high health complaints in immigrant youth with different ethnic backgrounds, while also taking into account the effect of socioeconomic status (SES)., Methods: A representative sample of 47,799 students (15% immigrants, among whom 4980 were from non-Western countries) aged 11, 13, and 15 years were recruited from schools throughout Italy within the framework of the Italian 2013/2014 Health Behaviour in School-aged Children study. Bayesian network analyses were used to assess the association between connectedness variables, and low life satisfaction and high health complaints., Results: The connectedness variables family and school support were strong protective factors against both low life satisfaction and high health complaints (99% probability of relative risk < 1 in all subgroup comparisons). This protective role was still present when subgroups with high SES were compared. Peer support also showed a protective effect, though it was weaker., Conclusions: Our results show that, among immigrant youth, perceived high support can act as a moderator on the effect of environmental stressors. In line with international guidelines, these results confirm that public health professionals should create school interventions that foster a culture of inclusiveness, promote a supportive school environment, and engage families of immigrant youth.

Objectives: The aim of this work was to explore whether adolescent immigrants have worse or better perceived well-being, and whether this perception varies by ethnic background or between first- and second-generation immigrants, when compared with adolescents from the host population., Methods: A representative sample of 47,799 students (13.4% immigrants) aged 11, 13, and 15 years were recruited throughout all Italian regions within the framework of the Italian 2013/2014 Health Behaviour in School-aged Children study., Results: Adolescent immigrants from Eastern European and non-Western/non-European countries had a higher occurrence of health complaints and the highest risk of reporting low life satisfaction, which increased among the second generation. The risk of reporting bullying behaviours and physical fights was higher in first-generation immigrants and decreased in the second generation, independent of ethnic background., Conclusions: Italian welfare immigration policies do not seem to offer the same opportunities to all adolescent immigrant groups, which leads to differing effects on their well-being. To tackle these inequalities, Italy should increase its investment in education through early prevention initiatives, e.g. providing support in intercultural education and proper training to school teachers and staff.

Background: A unique standardized national dataset on adolescent girls (21 regions) participating in the Italian Health Behaviour in School-aged Children Study (HBSC) was used to investigate the correlation between body mass index (BMI) and age at menarche., Methods: Two independent nationally representative survey datasets: one on 15-year-olds (n = 6907, in 21 regions, year 2013/2014) and one on 11-year-olds (n = 10,128, in 20 regions, year 2009/2010) were analysed. The survey instrument was a self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated by means of Kaplan-Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). "Region-level obesity" was measured as the prevalence of overweight/obesity (%) in each region., Results: Region-level median age at menarche ranged between 12 years/3 months and 13 years/4 months. Region-level prevalence of overweight among 15-year-old girls ranged between 4 and 19%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta = - 0.70; 95% CI, - 0.84 to - 0.56). Individual- and class-level measures of BMI accounted for 50% of the region-level variance in age at menarche., Conclusions: The results show that overweight in childhood is in relation with the early puberty in girls. Future surveys may take into account this report to clarify if overweight is the cause or consequence of early menarche.

Background: The use of medicines to treat common complaints, such as headache, stomachache, difficulty in getting to sleep and nervousness, is widespread among adolescents, and is increasing. The aim of this survey was to estimate the prevalence of recurrent specific complaints among 15-year-old adolescents in Tuscany over three years (2006, 2010 and 2014) and that of medicine use to treat these complaints among boys and girls., Methods: The present study is based on data from the Tuscan HBSC studies at three time points (2006, 2010 and 2014), which involved 2830 adolescents, aged 15 years old (1395 boys and 1435 girls)., Results: Overall, the data confirm that adolescents who suffer from recurrent complaints are more likely to use medicines. The prevalence rates of all complaints were higher in girls than in boys in the three years considered. Over the whole period, headache, stomachache and difficulty in getting to sleep increased in girls, while boys displayed significant decrease in nervousness and stomachache., Conclusion: Our findings underline the fact that the use of medicines in adolescence is a public health concern and constitutes an emerging issue that needs greater attention and investigation on the part of scientific research.

Objectives: to examine the prevalence and time trends in childhood overweight (including obesity) and obesity among children dwelling in Tuscany Region (Central Italy) in the period 2002-2016., Design: cross-sectional study at seven points (Tuscan Nutritional Surveillance System conducted in the years 2002, 2006, 2008, 2010, 2012, 2014, and 2016); height and weight of the subjects are directly measured by trained staff; body mass index was assessed by means of the International Obesity Task Force and of the World Health Organization cut-offs., Setting and Participants: representative sample of children dwelling in Tuscany Region (No. 10,155) aged between 8 and 9 years (5,258 boys and 4,897 girls)., Results: regarding the estimation of the absolute prevalence level of childhood overweight, a discrepancy was observed between the two criteria. In all surveys, more boys than girls were overweight (or obese). Trend analysis showed a significant decrease in the prevalence of overweight (including obesity) and obesity in Tuscan children in the period 2002-2016 (32.0% vs. 28.1%; p <0.001) and of 10.0% vs. 5.9% (p <0.001) for obesity., Conclusions: the present study is the first report from an Italian region showing a significant decrease in childhood obesity and overweight in the last 14 years. This reduction is probably a result of regional and local actions that were performed in many areas of society. However, efforts should be made to further reduce prevalence of childhood obesity and overweight.

Objective: The aim of the present study was to examine the prevalence and time trends in childhood overweight including obesity and obesity among Tuscan children from 2002 to 2012., Design: Cross-sectional study at five time points (Tuscan Nutritional Surveillance Surveys conducted in the years of 2002, 2006, 2008, 2010 and 2012). Trained personnel directly measured the height and weight of the subjects. BMI was assessed by means of the International Obesity Task Force (IOTF) and WHO cut-offs., Setting: Representative sample of children in the Tuscany region (Italy)., Subjects: Children (n 7183) aged between 7·5 and 9·5 years (3711 boys and 3472 girls)., Results: With respect to the estimation of the absolute prevalence level of childhood overweight, a discrepancy was observed between the two criteria. In all surveys, more boys than girls were overweight (including obesity). Trend analysis showed a significant decrease in the prevalence of overweight including obesity and obesity in Tuscan children from 2002 to 2012 (32·0 % v. 25·8 %, P<0·001 on using IOTF criteria and 37·7 % v. 34·3 %, P<0·001 on using WHO criteria for overweight including obesity; and 10·0 % v. 6·7 %, P<0·001 on using IOTF criteria and 12·5 % v. 11·3 %, P=0·035 on using WHO criteria for obesity)., Conclusions: The present study is the first report from an Italian region showing a significant decrease in childhood obesity and overweight in the last 10 years. This reduction is probably a result of regional and local actions that have taken place in many sectors of society. However, efforts should be made to lower the prevalence of childhood obesity and overweight further.

Background: The international increase in overweight and obesity among children and adolescents over the past three decades confirms that childhood obesity is a global 'epidemic'. The World Health Organization considers childhood obesity to be a major public health concern. Childhood obesity is associated with cardiovascular, endocrine, musculoskeletal and gastrointestinal complications, and may have psycho-social consequences. The aim of this paper is to examine overweight (including obesity) prevalence and its association with geographic area of residence, parental education and daily breakfast consumption in Italian students aged 11-15 yrs., Methods: A nationally representative sample of 11-15 year old students from 20 Italian Regions (Italian Health Behaviour in School-aged Children 2010-HBSC) was randomly selected (2,504 schools and 77,113 students). Self-reported anonymous questionnaires, prepared by the international HBSC network, were used to collect the data. BMI was calculated using self-reported weight and height and the International Obesity Task Force cut-offs. Multiple logistic regressions were performed to assess the relationship between the risk of overweight and parental education, area of residence and breakfast consumption in each age group and gender., Results: Boys were more likely to be overweight or obese than girls (28.1% vs. 18.9% at 11 yrs-old, 24.8% vs. 16.5% at 13 yrs and 25.4 vs. 11.8% at 15 yrs). The prevalence of overweight and obesity was lower among the older girls. Overweight and obesity rates increased from the North of Italy to the South in both boys and girls and in all age groups. Boys 11-15 yrs living in southern Italy had an OR=2.05 (1.77-2.38) and girls 2.04 (95% CI 1.70-2.44) for overweight (including obesity) compared with those living in the North. Parent's low educational level and no daily breakfast consumption were also associated with overweight including obesity (p<0.05)., Conclusion: The prevalence of obesity and overweight in Italian school-children 11-15 yrs old are high, in particular in the South and in boys. These findings suggest appropriate interventions are needed, at the community as well as the individual level, in particular in the southern regions. However, more research is warranted on intermediary factors to determine which interventions are likely to be most effective.