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Papers by christian napoli

Research paper thumbnail of Key Dimensions for the Prevention and Control of Communicable Diseases in Institutional Settings: A Scoping Review to Guide the Development of a Tool to Strengthen Preparedness at Migrant Holding Centres in the EU/EEA

International Journal of Environmental Research and Public Health, May 30, 2018

Migrant centres, as other institutions hosting closed or semi-open communities, may face specific... more Migrant centres, as other institutions hosting closed or semi-open communities, may face specific challenges in preventing and controlling communicable disease transmission, particularly during times of large sudden influx. However, there is dearth of evidence on how to prioritise investments in aspects such as human resources, medicines and vaccines, sanitation and disinfection, and physical infrastructures to prevent/control communicable disease outbreaks. We analysed frequent drivers of communicable disease transmission/issues for outbreak management in institutions hosting closed or semi-open communities, including migrant centres, and reviewed existing assessment tools to guide the development of a European Centre for Disease Prevention and Control (ECDC) checklist tool to strengthen preparedness against communicable disease outbreaks in migrant centres. Among articles/reports focusing specifically on migrant centres, outbreaks through multiple types of disease transmission were described as possible/occurred. Human resources and physical infrastructure were the dimensions most frequently identified as crucial for preventing and mitigating outbreaks. This review also recognised a lack of common agreed standards to guide and assess preparedness activities in migrant centres, thereby underscoring the need for a capacity-oriented ECDC preparedness checklist tool.

Research paper thumbnail of An Early Warning System Based on Syndromic Surveillance to Detect Potential Health Emergencies among Migrants: Results of a Two-Year Experience in Italy

International Journal of Environmental Research and Public Health, Aug 20, 2014

Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and... more Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability and usefulness of syndromic surveillance in this specific context.

Research paper thumbnail of Factors Influencing the Accuracy of Infectious Disease Reporting in Migrants: A Scoping Review

International Journal of Environmental Research and Public Health, Jul 5, 2017

We conducted a scoping review of literature to improve our understanding of the accuracy of infec... more We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased detection of cases. Incompleteness of denominator data underestimates the at-risk population. In conclusion, most studies show a lower probability of under-reporting infectious diseases in migrants compared with native populations.

Research paper thumbnail of Towards a European Framework to Monitor Infectious Diseases among Migrant Populations: Design and Applicability

International Journal of Environmental Research and Public Health, Sep 17, 2015

There are limitations in our capacity to interpret point estimates and trends of infectious disea... more There are limitations in our capacity to interpret point estimates and trends of infectious diseases occurring among diverse migrant populations living in the European Union/European Economic Area (EU/EEA). The aim of this study was to design a data collection framework that could capture information on factors associated with increased risk to infectious diseases in migrant populations in the EU/EEA. The authors defined factors associated with increased risk according to a multi-dimensional framework and performed a systematic literature review in order to identify whether those factors well

Research paper thumbnail of Collective Catering Activities and Official Controls: Dietary Promotion, Sustainability and Future Perspectives

Healthcare

Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requ... more Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requirement to guarantee health in different settings. This study aims to evaluate the compliance of collective catering menus adopted in both school canteens and healthcare facilities in a regional area where specific guidelines have been issued, assessing many matters from food weight to single courses and from the use of wholegrain pasta and bread to the rotation of seasonal fruit and vegetables. Overall, 85 menus, edited by freelance professionals and endorsed by the Food Hygiene and Nutrition Service staff of the Local Health Authority, were assessed from 2018 to 2022, highlighting critical issues potentially attributable at a local level to the lack of complete knowledge of the existence of guidelines and official reference documents among nutrition professionals. Since the preliminary outcomes show non-compliance in both sectors investigated, it is essential to continue to strengthen ...

Research paper thumbnail of Investigations on the Efficacy of Ozone as an Environmental Sanitizer in Large Supermarkets

Pathogens

Awareness of the importance of the microbial contamination of air and surfaces has increased sign... more Awareness of the importance of the microbial contamination of air and surfaces has increased significantly during the COVID-19 pandemic. The aim of this study was to evaluate the presence of bacteria and fungi in the air and on surfaces within some critical areas of large supermarkets with and without an ozonation system. Surveys were conducted in four supermarkets belonging to the same commercial chain of an Apulian city in June 2021, of which two (A and B) were equipped with an ozonation system, and two (C and D) did not have any air-diffused remediation treatment. There was a statistically significant difference in the total bacterial count (TBC) and total fungal count (TFC) in the air between A/B and C/D supermarkets (p = 0.0042 and p = 0.0002, respectively). Regarding surfaces, a statistically significant difference in TBC emerged between A/B and C/D supermarkets (p = 0.0101). To the best of our knowledge, this is the first study evaluating the effect of ozone on commercial str...

Research paper thumbnail of Open Access

Abstract: Profound geopolitical changes have impacted the southern and eastern Mediterranean sinc... more Abstract: Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability

Research paper thumbnail of www.mdpi.com/journal/ijerph Article Towards a European Framework to Monitor Infectious Diseases among Migrant Populations: Design and Applicability

Abstract: There are limitations in our capacity to interpret point estimates and trends of infect... more Abstract: There are limitations in our capacity to interpret point estimates and trends of infectious diseases occurring among diverse migrant populations living in the European Union/European Economic Area (EU/EEA). The aim of this study was to design a data collection framework that could capture information on factors associated with increased risk to infectious diseases in migrant populations in the EU/EEA. The authors defined factors associated with increased risk according to a multi-dimensional framework and

Research paper thumbnail of Il ruolo dell’educazione fisica nella promozione della salute: uno studio multicentrico

Parole chiave: educazione fisica, scuola secondaria di secondo grado, attività fisica, promozione... more Parole chiave: educazione fisica, scuola secondaria di secondo grado, attività fisica, promozione della salute RIASSUNTO Obiettivi: evidenziare limiti e punti di forza dell'insegnamento di Educazione Fisica (EF) nell'attuale sistema scolastico italiano sulla base delle opinioni degli studenti. Metodi: ad un campione di matricole provenienti da 14 università italiane è stato somministrato un questionario anonimo da autocompilare riguardante esperienze e giudizi relativi all'insegnamento di EF ricevuto nell'ultimo biennio di scuola. Sono state anche analizzate eventuali differenze tra Nord, Centro e Sud. Risultati: su 7.033 partecipanti, il 42,2% riportava come obiettivo principale perseguito durante le lezioni di EF quello "ricreativo". Più della metà degli studenti (62,2%) ha riferito nessuna o modesta influenza delle lezioni di EF sulla pratica corrente di Attività Fisica (AF). Il 67,2% del campione si ritiene soddisfatto degli insegnamenti di educazione fisica ricevuti, soprattutto nelle regioni del Nord. Discussione e conclusioni: l'analisi condotta ha evidenziato la necessità di migliorare l'offerta di tale insegnamento nella scuola italiana, sia incrementando il tempo dedicato alle lezioni, sia impiegando insegnanti adeguatamente preparati.

Research paper thumbnail of An Integrated Control Plan in Primary Schools: Results of a Field Investigation on Nutritional and Hygienic Features in the Apulia Region (Southern Italy)

Nutrients, 2021

Data concerning overweight and obesity in children and adolescent populations are alarming and re... more Data concerning overweight and obesity in children and adolescent populations are alarming and represent one of the most serious public health problems of our time. Moreover, it is demonstrated that the school environment may play an important role in health promotion with regard to nutritional aspects. This article reports the results of a study conducted in the Apulia region (Southern Italy), aimed at providing an integrated surveillance of the behaviors related to nutrition habits in students and the hygienic and nutritional conditions of the school’s canteens attended by enrolled students. To this purpose, a sample of 501 students attending primary school (third class—children approximately eight years old) replied to a validated questionnaire, and official controls (OC), of both food and nutritional safety, were performed in 22 primary schools. A team of healthcare professionals carried out the study, and the implementation of all the prescribed improvement actions were subsequ...

Research paper thumbnail of Acceptance of COVID-19 Vaccination in the Elderly: A Cross-Sectional Study in Southern Italy

Vaccines, 2021

In Italy, at the end of 2020, a voluntary immunization plan against COVID-19 was introduced, invo... more In Italy, at the end of 2020, a voluntary immunization plan against COVID-19 was introduced, involving elderly among the first target categories. The aim of this study was to assess, through an online questionnaire, the acceptance of COVID-19 vaccination in a sample of older adults from southern Italy. Of a total of 1041 respondents (41.7% males, mean age 76.6 ± 6.5), 965 (92.7%) were vaccinated or willing to be vaccinated against COVID-19, although less than half of the sample was favorable to vaccinations and agreed with mandatory immunization. Acceptance of COVID-19 vaccination was found to be positively related with higher educational level (OR = 1.875, CI95% = 1.113–3.161; p = 0.018) and having social/mass media as a main source of information (OR = 2.415 CI95% = 1.358–4.296, p = 0.003). On the contrary, an inverse relationship was found between acceptance of COVID-19 vaccination and having fulfilled the questionnaire after the introduction of green pass (OR = 0.218, CI95% = 0....

Research paper thumbnail of Knowledge and Acceptance of COVID-19 Vaccination among Undergraduate Students from Central and Southern Italy

Vaccines, 2021

At the end of 2020, the Italian Ministry of Health launched a national vaccination campaign to co... more At the end of 2020, the Italian Ministry of Health launched a national vaccination campaign to counteract the COVID-19 pandemic. The present study aimed at appraising levels of knowledge about and acceptance of COVID-19 vaccination in a sample of Italian undergraduates during the first phase of the immunization plan. A web-based questionnaire was administered to students attending universities in Bari, Naples, and Rome during the period February–April 2021. Of the total of 3226 participants, 91.9% were keen to receive a COVID-19 vaccination. More than 80% gave correct answers to questions about COVID-19 vaccine administration, functioning, and effects on community health. However, only 63.8% identified the correct composition of the available vaccines. Knowledge was found to be related to sociodemographic features and COVID-19 vaccination acceptance (p < 0.05). COVID-19 vaccination acceptance was found to be related to having a previous vaccination against influenza (OR 3.806, CI...

Research paper thumbnail of Moderate Vaccine Effectiveness against Severe Acute Respiratory Infection Caused by A(H1N1)pdm09 Influenza Virus and No Effectiveness against A(H3N2) Influenza Virus in the 2018/2019 Season in Italy

Vaccines, 2020

Every season, circulating influenza viruses change; therefore, vaccines must be reformulated each... more Every season, circulating influenza viruses change; therefore, vaccines must be reformulated each year. We aimed to estimate vaccine effectiveness (VE) against severe influenza infection for the 2018/19 season in Italy. We conducted a test-negative design case-control study at five Italian hospitals. We estimated influenza VE against severe acute respiratory infection (SARI) requiring hospitalisation overall, and by virus subtype, vaccine brand, and age. The 2018/19 season was characterised by A(H1N1)pmd09 and A(H3N2) influenza viruses. Vaccine coverage among <18 years recruited SARI cases was very low (3.2%). Seasonal vaccines were moderately effective against type A influenza overall (adjusted VE = 40.5%; 95% confidence interval (CI) = 18.7–56.4%) and subtype A(H1N1)pmd09 viruses (adjusted VE = 55%; 95% CI = 34.5–69.1%), but ineffective against subtype A(H3N2) viruses (adjusted VE = 2.5%; 95% CI = −50.0–36.7%). Both Fluad and Fluarix Tetra vaccines were effective against type A...

Research paper thumbnail of Safety in Wine Production: A Pilot Study on the Quality Evaluation of Prosecco Wine in the Framework of UE Regulation

International Journal of Environmental Research and Public Health, 2020

In Italy, wine production is considered a sector of excellence, where the wines’ appreciable sens... more In Italy, wine production is considered a sector of excellence, where the wines’ appreciable sensory features are favored by environmental factors, including weather and climate conditions, which benefit territories with a specific vocation. The whole chain involves many economic and agri-food sector operators, and requires an in-depth assessment of specific risks for identifying critical points, keeping the entire production process under control, and ensuring product traceability. This article describes the results of a pilot study conducted in the Prosecco DOCG (Designations of Controlled and Guaranteed Origin) area, concerning the detection of residues of plant protection products in fifty wine bottles. Although considerably below the maximum residue levels, all the samples tested were positive, ranging from two to five active substances detected in each sample. In addition to the provisions of the European Community legislation, this paper critically evaluates some best practic...

Research paper thumbnail of Physical Activity in Older Adults: An Investigation in a Metropolitan Area of Southern Italy

International Journal of Environmental Research and Public Health, 2020

Physical activity (PA) and exercise are fundamental to maintaining health in older adults. World ... more Physical activity (PA) and exercise are fundamental to maintaining health in older adults. World Health Organization guidelines state that older adults should practice at least 150 min/week of moderate/vigorous intensity PA to obtain health benefits. We assessed PA levels among older adults in southern Italy and evaluated possible associated determinants. The study was carried out between September and November 2019 in the metropolitan area of Bari. We collected information from participants over 65 years using a self-administered questionnaire. We investigated associations between sociodemographic characteristics, health conditions, and inactivity/PA levels. A total of 383 individuals completed the questionnaire. Mean body mass index indicated that 45.4% of participants were overweight. Mean time spent in PA was 476.2 ± 297.8 min/week, with women reporting lower levels than men (370.8 ± 210 vs. 555.2 ± 334.3 min/week, p = 0.08). Weekly sitting time was positively related to age. At...

Research paper thumbnail of Effectiveness of the trivalent MF59 adjuvated influenza vaccine in preventing hospitalization due to influenza B and A(H1N1)pdm09 viruses in the elderly in Italy, 2017 – 2018 season

Expert Review of Vaccines, 2019

Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidit... more Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidity in the elderly is weak. Our aim was to measure the VE against severe outcomes in the elderly. Methods: We conducted a multicentre hospital-based test-negative design (TND) case-control study, during the 2017/18 season, in four Italian hospitals. The study population included individuals aged ≥65 years hospitalized with Severe Acute Respiratory Infections (SARI). Patients were classified as cases and controls based on the results of the PCR influenza testing. We estimated VE by virus subtypes and specific VE for the trivalent adjuvanted vaccine (TIVadj). Results: 502 patients with SARI were enrolled: 118 (23.5%) tested positive (cases) and 384 (76.5%) tested negative (controls) for influenza. The adjusted VE of 48.5% for all vaccines was comparable to the adjusted VE for the TIVadj vaccine (48.3%). Adjusted VE for the TIVadj vaccine was 67.5% for A(H1N1) pdm09 and 44.5% for B viruses. Conclusion: We show a moderate adjusted VE of the TIVadj against all viruses, a good adjusted VE against A(H1N1)pdm09 strains and a moderate adjusted VE against B strains, despite a mismatch between the B circulating lineage and the lineage included in the vaccine. This is likely due to the crossprotection among B strains induced by the TIVadj in elderly patients.

Research paper thumbnail of Legionnaires’ disease in Italy: results of the epidemiological surveillance from 2000 to 2011

Research paper thumbnail of Control and prevention measures for legionellosis in hospitals: A cross-sectional survey in Italy

Environmental research, 2018

Risk assessment, environmental monitoring, and the disinfection of water systems are the key elem... more Risk assessment, environmental monitoring, and the disinfection of water systems are the key elements in preventing legionellosis risk. The Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine, and Public Health and the Italian Multidisciplinary Society for the Prevention of Health Care-Associated Infections carried out a national cross-sectional survey to investigate the measures taken to prevent and control legionellosis in Italian hospitals. A multiple-choice questionnaire was developed, comprising 71 questions regarding hospital location, general characteristics, clinical and environmental surveillance, and control and preventive measures for legionellosis in 2015. Overall, 739 hospitals were enrolled from February to June 2017, and 178 anonymous questionnaires were correctly completed and evaluated (response rate: 24.1%). The survey was conducted using the SurveyMonkey® platform, and the data were analyzed using Stata 12 software. Of th...

Research paper thumbnail of Factors Influencing the Accuracy of Infectious Disease Reporting in Migrants: A Scoping Review

International journal of environmental research and public health, Jan 5, 2017

We conducted a scoping review of literature to improve our understanding of the accuracy of infec... more We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased...

Research paper thumbnail of Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study

International journal of environmental research and public health, Jun 22, 2017

Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurr... more Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis(®)μ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis(®)μ were also analyzed by real-time PCR. Legionella presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolis(®)μ did not yield Legionella in any enrolled HF. However, molecular investigation using Coriolis(®)μ resu...

Research paper thumbnail of Key Dimensions for the Prevention and Control of Communicable Diseases in Institutional Settings: A Scoping Review to Guide the Development of a Tool to Strengthen Preparedness at Migrant Holding Centres in the EU/EEA

International Journal of Environmental Research and Public Health, May 30, 2018

Migrant centres, as other institutions hosting closed or semi-open communities, may face specific... more Migrant centres, as other institutions hosting closed or semi-open communities, may face specific challenges in preventing and controlling communicable disease transmission, particularly during times of large sudden influx. However, there is dearth of evidence on how to prioritise investments in aspects such as human resources, medicines and vaccines, sanitation and disinfection, and physical infrastructures to prevent/control communicable disease outbreaks. We analysed frequent drivers of communicable disease transmission/issues for outbreak management in institutions hosting closed or semi-open communities, including migrant centres, and reviewed existing assessment tools to guide the development of a European Centre for Disease Prevention and Control (ECDC) checklist tool to strengthen preparedness against communicable disease outbreaks in migrant centres. Among articles/reports focusing specifically on migrant centres, outbreaks through multiple types of disease transmission were described as possible/occurred. Human resources and physical infrastructure were the dimensions most frequently identified as crucial for preventing and mitigating outbreaks. This review also recognised a lack of common agreed standards to guide and assess preparedness activities in migrant centres, thereby underscoring the need for a capacity-oriented ECDC preparedness checklist tool.

Research paper thumbnail of An Early Warning System Based on Syndromic Surveillance to Detect Potential Health Emergencies among Migrants: Results of a Two-Year Experience in Italy

International Journal of Environmental Research and Public Health, Aug 20, 2014

Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and... more Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability and usefulness of syndromic surveillance in this specific context.

Research paper thumbnail of Factors Influencing the Accuracy of Infectious Disease Reporting in Migrants: A Scoping Review

International Journal of Environmental Research and Public Health, Jul 5, 2017

We conducted a scoping review of literature to improve our understanding of the accuracy of infec... more We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased detection of cases. Incompleteness of denominator data underestimates the at-risk population. In conclusion, most studies show a lower probability of under-reporting infectious diseases in migrants compared with native populations.

Research paper thumbnail of Towards a European Framework to Monitor Infectious Diseases among Migrant Populations: Design and Applicability

International Journal of Environmental Research and Public Health, Sep 17, 2015

There are limitations in our capacity to interpret point estimates and trends of infectious disea... more There are limitations in our capacity to interpret point estimates and trends of infectious diseases occurring among diverse migrant populations living in the European Union/European Economic Area (EU/EEA). The aim of this study was to design a data collection framework that could capture information on factors associated with increased risk to infectious diseases in migrant populations in the EU/EEA. The authors defined factors associated with increased risk according to a multi-dimensional framework and performed a systematic literature review in order to identify whether those factors well

Research paper thumbnail of Collective Catering Activities and Official Controls: Dietary Promotion, Sustainability and Future Perspectives

Healthcare

Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requ... more Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requirement to guarantee health in different settings. This study aims to evaluate the compliance of collective catering menus adopted in both school canteens and healthcare facilities in a regional area where specific guidelines have been issued, assessing many matters from food weight to single courses and from the use of wholegrain pasta and bread to the rotation of seasonal fruit and vegetables. Overall, 85 menus, edited by freelance professionals and endorsed by the Food Hygiene and Nutrition Service staff of the Local Health Authority, were assessed from 2018 to 2022, highlighting critical issues potentially attributable at a local level to the lack of complete knowledge of the existence of guidelines and official reference documents among nutrition professionals. Since the preliminary outcomes show non-compliance in both sectors investigated, it is essential to continue to strengthen ...

Research paper thumbnail of Investigations on the Efficacy of Ozone as an Environmental Sanitizer in Large Supermarkets

Pathogens

Awareness of the importance of the microbial contamination of air and surfaces has increased sign... more Awareness of the importance of the microbial contamination of air and surfaces has increased significantly during the COVID-19 pandemic. The aim of this study was to evaluate the presence of bacteria and fungi in the air and on surfaces within some critical areas of large supermarkets with and without an ozonation system. Surveys were conducted in four supermarkets belonging to the same commercial chain of an Apulian city in June 2021, of which two (A and B) were equipped with an ozonation system, and two (C and D) did not have any air-diffused remediation treatment. There was a statistically significant difference in the total bacterial count (TBC) and total fungal count (TFC) in the air between A/B and C/D supermarkets (p = 0.0042 and p = 0.0002, respectively). Regarding surfaces, a statistically significant difference in TBC emerged between A/B and C/D supermarkets (p = 0.0101). To the best of our knowledge, this is the first study evaluating the effect of ozone on commercial str...

Research paper thumbnail of Open Access

Abstract: Profound geopolitical changes have impacted the southern and eastern Mediterranean sinc... more Abstract: Profound geopolitical changes have impacted the southern and eastern Mediterranean since 2010 and defined a context of instability that is still affecting several countries today. Insecurity combined with the reduction of border controls has led to major population movements in the region and to migration surges from affected countries to southern Europe, especially to Italy. To respond to the humanitarian emergency triggered by this migration surge, Italy implemented a syndromic surveillance system in order to rapidly detect potential public health emergencies in immigrant reception centres. This system was discontinued after two years. This paper presents the results of this experience detailing its strengths and weaknesses in order to document the applicability

Research paper thumbnail of www.mdpi.com/journal/ijerph Article Towards a European Framework to Monitor Infectious Diseases among Migrant Populations: Design and Applicability

Abstract: There are limitations in our capacity to interpret point estimates and trends of infect... more Abstract: There are limitations in our capacity to interpret point estimates and trends of infectious diseases occurring among diverse migrant populations living in the European Union/European Economic Area (EU/EEA). The aim of this study was to design a data collection framework that could capture information on factors associated with increased risk to infectious diseases in migrant populations in the EU/EEA. The authors defined factors associated with increased risk according to a multi-dimensional framework and

Research paper thumbnail of Il ruolo dell’educazione fisica nella promozione della salute: uno studio multicentrico

Parole chiave: educazione fisica, scuola secondaria di secondo grado, attività fisica, promozione... more Parole chiave: educazione fisica, scuola secondaria di secondo grado, attività fisica, promozione della salute RIASSUNTO Obiettivi: evidenziare limiti e punti di forza dell'insegnamento di Educazione Fisica (EF) nell'attuale sistema scolastico italiano sulla base delle opinioni degli studenti. Metodi: ad un campione di matricole provenienti da 14 università italiane è stato somministrato un questionario anonimo da autocompilare riguardante esperienze e giudizi relativi all'insegnamento di EF ricevuto nell'ultimo biennio di scuola. Sono state anche analizzate eventuali differenze tra Nord, Centro e Sud. Risultati: su 7.033 partecipanti, il 42,2% riportava come obiettivo principale perseguito durante le lezioni di EF quello "ricreativo". Più della metà degli studenti (62,2%) ha riferito nessuna o modesta influenza delle lezioni di EF sulla pratica corrente di Attività Fisica (AF). Il 67,2% del campione si ritiene soddisfatto degli insegnamenti di educazione fisica ricevuti, soprattutto nelle regioni del Nord. Discussione e conclusioni: l'analisi condotta ha evidenziato la necessità di migliorare l'offerta di tale insegnamento nella scuola italiana, sia incrementando il tempo dedicato alle lezioni, sia impiegando insegnanti adeguatamente preparati.

Research paper thumbnail of An Integrated Control Plan in Primary Schools: Results of a Field Investigation on Nutritional and Hygienic Features in the Apulia Region (Southern Italy)

Nutrients, 2021

Data concerning overweight and obesity in children and adolescent populations are alarming and re... more Data concerning overweight and obesity in children and adolescent populations are alarming and represent one of the most serious public health problems of our time. Moreover, it is demonstrated that the school environment may play an important role in health promotion with regard to nutritional aspects. This article reports the results of a study conducted in the Apulia region (Southern Italy), aimed at providing an integrated surveillance of the behaviors related to nutrition habits in students and the hygienic and nutritional conditions of the school’s canteens attended by enrolled students. To this purpose, a sample of 501 students attending primary school (third class—children approximately eight years old) replied to a validated questionnaire, and official controls (OC), of both food and nutritional safety, were performed in 22 primary schools. A team of healthcare professionals carried out the study, and the implementation of all the prescribed improvement actions were subsequ...

Research paper thumbnail of Acceptance of COVID-19 Vaccination in the Elderly: A Cross-Sectional Study in Southern Italy

Vaccines, 2021

In Italy, at the end of 2020, a voluntary immunization plan against COVID-19 was introduced, invo... more In Italy, at the end of 2020, a voluntary immunization plan against COVID-19 was introduced, involving elderly among the first target categories. The aim of this study was to assess, through an online questionnaire, the acceptance of COVID-19 vaccination in a sample of older adults from southern Italy. Of a total of 1041 respondents (41.7% males, mean age 76.6 ± 6.5), 965 (92.7%) were vaccinated or willing to be vaccinated against COVID-19, although less than half of the sample was favorable to vaccinations and agreed with mandatory immunization. Acceptance of COVID-19 vaccination was found to be positively related with higher educational level (OR = 1.875, CI95% = 1.113–3.161; p = 0.018) and having social/mass media as a main source of information (OR = 2.415 CI95% = 1.358–4.296, p = 0.003). On the contrary, an inverse relationship was found between acceptance of COVID-19 vaccination and having fulfilled the questionnaire after the introduction of green pass (OR = 0.218, CI95% = 0....

Research paper thumbnail of Knowledge and Acceptance of COVID-19 Vaccination among Undergraduate Students from Central and Southern Italy

Vaccines, 2021

At the end of 2020, the Italian Ministry of Health launched a national vaccination campaign to co... more At the end of 2020, the Italian Ministry of Health launched a national vaccination campaign to counteract the COVID-19 pandemic. The present study aimed at appraising levels of knowledge about and acceptance of COVID-19 vaccination in a sample of Italian undergraduates during the first phase of the immunization plan. A web-based questionnaire was administered to students attending universities in Bari, Naples, and Rome during the period February–April 2021. Of the total of 3226 participants, 91.9% were keen to receive a COVID-19 vaccination. More than 80% gave correct answers to questions about COVID-19 vaccine administration, functioning, and effects on community health. However, only 63.8% identified the correct composition of the available vaccines. Knowledge was found to be related to sociodemographic features and COVID-19 vaccination acceptance (p < 0.05). COVID-19 vaccination acceptance was found to be related to having a previous vaccination against influenza (OR 3.806, CI...

Research paper thumbnail of Moderate Vaccine Effectiveness against Severe Acute Respiratory Infection Caused by A(H1N1)pdm09 Influenza Virus and No Effectiveness against A(H3N2) Influenza Virus in the 2018/2019 Season in Italy

Vaccines, 2020

Every season, circulating influenza viruses change; therefore, vaccines must be reformulated each... more Every season, circulating influenza viruses change; therefore, vaccines must be reformulated each year. We aimed to estimate vaccine effectiveness (VE) against severe influenza infection for the 2018/19 season in Italy. We conducted a test-negative design case-control study at five Italian hospitals. We estimated influenza VE against severe acute respiratory infection (SARI) requiring hospitalisation overall, and by virus subtype, vaccine brand, and age. The 2018/19 season was characterised by A(H1N1)pmd09 and A(H3N2) influenza viruses. Vaccine coverage among <18 years recruited SARI cases was very low (3.2%). Seasonal vaccines were moderately effective against type A influenza overall (adjusted VE = 40.5%; 95% confidence interval (CI) = 18.7–56.4%) and subtype A(H1N1)pmd09 viruses (adjusted VE = 55%; 95% CI = 34.5–69.1%), but ineffective against subtype A(H3N2) viruses (adjusted VE = 2.5%; 95% CI = −50.0–36.7%). Both Fluad and Fluarix Tetra vaccines were effective against type A...

Research paper thumbnail of Safety in Wine Production: A Pilot Study on the Quality Evaluation of Prosecco Wine in the Framework of UE Regulation

International Journal of Environmental Research and Public Health, 2020

In Italy, wine production is considered a sector of excellence, where the wines’ appreciable sens... more In Italy, wine production is considered a sector of excellence, where the wines’ appreciable sensory features are favored by environmental factors, including weather and climate conditions, which benefit territories with a specific vocation. The whole chain involves many economic and agri-food sector operators, and requires an in-depth assessment of specific risks for identifying critical points, keeping the entire production process under control, and ensuring product traceability. This article describes the results of a pilot study conducted in the Prosecco DOCG (Designations of Controlled and Guaranteed Origin) area, concerning the detection of residues of plant protection products in fifty wine bottles. Although considerably below the maximum residue levels, all the samples tested were positive, ranging from two to five active substances detected in each sample. In addition to the provisions of the European Community legislation, this paper critically evaluates some best practic...

Research paper thumbnail of Physical Activity in Older Adults: An Investigation in a Metropolitan Area of Southern Italy

International Journal of Environmental Research and Public Health, 2020

Physical activity (PA) and exercise are fundamental to maintaining health in older adults. World ... more Physical activity (PA) and exercise are fundamental to maintaining health in older adults. World Health Organization guidelines state that older adults should practice at least 150 min/week of moderate/vigorous intensity PA to obtain health benefits. We assessed PA levels among older adults in southern Italy and evaluated possible associated determinants. The study was carried out between September and November 2019 in the metropolitan area of Bari. We collected information from participants over 65 years using a self-administered questionnaire. We investigated associations between sociodemographic characteristics, health conditions, and inactivity/PA levels. A total of 383 individuals completed the questionnaire. Mean body mass index indicated that 45.4% of participants were overweight. Mean time spent in PA was 476.2 ± 297.8 min/week, with women reporting lower levels than men (370.8 ± 210 vs. 555.2 ± 334.3 min/week, p = 0.08). Weekly sitting time was positively related to age. At...

Research paper thumbnail of Effectiveness of the trivalent MF59 adjuvated influenza vaccine in preventing hospitalization due to influenza B and A(H1N1)pdm09 viruses in the elderly in Italy, 2017 – 2018 season

Expert Review of Vaccines, 2019

Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidit... more Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidity in the elderly is weak. Our aim was to measure the VE against severe outcomes in the elderly. Methods: We conducted a multicentre hospital-based test-negative design (TND) case-control study, during the 2017/18 season, in four Italian hospitals. The study population included individuals aged ≥65 years hospitalized with Severe Acute Respiratory Infections (SARI). Patients were classified as cases and controls based on the results of the PCR influenza testing. We estimated VE by virus subtypes and specific VE for the trivalent adjuvanted vaccine (TIVadj). Results: 502 patients with SARI were enrolled: 118 (23.5%) tested positive (cases) and 384 (76.5%) tested negative (controls) for influenza. The adjusted VE of 48.5% for all vaccines was comparable to the adjusted VE for the TIVadj vaccine (48.3%). Adjusted VE for the TIVadj vaccine was 67.5% for A(H1N1) pdm09 and 44.5% for B viruses. Conclusion: We show a moderate adjusted VE of the TIVadj against all viruses, a good adjusted VE against A(H1N1)pdm09 strains and a moderate adjusted VE against B strains, despite a mismatch between the B circulating lineage and the lineage included in the vaccine. This is likely due to the crossprotection among B strains induced by the TIVadj in elderly patients.

Research paper thumbnail of Legionnaires’ disease in Italy: results of the epidemiological surveillance from 2000 to 2011

Research paper thumbnail of Control and prevention measures for legionellosis in hospitals: A cross-sectional survey in Italy

Environmental research, 2018

Risk assessment, environmental monitoring, and the disinfection of water systems are the key elem... more Risk assessment, environmental monitoring, and the disinfection of water systems are the key elements in preventing legionellosis risk. The Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine, and Public Health and the Italian Multidisciplinary Society for the Prevention of Health Care-Associated Infections carried out a national cross-sectional survey to investigate the measures taken to prevent and control legionellosis in Italian hospitals. A multiple-choice questionnaire was developed, comprising 71 questions regarding hospital location, general characteristics, clinical and environmental surveillance, and control and preventive measures for legionellosis in 2015. Overall, 739 hospitals were enrolled from February to June 2017, and 178 anonymous questionnaires were correctly completed and evaluated (response rate: 24.1%). The survey was conducted using the SurveyMonkey® platform, and the data were analyzed using Stata 12 software. Of th...

Research paper thumbnail of Factors Influencing the Accuracy of Infectious Disease Reporting in Migrants: A Scoping Review

International journal of environmental research and public health, Jan 5, 2017

We conducted a scoping review of literature to improve our understanding of the accuracy of infec... more We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased...

Research paper thumbnail of Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study

International journal of environmental research and public health, Jun 22, 2017

Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurr... more Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis(®)μ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis(®)μ were also analyzed by real-time PCR. Legionella presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolis(®)μ did not yield Legionella in any enrolled HF. However, molecular investigation using Coriolis(®)μ resu...