Analysing features of home-based workout during COVID-19 pandemic: a systematic review.

OBJECTIVE: Since the beginning of the COVID-19 pandemic, a decrease in physical activity (PA) related to home confinement has been reported worldwide. However, some individuals were able to engage in physical activities at home. Thus, in a perspective of public health, it may be useful to analyse the available evidence regarding PA adopted during home restrictions, in order to identify possible strategies to help people stay active even during emergency situations. The aim of this review was to analyse how healthy individuals spontaneously exercised at home in the course of the pandemic, in order to detect possible factors associated with this behaviour. STUDY DESIGN: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHODS: The protocol was registered in PROSPERO, an international prospective register of systematic reviews, with the registration number CRD42023394673. A literature search was conducted in PubMed, Scopus, and Web of Science. Cross-sectional studies published in English from the inception of each database to February 06th 2023 and focused on healthy individuals practicing spontaneous PA/exercise at home during the pandemic were considered eligible. The quality assessment was performed using the adapted Newcastle-Ottawa Quality Assessment Scale. Bibliographic information, sample size, study paricipant/population with age, gender, ethnicity, socioeconomic status, education, smart workers or not, anthropometric parameters, characteristics of at home exercises, athletic status and sedentariness, associated health-related effects, and main findings were synthetised. RESULTS: From 504 articles, 19 were included. Notwithstanding the differences in the studies examined, the majority of them reported that previous PA level was associated with exercise in such challenging conditions. Furthermore, technologies aimed at supporting exercise were shown to be a useful resource. CONCLUSIONS: Being habitually active and using digital supports may be associated with a positive attitude towards exercise at home during isolation. This suggests that in emergency situations, exercise should be promoted, also through digital media, especially among those groups who are usually less engaged in PA. Further analyses of longitudinal studies are needed to confirm these findings.

Active breaks: a strategy to counteract sedentary behaviors for Health Promoting Schools. A discussion on their implementation in Italy.

Abstract: School Active Breaks are short bouts of physical activity (5-15 minutes) conducted by appropriately trained teachers and delivered during or between curricular lessons. They are a good strategy to counteract sedentary behaviors, and a growing body of evidence shows that they can represent also a tool to promote and improve health, school wellbeing and academic achievements. On 19 February 2022, the Working Group on Movement Sciences for Health of the Italian Society of Hygiene, Preventive Medicine and Public Health organized an Awareness Day on the effectiveness, usefulness and feasibility of School Active Breaks, opened to teachers, educators, school leaders, pediatricians, personnel from Departments of Prevention and Public Health and Health Policy-makers. During the event, the testimonies about the experiences already carried out in Italy showed that School Active Breaks are an effective intervention that each school can easily include in its educational offer and apply in any context.

Health risks for body pierced community: a systematic review.

OBJECTIVE: Body piercing is defined as the penetration of jewellery into openings made in different body areas. In the last decades, it has become increasingly common in the general population. The aim is to analyse the available literature about complications from body piercing for contributing to raise the awareness towards this issue and to plan and perform appropriate prevention interventions. STUDY DESIGN: This is a systematic review. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to perform this systematic review; the protocol was registered with PROSPERO [CRD42020177972]. PubMed, Scopus and Web of Science were searched from database inception to April 2020, and articles in English language reporting a proven association between piercings and health risks were included, and their quality were assessed by adequate quality assessment tools. RESULTS: A total of 4748 studies were found, and after duplicates removal and screening, 84 articles were included. Studies dealing with microbiological effects reported these complications both locally and at distant sites as a result of the spreading of the primary site infection: mastitis, endocarditis, glomerulonephritis, cephalic tetanus, viral hepatitis, HIV, cerebellar brain abscess and toxic shock syndrome. In addition, bleeding, gingival recession, dental injuries, contact dermatitis, granulomatous dermatitis, keloid, fibroma and basal cell carcinoma were reported. CONCLUSIONS: Health authorities should promote educational campaigns to spread the knowledge on health risks related to piercings. Besides, piercers are often not adequately aware of all the possible adverse effects due to piercings because their professional training differs among countries. It is therefore advisable to provide periodical upgrade of their education in this field.

Are nutrition and physical activity associated with gut microbiota? A pilot study on a sample of healthy young adults.

BACKGROUND: The literature shows that gut microbiota composition is related with health, and a lot of individual and outer factors may determine its variability. In particular, nutrition and exercise seem to influence the presence in the gut of the two major bacterial phyla of Firmicutes and Bacteroidetes. STUDY DESIGN: An ongoing cross-sectional investigation is aimed to explore these associations in humans. METHODS: Healthy Caucasian young adults were asked to provide a fecal sample in order to analyze their gut microbiome considering their Body Mass Index (BMI), adherence to Mediterranean diet and Physical Activity (PA) level. RESULTS: A total of 59 participants (49.1% males, mean age 23.1 ± 3.14 years) were enrolled so far. Firmicutes (61.6±14.6) and Bacteroidetes (30.7 ± 13.3) showed the highest relative abundance in fecal samples. The Pearson's analysis showed a significant negative correlation between PA and Firmicutes (r =-0.270, p = 0.03). Linear regression confirmed a significant decrease of this phylum with the increase of PA (R2 = 0.07, p = 0.03). CONCLUSIONS: These preliminary results suggest the association between physical activity and gut microbiota composition in healthy humans.

Swimming Pool safety and prevention at the time of Covid-19: a consensus document from GSMS-SItI.

Public health measures to cope with the Covid-19 pandemic, imposed also a shutdown of sports facilities and swimming pools. Safety issues related to recreational waters were emerging during the lockdown, rising concerns on how and when reopening pools and on how improve their management while SARS-CoV-2 is circulating in the population. The GSMS-SItI, Working Group on Movement Sciences for Health of the Italian Society of Hygiene Preventive Medicine and Public Health, discussed and summarized some indications for a suitable preventive approach. Several measures are highlighted, including social distancing, optimized water management, airflow and microclimatic parameters in the pool as well in the annexed rooms, verification of sanitation procedures. The GSMS-SItI underlines that prevention should be based on monitoring of the local epidemiological situation and on the constant collaboration with the local health authority and the national health service.

Peer Education strategies for promoting prevention of doping in different populations.

BACKGROUND: In the field of doping prevention, alongside the traditional functions of repression and control of the phenomenon, educational aspects are becoming increasingly important. Article 18 of the World Anti doping Code obliges the signatories to invest in anti-doping education with the aim of preserving the spirit of sport. The educational commitment should involve young people in health promotion interventions for the prevention of risk behaviors. Therefore, our attention has focused on finding the mechanisms that lead people to make certain behavioral choices. MATERIAL AND METHODS: In the context of preventive programs, to counter the doping phenomenon through health promotion programs, the most recognized method is peer education, particularly with adolescents. It is an educational method according to which some members of a group are empowered and trained to carry out specific activities with their peers. It is constituted as an example of equal relationship and finds its basis in cooperation and solidarity with the aim of increasing empowerment and a healthy development of the identity and collective dimension in young people. RESULTS: Numerous experts - biologists / nutritionists, hygienists, sports coaches, psychologists, teachers of physical education in secondary schools and other stakeholders have actively participated in the co-construction of a training package aimed at activating cascade training processes on the knowledge and skills of peer education in contexts of youth aggregation, such as schools, gyms, sports associations, social gatherings of all kinds. The path allowed to define a peer education model capable of enabling the participants to activate health promotion interventions for the prevention of doping risk behaviors, each in their own setting. CONCLUSIONS: In conclusion, we can say that prevention programs are the more effective the more they are addressed to young people and adolescents and provide interactive and action-oriented interventions. Successful initiatives aim to emphasize the development of life skills and to influence numerous determinants of behavior, including individual attitudes, knowledge, motivations, interpersonal relationships and social norms. If the aim is to act on the change of behavior, the efforts will be more successful if the content of the intervention will give due consideration to the context in which it applies and the target population, involving it and addressing its specific needs and values.

The prevention of doping and the improper use of drugs and food supplements in sports and physical activities: a survey on the activity of the prevention departments of Italian local health authorities.

INTRODUCTION: Doping is an important public health problem widespread not only among elite athletes, but also among amateur and recreational athletes and the general population. In Italy the introduction of doping prevention within the Essential Levels of Care (LEA) with the DPCM 12/1/2017 represents a crucial step towards the implementation of education and health promotion interventions. In this context, the Departments of Prevention (DP) of the Local Health Authorities (LHA) have to play a fundamental role, becoming the cultural and operational reference on this issue. As part of the "Doping prevention: development of a permanent educational tool coordinated by the National Health Service Prevention Departments" project, funded by the Italian Ministry of Health, a survey was conducted on the activities carried out by the DP regarding doping prevention and improper use and abuse of drugs and food supplements in sports and physical activities, as a basis for the harmonization of organizational structures and prevention programs and the creation of a collaboration network at a regional and national level. METHODS: A semi-structured questionnaire consisting of 11 questions, prepared on an electronic platform, was sent to the DP of all the Italian LHA. RESULTS: A total of 38 DP out of 131 (29%) completed the questionnaire, with representation from all regions. 42.1% of DP carried out or are still running programs for the prevention of doping, a percentage that decreases to 27% considering the programs for the prevention of misuse and abuse of drugs and food supplements in sports and in physical activities; in less than half of the DP, 37.5% and 41.7%, respectively, dedicated funds have been allocated. The professionals most involved in prevention of doping are the Specialists in Sport Medicine (81.3%) followed by Specialists in Hygiene (43.8%) and Psychologists (37.5%), while Health Care Assistants (50%) are the professionals most involved in the prevention of the improper use of drugs and food supplements, followed by Specialists in Hygiene and Specialists in Sport Medicine (40%). Most of the DP (71.9%) believe that the introduction of programs to prevent and counteract doping in the LEA will have repercussions on their approach against doping. CONCLUSIONS: The survey, although conducted on a limited sample, has provided an important framework relating to programs for the prevention of doping and the misuse and abuse of drugs and food supplements in sports and in the physical activities carried out by DP. A remarkable heterogeneity has been highlighted, both at national and regional level. It is urgent to provide DP with homogeneous and effective organizational models and adequate operational tools, paying particular attention to the training of all the professionals involved. It is also essential to implement permanent monitoring tools.

Exploring the association between physical activity and gut microbiota composition: a review of current evidence.

The gut microbiota is implicated in digestive, metabolic and immune processes of the host. The physiological and pathophysiological functions of the intestinal microbiota depend of its composition, and several individual or external factors may be associated with the presence of some categories, phyla or species of microorganisms in the gut. In particular, two bacterial phyla - Firmicutes and Bacteroidetes - are predominant in the human gut and their relative concentrations seem to be related with age, gender, diet habits and weight status. In the last decade, several studies have tried to characterize the possible role of physical activity in determining qualitative and quantitative composition of the intestinal microbiota. This review is aimed at exploring the current evidences regarding the association between physical activity and gut microbiota composition in animal models and in the humans. Further studies are needed to clarify the mutual relationships among exercise, diet, nutritional supplements/doping agents and gut microbiota.

Higher education on physical activity and sport: The Movement Sciences graduate as a resource to promote healthy lifestyles in the National Health System.

Currently, physical activity is an important tool that may be useful to improve people health and quality of life through sustainable and effective interventions. In order to obtain durable improvements of individuals' behaviors, however, consistent changes in services organization and the creation of new opportunities in life settings are needed. This requires necessarily the involvement of complementary figures with specific competences. Considering their peculiar training curriculum, Movement Sciences graduates represent key figures in this context and they can operate fully in interventions of health education and promotion, within multidisciplinary teams collaborating with the National Health System (NHS), in order to obtain the global undertaking of citizens.

Health protection and safety in physical activity and sport promotion: the continuous evolution of roles and regulations in Italy.

The promotion of physical activity is one of the main prevention strategies because of its fundamental role in reducing the risk of developing the major chronic diseases causing disability and death. Consistently with the approach of "health in all policies" for different age classes and health conditions, the Italian Ministry of Health identifies physical activity as a valid and economically sustainable instrument of prevention and health promotion for all the community. By highlighting the preventive role of physical activity, the Italian Government has recently inserted specific services regarding physical activity promotion among the Essential Levels of Care. The existing criticalities regarding the certification of physical fitness for sport practice, the use of defibrillator, and the transparency and safety criteria which should be guaranteed to the users of sport facilities are discussed in this article. The current debate among Italian Institutions may contribute to resolve these criticalities and to simplify the procedures, in order to make the practice of sport and physical activity even more accessible and safe for all citizens.

Analyzing the Effects of Psychotherapy on Weight Loss after Laparoscopic Gastric Bypass or Laparoscopic Adjustable Gastric Banding in Patients with Borderline Personality Disorder: A Prospective Study.

BACKGROUND AND AIMS: Personality disorders are frequently associated with eating disorders in obese patients and may negatively affect weight loss and maintenance after bariatric surgery. This non-randomized study aimed to assess the effects of different psychotherapeutic interventions on weight loss in a sample of patients with borderline personality disorder who underwent laparoscopic gastric bypass or laparoscopic adjustable gastric banding. MATERIALS AND METHODS: A total of 153 bariatric patients meeting borderline personality disorder criteria were chosen voluntarily and consecutively to undergo an interpersonal individual treatment (n = 50), a dialectical behavioral group treatment (n = 50), or treatment as usual (n = 53) for a year after surgery. Their body mass index was measured before and at the end of each treatment. RESULTS AND CONCLUSION: A total of 12 patients (7.8%) dropped out of the study. Significantly higher body mass index reductions were registered in both experimental groups (-14.2 and -9.4 kg/m2, respectively) compared with the treatment as usual group (-2.1 kg/m2; p < 0.01). Treated patients who underwent laparoscopic gastric bypass (total n = 94) showed better outcomes than those who underwent laparoscopic adjustable gastric banding (total n = 45), while no differences were observed in untreated patients. This study demonstrates the role of pre-operative psychological assessment and post-operative psychotherapeutic support in improving weight loss among bariatric patients with borderline personality disorder. A randomized controlled trial is needed to confirm these preliminary findings.

The role of the hygienist in prevention and health promotion through physical activity: the contribute of the Working Group "Movement Sciences for Health" of the Italian Society of Hygiene.

Inactivity is the fourth leading risk factor for chronic diseases morbidity and mortality, with high related costs. Exercise represents a useful instrument of preventive medicine due to its effects in maintaining and improving psycho-physical wellbeing at any age and condition. The promotion of physical activity may represent an important prevention strategy for public health, and it implies an interaction among several figures from health and wellbeing settings. Due to their competencies in prevention and health promotion, hygienists play a fundamental role as intermediary among the different actors involved in this multidisciplinary scenario. The Working Group "Movement Sciences for Health" of the Italian Society of Hygiene, established in 2009, is engaged in detailing, evaluating and strengthening the role of physical activity for health promotion. It combines rigorous research activities regarding human movement for health with their application in public health setting and with the evaluation of their sustainability. Its attention is also focused on the safety aspects related to structural conditions of sport facilities and to health conditions or behaviours of their users as well. These activities led to numerous scientific publications and training events.

Swimming pools and health-related behaviours: results of an Italian multicentre study on showering habits among pool users.

OBJECTIVES: Showering before entering a swimming pool is highly recommended to reduce the risk of biological and chemical contamination. This study evaluated the behaviour of indoor swimming pool users; analysed the variables associated with lack of showering; and assessed awareness of the importance of showering. STUDY DESIGN: Cross-sectional study. METHODS: A self-administered questionnaire was used to collect data about users of swimming pools located in five different Italian cities. The association between specific variables and the lack of showering was assessed. P < 0.05 was considered to indicate statistical significance. RESULTS: In total, 4356 questionnaires were analysed. Sixty-five percent of interviewees always showered before entering the pool. The main reason given for pre-swim showering was 'to wash oneself' (50.5%); or 'to get used to the temperature of the water' (44.3%); and 5.2% answered 'for both reasons'. Risk factors significantly associated with lack of showering were: female sex (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.2-1.59), age 14-17 years (OR 5.09, 95% CI 3.40-7.64); not reading the swimming pool rules (OR 1.24, 95% CI 1.10-1.41); living in Central Italy (OR 3.3, 95% CI 2.65-4.1) or Southern Italy (OR 1.35, 95% CI 1.18-1.55); and previous/current attendance of a swimming course (OR 1.7, 95% CI 1.48-1.97). CONCLUSIONS: The results revealed low compliance with the rule of showering before entering a swimming pool, and little awareness of the preventive role of showering in the hygienic management of swimming pools. There is a need for targeted educational interventions to inform swimming pool users of the reasons for the importance of showering before entering a pool.

Body art practices and health risks: young adults' knowledge in two regions of southern Italy.

BACKGROUND: In the past several decades the number of individuals, particularly young adults, acquiring body art has increased very seriously in occidental society. In order to verify young adults' practices and knowledge of the risks related to body art, an investigation was conducted among university freshmen in Bari (Apulia Region) and Naples (Campania Region), both in Southern Italy. METHODS: The study was carried out during the period 2008-2010 through an anonymous questionnaire distributed to 3,868 people selected among 26 Degree Courses of the University of Bari and Naples Parthenope. The two regional samples were matched for age and sex. RESULTS: On the whole, 84.4% declare to know the infectious risks associated with body art practices, but only 4.1% of them correctly identified the infectious diseases which can be transmitted through these procedures; while 59.2% of the sample declared that non-infectious diseases can occur after a tattoo or a piercing, but only 5.4% of them correctly identified allergies, cysts, bleeding and scars. The possible occurrence of infectious and non-infectious diseases has been acknowledged by most students in Apulia region (89.7 versus 79.1% and 64.8 versus 53.6% respectively). In this Region, of the 1,001 (32.4%) pierced and 597 (19.8%) tattooed youths 23.4% reported complications. Campania region youths reported a greater number of complications than Apulia did (30.3 versus 13.1%) and they also purchased more frequently their tattoos or piercings in unauthorized facilities (35.3% versus 15.9%). CONCLUSIONS: With regard to the knowledge of health risks associated to body art, it has been registered a higher awareness of infectious than non-infectious diseases. Information about freshmen's knowledge and practices could help in effective planning of health promotion strategies.

Environmental microbial contamination in dental setting: a local experience.

INTRODUCTION: Patients and operators are exposed during dental practice to an infective risk, which derives especially from microorganisms suspended in aerosols. Environmental microbiological monitoring in dental settings represents a good instrument to detect critical situations. METHODS: In order to investigate environmental microbial contamination level in a local reality, we analyzed water, air and surfaces samples of a community-based dental facility by using protocol and threshold values proposed in a recent multicenter study carried out by the Italian Society of Hygiene, Preventive Medicine and Public Health (S.It.I.) working group "Hygiene in Dentistry". Microbial contamination was assessed in the same room for 4 non-consecutive weeks during all the five working days, before and at the end of the daily activity. Air was sampled also during clinical activity, through both active and passive sampling systems. RESULTS: Contamination of water showed a decrease during activities, while a decrease in air contamination was registered only at the end of the day. Passive sampling values resulted more often above threshold values adopted. At the same time, surfaces contamination increases at the end of the activity. It seems that in the dental clinic analyzed microbial buildup represents the higher critical element. No differences have been registered among the different days of the week. DISCUSSION: Our study highlights the need to improve disinfection procedures and air treatment systems in the considered environment. Microbiological monitoring could represent an important element to detect the presence of risk factors and to adopt control measures.

Candida albicans identification: comparison among nine phenotypic systems and a multiplex PCR.

BACKGROUND: Candida albicans is the most common fungal pathogen isolated from clinical samples and is also the most common yeast species carried as a commensal by healthy individuals although some non-C. albicans species account for an important number of infections. OBJECTIVES: To compare nine phenotypic systems for C. albicans identification [API 20C AUX; RapID Yeast Identification panel (RYIP); Vitek2 ID-YST system; chromogenic media, CHRO-Magar, Oxoid Chromogenic Candida Agar (OCCA), Candida ID2, Candida Identification Agar, CandiSelect 4, and Chromalbicans Agar] with multiplex PCR. PATIENTS/METHODS: A collection of 390 yeast strains was obtained by routine isolation from oral and vaginal swabs. All of the yeasts isolated were tested for germ tube formation, and then submitted to a multiplex PCR protocol tested in previous studies, and to nine phenotypical commercial methods, together with the reference ATCC strains. Comparison was limited to the ability of the tests to identify C. albicans. RESULTS: 253 isolates were provisionally identified as C. albicans by germ tube, and their identities were further confirmed with the multiplex PCR. Sensitivity of phenotypical systems ranged from 81.9% (Vitek2) to 87.7% (Candida ID2 e CHROMagar). For specificity, the highest value was 96.8% for Candida ID2, and the lowest value (75.1%) was for Chromalbicans Agar. CONCLUSIONS: Although with differences in discriminatory power, the methods tested showed overall acceptable levels of sensitivity and specificity respect to the multiplex PCR; therefore, all could be useful for C. albicans identification where molecular differentiation is not available.

Microbiological quality of the water of recreational and rehabilitation pools: a 2-year survey in Naples, Italy.

OBJECTIVES: To analyse and compare the microbiological quality of the water in rehabilitation and recreational swimming pools in Naples, Italy. STUDY DESIGN: A 2-year survey investigated the microbiological quality of the water in seven recreational and rehabilitation pools, and the findings were compared with local guidelines. METHODS: For each facility, water was sampled at the intake point and at two points inside the pool. Total microbial contamination and Pseudomonas aeruginosa contamination were evaluated. RESULTS: Microbial mesophilic contamination and P. aeruginosa contamination were found in all seven pools. Microbial mesophilic contamination was more common in recreational pools (3-4.2% samples were above threshold values), probably due to the greater number of bathers. P. aeruginosa was more common in intake water than water inside the pool [mean values of 19.3 and 22.5 colony-forming units (cfu)/ml in recreational and rehabilitation pools, respectively]. A longer period of contact with chlorine and the dilution process may have led to lower levels of P. aeruginosa in the pool water (range 2-15 cfu/ml). CONCLUSIONS: There is a need to improve disinfection and cleaning procedures, with consideration given to the different uses and daily bather loads of each pool type. There is also a need to monitor water quality and to increase users' knowledge and awareness of the risks.

Oral candidiasis: a comparison between conventional methods and multiplex polymerase chain reaction for species identification.

BACKGROUND/AIM: Oral candidiasis is the most common fungal infection in dental practice, and is caused by yeasts that are normally present in the endogenous flora. METHODS: To evaluate a rapid diagnostic method for identification of Candida oral isolates, a multiplex polymerase chain reaction (PCR) was carried out on colonies and on oral rinse solutions from 95 subjects with suspected oral candidiasis and results were compared with those from seven commonly used phenotypic identification systems. RESULTS: Between four and nine species were characterized in the samples by the phenotypic methods. PCR identified the same species in 60 (74%) samples from both colony and oral rinse solutions. Statistical analysis, carried out only for the three most frequently isolated species (Candida albicans, Candida glabrata, and Candida tropicalis), showed good concordance in the comparison of multiplex PCR with API 20C AUX and with the Rapid Yeast Identification Panel; conversely, significant differences were registered in the comparison between the molecular method and other phenotypic systems, including four chromogenic media and the automated system Vitek2. DISCUSSION: Multiplex PCR was rapid and effective in the identification of Candida species and allowed the detection of more than one species in the same sample.

[Guidelines for infection control practices for dentistry]. / Linee guida dei Centres for Disease Control and Prevention (CDC) per il controllo delle infezioni in odontoiatria: analisi e considerazioni.

The infectious hazard in the dental offices (surgeries) is a relevant Public Health problem, especially if the large spread of this health practices is considered. The Working Group (WG) "Hygiene in Dentistry" of the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI) deals with the prevention in dental practice. The WG carried out some surveys in order to evaluate both the knowledge of cross-infection hazards in dental personnel and the microbial contamination in dental clinics. The results showed that some aspects of the daily practice could be at high risk for infectious diseases. Therefore, expecting the launch of Italian Guidelines on the infection-control in dental practices, the WG translated and revised the CDC Guidelines for infection control in dental-care settings. This document represents a good practices guide in the management of the dental outpatient.