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Background Prisoners spend most of their time in restricted environments, with strong limitations on freedom and social relationships. Inmates that committed sex crimes (sex-offenders) are subject to limitations more restrictive than other inmates. Physical inactivity is very common in these populations, with negative effects on both physical and mental health. Interventions that contrast physical inactivity are strongly encouraged in this context. Methods A health promotion intervention was carried out in the prison of Cassino (central Italy) in 2019. This intervention aimed to promote prisoners' health and physical activity, and increase their life skills. Intervention sessions, which included body awareness and proprioceptive exercises, were carried out two times a week for about 9 months. Focus group interviews were carried out with 9 sex-offenders and, separately, with 20 other inmates, exploring the topics of self-perceived health, and impact of the health promotion intervention. Results Both groups reported feelings of psychological stress and anxiety, leading to increases in cigarette smoking and excessive food consumption. Several focus group participants felt the need to do physical activity on a regular basis and they asked for sport facilities and programs. Sex-offenders reported that the health promotion intervention helped them fill the time, enjoy and relax, while non sex-offenders reported an increase in physical fitness and viewed this intervention as an opportunity of social rehabilitation. Conclusions Imprisonment leads to negative health behaviours, such as physical inactivity, cigarette smoking, and excessive food consumption, particularly among sex-offenders that are subject to stronger limitations than other inmates. Interventions that promote physical activity among prisoners may have positive effects on prisoners' physical fitness and mental health.

Background Studies on adolescent secondhand smoke exposure within the family often dichotomously operationalize migration background without paying attention to social and cultural diversity within migrant populations. As a result, little is known about variation within migrant groups in smoke-free family environments (SFFEs). This study analyses the association between SFFEs and parental migration from different world regions. Methods Data from 14- to 16-year-old adolescents (N = 17 144) on SFFEs and parental migration were obtained from cross-sectional repeated SILNE-R surveys. A multivariable multinomial regression was applied, presenting relative risks (RRs) with 95% confidence intervals (CIs) for maternal or paternal tobacco smoking and home smoking bans. Variation in migration background was measured according to parental sex and place of birth. Results Approximately 18% of adolescents are exposed to maternal smoking, and 25% are exposed to paternal smoking. Almost half of the respondents do not live in SFFEs but are subject to permissive (5%) or partial (39%) smoking bans at home. We found that adolescents of Eastern European descent are at a higher risk of being exposed to both paternal and maternal smoking. A sex difference in parental smoking was found among Arabic/Islamic migrants, where mothers are less likely to be smokers. Maternal and paternal African origins are associated with prohibitive smoking bans at home. Eastern European mothers show higher odds of permissiveness and freely allowing smoking at home. Conclusion Notable within-differences according to parental sex and place of birth were found for SFFEs and should be taken into account when implementing equity-sensitive tobacco prevention programs.

The Coronavirus pandemic has affected the lives of people all over the world. The perception of risk and people’s consequent behaviour during a pandemic are very complex and are affected by multiple cultural and psychological factors. The aim of this study was to investigate the change in risk perception, perceived self-efficacy and the perceived trust in the behaviour of others, the decisions of health authorities and government provisions, as well as the variation of self-restraint behaviours during the spread of the Covid-19 epidemic in Italy. We used a convenience sample of 707 university students (Mage = 22.99, SD = 4.01) from a central area of Italy. Participants freely joined the research by answering an online questionnaire between February and March 2020. Three time intervals defined by the progressive containment measures implemented by the Italian Government were considered. Main outcome measures were the Generalized Self-Efficacy Scale, the Risk Perception Index, the Index of Self-restraint Behaviours, and Institutional and Interpersonal Trust Measures. Results confirmed that significant changes in the time progression have occurred in the perception of risk, in the perception of individual self-efficacy, in the value attributed to social responsibility, in interpersonal trust and in trust in health authorities. The study also identified the participants’ personality traits and locus of control as predictors (positive and negative) of perceived self-efficacy and tested a mediation model of trust on the effect of risk perception on self-restraint intentions.

Background Secondhand smoke exposure is responsible for over half a million premature deaths. With regulation now reducing smoking in most public enclosed spaces, one major source of indoor exposure remains the home environment. Home smoking bans (HSBs) are household rules that restrict smoking from certain (partial HSB) or all areas (complete HSB). Recent data suggest growing trends of HSB adoption over time, but it is not known whether time trends vary according to household characteristics. Objectives The aim of this study is to examine changes in the prevalence of HSB in six European cities between 2013 and 2016, according to socioeconomic characteristics of the household and smoking behavior of household members. Methods Data were collected in all schools participating in both waves of SILNE study in 6 European cities. A self-administered questionnaire was used, targeting students age 14 to 16 (n = 22,326). Students reported their parents’ smoking status and if there was a HSB at their home. Detailed information on socio-economic characteristics were collected as well. Results Between 2013 and 2016 the percentage of households with a complete HSB increased from 51.5% to 53.1%, while partial HSB increased from 30.7% to 32.1%. The prevalence of HSB increased in Hannover (G), Latina (I), Amersfoort (N) and Coimbra (P), whereas decreased in Namur (B) and Tampere (F). Socioeconomic differences in HSB were reduced, with larger increases in HSB in households with a lower parental educational level. Increases in HSB were observed among intact households, those without migration background and those with non-smoking parents. Conclusions The increase in the prevalence of HSB observed in most cities and throughout a variety of household types and characteristics between 2013 and 2016 may reflect the effect of smoking denormalization in different social contexts. Further actions of the tobacco control community should target the most vulnerable groups. Key messages The percentage of households with a complete HSB increased between 2013 and 2016 in 4 out of 6 European cities. Increases in the prevalence of HSB over time were observed across all socio-economic groups.

A systematic review was undertaken to produce an annotated bibliography of meta-analyses in vaccinology and to evaluate their methodological quality. Based on our evaluation using the Oxman and Guyatt index, the methodological quality of the 121 meta-analyses included in this study is not satisfactory. The most frequent limitations include non-comprehensive bibliographic research; bias in the selection of the studies; lack of quality assessment of individual studies; absence of evaluation of heterogeneity among studies and publication bias. The methodological quality significantly increases with the year of publication and with declared financial support, without differences between profit and non-profit support. Meta-analyses with a higher Oxman and Guyatt quality score are more likely to include only randomized trials and to explore appropriately potential sources of heterogeneity. Most of the methodological deficiencies of meta-analyses in vaccinology could be corrected easily, and meta-analysts should improve the methodological quality of their work to maintain their impact on policy decisions.

Background Movie characters are often shown as engaging in unhealthy behaviours, such as smoking tobacco and drinking alcohol, in order to emphasize some personality characteristics, such as glamour and coolness. The frequency with which popular movie characters are shown while taking these risky behaviours may be an indicator of their social acceptability. James Bond’s movies depict a character whose charm and popularity have remained unaltered for half a century. This study aimed at evaluating whether time trends of …

BackgroundThe purpose of this study was to investigate whether paediatricians have appropriate knowledge, attitudes, and behaviours regarding vaccinations for infants in Italy.MethodsA random sample of 500 paediatricians received a self-administered anonymous questionnaire covering demographic and professional characteristics; knowledge about the mandatory, recommended, and not indicated vaccinations for infants; attitudes about vaccinations for infants; behaviour regarding current administration or willingness to administer mandatory or recommended vaccinations for infants and immunization education programs of the parents.ResultsOnly 42.3% paediatricians knew all recommended vaccinations for infants and this knowledge was significantly higher in females, in those who worked a higher number of hours for week, and in those who use guidelines for immunization practice. Only 10.3% had a very favourable attitude towards the utility of the recommended vaccinations for infants and this was significantly higher in those who administered recommended vaccinations for infants. A large proportion (82.7%) of paediatricians routinely informed the parents about the recommended vaccinations for infants and this appropriate behaviour was significantly higher among younger, in those with a higher number of years in practice, and in those who administered the recommended vaccinations for infants.ConclusionTraining and educational interventions are needed in order to improve knowledge, attitudes, and behaviours regarding vaccinations for infants among paediatricians.

Summary Objectives To analyse and compare the microbiological quality of the water in rehabilitation and recreational swimming pools in Naples, Italy. Study design A 2-year survey investigated the microbiological quality of the water in seven recreational and rehabilitation pools, and the findings were compared with local guidelines. Methods For each facility, water was sampled at the intake point and at two points inside the pool. Total microbial contamination and Pseudomonas aeruginosa contamination were evaluated. Results Microbial mesophilic contamination and P. aeruginosa contamination were found in all seven pools. Microbial mesophilic contamination was more common in recreational pools (3–4.2% samples were above threshold values), probably due to the greater number of bathers. P. aeruginosa was more common in intake water than water inside the pool [mean values of 19.3 and 22.5 colony-forming units (cfu)/ml in recreational and rehabilitation pools, respectively]. A longer period of contact with chlorine and the dilution process may have led to lower levels of P. aeruginosa in the pool water (range 2–15 cfu/ml). Conclusions There is a need to improve disinfection and cleaning procedures, with consideration given to the different uses and daily bather loads of each pool type. There is also a need to monitor water quality and to increase users' knowledge and awareness of the risks.

A prevalence study was conducted to evaluate Staphylococcus aureus nasal colonization in two groups of injection drug users recruited at two drug addiction treatment centres in Rome and Frosinone (Italy). Prevalence of Staphylococcus aureus nasal colonization in the 181 subjects included in the study was 8.83%. Significantly increased carriage rates were found among drug users in Frosinone with respect to those in Rome. No other significant determinants of colonization were identified through multiple logistic regression analysis. Only 2 of 16 Staphylococcus aureus strains (12.5%) were found to be methicillin resistant. Genomic DNA restriction pattern analysis, through SmaI digestion and pulsed field gel electrophoresis, demonstrated wide genetic heterogeneity among the isolates. Although the great majority of PFGE patterns were found in single isolates, in some cases common patterns were identified in isolates obtained from different drug users, clearly indicating the possibility of interhuman transmission of Staphylococcus aureus in this population.

Background Water coolers are popular in office buildings and commercial stores and the quality of this source of drinking water has the potential to cause waterborne outbreaks, especially in sensitive and immunocompromised subjects. The aim of this study was to determine the quality of water plumbed in coolers from commercial stores in comparison with tap water in Italy. Methods For each sample, microbial parameters and chemical indicators of contamination were evaluated and information about the date of installation, time since last ordinary and extraordinary maintenance of water coolers was collected. Results In all samples the chemical parameters (nitrite, ammonium, free active chlorine residual) did not exceed the reference values of the drinking water regulation; the pH value in 86.8% samples of the carbonated waters was lower than the reference limit. The microbiological results indicated that the bacteria count at 22°C and 37°C was higher than the required values in 71% and 81% for the non-carbonated water and in 86% and 88% for the carbonated one, respectively. Enterococcus spp. and Escherichia coli were not detected in any of the water samples. Pseudomonas aeruginosa was found in only one sample of the tap water and in 28.9% and 23.7% of the non-carbonated and carbonated water samples, respectively. No statistically significant differences in bacterial counts at 22°C and 37°C have been found between the non-carbonated and carbonated water from the sampled coolers in relation with the time since the last filter was substituted. The bacteriological quality of tap water was superior to that of non-carbonated and carbonated water from coolers. Conclusion The results emphasize the importance of adopting appropriate routinely monitoring system in order to prevent or to diminish the chances of contamination of this water source.

Background: Genomic DNA patterns generated by pulsed-field gel electrophoresis (PGFE) are highly specific for different strains of an organism and have significant value in epidemiologic investigations of infectious disease outbreaks. A disadvantage of PFGE is that the procedure requires up to 6 days to complete.Methods: We developed a rapid PFGE protocol for subtyping Legionella pneumophila isolates based on the standardized protocol currently used. Various combinations of reaction conditions (e.g., lysis time and temperature, restriction enzyme concentration) and electrophoresis parameters were applied to devise a simple and rapid PFGE protocol that could also be used for frozen bacteria.Results: PFGE analysis of Legionella pneumophila isolates can be completed in 26 hours using this protocol compared to 6 days for the conventional one.Conclusions: We successfully applied a rapid PFGE protocol for Legionella pneumophila typing and comparison of the patterns obtained from the rapid compared with the conventional method showed that the rapid protocol gave identical and highly reproducible results.