Adele Anna Teleman

Nutritional habits in Italian university students

INTRODUCTION Dietary habits have been indicated by research as key elements in both disease pathogenesis and prevention and health promotion. MATERIALS AND METHODS We analyzed data collected from Italian university students regarding consumption of fruits, vegetables, fast-foods, sweets, energizing drinks, and coffee, average number of eating episodes per day and regularity of breakfast habits. RESULTS 44% of the university student population eats in average at least 1 portion of fruit per day. 22.5% eats at least 2 portions of vegetables per day. 8.5% eats in average 5 times per day with 48.6% declaring an average of 3 eating episodes per day. 11.3% consumes eccessive amounts of caffeine. 49.1% of the females reaches the recommended consumption of fruit, compared to only 33.8% of males (p < 0.05). 27.7% of females eats at least 2 portions of vegetables per day, compared to 12.0% of males (p < 0.05). Eccessive coffee drinkers pass from 8.9% in the 18-21 age group to 16% in the 25-30 year old age group (p < 0.05). DISCUSSION This study showed that the eating habits of young adults do not follow national recommendations. Less than 50% of university students eats at least 1 portion of fruit per day and less than 1 out of 4 eats at least 2 portions of vegetables per day. Less than 10% of the students eats in average 5 times per day and more than 1 out of 3 does not have breakfast regularly every morning. CONCLUSION Interventions targeting university students are required in order to increase their knowledge on healthy eating habits and to ameliorate their dietary behaviours.

Are undocumented migrants’ entitlements and barriers to healthcare a public health challenge for the European Union?

Undocumented migrants (UMs) are at higher risk for health problems because of their irregular status and the consequences of economic and social marginalization. Moreover, the emergent reality of undocumented migration in Europe calls for action in the field of management of UM’s health demands as their access to health services has become a sensitive political and social issue. In this light, this paper aims to address UMs’ entitlement and barriers to healthcare and related policies citing evidence from peer-reviewed and grey literature concerning people living in a country within the European Union without the legal right to be/remain in the destination country. A systematic review was performed using several databases and websites, and a total of 54 publications in English, with full text available, were taken into consideration.Between 2000 and 2015, Europe hosted the second largest number of international migrants (20 million, 1.3 million per year) after Asia. Even though there is limited evidence specifically focused on UMs’ health, it is possible to state that infectious diseases, chronic illnesses, mental disorders, maternal-child conditions, dental issues, acute illnesses and injuries are the most common pathologies. In most cases across Europe, UMs have access only to emergency care. Even in countries where they are fully entitled to healthcare, formal and informal barriers hinder them from being or feeling entitled to this right. Socio-cultural barriers, such as language and communication problems, lack of formal and informal social and healthcare networks and lack of knowledge about the healthcare system and about informal networks of healthcare professionals are all common impediments. From the healthcare providers’ perspective, there can be difficulties in providing appropriate care and in dealing with cultural and language barriers and false identification. Communication strategies play a central role in addressing the inequalities in access to healthcare services, and the definition and provision of specific training, focused on UMs’ health needs, would be desirable.Improving access to healthcare for UMs is an urgent priority since the lack of access is proven to have serious consequences for UMs’ health and wellbeing. Notwithstanding, few available examples of policies and best practices aimed at overcoming barriers in the delivery of healthcare to UMs are available.

HTA of genetic testing for susceptibility to venous thromboembolism in Italiy

Venous thromboembolism (VTE) is a condition in which a thrombus (a solid mass of blood constituents) forms in a vein. VTE represents an extremely common medical problem manifested as either deep venous thrombosis (DVT) or pulmonary embolism (PE) affecting apparently healthy as well as hospitalized patients. Often PE is the physiopathological consequence of the DVT of low extremities vessels, in particular of the calve......

Placebo-controlled trials in pediatrics and the child’s best interest

For too long children have received medicines not sufficiently studied for their needs and, in fact, being considered as small replicas of adults, it was deemed sufficient to adjust the dosage of a drug approved for adults. Together with the limited availability of appropriate drug formulations, especially for neonates and toddlers, this approach has caused increased iatrogenic risk and/or suboptimal adherence to treatment. With the aim of encouraging the development of more efficacious and safer medicines for children, the Regulatory Agencies in Europe and U.S.A. commendably issued directives to promote adequate and well controlled pediatric clinical trials. In compliance with the agenda of the Pediatric Regulation, in the past decade the number of pediatric patients enrolled in double-blind randomized clinical trials (RCTs) is markedly increased. In order to establish the efficacy of new medicines, RCTs frequently include a placebo-control group that carries the burden of additional, and to some extent underestimated, ethical concerns with respect to trials in adults. Six years into the Pediatric Regulation implementation, off-patent drugs, most of which at present are extensively used off-label, are underrepresented in ongoing/proposed pediatric RCTs. We debate this status quo to assess what might be the child’s best interest. In fact, we argue that well-designed studies, in which efficacy and safety of new drugs are compared to off-patent drugs that are currently prescribed off-label, would achieve the aim of the Pediatric Regulation better and more ethically than placebo controlled RCTs.

Female genital mutilation of minors in Italy: is a harmless and symbolic alternative justified?

In 2004, Omar Abdulcadir - a gynecologist of the Centre for the prevention and therapy of female genital mutilation (FMG) at the Careggi Hospital (Florence) - proposed a “harmless and symbolic” alternative to FMG, which consists in the puncture of the clitoris under local anesthesia, in order to allow the outflow of some drops of blood (1). The intention behind the symbolic alternative is to avoid more severe forms of FGM while respecting cultural heritage. The proposal of this alternative procedure, which was sustained by the leaders of 10 local African immigrant communities, has encountered ample criticism (1). However, the question is: is the puncture of the clitoris prohibited by the Italian Law n. 7/2006? If it is not, could it be considered a method of reducing health risks caused by the more invasive forms of FGM (2)? Or could it culturally legitimize FGM, causing a greater difficulty in the attempts to prevent and eradicate FGM in Italy?

HVAC Management in Health Facilities

The errors in the design, installation and maintenance of an air-conditioning system within a health facility appear to have consequences that are more serious and complex than those that can be generally hypothesized and verified in the case of residential facilities or offices. This is also due to the presence in hospitals of patients with immune system deficiency. The use of a risk matrix can help to evaluate and better manage the HVAC (Heating, Ventilating and Air-Conditioning) system in healthcare facilities, also allowing to answer questions relating the need to clean the air-conditioning systems. In fact, the latter is associated not only with the reduction of microorganisms, but also with the risk of spreading microorganisms and chemical particles in the environment.

Environmental Pollution by Benzene and PM10 and Clinical Manifestations of Systemic Sclerosis: A Correlation Study

Atmospheric air pollution has been associated with a range of adverse health effects. The environment plays a causative role in the development of Systemic Sclerosis (SSc). The aim of the present study is to explore the association between particulate (PM10) and benzene (B) exposure in Italian patients with systemic sclerosis and their clinical characteristics of the disease. A correlation study was conducted by enrolling 88 patients who suffer from SSc at the Fondazione Policlinico “A. Gemelli” in Rome (Italy) in the period from January 2013 to January 2014. The average mean concentrations of B (in 11 monitoring sites) and PM10 (in 14 sites) were calculated using data from the Regional Environmental Protection Agency’s monitoring stations located throughout the Lazio region (Italy) and then correlated with the clinical characteristics of the SSc patients. Of the study sample, 92.5% were female. The mean age was 55 ± 12.9 years old and the mean disease duration from the onset of Raynaud’s phenomenon was 13.0 ± 9.4 years. The Spearman’s correlation showed that concentrations of B correlate directly with the skin score (R = 0.3; p ≤ 0.05) and inversely with Diffusing Lung Carbon Monoxide (DLCO) results (R = −0.36; p = 0.04). This study suggests a possible role of B in the development of diffuse skin disease and in a worse progression of the lung manifestations of SSc.

Cooperating to improve healthcare in Arab countries

This brief note presents a few examples of successful health collaboration to improve healthcare in Arab countries. Considerable growth has been noticed in the past years in the health sector of the Middle East and North Africa region countries due to the need to address health service capacity gaps and improve the quality of health infrastructure. The rising population coupled with the aging demographic is expected to drive healthcare demand in the Arab region, augmenting its demand. In order to meet this demand, a lot of progress within the public sector has been made and several initiatives have taken place to create awareness of the most common diseases affecting the region. Among the steps undertaken in order to face the shortage of experience of medical personnel and the rising cost of the delivery of health services, the most noticeable ones relate to major investments within the realm of healthcare provision. However, country-specific drivers of disease burden should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. Moreover, health gains will need to be sustained by supporting interventions on income, education, and fertility as drivers of health improvement.

Female-male differences in health-related behaviours in the Italian university student population: Perspectives from the “Sportello Salute Giovani” Project

Summary. This paper discusses the female-male diff erences in health status, health-related behaviours and self-perceived health of a large sample population of Italian university students enrolled in the “Sportello Salute Giovani” Project (SSGP). The Italian Health Behaviours in School-aged Children (HBSC) questionnaire was modifi ed by a committee of university professors and experts of the Italian National Institute of Health in order to adapt it to the university age range. The fi nal questionnaire consisted in 93 multiple choice questions and was distributed in 10 Italian universities. 8516 university students were included in the survey (67% were females). Signifi cant diff erences were found between females and males in almost all the healthrelated behaviours explored in the study. A great diff erence was found in the nutritional habits, where females generally seem to pay more attention to healthy behaviours. However, females show to suff er more from stress, to have a lower level of acceptance of their own bodies and to have a lower level of self-perceived health. Males have a higher tendency for risky behaviour and need to become more aware of the importance of routine andrological examinations. It would be appropriate to develop and implement health promotion and disease prevention strategies that are specifi cally targeted in order to address the sex-specifi c diff erences that have been observed.