Prevalence of maternal antenatal anxiety and its association with demographic and socioeconomic factors: A multicentre study in Italy.

BACKGROUND: Maternal antenatal anxiety is very common, and despite its short- and long-term effects on both mothers and fetus outcomes, it has received less attention than it deserves in scientific research and clinical practice. Therefore, we aimed to estimate the prevalence of state anxiety in the antenatal period, and to analyze its association with demographic and socioeconomic factors. METHODS: A total of 1142 pregnant women from nine Italian healthcare centers were assessed through the state scale of the State-Trait Anxiety Inventory and a clinical interview. Demographic and socioeconomic factors were also measured. RESULTS: The prevalence of anxiety was 24.3% among pregnant women. There was a significantly higher risk of anxiety in pregnant women with low level of education (p < 0.01), who are jobless (p < 0.01), and who have economic problems (p < 0.01). Furthermore, pregnant women experience higher level of anxiety when they have not planned the pregnancy (p < 0.01), have a history of abortion (p < 0.05), and have children living at the time of the current pregnancy (p < 0.05). CONCLUSION: There exists a significant association between maternal antenatal anxiety and economic conditions. Early evaluation of socioeconomic status of pregnant women and their families in order to identify disadvantaged situations might reduce the prevalence of antenatal anxiety and its direct and indirect costs.

Prescribing Patterns of Psychotropic Drugs and Risk of Violent Behavior: A Prospective, Multicenter Study in Italy.

BACKGROUND: This prospective cohort study aimed at evaluating patterns of polypharmacy and aggressive and violent behavior during a 1-year follow-up in patients with severe mental disorders. METHODS: A total of 340 patients (125 inpatients from residential facilities and 215 outpatients) were evaluated at baseline with the Structured Clinical Interview for DSM-IV Axis I and II, Brief Psychiatric Rating Scale, Specific Levels of Functioning scale, Brown-Goodwin Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, and State-Trait Anger Expression Inventory-2. Aggressive behavior was rated every 15 days with the Modified Overt Aggression Scale and treatment compliance with the Medication Adherence Rating Scale. RESULTS: The whole sample was prescribed mainly antipsychotics with high levels of polypharmacy. Clozapine prescription and higher compliance were associated with lower levels of aggressive and violent behavior. Patients with a history of violence who took clozapine were prescribed the highest number of drugs. The patterns of cumulative Modified Overt Aggression Scale mean scores of patients taking clozapine (n = 46), other antipsychotics (n = 257), and no antipsychotics (n = 37) were significantly different (P = .001). Patients taking clozapine showed a time trend at 1-year follow-up (24 evaluations) indicating a significantly lower level of aggressive behavior. Patient higher compliance was also associated with lower Modified Overt Aggression Scale ratings during the 1-year follow-up. CONCLUSION: Both inpatients and outpatients showed high levels of polypharmacy. Clozapine prescription was associated with lower Modified Overt Aggression Scale ratings compared with any other antipsychotics or other psychotropic drugs. Higher compliance was associated with lower levels of aggressive and violent behavior.

Biomonitoring of Metal Exposure During Additive Manufacturing (3D Printing)

BACKGROUND: Additive manufacturing (AM) is a rapidly expanding new technology involving challenges to occupational health. Here, metal exposure in an AM facility with large-scale metallic component production was investigated during two consecutive years with preventive actions in between.METHODS: Gravimetric analyzes measured airborne particle concentrations, and filters were analyzed for metal content. In addition, concentrations of airborne particles <300 nm were investigated. Particles from recycled powder were characterized. Biomonitoring of urine and dermal contamination among AM operators, office personnel, and welders was performed.RESULTS: Total and inhalable dust levels were almost all below occupational exposure limits, but inductively coupled plasma mass spectrometry showed that AM operators had a significant increase in cobalt exposure compared with welders. Airborne particle concentrations (<300 nm) showed transient peaks in the AM facility but were lower than those of the welding facility. Particle characterization of recycled powder showed fragmentation and condensates enriched in volatile metals. Biomonitoring showed a nonsignificant increase in the level of metals in urine in AM operators. Dermal cobalt and a trend for increasing urine metals during Workweek Year 1, but not in Year 2, indicated reduced exposure after preventive actions.CONCLUSION: Gravimetric analyses showed low total and inhalable dust exposure in AM operators. However, transient emission of smaller particles constitutes exposure risks. Preventive actions implemented by the company reduced the workers' metal exposure despite unchanged emissions of particles, indicating a need for careful design and regulation of the AM environments. It also emphasizes the need for relevant exposure markers and biomonitoring of health risks.

Influence of nutrition provision during the first two weeks of life in premature infants on adolescent body composition and blood pressure / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Adequate nutrition is paramount for premature infants. Longitudinal information is scant on the effects of early nutrition and later growth. The purpose of this study was to determine the influence of early energy and protein provision in premature infants on adolescent body composition and blood pressure.</p><p><b>METHODS</b>In 2007-2008 we obtained data from 36 male (12.3±1.7 years) and 25 female (11.5±1.8 years) adolescents born preterm at <34 weeks gestation (range 23-34 weeks) between October 1st 1989 and December 31st 1995 (birth weight <1850 g). The adolescents were divided into groups depending on infant intake mode (enteral vs parenteral), energy provision (<70 kcal/kg/d and ≥70 kcal/kg/d) and protein provision (>2.5 g/kg/d for ≥5 days and >2.5 g/kg/d for <5 days) during the first 14 days of life.</p><p><b>RESULTS</b>After controlling for birth weight and biological maturity, adolescents who received ≥70 kcal/kg/d during infancy were significantly taller (163±11 cm vs. 156±11 cm) and heavier (58±16 kg vs. 49±16 kg) than adolescents who received <70 kcal/kg/d. There were no significant differences in systolic and diastolic BP and total percent body fat between the two groups.</p><p><b>CONCLUSIONS</b>Our data suggests that higher infant energy provision appears to be related to adolescent size, it does not appear to contribute to adverse risk factors such as higher systolic BP or increased body fat.</p>