Human biomonitoring of PCDDs, PCDFs, and PCBs in women living in a Northern Italy industrial area.

In Brescia , a highly industrialized city in the Lombardy Region (Northern Italy) classified as a SIN (Contaminated Site of National Interest), a human biomonitoring study was carried out on breast milk of two groups of women residing in areas with presumably different levels of exposure to polychlorodibenzo-p-dioxins, polychlorodibenzofurans, and polychlorobiphenyls. This study was aimed at evaluating the possible difference between women living in Brescia and women living far from it but in the same Region. Between 2016 and 2018, 82 women were enrolled (41 "exposed" subjects and 41 "not exposed"), breast milk samples were collected, and a specific questionnaire was administered to the donors. Data obtained were processed by robust regression and Principal Component Factor Analysis. The differences in concentration between the two groups were significant for all the classes of analytes (except for PCDDs). The concentration increase rates from the not exposed to the exposed group resulted highly significant: some PCB congeners showed increase rates more than 1000 ng/g lb per one-unit change of the independent variable. Among the variables significantly associated with the observed concentrations, age showed the greatest influence, while BMI showed a counteracting effect. Consumption of vegetable oil and fruit resulted to possibly influence the chemicals body burden. For the not exposed group, the levels appear to be in line with the decreasing trend (2001-2018) observed for these contaminants in Italy.

[When health "sells": presence and characteristics of health-related advertising in the Italian press]. / Quando la salute "vende": presenza e caratteristiche di pubblicità a contenuto sanitario sulla stampa italiana.

The authors evaluated the amount of health-related advertising that appeared in major Italian newspapers and magazines during the months of July 2009 and November 2009. Advertisements related to health (as defined by the World Health Organization) were found to be widely present in the Italian press. Health promotion messages given by health institutions must therefore compete with the above advertisements that deal with health issues usually for purely commercial purposes.

"Save 30% if you buy today". Online pharmacies and the enhancement of peripheral thinking in consumers.

PURPOSE: Online pharmacies (OPs) are recognized as a potential threat to public health. The growth of an unregulated global drugs market risks increasing the spread of counterfeit medicines which are often delivered to consumers without a medical prescription. The aim of the study was to assess the strategies of argumentation that OPs adopt in their marketing. METHODS: A sample of 175 OPs was analyzed using the content-analysis method, and evaluated by relying on the Elaboration Likelihood Model (ELM) of persuasion. RESULTS: Almost 80% of the sample of OPs did not ask for a medical prescription by the consumer's physician. The selling arguments used included privacy policy, economic, quality, and service issues. About one-third of the OPs did not declare any side-effects regarding the drugs offered. CONCLUSION: Our results show that OPs advertise their products in an argumentative fashion that enhances consumers' peripheral reflection: by analogically playing with the selling of other commodities, they magnify aspects of the online trade that consumers might find convenient, but overshadow the nature and risks of the actual products they sell.

Italian hospitals on the web: a cross-sectional analysis of official websites.

BACKGROUND: Although the use of the Internet for health purposes has increased steadily in the last decade, only a few studies have explored the information provided by the websites of health institutions and no studies on the on-line activities of Italian hospitals have been performed to date. The aim of this study was to explore the characteristics of the contents and the user-orientation of Italian hospital websites. METHODS: The cross-sectional analysis considered all the Italian hospitals with a working website between December 2008 and February 2009. The websites were coded using an ad hoc Codebook, comprising eighty-nine items divided into five sections: technical characteristics, hospital information and facilities, medical services, interactive on-line services and external activities. We calculated a website evaluation score, on the basis of the items satisfied, to compare private (PrHs) and public hospitals, the latter divided into ones with their own website (PubHs-1) and ones with a section on the website of their Local Health Authority (PubHs-2). Lastly, a descriptive analysis of each item was carried out. RESULTS: Out of the 1265 hospitals in Italy, we found that 419 of the 652 public hospitals (64.3%) and 344 of the 613 PrHs (56.1%) had a working website (p = 0.01). The mean website evaluation score was 41.9 for PubHs-1, 21.2 for PubHs-2 and 30.8 for PrHs (p < 0.001).Only 5 hospitals out of 763 (< 1%) provided specific clinical performance indicators, such as the nosocomial infection rate or the surgical mortality rates. Regarding interactive on-line services, although nearly 80% of both public and private hospitals enabled users to communicate on-line, less than 18% allowed the reservation of medical services, and only 8 websites (1%) provided a health-care forum. CONCLUSIONS: A high percentage of hospitals did not provide an official website and the majority of the websites found had several limitations. Very few hospitals provided information to increase the credibility of the hospital and user confidence in the institution. This study suggests that Italian hospital websites are more a source of information on admissions and services than a means of communication between user and hospital.

Marketing and pricing strategies of online pharmacies.

Internet and e-commerce have profoundly changed society, the economy, and the world of health care. The web offers opportunities to improve health, but it may also represent a big health hazard since it is a basically unregulated market with very low consumer protection. In this paper we analyze marketing and pricing strategies of online pharmacies (OPs). Our analysis shows that OPs use strategies that would be more suitable for a commodity market than for drugs. These strategies differentiate according to variety (brand or generic), quality, quantity, and target group. OPs are well aware that the vacuum in the legislation allows them to reach a target of consumers that pharmacies cannot normally reach, such as those who would like to use the drug without consulting a physician (or, even worse, against the physician's advice). In this case, they usually charge a higher price, reassure the users by minimizing on the side effects, and induce them to bulk purchase through sensible price discounts. This analysis suggests that the selling of drugs via the Internet can turn into a "public health risk", as has been pointed out by the US Food and Drug Administration.

Online consultations in cyberpharmacies: completeness and patient safety.

Many online pharmacies that serve as a substitute for original or personal medical prescriptions use a health questionnaire for consumers to complete on their Web site for buying prescription-only medicines. A content analysis of online medical questionnaires from a sample of online pharmacies (OPs) examined their completeness. Fifty-seven questionnaires were identified in which online pharmacies sought health status assessment from online purchasers. To evaluate the questionnaires, a checklist tallied their characteristics, including general features, medical history requested, and involvement of the consumer's doctor. Drug allergies were queried in 55 OPs (96.5%) and other allergies in 40 (70.2%). All of the questionnaires asked whether the consumer had suffered or was currently suffering from a particular illness, but a question about past surgery was present in 23 sites (40.3%) only; 40 sites (70.2%) asked women if they were pregnant or breastfeeding. Only 30 pharmacies out of 57 (52.6%) asked if the consumer's family doctor was aware of his/her intention of buying online and an even lower percentage (19.3%) asked if the purchase was based on a medical diagnosis rendered by a physician. Less than 20% of the pharmacies asked for the name, address, or telephone number of the consumer's family doctor. The results confirm the inadequacy of online pharmacy medical questionnaires in the assessment of health status for prescribing drugs. The results suggest that these questionnaires aim more at giving the consumer a false sense of health assurance than performing an effective assessment of his or her health status relative to the drug purchase.

The epidemiological pattern of chronic liver diseases in a community undergoing voluntary screening for hepatitis B and C.

BACKGROUND: Vallecamonica-Sebino is a community in Northern Italy (99,776 inhabitants) with one of the highest mortality rates for primary liver cancer and cirrhosis in Italy, and voluntary screening for HCV and HBV is widespread. The aim of this study was to estimate the prevalence of chronic liver diseases and their aetiology in the area. METHODS: We used the following sources of data, linked at an individual level: (1) hospital discharge data; (2) local Viral Hepatitis Services; (3) tests for anti-HCV antibodies and HBsAg from local laboratories; (4) Local Health Authority registry of chronic liver disease patients; (5) drug prescriptions for HBV and HCV treatment; (6) archives of Alcohol Units. RESULTS: 3.5% of the residents had chronic liver disease, mainly chronic hepatitis (61.6%), followed by cirrhosis (14.0%) and alcoholic liver disease (11.2%). HCV was the main cause of chronic liver disease in females (46.3%) and males (29.8%), followed by alcohol abuse in males (22.9%) and HBV (10.9% males and 9.2% females). Prevalence of anti-HCV positivity was 3.2%, and increased with age to 8.8% in subjects aged 65 years and over. CONCLUSION: This study shows that an epidemiologic pattern of the prevalence of chronic liver diseases and their aetiology can be obtained using routinely collected data.