Background The use of pharmaceutical stimulants without a medical prescription (PSWMP) among adolescents is considered an established public health issue. The present study aimed to investigate the potential links between different patterns of non-medical use of pharmaceutical stimulants, psycho-social factors, and other risky behaviours (e.g. psychoactive substance use). Methods For this purpose, data from a sample of 14,685 adolescents aged 15-19 participating in the ESPAD®Italia 2019 study were analysed by conducting descriptive analyses and multinomial logistic regressions. Results The findings highlight the key role of psycho-social factors and engagement in other risky behaviours in either reducing or promoting the risk of PSWMP use. Particularly, being satisfied with peer relationships and with oneself is significantly associated with lower use of PSWMP. Conversely, the consumption of other psychoactive substances (both legal and illegal) and engagement in other risky behaviours (e.g., gambling and cyberbullying) may increase this phenomenon. Conclusions Considering their representativeness, the results of the present study could be used as groundwork for the development of effective and targeted prevention programs and interventions.

Through the establishment of an educational laboratory, the Institute of Environmental Geology and Geoengineering of the National Research Council (CNR IGAG) intends to provide the students of lower and upper secondary schools with an understanding of the concept of seismic and hydrogeological hazards and risks, and disseminate the knowledge on mitigation measures aimed at reducing the impact of disasters on cultural heritages (e.g., earthquakes and floods). A prestigious case study addressed in this context is offered by the city of Rome and the central archaeological area including the Colosseum and the Palatine Hill, since: i) three arches of the second ring of the Colosseum collapsed in 1703 due to an earthquake; ii) the underground structures of the Colosseum were flooded in 2011 when, after a very intense rainfall event, the hypogea were flooded to more than six metres from the ground. Starting with historical memory, the students will be encouraged to actively participate in the natural disasters preparedness throughout the use of analogue and digital models and solutions for the study of the Earth sciences focused on natural risks.

Age-related macular degeneration (AMD) is a chronic multifactorial eye disease representing the primary cause of vision loss in people aged 60 years and older. The etiopathogenesis of the disease remains uncertain, with several risk factors contributing to its onset and progression, such as genotype, aging, hypertension, smoking, overweight, and low dietary intake of carotenoids. Since the aging populations of the industrialized world are increasing rapidly, the impact of AMD in the socio-economical life-developed countries is expected to increase dramatically in the next years. In this context, the benefits of prevention and early disease detection for prompt and effective treatment can be enormous to reduce the social and economic burden of AMD. Nutritional and lifestyle changes, including dietary intake of xanthophyll pigments, such as lutein and zeaxanthin, no smoking, and regular exercise, are known to protect from risk of AMD progression from early to advanced disease stages. In this review, we present the clinical outcomes of a pilot study on trans-scleral iontophoresis delivery of lutein in patients with AMD. Topical delivery of lutein directly to the macula may provide a more efficient method for enriching the macular pigment and for achieving greater patient compliance to therapy than oral administration and thus enhancing prevention strategies. Modern diagnostic methodologies shall address the major problem of accurately detecting the risk of transition from intermediate AMD to advanced AMD stages. Adaptive optics retinal imaging and resonance Raman spectroscopy are two highly promising technologies for the objective assessment of patients with AMD. In this review, we present some of their clinical applications for collecting quantitative measurements of retinal cellular changes and macular content of xanthophyll pigments, respectively. In conclusion, there is great expectation that technological advancements in AMD management will deliver improved screening, therapeutic prevention, and diagnostic systems in the coming decade through a pro-active strategy of "treatment for prevention" that will aim to reduce the global burden of vision loss caused by AMD in the elderly.

A surgical site infection (SSI) is an infection that occurs in the incision created by an invasive surgical procedure. Although most infections are treatable with antibiotics, SSIs remain a significant cause of morbidity and mortality after surgery and have a significant economic impact on health systems. Preventive measures are essential to decrease the incidence of SSIs and antibiotic abuse, but data in the literature regarding risk factors for SSIs in the pediatric age group are scarce, and current guidelines for the prevention of the risk of developing SSIs are mainly focused on the adult population. This document describes the current knowledge on risk factors for SSIs in neonates and children undergoing surgery and has the purpose of providing guidance to health care professionals for the prevention of SSIs in this population. Our aim is to consider the possible non-pharmacological measures that can be adopted to prevent SSIs. To our knowledge, this is the first study to provide recommendations based on a careful review of the available scientific evidence for the non-pharmacological prevention of SSIs in neonates and children. The specific scenarios developed are intended to guide the healthcare professional in practice to ensure standardized management of the neonatal and pediatric patients, decrease the incidence of SSIs and reduce antibiotic abuse.

Health pods are new systems such as small spaces equipped with medical devices where users can measure several biomedical parameters related to their health status and receive other medical services. Their impact on health over a life course could be relevant in defining healthy aging strategies and/or management of chronic diseases and the early detection of possible symptoms related to some common pathologies. The generated data have not only a personal value but even at a community/society level. Health pods also support educational and empowerment actions to enable the 5P medicine approach, and specifically prevention, health promotion, and public health policymaking. This paper aims at defining their taxonomy, conducting a market and typologies survey, and discussing their potential impact in preventive medicine, presenting data of a pilot test carried out placing two health pods in a superstore environment to validate the demand and the participation of people in a prevention campaign. A 57-day period was observed at two sites: the number of free accesses and administered tests was impressive for size and completeness. The test revealed a good picture of the general health status of the population, with satisfying AGE values in the cardiovascular check and stress index through an HRV analysis. The body composition test revealed a small number of overweight subjects, more in males than in females. This pilot confirmed the huge demand for personalized services for improving well-being, health status, and quality of life and the relevance of these solutions for their individual and societal impact in preventive medicine.

Marine litter is one of the most relevant pollution problems that our oceans are facing today. Marine litter in our oceans is a major threat to a sustainable planet. Here, we provide a comprehensive analysis of cutting-edge solutions developed globally to prevent, monitor and clean marine litter. Prevention in this research includes only innovative solutions to prevent litter entering oceans and seas rather than interventions such as waste reduction and recycling. On the basis of extensive search and data compilation, our analysis reveals that information is dispersed across platforms and is not easily accessible. In total, 177 solutions-the equivalent to <0.9% of the search hits-fulfilled our validation criteria and were evaluated. Most solutions (n = 106, 60%) primarily address monitoring and were developed during the past 3 years, with the scientific community being the key driver. Few solutions reached mature technical readiness and market availability, while none were validated for efficiency and environmental impact. Looking ahead, we elaborate on the limitations of the existing solutions, the challenges of developing new solutions, and provide recommendations for funding schemes and policy instruments to prevent, monitor and clean marine litter globally. In doing so, we encourage researchers, innovators and policy-makers worldwide to act towards achieving and sustaining a cleaner ocean for future generations.

Relatore alla giornata di studio su Les opportunités et les défis pour une convention internationale sur les entreprises et les droits de l'homme, organizzato dal Centre de recherche sur les droits de l'homme et le droit humanitaire dell'Université Panthéon-Assas Paris II,

Objective: Thirty years ago it was demonstrated that folic acid taken before pregnancy and in early pregnancy reduced the risk of a neural tube defect (NTD). Despite Public Health Initiatives across Europe recommending that women take 0.4 mg folic acid before becoming pregnant and during the first trimester, the prevalence of NTD pregnancies has not materially decreased in the EU since 1998, in contrast to the dramatic fall observed in the USA. This study aimed to estimate the number of NTD pregnancies that would have been prevented if flour had been fortified with folic acid in Europe from 1998 as it had been in the USA. Design and Setting: The number of NTD pregnancies from 1998 to 2017 that would have been prevented if folic acid fortification had been implemented in the 28 countries who were members of the European Union in 2019 was predicted was predicted using data on NTD prevalence from 35 EUROCAT congenital anomaly registries and literature searches for population serum folate levels and folic acid supplementation. Results: From 1998 to 2017 an estimated 95,213 NTD pregnancies occurred amongst 104 million births in the 28 countries in the EU, a prevalence of 0.92 per 1,000 births. The median serum folate level in Europe over this time period was estimated to be 14.1 ?g/L. There is a lack of information about women taking folic acid supplements before becoming pregnant and during the first trimester of pregnancy, with one meta-analysis indicating that around 25% of women did so. An estimated 14,600 NTD pregnancies may have been prevented if the European countries had implemented fortification at the level adopted by the USA in 1998 and 25% of women took folic acid supplements. An estimated 19,500 NTD pregnancies would have been prevented if no women took folic acid supplements. Conclusions: This study suggests that failure to implement mandatory folic acid fortification in the 28 European countries has caused, and continues to cause, neural tube defects to occur in almost 1,000 pregnancies every year.

The ideal operational scenario for the future tokamak reactor is disruption-free operation. However, so far all the experimental evidence indicates that disruptions are unavoidable and can occur with alarming frequency when approaching reactor conditions (low q95, high radiated fraction, divertor detachment, etc). In this article, a unified strategy for disruption avoidance, prevention, and mitigation is proposed and validated on JET data. The approach is based on three phase-oriented predictors to detect the main instabilities leading to the undesired and sudden end of the discharge. The first model detects dangerous profiles as an early indication of a critical situation. The second is designed to identify multifaceted asymmetric radiation from the edge and other abnormal radiative events. The third model is devoted to mitigation, and triggers alarms around few tens of ms before the beginning of the current quench. The models have been trained and tested with a database of almost 1000 JET discharges of recent campaigns with the ITER-like wall. The overall performances are very close to 100% of successful detections with a few percent of false alarms. In addition to the first systematic use of visible cameras for disruption prevention in JET, the most relevant aspect of this work is related to the distribution of the alarms of the three predictors, which do not overlap and are sequential. Consequently, the three predictors are meant to work in parallel over running discharges and, depending on which one triggers the alarm, the cause can be determined and approximate remaining time to intervene can be estimated, potentially allowing for the optimisation of the remedial actions.

Tobacco smoke is the main source of preventable morbidity and mortality, and children are particularly susceptible to developing smoke-related adverse health effects. Interventions for prevention and cessation of smoking can be performed at both population and individual levels. Preventing exposure to second-hand smoke should begin before childbirth and continue throughout childhood, as no level of exposure to tobacco smoke is risk free. Paediatric practitioners must take an active role in smoking prevention and cessation.

The natural history of urinary kidney stone disease includes the risk of relapses and can be associated with the risk of chronic kidney disease, bone and cardiovascular disease. For this reason, a wide clinical-metabolic assessment of the kidney stone patient is of great importance since the first presentation of the stone, to set an appropriate preventive treatment. The proposed diagnostic-therapeutic pathway includes a careful medical history, in order to highlight a secondary kidney stone disease and the main risk factors for kidney stones, chronic renal disease, or cardiovascular and bone disease; a metabolic evaluation on multiple levels, according to the severity of the disease, and the presence or absence of risk factors, and appropriate instrumental investigations. Thus, the information collected makes it possible to set a preventive treatment consisting of general rules and, if necessary, specific pharmacological or nutritional interventions. This paper has been prepared by the Italian Multidisciplinary Study Group for Kidney Stone Disease, and it is addressed to the several professional figures involved in the management of patients suffering from nephrolithiasis, from the emergency doctor to the general practitioner, urologist, nephrologist, radiologist, and dietician. A diagnostic-therapeutic pathway for patients with kidney stone disease was first published on this Journal in 2010. The present contribution aims at amending and updating the article published exactly ten years ago, to serve as an easy-to-use reference and to guide good clinical practice in this field.

Notwithstanding the efforts exerted over many years, disruptions remain a major impediment on the route to a magnetic confinement reactor of the tokamak type. Machine learning predictors, relying on adaptive strategies, have recently proved to achieve very good performance. Even if their last generation implement a 'from scratch' approach to learning, i.e. they can start predicting after the first example of each class (safe and disruptive), it would be extremely useful to profit from the experience of previous devices, when new machines come on online, to reduce excessive errors at the beginning of the learning process. In this paper, adaptive predictors, based on ensemble classifiers, have been operated on a series of AUG campaigns and then they have been deployed on several JET campaigns with the ILW, all together covering more than order of magnitude in plasma current. The criteria to normalise the signals and to translate the parameters of the predictors from one device to the other are discussed in detail. With regard to mitigation, the overall performance, both in terms of success rate and false alarms, are quite positive (98% success rate and only 1.9% false alarm rate). Encouraging results have also been obtained for prevention (94.2% success rate and only 7.7% false alarm rate), by providing as inputs to the classifiers appropriate profile indicators. Even if they require significant refinements, adaptive predictors, capable of capitalising on the experience of smaller devices, have therefore become a serious candidate for deployment in the next generation of machines.

While plant polyphenols possess a variety of biological properties, exploration of chemical diversity around them is still problematic. Here, an example of application of the Ugi multicomponent reaction to the combinatorial assembly of artificial, yet "natural-like", polyphenols is presented. The synthesized compounds represent a second-generation library directed to the inhibition of ?-amyloid protein aggregation. Chiral enantiopure compounds, and polyphenol-?-lactam hybrids have been prepared too. The biochemical assays have highlighted the importance of the key pharmacophores in these compounds. A lead for inhibition of aggregation of truncated protein A?pE3-42 was selected.

The process of atherosclerosis may begin early in lifetime and develop for decades, until leading to manifest cardiovascular disease (CVD). Efforts for early identification and management of predisposing factors for CVD for primordial and primary prevention, sustaining the "ideal cardiovascular health", must start early in life. Oxidative stress is among the first signs of endothelial activation and cardiometabolic alterations, and might serve in future as an early tool to predict risk of developing cardiometabolic and lifestyle-related diseases in childhood and adolescence and later in adulthood. This review aims to discuss available data on all these aspects, with particular emphasis on the relationship between cardiometabolic risk and oxidative stress in children and adolescents.

Adolescence is a stage in life when dramatic physical, cognitive and socio-emotional changes occur. When adolescents grow-up in deprived social environments, the chance of psychophysical well-being severely decreases and problems such as delinquency, substance abuse and mental health issues are much more likely to ensue. Third wave cognitive-behavioral interventions are increasingly becoming the chosen instruments to support psychological intervention for young people and adolescents. In this study, we aim to test the feasibility and the adequacy of the outcome measures of an intervention for adolescents at high psychosocial risk, using a modified Discoverer, Noticer, Advisor and Values (DNA-V) protocol aimed at increasing flexible and positive values. The project was conducted in a school located in a low Socio-Economic Status (SES) and severely deprived district of a metropolitan area in Messina, Italy, with 3 classes from 6th to 8th grade. All parents and teachers allowed participants to take part in the pilot study. However, the participants' willingness to engage in the study was low (1 out of 3 classes). Overall, 13 adolescents (72% of the enrolled class) participated in the pilot and only 2 out of 7 teachers and no parents were available for interviews. In its current form, a full RCT is not considered feasible due to general low motivation showed by the participants. Although the sample size was small, the intervention program showed a statistically significant main effect for students' self-report questionnaire, suggesting that those measures were appropriate. Modifications and additional measures are suggested to increase participants' engagement and to overcome the need for parents and teachers' interviews.

The Behavioural Assessment to improve School Environment (BASE) European Erasmus+ project responses to the European requirement of reforming the whole scholastic disciplinary system identifies in the proven US-born concept of the Positive Behaviour Support (PBS) one possible solution, and tries to adapt its practical and evidence-based principles to the heterogeneous European school settings. Recently, scientific studies (Sugai, Horner, 2016) have emphasized the promising role of PBS in reducing the occurrence of behavioural problems by setting up a preventive, proactive and multilevel system based on the direct involvement of the entire school team: starting from teachers, school leaders until all actors of the community involved in the educational processes. The features of PBS are rooted in the behavioural science and in the practice of Functional Behaviour Analysis (FBA). It works very well in coping with challenging behavioural problems in everyday school life. The growing expectation is that schools will deliver socially acceptable, effective, and efficient interventions to ensure safe and productive environments where the prosocial behaviour is promoted and pupils can become successful adults. With the purpose of achieving these goals, the rationale for this project is to combine the PBS approach with the FBA practice, taking advantage of the important results achieved by two funded European projects: the Web Health Application for Adhd Monitoring (WHAAM) and the PBS project. The web-based BASE application will expand the functionalities included in the WHAAM application according to the theoretical and methodological constraints defined by the PBS project. While the original WHAAM application was focused only on the functional assessment applied to problem behaviors of children with ADHD, the new BASE web application will include features useful for a larger field of intervention. The BASE application will include functionalities that can be grouped in the following categories: - Tools to perform the functional assessment of problem behaviours; - tools to evaluate the well-being status of teachers and students (i.e. rating, emotional thermometer, or visual analogue scales); - tools to collect information about academic progresses such as discipline referrals, attendance reports, etc.; - tools to easily create qualitative and quantitative measures for the observation according to the PBS principles; - tools to easily generate reports about the data collected with the application. The data collected with the BASE application will be used to take informed decisions about the strategies to increase the well-being of the school, preventing and reducing the occurrence of problem behaviors, teachers' burnout, students' drop out, and property destruction. Teachers will take advantage of the possibility to access evidence-based features that help them to evaluate the efficacy of their actions on multiple levels (students' performance, reduction of problem behaviours, levels of the classroom wellbeing, etc.), to share the educational events with other colleagues and with students' caregivers promoting a better communication and connection between school and families.

Medical Geology is a new scientific field, whose main goal is to assess the geo-environmental characteristics that could influence health, including areas in which certain diseases have been found, either widespread or isolated. This new discipline have a distinctly multidisciplinary nature that make two fields so different from each other more and more complementary.

There is evidence that the toll of death and destruction caused by natural hazards is rising. This is often ascribed to the impact of climate change that resulted in an increased frequency of extreme meteorological events. As a consequence, it is realistic to expect that the casualties and damages caused by floods will increase in the near future. Advanced weather forecast is a fundamental tool to predict the occurrence of floods and structural mitigation measures are crucial for flood protection. However, these strategies should be associate with tools to promote and increase natural-disaster awareness and nonstructural mitigation measures in the exposed population. To bridge this gap, we coupled innovative, ICT-based technologies with crowdsourcing. The idea is to exploit geospatial data gathered by citizens and volunteers with their own devices such as mobile phones to provide authorities with relevant information in case of flood emergencies. This paper describes the design and testing of an Android application named MAppERS (Mobile Applications for Emergency Response and Support), thought to enhance active participation and response of the population in territorial and flood-risk mitigation in Frederikssund, Denmark. The results of the piloting fully validate MAppERS as an effective tool to support the decision-making process during a crisis and to improve the awareness of the community and their disaster resilience.

sane abitudini vengono discusse come mezzi di prevenzione piu' efficaci e comunque complementari e preferibili rispetto a qualunque terapia