Attitude and concerns of healthy individuals regarding post-mortem brain donation. A qualitative study on a nation-wide sample in Italy.

BACKGROUND: Collecting post-mortem brain tissue is essential, especially from healthy "control" individuals, to advance knowledge on increasingly common neurological and mental disorders. Yet, healthy individuals, on which this study is focused, are still understudied. The aim of the study was to explore, among healthy potential brain donors and/or donors' relatives, attitude, concerns and opinion about post-mortem brain donation (PMBD). METHODS: A convenience sampling of the general population (twins and their non-twin contacts) was adopted. From June 2018 to February 2019, 12 focus groups were conducted in four Italian cities: Milan, Turin, Rome and Naples, stratified according to twin and non-twin status. A qualitative content analysis was performed with both deductive and inductive approaches. Emotional interactions analysis corroborated results. RESULTS: One hundred and three individuals (49-91 yrs of age) participated. Female were 60%. Participants had scarse knowledge regarding PMBD. Factors affecting attitude towards donation were: concerns, emotions, and misconceptions about donation and research. Religion, spirituality and secular attitude were implied, as well as trust towards research and medical institutions and a high degree of uncertainty about brain death ascertainment. Family had a very multifaceted central role in decision making. A previous experience with neurodegenerative diseases seems among factors able to favour brain donation. CONCLUSIONS: The study sheds light on healthy individuals' attitudes about PMBD. Brain had a special significance for participants, and the ascertainment of brain death was a source of debate and doubt. Our findings emphasise the importance of targeted communication and thorough information to promote this kind of donation, within an ethical framework of conduct. Trust in research and health professionals emerged as an essential factor for a collaborative attitude towards donation and informed decision making in PMBD.

The two behavioural risk factor surveillances on the adult and elderly populations as information systems for leveraging data on health-related sustainable development goals in Italy.

INTRODUCTION: Current lengthening of average life and constant increase of population ageing associated to forces that include rapid unplanned urbanisation and globalisation of unhealthy behaviours have determined the huge relevance of noncommunicable diseases (NCDs). Monitoring key modifiable behavioural risk factors has resulted to be crucial both in spatial terms and as per temporal trends in order to allow comparisons between different geographic areas or levels and over time. MATERIALS AND METHODS: In Italy, PASSI (Progressi delle Aziende Sanitarie per la Salute in Italia) and Passi d'Argento are the ongoing Behavioural Risk Factor Surveillance Systems (BRFSSs), respectively, on adults (people aged 18-69) and elderly (65 and older). RESULTS: The two Italian surveillances are information systems providing data not only on the third Sustainable Development Goal (SDG) that explicitly addresses ensuring healthy lives and promoting well-being for all, but on a total of nine health-related SDGs (HRSDGs) and 19 HRSDG targets/indicators. We describe these pairs more in detail specifying where in case of BRFSS core indicators (N = 14 HRSDG targets/indicators) concerning six HRSDGs or, on the other hand, as per BRFSS further in-depth analysis (N = five HRSDG targets/indicators) in regard of four different HRSDGs. About the HRSDG 3, HRSDG target 3.4, HRSDG indicator 3.4.1, from the PASSI and Passi d'Argento data it is possible not only to detect the prevalence of NCDs in adults and elderly living in Italy, but also to evaluate the social determinants of health, such as gender, age group, educational level, economic difficulties, as well as the associations with modifiable lifestyle risk factors. CONCLUSIONS: The two Italian BRFSSs generate accurate data, which are highly relevant to design, implement, monitor, and evaluate programs and policies at different levels (local, regional, national) for NCD prevention and health promotion. They provide numbers which can also serve as propaedeutic or, in some cases, complementary ground to address a robust measurement of several HRSDG patterns.

Prevalence of tobacco smoking and electronic cigarette use among adolescents in Italy: Global Youth Tobacco Surveys (GYTS), 2010, 2014, 2018.

This research aims to study tobacco smoking and vaping among adolescents in Italy through three repeat national cross sectional surveys conducted before (in 2010, 2014) and after (2018) the 2016 introduction of the European Union - Tobacco Product Directive (EU-TPD) and its transposition into Italy, and before Juul entered the Italian market in 2019. Prevalence of smoking and vaping, access to cigarettes and electronic cigarettes in adolescents aged 13-15 years were estimated from the 2010, 2014, and 2018 Global Youth Tobacco Surveys (N = 1587; N = 1428; N = 1518, respectively) conducted in Italy. Prevalence of current smokers and/or current vapers combined, accounting for dual users, non-significantly increased from 20.7% in 2010 to 27.9% in 2018. Although current smokers stalled around 20%, current vapers substantially increased from 0% in 2010, 7.4% in 2014, to 17.5% in 2018, and current exclusive vapers recorded an almost 3-fold significantly increase from 2.9% in 2014 to 8.2% in 2018. Moreover, 42% of ever vapers used nicotine-free electronic cigarettes, and only 5% of current users were frequent vapers (≥20 days in the past month). About 65% of current smokers and 76% of current vapers easily accessed to cigarettes or electronic cigarettes in 2018. After 2 years from its implementation in 2016, the EU-TPD does not seem to have slowed down the increase in vaping among Italian adolescents before Juul entered the Italian market. Additional research is needed in order to show a clear association between EU-TPD and changes in vaping and smoking in Italy and in the EU.

[Food-borne illnesses: a survey of regional reference laboratories in Italy.]. / Malattie trasmesse attraverso gli alimenti: indagine sui laboratori regionali di riferimento in Italia.

Many problems exist in the surveillance of human food-borne illnesses, and one of the most important is identifying the responsible microorganisms. For this reason, a survey was carried out to identify regional reference laboratories and laboratories with the capacities necessary for identification of pathogenic microorganisms in Italy. All 21 Italian regions and autonomous provinces completed the survey except three (Basilicata, Tuscany and Sardinia).Only 6% of the identified laboratories were found to have been formally designated as regional reference laboratories. Seventy-one percent of all laboratories reported having the capacity to diagnose over half (>7/13) of the listed bacteria, 69% over half of the listed parasites (> 4/8) and 51% over half of the listed viruses (>2/4). No differences were found in the capability to diagnose bacterial and parasitic infections, between laboratories in northern, central and southern Italy, while a significant difference was found in the capability to diagnose viral infections between laboratories in the three geographical areas (p <0.01). This study clearly shows that there is a need to improve diagnostic capacities of regional reference laboratories and laboratories involved in the surveillance of food-borne illnesses in Italy.