Dental unit water content and antibiotic resistance of Pseudomonas aeruginosa and Pseudomonas species: a case study

Background

Many studies consider the contamination of dental unit waterlines (DUWLs), but few of them have studied the possible presence of antibiotic resistant Pseudomonas aeruginosa in the DUWLs.

Aims

Investigation of the presence of P. aeruginosa and Pseudomonas spp. strains in DUWLs and evaluation of their resistance to six antibiotics (ceftazidime, netilmicin, piperacillin/tazobactam, meropenem, levofloxacin, colistin sulfate) at a public dental clinic in Milan, Italy.

Results

Dental units were contaminated by P. aeruginosa with loads of 2–1,000 CFU/L and were mainly located on the mezzanine floor, with a range of 46–54%, while Pseudomonas spp. were primarily found on the first and second floors, ranging from 50 to 91%. P. aeruginosa was antibiotic resistant in 30% of the strains tested, andPseudomonas spp. in 31.8% . Cold water from controls was also contaminated by these microorganisms.

Conclusion

Monitoring antibiotic resistance in the water and adopting disinfection procedures on DUs are suggested within the Water Safety Plan.

Nurse Case Manager Lifestyle Medicine (NCMLM) in the Type Two Diabetes patient concerning post COVID-19 Pandemic management: Integrated-Scoping literature review

BACKGROUND

The American Case Manager Association defines Case Management, in Lifestyle Medicine perspective, a collaborative practice between all the actors involved in the care process. The goal of this review was to evaluate the Nurse Case Manager role in Type 2 Diabetes patients, analyzing the quali/quan-titative data related to Nurse Case Management programs in Lifestyle Medicine view.

STUDY DESIGN AND METHODS

Three independent operators were involved in two distinct phases, applying the Prisma method, specifics PICOS and research strategies from PubMed and Cinahl. The first part integrated a Cochrane systematic review on the Specialist Nurses in Diabetes Mellitus, while the second part evaluated the Nurse Case Manager interventions in Lifestyle Medicine view.

RESULTS

The first part includes 13 studies and the second 6. The glycemic control was improved in the Nurse Case Manager groups in Lifestyle Medicine perspective. Good results were appreciated in secondary outcomes: lipid profile, Body Mass Index, quality of life and stress management. The results for the management of self-care and adherence to Lifestyle Medicine programs are encouraging.

CONCLUSIONS

It emerged unequivocally that, taking care and supporting the diabetic subject, leads to significant benefits in the general health and to reduction of possible complications. After the Covid-19 Pandemic, the Nurse Case Manager Lifestyle Medicine could represent a valid alternative of health management for the improvement of care in Type 2 Diabetic patients.

Healthcare acquired infections: malpractice and litigation issues

BACKGROUND

Healthcare acquired infections (HAIs) represent a significant burden for hospitalized patients in terms of mortality, morbidity, length of stay and costs. Also cause medical liability and medical malpractice litigation.

METHODS

Specific keywords combinations were analitically searched in PubMed and Scopus databases. Publications concerning medical liability, medical malpractice and litigation issues were reviewed.

RESULTS

The authors outlined the healthcare workers and healthcare settings mandatory duties in consideration of the Italian law. In case of infections occurred in hospital environment the patients must demonstrate the guilty nature of the physicians and healthcare settings, the existence of a harm and causal connection. Physicians and healthcare facilities defence is mainly based on demonstration that protocols and aseptic measures were adopted scrupulously applying the up to date scientific knowledge.

CONCLUSIONS

HAI are a complex issue which need a multitask strategy and a surveillance system to control the phenomenon and help physicians and healthcare facilities to reduce malpractice litigation.

Burnout syndrome: a preliminary study of a population of nurses in italian prisons

INTRODUCTION

Burnout is a set of psychological manifestations ("emotional exhaustion", "depersonalization" and reduced "personal accomplishment") that principally affects healthcare professionals.

OBJECTIVES

Analysis of the level of burnout among twelve nurses who work in two Italian prisons.

MATERIAL AND METHODS

The Maslach Burnout Inventory was administered. In order to explore possible correlations between the three dimensions of the Maslach Burnout Inventory and such variables as age, years of service in general and years of service in prisons, multiple regression based on the ordinary least squares method (OLS model) was performed.

RESULTS

The response rate was 100%, of whom 66.6% female and 33.4% male. The average age is 38.1 years. Over half of the sample had worked from 0 to 10 years in prisons (58.4%), and only one respondent had done so between 21 and 30 years (8.3%). The data indicate that the highest levels of burnout concerned the dimension of "depersonalization" (66.7%) and "personal accomplishment" (41.6%). Emotional exhaustion of nurses in carrying out their work diminished with the increase of the independent variable of "personal accomplishment" (p-value 0.0361); it increased with the increase of the age variable (p-value 0.0117). Personal accomplishment decreased with the increase of the independent variables of emotional exhaustion (p-value 0.0361) and years of service in prisons (p-value 0.0238). For depersonalization, no statistically significant coefficients were observed. Model 1 of multiple regression showed a significant statistical association between the emotional exhaustion (dependent variable) and personal achievement (p-value 0.0361), and increase in age (p-value 0.0117). Model 2 showed significant statistical association between personal achievement (dependent variable) and emotional exhaustion (p=value 0.0361) and years of service nursing in prisons (p-value 0.0238). Model 3 showed no statistical association between depersonalization (dependent variable) and the other variables.

CONCLUSIONS

While twelve nurses formed this small sample, the study nonetheless indicated how the variables examined can influence the levels of burnout. Given that thorough inquiries into the levels of burnout among nurses who work in Italian prisons, specifically in the Marche Region, have yet to be conducted, this pilot study can serve as a point of reference for future research to improve evidence-based medicine.

Campaign manufacturing of highly active or sensitizing drugs: a comparison between the GMPs of various Regulatory Agencies

BACKGROUND

Cross-contamination and mix-ups are among the problems which could have a negative impact on the quality of the finished product during the production of highly active or sensitizing drugs with campaign manufacturing. Standardised, validated procedures ensure quality standards are maintained during production. In spite of this, the operating conditions and applicability of methods adopted by the various regulatory agencies manifest significant differences which could consequently compromise the safety of the finished product. This work has analysed and compared the GMP of various Regulatory Agencies to examine issues connected to campaign manufacturing highly active or sensitizing drugs.

METHODS

The GMP of the following Regulatory Agencies have been studied: EMA, CFDA, COFEPRIS, FDA, Health Canada, ANVISA, CDSCO, PIC/S and WHO. The study was carried out for the purpose of understanding which agencies consent to the use of campaign manufacturing for the following categories of medicinal products: hormones, immunosuppressants, cytotoxic agents, highly active pharmaceutical ingredients (APIs), biological preparations, steroids, sensitizing pharmaceutical materials, antibiotics, cephalosporins, penicillins, carbapenems and beta-lactam derivatives.

RESULTS

The GMP of Health Canada, EMA, PIC/S and FDA show a number of similarities, starting with the fact that they allow campaign manufacturing for similar categories of pharmaceutical products after an appropriate risk evaluation has been performed. CFDA, WHO, ANVISA authorise campaign manufacturing in "exceptional circumstances", though they do not always define what they mean by this. COFEPRIS authorises campaign manufacturing for certain classes of drugs, while there is no mention of campaign manufacturing in the CDSCO regulations.

CONCLUSIONS

Quite a few significant differences have been found in the various regulations concerning the use of campaign manufacturing and the classes of drugs that can be produced with this method. In the light of this, it is obvious that efforts to harmonise legislation internationally have not yet been successful: currently, states can adopt different quality standards. The pharmaceutical industry could use this situation to its advantage by delocalising production on the basis of existing standards. The need to harmonise GMPs is a priority which must be achieved as soon as possible.

Obesity in the European region: social aspects, epidemiology and preventive strategies

Obesity related to metabolic syndrome is gaining an increasing importance as the main risk factor for diseases and disability in the European region. We herein review the increasing trend of obesity and overweight in males and females from Europe, preventive programs addressed to children, youngsters, adult population and subjects with particular diseases which can profit from healthy nutrition. The main feature is that some European countries have implemented programs on World Health Organization (WHO) proposals, while some others have focused attention only on some aspects. Based on the reported obesity increase over the last twenty years, prevention programs seem to have been ineffective. Most likely, the effects will be observed later on. In this concern, it will be fundamental to continue and finance the countries of the European region, where those programs have been extensively applied, to obtain even better results in terms of obesity prevention.

Knowledge and Attitudes on Food Hygiene among Food Services Staff on Board Ships

BACKGROUND

Ships have long been sites for outbreaks of infectious diseases, particularly gastrointestinal diseases. The ship environment has the potential to facilitate the spread of such diseases, infecting susceptible cohorts of embarked passengers and crew. Gastrointestinal disorders among seafarers are fairly common and usually represent the first or second cause of requests for medical assistance aboard ships in international waters.

STUDY DESIGN

The purpose of this study was to evaluate food safety and the level of knowledge among food service personnel on board merchant ships, where food handlers could be a cause of health problems for all crew members.

METHODS

An anonymous self-administered questionnaire containing specific questions about food hygiene and safety knowledge was administered.

RESULTS

The overall score of correct answers for the food safety aspects tested was 51.77 (SD 3.87) out of 76 points, corresponding to 68.12% of questions answered correctly. Food workers who followed a training course showed higher mean knowledge score (p < 0.05) compared to not-trained workers. The most relevant significant differences (p < 0.05) were noticeable in the personal hygiene, cross-contamination, safe storage, and knowledge of foodborne pathogens sections.

CONCLUSION

Food services staff on board cargo ships should be adequately trained and should understand basic and fundamental aspects of food hygiene, related pathologies and sanitation, as they are responsible for the health and wellbeing of many seafarers.

Implications of modified food choices and food-related lifestyles following the economic crisis in the Marche Region of Italy

BACKGROUND

The economic crisis in Italy has led to profound changes in resource management not only at the macro level but also for individual families, causing substantial changes in different habits of Italians.

STUDY DESIGN

The purpose of this research was to conduct a study on changes in family eating habits potentially triggered by the economic crisis was conducted in an area of the Marche Region in central Italy.

METHODS

The research was conducted in the period 2016 - 2017 by administering a specific and anonymous questionnaire.

RESULTS

The interviewed people has reduced its food consumption. In particular, analyzing the results for the animal protein food group, there has been a reduction in purchase of beef, and an increase in that of pork. Overall fish consumption has decreased by 44%, with a decrease in the purchase of fresh fish, and an increase in that of canned fish products. Finally, consumers have reduced their purchases of fresh and canned legumes, fresh vegetables, and fresh fruit.

CONCLUSION

The economic crisis seems to have changed the eating habits and food-related lifestyle choices of the subjects studied, especially in the urban area affected by the deeper economic depression. These changes are likely to have permanent social consequences, and deserve to be analyzed also in smaller territories in order to better understand the dynamics of individual choices and the social framework.

Fighting obesity in children from European World Health Organization member states. Epidemiological data, medical-social aspects, and prevention programs

Childhood obesity is one of the most serious public health chal-lenges of this century. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age. In the WHO European Region one child out of 3, is overweight or obese. Over 60% of children who are overweight before puberty will be overweight in early adulthood. Children and adolescents, aged 5-19 have shown rising obesity rates in almost all nations, including where the situation was far from alarming 40 years ago. Several nations have seen the prevalence almost double: Israel has gone from 5.8% in 1975 to 11.9% in 2016, Andorra from 6.2% to 12.8%, and Malta from 7.4% to 13.4%. Analyzing overweight and obesity, we can see that they follow similar trends and patterns. In 1975 the majority of European countries had a prevalence less than 10% and obesity less than 5%, while no European country had overweight prevalence higher than 30% and obe-sity higher than 10%. In 2016 the trend reversed, showing a worrying increase in the number of European countries with a high prevalence of overweight (over 30%) and obesity (over 10%) (Fig. 1)(29). Starting from the analysis of epidemiological data on obesity in the WHO European Region, the paper analyzes the adopted prevention programs in order to assess their effectiveness and figure out the best strategies to reduce the prevalence of overweight and obesity. The WHO European Childhood Obesity Surveillance Initiative reported that children tend to overeat and not to do enough physical exercise. Different preventive programs have identified different areas of action and corresponding measures: consumption of healthy foods, physical exercise, care before conception and during pregnancy, early childhood, school age children, weight management, monitoring and evaluation. Primary prevention is essential to reduce obesity incidence: it is easier to act on the adoption of healthy eating habits than intervene with diets on children who already have weight issues. Working on pre-vention programs represents an investment for the future of children's health. By simply acting on prevention, particularly on body weight reduction, it could be possible to tackle the spreading of correlated di-seases. Therefore, prevention programs ought to be prioritized priority at a national and international level.

Immunization in Vietnam

Since the Expanded Program on Immunization was proposed by the World Health Organization in 1981, it has been promptly adopted by Vietnam as one of the country's national priority programs. In 1986, Vietnam achieved some remarkable goals, including polio-free status and the elimination of neonatal tetanus. At the same time, however, barriers and difficulties have also emerged. This article aims to provide an overview of both achievements and barriers to the implementation of the program and proposes some solutions.

Energy drink consumption: a survey in high school students and associated psychological effects

Introduction

Energy drinks represent an emerging health problem among young people. Energy drinks generally refer to a class of beverages containing sugars and various combinations of bioactive ingredients such as caffeine, taurine etc. Also the mix of energy drinks with alcohol is fairly frequent among young people and could be associated with dangerous effects.

Methods

In 2016-2017, a cross-sectional study was conducted in 1581 students attending eight high school in the Marche Region. Data were collected via an anonymous self-administered questionnaire.

Results

The 27.7% of students use energy drinks and the majority, corresponding with the 93.0%, are aware of the main ingredients contained in energy drinks. The main activities for which young people use these drinks are: sport, leisure, pleasure, study. Young people who admit to using alcohol mixed with energy drinks more than 4 times a month are an alarming fact.

Conclusions

This research confirms that energy drinks are used more by young males and especially by those who practice sports. Furthermore, the use these beverages to increase the concentration in the study and to be more brilliant in free time, is confirmed.

Vaccine hesitancy, a public health problem

The phenomenon of "vaccine hesitancy" has only been studied for a few years, and this attitude is becoming a serious threat that can frustrate the efforts of recent years that have led to the achievement of relevant scientific advances to human health. The paper analyzes the possible causes, the scope of the phenomenon and its consequences, trying to identify the most effective actions to resolve this trend.

Level of understanding of medical terms among italian students

Problems related to medical treatment and health literacy are nowadays a considerable difficulty, particularly if awareness of them is low. There is still a lack of information about students understanding of medical recommendations. The aim of this work was to determine the understanding of medical terms among Italian students and to find out if there is any relation between understanding and age, gender, education or parental occupation. The research was realized via questionnaires in the Marche region of Central Italy in 2015. Students were chosen at random from grammar schools, vocational schools and the local university. 387 completed questionnaires were subsequently evaluated. The level of understanding of medical terms among students was quite poor. Most of the terms included in the study were known to only a third of respondents on average. A significant link between the comprehension of medical terms and education level or parental occupation was observed, especially in the terms that are not commonly used. Nevertheless, no relation between knowledge of medical terms and gender was found. This topic, which requires attention, should be investigated because of correct implementation of preventive medicine programs.Key words: medical terms Italian students correct use of medicine risk.

Awareness of health risks at the workplace and of risks of contracting communicable diseases including those related to food hygiene, among seafarers

BACKGROUND

The awareness of health risks on board ships in terms of knowledge of dangers and discomfort at the workplace, and of risks of contracting communicable diseases including those related to food hygiene was assessed in a sample of workers of an Italian shipping company. Analysis was performed on crew members and on ashore personnel of the same firm to assess possible differences in risk perception.

MATERIALS AND METHODS

The study was conducted by proposing an anonymous questionnaire to the crew members of 9 tankers and to the office staff of the shipping company Finaval S.p.A., which has its headquarters in Rome.

RESULTS

People living ashore have a better knowledge of infectious risks than seafarers. Both ashore workers and seafarers have a reasonable awareness of blood-borne and sexually-transmitted diseases. Seafarers are more concerned about the risks of psychological problems due to isolation than are office personnel. The risk of not being adequately cared for in case of disease or injury on board is also perceived as a major problem by seafarers. Ashore personnel, eating raw fish more than their mates on board, are at a greater risk of communicable gastrointestinal diseases.

CONCLUSIONS

Seafarers should be the target of specific informative campaigns about health risks, possible consequences, and how to minimize exposure to them during travel/life at sea.

Survey on HIV risk perception and sexual behaviours among seafarers

Because the nature of their work seafarers spend long periods of time away from their families and therefore represent a group at risk for sexually transmitted diseases, including HIV infection. This paper reports the results of a survey to evaluate awareness and knowledge of the risk of HIV infection among seafarers. Risky behaviours for HIV transmission were also assessed. The survey was conducted using anonymous questionnaires on 197 workers of 9 vessels and 26 office employees of an Italian shipping company (FINAVAL S.p.A., Rome). The respondents considered HIV/AIDS as one of the diseases with a high risk of transmission. Most respondents had a good general knowledge of HIV/AIDS and on the ways of its transmission. However, there is still lack of knowledge on the basics of this disease. On the other hand, in spite of knowledge and awareness about the risks of the disease, only 56.35% of the interviewed crewmembers used protection in sexual intercourse with occasional partners. Compared to data available in literature, the percentage of self-protecting people is increasing, but the number of seafarers exposing themselves to risky behaviours is still high. As expected, condoms are used with regular partners with lower frequency compared to occasional intercourse. The results of this survey indicate that adequate prevention campaigns and major attention paid to seafarers health is useful for stimulating responsible conduct for the prevention of infectious diseases, including HIV infection. Nevertheless, it is still necessary to increase information about the risk of sexually transmitted diseases and how to reduce it.

[The monitoring of watercourses on the basis of the Water Framework Directive 2000/60/CE. An integrated methodological approach applied to the appenninici rivers. First data]

The pollution of the watercourses is one of the principal causes of the water emergency and, under the sanitary profile, one of the most complex and urgent problem within the Environmental Hygiene. The European Water Framework Directive 2000/60, has confirmed that for a correct qualitative evaluation of the superficial waters the monitoring must be inspired to the prevention and not only to the improvement. In our work we have experimented a new methodological approach to read and to understand the river ecosystem. The River Tronto and the River Tenna has been studied under the chemical-bacteriological profile and under the biological profile, through the Extended Biotic Index. The river continuum has been studied through the Functional Fluvial Index. The data have been correlated among through Principal Component Analysis. The statistic analysis underlines a direct correlation among the two biological indexes and a strong indirect correlation among these last ones and those of chemical-bacteriological nature. The pollution of the watercourses is one of the principal causes of the water emergency and, under the sanitary profile, one of the most complex and urgent problem within the Environmental hygiene. The European Water Framework Directive 2000/60, has confirmed that for a correct qualitative evaluation of the superficial waters the monitoring must be inspires to the prevention and not only to the improvement. In our job we have experimented a new methodological approach to read and to interpret the river ecosystem. The River Tronto and the River Tenna has been studied under the chemical-bacteriological profile and under the biological profile, through the Extended Biotic Index. The river continuum has been studied through the Functional Fluvial Index. The data have been correlated through Principal Component Analysis. The statistic analysis underlines a direct correlation among the two biological indexes and a strong indirect correlation among these last ones and those of chemical-bacteriological nature.

Health care system in the Czech Republic

This article reviews the health care system in the Czech Republic. It is aimed to point out the different matters in contrast to the Italian system. It summarizes the historical changes regarding the health care after the "fall of communism" in 1989 and the split of Czechoslovakia (1993) and basic organizational questions; particular consideration is devoted to the pharmaceutical care, hospitals accreditation, a responsibility of the physician and free and informed consent. The health care system in the Czech Republic has underwent many changes during the last years and its further transformation reflecting social requests can be expected.

[Protection of the environment, protection of health. Note 2--Monitoring of flood environments: comparison of the results of the different methods and hygienic evaluations]

The authors take into consideration the results obtained from the application of the different methods and systems of river monitoring (E.B.I, Law 152/99, I.F.F), and they evaluate the agreement of the final judgment. The comparative analysis is conducted pointing out the conceptual and methodological differences of the three systems of the river monitoring. A good agreement of judgement arises from the correlation.

[Protection of the environment, protection of the health. Note 1 - fluvial monitoring: cultural evolution and methodological evolution]

The article underlines the fundamental importance of the protection and promotion of environmental quality for the human health. The evolution of fluvial monitoring techniques is contemplated from chemical and bacteriological analysis until the Index Functional Index (I.F.F). This evolution it's very important because shows a new methodological and cultural maturation that has carried from a anthropocentric vision until an ecocentric vision. The target of this ecological vision is the re-establishment of ecological functionality of the rivers, eliminating the consumer's vision of the water considered only as a usable resource. The importance of an correct monitoring of a river is confirmed, even though the preventive approach priority remains.

[Normative evolution of waters for human consumption]

Recent laws (D.Lgs 339/1999 and 31/2001) have allowed the bottling and sale of spring water and of table water provided they are not defined as "mineral", "natural" or "mineralized", but without characteristics that constitute a danger to human health. Like mineral water spring water mustn't be purified; is bottled as it gushes out from the source and is subject to the same requisites as tap water (DPR 236/1988). Table water is bottled purified water subject to the same requisites as tap water, whatever its original characteristics, during the process of purification, it can be modified to render it ideal for the needs of the consumer.

[Young people and drug: distress or new style? Epidemiological survey among an Italian student population]

The Authors examined the knowledge and motivations which lead young people to using alcohol, smoking and psychotropic substances, and the possible risks deriving from such use. 7588 questionnaires were distributed and 4118 duly returned completed (54.2%). 29.9% of the boys admitted that they were either taking or had taken drugs. The majority of substances identified were "new drugs"--ecstasy, special K, poppers, etc.--(79.8%), marijuana (72%) and hashish (49.2%). 42% claimed that these substances couldn't be considered to be drugs or to have the effects of drugs. 7.5% didn't seem able to reply to the questions. Distress, curiosity, need to overdo, search of the pleasure, they probably lead young people to use the drugs.

[Natural disaster and effects on the health]

A research was set up among the residents in the seismic epicentral zone of the earthquake which hit the Marches and Umbria in September 1997, using an appropriately formulated questionnaire to assess the repercussions of the seismic event on the psycho-physical condition of the population. Was also administered the Croq and Steinitz questionnaire for post-traumatic stress. The results obtained show that the state of health was undermined by the aggravation of already existent syndromes. Despite the powerful emotional reaction that the earthquake produced, there was found to be only a medium to light level of trauma. In addition, the survey brings out some problems regarding the life style in the prefabricated huts, both in terms of comfort and of building characteristics.

[Eating disorders: results of an inquiry carried out on a section of the school age population]

Anorexia and Bulimia are considered to be among the most frequently manifested psychological problems of today, found mainly in adolescent girls, but ever more frequently in boys. Recent research has been carried out among middle-school students in various Marche towns using a psychometric method (Eat-40, Eating Attitudes Test). The analysis is based on the points highlighted in the response to a questionnaire detailing repetitive behavioral traits that characterize subjects with eating disorders even in their initial stages. From the analysis of the data collected, and bearing in mind the BMI and the different correlation between EAT and BMI, the total number of cases that present anomalies amounts to 24.5% of the individuals who completed the questionnaire.

[Electrical field exposure and human health. Risk assessment and problems relative to bureaucratic procedures and to the role of instituitional organizations in control and prevention]

After closely analyzing the phenomenon regarding the immense increase and diffusion of equipment which generates low- and high-frequency electromagnetic fields, the AA emphasize both the methodological and interpretive difficulties of assessing the effects produced on public health. They maintain the need to exercise caution in determining the tolerable limits of exposure, and in particular long-term ones. Finally, after analyzing the bureaucratic procedure which led to the formulation of Decree No. 381 of 1998, they express the hope that the various Regions will set themselves high-quality objectives when promulgating the necessary legislation, so as to minimize the risk factor.

[Quality of housing in relation with human health. I: Building characteristics of the houses in the Marchesian region]

In view of the fact that a considerable proportion of the population particularly at risk (the aged, children, the sick, etc.) spend many hours of the day indoors, the authors report the results of an investigation carried out on the building characteristics of 1833 houses sampled in four towns in the Marches region. The questionnaire of Fusillo et al. was used. The results show an excellent situation with regard both to the quality of outdoor air and acoustic pollution (only 27% of the sample complained of the vicinity of their house to zones of intense traffic). The low index of overcrowding (0.7 inhabitants per room) as well as the overall surface area of the houses (in 60% more than 100 m2), the large number of bathrooms (almost 50% of the houses with two, and another 15% with three or more), and the prevalence of detached houses are factors that show how the Marchean population pay particular attention to building criteria. However, even though from the structural standpoint the housing situation might seem a very good one, specific problems can be found, also common to other Italian regions, regarding building techniques and the materials adopted (e.g. the use of reinforced concrete, which together with the undoubted advantages it offers also has a number of disadvantages). The authors therefore stress the need for incentivating a bioecologically based building tradition, even if this is economically more costly, and give guidelines on how to conciliate the bioecological and economic aspects with regard to choice and use of materials. Finally, they express the hope that the "EC" symbol foreseen for building materials by Law No. 246 of 21 April 1993 will be adequately used in the ways laid down in appendix A to that law.

Vaccination against hepatitis B: the Italian strategy

Viral hepatitis B, which is a major health problem worldwide, is endemic in Italy. In response to this, vaccination became compulsory in 1991. Vaccine is administered to neonates and 12-year-old adolescents; in 12 years time, all Italians under the age of 24 will be immune to HBV.

[Daily intake of macro and trace elements in the diet. 4. Sodium, potassium, calcium, and magnesium]

To complete the picture of the daily dietary intake of minerals, sodium, potassium, calcium and magnesium have now been considered. The study has been carried out in the Italian Marches Region after carefully evaluating the food consumption habits of the population. The foodstuffs comprising the 70 diets examined were collected in institutional canteens and private homes immediately prior to meals. The food was sampled ready for consumption as it had thus undergone the various preparation and cooking procedures, during which considerable changes in mineral content occur. In comparison with the various food consumption standards, the amount of sodium found appears excessively high (4.8 g/d) whereas that of magnesium is insufficient (0.24 g/d). A high sodium intake, and more recently a high Na/K ratio, have been associated with hypertension. Also a lack of magnesium and a high Ca/Mg ratio have repeatedly been associated with hypertension risk. The data to emerge from our study: a high sodium intake, an insufficiency of magnesium, and thus high Na/K and Ca/Mg ratios, would appear likely to enhance cardiovascular disease risk. Even though not all Authors agree on the existence of such correlations, a more correct diet as regards mineral intake is undoubtedly something to encourage.

[The socioeconomic and health status of the elderly in the town of Camerino]

The Authors, after outlining the problem of elderly people, refer to data from their research defining precisely the particular demographic-social situations of the elderly in the city of Camerino. Research, using the same questionnaire, was carried out into the most frequent state of health and pathology of elderly people living in the city of Camerino. The most significant data provided some points for discussion as well as considerations relative to prevention and care in old age. The occasion was taken for stimulating our Society to not neglect elderly people but rather to find the right solutions for maintaining their standard of living at the highest level possible.

Comparative study by histochemical, biochemical, and histophotometrical methods of carbonic anhydrase activity in the stomach of various vertebrate classes

Histochemical, biochemical, and histophotometrical studies of carbonic anhydrase activity have been carried out on the stomach of the various vertebrate classes, in order to make functional comparisons. Our results on carbonic anhydrase activity of epithelial surface may be interpreted in favour of a protective role by the secretion of an alkaline fluid against damage due to intraluminal low pH values. As regards the presence of carbonic anhydrase in the different types of gastric glandular cells, in addition to the already known function of the enzyme in hydrochloric acid secretion in the oxyntic and oxyntic-peptic cells, we suggest an interpretation of carbonic anhydrase presence observed in many chief cells.