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Phosphazene (t-butylimino-tris(dimethylamino)phosphorane (P1-t-Bu), t-butylimino-tris(pyrrolidino)phosphorane (BTPP)) and amidine (1,8-diazabicyclo[5.4.0]undec-7-ene (DBU)) superbases have been investigated as catalysts in the direct reaction of pyrrole with dimethyl carbonate (DMC). The system phosphazene/pyrrole/DMC proves to be a flexible synthetic tool, as it offers a solution not only for the direct and selective phosgene-free synthesis of 1-methoxycarbonyl pyrrole (1), but also for the straightforward and selective synthesis of 1-methylpyrrole (2) through a safer way which avoids the use of harmful methylating agents such as methyl halides and (MeO)2SO2. The influence of factors (temperature, catalyst loading, reaction time, etc.) affecting yields and selectivities has been investigated. We have also ascertained that a major reaction pathway to the formation of 2 involves the decarboxylation of the primary product 1. Also this process was catalytically promoted by the phosphazene catalyst. Co-generated CO2 opened a way to the deactivation of phosphazene catalyst, which converted mainly into catalytically inactive OP(NR2)3 (NR2 = NMe2, NC4H8).

Carbonic acid diesters have been investigated as carbonylating agents in the direct reaction with pyrrole (HetNH). In the presence of superbases (DBU, P1-t-Bu, BTPP) as catalysts, the heteroaromatic substrate can be N-carbonylated by direct reaction with carbonic acid diesters under not-severe experimental conditions. The carbonylation reaction makes accessible pyrrole N-carbonyl derivatives (HetNC(O)OR, (HetN)2CO) selectively through a simple straightforward way, which offers a safe eco-friendly alternative to the traditional synthetic methods based on hazardous phosgene or phosgene-derivatives.

The onset of cigarette smoking and alcohol con-sumption during early adolescence is of criticalsignificance since it may contribute to the devel-opment of a variety of diseases. Indeed, there is astrong link between smoking and alcohol consump-tion and the increasing mortality and morbidityrates of respiratory and cardiovascular diseases,cancer, and psychiatric disorders. In Italy, greatattention has been paid to prevention strategiesaimed at communicating health risks and reducingconsumption, and recently the parliament enactedmore comprehensive and aggressive tobacco con-trol legislation, which included restrictions onsmoking in all public settings and an increase inthe price of a packet of cigarettes.The purpose of this study was to evaluate theprevalence of cigarette smoking and alcohol con-sumption, and the knowledge concerning theirhealth effects among adolescents in Italy.This study was conducted from October toDecember 2002, involving 700 adolescents aged14–18 years randomly selected from randomlyselected public secondary classes in the city ofCatanzaro, Italy. Students completed an anon-ymous self-administered questionnaire in the class-room; participation was voluntary after providinginformed consent. The questionnaire includeditems on: socio-demographics; past and currentcigarette smoking and alcohol consumption beha-viour; knowledge and main sources of informationon the health effects of active and passivecigarette smoking and of alcohol consumption;number of adult family members and close friends

Objective: Sexually transmitted infections (STI) among adolescents continue to be an important public health problem for many industrialized and developing countries. This study evaluated knowledge and behaviour in adolescents regarding prevention of STI. Methods: Informationwasobtainedbyusingself-reportedquestionnairefromarandomsampleof644undergraduatestudents at university and at public high schools aged 14–20 years in Catanzaro (Italy). Results: Only 14.2% of respondents knew about the main STI and that they can be transmitted through sexual intercourse with HIV seropositive partners; this knowledge was significantly higher among adolescents who had had a higher number of sexual partners in their lifetime and who had received information from physicians about STI. A total of 33.8% reported having had sexual intercourse at least once and the mean age at first intercourse was 16 years. Older males and adolescents with employed mothers were more likely to have reported having had a sexual experience. The prevalence of using condoms every time during sexual intercourse was 51.8% and such behaviour was more likely in younger adolescents and males. The prevalence of condom use on the last occasion of sex was 71.9%. Younger adolescents, those with a higher perception of the risk of contracting STI and those with lesser knowledge about STI were independent predictors for using condoms. The mean total score of the respondents’ perception of a risk of contracting STI was 5.8. Conclusions: Evidence to develop and implement strategies with the hope of improving adolescents’ level of knowledge and reducing unsafe sexual practices. Sexually transmitted infections (STI) among adolescents continue to be an important public health problem for many industrializedanddevelopingcountries.Thesehaveseriousconsequences for women, including pelvic inflammatory disease, ectopic pregnancy, infertility and cervical cancer. International surveillance data indicate that 70% of those with STI are aged between 15 and 24 years and the World Health Organization estimates that one in every 20 ‘teenagers’ contracts an STI each year. In addition, roughly one in four adolescents between the ages 13 and 19 years who have sexual intercourse acquire an STI each year. In the USA, reported STI rates are the highest in the industrialized world. In Italy, the prevalence of several STI is unknown and of the 51172 cases of AIDS reported by 31 December 2002, approximately 200 were in the area of this study; whereas, of the 793 and 1363 cases for syphilis and hepatitis B respectively, zero and nine cases have been reported. However, reported disease rates grossly underestimate the true burden of infection, both because most STI are asymptomatic and because of underreporting. The understanding and prevention of STI among adolescents represent a critical aspect of minimizing the risk of sexual transmission and of reducing the frequency of STI. Information on the sexual practices of adolescents and, in particular, on knowledge and behaviour about the risk related to unprotected sexual intercourse would permit the spread of knowledge of these preventive measures. Compared to the extensive reports available on other epidemiological aspects of the STI, limited research has been devoted to studying these aspects over the last decade.

The study investigated the use of, attitudes towards, and adherence to motorcycle helmets in a group of adolescents. A random sample of 412 adoles- cents (14-19 years old) attending randomly selected public secondary classes in Catanzaro (Italy) received a questionnaire consisting of questions on socio-demo- graphics, patterns of motorcycle use, frequency of hel- met use, helmet use by adult family members and close friends who are motorcyclists, attitudes towards helmet use and number of traffic-related motorcycle accidents in the last year. A total of 387 adolescents participated. The frequency of self-reported helmet use as a driver of the motorcycle or as the passenger was 34.7% and 33.7% respectively. Routine helmet use was greater for adolescents from households in which at least one family member wore a helmet, for youths who agreed that helmet use should be mandatory, and for those who did not experience an accident in the past year. Regression analysis of the attitude models indicated that the youn- ger the age, the more willing an adolescent would be to believe that helmet use reduced the risk of head injuries and the positive attitude that helmet use should be mandatory was higher in younger adolescents and in those who had no road accident within the past year. A total of 17% reported that they had an accident during the last 12 months of the study period and 30 of them presented motorcycle-related injuries. Conclusion: The development of programmes on helmet use starting as early as primary school is strongly needed.

Objective. The objective of this study was to measure inappropriateness of admission and inpatient days in pediatric hospital wards in Catanzaro, Italy, and the effect of different variables on such inappropriateness.Design. A retrospective application was made using the Pediatric Appropriateness Evaluation Protocol list of criteria. For each patient, there were recorded data on: sociodemographic characteristics; distance from home to hospital; date, day of the week, ward, and type of admission; overall and pre-index day length of hospital stay; and location within the stay of the day reviewed.Results. A total of 656 children were reviewed. Overall, 30% of the hospital admissions and 55.5% of days of stay were judged to be inappropriate; for about one third of those admitted inappropriately, the hospital stay was judged to be appropriate. Multiple logistic regression analysis indicated that the inappropriate admission was significantly higher if the admission occurred during the daytime. The inappropriate number of days of hospitalization was significantly higher if the patient was female, if the admission was urgent, in medical wards, for patients who were inappropriately admitted, and for those sampled close to discharge. The main reasons for inappropriate use were hospital organization and an over-cautious physician in the management of a patient.Conclusions. The high degree of inappropriate admission or days of stay in pediatric wards and the reasons for such unnecessary hospital use suggest the need for a more vigilant interaction between hospital and community-based services to mitigate such inappropriateness and for a continuing education system to define standardized guidelines.

Summary Objective This study assessed knowledge and sexual behaviour regarding sexually transmitted infections (STIs) among female sex street workers in the area of Milan, Italy. Methods A questionnaire was administered covering socio-demographic characteristics; knowledge about STIs; sexual behaviour. Results A total of 241 female sex street workers were interviewed. A vast majority knew AIDS and syphilis, whereas the knowledge about other STIs was unsatisfactory. Only 11.7% knew that STIs are transmitted by sexual intercourse with HIV seropositive partners, by unprotected sexual intercourse, and that kissing was not a mode of transmission. This knowledge was significantly higher in female sex street workers with a higher number of years in sex work and among those who received information from physicians and associations about STIs. The mean score of fear for contracting STIs was 7.5 and being younger, practicing prostitution for shorter period of time, and requiring more information about STIs were significantly associated with this fear. ‘Ever condom use' was 100% during anal intercourse with clients; whereas only one woman reported vaginal and oral intercourse without condom. Only 15.2, 16.7, and 30% of those engaged in vaginal, oral, and anal intercourse with a non-paying sexual partner used condoms all the times. Overall, 83.5% of female sex street workers used a condom every time with clients or non-paying partners and those with fewer clients and partners routinely were more likely to use it. Conclusion Interventions for preventing STIs and for improving the level of knowledge of STIs among female sex street workers are strongly needed.