Background: Falls represent a leading cause of disability and mortality in the elderly population, yet traditional screening methods, such as the Timed Up and Go (TUG) test, often lack the sensitivity to detect subtle motor deficits. This study aims to evaluate whether gait parameters derived from wearable inertial sensors, improve fall risk prediction in community-dwelling older adults compared to conventional methods. Methods: This prospective longitudinal study enrolled participants aged ≥65 years in Rome, Italy. At baseline, participants underwent the Short Functional Geriatric Evaluation (SFGE) and performed the TUG and 10-Meter Walk Test (10MWT) wearing a tri-axial accelerometer. A 6-month follow-up was conducted to record falls incidence. A multivariate logistic regression model was developed to identify predictors of future falls, and Receiver Operating Characteristic (ROC) analysis was used to determine optimal cut-off values. Results: A total of 234 participants aged ≥65 years were enrolled. At the 6-month follow-up, 26.6% of the 94 participants who completed follow-up experienced a fall. The strongest predictors of future falls were history of previous falls (OR 6.8) and antero-posterior asymmetry during TUG (OR 5.8). A composite predictive score incorporating fall history, gait asymmetry, step count, and test duration achieved an Area Under the Curve (AUC) of 0.85, significantly outperforming single-parameter assessments. Notably, the standard CDC-recommended TUG cut-off (≥12s) demonstrated high sensitivity (92%) but poor specificity (15.2%) in this cohort. Conversely, a data-driven cut-off of ≥16s offered a better balance of predictive accuracy (Youden Index 0.261 vs. 0.072). Discussion: The integration of wearable sensor data into a multiparametric assessment reveals a distinct "motor signature" in at-risk elderly individuals characterized by gait asymmetry and variability. The multiparametric approach shows a stronger association with falls than is observed for the TUG, supporting the adoption of instrumented gait analysis for precision fall prevention strategies in community settings.
Background: The prevalence of respiratory allergic diseases is increasing worldwide. In Europe, migration is a significant phenomenon, but little is known about their epidemiology in immigrants, normally coming from low-income countries and showing lower prevalence than natives. Over time, seasonal respiratory allergies increase with different patterns among first- and second-generation immigrants. Airborne pollen can be an indicator of exposure to airborne allergens, but traditional monitoring using Hirst-type samplers requires considerable resources, time consuming and delay of data. As a complementary and low-cost alternative, researchers are increasingly analysing internet search behaviour to monitor allergy-related phenomena. This study evaluated Google Trends (GTs) as an indicator for the epidemiological surveillance of seasonal pollen-related allergies among different immigrant populations living in Italy, considering that immigrants represent 8.8% of the Italian population. Methods: By GTs we analysed flow, searched for terms related to allergy and performed in different languages from 2009 to 2019. The search terms such as “allergy”, “rhinitis”, “asthma”, “antihistamine” and “pollen” were analysed. Descriptive statistics and correlations were performed. Results: Cross-language GTs analyses showed distinct seasonal peaks mostly in April and May but also in June, August and October with correlations between some languages. Discussion: Language-specific search suggests varying awareness, health-seeking behaviour and exposure patterns among immigrant communities.
Background. Sleep disorders are highly prevalent among European adults, with disease-specific estimates ranging from 10% for insomnia to 18% for obstructive sleep apnoea; however, sleep health remains underrepresented in national public health strategies. Population-based evidence on sleep quality and its broader determinants is scarce in Italy, where the only nationally representative survey was conducted in 2002. This narrative review synthesizes a coordinated sleep health research program in South Tyrol, a bilingual region in Northern Italy. Methods. Six peer-reviewed publications (2025–2026) based on a representative adult survey (n = 2,090), adolescent mental health screening (n = 1,471), and regional pharmaceutical data were reviewed following the SANRA framework. Contextual literature was identified using PubMed and the Consensus academic search engine. Results. Among adults, 18% met the criterion for poor sleep quality (B-PSQI ≥6), and 28% slept six hours or less. Latent profile analysis identified a Struggling Navigators cluster (25.8%) characterized by poor sleep, low health literacy, and elevated health care utilization. Mistrust of professional health information was independently associated with poor sleep and not mediated by health behaviors. Benzodiazepine consumption was approximately half the national average, offset by higher sedating antidepressant use, mirroring the German-language prescribing culture. Among adolescents, each additional hour of sleep reduced the odds of anxiety by 31% (OR = 0.69; 95% CI: 0.56–0.84) and depression in males by 40% (OR = 0.60; 95% CI: 0.44–0.81). Patient activation partially mediated the chronic disease–sleep relationship (4.7–6.3%) with disease-specific variation. Discussion. The findings provide rare European population-based evidence on the health literacy–sleep and patient activation–sleep associations, introduce health information mistrust as a novel correlate of sleep quality, and document culturally shaped prescription patterns within a single national framework. The results support the integration of sleep into public health strategies and offer a replicable model for regional surveillance.
Background: Mental health issues, including stress, anxiety, and depressive symptoms, are increasingly prevalent among high school students. Despite this growing concern, the related factors to these problems remain insufficiently explored, particularly within the Vietnamese context. Methods: This cross-sectional study aimed to identify factors associated with stress, anxiety, and depressive symptoms among 789 Vietnamese high school students. Univariable and multivariable logistic regression analyses were conducted to examine these associations. Results: The current study revealed significant associations between various factors and stress, anxiety, and depressive symptoms among high school students. Regarding stress, female students reported higher odds of stress symptoms than males, and those attending gifted schools experienced higher odds compared to their peers in non-gifted schools. Furthermore, students who reported feeling less happy or unhappy or moderately happy had higher odds of stress than those who described themselves as happy or very happy. In terms of anxiety, elevated odds of anxiety were observed among female students compared to male counterparts, those aged 18–20 compared to 16-year-olds, and students with less, unhappy, or moderately happy feelings compared to those with happy and very happy feelings. Regarding depressive symptoms, higher odds of depressive symptoms were found among female students, individuals not living with either parent, those with a family history of mental disorders, students with less, unhappy, or moderately happy feelings, and those who perceived their academic environment as negative or very negative. Conclusion: Being female, having lower perceived happiness, and experiencing negative academic or familial circumstances were significantly associated with higher odds of stress, anxiety, and depressive symptoms. These findings highlight the need for targeted mental health interventions, particularly those that address gender-specific needs, enhance students’ well-being, and improve academic and family support systems. These findings support the need for school-based mental health screening and supportive interventions, while recognizing that DASS-21 outcomes reflect symptom burden rather than clinical diagnoses.
Background: Influenza and dengue are two high-impact infectious diseases representing a persistent challenge to health systems worldwide. Their control depends not only on identification of viral transmission patterns, but also on understanding human choices, including vaccine uptake, personal protection, and adherence to public guidance. Classical reporting mechanisms, although reliable, often provide delayed or incomplete pictures of population behavior. In recent years, alternative information streams, such as online searches, social platforms, and mobile-based tools have been explored as rapid proxies to capture preventive actions and community sentiment. Methods: We performed a systematic review of the literature, according to PRISMA standards. Multiple databases (PubMed/MEDLINE, Scopus, EMBASE and PsycInfo) were queried without language restrictions. Eligible contributions were those employing unconventional digital traces or unconventional data to monitor prevention-related behaviors in the context of influenza or dengue. Extracted items included data source, infectious diseases explored, behavioral outcome and principal conclusions. Results: From 5,448 records, 44 articles satisfied inclusion parameters. Overall, 33 studies addressed influenza vaccination interest and protective measures, whereas nine examined dengue-related prevention behaviors, and two addressed both influenza and dengue. Internet search activity and microblogging platforms were the most frequently used sources. Approaches ranged from straightforward frequency tracking to advanced predictive algorithms. Several studies demonstrated that these data sources could anticipate behavioral shifts before official statistics; however, validation against ground-based behavioral measures was inconsistent and representativeness remained a recurrent concern. Discussion: Unconventional information streams appear promising for complementing established monitoring frameworks by offering faster signals and broader contextual awareness. Yet their usefulness is tempered by biases in digital participation, susceptibility to rumor propagation, and lack of standardized evaluation. Considering the distinct characteristics of influenza and dengue, these findings suggest that unconventional data can enrich prevention monitoring if integrated with traditional systems, coupled with rigorous methodological assessment, and applied with attention to equity.
Background: West Nile Virus (WNV) represents an emerging public health concern in Slovakia due to climatic changes and the expansion of invasive mosquito species. This study examined demographic and regional differences in knowledge, attitudes, and preventive practices related to WNV among Slovak residents. Methods: A structured online questionnaire was completed by 368 participants from diverse backgrounds. Data were analyzed using analysis of variance (ANOVA) to assess the influence of gender, age, education, residence, employment status, regional affiliation, and time spent outdoors on selected WNV-related indicators. Results: Significant differences were observed primarily for gender, age, and region. Gender was associated with differences in factual knowledge, subjective feeling of threat, and repellent use. Age was significantly related to knowledge levels, while regional affiliation influenced knowledge, perceived threat, and selected protective behaviors. In contrast, educational attainment, type of residence, employment status, and time spent outdoors did not demonstrate statistically significant effects. Discussion and Conclusions: The findings indicate variability in WNV-related awareness and selected preventive behaviors across certain demographic and geographic subgroups. As an exploratory assessment based on non-probability sampling, the study provides preliminary evidence that may inform future large-scale, representative investigations and context-sensitive public health communication strategies in Slovakia.
Background: Hygiene practices in healthcare settings are crucial for infection prevention, patient safety, and they have significant public health and environmental implications. Routine patient-care activities generate substantial healthcare waste, contributing to the ecological footprint. This multicentre, cross-sectional observational study investigated patient hygiene management and waste disposal in healthcare facilities, focusing on nursing and midwifery coordinators' practices, knowledge, awareness. Methods: An anonymous online survey was conducted between April and December 2024 among coordinators from eleven public and private healthcare facilities in Apulia, Southern Italy. Data included organizational protocols, hygiene practices, and waste management procedures. Descriptive statistics and Chi-square tests were used, with p < 0.05 considered significant. Results: 123 coordinators participated. Sixty-five percent (n = 79) reported absence of hygiene protocols, 71.5% (n = 88) lacked standard operating procedures. Liquid soap was used by 58% (n = 72) and single-use soaped gloves by 41.5% (n = 51) . Urban-like waste management protocols were present in 79.7% (n = 98) of units. Refillable dispensers and reusable bottles were used in 30.1% (n = 37) of units, while 69.1% (n = 85) disposed of residual detergents into the sewage system. Refillable dispensers were in 21.6% (n = 8) of ICUs, 42.3% (n = 16) of surgical wards, and 35.1% (n = 13) of medical and long-term care wards. The source of hygiene products for self-sufficient patients differed significantly across clinical areas (chi(2) = 10.91, df = 2, p = 0.013). Discussion and Conclusions: Considerable variability exists in hygiene practices and waste management across clinical areas, with gaps in protocol availability and adherence. Environmental sustainability remains inconsistently addressed. Coordinators play a strategic role in improving standardization and promoting sustainable practices. Implementing standardized, evidence-based hygiene protocols, staff training, and sustainable waste-management practices, is essential to improve patient safety, infection prevention, and environmental sustainability in healthcare facilities.
Background: Diagnoses of specific learning disorders (SLDs) have increased in recent years, as has the number of certified students entering university. From a public health perspective, the potential impact of dyslexia, dysgraphia, dysorthography, and dyscalculia on health literacy (HL) deserves attention. However, empirical evidence on the relationship between SLDs and HL remains limited. Methods: We conducted an observational pilot study to assess HL levels among students with documented SLDs at the University of Udine (Italy). Between November 2023 and April 2024, participants completed an online selfadministered questionnaire collecting sociodemographic data and the European Health Literacy Survey Questionnaire (HLS-EU-Q47), which was used to measure HL. Results: The study sample consisted of 38 students (mean age: 24 years; 60.5% female). A single SLD diagnosis was reported by 42.1% of participants, whereas 57.9% had two or more co-occurring SLDs. Dyslexia was the most prevalent disorder (71.1%), followed by dysgraphia (52.6%). Overall, 65.8% of students showed problematic or inadequate HL levels. The presence of multiple SLDs was not significantly associated with HL level. Additionally, no significant differences in HL were observed according to the type of SLD or the use of compensatory or dispensatory measures. Discussion and Conclusions: These preliminary findings support the hypothesis that SLDs are associated with difficulties in accessing, understanding, appraising, and applying health-related information. Future research is needed to further substantiate the findings of this exploratory study as well as to clarify their public health implications, particularly in relation to healthcare access, disease prevention, and health promotion.
Background: Global prison population has increased worldwide approximately 24% since the 2000s. The objective of our study was to create a health status index for inmates at the LA'quila prison and to describe their health profiles. Methods: The pathologies examined concerned: heart valves, arterial ischemia, cerebral vascular accidents, endocrine diseases, Type 2 diabetes, malignant and benign neoplasms. In addition, respiratory, kidney, urogenital, osteo-articular, gastrointestinal, neurological, anemia, otorhinolaryngology, ophthalmology, dermatological, dental, and infectious diseases. A score was given to the therapies: 0-absence of therapy; 1-monotherapies; 2-polytherapies; 3-high-cost therapies. The health state was: good, fairly good, poor, compromised/serious. The pathologies taken into consideration were introduced into the MCA model to highlight health profiles. Results: The synthetic health index showed the following health status: good (25 cases, 15.9%), fairly good (104, 66.2%), poor (25, 15.9%), compromised/serious (3, 1.9%). The MCA identified three profiles. The first consisted of individuals aged >= 60, with the presence of arterial hypertension, respiratory diseases, cardiovascular diseases, endocrine diseases, neoplasms, and compromised/serious health status. The second were inmates aged 50 to 59, with renal, gastrointestinal, neurological and infectious diseases, undergoing psychological treatment, with an average health status index. The third consisted of individuals under 50 with no underlying health conditions. Discussion: prevention must be a priority among young people in good health, to prevent their well-being from declining to a fair level, and above all, to prevent further deterioration into mediocre conditions. In conclusion, early
Background: Early childhood education and care (ECEC) is crucial for children's early awareness of well-being and prevention concepts, which are essential for a future healthy lifestyle. Therefore, as public health agents, teachers and educators in ECEC should be taught core topics related to public health and well-being. Methods: We investigated the presence and characteristics of public health courses (MEDS-24/B) in Italian primary education sciences Master's programmes in the academic year 2023-24 and propose a model for public health topics to be covered, based on the WHO Essential Public Health Functions. Results: Only a small proportion of the Master's programmes in primary education sciences (n.14/38; 38%) included the course 'General and applied hygiene' (MEDS-24/B). We found no statistically significant differences in attendance according to any of the variables analysed (i.e. geographical location of the university, size, or public/private status of the university). While topics like "infectious disease prevention and immunization" were covered in >75%, others like "oral hygiene" were not covered at all. Detailed analysis showed great heterogeneity at national level in the topics covered between primary education sciences Master's programmes. Discussion: The current suboptimal presence and coherence of the public health course within the Master's degree in primary education sciences at national level affects the competencies of ECEC educators and teachers, which in turn affects their ability to implement health promotion, disease prevention, and control measures in primary education and the wider community. At national level, more attention should be paid to the academic education of all public health agents.
Background: University students are at increased risk for unhealthy behaviours, including poor diet and hazardous alcohol use. Mediterranean Diet (MD) adherence has been linked to favourable health outcomes, but evidence in young adults is scarce. This study examined the association of MD adherence with self-rated health (SRH), body mass index (BMI), and alcohol-related risk in Italian university students, considering also food delivery app use. Methods: A cross-sectional study was conducted among 2,697 students (70.6% female) at the University of Milan during the academic year 2021/2022. MD adherence was assessed with the validated Medi-Lite questionnaire (score range 0-18, with higher scores indicating greater adherence), SRH with a single-item indicator, BMI from self-reported data, and alcohol-related risk with the AUDIT-C. Multivariable logistic and multinomial regression models were applied. Results: Compared with students with low MD adherence, those with high MD adherence (>= 12 score) had higher odds of good SRH (aOR = 3.16, 95% CI = 1.23-8.11) and lower odds of overweight/obesity (aOR = 0.66, 95% CI = 0.52-0.85), with no significant association with alcohol risk. Greater consumption of fruits, vegetables, legumes, cereals, and olive oil predicted better SRH and lower BMI. Food delivery app use was associated with overweight/obesity and alcohol risk. Discussion: Higher MD adherence is linked to improved perceived health and lower odds of overweight/obesity among university students. Public health strategies should promote MD and improve digital food environments by limiting unhealthy food marketing and facilitating healthier online choice.
Background: Traditional health and safety training often fails to engage workers effectively. Gamification has emerged as a promising strategy to enhance motivation and learning outcomes. This study aimed to assess the effectiveness of a gamified training course in improving occupational health and safety knowledge. Methods: A randomized controlled field trial was conducted with 77 participants. Participants were divided into two groups: an experimental group (EG) and a control group (CG). The intervention, titled "Let's play to 626!" consisted of a one-day course comprising a seminar and gaming session. The participants were assessed using an internally validated Q626 questionnaire at baseline (T0) and after the intervention (T1), with a knowledge score was computed ranged from 0 to15. Descriptive statistics, paired sample tests, and regression analyses were used to analyse the data. Results: The internal reliability of the Q626 tool was moderate, with Cronbach's alpha of 0.723. The results indicated a significant improvement in Q626 scores for both the experimental group (EG) and the control group (CG) at T1 Discussion: The gamification session was associated with improved knowledge outcomes, comparable to those observed with traditional seminar-based training. Future studies should explore the long-term impact of gamified learning on occupational health and safety training.
Introduction: Granulomatous lymphocytic interstitial lung disease (GLILD) is a non-infectious complication affecting 10-20% of patients with common variable immunodeficiency disorders. Exercise capacity in GLILD patients, who often report shortness of breath during exercise, has not been previously evaluated. This study aimed to assess the utility of the six-minute walk test (6MWT) as an outcome measure in GLILD. It also evaluated reproducibility and effectiveness of King's Brief ILD Questionnaire (K-BILD) questionnaire in capturing the multidimensional impact of GLILD on quality of life. Methods: This was an observational prospective cohort study. The 6MWT and questionnaires were conducted at baseline and two follow-ups. The 6MWT was performed according to ERS/ATS guidelines. The utility was evaluated by correlating the 6MWT measures (walked distance (6MWD) and distance-saturation product (DSP)) with clinical parameters and health-related quality of life (HRQOL) questionnaires. Reproducibility was assessed using the Intraclass Correlation Coefficient. Results: Thirteen participants (54% male, median age 45 (IQR 38-62) years) were included. The median 6MWT distance was 457 meters. DSP was the only measure strongly correlated with FVC% and FEV1%, and it showed stronger correlations with clinical measures than 6MWD. The 6MWT has good 6-month and one year reproducibility. Finally, K-BILD appeared to be a useful tool for assessing HRQOL in patients with GLILD, who often have multi-system involvement. Conclusion: Our findings highlight the potential of the 6MWT as a useful measure to assess GLILD. The 6MWT and K-BILD correlations with clinical parameters suggest utility in assessing disease severity and monitoring patients' physical functioning.
Background: Academic rankings may influence student enrolment, faculty recruitment, and funding opportunities, however their methodology is often criticized, primarily because it disregards financial efficiency. Methods: We analyzed the best 100 biomedical universities in three recognized international rankings (Times Higher Education, Quacquarelli-Symonds, and Shanghai), to investigate the association between expenditure and performance. Times, Q-S and SH overall quality scores, specific sub-scores, operating expenditures, and total students' number were extracted from official websites. A global quality score was computed as weighted mean of the three scores, and a composite efficiency score was calculated dividing the average annual expenditure per student by the global quality score. Results: Despite a general alignment, the three rankings showed several discrepancies, highlighting the potential role of a composite quality score, which showed high internal validity and reliability. Sixteen of the 20 top academies were located in USA (n=12) or UK, but the median expense per student of USA universities (183,100 USD) was more than five times larger than the European, Australian (both 28,100 USD), or Canadian (25,000 USD) centers, which showed the best efficiency scores. Indeed, greater funding was significantly associated with a higher global quality score, as well as Times, SH, Q-S scores, and most sub-scores. Discussion and Conclusions: Considering the steep differences in funding that were detected between top-ranking universities and those just below the top 40, the proposed measure of efficiency may serve as a complementary metric to recognize and reward the academies that are able to maximize resources, still delivering high-quality education.
Background. The COVID-19 pandemic profoundly reshaped healthcare systems, accelerating ongoing structural transformations and intensifying pre-existing regional disparities in workforce distribution. Understanding the socioeconomic determinants that shape the diffusion of self-employment in nursing is essential, particularly in the post-pandemic phase, to support equitable workforce planning and the reorganization of territorial care envisioned by current national reforms. This study investigates the socio-economic factors influencing self-employed nursing practice and examines its implications for the future of Italy's healthcare system. Methods: A descriptive ecological observational study was conducted across all 20 Italian regions. Regional-level data were collected from official administrative sources, including ENPAPI, FNOPI, ISTAT, the Ministry of Health, and C.R.E.A. Sanit & agrave;. The dependent variable was the number of self-employed nurses per 10,000 inhabitants. Independent variables included average per capita income, out-of-pocket health expenditure, hospital beds per 1,000 inhabitants, and the number of National Health Service (NHS) nurses per 1,000 inhabitants. Multiple linear regression was performed, and the study followed the RECORD reporting guidelines. Results: The density of self-employed nurses varied considerably across regions, with higher values in Lombardy, Piedmont, and Aosta Valley. Among the predictors, average per capita income was positively and significantly associated with the number of self-employed nurses ((3 = 0.739, p = 0.001). Conversely, the number of NHS-employed nurses per 1,000 inhabitants was negatively and significantly associated with the number of self-employed nurse ((3 = -1.384, p = 0.001). Compared with pre-pandemic evidence, post-COVID trends indicate continuity in socioeconomic gradients but also the emergence of a substitution effect: public recruitment campaigns increased NHS staffing over 7% at the national level, with regional estimates for Lazio approaching 10%, coinciding with a proportional decline in self-employed nurses. Conclusion: Self-employment in nursing appears to operate as a flexible response to workforce shortages rather than a purely autonomous professional choice. Regional socioeconomic disparities continue to shape its distribution, with wealthier areas supporting dual public-private care markets.
Background: Respiratory syncytial virus (RSV) is an under-recognised cause of acute respiratory infections (ARIs) in older adults, despite a burden comparable to influenza and the recent availability of RSV vaccines. Robust community-based data from Italian primary care are lacking. Methods: We conducted a prospective, multicentre cohort study in four Italian regions (Liguria, Lombardy, Tuscany, Apulia) over three consecutive winter seasons (2022-2025). Community-dwelling adults >= 60 years presenting to participating general practitioners (GPs) with a WHO-defined ARI were enrolled. Nasopharyngeal swabs were collected and tested using a multiplex RT-PCR respiratory panel. RSV-positive participants were followed by telephone at day 14 (T14) and day 30 (T30). Adjusted prevalence ratios (PRs) for symptoms were estimated with Poisson regression. Results: Among 664 ARI episodes, 663 had a valid RSV result, and 88 were RSV-positive (13.3%). Positivity rates varied by season (21.7% in 2022-23, 11.9% in 2023-24, and 10.4% in 2024-25) and region (range: 11.2-28.3%), with peaks occurring between ISO weeks 51 and 10. The median age of RSV-positive patients was 75 years (IQR, 68-82); 42% were male. Compared with RSV-negative ARIs, RSV-positive cases had higher adjusted prevalence of cough (PR 1.07, 95% CI 1.02-1.13) and wheezing (PR 1.83, 95% CI 1.14-2.93); other symptoms overlapped substantially. RSV-B predominated (68.2%). Any co-infection occurred in 35.2% of RSV-positive cases, mainly with Haemophilus influenzae and Streptococcus pneumoniae. Median illness duration was 19.5 days (IQR 11.3-30.0). Within 14 days, 65.9% re-contacted their GP and 10.6% sought additional medical care; emergency visits (3.5%) and hospitalisations (2.4%) were uncommon. Conclusions: Across three winters, RSV accounted for approximately one in eight medically attended ARIs in Italian adults >= 60 years, with prolonged illness also leading to hospitalisations and frequent re-consultations. These findings provide baseline data to support adult RSV vaccination policies and integration of RSV into routine respiratory surveillance in Italy.
Background: Air pollution in urban high-traffic areas contributes to exposure to heavy metals, such as cadmium (Cd) and lead (Pb), posing health risks to vulnerable populations, particularly street children. This study aimed to assess the relationship between Cd and Pb concentrations in ambient air and their levels in the blood of street children in Makassar City, Eastern Indonesia, and to evaluate the influence of age and sex. Methods: A cross-sectional study was conducted on 80 street children aged 3-12 years living within 700 m of six high-traffic sites. Ambient air samples were collected using a high-volume sampler and analyzed by Atomic Absorption Spectrophotometry, while blood samples were examined using Inductively Coupled Plasma Mass Spectrometry. Results: The mean blood Pb concentration was 0.32 ng/mL (range 0.05-0.87 ng/mL), which is below the WHO reference threshold of 5 & micro;g/dL, although approximately 10% of the children exceeded this level. The mean blood Cd concentration was 0.68 ng/mL (range 0.12-1.23 ng/mL), which is close to or slightly above the WHO recommended threshold of 1 & micro;g/L in some participants, indicating potential health concern. The correlation between ambient and blood Pb levels was very weak (r = 0.041; 95% CI: -0.180 to 0.258), and the correlation between ambient and blood Cd levels was weak and imprecise (r = -0.172; 95% CI: -0.377 to 0.050). A moderate negative correlation was observed between age and blood Cd (r = -0.460; 95% CI: -0.617 to-0.267), indicating higher Cd accumulation in younger children than in older children. Sex had little effect on blood Cd and Pb levels. Discussion: These findings highlight that multiple exposure pathways, beyond ambient air, contribute to the heavy metal body burden among street children. Public health interventions addressing environmental sources, nutritional support, and healthcare access are essential to reduce the risk of chronic Cd and Pb exposure in this vulnerable group.
Background: The global shortage of healthcare professionals is critical, with the WHO reporting a deficit of 5,9 million nurses in 2020-a number expected to increase due to rising demand and high turnover. In high-income countries, absenteeism among healthcare workers, absence due to personal or health reasons, worsens this shortage, causing service disruptions, reduced productivity, and higher costs. This study examines trends in absences among non-medical staff at the Azienda Ospedale-Universita Padova (AOUP), a large hospital in the Veneto Region, employing nearly 7,000 staff. Methods: A descriptive longitudinal analysis was conducted using administrative data from January 2018 to December 2023. Absence days per Full-Time Equivalent (FTE) were classified as sickness, injury, maternity, authorized, unpaid, vacation, and COVID-related (from 2020). Absence rates were standardized per 100 FTE-days with 95% confidence intervals. Workforce composition before and after the 2020 reorganization was assessed to control for structural changes. Results: From 2018 to 2023, average absence days per employee (including vacation) rose by 2.86 days, peaking in 2022. Sickness absences rose by 9.9%, paid leave days by 24.8%, and unpaid leave by 6.1%, while injury (-36.7%) and maternity leave (-6.2%) declined. The 2022 peak corresponded to a temporary reduction of approximate to 330 FTEs in active service. Young nurses and young healthcare assistants (<30 years) experienced the sharpest increases. Discussion: The findings reflect both post-pandemic effects and regulatory changes, including the November 2022 CCNL reform, which simplified certification for personal reason leave. Despite a post-pandemic decline, absence rates remain above pre-2020 levels, driven by sustained workload and psychosocial stress. The study highlights the need for workforce policies addressing structural and behavioural determinants of absenteeism.
