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.

Dietary supplements intake among youth: preliminary results of a multicentric survey

Background

In the last decades, a wide spread of dietary supplements (DSs) has been observed worldwide. However, DS use is not always motivated by real nutritional needs. In this context, commercial strategies and peers’ suggestions seem to play an important role in determining this habit, with harmful effects on consumers’ health. This cross-sectional study was aimed to evaluate the DS consumption patterns among a sample of undergraduate students attending 14 Italian universities.

Methods

An anonymous web questionnaire was used to collect information about DS use and consumption habits, related motivations and possible adverse effects. The survey is still ongoing and its conclusion is expected to be on May 2022.

Results

On a total of 2019 participants enrolled so far (69.7% female, mean age 22.8±4.7), 72.6% reported the use of at least a DS in the last six months. Multivitamin and multimineral products were the most used, being reported by 35.8% of the participants, while caffeinated energy supplements were the less reported (2.0%). The main reason for DS use was to deal with a specific deficiency following a physician or nutritionist indication (47.8%). The 3.4% of participants reported the occurrence of negative outcomes, mainly gastrointestinal disorders (74%).

Conclusions

These preliminary results evidenced a wide use of DSs in the studied population. Although the main motivation was a nutritional need with a medical recommendation, a notable proportion of the sample assumed DSs without any specific prescription. Thus, it is essential to increase the knowledge about DSs and related threats deriving from their inappropriate use in the population, especially among youths. Further analysis will allow to identify possible correlations with socio-demographic and behavioural variables.

Key messages

• It is essential to increase the knowledge about dietary supplements to avoid an inappropriate use in the population.

• Youths are the most exposed to this consumption.

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.

Undergraduates' perception of health risk of body arts: results of an Italian multicentre study

Background

In the last decades, body art practices such as tattooing and piercing have known an increasing popularity, mainly in young people. These procedures are associated with infectious and non-infectious health risks. The aim of this multicenter study was to evaluate the knowledge of health risks related to body art procedures among undergraduate students from ten Italian universities.

Methods

A cross-sectional study was performed on undergraduate students attending universities in northern, central and southern Italy. An anonymous questionnaire was administered to the participants for collecting their socio-demographic characteristics and for assessing their knowledge about health risks associated with tattoos and piercing.

Results

A total of 2985 students (mean age 23.15 ± 3.99, 73.9% females) completed the questionnaire. 775 (25.9%) of them were from northern Italy, 906 (30.3%) from the Centre and 1324 (44.4%) from the South. More than 90% of the sample were aware that tattoo/piercing procedures can cause health problems. However, the mean values of correct answers about the health risks associated to body art practices were low (5.38 ± 2.39 on a total of 11 correct answers for tattooing and 5.93 ± 3.12 on a total of 14 for piercing). Higher knowledge of the health risks related to tattooing was found among those attending university since more than four years (p < 0.001), life science courses (p < 0.001) and residing/living in the university area (p = 0.023). Those attending North/Centre universities (p < 0.001), since more than 4 years (p < 0.001), life science courses (p < 0.001), and those with graduated father (p = 0.013) had better knowledge of the health risks related to piercing.

Conclusions

These results show a lack of knowledge about health risks related to body art practices in the sample. Educational interventions on this issue targeted to youth are needed in Italy.

Key messages

Undergraduates do not show a good knowledge of health risks related to tattooing and piercing. Educational interventions are needed to raise youth awareness and knowledge of health risks of body art.

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.

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.

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.

Influence of tobacco and e-cig smoke on intestinal microbiota: a systematic review

Background

Intestinal microbiota (IM) plays a crucial role in maintaining human body homeostasis, yet it is highly susceptible to lifestyle changes and environmental factors, such as tobacco and e-cig smoking.

This systematic review aims to investigate the relationship between smoking and IM in healthy humans, by assessing abundance of Phyla and species' variability.

Methods

PubMed, Scopus and Web of Science were searched until April 2019. Studies assessing IM of healthy adult tobacco/e-cig smokers, collected on faecal samples and analysed with genome sequencing of rRNA 16 S, were included. Any type of study design, described in English, was considered. Quality assessment was performed with Methodological index for non-randomized studies and Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies.

Results

Eight out of 1,838 studies (one controlled prospective and seven cross-sectional studies) were included. The only controlled prospective study found a significant increase in α and β-diversity, an increase in Firmicutes (p = 0.014) and a decrease in Bacteroidetes (p = 0.019) after a smoking cessation intervention. In cross- sectional studies, five out of seven studies found a statistically significant decrease in α-diversity among tobacco/e-cig smokers, while results on β-diversity were more contradictory. One out of two studies evaluating Firmicutes found a significant decrease in smokers (p = 0.047). The only study assessing Bacteroidetes found a significant increase among smokers (p = 0.015). Five studies analysed genera, three of them found a decrease in Bacteroides and two an increase in Prevotella.

Conclusions

What seems to emerge is a decreasing species’ variability in smokers, yet it is difficult to profile IM in smokers in terms of phyla’s abundance, because of few studies available and some further limitations, such as small sample sizes and lack of adjusted analysis to cope with confounding factors like gender, diet and other lifestyles.

Key messages

There is a decrease in species’ variability among smokers. Further studies are needed to assess abundance of phyla in healthy smokers, taking into account confounding factors.

Physical activity and gut microbiota: a cross-sectional study

Background

The composition of gut microbiota, and in particular the intestinal abundance of the two main bacterial phyla of Firmicutes and Bacteroidetes, are associated with human health and diseases and may be conditioned by host and environmental factors such as age, gender and diet. The role of Physical Activity (PA) in determining gut microbiota composition has not been yet completely clarified. A cross-sectional study involving undergraduates from two Italian cities is ongoing to explore this relationship.

Methods

Students were invited to provide a fecal sample and to complete the International Physical Activity Questionnaire (IPAQ) in order to define their habitual PA level (inactive, minimally active, health enhancing physical activity -HEPA- active). Demographic and anthropometric information were also collected. DNA from fecal samples was analyzed through the 16S amplicon sequencing. Microbial composition and variability of the samples were evaluated on the light of participants' PA levels.

Results

A total of 153 students (47.7% males, mean age 22.4±2.9, mean BMI 22.3±2.7) participated to the study so far. Firmicutes and Bacteroidetes were the main represented phyla. An increase in Firmicutes (58.3±16 to 61.4±13.3, p = 0.68) and a reduction in Bacteroidetes (32.6±14.8 to 30.3±11.4, p = 0.51) have been registered with the increase of PA level. A higher variability (expressed as Shannon α-index) has been detected in minimally active (3.39±0.03) and HEPA-active (3.41±0) individuals respect to inactive subjects (3.35±0.07) (p = 0.05).

Conclusions

Even if they are not significant, these preliminary results suggest a relationship between PA levels and gut microbiota composition. An active lifestyle seems to be associated with a greater microbial diversity in the gut. Further researches are needed to explain these findings.

Key messages

Physical activity seems to be associated with gut microbiota composition. A greater variability in gut microbiota was found in active people.

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.

T Serotyping and Genomic Profile of Erythromycin- Resistant or -SensitiveStreptococcus pyogenesIsolated in Campania Region, Italy

Streptococcus pyogenes causes mild infections, such as pharyngitis, and severe infections, such as necrotizing fascitis. In recent years, erythromycin-resistant strains of S. pyogenes have been reported in many countries. In some areas of Italy, increased rates of erythromycin resistance were first observed in the mid-1990s. Here, we report epidemiological T serotyping, invasiveness, erythromycin resistance, and PFGE patterns of 99 S. pyogenes strains isolated at the Laboratory of Clinical Microbiology of the Second University of Naples, Italy. Regarding T serotyping, 26 of 99 strains were W+, 16 strains were U+, 16 were X+, and 14 were agglutinated by anti T serum. A low percentage revealed Y+. Twelve strains were not T serotyped. PFGE patterns showed species polymorphism; however, inside the various serotypes, we demonstrated a fair homogeneity. No correlation among invasiveness and T serotype or PFGE pattern has been shown. Twenty-two of 99 strains were erythromycin-resistant.

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.

Vaccines and prevention in dental care

As epidemiological data demonstrate, dental workers are exposed during their activity to a biological risk that may result in serious damages for their health. Vaccination practice is one of the main instruments for prevention of infectious diseases, and thus an important measure for protection of dental personnel. The authors report current obligatory and recommended vaccinations for health-care workers in Italy, which may be applied to the dental staff. For each vaccine-preventable disease, a comparison with American guidelines is carried out. Vaccines for other infectious diseases, that may be employed for protection of dental personnel, were also considered.

Commonly used antibiotics induce expression of Hsp 27 and Hsp 60 and protect human lymphocytes from apoptosis

Heat shock proteins (Hsps) are abundant molecular chaperones participating in the cytoprotection. The kinetics of synthesis of Hsps closely correlates with the kinetics of development of resistance to cell death. In this study, we analysed the probable involvement of Hsp 27 and Hsp 60 in the protection of cells undergoing apoptosis. Human lymphocytes cultured in the presence of ampicillin or ceftriaxone produced Hsp 60 and Hsp 27, estimated by immunoblotting in a time-dependent manner and the increased levels of Hsp 60 and Hsp 27 correlated with enhanced resistance of the lymphocytes to apoptosis, as determined by flow cytometry. Cultures treated with ampicillin or ceftriaxone also exhibited smaller numbers of apoptotic cells than untreated cultures when exposed to the apoptosis-inducing agent staurosporine (1 mM). In contrast, cloramphenicol induced the production of only small amounts of Hsp 60, and no resistance apoptosis. Further studies are needed to clarify the potential role of Hsp 27 and Hsp 60 in the resistance of human cells to apoptosis and the effects of antibiotics on this phenomenon.

[Microbial environmental monitoring in the dental surgery room]

The aim of our study is to analyse the contamination level of air, water and hard surfaces before and after works activities in a dental clinic. Four different methods are detected for the sampling of the hard surfaces: contact plates, nitrocellulose membranes, swab and mask system, bioluminometer. Our results are overall satisfactory, but few critical situations related to some practice, were observed. In comparing the four methods of sampling the hard surfaces, the use of bioluminometer although referring to indirect indices, appears to give results comparable to those obtained with the contact plates and nitrocellulose membranes, which determine the microbiologic count. Contact plates and nitrocellulose membranes appear to be of more friendly use and show same results.

Chlamydia pneumoniae infections prevent the programmed cell death on THP-1 cell line

Chlamydia pneumoniae is an obligate intracellular bacterium which frequently causes airway infection in humans and has been implicated in chronic inflammatory disease and atherosclerosis. Here we show that infection with C. pneumoniae protects THP-1 cells against the apoptosis which spontaneously occurs in macrophages in the absence of an activation signal. Analysis by flow cytometry at different post-infection times revealed that 50+/-7% of THP-1 cells were apoptotic at 48 h after onset of the experiments, whereas C. pneumoniae-infected cultures (multiplicity of infection, MOI=30) displayed only 18+/-4% of cells in apoptosis. At MOI=20 and MOI=10 the cells susceptible to apoptosis at 48 h were 28+/-5% and 35+/-6% respectively. Moreover, the results show that heat-inactivated bacteria do not give significant protection against apoptosis, even at higher MOI (MOI=30), while UV-treated Chlamydia did provide a degree of protection against apoptosis. These data suggest that the anti-apoptotic effect of C. pneumoniae requires a heat-labile component released during infection, and that the effect is not lipopolysaccharide-dependent.