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Objective:The present study aimed at surveying the nutritional quality of prepacked biscuits and sweet snacks sold on the Italian market, and at identifying whether the product type and other information reported on the pack could discriminate the overall quality of products analysed.Design:Data on energy, nutrient and salt content of the products from two different categories of prepacked sweet cereal products (i.e. biscuits and sweet snacks) were collected from thirteen retailers present on the Italian market. Based on the product type, nutrition and health claim (NHC) and gluten-free (GF) declaration, a comparison of nutrient profile within each category was performed.Setting:This work is part of the Food Labelling of Italian Products (FLIP) study that aims at systematically investigating the overall quality of the prepacked foods sold on the Italian market.Results:A total of 1290 products were analysed (63 % biscuits and 37 % sweet snacks). After comparing different product types within each category, a high intra-type product variability was evidenced, which was more pronounced for biscuits. Overall, NHC-carrying products seemed to have a better nutrition profile than those without claims, except for salt content. Conversely, a comparison between GF and gluten-containing products did not show consistent results within the two categories analysed.Conclusions:Due to the high intra-type variability within each category, the different characteristics and regulated information reported on the pack do not seem to be a clear marker of the overall nutritional quality of biscuits and snacks.

Background The Mediterranean Diet (MD) is one of the healthy eating plans recommended to promote health and prevent chronic diseases. During the COVID-19 pandemic, many countries adopted restrictive measures to mitigate infection spread, which might have influenced people's lifestyle and dietary habits. We conducted a systematic review to evaluate the impact of stay-at home orders' implementation on adherence to MD. Methods Studies were identified searching Medline, Embase, and Web Of Science, the search strategy was developed using a combination of free text and mesh terms referring to COVID-19 pandemic, lockdown, and MD. Studies published until March 31st, 2021 were included. We only considered studies reporting original data from quantitative analysis and assessing modifications of adherence to the MD through validated dietary scores or any change in consumption of food categories that are typically ascribed to the MD. Data extraction, pooling and quality appraisal of the included studies, were conducted applying PRISMA guidelines. Results 42 studies were retrieved. After duplicates removal, and in-blind two-step screening, 10 studies met our a priori defined inclusion criteria and were included in the review. 71.4% of the studies reporting a rate of change in adherence, measured through validated questionnaire both before and during lockdown, reported an increase, while 28.6% reported no significative changes. All included studies reporting the percentage of participants having a high adherence to the MD, based on their results on MEDAS questionnaire, before and during the lockdown, found an increase in this percentage. Conclusions Adherence to the MD could have raised in people undergoing lockdowns due to COVID-19. Key messages The impact of restrictive measures on determinants of health must be monitored. Despite the literature suggests adherence to MD has declined in the last years, this trend may have reversed or, at least, slowed during the initial phases of the current pandemic.

During the COVID-19 pandemic, many countries adopted restrictive measures to mitigate infection spread, which might have influenced people's lifestyle and dietary habits. We conducted a systematic review to evaluate the impact of national lockdowns on adherence to the Mediterranean Diet (MD).Studies were identified searching Medline, Embase, Web of Science, and the Cochrane Library. Studies published until 4th May 2021 were included. We only considered studies reporting original data from quantitative analysis and assessing changes in adherence to the MD, using validated dietary scores, or in consumption of MD food items. Data extraction, pooling, and quality appraisal of included studies were conducted following the PRISMA guidelines.Forty-two studies were retrieved. After screening, 12 studies met inclusion criteria and were included in the review, of which 4 (33%) were longitudinal studies. Six (85.7%) of the seven studies that measured changes in MD adherence before-during lockdown reported an increase (rate of change of high-adherence to MD ranged between +3.3% and +21.9%). Evidence indicates that consumption of MD food items increased during lockdown but is heterogeneous in study design, quality, and findings.Our results suggest adherence to the MD during lockdown might have increased in some settings, while the determinants of such a trend are to be further explored. We raise awareness of the need to research further the impacts and long-term consequences of COVID-19 containment measures on dietary and lifestyle habits.

Introduction: Breast cancer is the most common cancer in women worldwide, for which the survival rate is increasing over time. Growing evidence is showing that the effect of lifestyle could have the same weight of the effect of the usual clinical-pathological risk factors on survival rate. The DianaWeb study responds to the pressing request of patients diagnosed with breast cancer to know the most advanced point of scientific research on the prevention of recurrences, to have a virtual space to meet, where to receive advice and practical information for the daily management the lifestyle change. DianaWeb is a community-based participatory research, dedicated to breast cancer patients, aimed to monitor lifestyle, provide them tips to encourage sustainable lifestyle changes, and to analyze clinical outcomes. In order to achieve these aims, DianaWeb uses a specific interactive website (http://www.dianaweb.org/). Methods: The web architecture has been designed essential and light, with a rigorous implantation that brings the figure of the woman to the center. In order to humanized the project the acronym used to identify the study was Diana (Diet and Androgens), a classical female name, who was illustrated as a female avatar, aimed to symbolize all women. The graphical interface was developed using seven pastel tones colors, which become a fundamental elements of the layout, such as frame, navigation menu, and separation interspaces. Results: The project started in 2015, and in 4 days the web site was visited by more than 1000 people. A total of 2823 persons enrolled in the study, but 2182 did not send the full documentations, 61 persons abandoned the study, 641 timely answered to the questionnaires. Conclusions: The high number of participants' interaction within the web page, confirmed the high usability of the web page and the great interest of patients. Prevention of breast cancer recurrences with low cost technologies, easily available to everybody, is a priority for both public health and public finances

The packaged foods sold in food stores may be “private-label” products (PL), when branded by the supermarket, and “branded” products (BR). PL products are generally cheaper than the BR counterparts, and this can be perceived as a sign of general low quality by consumers, when items are compared with their branded counterparts. Thus, the aim of the present study was to compare the nutrient content of BR and PL cereal-based foods, by evaluating the nutritional declaration reported on the food pack of products on the home-shopping website of major retailers present on the Italian market. A total of 3,775 items (~58% BR and ~42% PL), collected in the period from July 2018 to March 2019 and updated in March 2020, were included in the final analysis. Data were analyzed by means of the Mann–Whitney nonparametric test for two independent samples for differences between BR and PL categories and types. Overall, BR products showed higher contents of total and saturates than PL items. When products were grouped for categories and types, items only differed for the content of total fats, saturates, total carbohydrates, proteins, and salt. No differences were instead found for energy and sugar contents among any of the categories. However, we did not find any consistency in the direction of results. These results could be useful for future education activities aimed to help consumers in making informed food choices.

Traceability in software engineering is the ability to connect different artifacts that have been built or designed at various points in time. Given the variety of tasks, tools and formats in the software lifecycle, an outstanding challenge for traceability studies is to deal with the heterogeneity of the artifacts, the links between them and the means to extract each. Using a unified approach for extracting keywords from textual information, this paper aims to compare the concepts extracted from three software artifacts: source code, documentation and tests from the same system. The objectives are to detect similarities in the concepts emerged, and to show the degree of alignment and synchronisation the artifacts possess. Using the components of three projects from the Apache Software Foundation, this paper extracts the concepts from 'base' source code, documentation, and tests (separated from the source code). The extraction is done based on the keywords present in each artifact: we then run multiple comparisons (through calculating cosine similarities on features extracted by word embeddings) in order to detect how the sets of concepts are similar or overlap. For similarities between code and tests, we discovered that using pre-trained language models (with increasing dimension and corpus size) correlates to the increase in magnitude, with higher averages and smaller ranges. FastText pre-trained embeddings scored the highest average of 97.33% with the lowest range of 21.8 across all projects. Also, our approach was able to quickly detect outliers, possibly indicating drifts in traceability within modules. For similarities involving documentation, there was a considerable drop in similarity score compared to between code and tests per module - down to below 5%.

The aim of this work is to provide a picture about the problem of childhood obesity and its relationship with mass media and food advertising. Examining scientific literature, we described the epidemiology of obesity focusing on its increase in children and young people. In particular, it will be examined the effects of television advertising addressed to children, in order to explain how it operates and affects children's food choices. Finally, we will provide information about health promotion and prevention strategies to fight obesity both in European Union (EU) and in Italy. For the EU strategies, we considered the 'Action Plane on Childhood Obesity 2014-2020'. In the case of Italy we focused our attention primarily on SIAN (Servizio Igiene degli Alimenti e della Nutrizione) that operate through the local health authorities of the various Italian regions, to promote health. Moreover, we considered the actions that have taken place to reduce the influence of mass media and food advertising on the food habits of children.

Alcohol consumption has a substantial importance in the causation of cancer of the oral cavity, pharynx, liver, colon, rectum; and in women, breast. It is also recognized as an independent risk factor for esophageal squamous cell carcinoma (ESCC). Nevertheless, the association with esophagus adenocarcinoma (EAC) is still not completely defined; as well as the association between alcohol intake and Barrett's Esophagus (BE). The aim of this mini-review is to summarize recent findings from population studies focused on the association between alcohol consumption and risk of BE. The research was carried out in PubMed, filtering for studies conducted in the period 2009-2015. Our mini-review has shown no association between the consumption of alcohol and BE. Some type of alcoholic beverages has shown an inverse association. Direct public health applications of these findings are limited, considering the causal link between moderate-to-heavy alcohol consumption with increased risks of several cancers. Given the rising incidence of BE and EAC, it is important to understand the interplay of dietary and lifestyle factors that influence the development of these conditions.

Vaccines recommendations are available for both healthcare professionals and the general public, but although the vaccination is the most effective method to prevent infectious diseases, the coverage is still behind the recommended rate. In Italy, according to a recent study, the anti-flu vaccination rate among healthcare worker range between 9% to 30%. The aim of our study was to identify knowledge, attitude and behaviours regarding influenza vaccination among community pharmacists in order to increase the coverage rate among healthcare professional. “PErCEIVE (Pharmacist pERCEption on Influenza VaccinE) in Umbria” was a cross sectional survey among community pharmacists in Umbria conducted between 16th November 2015 to 29th February 2016. The questionnaire was anonymous, on-line self-administered survey.Statistical analysis were performed using STATA/SE 12 software. The response rate was 28.91% (n= 72/249). Among the studied population 76.39% (n=55) had never performed influenza vaccine during the previous 5 years. Regarding source of information, only 15.28% of the subjects (n=11) consulted the scientific publications, vs 52.78% (n=38) who did not show any kind of interest upon the influenza vaccine. Our results show a low attitude to be vaccinated among pharmacists together with a low grade of awareness regarding the important role that pharmacists might play in order to reduce influenza burden, to promote health literacy among their patients and to decrease the risk of patients infection. Pharmacists might be crucial healthcare workers involved in health promotion, in vaccines’ uptake and practices progression., Journal of Preventive Medicine and Hygiene, Vol 59, No 1 (2018): 2018591

Breakfast cereals are present on the market as different types and, in general, are one of the food categories in which voluntary information, such as nutrition or health claims (NHC) or gluten free (GF) declarations, have the largest distribution. The aims of the present study were to compare (i) the nutritional declaration among different types of breakfast cereals, as well as among products with and without NHC or GF declarations, and (ii) the salt and sugar contents with the &ldquo, Italian shared objectives for the improvement of the nutritional characteristics of food&rdquo, To this aim, the nutrition declarations of 371 different breakfast cereal items, available in 13 retailers present on the Italian market, were analysed. Data showed an elevated inter-product variability, with cereal bars and muesli having the highest energy, total fat, and saturate contents per 100 g. Limited differences were found comparing products with and without NHC, as well as those with GF declaration. Most of the breakfast cereals were compliant to the shared objectives, although some items with NHC or GF declaration still have sugar or salt contents higher than these objectives. In conclusion, these data suggest that the different characteristics and the regulated information reported on the food label should not be considered as a marker of the overall nutritional quality. Thus, this study supports the importance of reading and understanding the information made on food label.

The WHO Global Action Plan on physical activity underlines the binomial "diet and physical activity" for the maintenance of well-being state. The adequate nutritional intake is required for sport and can be achieved by a well-adjusted diet without adding artificial food supplements, whose abuse can even represent a risk and appear as an antechamber of doping. Within a national doping prevention project, a peer education tool was realized in the form of a book and e-book, based on the principle of the Mediterranean Diet as an effective nutritional support in sport and physical activity. This health-literacy book contains recipes from all Italian regions revised for their capability to satisfy sport nutritional needs.

Aim: To allow children to make healthy nutrition choices through multiple and diversified didactic nutritional game-interventions, focused on knowledge, attitude and behaviour change. Methods: The COcONUT (Children prOmOting NUtrition through Theatre) project will assess the effectiveness of an educational nutritional intervention, based on theatre and a mix of theoretical and practical nutrition workshops, for children (n=20) aged 5-12 years, members of Pro-Pila Association and voluntarily enrolled upon informed consent signed by parents or caregivers. Parents/caregivers will be involved during the proposed activities. The duration of the project will be 1 year. The childrens’ knowledge about nutrition and the food behaviour will be assessed before and after the intervention, through validated self-administrated questionnaires, KIDMED and Zoom8. The final theatre representation will be based on the learned nutritional knowledge and children will be the protagonists of the story. Results: Of the participants (15 children) 60% are female, aged 5-12 years. Preliminary results shown that before the intervention 73% of the children consume at least 1 fruit and vegetable per day, but only 46%-53% respectively more than 1 fruit and 1 vegetable per day. 80% of children eat everyday pasta/rise and 86.6% bread/cereals for breakfast, 40% use industrial backed cake for breakfast, and 13% skip the breakfast. 7% of the children had a low Kidmed Score (0-3), 46% had a medium score (4-7), and 47% had an high score (8-12) (Figure 1). The Kidmed Score mean value is 7.17 for male vs 7.44 for female, with a significant difference p=0.02 (t-test). The expected results, after the intervention, will be: increase in fruit and vegetable consumption; reduction of intake of poor-nutrient energy-dense food and beverages; increase the intake of water rather than sugary drinks; decrease time spent in sedentary activities; develop awareness on healthy eating as a protective factor against chronic diseases. Conclusion: Several evidences shows that funny and active learning is the best way to make children aware about healthy lifestyle in order to prevent obesity and diseases obesity-related. In our community-based study, we involved Pro-Pila association, formed by inhabitants of the same town, because emerging evidence shows that directly involve stakeholders, from civil society and local communities, play a crucial role in the health promotion process.

INTRODUZIONE L’insonnia è definita da International Classification of Sleep disorders, International Classification of Diseases e nel Diagnostic and Statistical manual of Mental Disorders, come esperienza di sonno insufficiente o di scarsa qualità composto da almeno uno dei seguenti: difficoltà a iniziare o mantenere il sonno, risveglio precoce, sonno poco ristoratore. In Italia, lo studio Morfeo 1, rileva una prevalenza pari al 20% con il 44% dei soggetti che presenta anche sintomi diurni. La deprivazione cronica di sonno causa disturbi cognitivi con ripercussioni sulla vita sociale. È noto come anche gli stili di vita incidano, a loro volta, sul sonno. Alcune delle “norme igieniche del sonno” riguardano il fumo, il consumo di caffè e la dieta. La Dieta Mediterranea (DM), con il suo elevato contenuto di triptofano, può influenzare positivamente il sonno e proteggere da stress e ansia. METODO Studio cross-sectional a studenti di Scienze infermieristiche dell’Università di Perugia al fine di valutare la prevalenza di disturbi del sonno e l’aderenza alla DM (calcolo del MedIndex) RISULTATI Hanno completato il questionario 117 studenti su 185 (82 donne e 35 uomini; età media di 24 anni; MedIndex basso 8% e 92% medio; presenza di insonnia nel 20% dei casi) (Figura1). Il basso rendimento accademico (p=0.031) e il sonno non ristoratore (p=0.005) risultano maggiormente frequenti in soggetti con ridotta aderenza alla DM. L’insonnia con sintomi diurni, il dormire

INTRODUZIONE I farmaci antiblastici (AB) sono un gruppo di sostanze chimiche note per il loro effetto mutageno/cancerogeno. Il possibile rischio genotossico da esposizione professionale ha sollevato crescenti preoccupazioni nel personale sanitario coinvolto nella loro manipolazione, nonostante il significativo miglioramento delle politiche di sicurezza. Infatti, molti studi hanno dimostrato, mediante il monitoraggio biologico [micronuclei (MN) o aberrazioni cromosomiche (AC) su linfociti di sangue periferico] un rischio genotossico da esposizione lavorativa. CONTENUTI È stata condotta una revisione meta-analitica degli studi di epidemiologia molecolare, al fine di valutare l’associazione tra esposizione occupazionale ad AB e frequenza di effetti genotossici espressi come MN, nel comparto occupazionale considerato. La ricerca è stata effettuata tramite Pubmed, selezionando lavori sull’uomo in inglese, in extenso, cross-sectional con valutazione degli effetti biologici dell’esposizione ad AB in personale sanitario coinvolto in attività di preparazione, somministrazione e smaltimento, e che riportassero dati medi di gruppo relativi alla frequenza di MN e i corrispondenti indici di dispersione (SD o SEM). La ricerca ha fornito 96 studi di cui solo 25 rispondevano ai criteri di selezione. La maggioranza degli studi evidenziava un incremento statisticamente significativo della frequenza di MN nel personale esposto agli AB, rispetto ai non esposti. La meta-analisi è stata effettuata utilizzando il programma Review Manager (RevMan 5.1) della The Cochrane Collaboration. I risultati sono stati espressi come rapporto delle medie, con lo scopo di poter combinare studi che esprimevano lo stesso end point in modalità differenti. CONCLUSIONE I valori di rischio relativo ottenuti (RoM 1.74 IC95% 1.30-2.33) indicano che la manipolazione di AB determina un incremento dei MN e, in virtù del già noto valore prognostico di tale biomarcatore, lo studio conferma il rischio genotossico nel personale esposto alla manipolazione di AB, rispetto ai non esposti. La manipolazione di tali farmaci coinvolge varie figure professionali e il successo degli interventi di prevenzione è legato alla conoscenza del rischio sulla salute e dei metodi disponibili per prevenire la contaminazione.

Our chapter explores the US Food and Drug Administrations (USFDAs) regulation of medical foods, a growing industry that lies between pharmaceutical drugs and food.In addition to an overall discussion of the short regulatory history of medical foods, we cover the agencys recently released revised draft guidance and other regulatory requirements for medical foods, including the applicable Current Good Manufacturing Practices and import/export requirements, as well as FDAs enforcement actions to date.

Modeling the power profile of mobile applications is a crucial activity to identify the causes behind energy leaks. To this aim, researchers have proposed hardware-based tools as well as model-based and software-based techniques to approximate the actual energy profile. However, all these solutions present their own advantages and disadvantages. Hardware-based tools are highly precise, but at the same time their use is bound to the acquisition of costly hardware components. Model-based tools require the calibration of parameters needed to correctly create a model on a specific hardware device. Software-based approaches do not need any hardware components, but they rely on battery measurements and, thus, they are hardware-assisted. These tools are cheaper and easier to use than hardware-based tools, but they are believed to be less precise. In this paper, we take a deeper look at the pros and cons of software-based solutions investigating to what extent their measurements depart from hardware-based solutions. To this aim, we propose a software-based tool named PETRA that we compare with the hardware-based MONSOON toolkit on 54 Android apps. The results show that PETRA performs similarly to MONSOON despite not using any sophisticated hardware components. In fact, in all the apps the mean relative error with respect to MONSOON is lower than 0.05. Moreover, for 95% of the analyzed methods the estimation error is within 5% of the actual values measured using the hardware-based toolkit.

Code smells are symptoms of poor design solutions applied by programmers during the development of software systems. While the research community devoted a lot of effort to studying and devising approaches for detecting the traditional code smells defined by Fowler, little knowledge and support is available for an emerging category of Mobile app code smells. Recently, Reimann et al. proposed a new catalogue of Android-specific code smells that may be a threat for the maintainability and the efficiency of Android applications. However, current tools working in the context of Mobile apps provide limited support and, more importantly, are not available for developers interested in monitoring the quality of their apps. To overcome these limitations, we propose a fully automated tool, coined ADOCTOR, able to identify 15 Android-specific code smells from the catalogue by Reimann et al. An empirical study conducted on the source code of 18 Android applications reveals that the proposed tool reaches, on average, 98% of precision and 98% of recall. We made ADOCTOR publicly available.

The Erice Charter was unanimously approved at the conclusion of the 47th Residential Course "Adapted Physical Activity in Sport, Wellness and Fitness: New Challenges for Prevention and Health Promotion", held on 20-24 April 2015 in Erice, Italy, at the "Ettore Majorana" Foundation and Centre for Scientific Culture, and promoted by the International School of Epidemiology and Preventive Medicine "G. D'Alessandro" and the Study Group on Movement Sciences for Health of the Italian Society of Hygiene, Preventive Medicine and Public Health. After an intense discussion the participants identified the main points associated with the relevance of physical activity for Public Health, claiming the pivotal role of the Department of Prevention in coordinating and managing preventive actions. The participants underlined the importance of the physicians specialized in Hygiene, Preventive Medicine and Public Health. The contribution of other operators such as physicians specialized in Sport Medicine was stressed. Further, the holders of the new degree in Human Movement and Sport Sciences were considered fundamental contributors for the performance of physical activity and their presence was seen as a promising opportunity for the Departments of Prevention. Primary prevention based on recreational physical activities should become easily accessible for the population, avoiding obstacles such as certification steps or complex bureaucracy. The Sport Doctor is recognized as the principal referent for preliminary physical evaluation and clinical monitoring in secondary and tertiary prevention actions based on adapted physical activities. Developing research in the field is essential as well as implementing higher education on physical activity management in Schools of Public Health.