Alcohol-Related Behaviour in Freshmen University Students in Sardinia, Italy.

This study aims to provide a picture of University of Cagliari students' alcohol-related behaviour and to explore factors associated with it. Data were collected by administering a questionnaire to 992 freshmen university students from different programs consisting of twelve closed questions, including three questions from the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C short form). Three subgroups of alcohol-related behaviour were distinguished (risky drinkers, social drinkers and abstainers). In order to explore factors associated with patterns of alcohol consumption, a multivariate logistic regression was performed. The prevalence of risky drinkers was 35%. A binge-drinking behaviour at least once in the last twelve months was declared by 65% (more widespread in men and in students living away from their parents). Risky consumption is significantly associated with age of onset of alcohol use, living away from parents' home, drinking outside meals and attending health courses. Regarding the levels of daily alcohol consumption perceived as a health risk, 66% of men and 88% of women indicate values higher than those recommended. The results underline the need for tailored prevention measures. University could be a promising setting to implement actions according to a health promotion perspective, to empower students to control their alcohol consumption.

[Accurate compiling of the hospital discharge records according to clinicians' perception: critical issues and perspectives]. / L'accurata compilazione delle schede di dimissione ospedaliera secondo la percezione dei medici: criticità e prospettive.

OBJECTIVES: to explore clinicians vision on hospital discharge records in order to identify useful elements to foster a more accurate compiling. DESIGN: qualitative research with phenomenological approach. SETTING AND PARTICIPANTS: participants were selected through purposive sampling among clinicians of two hospitals located in Sardinia; the sample included 76 people (32 medical directors and 44 doctors in training). MAIN OUTCOME MEASURES: identified codes for themes under investigation: vision of accurate compiling, difficulties, and proposals. RESULTS: collected data highlighted two prevailing visions, respectively focused on the importance of an accurate compiling and on the burden of such activity. The accurate compiling is hindered by the lack of motivation and training, by the limits of the registration system and the information technology, by the distortions induced by the prominent role of the hospital discharge records in the evaluation processes. Training, timely updating of the information system accompanied by a proper cross-cultural validation process, improvement of the computer system, and activation of support services could promote more accurate compiling. CONCLUSIONS: the implementation of services, unconnected with evaluation and control processes, dedicated to training and support in the compiling of the hospital discharge records and in the conduction of related epidemiological studies would facilitate the compliance to the compilation. Such services will make tangible the benefits obtainable from this registration system, increasing skills, motivation, ownership, and facilitating greater accuracy in compiling.

Professional competencies in health promotion and public health: what is common and what is specific? Review of the European debate and perspectives for professional development.

According to the Nairobi Call to Action, the growth of practitioners' skills can be favoured by setting accreditation standards and by reorienting professional competencies of current and future health workers. This will make it possible to develop a critical mass of competent practitioners, foster training, and increase visibility of the professional field. Through a review of the literature, the authors offer an overview of competency-based strategies for professional development in health promotion. The main research questions discussed were as follows: Is there a shared definition of public health?; Is there a shared definition of health promotion?; Who are the main stakeholders for public health and health promotion in Europe?; What is the meaning of professional competencies in education and practice for public health and health promotion?; Is there a shared system of professional core competencies in public health and health promotion?;What is common and what is specific between the two systems of professional competencies?; Is it useful and feasible to create specific strategies of professional development for public health and health promotion? A transformative use of competencies makes it possible to inform students, professionals, employers, and political decision-makers about what is expected from a specific profession and its values.

Developing a competency-based Pan-European Accreditation Framework for Health Promotion.

BACKGROUND: The CompHP Pan-European Accreditation Framework for Health Promotion was developed as part of the CompHP Project that aimed to develop competency-based standards and an accreditation system for health promotion practice, education, and training in Europe. METHOD: A phased, multiple-method approach was employed to facilitate consensus building with key stakeholders in health promotion across Europe. Consultation processes included focus and discussion groups at European and country levels, an online survey, a web-based consultation, and testing in academic and practice settings. Successive drafts of the Framework (a total of five) were revised based on the feedback from each consultation stage. FINDINGS: A total of 405 participants from 29 of the 34 target countries contributed to the consultation process. The overall response to the Framework was positive, with negative feedback focusing mainly on the barriers that may impact on its implementation. CONCLUSIONS: The CompHP Pan-European Accreditation Framework for Health Promotion provides an agreed system to promote quality assurance and competence for health promotion practice and education in Europe. The Framework, which builds on the CompHP Core Competencies and Professionals Standards, outlines the systems and processes for the accreditation of health promotion practitioners and health promotion education and training by accrediting organizations at national and European levels.

Antonovsky's Sense of Coherence Scale: Cultural Validation of Soc Questionnaire and Socio-Demographic Patterns in an Italian Population.

BACKGROUND: The theory of salutogenesis entails that the ability to use resources for one's wellbeing is more important than the resources themselves. This ability is referred to as the Sense of Coherence (SOC). This paper present the cross-culturally adapted version of the Italian questionnaire (13 items), and the psychometric and statistical testing of the SOC properties. It offers for the first time a view of the distribution of SOC in an Italian sample, and uses a multivariate method to clarify the effects of socio-demographic determinants on SOC. METHODS: The cross-cultural adaptation of the English SOC questionnaire was carried out according to the guidelines reported in literature. To evaluate the psychometric and statistical properties we assessed reliability, validity and frequency distribution of the collected data. A Generalised Linear Model was used to analyse the effects of socio demographic variables on SOC. RESULTS: The Italian SOC scale demonstrates a good internal consistency (α = 0.825). The model obtained with factorial analysis is not related to the traditional dimensions of SOC represented in more than one factor. The multivariate analysis highlights the joint influence of gender, age and education on SOC. CONCLUSION: The validated Italian questionnaire is now available. Socio-demographic variables should be taken into account as confounders when SOC values among different populations are compared. Presenting data on SOC of the Italian population makes a control population available for comparisons with specific subgroups, such as patient populations. Now, the Italian challenge is to integrate the salutogenic approach into Public Health police.

A bottom-up art event gave birth to a process of community empowerment in an Italian village.

Although community participation is a component of community empowerment, it often remains a theoretical exhortation. Reporting experiences which enable people to take control of their lives, can be useful to suggest practical elements for promoting empowerment. This article describes the experience of a Sardinian village (Ulassai), that developed into a community empowerment. The Laverack's operational domains were used to measure the community empowerment process. The process started in 1979 'almost by chance' with an art performance that was the entry point for community participation. This experience has been the foundation for the community empowerment. Citizens acquired the 'ability of thinking and planning as a community and not mere individuals'. In the following 30 years citizens gave birth to several outcomes rooted in that event. The intermediate outcomes highlight the 'ability of action by a group to mobilize existing resources, and act collectively against opposing forces'. The long-term outcomes demonstrate the 'ability to integrate the cultural experiences that strengthened the community's identification into a sustainable community asset', and the 'ability to cope with global environmental challenges and to collaborate on an equal basis with other stakeholders. The pathways to community empowerment, showed by the community of Ulassai, overlap with the 'operational domains'. The Ulassai experience shows that the empowerment process can start from an event apparently unrelated to health promotion. This community experience illustrates the positive role arts can play in community development. Hence, the call for health promoters to look carefully into those situations that occur naturally in communities.

A healthy nutrition programme with child 'Cub Scouts'.

This commentary describes the development of the Health Nutrition programme carried out by University of Cagliari with 19 Italian scout groups. In total 353 children between the ages of 6 and 10 participated in the programme. The objectives were to develop children's knowledge on the Mediterranean diet through games. The project was developed between January and June of 2006. The activities were carried out by the Cub Scout leaders with the objective to improve the Cub Scouts' knowledge on nutrition. Every week they implemented a different game, which showed the Cub Scouts' increased levels of interest and participation. This experience demonstrated that it is possible to involve children in a context outside of the school to carry out a health promotion programme.

[Genetically modified organisms: European and Italian legislation to protect citizens' health]. / O.G.M.: legislazione Europea e Italiana in tutela della salute del cittadino.

UNLABELLED: The development of GM foods and organisms has concentrated everyone's attention on the importance of food safety and on protecting citizens' health, and inevitably influenced healthcare policies regarding food safety. Personal ethical beliefs regarding food and in particular, the consumption of foods derived from biotechnology should be taken into account when deciding healthcare policy. AIM: The aim of this study was to analyse whether European, Italian and Regional legislation meets basic human rights regarding health and the right to choose, based on the precautionary principle. METHODS: European and Italian laws regarding the production and marketing of GM foods were analysed and compared to food safety legislation, in order to evaluate how and to what degree existing legislation protects consumers' right to choose. Results show that existing legislation protects consumers from possible foodborne diseases, but the right to informed consent and to free choice is not warranted. Existing laws do not attach enough importance to consumers' right to information; arbitrary threshold levels set for labeling and clauses concerning technical causes allow food businesses to avoid labeling and do not give consumers the possibility of making an informed choice.

Does the "hygiene hypothesis" provide an explanation for the high prevalence of multiple sclerosis in Sardinia?

The "hygiene hypothesis" describes a hypothetical scenario in which the balance between TH1 (defending host against bacterial and viral infections) and TH2 (defending against parasitic infections) immune responses is pivotal and in which the consequence of reducing the infectious stressors during infancy is increased autoimmunity (TH1-mediated) and allergy (TH2-mediated). Many epidemiological observations confirm that allergic and autoimmune diseases are significantly increased in the "developed" countries and negatively associated with childhood infections. However, it has been recently revealed that immune elements associated with allergy are extensively involved also in the pathogenesis of autoimmune demyelination and that TH2- and TH1-mediated infections ameliorate the course of the disease confirming that the allergic root is also responsible for the escalation of autoimmune disorders, and both have a common immunological denominator. In the Italian island of Sardinia, MS and type-I diabetes frequencies have sharply increased in the last decades compared to other populations living in the same Mediterranean area. Initial observation led us to believe that environmental changes favoured the MS risk rise, thus sustaining the hygiene hypothesis. However, data on MS prevalence distribution in this territory suggest that other mechanisms than environment have also to be taken into great account. Our recent epidemiological studies reveal significant differences in the MS prevalence between rural and urban areas within the same province of Sassari but, contrarily to what expected from the hygiene hypothesis, MS prevalence is significantly higher in rural, genetically "archaic", areas where the westernalization process has been less pronounced. On this basis we believe that, beside hygiene-related factors, genetics could represent a more relevant determinant of Sardinian high susceptibility to MS.