Search

Using ChatGPT in scientific research offers revolutionary opportunities thanks to its natural language interaction capabilities and production of coherent and sophisticated text.Artificial intelligence can automate activities such as information synthesis and schematization, improving scientific communication and computer code writing.However, the lack of a complete understanding of context, the risk of spreading misleading information, and the possibility of plagiarism represent some of the biggest limitations in the current use of this technology.The role of human experience remains fundamental for in-depth understanding of context, exercising critical thinking, and ensuring respect for the ethical principles of scientific research.A responsible and aware use of tools such as ChatGPT can offer great benefits to the scientific community, but it is essential to remember that these tools are only a support and cannot replace human judgment and experience.

Objectives: to assess the prevalence of post-traumatic stress disorder (PTSD) symptoms in a sample of Italian citizens during the first COVID-19 pandemic wave and its association with sociodemographic characteristics, housing conditions, and lifestyles modifications., Design: cross-sectional survey., Setting and Participants: between 21st April and 7th June 2020, a self-administered online questionnaire aiming at investigating mental well-being and lifestyle habits during the lockdown period was disseminated online. Respondents were recruited through a snowball sampling., Main Outcome Measures: PTSD symptoms were assessed using a validated screening tool, the SPAN (Startle, Physiological arousal, Anger, Numbness) questionnaire., Results: the study population is composed of 6,687 participants, of whom 71.5% were females. The mean age of the sample was 48.7 years. Globally, 43.8% of the participants reported symptoms of PTSD, especially females. PTSD prevalence showed a decreasing trend across age groups. The likelihood of PTSD symptoms was higher among those who increased alcohol consumption, decreased physical activity, and experienced restless sleep., Conclusions: a high prevalence of PTSD symptoms emerged from this survey, especially among women and younger subjects. Preventive strategies should be implemented to protect the mental health of the most vulnerable citizens in a period of emergency.

Objectives: to investigate the combinations of clinical features and symptoms that best predict the positive outcome of the SARS-CoV-2 swab in a primary care setting., Design: prospective cohort study., Setting and Participants: patients listed in the rosters of general practitioners volunteering for the study who reported flu-like symptoms and/or anosmia/ageusia between 01.03.2020 and 30.06.2020., Main Outcome Measures: positive molecular swab result. The predictive value of the reported symptoms and their association with this outcome were estimated using multivariable logistic regression models, adopting an inverse probability weighting approach., Results: a swab was requested for 1,045 (77.2%) out of 1,354 patients included in the study: 79.6% of them were tested, with a positive result in 50.4% of cases. Patients aged 40 to 64 years (OR 1.59; 95%CI 1.09-2.33) and those older than 64 years (OR 2.64; 95%CI 1.66-4.19) showed a higher likelihood of a positive swab results, compared with younger subjects (<40 years). A positive association with a positive swab result was observed among patients reporting fever >37.5°C (OR 1.67; 95%CI: 1.18-2.36) and anosmia/ageusia (OR 1.44; 95%CI: 1.01-2.04). The predictive value of fever tended to increase with increasing age, while an opposite trend was observed for anosmia/ageusia. No difference by gender was observed., Conclusions: among patients reporting flu-like symptoms in a general practice setting, fever >37.5 and anosmia/ageusia were predictive of a positive SARS-CoV-2 swab test result and this association was modified by age. Although the generalizability of these findings might be limited, this study highlights the importance of the contribution of the research conducted in primary care settings to the definition of effective and sustainable strategies to contrast the pandemic emergency.

Objectives: to compare cervical cancer screening diagnostic indicators in women accessing screening through volunteer non-governmental organisations (NGOs) and in those who access via the National Health Service (NHS) programme., Design: cohort study on archive data., Setting and Participants: the study cohort consists of 93,086 women aged 30-64 years who underwent an HPV test via NHS screening programme or through premises implemented within volunteers NGOs in Turin between 2015 and 2019. The screening history and Census data recorded into the Piedmont screening archive were used., Main Outcome Measures: positive baseline HPV test, positive triage cytology (low-grade lesions, ASC-US, L-SIL and high-grade lesions, H-SIL, ASC-H, AGC, Cancer), attendance at one-year HPV test repeat, referral and attendance to colposcopy at first and test repeat, and detection rate at first and test repeat, for cervical intraepithelial neoplasia grade >=2 (CIN2+) and >=3 (CIN3+), overall detection rates., Results: women performing cervical screening through volunteer NGOs (WASVO) are disadvantaged in terms of diagnostic indicators compared to women accessing via the NHS. WASVO are 60% more likely to be positive at the first HPV-test (adjusted prevalence ratio 1.6; 95%CI 1.2-2.0); their likelihood of being referred to colposcopy is double (adj PR 2.1; 95%CI 1.3-3.4); attendance rate to one year HPV test repeat is lower (adj PR 0.2; 95%CI 0.1-0.5); detection rates at first HPV screening test both for CIN2+ (adj PR 2.1; 95%CI 0.9-4.6) and CIN3+ (adj PR 2.1; 95%CI 0.9-5.1) is higher, even if statistical significance is borderline for the latter results., Conclusions: those responsible for screening programmes should establish and maintain collaborative relationships with local volunteer NGOs and migrant organisations for promoting strategies to raise awareness on cancer prevention among subgroups that are not captured in the main screening programs.

Objectives: to study the impact of social isolation, related to the SARS-CoV-2 epidemic, on lifestyles in Italy, with particular reference to physical activity, alcohol consumption, smoking, and eating habits. Moreover, to investigate the association between lifestyle changes during the pandemic and sociodemographic characteristics., Design: epidemiological investigation based on a cross-sectional study., Setting and Participants: between April 21st and June 7th 2020, an electronic questionnaire to collect information on physical activity, alcohol consumption, smoking, and eating habits during the period of home containment was made available on the web. Respondents were recruited through non-probabilistic snowball sampling. The link to the electronic questionnaire was disseminated through institutional websites, social networks (Facebook, Twitter), and messaging systems such as WhatsApp, Telegram, and SMS. A total of 10,758 interviews were collected, of which 7,847 (73%) were complete for a minimum set of indicators (age, gender, and area of residence)., Main Outcome Measures: reduction of physical activity, increase in alcohol consumption, increase in cigarette smoking, increase in consumption of unhealthy foods (processed meat, red meat or desserts) without increasing healthy foods (vegetables, legumes or whole grains) and, vice versa, increase in consumption of healthy foods without increasing unhealthy foods., Results: the population under study consists of 7,847 people with a mean age of 48.6 years (standard deviation: 13.9). Most of respondents are women (71.3%), 92.5% have a high school or university degree and 91% live in Northern Italy. During home containment, 56% of interviewees reported they had reduced the time devoted to physical activity. In particular, this happened among older people and those living in large cities. More than 17% of respondents increased their alcohol consumption, especially men, those highly educated and those living in large urban centres. Older age and residence in the Southern Italy represent, instead, protective factors for this outcome. Among smokers, 30% increased cigarette consumption during the period of home containment, on average of 5.6 cigarettes per day. A small proportion of former smokers (0.6%) resumed smoking. With regard to eating habits, 3 out of 10 respondents (29.9%) reported an inappropriate eating behaviour (increasing unhealthy food without increasing healthy ones). This behaviour was less frequent among men (adjusted Prevalence Ratio 0.80, p=0.005). A lower percentage of respondents (24.5%) increased the consumption of healthy foods without increasing the consumption of unhealthy ones., Conclusions: the results of this survey show that social isolation during the SARS-CoV-2 pandemic has had an impact on citizens' behaviours. In particular, it was found a noteworthy increase in sedentariness, alcohol consumption, and tobacco smoking. A meaningful proportion of respondents reported a worsening of eating habits, especially among women. However, for each of the behavioural risk factors investigated, small proportions of respondents with resilient attitudes were also found, namely, capable of taking advantage of social isolation for improving their daily habits. Studying changes in lifestyles during a pandemic, identifying population groups most at risk of adopting unfavourable behaviours, is a useful tool for policy makers to plan targeted and effective public health interventions.

Objectives: to estimate the number of deaths from noncommunicable chronic diseases (NCD) attributable to behavioural risk factors (tobacco smoking, unhealthy nutrition, physical inactivity, overweight, and excessive alcohol use) in 2016 for Italy and for the Italian regions., Design: descriptive study., Setting and Participants: mortality data were obtained by the Italian National Institute of Statistics. Causes of deaths from NCD associated with the five RFs were selected. Italian attributable fractions were obtained by the 2016 estimates of the Global Burden of Disease Study and applied to the mortality data. Regional prevalence of risk factors was obtained by the national surveillance system PASSI for the years 2013-2016., Main Outcome Measures: absolute number of attributable deaths, joint attributable fraction, proportion of total deaths attributable to RFs (MAprop)., Results: about 191,000 out of 614,307 deaths occurred in Italy in 2016 were attributable to combined RFs (about 37% in males; 26% in women). Joint MAprop was between 33% in men (24% in women) from Val d'Aosta and 40% in men (31% in women) from Campania. In Italy, 17% and 6% of the total amount of deaths were attributable to smoking in men and women, respectively; 6% and 3% to alcohol abuse; 7% and 8% to overweight; 13% and 12% to dietary RFs, and 2% and 3% to low physical activity. The higher proportion of attributable deaths by age-group was recorded in people aged 40-59 years (43% in men; 28% in women). Regional differences in attributable deaths are confirmed by regional RF prevalence recorded by the PASSI surveillance system for the years 2013-2016., Conclusions: these are the first estimates of the number of deaths due to NCDs attributable to behavioural RFs estimated for each region and for Italy as a whole. Effective primary prevention policies should be reinforced, since these RFs are potentially modifiable.

Objectives: to study regional differences in Italy of quit smoking attempts and of successful abstinence, in relation to socioeconomic status, cigarettes per day (cig/die), and smoking cessation method in a representative sample of the population resident in Italy., Design: cross-sectional survey., Setting and Participants: in 2014-2017, PASSI survey (the ongoing Italian behavioural risk factor surveillancesystem) gathered data on smoking and sociodemographic characteristics of 35,157 smokers; 13,130 aged 18-69 years made >1 quit attempt in the previous year, 1,176 of them were successful quitters for >6 months., Main Outcome Measures: proportion of smokers who tried to quit; proportion of smokers who successfully quitted., Results: about 35% of smokers made >1 quit attempt in the last year. Northern Italians and smokers with many economic difficulties were more likely to make a quit attempt, whereas heavy smokers were less likely. About 10% of attempters were abstinent for >6 months: from 6% in Campania and Abruzzo to 17% in the Bolzano province. Attempters who smoked <20 cig/die had higher likelihood to be abstinent, compared to those smoking <20 cig/die. Attempters with many economic difficulties had the lowest likelihood to be abstinent (7%), with no differences by region, educational level, quitting method. Attempters with no economic difficulties recorded the highest cessation rates (12%). Among them, those from Northern Italy, Tuscany, Marche, and Lazio (Central Italy), and Apulia (Southern Italy) compared to attempters from most Southern regions, and those with high education level or using traditional quitting methods compared to those using electronic cigarettes or unaided were more likely to be abstinent for >6 months., Conclusions: smokers with many economic difficulties in all Italy, and those with no economic difficulties residing in Umbria and in most Southern Italian regions, except for Basilicata and Puglia, recorded lower chances to quit. Regional differences may have two possible explanations integrating each other: Northern-Central regions are in a slightly more advanced stage in the tobacco epidemic; regions which developed specific tobacco control interventions in their Prevention Plans recorded higher quitting rates. Not-yet-implemented interventions could promote smoking cessation in smokers from Southern Italy and in those with lower socioeconomic status: reimbursement of smoking cessation treatments, a well-developed national Quitline linked to a webplatform and to mobile phone application or text-messaging, an opt-out smoking cessation service offered systematically to all smokers at every encounter in hospitals or health services.

Introduction: Depression may increase the likelihood of adopting behaviors risky to health. Population studies investigating the association between depressive symptoms and behavior-related risk factors are lacking in Italy. The aim of this study was to estimate the prevalence of various self-reported behavior-related risk factors and to study their associations with current depressive symptoms in the Italian adult general population., Methods: Data collected in 2013 from people aged 18 to 69 years participating in the Italian behavioral risk factor surveillance system were used for the analysis. Indicators of no leisure-time physical activity, obesity, cigarette smoking, and excessive alcohol consumption were investigated. Depressive symptoms were explored through the Patient Health Questionnaire-2., Results: In the survey sample of 39,463 participants, 34.4% of adults engaged in no leisure-time physical activity, 26.2% were cigarette smokers, 11.5% were excessive alcohol consumers, and 10.3% were obese. The prevalence of depressive symptoms was 6.2%. People with depressive symptoms were more likely to be physically inactive (adjusted prevalence ratio [APR], 1.13), cigarette smokers (APR, 1.34), obese (APR, 1.27) and excessive alcohol consumers (APR, 1.43) than those without depressive symptoms., Conclusion: The contribution of this study to the existing evidence lies not just in confirming the association between depression and behavior-related risk factors in the Italian context but also in suggesting that programs for simultaneously improving people's mental and physical health should be developed and implemented.

Background: In Italy, organized screening programmes invite the vast majority of the population for cervical and breast cancer, and about one half of the population for colorectal cancer. Programme activity and quality are closely monitored. Nevertheless, there is a vast spontaneous activity, both public and private, for which information on service and coverage is missing. To estimate actual population coverage for the three types of screening the extent of spontaneous screening needs to be known., Methods: PASSI is a national telephone-interview surveillance system that continuously collects information about behavioural health risk factors and the diffusion of preventive health interventions. From 2010 to 2013, more than 151,000 18- to 69-year-olds were interviewed. During 2013, 136 out of 147 Italian local health authorities participated in the survey. Information about screening includes: test uptake (Pap smear, HPV, mammography, faecal occult blood test, colonoscopy), date of the last test, provider of the last test (whether paid or for free, proxy of the organized screening programme), reason for not participating in screening, and screening promotion/recommendation received. Individual information on socio-economic characteristics is available., Results: Seventy-seven percent of the 25-64 year-old women interviewed said they had undergone a Pap smear or HPV test in the three years before the interview, 40%within the screening programme, 37% spontaneously and paying. Seventy percent of the 50-69 year-old women interviewed reported having had a mammography in the two years before the interview, 51% within the screening programme, 19% spontaneously and paying. Thirty-eight percent of the 50-69 year olds interviewed reported having undergone colorectal screening in the two years before the interview, 31% within the screening programme, 7% spontaneously and paying. All three screening programmes showed a decreasing North-South trend in coverage. From 2010 to 2013, coverage increased for all types of screening; the trend was stronger in the South; the increase was mostly due to the tests performed within the organized programmes. People with low education, economic problems, and immigrants from high migration pressure countries had lower coverage levels. In regions with well-implemented organized screening programmes, test coverage was higher and differences for socio-economic factors were smaller than in regions with incomplete programme activation.