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Aims Several chronic care models for diabetes have been implemented in Italy, although conclusive data on their effectiveness are lacking. In the Cusano-Milanino diabetes clinic, patients with Type 2 diabetes with a stable disease/therapy (i.e. a steady level of HbA1c without need for therapy changes) are included in the SINERGIA programme: diabetologists, nurses and dietitians empower patients and telemedicine resources are utilized efficiently. Methods Clinical outcomes measured in the year before and after the initiation of SINERGIA were compared. A generalized hierarchical linear regression model for repeated measures was used. Results Altogether, 1004 patients were included; baseline characteristics were (mean ± SD): age 66.6 ± 6.2 years, 54.1% male, diabetes duration 10.8 ± 7.7 years, BMI 29.5 ± 4.8 kg /m², HbA1c 6.9 ± 0.9% (52 ± 14 mmol/ mol); 72.9% of patients were treated with anti-hypertensive drugs; 32.7%were treated with lipid-lowering drugs. After a median follow-up of 12 months (range 6-24 months), the proportion of patients with HbA1c ≤ 7.0% (≤ 53 mmol/mol) increased from 32.7 to 45.8%(P < 0.0001), while those with HbA1c ≥ 9%(≥ 75 mmol/mol) decreased from 10.5 to 4.3%(P < 0.0001). Patients with LDL cholesterol < 100 mg/dl (< 2.59 mmol/l) increased from 40 to 47% (P < 0.0001), while those with LDL cholesterol ≥ 130 mg/dl (≥ 3.36 mmol/l) decreased from 26.6 to 19.7%; blood pressure levels were slightly improved. The mean number of face-to-face encounters decreased from (median and range) 2.8 (2.3-3.4) to 2.3 (1.9-2.7) (P < 0.0001) visits per patient/year. Conclusions The SINERGIA model is effective in improving metabolic control and major cardiovascular risk factors, while allowing diabetologists to dedicate more time to patients with more acute disease. [ABSTRACT FROM AUTHOR]

African swine fever (ASF) is a notifiable infectious disease, caused by the ASF virus (ASFV), which is a DNA virus belonging to the family Asfarviridae, genus Asfivirus. This disease has gained importance in the last decade after its spread in several countries in Eastern and Central Europe, and more recently, in China. Despite the efforts made to eradicate it, ASF is still present on the Mediterranean island of Sardinia (Italy) and has been since 1978. ASF risk factors on the island have been analysed in previous studies; the role of free-ranging pigs in virus persistence has been suggested, but has not been fully elucidated. The most recent eradication plan provides more stringent measures to combat free-ranging pigs and any kind of illegality in the pig sector. From December 2017 to June 2018, a total of 29 depopulation actions were performed in 13 municipalities in central Sardinia, during which 2,281 free-ranging pigs were culled and more than 50% of them were tested for ASFV and antibody presence (1,218 and 1,416, respectively). A total of 651 pigs were seropositive, with a mean seroprevalence of 53.4% (CI 95% = 50.6-56.3), and 38 were ASFV positive (virus prevalence = 2.6%; CI 95% = 2.1-3.0). To the best of our knowledge, the present study is the first to provide a complete evaluation of this millennial system of pig farming and ASFV prevalence in free-ranging pigs. Furthermore, it has emphasised the necessity of combining the maintenance of an epidemiological surveillance program with continuous education of farmers and other people involved in pig husbandry, based on cultural and economic aspects., (© 2019 The Authors. Transboundary and Emerging Diseases Published by Blackwell Verlag GmbH.)

Background: The aim of the study was to assess radon concentration in schoolrooms in a city located in the midwest of Italy., Methods: A two-phase environmental study was carried out in 19 school buildings of 16 primary, secondary, and tertiary schools., Results: Median (interquartile range-IQR) indoor radon concentration in schoolrooms was 91.6 (45.0-140.3) Bq/m³. The highest (median 952.8 Bq/m³) radon concentration was found in one (3.6%) classroom, located in a building of a primary school whose median concentration was 185 Bq/m³. Radon concentration was significantly correlated with the number of students and teachers, foundation wall construction material, and with the absence of underground floors. A geopedological survey was performed close to the building with highest radon level, showing the presence of granite and tonalithic granodiorite in the soil., Conclusions: Radon levels should be routinely assessed where individuals live or work. Schools are susceptible targets, because of childhood stay and the long daily stay of occupants. Low-cost interventions, such as implementation of natural air ventilation and school maintenance, can reduce radon levels, limiting individual exposure., Competing Interests: The authors declare no conflict of interest.