Traits of orthorexia nervosa and muscle dysmorphia in Italian university students: a multicentre study

PURPOSE

This study aimed to evaluate the prevalence of traits of orthorexia nervosa (ON) and muscle dysmorphia (MD) in a group of undergraduates, investigate the associations between the risk of these conditions and the type of university course attended, the individual characteristics (gender, BMI, amount of physical activity, supplements and medicines use, dieting) and the risk of eating disorders (EDs).

METHODS

A self-reported questionnaire consisting of a socio-demographic section and three tests validated for the evaluation of a risk of ON (ORTO-15), MD (MDDI-ITA) and EDs (EAT-26) was completed by 918 students from three Italian universities.

RESULTS

29.0% of participants demonstrated traits of ON and 5.0% of MD, without differences in prevalence in the three areas of study investigated (health-scientific, economic-humanistic, sport sciences); students of sport sciences exhibited a significantly higher score for MDDI-ITA (F = 6.493, p = 0.002). Participants with ON and MD traits were more on a diet (OR = 0.47, p ≤ 0.001 and OR = 0.428, p = 0.020, respectively) and showed a higher prevalence of EDs risk (OR = 3.55, p < 0.001 and OR = 10.23, p ≤ 0.001, respectively). The simultaneous presence of ON, MD, and EDs traits was seen in 5.4% of the students and the three test scores were correlated.

CONCLUSIONS

The prevalence of ON and MD traits was found similar to that reported in the literature on undergraduates. Some associations observed improvement in the knowledge about these conditions, especially the association of participants with ON and MD traits with dieting and EDs traits and the correlation of the three test scores suggests a connection among these potential conditions.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional survey.

Why do people renounce dental health care? An analysis of data from the Italian population

OBJECTIVES

Oral diseases affect a large number of people in the world and have a great influence on their quality of life. Nevertheless, oral health promotion and prevention initiatives are lacking. The aim of this study was to identify characteristics of individuals in Italy who renounce dental care in order to better support institutional prevention campaigns.

METHODS

Using data from the Italian National Institute of Statistic (ISTAT) survey "Health condition and use of health services", we divided the sample into two groups: individuals who renounced dental care even when needed and those who accessed dental healthcare. We then compared information about socio-economic and oral health profile of the two groups.

RESULTS

People who renounced dental treatments are mostly young adults, smokers, belonging to the middle-low socioeconomic level, not married and unemployed. Economic resources are often the main reason behind renouncing dental treatments.

CONCLUSIONS

Our study underlines that economic conditions play a leading role in renouncing dental care. In order to avoid additional costs to the Italian healthcare system, our proposal is to implement a specific prevention campaign for oral diseases, targeting young adults living in Italy.

European cardiovascular mortality over the last three decades: evaluation of time trends, forecasts for 2016

BACKGROUND

The circulatory diseases, in particular ischemic heart diseases and stroke, represent the main causes of death worldwide both in high income and in middle and low income countries. Our aim is to provide a comprehensive report to depict the circulatory disease mortality in Europe over the last 30 years and to address the sources of heterogeneity among different countries.

METHODS

Our study was performed using the WHO statistical information system - mortality database - and was restricted to the 28 countries belonging to the European Union (EU-28). We evaluated gender and age time series of all circulatory disease mortality, ischemic heart diseases, cerebrovascular diseases, pulmonary and other circulatory diseases and than we performed forecast for 2016. Mortality heterogeneity was evaluated by countries using the Cochrane Q statistic and the I-squared index.

RESULTS

Between 1985 and 2011 SDR for deaths attributable to all circulatory system diseases decreased from 440.9 to 212.0 x 100,000 in EU-28 and a clear uniform reduction was observed. Heterogeneity among countries was found to be consistent, therefore different analysis were carried out considering geographical area.

CONCLUSIONS

We forecast a reduction in European cardiovascular mortality. Heterogeneity among countries could only in part be explained by both geographical and health expenditure factors.

Knowledge and training needs on built environment and indoor health of Italian public health residents: a national survey

INTRODUCTION

The Working Group for Hygiene of Built Environment and the National Council of Residents of the Italian Society of Hygiene, Preventive Medicine and Public Health conducted a nation-wide survey to evaluate the knowledge and training needs on Built Environment and Indoor Health of Italian public health residents.

RESULTS

The compliance was very high (52,4%), covering the totality of Italian postgraduate schools. The results underline a severe lack of theoretical formation and practical training, but also diffuse discrepancies across the country, and show a strong interest of residents on this topic.

CONCLUSIONS

The authors propose to adopt a national core curriculum, and suggest some strategies to improve learning.

The role and working conditions of Movement Science students employed in sport and recreational facilities: An Italian multicenter study

BACKGROUND

In Italy, students from Movement Science (MS) Degree Courses often work in sport and recreational facilities before graduation.

OBJECTIVE

The employment conditions of Movement Science students working in sport/recreational facilities were investigated, and the management and structural features of the facilities were evaluated, including safety policies. Regional differences were also considered.

METHODS

Questionnaires were administered to undergraduate and graduate students (N = 4,217) in 17 Universities. Students' perceptions of the quality of the facilities where they had been employed was evaluated using multivariate analysis. A latent class model with covariates was used to evaluate how variables relating to participants, employment facilities or regions influence their opinions.

RESULTS

A high proportion of MS students were employed in sporting facilities (undergraduate level: 33% ; graduate level: 55%), in most cases without any formal employment contracts. Both the structural and hygienic features, as well as the professional knowledge of the staff, were considered good to excellent by the majority of participants (about 70%). Communication of the basic behavioral rules was considered adequate by 61-63% of undergraduate students and 71-75% of graduate students, while nearly half of the participants were dissatisfied with the staff safety training. Correlations between the perceived good structural/hygienic conditions, the presence of regulations and training programs for the staff were investigated. Differences regarding occupational level and safety training among different regions of Italy were also observed.

CONCLUSIONS

Italian students in Movement Science were easily employed in sport/recreational facilities, but frequently without a formal contract. This is a consequence of the lack of specific regulations in the field of recreational/leisure employment and could have negative implications, especially in terms of safety.

Benchmarking of health technologies distribution models

Purpose

– The purpose of this paper is to develop a benchmarking framework for assessing the performance of the distribution models adopted by the local branches of National Health Services (NHSs) for delivering health technologies to patients at a local level, and to derive prescriptions for enhancing design and optimal management of the distribution models.

Design/methodology/approach

– The authors focussed the study on the distribution of absorbent devices for incontinence, adopting the analytic hierarchy process as a tool for developing the benchmarking framework. The authors applied the framework to the context of the Italian NHS with respect to the Lombard Local Health Authorities, assessing their performance in terms of operational efficiency and service quality.

Findings

– The developed framework constitutes a novel contribution, and it allows for generating prescriptions. Through its application to the context studied the authors found that a “one-size-fits-all” distribution model cannot be proposed, as regards both efficiency and effectiveness, since process standardization does not provide benefits or savings in all contexts. Rather, a total landed cost approach in the evaluation of the distribution practices must be adopted.

Practical implications

– This paper offers to managers and decision makers an innovative approach to the design of distribution models for health technologies. It provides policy makers with prescriptions to develop regulations fostering a comprehensive view of the factors for an optimal health technologies distribution at a local level.

Originality/value

– Given the dearth of scientific publications focussed on the distribution at the local level of health technologies, this paper significantly contributes to the existing body of knowledge and it offers an innovative framework which can be proficiently replicated in manifold contexts.

Hygienic and sanitary requirements of gyms in force in Italy: national issues and analysis of regional regulations

In recent years, the awareness of the importance of physical activity for human health is growing, as people practicing it; the number of gyms has also substantially increased. Currently, in Italy there is not a consistent regulation regarding hygienic and sanitary requirements of gyms. Several Italian regions issued laws about this topic. The authors analyse the standards required by the Italian Olympic Committee (CONI) and the regional laws, highlighting the numerous issues, among which the possible location of gyms in semi-basements and basements. They eventually call for a national regulation that should clearly transpose the hygienic and sanitary requirements of gyms into a satisfactory rule of law.

[Knowledge of oral hygiene amongst adolescents in Lombardy, Italy]

The study evaluated oral hygiene knowledge among a group of 12-year-old students in Lombardy, Italy (n=182). Two different questionnaires were administered, respectively to adolescents and to their parents. Results indicate a low level of general knowledge on this topic. Factors influencing knowledge include the number of learning sources and yearly access to a dental clinic. The described situation highlights the need to implement school-based educational interventions.

[Epidemiological study of dental and facial asymmetries in a sample of preschool subjects]

OBJECTIVES

to identify the typologies of facial and dental asymmetries in a sample of children aged between 3 and 6 years and to correlate these asymmetries with possible morphological and functional situations.

DESIGN

cross-sectional observational study.

SETTING AND PARTICIPANTS

sample of 95 subjects aged between 3 and 6 years. Clinical data were collected in 10 sessions conducted during school hours in April 2013 by a doctor of Dentistry at two preschools in the city of Sanremo (Liguria Region, Northern Italy) and a kindergarten in the city of Pavia (Lombardy Region, Northern Italy). To collect the data, a weighted clinical questionnaire was used.

MAIN OUTCOME MEASURES

presence and type of bad habit, type of breathing, presence and type of facial asymmetry, dental formula, presence of diastema, presence and type of occlusal asymmetries, presence and type of dental malocclusions.

RESULTS

analysed sample consisted of 53.7% (51/95) of males and 46.3 % (44/95) females; the mean age was 4.3 ± 0.9 years. Most frequent facial asymmetry is orbits asymmetry (35%, 33/95); dental malocclusions are detected in 70%(67/95) of cases. High percentage of subjects (69.5%, 66/95) presents displacement between superior dental midline (SDM) and inferior dental midline (IDM). Several statistically significant associations are observed: in particular, asymmetry of molar ratios is linked to asymmetry of the cheekbones and displacement of the SDM; facial midline has statistical association with asymmetry of the cheekbones (p <0.001).

CONCLUSIONS

the results of this study agree with scientific literature, in particular as regards the prevalence of compromising habits observed and the close correlation between: the presence of dental malocclusions and the presence of compromising habits, the presence of dental malocclusions and the presence of oral breathing.

Deep breathing acutely improves arterial dysfunction in obese children: evidence of functional impairment?

BACKGROUND AND AIMS

Similarly to diabetes type 2, patients with obesity show insulin resistance and autonomic and vascular abnormalities associated with increased morbidity and mortality. We tested whether arterial dysfunction in obese children may have a functional nature, reversible with appropriate interventions (e.g., by reduction of sympathetic activity), or else results from anatomic arterial modifications (likely irreversible). For this purpose, we tested whether deep breathing (an intervention known to transiently reduce sympathetic activity) could acutely improve arterial function, hence showing a functional abnormality.

METHODS AND RESULTS

A total of 130 obese children and 67 age-matched healthy normal-weight control children were recruited. Arterial function was measured by augmentation index (AIx), by direct analysis of blood pressure contour, and by pulse wave velocity (PWV), during spontaneous and controlled breathing. The markers of metabolic syndrome were evaluated at baseline. AIx showed increased values in obese male participants as compared with the control group. Slow breathing acutely reduced Aix in obese children, to a greater extent than in normal-weight control children. Similarly, the blood pressure contour showed higher values in obese children that were significantly attenuated by slow breathing. Baseline PWV was not altered in obese participants. The markers of metabolic syndrome correlated with AIx and PWV.

CONCLUSIONS

Obese subjects showed impaired arterial function. The acute improvement in vascular abnormalities with reduction in sympathetic activity indicates that this alteration was largely functional, likely related to initial autonomic dysfunction and to metabolic abnormalities. As a consequence, this study provides a rationale for strategies aiming at preventing arterial function deterioration in the early ages.

[The "Smoke-free hospital" project: prevalence of smokers in a large hospital in Pavia (Italy) from 2006 to 2010]

This study was conducted in the context of the "Smoke-free Hospital" project and its aims were to describe the prevalence of smokers among employees and patients of the Hospital of Pavia from 2006 to 2010, and to evaluate its determinants. The target population was represented by all employees (healthcare and other staff) and patients (inpatients and outpatients) of the Hospital of Pavia. Data collection took place by means of two self-administered and anonymous questionnaires (one for employees and one for patients). Overall, 3,996 employees and 2,301 patients completed the questionnaires. The prevalence of smokers among participating individuals remained largely unchanged in the observed period. The percentage of smokers among employees ranged from 21.88% in 2007 to 23% in 2006, while among patients it ranged from 16.67% in 2006 to 24.05% in 2008. Knowledge about tobacco-related issues was found to be poor and did not change over time. The low response rate did not allow us to generalize results to the entire target population. However, results indicate the need for health promotion campaigns both among hospital employees and among the general population, to raise awareness regarding the risks of tobacco smoking and to reduce the prevalence of smokers.

Improved metabolic and cardiorespiratory fitness during a recreational training program in obese children

Physical activity may protect from the adverse effects of obesity. In obese children, an increased adherence and a decreased drop-out rate during exercise could be achieved with adapted activities. We studied a recreational 12-week controlled training program for sedentary obese children, including interactive video games. We enrolled 22 obese subjects (13.23±1.76 years) in an exercise program, implemented twice a week for a 12-week period. The program consisted of a combination of circuit-based aerobics, strength and resistance exercises; specifically soccer, rugby, volleyball and basketball and interactive video game exercises. Outcome measurements included body composition, metabolic profile and cardiorespiratory fitness. During the 12-week training program there was a significant decrease in body mass index (BMI) (p=0.002), SDS-BMI (p=0.003), waist circumference (p=0.004), waist circumference/height ratio (p=0.001),% fat mass (p=0.001), blood glucose (p=0.001), homeostasis model assessment for insulin resistance (HOMA-IR) (p=0.04), triglycerides (p=0.03) and systolic pressure (p=0.04) before and after exercise. Improvement in estimated maximum oxygen consumption (VO2max) (p<0.001) correlated with a decrease in fat mass (p=0.01), triglycerides (p=0.04) and insulin resistance (p=0.02). Exercise improved metabolic and cardiorespiratory fitness in obese children. Exercise training does not necessarily need to be vigorous, recreational programs are also effective and may encourage children to participate in physical activity and limit initial drop-out.

[World Health Organization (WHO) Guidelines for coastal and fresh waters: Italian translation by the Society of Hygiene, Preventive Medicine and Public Health (SItI) Working Group "Movement Sciences for Health"]

The Working Group "Movement Sciences for Health" of the Italian Society of Hygiene, Preventive Medicine and Public Health has promoted the Italian translation of the WHO Guidelines for Safe Recreational Water Environments, relating to coastal and freshwater environments. In this article the authors briefly summarize the main areas covered in the guidelines, namely drowning and injury, exposure to cold, heat and sunlight, water quality, contamination of beach sand, exposure to algae and their products, aesthetic issues, exposure to chemical and physical agents, dangerous aquatic organisms, monitoring and assessment hazards and risks.

[Medicine and physical activity and their relatedness in history]

The authors outline how scientific and social ideas and concepts, regarding the role of physical activity in human health, have evolved throughout the last centuries,.

[Prevalence of hearing loss in elderly individuals over 65 years of age: a pilot study in Lombardia (Italy)]

A cross sectional study was performed to determine the prevalence of hearing loss in individuals over age 65 years presenting to a medical centre in Lombardia (Italy). The aim was to assess the feasibility of performing a survey to evaluate the prevalence of hearing loss in the entire region. Audiometric testing was performed in each enrolled subject, to reveal losses in hearing levels at 250 to 8000 Hz; hearing levels were measured in decibels. Prevalences of mild, moderate, severe, and profound hearing impairment were found to be 39%, 17.4%, 2.9% and 0.6% respectively when using the WHO classification, and 59.9%, 25.6%, 2.9%, and 0.6% respectively when using the classification of the Bureau International d'Audiophonologie (BIAP).This study has shown that a relevant part of the study population is affected by hearing impairment and has served as a pilot study for a larger-scale study to be performed in the Lombardia region.