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Due to major global urbanisation, a careful evaluation of plans (town planning and mobility) and projects (industrial and development) is required in order to measure their impact on health and environmental matrices. In Italy, Legislative Decree No 152/06 introduced two procedures: the EIA (Environmental Impact Assessment) and SIA (Strategic Impact Assessment). Their focus, however, does not consider human health. Recently, the Integrated Environmental and Health Impact Assessment (IEHIA) was introduced; this defines the parameters necessary to provide an EIA that includes human health as a factor. This systematic review was conducted, including both the population impacted by new facilities and the method used to define their impact. Our database search produced 724 articles, of which 33 were eligible. Studies included landfill plans, manufacturing industries, mobility policies, energy production, and the environmental health of an area. All studies show how an approach encompassing multiple parameters can analyse the impact of a new facility in a comprehensive manner. This review shows that the use of health-related environmental impact parameters is essential for the integration of a project into a community, and can allow a wider understanding of the possible impacts on human health, both direct and indirect. [ABSTRACT FROM AUTHOR]

Background: Physical activity is an important predictor of quality of life in older adults with type 2 diabetes (T2D). Unfortunately, most T2D adults adopt a sedentary lifestyle. The randomized, controlled TRIPL-A trial aims to verify the effect of a personalized, discontinuous exercise program on a sedentary lifestyle of T2D older adults. Methods: A total of 305 T2D patients (mean age ± SD: 68.8 ± 3.3 years) were divided into a control arm receiving only behavioral counseling and an intervention arm of an 18-month supervised discontinuous exercise program (ERS). The primary outcomes were the changes in sitting time (ST) and metabolic equivalent (MET) values, both evaluated by the International Physical Activity Questionnaire short form. A repeated measures ANOVA with Bonferroni correction for multiple comparisons was used to compare study outcomes. Results: The ST and MET differed significantly during the study compared to the control group (p = 0.028 and p = 0.004, respectively). In the intervention group, a decrease from baseline in ST at 6 months (p = 0.01) and an increase in MET values at 6 months (p = 0.01) up to 12 months (p < 0.01) were found. No significant differences were found for the other variables. Conclusions: Beneficial lifestyle changes were found within the first year of intervention. These results align with the theory of change. [ABSTRACT FROM AUTHOR]

Despite the increasing availability of gerontological training programs, knowledge of their contents, characteristics, methods, and outcomes remains limited. However, the transition from multidisciplinarity to interdisciplinary orientations is now fundamental to such training, providing participants from diverse academic orientations and professional backgrounds with opportunities to interact across boundaries. In response to recommendations of the European Union Futurage "A road map for European ageing research" (FUTURAGE, 2011) concerning training and career-development needs of future cohorts of practitioners and scholars in aging, an International Summer School on Ageing (ISSA) was developed in 2012. Its aim was to initiate the practical implementation of some of the capacity building goals identified by Futurage. The design and structure of the ISSA was informed by the experience of Canada's Summer Programme in Ageing--run by the Institute of Aging of the Canadian Institutes of Health Research--and by the cross-border academic training activities organized by Lund University (Sweden) in Scandinavian countries. As Italy has lacked a tradition of comprehensive, interdisciplinary training programs in gerontology, the Italian National Institute of Health and Science on Ageing undertook to launch the inaugural ISSA. In this article, the core aims and methodology of the ISSA are presented, together with an analysis of its main outcomes, as measured by participant evaluations. These are discussed in the context of international debate on this topic.

Purpose: The SOUND method offers an innovative blended intervention based on music circle-activities and cognitive stimulation approaches which was codesigned by musicians, health professionals, older people with dementia, family caregivers and researchers, for its application in dementia settings. The purpose of the paper is to describe the detailed procedure of the quasi-experimental pilot study. Method: The experimental phase of SOUND uses a mixed-method design encompassing qualitative and quantitative observations, cognitive testing, selfreport and interviewer-assisted questionnaires to investigate the effectiveness of the intervention for 45 people with dementia and 45 professionals (15 in every study country: Italy, Portugal, Romania). Results: The pilot study will be the first implementation of the SOUND intervention aiming to investigate the feasibility and preliminary effects of the method. Conclusion: The novelty of SOUND is its multicomponent method, including the most evidenced features for improving the wellbeing of participants. [ABSTRACT FROM AUTHOR]

In the Northern Apennines, the Internal Ligurian Units are considered deformed and metamorphosed fragments of the Ligure-Piemontese oceanic basin. In this paper, we report on the temperature and pressure conditions of the metamorphic peak for four Internal Ligurian Units, estimated using different geothermometers and geobarometers based on the white mica and chlorite compositions. These minerals were formed during the D1 deformation phase in the pre-Oligocene. The results indicate that the Portello and Gottero units are both characterized by metamorphic conditions pertaining to low blueschists facies, while the Colli-Tavarone and Bracco-Val Graveglia Units show a lower metamorphic imprint that produces assemblages of prehnite-pumpellyite facies. The estimated geothermal gradient for the metamorphic peak achieved by the analyzed Internal Ligurian Units during the D1 phase is 7–15 °C/Km, which is indicative of deformation in a subduction setting. Under these conditions, the D1 phase developed in these units as a result of underplating at the base of the accretionary wedge during the closure of the Ligure-Piemontese basin. These data indicate a close geodynamic correlation among the Internal Ligurian Units and the ophiolite-bearing units of the Alps. [ABSTRACT FROM AUTHOR]

Although the active ageing concept generally has positive connotations, with expected benefits at the micro, meso and macro levels, the application of this concept in terms of policy making presents challenges and risks to be avoided (for instance, a predominantly productivist interpretation and a top-down imposition with limited possibilities for bottom-up exchanges; or a disregard for the risk of excluding older people with more disadvantaged backgrounds). Two crucial strategies to minimise risks are the implementation of policies by considering and respecting territorial diversity, and the involvement of all the relevant stakeholders in a participatory consultative and co-decisional approach. This paper entwines both strategies together by focusing on Italian in-country differences in terms of active ageing, and employing the Active Ageing Index for policy-making purposes. This activity is part of a governmental national pilot project aimed at promoting multilevel co-managed co-ordination of active ageing policies across Italy. The analysis identified five groups of regions that differ from the classical, geographic and socio-economic division between the North, Centre and South. Additional in-group analyses were conducted to investigate within-cluster differences. This study will inform a large multilevel stakeholder network for evidence-based policies and their monitoring at both the national and regional levels, in line with the perspective of mainstreaming ageing. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has affected health services worldwide. The suspension of cancer screening programs during the lockdown period, coupled with the other measures taken to limit the SARS-CoV-2 spread, contributed to the idea that cancer preventive interventions are deferrable. In this opinion paper, we present some data on cancer screening coverage in one of the largest Local Health Authorities in Italy in recent years. Within this context, we introduce the benefits of a pilot project in which we took advantage of the great attention on the COVID-19 vaccination campaign to improve screening uptake. In this project, we offered men and women eligible for cancer screening the opportunity to book appointments while waiting to be vaccinated. In addition, trained healthcare personnel were available on-site to discuss any barriers to participation with the attendees. Despite the project having only just started, preliminary results are encouraging, with positive feedback from the attendees. In conclusion, we advocate for the need to adopt a comprehensive approach when it comes to population health, and we use this project as an example to discuss how it is possible to contribute to minimizing the long-term impact of the COVID-19 pandemic with resources already in place. [ABSTRACT FROM AUTHOR]

Italy experienced the transition from a country of emigration to a country of immigration only in the last decade of the 20th century. The extreme heterogeneity of the Italian scene – from the distribution and variety of productive sectors and local economic dimensions, to the geographical, cultural and linguistic varieties – results in an incredibly differentiated background on which the phenomenon of migrations fits as multiplier of diversity. But there are some particular fields in Italy where the challenges of superdiversity appear to be more prominent: the impact on the school system, in terms of linguistic-cultural pluralism; the change in religious belonging and identities; the dynamics of cohesion/marginality in everyday life; and the relationship between spaces and identities in a superdiverse context. [ABSTRACT FROM AUTHOR]

This article aims to present a few considerations regarding the phenomenon of migrant families' integration processes, in the broader framework of the relationship between politics, policies and services. The stabilization of migrant people in Italy has determined, on the one hand, the growth of the family-based character of the immigrant population, in the face of which, institutions and reception services, in the wake of policy directives, have been called upon to remodel interventions and integration practices. On the other hand, the drastic reduction in political attention to the social, civil and economic integration of migrants and, in particular, of migrant families, linked to the direction taken by migration policies, has had serious effects in terms of social inclusion. The effects of "unsupportive" policies towards migrants have generated major obstacles to integration (ISTAT, 2021), that are added to, exacerbating them, the crisis caused by the pandemic has exacerbated the fragility of migrant families. There has been a fall-out on integration processes, in which the family, the network of relationships and social and socio-medical services play a fundamental role. The provision of social welfare services, up to now, needs both to direct attention not only at the vulnerable and marginalized, but also at the collective dimension, and to integrate the ordinary provision with strategies and resources able to transform the immigrant population from simple consumers to active responsible protagonists. [ABSTRACT FROM AUTHOR]

Objectives: To assess if the lockdown period (March–April 2020) during the coronavirus disease‐19 outbreak in Italy influenced the number, presentation, and treatment of urgent admissions to the emergency department for ureteral lithiasis, and to evaluate the same variables during the reopening phase (May–June 2020). Methods: We performed a retrospective analysis of patients admitted to the emergency department of three different hospitals (two coronavirus disease‐19 hubs). Demographics and data on acute pyelonephritis, acute kidney injury, urinoma, hematuria, inpatient admission/discharge home, and type of treatment were gathered and compared with the same periods in 2019. Results: A total of 516 patients were admitted during the study period, of whom 62.4% were male. Their mean age was 58.86 ± 16.24 years. The number of admissions decreased significantly, by 51.25% (P = 0.003), during lockdown compared to 2019 (78 vs 160 admissions). The number of admissions in the reopening phase (May–June 2020) was in line with that in 2019 (n = 138). The number of hospitalizations (P = 0.005), acute obstructive pyelonephritis (P = 0.019), and complications (P = 0.02) was statistically significantly higher during lockdown compared to 2019. The increase in the rate of surgical procedures nearly reached significance (P = 0.059). The odds of having complications and being hospitalized were almost fivefold (odds ratio 4.68, 95% confidence interval 1.98–11.07) and twofold greater (odds ratio 2.39, 95% confidence interval 1.29–4.43) compared to the same period in 2019. No difference was noted between May–June 2020 and 2019. Conclusion: The coronavirus disease‐19 lockdown period provoked a meaningful reduction in symptomatic ureteral lithiasis admission. Most patients presented with complicated disease, which required an increased rate of interventional procedures compared to the equivalent period in 2019. Admissions reverted to normal levels during the reopening phase. [ABSTRACT FROM AUTHOR]

This longitudinal study explores whether the working situation (no change in working hours despite care, reduction of working hours due to care or not working) moderates mental and physical health of informal caregivers of older people with Alzheimer's disease (AD) in Italy. Data from a sample of 146 caregivers of older people with moderate AD involved in the UP-TECH trial across three waves were analysed. Multivariate analyses were used to study the association between independent variables (caregivers' work situation) and dependent variables (caregivers' psycho-physical health). In a second model, elements relating to the caregiver, the cared-for individual and the caregiving situation were added as controls. Being forced to reduce working hours due to care tasks or not being employed independently from care was negatively associated with informal caregiver's physical health, compared with working carers not experiencing reduction of working hours. In the extended model, this result was confirmed. In comparison with working carers not forced to reduce working hours, non-working carers experienced higher levels of caregiver burden and depression, however these results were not confirmed in the adjusted model. Other factors also emerged as important including weekly hours of care, the cared-for older individual's ADL/IADL scores and informal support network. Given the positive effect of labour force participation on health of informal caregivers of older people with AD, policy makers should promote their employment avoiding their forced reduction of working hours, while also putting measures in place to decrease the intensity of informal care provision. [ABSTRACT FROM AUTHOR]

Mesomycetozoean-induced infections (order Dermocystida, genus Amphibiocystidium) in European and North American amphibians are causing alarm. To date, the pathogenicity of these parasites in field conditions has been poorly studied, and demographic consequences on amphibian populations have not been explored. In this study, an Amphibiocystidium sp. infection is reported in a natural population of the Italian stream frog (Rana italica) of Central Italy, over a 7-year period from 2008 to 2014. Light and electron microscope examinations, as well as partial 18S rDNA sequence analysis were used to characterize the parasite. Moreover, a capture-mark-recapture study was conducted to assess the frog demographics in response to infection. Negative effects of amphibiocystidiosis on individual survival and population fitness were absent throughout the sampling period, despite the high estimates of disease prevalence. This might have been due to resistance and/or tolerance strategies developed by the frogs in response to the persistence of Amphibiocystidium infection in this system. We hypothesized that in the examined R. italica population, amphibiocystidiosis is an ongoing endemic/epidemic infection. However, ecological and host-specific factors, interacting in a synergistic fashion, might be responsible for variations in the susceptibility to Amphibiocystidium infection of both conspecific populations and heterospecific individuals of R. italica. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate a 1‐year social farming programme conducted between 2014 and 2015, including horticultural and occupational activities on six agricultural farms for older people in good general health. Social farming is a practice that uses agricultural resources to provide health, social or educational services to vulnerable groups of people. Activity participation, social relationships, physical activity, and the quality of life of the participants were assessed using a pretest, posttest design. A total of 112 subjects were interviewed at baseline, though only 73 participants were retained through the end of the follow‐up, resulting in a dropout rate of 34%. Data analysis revealed significant improvements in both social relationships and overall occupational engagement at the end of the programme, with significant increases in the frequency of contact with friends or relatives as well as the number of activities performed by the participants. This work adds to the literature on the effects of social farming and indicates that farming may provide opportunities for older people to engage in activities that stimulate social behaviours. [ABSTRACT FROM AUTHOR]

‘The Internet is the fabric or our lives’ [Castells, M. (2001). The Internet Galaxy: Reflections on the Internet, Business, and Society. Oxford: Oxford University Press, p. 1] - but which are the weaves that nowadays connect Italian social workers into such a fabric? Herein we aim at answering this question through a survey of on-line resources, nodes and practices of e-Social Work in Italy. We shall be discussing ICT impact on the Italian context, and the utilization of ICT by Italian social workers, in order to build up the internal and external factors that determine the current utilization levels of these emerging tools within the professional community. A review of the major on-line social work portals will identify their key features and peculiarities and aim to provide an overview of the substance and current on-line functions of Italian social work, with a summing-up of criticalities and opportunities that might prompt reflection on possible future developments. [ABSTRACT FROM AUTHOR]

Aim: To determine if age is a factor influencing the type of breast cancer surgery (radical versus conservative) in Italy and to investigate the regional differences in breast cancer surgery clinical practice.Methods: Retrospective study is based on national hospital discharge records. The study draws on routinely collected data from hospital discharge records in Italy in 2010. The following exclusion criteria were applied: day hospital stays, patients younger than 17 years, males, patients without an ICD-9CM code indicating breast cancer and breast surgery, and repeated hospital admission of the same patient. Overall, 49,058 patient records were selected for the analysis.Results: The proportion of conservative breast cancer operations was 70.9%. A greater number of women younger than 70 had undergone a breast-conserving operation compared to older women. There were regional variations ranging from a minimum in Basilicata to a maximum in Val d’Aosta. Multivariate analysis revealed that older patients with lower clinical severity were more likely to have undergone a radical operation than younger women. In addition, radical surgery was approximately twice as likely to occur in a private hospital that performed at least 50 breast cancer operations annually than in a public hospital that performed <50 breast surgeries.Conclusion: Notwithstanding increases in life expectancy and the lack of clinical evidence to support the use of age as a surrogate for co-morbid conditions and frailty, our data on breast cancer operations in Italy are consistent with the hypothesis suggesting the persistence of ageistic practice in the healthcare system. [ABSTRACT FROM AUTHOR]

The area between Golo and Tavignano valleys in Central Corsica (latitudes 42°23′12,18″N to 42°18′24,60″N, longitudes 9°07′49,30″E to 9°11′35,90″E) is characterized by the occurrence of continental metamorphic units belonging to the Lower Units of Alpine Corsica. These units, also known as Corte Slices, represent the fragments of the European continental margin involved in the continental subduction and the subsequent collision, both resulting from the closure of the Ligure-Piemontese oceanic Basin. These units are thus characterized by complex, polyphased deformation history developed under blueschist to greenschist metamorphic facies conditions during the Late Eocene to Early Miocene time span. In the study area, the Corte Slices have been investigated by a multidisciplinary approach consisting of a detailed mapping associated with meso- and micro-structural analyses and estimate of the P-T conditions of the metamorphic events. The 1:10,000 scale geological map illustrates the results of this approach that has provided a detailed snapshot of the stratigraphic and structural setting of Corte Slices. [ABSTRACT FROM PUBLISHER]

Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer’s disease (AD) and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman’s correlation coefficients, principal-component analysis, and Cronbach’s alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach’s alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD. [ABSTRACT FROM AUTHOR]

Objective:The aim of the analysis is to assess the impact of privately employed migrant care workers (MCWs) on the burden of Italian family members who care for a disabled older person. Methods:EUROFAMCARE is a one-year prospective survey carried out to provide evidence on the availability and use of support services by family carers of older people in Europe. In Italy, 990 family caregivers were enrolled and successful follow-ups were completed for 863 subjects. The survey also assessed the level of caregiver burden using the COPE index, which has three sub-sections: ‘Positive Value’ (PV), ‘Quality of Support’ (QS) and ‘Negative Impact’ (NI). We used the one-year change of the COPE-NI as dependent variable and we realised multilevel regression models to estimate the longitudinal predictors of caregivers’ burden increase. Results:At a cross-sectional level, most burdened caregivers are those caring for a demented relative (COPE-NI = 13.6), with no educational title (14.5) and looking after their own spouses (15.1). Longitudinally those employing an MCW are significantly protected against burden increase (regression coefficient: −1.52;p< 0.01) while those who cannot rely on the support of other family members are exposed to the risk of burden increase (0.991;p< 0.05). Other formal services do not have any protective effect. Conclusion:Our study suggests that employing an MCW, rather than using formal services, is associated with a reduction of caregiving burden. Further research should assess whether the shift in care responsibilities to the MCWs also implies a transfer of care burden, and understand how these workers can be better supported by existing formal services. [ABSTRACT FROM PUBLISHER]

Italy is characterized by a very high and increasing demand for elder care but, paradoxically, also by a surprisingly low level of public service provision in this sector. Due to current demographic, economic and socio-cultural trends, the potential availability of informal family care has been decreasing while, on the other hand, still strong familistic attitudes have so far limited the emergence of formal—both home and residential—care services. The ‘cash-for-care’ orientation of the Italian welfare system, with direct payments prevailing over in-kind services, has thus gradually developed into a care regime where monetary transfers to dependent (older) people are often used to privately employ migrant care workers. This phenomenon is analyzed in the context of two different studies (EUROFAMCARE and DIPO), in order to understand how migrant care work has been affecting both family care and professional care work in Italy. The main findings suggest that the widespread employment of migrant care workers—propelled by public care allowances—has certainly relieved many families from most burdensome care tasks, but at the same time partly ‘crowded out’ formal care services. Care quality issues remain. however, largely under-investigated, as do care drain effects in sending countries. [ABSTRACT FROM AUTHOR]

To evaluate seroprevalence of B. henselae infection both in Sicilian children and healthy blood donors. Furthermore, circulation of Bartonella in the natural reservoir was also studied. Two hundred forty-three children, living in Sicily (Palermo), affected by various diseases, without clinical features suggesting B. henselae infection, together with 122 healthy blood donors were serologically investigated for IgG and IgM antibodies by indirect fluorescent antibody test (IFAT). One hundred twenty stray and 62 pet cats were also analyzed only for IgG. Among children 25.1% had IgG antibodies to B. henselae; 18.5% showed a titer 1:64, 2.4% 1:128, 2.4% 1:256, 0.8% 1:512, 0.4% 1:1024, and 0.4% 1:5120. Among healthy blood donors 11.4% had IgG class antibodies to B. henselae; 9.8% showed a titer 1:64 and 1.6% 1:128. All the human serum samples did not show positive results for B. henselae IgM class antibodies. Stray cats (68.3%) and pet cats (35.4%) also had IgG class antibodies to B. henselae. We demonstrated high frequency of serologic evidence of past B. henselae infection, in young Italian children, affected by various diseases, apparently free of any clinical features suggesting B. henselae infection. This observation is supported by high circulation of Bartonella in cats. [ABSTRACT FROM PUBLISHER]

The in-beam PET is a novel PET application to image the β+ activity induced in biological tissues by hadronic therapeutic beams. Thanks to the correlation existing between beam-delivered dose profiles and beam-induced activity profiles, in vivo information about the effective ion paths can be extracted from the in-beam PET image. In-situ measurements, immediately after patient irradiation, are recommended in order to exploit the maximum statistics, by also detecting the contribution provided by the very short lived isotopes, e.g. 15O. A .compact, dedicated tomograph should then be developed for such an application, so as to be used in the treatment room. We developed a small PET prototype in order to demonstrate the feasibility of such a technique for the monitoring of proton therapy of ocular tumors at the CATANA facility (Catania, Italy). The prototype consists of two planar heads with an active area of about 5 cm × 5 cm. Each head is made up of a square position sensitive photomultiplier (Hamamatsu H8500) coupled to a matrix of the same size of LYSO scintillating crystals (2 mm × 2 mm × 18 mm pixel dimensions). Dedicated, compact electronic boards are used for the signal multiplexing, amplification and digitization. The distance between the pair can be varied from 10 cm up to a maximum of about 20 cm. The validation of the prototype was performed on plastic phantoms using 62 MeV protons at the CATANA beam line. Different dose distributions were delivered and a good correlation between the distal fall-off of the activity profiles and of the dose profiles was found, i.e., better than 2 mm along the beam direction. [ABSTRACT FROM AUTHOR]

Concentrations of commonly used organochlorine pesticides (OCPs) were determined in tissues of 23 adult and 24 larval water frogs of two coexisting species (Rana lessonae and the hemiclonal hybrid R. esculenta) and in the water of their breeding pond in an agricultural zone in Umbria, central Italy, where increased occurrence of infectious diseases and distinctly oversized tadpoles were recently observed. The concentrations of OCP in tissues of both species were lower than those in the water of their breeding pond, except for DDT, which was more concentrated in adult frogs than in pond water (bioaccumulation factor 7 for R. lessonae, 15 for R. esculenta). Total OCP concentration and adult body weight were positively correlated for both species, which is consistent with bioaccumulation. In accord, adults contained higher OCP concentrations than tadpoles. Oversized tadpoles had higher OCP concentrations than normal tadpoles. Mean OCP concentrations in individual organs were about an order of magnitude higher than those in whole-frog homogenates. They were highest in brain, higher in ventral than in dorsal skin, and moderately high in ovaries; transmission of bioaccumulation loads to the next generation is therefore possible. The observed OCP concentrations appear too low to directly cause mortality in water frogs, but effects of cumulative exposure to low-level pollutants and their synergistic interactions with the effects of other natural and anthropogenic environmental stressors are unknown. [ABSTRACT FROM AUTHOR]

Simple Summary: For the purposes of raising awareness of five historical cheeses of Southern Italy that are less known by consumers, and of restoring dignity to the breeders and producers of these cheeses, we studied their quality in terms of chemical composition, monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), conjugated linoleic acid (CLA), PUFA-ω6, PUFA-ω3, α-tocopherol, retinol, cholesterol, polyphenol content (TPC), total antioxidant capacity (FRAP and TEAC), and health index (GHIC). Two stretched-curd bovine cheeses, Caciocavallo Palermitano (CP) and Casizolu del Montiferru (CdM), two ovine cheeses, Vastedda della Valle del Belìce (VVB) and Pecorino Siciliano (PS), and one caprine cheese, Caprino Nicastrese (CN), were evaluated. These cheeses are produced in different months, with raw milk from animals reared in an extensive feeding system. In April, the CP cheese showed high values for CLA, TPC, and GHIC, while the CN cheese exhibited high PUFA, PUFA-ω6, PUFA-ω3, TEAC, and GHIC. In May, the CdM cheese exhibited high content of fat, saturated fatty acids, PUFA-ω3, α-tocopherol, TEAC, and GHIC, while the PS cheese showed high values of protein, CLA, PUFA, PUFA-ω3, α-tocopherol, and GHIC. These measured parameters characterize and distinguish each cheese due to links with numerous factors: species, breed, feeding system, pasture biodiversity, climate, production technology, traditional tools, and ripening type. It is highlighted that, in general, the highest nutritional quality, linked to the highest presence of healthy compounds, originates from the pasture of cheese production in the spring. Five natural historic cheeses of Southern Italy were investigated—Caciocavallo Palermitano (CP), Casizolu del Montiferru (CdM), Vastedda della Valle del Belìce (VVB), Pecorino Siciliano (PS), and Caprino Nicastrese (CN)—which are produced with raw milk and with traditional techniques and tools, from autochthonous breeds reared under an extensive system. The effects of the month of production on gross composition, MUFA, PUFA, PUFA-ω6, PUFA-ω3, α-tocopherol, retinol, cholesterol, TPC, TEAC, and GHIC were evaluated. In CP, CLA, TPC, and GHIC were higher in April than in February. CdM showed higher values in terms of fat, saturated fatty acids, PUFA-ω3, α-tocopherol, TEAC, and GHIC in May than in February and September, while low values in terms of protein, moisture, and CLA were found. In VVB, MUFA, PUFA-ω6, and α-tocopherol increased in June compared with April; conversely, protein, FRAP, and TEAC were higher in April. In PS, protein, CLA, PUFA, PUFA-ω3, α-tocopherol, and GHIC increased in May compared with January; on the contrary, moisture, NaCl, and TEAC showed high values in January. CN showed higher values in terms of PUFA, PUFA-ω6, PUFA-ω3, TPC, TEAC, and GHIC in April and June compared with January. It is shown that each cheese is unique and closely linked to the production area. Cheeses produced in the spring months showed a high nutritional quality due to the greatest presence of healthy compounds originating from an extensive feeding system. [ABSTRACT FROM AUTHOR]

Context: Pasture is widely used in rural Mediterranean areas as a local resource for animal feeding in a sustainable food system. Aims: The present study aimed at evaluating the effects of pasture from a Mediterranean environment on milk fatty acid profile and organoleptic characteristics in grazing Cilentana goats bred in Cilento (Salerno province, southern Italy). Methods: Twelve Cilentana dairy goats, grazing on local feeding resources were studied for 5 months (from May to September), starting from 60 days after kidding. Bodyweight and milk yield were recorded, whereas milk samples were collected and analysed for milk chemical composition and fatty acid profile. Milk organoleptic characteristics were analysed using an instrumental sensory platform. Key results: Season significantly (P < 0.01) affected the pasture fatty acid profile, with the highest polyunsaturated fatty acid (PUFA) content (64.83%) occurring in May. Results of the milk fatty acid composition, permitted to classify as 'High quality' the goat milks sampled in May and June, with the significantly (P < 0.01) highest monounsaturated fatty acid (MUFA; 23.98% and 25.37%) and PUFA (4.74% and 4.43%) contents and lowest saturated fatty acid:unsaturated fatty acid (SFA:UFA) ratio (2.50 and 2.36), and as 'Low quality' those sampled in August and September with the significantly (P < 0.01) highest SFA (75.79% and 75.84%) content. Milk n -6: n -3 polyunsaturated fatty acid ratio was always lower than 4. Some sensory differences in milk organoleptic characteristics were detected by the artificial senses platform, which would be almost impossible to detect by a human panel. Conclusions: Milk samples obtained from grazing goats were influenced by the quality of local feeding resources in terms of nutraceutical value and sensory profile. Implications: Pasture influenced the composition of milk functional compounds, improving the UFAs and conjugated linoleic acid isomers, widely recognised as having beneficial effects on human health. The n -6: n -3 PUFA ratio, lower than 4, confirms the positive effects of pasture on nutritional characteristics of goat milk and underlines the important role of pasture of marginal areas for the quality of livestock products in the frame of a sustainable agro-food system. Some differences were detected by the artificial senses platform among milk samples, which were almost impossible to detect by a human panel, highlighting the potentiality of the artificial senses to link animal-sourced foods to a territory. Pasture is widely used in Mediterranean areas as local resource for animal feeding, guaranteeing favourable chemical and sensory characteristics of products. The aim of the study was to assess milk chemical and sensory characteristics of 12 Cilentana goats grazing in a mountainous area of Cilento (southern Italy). Positive effects of pasture on nutritional characteristics of goat milk underline the important role of pasture of marginal areas for the quality of livestock products in the frame of a sustainable agro-food system. [ABSTRACT FROM AUTHOR]

The diffusion of new psychoactive substances (NPS) is highly dynamic and the available substances change over time, resulting in forensic laboratories becoming highly engaged in NPS control. In order to manage NPS diffusion, efficient and innovative legal responses have been provided by several nations. Metabolic profiling is also part of the analytical fight against NPS, since it allows to identify the biomarkers of drug intake which are needed for the development of suitable analytical methods in biological samples. We have recently reported the characterization of two new analogs of fentanyl, i.e., 4-fluoro-furanylfentanyl (4F-FUF) and isobutyrylfentanyl (iBF), which were found for the first time in Italy in 2019; 4F-FUF was identified for the first time in Europe and was notified to the European Early Warning System. The goal of this study was the characterization of the main metabolites of both drugs by in vitro and in vivo experiments. To this end, incubation with mouse hepatocytes and intraperitoneal administration to mice were carried out. Samples were analyzed by means of liquid chromatography-high resolution mass spectrometry (LC–HRMS), followed by untargeted data evaluation using Compound Discoverer software with a specific workflow, designed for the identification of the whole metabolic pattern, including unexpected metabolites. Twenty metabolites were putatively annotated for 4F-FUF, with the dihydrodiol derivative appearing as the most abundant, whereas 22 metabolites were found for iBF, which was mainly excreted as nor-isobutyrylfentanyl. N-dealkylation of 4F-FUF dihydrodiol and oxidation to carbonyl metabolites for iBF were also major biotransformations. Despite some differences, in general there was a good agreement between in vitro and in vivo samples. [ABSTRACT FROM AUTHOR]

Lockdowns imposed by governments worldwide as a way to limit the spread of severe atypical respiratory syndrome-coronavirus-2 (SARS-CoV2) have had heavy psychological and economic consequences. Arthritis patients are a vulnerable population at an increased risk of peritraumatic stress. This could be due to several reasons, including the fear of shortage of medicine and difficulty receiving periodical medical checks. In the present case-control study, psychological distress in patients with autoimmune arthritis during the coronavirus disease 2019 (COVID-19) pandemic were investigated. An electronic survey was conducted to gather information on the perceived change in the emotional state, general health (GH), fatigue, joint pain, and disease activity during the lockdown, in 100 patients with autoimmune arthritis and 100 controls. Mental health status was measured using the Depression, Anxiety and Stress Scale (DASS-21). The COVID-19 Peritraumatic Distress Index (CPDI) was used to assess the frequency of peritraumatic stress disorders related to COVID-19. Patients reported a significant worsening of perceived GH (36% vs. 7%; p < 0.001), a significantly higher mean CPDI score (p < 0.001) than controls. Using multivariate analysis, arthritis patients had significantly higher CPDI scores (+3.67 points; p = 0.019), independent of depression, anxiety, and stress symptoms, comorbidities, and sociodemographic and lifestyle characteristics. Logistic regression analysis showed that the risk of reporting worsened GH was 9-fold higher in patients than controls (p < 0.001). Patients with autoimmune arthritis are at higher risk of psychological distress related to COVID-19 pandemic; thus targeted intervention should be designed to strengthen coping capacity in this vulnerable population. [ABSTRACT FROM AUTHOR]

Aim Several factors can affect antipsychotic prescriptions, among which, caregivers. However, whether being assisted by a care worker might increase the rate of antipsychotic prescriptions at discharge from acute care hospital has not been previously investigated. We aimed to investigate whether being assisted by a care worker is associated with increased use of antipsychotics among older patients discharged from acute care hospitals. Methods The present series consisted of 928 patients not taking antipsychotics at admission in seven acute care wards of geriatric medicine in Italy (mean age 80.8 ± 7.2 years, 54.9% women). The outcome of the study was defined as receiving an antipsychotic prescription at discharge. Patients were grouped according to their living conditions as follows: (i) living alone; (ii) living only with care worker; (iii) living with care worker and family members; and (iv) living only with family members. The association between study variables and antipsychotic prescription at discharge was investigated by logistic regression analysis. Results After adjusting for potential confounders, being assisted by care workers was significantly associated with the outcome (OR 2.64, 95% CI 1.21-5.75). Diagnosis of dementia (OR 2.73, 95% CI 1.65-4.51), instrumental activities of daily living limitations (OR 1.12, 95% CI 1.05-1.21) and delirium during stay (OR 3.87, 95% CI 2.01-7.47) also qualified as independent correlates of antipsychotic prescription at discharge. Conclusions Being assisted by care workers could increase the likelihood of receiving antipsychotics at discharge from acute care hospitals. Geriatr Gerontol Int 2017; 17: 1707-1713. [ABSTRACT FROM AUTHOR]

Objectives: Seasonal influenza represents a major threat to public health but vaccination campaigns are strongly recommended to reduce the risks of serious complications and mortality among community-dwelling elderly persons. We investigated on potential social predictors of influenza vaccination among older adults in Italy. Methods: Data analysis was based on the national survey “Health and use of health care,” which was carried out in 2004/2005 and reached a sample of 25,183 elderly persons. After initial univariate and bivariate statistics, we used multivariate logistic regression to evaluate potential independent predictors of influenza immunization. Results: 62.6% of the recruited subjects declared to be vaccinated against influenza. At bivariate analysis, significative differences in immunization rates arose by each socioeconomic variable investigated. Logistic regressions confirmed that individuals in lower social classes have higher chances of being vaccinated. Moreover, older age and chronic disease were associated with higher likelihood of immunization. Conversely, reporting good health predicted a lower uptake. Conclusion: In our analysis we found several independent predictors of influenza vaccination. Surprisingly, individuals belonging to lower social classes have higher chances of being vaccinated. These results suggest that vaccination policies have a positive effect in preventing socioeconomic inequalities in access to this service in Italy. [Copyright &y& Elsevier]

Background: User-centred design (UCD) is a process whereby the end-user is placed at the centre of the design process. The WIISEL (Wireless Insole for Independent and Safe Elderly Living) system is designed to monitor fall risk and to detect falls, and consists of a pair of instrumented insoles and a smartphone app. The system was designed using a three-phase UCD process carried out in Ireland, which incorporated the input of Irish end-users and multidisciplinary experts throughout.Objective: In this paper we report the results of a usability and user experience (UX) assessment of the WIISEL system in multiple countries and thus establish whether the UCD process carried out in Ireland produced positive usability and UX results outside of Ireland.Methods: 15 older adults across three centres (Ireland, Italy and Israel) were recruited for a three-day trial of the system in their home. Usability and UX data were captured using observations, interviews and usability questionnaires.Results: The system was satisfactory in terms of the usability and UX feedback from the participants in all three countries. There was no statistically significant difference in the usability scores for the three countries tested, with the exception of comfort.Conclusions: A connected health system designed using a UCD process in a single country resulted in positive usability and UX for users in other European countries. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the prognostic weight of multimorbidity and functional impairment over long-term mortality among older patients discharged from acute care hospitals. A prospective multicenter observational study. Our series consisted of 1967 adults aged ≥65 years consecutively admitted to acute care wards in Italy, in the context of the Report-AGE project. After signing a written informed consent, all patients underwent comprehensive geriatric assessment by Inter-RAI Minimum Data Set acute care. The primary endpoint of the present study was long-term mortality. Patients were grouped into 3 functional clusters and 3 disease clusters using the K-medians cluster analysis. The association of functional clusters, disease clusters, and Charlson score categories with long-term mortality was investigated through Cox regression analysis and the intercluster classification agreement was further estimated. Finally, the additive effect of either disease clusters or Charlson score on predictive ability of functional clusters was assessed by using changes in Harrell's C-index and categorical Net Reclassification Index (NRI). Functional clusters, disease clusters, and Charlson score were significant predictors of long-term mortality, but the interclassification agreement was poor. Functional clusters predicted mortality with greater accuracy [C-index 0.66, 95% confidence interval (CI) 0.65–0.68] compared with disease clusters (C-index 0.54, 95% CI 0.53–0.56), and Charlson score (C-index 0.58, 95% CI 0.56–0.59). Adding multimorbidity (NRI 0.23, 95% CI 0.14–0.31) or Charlson score (NRI 0.13, 95% CI 0.03–0.20) to functional cluster model slightly improved the accuracy of prediction. Functional impairment may better predict prognosis compared with multimorbidity, which may be relevant to optimally address individuals' needs and to design tailored preventive interventions. [ABSTRACT FROM AUTHOR]

• Description of life stages of Amphibiocystidium sp. parasite from Rana italica. • Morphological and histochemical similarities with Rhinosporidium seeberi. • Characterization of juvenile sporangia, early mature sporangia, and mature sporangia. • Contribution to knowledge of biology of parasites of the genus Amphibiocystidium. Amphibian parasites of the genus Amphibiocystidium are members of the class Ichthyosporea (=Mesomycetozoea), within the order Dermocystida. Most of the species in the Dermocystida fail to grow in ordinary culture media, so their life cycle has only been partially constructed by studies in host tissues. However, to date, there have been few reports on the life cycle of Amphibiocystidium parasites with respect to the developmental life stages of both Dermocystidium and Rhinosporidium parasites. In this study, we provide light and electron microscopic findings of developmental phenotypes of Amphibiocystidium sp., a parasite previously characterized in the Italian stream frog (Rana italica), which has caused an ongoing infection in a natural population of Central Italy. These phenotypes exhibited distinct morphological characteristics that were similar to A. ranae from the skin of R. temporaria , but showed histochemical properties particularly comparable with those of maturing phenotypes of Rhinosporidium seeberi , and compatible with fungal-like parasites. Therefore, for Amphibiocystidium sp. phenotypes, we suggest adopting the terminology used for maturing stages of R. seeberi , such as juvenile sporangia, early mature sporangia and mature sporangia. The characterization of these developmental stages will be useful to increase the understanding of the life cycle of parasites of the genus Amphibiocystidium and of the interactions with their amphibian hosts. [ABSTRACT FROM AUTHOR]

The prevalence of burnout in oncology staff was compared with that of the ophthalmology staff, who normally present a low prevalence of burnout as described in this literature. The correlation of burnout with the emotion of anger was also investigated. Thirty-six subjects working in an oncology department and 32 working in an ophthalmology department were examined using the Maslach Burnout Inventory and the State-Trait Anger Expression Inventory. The oncology group showed higher mean scores on the MBI Emotive Exhaustion and Depersonalization scales with respect to ophthalmology staff. Correlation analysis showed that increasing burnout was associated with higher anger expressed towards the environment and loss of anger control. Anger, as a response to frustration, appears to be a feature constantly associated with the clinical expression of burnout and it should not be underestimated in theoretical and preventive contexts.

Objective: This study investigated the frequency of the panic-agoraphobic spectrum symptoms in a sample of obese subjects affected by Binge Eating Disorder (BED) vs controls., Method: Fifty obese with BED were matched by age, sex and marital status to twenty-five normal weight controls. The Structured Clinical Interview For Panic-Agoraphobic Spectrum--SCI-PAS was administered to all participants., Results: Obese subjects with BED presented significantly higher frequencies of typical and atypical panic symptoms (82% vs 8%, p<0.0001), agoraphobia (58% vs 12%, p=0.002) and reassurance orientation (56% vs 8%, p=0.001) than controls., Discussion: BED frequently co-occurs with other major psychiatric disorders, traditionally assessed using categorical methods of classification of mental disorders. The spectrum of the subthreshold, atypical and partial symptoms of full-blown mental disorders, often neglected by categorical approach, may also affect subjective well-being and functioning as full-blown disorders. The identification of the subthreshold symptomatology may have relevant implications for the response to treatment and the outcome of the eating disorder.