Urban Health and Social Marginality: Perceived Health Status and Interaction with Healthcare Professionals of a Hard-to-Reach Community Living in a Suburban Area of Rome (Italy).

The study reports an urban health investigation conducted in Bastogi, an outskirt of Rome (Italy) characterised by social marginalization and deprivation. Our aim was to analyse the health perception, health-related behaviours, and interaction with healthcare professionals of the inhabitants of Bastogi compared to the population living in the area of the same local health unit (ASL). The Progresses of Health Authorities for Health in Italy questionnaire (PASSI) was administered to a sample of 210 inhabitants of Bastogi. Data were analysed and compared to those of the ASL collected in 2017-2018. The socio-economic indicators showed an overall worse condition for the inhabitants of Bastogi, with a significantly higher proportion of foreign and unemployed residents and a lower educational level compared to the ASL. Significant differences in the prevalence of non-communicable diseases, mental health complaints, and participation in prevention strategies, including cancer screening, were found. The questionnaire showed a lower help-seeking behaviour and a lack of reliance on health professionals in Bastogi inhabitants. Our findings highlight how social determinants produce health inequities and barriers to accessing healthcare. The difficulties of conducting quantitative research in complex and hard-to-reach contexts, characterized by high social vulnerability, are outlined.

Predictors of Mammography Uptake Among Italian Women Aged 50-69: a Cross-sectional Study.

Screening coverage is of concern in several countries, including Italy. The aim of the study is to assess predictors of participation in the mammography screening program at the Local Health Unit RMA (Rome, Italy). A telephone-based questionnaire was administered to randomly selected eligible women. The study population was interviewed by the personnel of the health center. Five hundred two women were interviewed, of which 264(52.6%) have attended the breast cancer screening program at least once. The attendees received the invitation letter more often than the non-attendees (88.3% vs. 77.7%; p = 0.002) and were more willing to participate (85.6% vs. 69.3%; p < 0.001). Employees were more among the non-attendees of the screening program (66% vs. 52.3%; p = 0.002). Age over-61 (OR = 2.75; 95%CI 1.84-4.09), receiving the invitation letter (OR = 2.54; 95%CI = 1.52-4.24), and intention to participate (OR = 3.09; 95%CI = 1.94-4.91) were significantly associated with participation in the screening program. Although the invitation rate of the Local Health Unit RMA has improved in recent years, the mammography uptake rate remains very low. The presence of opportunistic screening activities, younger age, and low educational status could explain the low participation rates. Organizational barriers (e.g., screening hours coinciding with work hours, screening facilities located far away) may also limit participation. Major efforts should be made towards the regulation of opportunistic screening activities and reorganization of the screening centers and communication strategies to better comply with the needs of the target population. In this light, the involvement of different healthcare professionals, especially general practitioners, and gynecologists, is crucial.

Association between diverticulosis and colonic neoplastic lesions in individuals with a positive faecal immunochemical test.

BACKGROUND: The association between diverticulosis and colonic neoplastic lesions has been suggested, but data in literature are conflicting. This study aimed to investigate such a relationship in patients participating in a colorectal cancer screening program who underwent high-quality colonoscopy. METHODS: Data from consecutive individuals 50-75 years of age with a positive faecal immunological test were considered. Diverticulosis was categorised as present or absent. The prevalence of neoplastic lesions (adenoma, advanced adenoma, and cancer) between individuals with and those without diverticula was compared. A multivariate analysis was performed. RESULTS: Overall, data from 970 consecutive individuals were evaluated, and diverticulosis was detected in 354 (36.5%) cases. At least one adenoma was detected in 490 (50.5%) people, at least one advanced adenoma in 264 (27.2%), multiple adenoma in 71 (7.3%), whilst a cancer was diagnosed in 48 (4.9%) cases. At univariate analysis, the adenoma detection rate in patients with diverticula was significantly higher than in controls (55.9% vs 47.4%; p = 0.011). At multivariate analysis, presence of diverticulosis was an independent risk factor for both adenoma detection rate (OR = 1.58; 95% CI = 1.14-2.18; p = 0.006) and advanced adenoma (OR = 1.57; 95% CI = 1.10-2.24; p = 0.013), but not for colorectal cancer. CONCLUSIONS: In a colorectal screening setting, the adenoma detection rate was significantly higher in individuals with diverticulosis than in controls.

[Validation of a questionnaire to assess consumer satisfaction with mammography screening, Rome (Italy)]. / Validazione di un questionario per valutare il gradimento dello Screening Mammografico fra donne residenti nel territorio della ASL RMA che hanno già aderito al programma almeno una volta.

Only 40% of women in the territory of the Local Health Unit RMA (Rome, Italy) adhere to the local breast cancer screening programme. A questionnaire was administered to participating women, to assess their level of satisfaction with the programme. A descriptive analysis, logistic regression and reliability analysis using the Cronbach's alpha as a measure of internal consistency, were performed. Most women who adhere to mammography screening are employers, retired, and with a low education. Factors that affect adherence include receiving a letter of invitation, intent to participate, age, and low education. The questionnaire is reliable for evaluating reasons affecting participation.

Induction and memory of chirality in porphyrin hetero-aggregates: the role of the central metal ion.

The anionic H2TPPS porphyrin and its copper derivative, CuTPPS, form in aqueous solution hetero-aggregates with the cationic H2T4 porphyrin and its copper derivative, CuT4. In the presence of poly-L-glutamate, at pH 4.0, a CD signal appears in the Soret region of the spectrum, indicating that the polypeptide has induced chirality into the structure of the aggregates. These species exhibit remarkable inertness due to the strength and number of the coulombic interactions between the anionic and the cationic porphyrins. This property allows them to preserve the chiral structure, even when the matrix changes or loses its chiral conformation, demonstrating that these aggregates are capable of memorizing the chiral information. The remarkable properties of the title systems may find various applications (chiral amplification, discrimination, and separation) that, on the other hand, require a more strict control of the aggregate dimension. Here, we show that the central copper of these macrocycles is crucial for determining the aggregate dimension.

Hierarchical porphyrin self-assembly in aqueous solution.

In aqueous solution meso-tetrakis(4-phosphonatophenyl)porphyrin shows self-aggregation processes controlled by the "sergeant-soldier rule". After partial protonation of the external phosphonic groups, it is possible (i) to further protonate the inner nitrogen atoms of the molecules or (ii) to allow, over time, the system to aggregate. Therefore, the two procedure lead to a different system evolution, producing species with different chemico-physical properties.