搜索结果：Journal of preventive medicine and hygiene

The arrival of Cholera Morbus in Europe and Italy elicited a prompt institutional reaction. Starting in 1831, preventive measures characteristic of the plagues of the "Ancien Régime" were reactivated. The new disease triggered several instinctive and irrational reactions in the population, which resulted in the most diverse fears: fear of death, of doctors, of food, isolation, and abuse of food and alcohol. Ignorance of the origin of the disease, its etiology and modes of transmission meant that containment measures and treatment were often inefficacious. When patients recovered from the disease, this was due more to their living conditions and underlying state of health than to medical treatment, which was still limited to bloodletting, purgatives, and natural remedies (as emerges from the data from 1835 in the archives of the Genoese hospitals). As revealed by the pamphlets distributed around 1830, the disease was attributed to dietary disorders, personal and domestic hygiene, damp environments, menial occupations, and exposure to cold.The medical theories of the time were still closely bound to the "miasmatic-humoral paradigm", as the discoveries of Filippo Pacini, (1812-1883), John Snow (1813-1858) and Heinrich Hermann Robert Koch (1843-1910) had not yet been made. As for preventive measures at the institutional level, "contagionist" theories prevailed, which meant that sanitary cordons were reintroduced, safety measures (e.g. quarantine on people and goods) were implemented and great attention was placed on cleansing and disinfecting streets and public places. For centuries, Cholera Morbus was endemic to the territory of Bengal; only with the revolution in transport, starting from 1817, did the disease first spread beyond India [1], replacing the plague as the "scourge of urban populations" [2]. Cholera was localized in Asia until 1817, when a first pandemic spread from India to other regions of the world. Endemic in Asia, (in the delta of the Ganges-India), it remained enclosed to that geographical area until the beginning of the 1800s. It first emerged from the Sundarbans Forest where the bacterium Vibrio cholerae had perhaps been mutating for millennia.It afterwards moved to the Mediterranean and Europe as new commerce routes were opened up between East and West and in the 1830s, Western Europe was faced with this totally new and unknown evil [3], which appeared in Italy in 1835.

Hand hygiene is a cornerstone of preventing healthcare-associated infections, particularly in maternity and neonatology. This study evaluated the knowledge, attitudes, and practices of Benin healthcare professionals regarding hygiene deficiencies that contribute to maternal and neonatal infections via a data collection survey. Hand hygiene knowledge was evaluated among healthcare professionals from six healthcare centers between August and September, 2023, using the WHO Hand Hygiene Self-Assessment Framework (HHSAF). Hand hygiene compliance was assessed by observing 30 trained IPC professionals across the hospitals during the five WHO moments. A total of 159 health care professionals were included in the study. Most healthcare workers demonstrated good awareness of the appropriate moments for hand hygiene, with a minimum knowledge rate of 65%. Hand hygiene compliance rates exceeded 50% across the surveyed facilities. Compliance rates varied notably by profession, with doctors showing the highest adherence, particularly in hand hygiene before patient contact (100%), followed by nurses (92.30%). Male professionals generally adhered to hand hygiene practices more than their female counterparts, with the highest male compliance at CHUD B/A (100%) and the lowest at HZ-Tanguieta (35%). However, no statistically significant differences in hand hygiene or glove-wearing compliance were observed across gender, department, or professional qualification (p > 0.05). These findings provide valuable insights into current hygiene practices among healthcare professionals, highlighting areas requiring improvement to effectively reduce maternal and neonatal infections. The results will inform targeted training programs to enhance compliance and ultimately improve health outcomes for mothers and newborns.

Hand hygiene (HH) is a straightforward yet highly effective preventive measure against healthcare-associated infections; however, global compliance remains suboptimal. This study analyzed a substantial Italian dataset, focusing on adherence to HH guidelines among healthcare professionals, and identified key factors influencing compliance. Direct multi- wave cross-sectional observational data on hand hygiene from over 749,000 opportunities were collected between 2017 and 2024 across 30 Italian hospitals participating in the Joint Commission International Hand Hygiene Project. Traditional statistical analyses and supervised machine learning (ML) models were employed to evaluate compliance rates and to examine their association with the year of observation, clinical area, professional role, and patient interaction moment (opportunity). Additionally, ML models were implemented to support proactive, risk- based surveillance within hospital settings by identifying high- risk contexts and facilitating more targeted monitoring strategies. Overall hand hygiene compliance increased from 73.5% in 2017-82% in 2024, surpassing the World Health Organization's (WHO) target of 80% from 2020 onwards. Nursing staff demonstrated the highest adherence. High-risk opportunities, such as pre-aseptic procedures and post-exposure to bodily fluids, exhibited higher compliance than other moments. Emergency departments recorded the lowest compliance rates (76.3%). ML models confirmed that the year, patient interaction moment, and professional role are the most significant predictors of adherence. The most effective ML model achieved an accuracy of 64.6% in classifying hand hygiene actions. This analysis underscores an improving trend in hand hygiene practices within Italian hospitals and concurrently identifies specific contexts-such as emergency departments-that require targeted interventions. The integration of observational monitoring with predictive artificial intelligence models could facilitate proactive, risk-based surveillance and focused improvement strategies. Accreditation-driven, multi-modal initiatives like this project highlight the vital role of measurement in fostering a culture of hand hygiene and advancing patient safety.

Developmental delay affects daily living, social functioning, and mental health. Maternal cardiovascular health (CVH) during pregnancy may indicate an adverse intrauterine environment, but its association with developmental delay is unclear. To examine the association between maternal CVH during pregnancy and developmental delay in offspring at 4 years of age. This cohort study enrolled patients between July 19, 2013, and March 31, 2017, with 5 years of follow-up, at obstetric hospitals and clinics in Miyagi Prefecture, Japan. Participants included eligible mother and offspring pairs enrolled in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Offspring were followed up until age 4 years. Data analyses were conducted from November 12, 2024, to March 24, 2026. Maternal CVH during pregnancy, which was assessed using Life's Essential 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure). Each metric was scored on a scale of 0 (least favorable) to 100 (most favorable), and these scores were used to categorize mothers as having high (80-100), moderate (50-79), or low (0-49) CVH. Developmental delay at age 4 years, which was evaluated by the mother using the validated Japanese version of Ages and Stages Questionnaire, Third Edition. This instrument has 5 domains: communication, gross motor, fine motor, problem solving, and personal-social skills. Domain-specific delay was defined as 2 or more SDs below the mean score, and developmental delay in total was defined as delay in 1 or more of the 5 domains. Among 19 160 eligible mother and offspring pairs, 8238 (43.0%) were analyzed. Offspring were assessed at a mean (SD) age of 4.1 (0.2) years and included 4299 males (52.2%). Among mothers with high, moderate, and low CVH, 154 (8.8%), 763 (12.1%), and 33 (16.8%), respectively, had offspring with developmental delay in total. Compared with high CVH, moderate (risk ratio [RR], 1.30; 95% CI, 1.09-1.54) and low (RR, 1.62; 95% CI, 1.11-2.36) CVH during pregnancy were associated with developmental delay in total. Low CVH was associated with higher prevalence of developmental delay across all 5 domains, with personal-social domain having the largest effect size (RR, 2.23; 95% CI, 1.23-4.07; P for trend = .002) and communication domain having the smallest effect size (RR, 1.40; 95% CI, 0.69-2.85; P for trend = .03). In this cohort study of mother and offspring pairs in Japan, better maternal CVH during pregnancy was associated with a lower risk of offspring developmental delay at age 4 years.

As part of the GOV.E.R.NI projects (Effective Government in Reports for New Integrations) and Più Su.Pr.Eme, project that is part of the three-year plan to combat labor exploitation in agriculture and the caporalato approved within the specific Caporalato Table promoted by the Directorate General for Immigration of the Ministry of Labor and Social Security with the aim of combating and overcoming all forms of serious labor exploitation and serious marginality and vulnerability of migrant workers in the territories that present the most critical issues in Southern Italy. The research institute FARBAS has carried out health surveillance activities on migrant workers in Basilicata with the aim of assessing the state of health and conditions that may put the health of workers at risk. The epidemiological study concerns the analysis and study of data obtained from a cohort of 135 migrant workers hosting in two reception centers located in the territory of Basilicata (Italy) who have voluntarily joined the health screening activities by means of electrocardiogram examination, spirometry tests, blood pressure measurement and physiological and pathological history. Enlisted come from 12 Central African countries, with a mean age of 37.08 ± 9.8, of male gender. Analysis of clinical and instrumental data shows that 51.1 % of patients have higher than optimal blood pressure values; 42.2 % have higher than normal systolic blood pressure values, 11.1% have above-normal diastolic blood pressure values. From the analysis of the data obtained from the instrumental examinations it is clear that 20% of the subjects present an electrocardiogram indicating a pathological alteration and 14% of the population present an altered spirometry trace attributable to a pathological state. 64% of the population has a normal BMI, the overweight rate is 30.8 % while 1.5% has grade I obesity and the remaining 3.7 % is underweight. The study shows a significant prevalence of arterial hypertension, cardiovascular disease and pathological changes in the respiratory system. In particular, the presence of risk factors such as high blood pressure associated with work factors such as maintaining difficult postures and working in the presence of heat represent a high risk to the health of seasonal workers working in the field of tomato harvesting in Southern Italy [1]. Future public health and preventive medicine actions should be geared towards precision health surveillance that can control, manage and reduce this risk to the health of workers.

INTRODUCTION: Sexual harassment is a form of power abuse prevalent in healthcare, with medical students experiencing it frequently, especially in practical training. A high proportion of medical students in Germany experience harassment or discrimination during their education, yet detailed data on their perceptions and coping strategies in the clinical environment are lacking. AIM: This study aims to analyze the experiences of final-year medical students in Germany with sexual harassment, identify factors that hinder or support coping, and offer recommendations for preventive measures and support services. METHODS: We conducted semi-structured, guideline-based individual interviews with medical students in their final year of medical training at the University Hospital Augsburg (UKA) who reported a history of sexual harassment during their studies. We analyzed the data using Kuckartz’s qualitative content analysis method. RESULTS: We conducted twelve interviews with ten female and two male medical students. Our analysis revealed five interrelated themes illustrating how experiences of gender-based discrimination and sexual harassment intersect with processes of professional identity formation within hierarchical medical training environments. First, participants described a spectrum of gendered boundary violations occurring in both educational and clinical relationships. These experiences were shaped by the specific relational context and involved supervisors within hierarchical training structures and patients within therapeutic encounters. Second, such incidents were closely intertwined with students’ emerging professional identities, often generating uncertainty in interpretation and tension between maintaining professional conduct and protecting personal boundaries. Third, rigid hierarchies and cultural normalization within medical training environments reinforced silence and limited students’ willingness to challenge inappropriate behavior. Consequently, students often adopted adaptive strategies characterized by restraint, minimization, or strategic silence. Finally, participants articulated the need for institutional structures, cultural change and practical skills to enable them to set professional boundaries with confidence. CONCLUSION: Students’ narratives reflect a dynamic interplay between gendered boundary violations, role insecurity, hierarchical dependency, constrained agency, and perceived gaps in institutional support. Sustainable prevention of SH in medical education requires both structural reforms and educational programs to enhance individual competencies.

Community pharmacists can play a key role in the prevention and management of unintended pregnancy, including in the provision of counselling and by dispensing contraception, and for medication abortion (MA). However, Australian pharmacists' practice and knowledge of effective contraceptive methods, including long-acting reversible contraception (LARC), is unknown, and few were registered to dispense MA at the time of the study. Our aim was to understand the knowledge, attitudes and practices of Australian community pharmacists in LARC and MA care. We conducted a cross-sectional national online survey of community pharmacists from July until October 2021. Participants were recruited through convenience sampling via mail and partner organisations' emails, newsletters, and mailing lists. We used descriptive statistical analysis, including counts, proportions, Pearson's chi-squared tests and Poisson regression for data analysis. Our descriptive survey forms part of the Australian Contraception and Abortion Primary Care Practitioner Support Network (AusCAPPS) mixed-methods project (ACTRN12622000655741). There were 533 eligible responses; 72% (n = 385) self-identified as women, and 71% (n = 378) were from metropolitan areas. Respondents' correct LARC knowledge varied, with 88% understanding LARC effectiveness, 67.7% understanding return to fertility, and 65.9% understanding LARC suitability for nulliparous women. Most pharmacists were registered to dispense MA (70%; n = 373), although fewer than half discussed LARC at the time of dispensing MA. Those working outside metropolitan areas were more likely to be registered to dispense MA and feel that they had the knowledge and confidence to dispense MA. With community pharmacists increasing scope of service in relation to contraception and MA, ongoing education and support will ensure they have accurate information for the provision of LARC and MA.

Equitable access to healthcare is a fundamental human right. As capital intensive infrastructures, hospitals consume 40-50% of health expenditure in low and middle-income countries. However, inequities in the allocation of hospital beds compromise efficiency, accessibility and outcomes. This study aimed to systematically review and meta-analyze the available evidence on the allocation of hospital beds in Iran and to quantify the inequality with established indices. A systematic review has been done in accordance with the principles of PRISMA, and the search process was conducted in international (PubMed, Scopus, Web of Science, EMBASE, CINAHL, DOAJ, MEDLine) and Iranian (SID, BKNS, Magiran) databases, and studies published from 2000 to 2025 in English and Persian language. Eligible studies reported quantitative measures of the allocation of hospital beds using inequality indices. Study quality was evaluated by using the Joanna Briggs Institute checklist. Meta-analysis was conducted using random effects and quality effects models, with heterogeneity being tested by Cochran's Q, I2, and H2. Thirty studies were eligible for inclusion (16 English, 14 Persian). Eight studies contributed 18 effect sizes for meta-analysis. The pooled Gini coefficient was 0.24 (95% CI: 0.20-0.28), and this indicates relative equity across the country, though heterogeneity was very high (I2 = 96.3%). Quality-effects modelling produced a very similar, higher estimate 0.26 (95% CI: 0.21-0.30). At the provincial level, Gini values were found to be between 0.229 (South Khorasan) and > 0.50 (Sistan and Baluchestan, Bushehr), showing the existence of important regional differences. City level inequalities were greater where values of 0.46 and 0.68-0.70 were found in Tehran and Shiraz, respectively, compared to those in Shanghai and Shenyang. While there is national equity in the allocation of hospital beds in Iran there are significant sub-national (provincial and urban) inequities. Addressing these requires equity-focused planning, monitoring and prioritization of disadvantaged regions.

Cardiovascular disease has historically been the most common cause of death (COD) among people with and without diabetes. However, substantial progress has been made in the management of cardiovascular disease. We conducted a multinational analysis to establish whether this trend is still the case. In this multinational, population-based study, we assembled aggregated annual mortality data collected during routine clinical care from nationally or regionally representative administrative datasets in high-income jurisdictions between 2000 and 2023. For inclusion, datasets must have ongoing enrolment of new patients with diabetes, cause-specific death counts in people with and without diabetes, and sex-specific and age-specific data. We collected population size, counts of prevalent diabetes (type 1 and type 2), death counts, and person-years of follow-up in people with and without diagnosed diabetes by sex and 10-year age group. We estimated cause-specific trends in mortality rates, proportional mortality, and mortality rate ratios (MRR) for people with versus those without diabetes (type 1 and type 2) using Poisson models standardised for age and sex. Using data from 11 jurisdictions, we identified 2·7 million deaths in people with diabetes and 11·0 million deaths in people without diabetes during a total of 1·7 billion person-years of follow-up. Cardiovascular disease mortality decreased in all jurisdictions in populations with and without diabetes. Mean 5-year declines in cardiovascular disease mortality among people with diabetes ranged from 8·3% (95% CI 5·9 to 10·7) to 25·4% (22·8 to 28·0). Mortality due to diabetes declined in most jurisdictions. Dementia mortality increased in people with and without diabetes in six (86%) of seven jurisdictions. Cancer mortality declined in people with diabetes in three (33%) of nine jurisdictions and in people without diabetes in six (67%). At the end of the observation period, cancer was the leading COD in people with diabetes in four (36%) of 11 jurisdictions. MRRs were generally stable for all CODs. Exceptions include Lithuania, where the mean 5-year change in MRR for cardiovascular disease was -7·6% (-10·1 to -5·1), indicating a more rapid fall in cardiovascular disease mortality in people with diabetes than in people without. For dementia, the MRR increased in Denmark (5-year change 8·0% [5·0 to 11·1]) and Scotland (11·4% [8·5 to 14·3]). Mortality from cardiovascular disease and diabetes has declined among people with diabetes in most jurisdictions, whereas mortality from dementia has increased markedly, independent of age. Cardiovascular disease is no longer universally the most common COD among people with diabetes in high-income countries. US Centers for Disease Control and Prevention, Diabetes Australia Research Program, and Victoria State Government Operational Infrastructure Support Program.

While oral health status and psychosocial factors are associated with oral health-related quality of life (OHRQoL), the mechanisms remain unclear. This study aims to investigate their relationships and explore potential mediating effects. Cross-sectional data were collected from dental examination and psychosocial scales of patients who visited the dental clinic for routine check-ups and/or preventive measures in 2023. All data were analysed using SPSS with the AMOS plugin. Data preprocessing included Little's MCAR test and multiple imputation. Reliability and validity tests were conducted to optimize the psychosocial scales. The Mann-Whitney U test and Spearman test analysed the differences and correlations between variables. A hierarchical multiple linear regression identified factors associated with the OHRQoL score and identified potential mediating effects. The structural equation model (SEM) supplementarily quantified the mediating effects. 104 adults, with a median age of 59 years, were included. The linear regression results were consistent with statistical mediation by oral health status (periodontal treatment need, plaque control record (PCR), caries treatment need), such that the direct association between psychosocial scores (self-efficacy of tooth-brushing score (SEoTB), self-efficacy of inter-dental cleaning (SEoIDC)) and the OHRQoL score was no longer evident after inclusion of oral health variables. The bias-corrected and accelerated (BCa) 95% confidence interval for the mediating path was -0.102 and -0.011 (P < .05). The mediating effect was -0.055, accounting for 12.6% of the total effect. Higher oral hygiene-related self-efficacy (OHRSE) is associated with better OHRoL, with this association partly explained by more favourable clinical oral health status. These results highlight the potential of combining psychological and oral health management strategies in both individualized treatment and public health programs. By strengthening oral hygiene self-efficacy, clinicians may reduce treatment needs, improve periodontal and caries status, and consequently enhance OHRQoL.

Nutritional deficiencies affecting the immune and haematopoietic systems represent a well-known global public health challenge: only the iron deficiency anaemia affects 1.62 billion individuals, especially in vulnerable populations. However, the protective effect that nutrition might give on disorders of these systems is still poorly understood. This umbrella review aims to synthesise the available evidence on the effectiveness of nutritional interventions in the primary prevention of blood and immune disorders, with a focus on the role of essential micronutrients and bioactive compounds. The protocol for this review was registered on PROSPERO (registration number 535785). A systematic search was conducted on PubMed, Web of Science, Embase and Cochrane until April 2024, using MeSH terms and keywords related to nutritional interventions, preventive effects and immune and haematopoietic system disorders. The search strategy followed the PRISMA guidelines for umbrella reviews. Two independent review teams performed the screening and data extraction, while a third reviewer resolved any disputes. Methodological quality was assessed using the JBI Critical Appraisal Checklist, risk of bias was analysed using the tools ROBINS-E for non-experimental studies, ROBIS for systematic reviews and RoB 2 for RCTs. The quality of evidence was assessed according to the GRADE approach. Of the 1028 articles identified, 13 met the inclusion criteria after systematic screening. Considering specific infection rates, vitamin D supplementation showed a significant protective effect (OR 0.88, 95% CI 0.81-0.96), with particular efficacy in deficient subjects (< 25 nmol/L). Zinc showed significant preventive efficacy (RR 0.68, 95% CI 0.58-0.80), especially in nasal formulations. Multiple micronutrient interventions demonstrated synergistic effects in reducing iron deficiency (RR 0.44, 95% CI 0.32-0.60) and vitamin A deficiency (RR 0.42, 95% CI 0.28-0.62). The methodological quality of the included studies was high, with JBI scores ranging from 9.5 to 11/11, indicating a solid evidence base. The evidence supports the effectiveness of nutritional interventions in boosting the immune system, with particular relevance for vitamin D and zinc supplementation. The multiple micronutrient approach emerges as a promising strategy, especially in more-at-risk populations. Both individualised approaches and public health interventions are recommended. Future research should focus on optimising nutrient combinations and identifying predictive biomarkers of response for the primary prevention of blood and immune disorders.

The 650th anniversary of the death of the Tuscan writer Giovanni Boccaccio (1313-1375) provides an opportunity to reread some pages of his masterpiece, the Decameron, from a historical-medical perspective. In this work, Boccaccio gives an account of the "Black Death", a devastating pandemic of bubonic plague, which reached Europe, Messina (Sicily), from Asia Minor in September of 1347. The plague travelled along the commercial route taken by Genoese sailors returning from their strategic trading posts at Kaffa on the Crimean Peninsula, which was under siege by the Mongols. The framework, the cage that encloses the 100 short stories that comprise Boccaccio's work, is the starting point for a novelistic reinterpretation. On an unspecified summer day in 1348, the plague broke out in Florence, Italy. In a few years, the terrible "Black Death" decimated the population of Europe. The city of Florence was shocked by the aggressiveness of the disease and by the collapse of the most basic norms of respect and civil coexistence. On the 650th anniversary of Boccaccio's death, the authors of this short article commemorate this great writer, his work and, in particular, the historical, social and public health responses to this massive pandemic. The Black Death shared some similar features with the recent COVID-19 pandemic: from the initial difficulties and misunderstandings to the adoption of public safety and prevention measures, such as quarantine, and the lasting impact on society after the event had passed. The similarities between Boccaccio's description and what we experienced during the COVID-19 era regard also other aspects of public health aspects.

This review aims to synthesize current evidence on maternal birth weight (MBW) as a determinant of reproductive health and pregnancy outcomes, examining biological mechanisms and potential intergenerational effects within the Developmental Origins of Health and Disease (DOHaD) framework. Evidence from large-scale cohort studies, systematic reviews, and experimental research examining the association between MBW and pregnancy-related outcomes, including hypertensive disorders of pregnancy, gestational diabetes mellitus, preterm birth, offspring birth weight, and selected congenital malformations, is summarized. Findings are interpreted within a DOHaD framework, with attention to methodological heterogeneity, population differences, and potential confounding by shared familial socioeconomic and lifestyle factors. Recent large-scale cohort studies, including those conducted in Japan, further indicate that MBW is associated with pregnancy complications, offspring birth weight, and specific congenital malformations, suggesting potential intergenerational pathways involving genetic, epigenetic, and placental processes. Despite accumulating evidence, substantial heterogeneity persists across populations, and the underlying causal pathways remain incompletely understood. Interpretation is further complicated by family-level factors, such as socioeconomic disadvantage, nutritional patterns, and shared lifestyle behaviors, which may partially influence both MBW and subsequent pregnancy outcomes. Nevertheless, MBW is a simple and widely available metric that may enhance preconception risk assessment, improve risk stratification for pregnancy complications, and contribute to individualized perinatal care. Overall, current epidemiological evidence is consistent with biological mechanisms linking MBW to pregnancy and offspring outcomes. Research priorities are outlined to clarify causal pathways and inform DOHaD-based interventions.

population working or living in agriculture settings may experience important exposure to pesticides and other agents. Although some health effects associated with them are well known, for others (e.g., neurological diseases and lymphoid, hematopoietic and related tissue cancers) additional epidemiological evidence is needed. to investigate mortality for neurological diseases and cancer in workers employed in agriculture in Italy. case-control study using mortality data linked with working histories retrieved from the Italian National Social Insurance archive. countrywide mortality data from 2005 to 2018 were used. Cases were blue-collar workers with primary/middle school education who died from selected causes; controls were individuals with the same characteristics, but died from all other causes. Each participant was assigned to the economic sector in which he/she worked for the longest period. Cause-specific mortality odds ratios (MORs) adjusted for age class, educational level, year of death, and region of residence were estimated using logistic regression models in which exposure of interest was "ever/never" (or length of employment) in agriculture using the service sectors as (unexposed) reference category. Analyses were adjusted for or stratified by gender. MORs for causes of death within the groups of mental, behavioural and neurodevelopmental disorders (F01-F99), diseases of the nervous system (G00-G99), and malignant neoplasms (C00-C96)Results: about 64,000 workers employed in agriculture were included and compared with a control group of 107,000 workers in the service sector. Elevated mortality risk in agriculture workers was found for spinal muscular atrophy (MOR 1.26; 95%CI 1.03-1.56; 261 deaths) and Parkinson's disease (PD) (MOR 1.16; 95%CI 1.00-1.34; 742 deaths). As for cancer mortality, positive associations were found for non-follicular lymphoma (NFL) (MOR 1.59; 95%CI 1.03-2.46; 82 deaths), multiple myeloma (MM) (MOR 1.42; 95%CI 1.22-1.65; 546 deaths), and myeloid leukaemia (ML) (MOR 1.36; 95%CI 1.16-1.60; 474 deaths), as well as for stomach (MOR 1.30; 95%CI 1.20-1.41; 1,732 deaths), prostate (MOR 2.03; 95%CI 1.85-2.24, 1,582 deaths), and brain and central nervous system cancer (MOR 1.30; 95%CI 1.13-1.50; 601 deaths). PD, NFL, ML, cancers of skin, of connective and soft tissue, of prostate and of brain were found to involve mainly men. employment in agriculture has been associated with various health risks, some of which may be attributed to pesticides exposure. Although the use of the different agronomic categories of pesticides changed over time and some active ingredients were prohibited or limited, their health effects remain of concern for their large use, demanding further focused investigations and preventive measures.

Personalized prevention is an important component of personalized medicine, tailoring interventions to the biological, behavioral, sociocultural and environmental characteristics of individuals for the prevention of disease onset, progression and recurrence. Despite its potential, personalized preventive interventions (PPI) remain less commonly implemented in clinical practice. This study explored the main barriers to a broader adoption of PPI in European healthcare systems. A multi-stakeholder consultation involving citizens/patients, health professionals, researchers, and policymakers was conducted using a sequential mixed-methods approach. In the first phase, semi-structured interviews with key informants representing different stakeholder groups were conducted. The thematic analysis of interview findings, complemented by insights from a review of the literature, informed the development of an online survey implemented in the second phase of the study. Twenty-six interviews and 270 complete surveys were analyzed. Stakeholders identified barriers across three main domains: (1) healthcare systems, (2) implementation, and (3) awareness, education, and literacy. Key barriers associated with limited PPI adoption included the predominant focus of health strategies on treatment over prevention, unresolved ethical, legal, and social issues (ELSI), limited awareness and knowledge of personalized prevention among both professionals and citizens, and the lack of appropriate cost-benefit evaluation models. Findings highlight interconnected barriers that may impact a broader PPI adoption across healthcare system, governance, implementation, and awareness-related domains. Continued stakeholder dialogue and engagement, alongside efforts to address awareness and governance-related challenges, may support the broader integration of PPI into European healthcare systems.

Contaminated hospital surfaces play a key role in the transmission of healthcare-associated infections (HAIs), particularly those caused by antimicrobial-resistant pathogens. Despite routine cleaning and disinfection, high-touch surfaces may remain reservoirs for multidrug-resistant organisms, including biofilm-forming Staphylococcus aureus. An environmental surveillance study was conducted in a single-bed room of an Internal Medicine ward in a hospital in Northern Italy. High-touch surfaces in the near-patient area and room furniture were sampled twice daily over one week, before and after routine cleaning/disinfection with chlorine-based agents (0.1-0.5% Cl). Cleaning effectiveness was evaluated using aerobic colony count (ACC) and detection of S. aureus as indicators of environmental hygiene, applying accepted microbiological benchmarks (ACC < 5 CFU/cm2; S. aureus < 1 CFU/cm2). S. aureus isolates were characterized by PFGE, spa typing, antimicrobial susceptibility testing, and biofilm production assays. Mean ACC decreased significantly after cleaning/disinfection (10.06 &#xb1; 15.67 vs 2.89 &#xb1; 5.52 CFU/cm2; p < 0.001), with a substantial reduction in non-compliant samples. However, residual contamination persisted on high-touch surfaces. S. aureus was detected in 12/238 samples, including post-cleaning samples from the near-patient area. Molecular analysis identified four distinct strains; notably, a spa type t032 (MLST ST22) isolate-methicillin-resistant, multidrug-resistant, and a strong biofilm producer-persisted on the bedside table handle both before and after cleaning. Routine cleaning and disinfection significantly reduce environmental bioburden but may not reliably eliminate biofilm-forming multidrug-resistant S. aureus from critical hand-contact surfaces. These findings highlight the need for continuous microbiological surveillance and targeted IPC interventions to address environmental reservoirs of antimicrobial resistance in healthcare settings.

Background and Objectives: Sleep is a vital psychological function for health and well-being in all age groups, from children to adolescents, to adults and the elderly, and impacts quality of life. This study evaluated temporal changes in sleep quality and lifestyle behaviors among medical students in North-Western Romania (Transylvania) between the COVID-19 pandemic and the post-pandemic period. Materials and Methods: A cross-sectional design was employed involving 709 medical students assessed during the first pandemic wave (2020) and the 2023-2024 academic year. Online questionnaires collected data on demographics, body mass index (BMI), substance use, and physical activity. Sleep quality was measured using the validated Athens Insomnia Scale (AIS), and multiple linear regression was performed to identify predictors of sleep outcomes. Results: Post-pandemic data revealed a significant decline in sleep quality, with female gender and lower academic performance identified as significant predictors of insomnia symptoms (R2 of 0.258, p < 0.05). While physical activity levels improved significantly in 2024 compared to the confinement period, this was accompanied by increased fast-food consumption and a rise in overweight and obesity rates. Conversely, illicit drug use decreased, and alcohol consumption patterns shifted, characterized by reduced weekly frequency among females but persistent binge drinking episodes. Conclusions: The transition to post-pandemic education yielded mixed health outcomes; while physical activity rebounded, sleep quality and nutritional status deteriorated. These findings highlight the necessity for university-based interventions focusing on sleep hygiene, nutrition, and stress management to support the well-being of medical students.

Depression is a major public health problem that affects quality of life, social functioning, and overall well-being. Among the social factors potentially related to depressive symptoms, living alone has gained increasing attention, although findings have been inconsistent across settings. In Peru, where household composition and social support dynamics may differ from those reported in other contexts, evidence on this association remains limited. Therefore, this study aimed to determine the association between living alone and depressive symptoms in Peruvian adults. This observational, cross-sectional, and analytical study used secondary data from the 2022 Demographic and Family Health Survey (ENDES), conducted in 30,087 Peruvian adults aged 18 years old and older. The dependent variable was the presence of moderate to severe depressive symptoms (yes/no), measured by the Patient Health Questionnaire-9 (PHQ-9), while the independent variable was living alone (yes/no). Generalized linear models of the Poisson family and log link function, were used to estimate crude and adjusted prevalence ratios (PRs). The analyses were performed in Stata v18.0 with a significant level of 5%. Moderate to severe depressive symptoms was identified in 7.9% of participants, while 7.5% lived in single-person households. In the crude analysis, living alone were associated with a higher probability of presenting depressive symptoms (PR: 1.60; 95% CI: 1.33-1.92; p < 0.001). However, after adjusting for confounding variables, the association ceased to be significant (aPR: 1.01; 95% CI: 0.82-1.24; p = 0.928). Unlike studies where living alone is associated with a higher prevalence of depressive symptoms, in the Peruvian context, no statistically significant association was observed in the adjusted analysis. This finding suggests that other social and cultural determinants may be associated with depressive symptoms among adults living alone in Peru. Understanding these differences is key to the design of mental health prevention and intervention strategies adapted to the specific characteristics of the population.

This study was designed to achieve more effective treatment for patients and to encourage the development of new antibiotics, specifically targeting multidrug-resistant Escherichia coli. This bacterium is one of the primary causative agents of hospital-acquired infections (HAI). It is classified as a critical priority pathogen for the development of new antibiotics according to the World Health Organization (2024). In this study, 76 isolates from four bacterial genera were analyzed. E. coli was identified as the most prevalent infectious agent with 52% of the isolates, followed by Klebsiella pneumoniae (20%), Pseudomonas aeruginosa (12%), and Acinetobacter baumannii (16%). Internal Medicine was the hospital department with the highest frequency of E. coli infections. Sixty-five percent of the samples were derived from urine. This bacterium was more prevalent in females (57.5%) than in males (42.5%). The highest resistance rates were observed for Ampicillin and Ciprofloxacin, with 90% and 77.5% respectively, while the lowest resistance was found for the Carbapenems Ertapenem, Meropenem, and Aminoglycoside Amikacin, with 22.5%. Twenty-two point five percent of the E. coli isolates were classified as resistant, and 77.5% as multidrug-resistant. Sixty-two point five percent were extended-spectrum beta-lactamase (ESBL) producers. All of these isolates resisted Ampicillin, while 4% were resistant to Ertapenem, Meropenem, and Amikacin. E. coli was identified as the primary causative pathogen of HAI in the Hospital under study and demonstrated resistance to most currently prescribed antibiotics.