ABSTRACT
In this paper we describe our work aimed at designing a system able to measure the particulate matter (PM) concentrations via an optical particle counter (OPC) and simultaneously collect it via standard 2.5 cm filters for laboratory characterization. The Port of Civitavecchia (Italy), one of the most important maritime hubs of the Mediterranean Sea, was selected as a test site for an eight-months monitoring campaign. Comparison between the data provided by our device with those from the referenced and certified monitoring stations from the governmental Regional Agency for the Protection of the Environment (ARPA Lazio) allowed to define clear threshold values (PM10 = 25 μg/m3 and PM2.5 = 10 μg/m3). These threshold values need to be considered when correcting the OPC raw data with respect to the humidity (RH) conditions. The sample material was characterized through optical microscopy and SEM-EDS (scanning electron microscopy coupled with energy-dispersive X-ray fluorescence) and spectroscopy (FTIR, Raman), showing a variegate composition from Al-Fe-oxides to silicates, carbonates, and sulfates, to coal and amorphous carbon together with microplastics and textile fibers. As a final test, we analyzed the PM trends provided by our device during the COVID-19 lockdown, when stringent restrictions in the human activities caused well-known fluctuations in the atmospheric pollution. We again observed an evolution of the PM peaks in excellent agreement with the results yielded by the ARPA Lazio monitoring stations. This result provides a valuable confidence test for our devices highlighting the effectiveness of the presented strategy for airborne particulate-matter monitoring. © 2022
ABSTRACT
Background: The fight against fake news, mainly spread through Internet, is a major public health issue, even among undergraduate students. This study aims to evaluate the effectiveness of a website promoted by the Italian Federation of the Provincial Orders of the Medical Doctors as a first aid communication kit for health topics. Study design: Pre-post study using a web-based survey, conducted in April-May 2019 on Medical students and October-November 2020 on Communication Sciences students at the University of Florence (Italy). Methods: Undergraduate students of both schools were exposed to the use of the "dottoremaeveroche" website. Primary and secondary outcomes measures: the Italian-electronic Health Literacy Scale self-assessment tool was used to examine subjects' electronic Health literacy, and source quality. All responses were rated on a 5-point Likert scale. Changing in perception of abilities were examined using the Wilcoxon test. Results: The 362 participants felt moderately confident in electronic Health Literacy, with an initial Italian-electronic Health Literacy Scale overall mean score of 3.6±0.7 for medical and 3.2±0.8 for communication students. Medical students had a good idea of how to find helpful sources (3.9±0.8) and communication students felt confident in recognizing their quality (3.5±1.0). In contrast, their confidence in using Web information to make health decisions was low (medical: 2.9±1.1; communication: 2.8±1.1). All items improved significantly after "dottoremaeveroche" use (p<.001), with the overall mean score of Italian-electronic Health Literacy Scale increasing to 4.3±0.6 for medical and 4.1±0.8 for communication students. Conclusions: Low electronic health literacy levels can affect public health efforts, as seen during the COVID- 19 pandemic. The effectiveness of "dottoremaeveroche" among students showed the usefulness of online educational interventions that, if further implemented, could help combat the spread of infodemic.
ABSTRACT
Background The COVID-19 infodemic is putting pressure on public health systems to control the pandemic. With the internet and social media playing a key role in emergency communication, digital health literacy (DHL) can be considered a determinant of health. This study aims to assess the impact of infodemic on the skills of medical students, for whom low levels of DHL may affect the ability to identify the best available medical evidence. Methods A cross-sectional web-based survey was conducted at the University of Florence (Italy) in Apr-May 2019 (pre-pandemic period) and in Nov-Dec 2020 (pandemic period) to investigate DHL skills. Two different cohorts of students, both in their first year of medical school, participated in the survey. The 8-item self-assessment tool (IT-eHEALS) with a 5-point Likert scale was used to examine DHL. The change in perception of ability between the two cohorts was examined using the Wilcoxon test. Results A total of 329 students participated in the survey in 2019 (F: 58.1%;mean age 20.6±2.1) and 341 in 2020 (F:61.9%;mean age 19.8±2.0). In 2019, participants’ DHL level was moderate with a IT-eHEALS overall mean score (MS) of 28.4±5.8. Students had a good idea of how to find helpful health information (MS 3.9±0.8) and how to use the web for this purpose (MS 3.8±0.9), but they were less confident about the usefulness of the information they received (MS 2.9±1.1). In 2020, the medical students’ DHL level deteriorated as the overall MS of IT-eHEALS decreased to 23.4±7.2 (p < 0.01). The scores of the IT-eHEALS items were significantly lower and students indicated that they found it difficult to assess the information they found (MS 2.4±1.1;p < 0.01). Conclusions DHL can contrast infodemic, but the latter in turn may have a negative impact on perceived DHL skills if personal knowledge base is not well structured. Training programmes for medical students as future health care providers should be reinforces to guide their practise. Key messages Assessing digital health literacy is the first step in directing public efforts towards empowering educational programmes to improve health literacy. Medical students, as future health professionals, should be able to use the best evidence to help their patients identify healthy beliefs and behaviours to manage in health emergencies.
ABSTRACT
Background The struggle against fake medical news, nowadays widely spread by web sources, is a main issue in public health especially in a pandemic period. Even among medical students, there is a lack of eHealth literacy (eHL) skills to solve medical problems. The Italian Medical Doctors Federation (FNOMCeO) promoted a Web source as a first-aid communication kit for basic notions in health hot-topics named “dottoremaeveroche” (DMVEC). This study aims to evaluate its effectiveness in improving eHL. Methods Between April and November 2019, medical students from the University of Firenze (Italy) joined a cross-sectional web-based survey before and after accessing the DMVEC Web source. The 8-item self-assessment tool (IT-eHEALS) was used to examine subject's eHL, in addition to questions on source's features and its quality. All responses were rated on a 5-points Likert scale. Changing of abilities' perception was assessed using Wilcoxon test. Results A total of 329 joined the survey, 42% male, mean age of 20.6±2.1. Participants felt moderately confident in eHL, in fact the initial eHEALS overall mean score was 3.6± 0.7. Students had a good perception on how to find helpful health resources (mean score 3.9±0.8) and how to use the Internet to answer health questions (mean score 3.8±0.9), but their ability in using this information to make health decisions was low (mean score 2.9±1.1). All items improved after the use of DMVEC, with overall mean score of IT-eHEALS increasing to 4.3±0.6 (p < 0.0001). Regarding source's quality, mean score related to transparency of sources, an aspect underestimated at first, increased from 3.5±1.2 to 4.7±0.7 (p < 0.0001). Conclusions Low levels of eHL can damage public health efforts, as seen during COVID19 pandemic. DMVEC effectiveness in medical students demonstrated that the scaling up to the general population of online educational interventions, with further implementation, could help in tackling infodemic and fake news spreading. Key messages Moderate levels of eHL among medical students could reflect lower levels in general population, highlighting this as critical issue in public health. Educational programs addressed to Health professionals could be adapted and empowered considering general population as target.
ABSTRACT
Introduction: Patients with multiple sclerosis (MS) often receive disease-modifying therapies (DMTs) which can reduce the response to vaccines. BNT162b2 (Pfizer-BioNTech) is the first COVID-19 vaccine authorized in Italy but was not evaluated in MS patients receiving DMTs. Objectives: To evaluate serological response and safety to BNT162b2 in patients with MS. Methods: This is an early multicenter, case-control and prospective study. Patients were healthcare workers (HCWs) with MS, receiving at least one DMT, and having received BNT162b2. Blood samples were collected between 2 and 6 weeks after the second vaccine dose and analyzed to quantify anti-Spike antibodies (Abbott). Anti-Spike cut-off for response was set at 7.1 BAU/ ml. Anti-Spike levels in patients considered at-risk of reduced response were compared to those considered non-at-risk, according to literature and expert consensus. Anti-Spike levels were compared to those of a control population of HCWs, without MS or immune-related disease, untreated, and having received BNT162b2. Total follow up was of 9 weeks from the first vaccine dose. Results: From February 2020, 39 MS patients were enrolled. One patient, treated with ocrelizumab, did not develop serological response (1.8 BAU/ml). The remaining patients responded to the vaccine, including two ocrelizumab-treated patients. The control population consisted of 273 HCWs. All controls responded to BNT162b2. Median anti-Spike levels in patients (1471.0 BAU/ ml;range 779.7-2357.0) and controls (1479.0 BAU/ml;range 813.1-2528.0) were comparable. Patients receiving at-risk treatments (n=9;5 fingolimod, 3 ocrelizumab, 1 natalizumab) showed significantly reduced median anti-Spike levels (241.9 BAU/ml;range 40.2-530.0) compared to non-at-risk (n=30;15 dimethyl fumarate, 5 teriflunomide, 4 interferons, 3 glatiramer acetate, 2 cladribine, 1 alemtuzumab) ones (1707.7 BAU/ml;range 1356.2- 2432.8) (p<0.001). No COVID-19 cases were reported. Two patients had a clinical MS relapse after 17 and 30 days after the second dose. A causal relationship with the vaccination could not be established. Conclusions: In our study, most MS patients produce a serological response to BNT162b2 similar to non-MS controls;however, at-risk DMTs resulted in reduced anti-Spike levels and one ocrelizumab- treated patient did not respond. These observations should be better investigated and replicated in larger studies to support clinical decision in COVID-19 vaccine management.
ABSTRACT
In this article we discuss if the German public health response to the COVID-19 pandemic in the first months of 2020 included a strategic focus on health equity. This preliminary evaluation is taken as a case study to rate the overall state of Health in All Policies for health equity in the country. Some ideas of HiAP were present in the actual response to the pandemic but a coherent strategy to improve health equity was not present. © 2020 De Gruyter. All rights reserved.
ABSTRACT
In this article we discuss if the German public health response to the COVID-19 pandemic in the first months of 2020 included a strategic focus on health equity. This preliminary evaluation is taken as a case study to rate the overall state of Health in All Policies for health equity in the country. Some ideas of HiAP were present in the actual response to the pandemic but a coherent strategy to improve health equity was not present.