Risk perception about zoonoses in immigrants and Italian workers in Northwestern Italy

OBJETIVO: To assess factors associated with a low risk perception of zoonoses and to identify the gaps in knowledge about transmission and prevention of zoonoses in immigrant and Italian workers. MÉTODOS: A cross-sectional study with 175 workers in the agro-livestock and agro-food industry in Piemonte, Italy, was carried out. Data were collected with a semi-structured questionnaire based on knowledge, attitudes and practices (KAP) survey. We calculated proportions and used chi-square tests and odds ratios to assess associations. Eight individual interviews with key informants on immigration and public health in Piemonte were carried out. RESULTADOS: Participants were 82 (47%) Italians and 93 (53%) immigrants. Immigrants were from Romania, Morocco, Albania, India, China, Argentina, Peru, Macedonia, Ivory Coast, Ukraine and Colombia. The study revealed significant differences in risk perception at work (p = 0.001). We found associations between "not having correct knowledge about zoonoses" and the following variables: i. "being immigrant" OR = 4.1 (95%CI 1.7;9.8 p ≤ 0.01); ii. "working in the livestock industry" OR = 2.9 (95%CI 1.2;15.4 p = 0.01); and iii. "being an unqualified worker" OR = 4.4 (95%CI 2.9;15.4 p ≤ 0.01). Another strong association was found between being immigrant and having a low job qualification OR = 6.7 (IC95% 2.9 - 15.4 p ≤ 0.01). Asian immigrants were the group with the highest frequency of risky behaviours and the lowest level of knowledge about zoonoses. CONCLUSÕES: Our results indicate that there were differences in risk perception of zoonoses between the groups participating in our study. These results suggest that immigrant status can be considered a risk factor for having lower risk perception and lower level of knowledge of zoonoses at work. There is a relationship between this specific knowledge of zoonoses and lack of training and instruction among migrant populations. Our results stress the need for developing education programs on zoonoses prevention among the immigrant population in Piemonte, Italy.

Toward validating the Italian version of the "Spanish Burnout Inventory": a preliminary study

AbstractOBJECTIVEThe aim of this study was to develop the Italian version of the Spanish Burnout Inventory (SBI) and to examine its psychometric properties within a sample of nursing staff.METHODThe study was cross-sectional and not randomized. The data were gathered using an anonymous, self-report questionnaire. The sample consisted of 391 staff nurses employed in three hospitals in the Northern Region of Italy To evaluate burnout, the SBI and the Maslach Burnout Inventory were administered.RESULTSAn Exploratory Factor Analysis showed a four-factor structure close to the expected one. All Cronbach's alpha values were satisfactory. Furthermore, correlations support the concurrent validity.CONCLUSIONOverall, the results of this study provided evidence that the SBI is an adequate instrument to study burnout in the Italian nursing sample and indicated the feeling of guilt as an important dimension to gauge the structure of this phenomenon.

Pasture characteristics of Italian ryegrass and milk production under different management strategies

The objective of this work was to assess the effects of the sward structure of Italian ryegrass (Lolium multiflorum), during the first grazing cycle, on its morphological and bromatological characteristics throughout the growing season, and on the performance of dairy cows. The treatments consisted of two structures obtained as a function of canopy-light interception: high-light interception (HLI) and low-light interception (LLI), with different pre-grazing heights in the first grazing cycle. Pasture was managed under rotational grazing with a herbage allowance not below 30 kg dry matter (DM) per cow per day. Three grazing cycles, with a grazing interval of 30 days, were evaluated. Pre-grazing herbage mass was greater (2,240 vs. 1,656 kg ha-1 DM), but the proportion of leaf blades was smaller (0.35 vs. 0.43) for HLI swards. Neutral detergent fiber (NDF) content and organic matter digestibility (OMD) were similar between treatments in the first grazing cycle, but in the second and third ones NDF was greater, and OMD lower, for the HLI swards. Milk yields were greater for cows grazing LLI swards (19.4 vs. 21.1 kg per day). Initial grazing with 90% of light interception promotes greater nutritional value in the subsequent cycles.

A third generation regimen VACOP-B with or without adjuvant radiotherapy for aggressive localized non-Hodgkin's lymphoma: report from the Italian Non-Hodgkin's Lymphoma Co-operative Study Group

The objective of this multicenter prospective study was to determine the clinical efficacy and toxicity of a polychemotherapeutic third generation regimen, VACOP-B, with or without radiotherapy as front-line therapy in aggressive localized non-Hodgkin's lymphoma. Ninety-three adult patients (47 males and 46 females, median age 45 years) with aggressive localized non-Hodgkin's lymphoma, 43 in stage I and 50 in stage II (non-bulky), were included in the study. Stage I patients received VACOP-B for 6 weeks plus involved field radiotherapy and stage II patients received 12 weeks VACOP-B plus involved field radiotherapy on residual masses. Eighty-six (92.5%) achieved complete remission and 4 (4.3%) partial remission. Three patients (3.2%) were primarily resistant. Ten-year probability of survival, progression-free survival and disease-free survival were 87.3, 79.9 and 83.9%, respectively. Eighty-four patients are surviving at a median observation time of 57 months (range: 6-126). Statistical analysis showed no difference between stages I and II in terms of response, ten-year probability of survival, progression-free survival or disease-free survival. Side effects and toxicity were negligible and were similar in the two patient groups. The results of this prospective study suggest that 6 weeks of VACOP-B treatment plus radiotherapy may be the therapy of choice in stage I aggressive non-Hodgkin's lymphoma. Twelve weeks of VACOP-B treatment with or without radiotherapy was shown to be effective and feasible for stage II. These observations need to be confirmed by a phase III study comparing first and third generation protocols in stage I-II aggressive non-Hodgkin's lymphoma.

Rheological and structural evaluations of commercial italian salad dressings

The emulsion stability, composition, structure and rheology of four different commercial italian salad dressings manufactured with traditional and light formulations were evaluated. According to the results, the fat content ranged from 8% (w/w) (light) to 34% (w/w) (traditional), the carbohydrate concentration varied between 3.8% (w/w) (traditional) and 14.4% (w/w) (light) and the pH was between 3.6-3.9 for all samples. The microscopic and stability analyses showed that the only stable salad dressing was a light sample, which had the smallest droplet size when compared with the other samples. With respect to the rheological behaviour, all the salad dressings were characterized as thixotropic and shear thinning fluids. However, the stable dressing showed an overshoot at relatively low shear rates. This distinct rheological behavior being explained by the differences in its composition, particularly the presence of a maltodextrin network.

Sensory profile of Italian salami with coriander (Coriandrum sativum L.) essential oil

The descriptive terminology and sensory prolife of four samples of Italian salami were determined using a methodology based on the Quantitative Descriptive Analysis (QDA). A sensory panel consensually defined sensory descriptors, their respective reference materials, and the descriptive evaluation ballot. Twelve individuals were selected as judges and properly trained. They used the following criteria: discriminating power, reproducibility, and individual consensus. Twelve descriptors were determined showing similarities and differences among the Italian salami samples. Each descriptor was evaluated using a 10 cm non-structured scale. The data were analyzed by ANOVA, Tukey test, and the Principal Component Analysis (PCA). The salami with coriander essential oil (T3) had lower rancid taste and rancid odor, whereas the control (T1) showed high values of these sensory attributes. Regarding brightness, T4 showed the best result. For the other attributes, T1, T2, T3, and T4 were similar.

Antioxidant activity of essential oil from Coriandrum Sativum L. in Italian salami

Four formulations of Italian salami type were produced: without antioxidants; with essential oil of coriander essential oil (0.01%); with BHT (0.01%); and with Coriander essential oil and BHT (0.005 and 0.005%). The antioxidant activity of salamis was evaluated by the lipid oxidation, through the techniques of peroxide number and TBARS. The salami with the coriander essential oil exhibited reduction in lipid oxidation by increasing the shelf life of the product. The salami with the coriander essential oil and BHT showed no synergism between the antioxidants. The salami using BHT presented less antioxidant activity than that of the salami using coriander essential oil.

Lipid and protein oxidation in the internal part of italian type salami containing basil essential oil (Ocimum basilicum L.)

Different concentrations of basil essential oil (Ocimum basilicum L.) (0.19; 0.38; 0.75; 1.87; 3.75 and 6.00 mg.g-1) were evaluated in relation to their antioxidant activity using the DPPH● radical methodology. From the IC50 obtained data, the concentrations of 0.19; 0.38; 0.75; 1.87; 3.75; 6.00 and 12.00 mg.mL-1 were applied directly to the product and these were sensorially evaluated by the test of control difference. The concentrations related to the highest acceptability (0.19; 0.38 and 0.75 mg.g-1) were tested for antioxidant activity in the internal part of Italian type salami - during the processing and after 30 days of storage, in terms of lipid and protein oxidation. The oxidation of lipids was determined using the method of TBARS. The method of carbonyl compounds was employed for proteins oxidation. Five different formulations of salami were elaborated: blank (without the use of antioxidant); control (using sodium eritorbate as antioxidant); and adding 0.19; 0.38 and 0.75 mg.g-1 of basil essential oil. The product was kept between 25 ºC and 18 ºC and UR between 95% and 70%, for 28 days. Analyses were carried out on the processing day and after 2, 7, 14, 21 and 28 days, and also following 30 days of storage. The basil essential oil in vitro presented an antioxidant activity of IC50 12 mg.mL-1. In the internal part of the Italian type salami the commercial antioxidant (control) and the formulation containing 0.75 mg.g-1 of basil essential oil presented antioxidant activity in relation to the lipids, but not to the proteins - during processing and storage.

Use of starter cultures isolated from native microbiota of artisanal sausage in the production of Italian sausage

The most promising microorganisms for use as starter cultures are those isolated from the native microbiota of traditional fermented products. The aim of this study was to evaluate the use of lactic acid bacteria selected from the native microbiota of sausages produced by spontaneous fermentation as starter cultures for the production of sausage. Strains of Lactobacillus plantarum 503 and 341 have the potential for use as starter cultures in the manufacture of Italian sausage type. The population of lactic acid bacteria in sausages was &gt;8 log CFU.g-1 during fermentation, which caused the pH to decrease to <4.5. This decrease in pH and the water activity of < 0.90 of sausages ensures the safety and preservation of this product. Sausages produced with these lactic cultures fulfill the requirements for microbiological quality and composition of Italian sausage type. Our results suggest the possibility of using these starter cultures for the production of sausages with peculiar characteristics that contribute to the identity of the product.

Doença alérgica polínica: polens alergógenos e seus principais alérgenos

Pacientes com alergia a pólen de gramíneas, comumente denominada polinose, freqüentemente apresentam reatividade a alérgenos de pólen de inúmeras gramíneas devido às reatividades cruzadas entre anticorpos IgE dirigidos contra proteínas presentes nos polens de gramíneas. Nesse contexto, pólen de Italian ryegrass (Lolium multiflorum), ou azevém anual, gramínea da família Poaceae cultivada no Sul do Brasil, é considerado o principal agente sensibilizante em pacientes com polinose. Nessa região, o azevém é capaz de produzir grande quantidade de pólen. Adicionalmente, outras gramíneas da família Poaceae crescem naturalmente no Sul, entretanto, sem relevância clínica. Extratos de pólen derivados de gramíneas homólogas ou heterólogas são freqüentemente empregados no diagnóstico e tratamento da alergia sazonal a pólen, sendo que para esses fins não se encontra comercialmente disponível no Brasil extrato padronizado de pólen de L. multiflorum. Futuros estudos serão importantes para melhor caracterizar a reatividade cruzada entre alérgenos de pólen de L. multiflorum e alérgenos de outras gramíneas com o objetivo de aprimorar o diagnóstico e imunoterapia de pacientes com alergia a pólen causada por L. multiflorum.

Detecção do mofo-branco no feijoeiro, utilizando características espectrais

Neste trabalho, objetivou-se estudar a resposta espectral de plantas de feijoeiro à infecção por Sclerotinia sclerotiorum, fungo causador do mofo-branco. Foram conduzidos dois ensaios, no delineamento em blocos ao acaso, com cinco tratamentos e quatro repetições, no primeiro ensaio, e seis tratamentos e quatro repetições, no segundo. Medidas de reflectância espectral do dossel do feijoeiro, entre os comprimentos de ondas de 400 a 850 nm, foram tomadas aos 60, 71, 91 e 102 dias após a emergência (DAE), no primeiro ensaio, e aos 13, 27, 34, 56, 71 e 91 DAE, no segundo. Os dados espectrais foram transformados em índices de vegetação: da diferença normalizada (NDVI), da diferença de verde normalizado (GNDVI) e ajustado para o solo (SAVI). A severidade do mofo-branco foi avaliada, visualmente, aos 102 DAE, no primeiro ensaio, e aos 92 DAE, no segundo. Houve correlação significativa apenas no segundo ensaio, entre a severidade da doença e o NDVI, aos 71 DAE. A resposta espectral do feijoeiro pode ser utilizada para a detecção da ocorrência do mofo-branco e, consequentemente, como ferramenta no manejo integrado.

Análise multivariada de fatores de risco para o baixo peso ao nascer em nascidos vivos do município de São Paulo, SP (Brasil)

Em casuística de 20.850 nascidos vivos não gemelares ocorridos em 31 maternidades do Município de São Paulo, SP, Brasil (parte da casuística total do Estudo Antropométrico do Recém-nascido Brasileiro), procurou-se identificar fatores de risco para o baixo peso ao nascer (peso < 2.500 g), tendo sido estipulados a priori, para estudo, os fatores escolaridade materna, estado marital, idade materna, paridade, peso pré-gestacional, tabagismo na gravidez e assistência pré-natal. A partir de análise multivariada pela técnica de modelos log-lineares, foram identificados quatro fatores de risco significativos: "ausência de assistência pré-natal", "peso pré-gestacional < 50 kg", "tabagismo na gestação" e "idade materna < 20 anos". O risco relativo associado a "ausência de pré-natal" foi de 2,2 nas mães de escolaridade inferior ao ginásio completo e de 3,4 nas de escolaridade igual ou superior àquele nível. Os riscos associados às características maternas de peso, tabagismo e idade foram respectivamente 1,9, 1,7 e 1,4 e independentes da escolaridade materna. Considerando-se além da magnitude dos riscos detectados a freqüência com que os fatores de risco se apresentaram na população, constatou-se que o peso pré-gestacional insuficiente, o tabagismo na gestação e a ausência de assistência pré-natal, particularmente em mães de "baixa escolaridade", são fatores cujo controle exerceria importante decréscimo na incidência de recém-nascidos de baixo peso. Assim sendo, tais fatores deveriam ser cuidadosamente considerados em programas de intervenção.

A inadequação dos exames radiológicos periódicos indiscriminados em saúde ocupacional: resultados do censo de 1984 em uma empresa de grande porte

São aqui relatados os resultados do censo abreugráfico de 1984 de uma empresa de grande porte, isenta de riscos ocupacionais para o aparelho respiratório. Em 5,308 abreugrafias realizadas foram detectados 53 casos de anormalidades abreugráficas (1%), dos quais apenas 4 de tuberculose ativa. O rendimento foi de 0,75/1,000 abreugrafias. O custo médio de detecção de cada caso de tuberculose ativa foi de 256,32 ORTN (ao redor de 1.850 dólares). Foi também constatado um menor comparecimento de funcionários ao exame abreugráfico periódico, 1,6% de ausências em 1982 e 7,8% em 1984, causado provavelmente pelo crescente conhecimento leigo sobre radiações ionizantes, Os resultados são discutidos e é apresentada uma revisão sobre o emprego de exames radiológicos periódicos em saúde ocupacional.

Valor preditivo de exames pré-operatórios em facectomias

OBJETIVO: Determinar a prevalência de resultados anormais numa rotina de exames pré-operatórios para facectomias e sua influência na ocorrência de complicações clínicas perioperatórias. MÉTODOS: Estudo prospectivo desenvolvido em um centro médico acadêmico no Brasil, com uma amostra de 746 pacientes, selecionados entre indicados para cirurgia de catarata. Para todos os pacientes foram solicitados eletrocardiograma, hemograma completo e glicemia de jejum, além de uma avaliação clínica. Foram excluídos do estudo pacientes com menos de 40 anos de idade, pacientes submetidos previamente à cirurgia ocular, pacientes com indicação de anestesia geral, ou pacientes que sofreram infarto agudo do miocárdio até três meses antes da cirurgia. Eventos médicos intra-operatórios foram registrados numa ficha de protocolo. Para análise, utilizou-se do teste de Fisher e análise de variância (ANOVA). RESULTADOS: Na amostra de 746 pacientes, 405 (54,3%) eram homens. A idade média foi de 66,6&plusmn;11,6 anos. Ocorreram complicações intra-operatórias em 71 (9,5%) pacientes. Houve resultados anormais em 13,5% (101 pacientes) das dosagens de hemoglobina e em 16,6% (124) das dosagens de glicemia de jejum. Em relação aos eletrocardiogramas, foram constatadas anormalidades em 46,6% (348) dos indivíduos. Houve maior prevalência de eletrocardiogramas com anormalidades em pacientes com complicações clínicas perioperatórias (p=0,02). Não existiu diferença estatisticamente significativa nas dosagens de hemoglobina (14,0&plusmn;1,6 g/dL em pacientes sem complicações intra-operatórias e 14,3&plusmn;1,3 g/dL em pacientes com complicações - p=0,150) e nas de glicemia de jejum (104&plusmn;29 mg/dL em pacientes sem complicações e 105&plusmn;41 mg/dL em pacientes com complicações - p=0,850). CONCLUSÕES: Dentro da rotina investigada de exames pré-operatórios para facectomia, apenas os resultados anormais presentes no eletrocardiograma estiveram associados à ocorrência de complicações durante o período de perioperatório.

Readability of medicinal package leaflets: a systematic review

OBJECTIVE To review studies on the readability of package leaflets of medicinal products for human use.METHODS We conducted a systematic literature review between 2008 and 2013 using the keywords &#8220;Readability and Package Leaflet&#8221; and &#8220;Readability and Package Insert&#8221; in the academic search engine Biblioteca do Conhecimento Online,comprising different bibliographic resources/databases. The preferred reporting items for systematic reviews and meta-analyses criteria were applied to prepare the draft of the report. Quantitative and qualitative original studies were included. Opinion or review studies not written in English, Portuguese, Italian, French, or Spanish were excluded.RESULTS We identified 202 studies, of which 180 were excluded and 22 were enrolled [two enrolling healthcare professionals, 10 enrolling other type of participants (including patients), three focused on adverse reactions, and 7 descriptive studies]. The package leaflets presented various readability problems, such as complex and difficult to understand texts, small font size, or few illustrations. The main methods to assess the readability of the package leaflet were usability tests or legibility formulae. Limitations with these methods included reduced number of participants; lack of readability formulas specifically validated for specific languages (e.g., Portuguese); and absence of an assessment on patients literacy, health knowledge, cognitive skills, levels of satisfaction, and opinions.CONCLUSIONS Overall, the package leaflets presented various readability problems. In this review, some methodological limitations were identified, including the participation of a limited number of patients and healthcare professionals, the absence of prior assessments of participant literacy, humor or sense of satisfaction, or the predominance of studies not based on role-plays about the use of medicines. These limitations should be avoided in future studies and be considered when interpreting the results.