Promoting health and productivity among ageing workers: a longitudinal study on work ability, biological and cognitive age in modern workplaces (PROAGEING study).

BACKGROUND: Large changes in ageing population and in retirement age are increasing the number of older people in the workforce, raising many challenges for policymakers in promoting employment opportunities and health for older workers. In this respect, longitudinal assessments of workability, well-being perception and cognitive skills over time may allow to detect factors influencing workers' health. Moreover, new available molecular markers permit the measurement of biological age and age-related changes. Most studies analysed one aspect at time (psychological, biological, labour productivity), without considering their interaction. Aims of the study are to evaluate the relationship between workability, cognitive skills, and biological age in a population of ageing workers; to conduct a cross-sectional analysis to assess the impact of occupational exposures on workability, cognitive skills, and biological age; to evaluate inter-individuals changes in a prospective analysis with a re-evaluation of each worker. METHODS: Our study plans to enrol 1000 full-time workers, aged over 50, undergoing the medical surveillance required by the current Italian Legislation. Data collection includes information about: (a) work ability and psychosocial risk factors (work ability index, HSE Management Standard-21 item, Utrecht Work Engagement Scale, World Health Organisation-Five, Well-Being Index, job satisfaction, general well-being, technostress); (b) cognitive skills (Stroop Color and Word test, Simon task, Corsi's block-tapping test, Digit span test); (c) sleep habits and psychological well-being (Pittsburgh Sleep Quality Index, Insomnia Severity Index, Ford Insomnia Response to Stress Test; Symptom Check List 90, Psychological Well-Being Index, Profile of Mood State, Beck Depression Inventory, Beck Anxiety Inventory, Perceived Stress Scale, Brief COPE); (d) biological age (telomere length, DNA methylation) for 500 workers. All workers will repeat the evaluation after one year. DISCUSSION: This study aims to increase our knowledge about interactions between work ability, cognitive ability, well-being perception and psychological status also by including molecular markers, with a longitudinal and multidisciplinary approach. By bringing better insights into the relationship between risk factors and their impact on perceived and biological health, this study also aims at identifying possible interventions and protective measures to ensure aged workers' well-being, consistent with all the eminent calls for actions promoted by key International and European labour organizations.

A new integrated approach for adolescent health and well-being: the AVATAR project.

BACKGROUND: Limited number of studies examined the relationship between factors (lifestyle, social, emotional, cognitive) affecting adolescents' health and well-being. The aims of this study were to identify the more important variables of the different components affecting adolescents' health [lifestyle habits (LH); emotional status (ES); social context (SC); and cognitive abilities (CA)], and explore the relationship between the aforementioned components. METHODS: Data were collected between 2017 and 2018 from 756 eligible students, recruited from 5 Italian junior high school, by using KIDSCREEN-52 and cognitive processing using the Stroop Test. School engagement was estimated through questions concerning the scholastic achievement. RESULTS: Of 756 adolescents, 395 were boys with a mean (SD) age of 12.19 (0.81) years. Compared to International T-value of reference group for KIDSCREEN-52, autonomy, bullying, psychological well-being and mood were lower than the reference groups, while self-perception score was higher. For LH, the most important predictor was autonomy (p < .0001). The most important aspects in the SC were the relationship with the parents (p < .0001), and the adolescent's relationships with peers (p < .0001). For ES, mood variables had the greatest contribution (p < .0001). The School performance related to Language & Literature (p < .0001) was the most important predictor in the CA latent variable. LH was positively associated with SC (p < .0001), ES (p < .0001), and CA (p < .0001). SC was positively associated with ES (p < .0001) and with CA (p < .0001). CONCLUSIONS: This study suggests the importance of an integrated approach to characterize adolescents' health and well-being. The approach suggested here may highlight additive synergistic effects of the various components in health and well-being assessment that may not be considered with a late approach and focused only on single factors.

The impact of menarche on health-related quality of life in a sample of Italian adolescents: evidence from school-based AVATAR project.

Adolescence is a period characterized by rapid physical maturation, involving bodily changes that often necessitate a reorganization of self-perception. The current study investigated the impact of menarche on the determinants of quality of life in healthy female adolescents. Data were collected from 361 healthy female adolescents divided into two groups: pre- and post-menarcheal event. Participants, according the AVATAR project, completed Italian version of KIDSCREEN-52 questionnaires on health-related quality of life. Pre-menarcheal females had the higher score in psychological well-being and mood than post-menarcheal females. As concerns self-perception, post-menarcheal females exhibited lower score compared to pre-menarcheal females. In social context, pre-menarcheal females perceived a better school environment, also when we considered it in terms of social acceptance.Conclusion: Menarche event affects all the components of quality of life, from mood, self-esteem to social relationships, underlining how this hormonal variation is responsible of psychological and emotional changes, opening up the opportunity for preventive approaches aimed not only at traditional risk factors but according a more integrated perspective.What is Known:• Adolescence is a time of increasing behavioural divergence between males and females, probably due to the different hormonal development.• There is a possible link between menarche and the health-related quality of life variables.What is New:• Menarche condition affects all the components of quality of life, from mood to social relationships.• Post-menarcheal condition is associated to psychosocial and emotional changes, with possible multiple pathways to post-pubertal depressive symptoms.

A Novel Application for Cognitive Evaluation in Mountain Ultramarathons: Olfactory Assessment.

OBJECTIVE: Olfactory function, a cognitive impairment biomarker, was evaluated in mountain ultramarathon (MUM) runners during the Tor des Géants race (332.5 km with an overall altitude gain of 24,000 m; altitude range 330-3296 m above the sea). METHODS: An Odor Identification Test was administered before (T0; n = 53), at 148.7 kms (T1; n = 32) and after the race (T2; n = 28). The effect of dehydration and sleep deprivation on olfactory function was assessed. Olfactory function was also assessed in non-MUM athletes and sedentary controls (C) at rest. RESULTS: A majority of the athletes completed the olfactory test at all time intervals. Olfactory function decreased throughout the race (T0: 13.8 ± 1.9, T1: 13.7 ± 1.6, T2: 13.1 ± 1.8; T0 vs T2 P = .01). There was no relationship with race time or sleep deprivation on the sense of smell throughout the competition. However, there was a combined effect with decreased olfaction during the second half of the race, while a poor relationship was seen between olfaction and total body water at midterm (T1: rs = -0.427; P = .019), but not at baseline or after the race. MUM athletes had similar olfactory scores to C (13.8 ± 1.9 vs 13.7 ± 1.4) and non-MUM (13.8 ± 1.9 vs 13.9 ± 1.6) athletes. CONCLUSIONS: This pilot study showed the feasibility of olfactory evaluation as a minimally invasive cognitive impairment assessment. The test can be used in logistically difficult environments, adding scientific value to this promising method. Although olfaction decreased after prolonged physical activity, further studies are warranted to make the relationship between cognition and external factors (eg, sleep deprivation, dehydration) more clear.

Chronic and acute effects of endurance training on telomere length.

Telomere shortening is considered a cellular marker of health status and biological ageing. Exercise may influence the health and lifespan of an individual by affecting telomere length (TL). However, it is unclear whether different endurance exercise levels may have beneficial or detrimental effects on biological aging. The aims of the study were to assess both chronic and acute effects of endurance training on TL after an exceptional and extreme trail race. TL was assessed in 20 endurance athletes (17 males; age = 45.4 ± 9.2 years) and 42 age- and gender-matched sedentary controls (32 males; age = 45.9 ± 9.5 years) with quantitative real-time PCR at baseline conditions. Of the 20 runners enrolled in the 'Tor des Géants ®' ultra-distance trail race, 15 athletes (12 males; age = 47.2 ± 8.5 years) were re-evaluated at the intermediate point and 14 athletes (11 males; age = 47.1 ± 8.8 years) completed the competition and were analysed at the final point. Comparison between the two groups (endurance athletes vs. sedentary controls) revealed a significant difference in TL (1.28 ± 0.4 vs. 1.02 ± 0.3, P = 0.005). TL was better preserved in elder endurance runners compared with the same age control group (1.3 ± 0.27 vs. 0.91 ± 0.21, P = 0.003). TL was significantly reduced at the intermediate (0.88 ± 0.36 vs. 1.11 ± 0.34, P = 0.002) and final point compared with baseline measurements (0.86 ± 0.4 vs. 1.11 ± 0.34, P = 0.0006) for athletes engaged in the ultra-marathon race. Our data suggest that chronic endurance training may provide protective effects on TL attenuating biological aging. Conversely, acute exposure to an ultra-distance endurance trail race implies telomere shortening probably caused by oxidative DNA damage.

Linking Sleep Slow Oscillations with consciousness theories: new vistas on Slow Wave Sleep unconsciousness.

We review current models of consciousness in the context of wakefulness and sleep. We show that recent results on Slow Wave Sleep, including our own works, naturally fit within consciousness models. In particular, Sleep Slow Oscillations, namely low-frequency (<1Hz) oscillations, contain electrophysiological properties (up and down states) able to elicit and quench neural integration during Slow Wave Sleep. The physiological unconsciousness related to the Sleep Slow Oscillation derives from the interplay between spontaneous or evoked wake-like activities (up states) and half-a-second's electrical silences (down states). Sleep Slow Oscillation induces unconsciousness via the formation of parallel and segregated neural activities.

Disentangling different functional roles of evoked K-complex components: Mapping the sleeping brain while quenching sensory processing.

During non-REM sleep the largest EEG response evoked by sensory stimulation is the K-complex (eKC), composed of an initial positive bump (P200) followed by a bistable cortical response: a giant negative deflection (N550) and a large positive one (P900), respectively reflecting down states and up states of < 1 Hz oscillations.Sensory-modality-independent topology of N550 and P900, with maximal detection rate on fronto-central areas, has been consistently reported, suggesting that sensory inputs arise to the cortex avoiding specific primary sensory areas. However, these studies neglected latencies of all KC components as a function of electrode sites.Our aim is to identify, component by component, which topological/dynamical properties of eKCs depend on stimulus modality and which are mainly related to local cortical properties. We measured temporal and morphological features of acoustic, tactile and visual eKCs to disentangle specific sensory excitatory activities from aspecific responses due to local proneness to bistability, measured by means of the N550 descending steepness (synchronization in falling into down state).While confirming the sensory-modality independence of N550 and P900 topology with maximal detection rate in fronto-central areas, four main original results emerge from this study: (i) the topology of P200 latency depends on the sensory modality with earliest waves in the stimulation-related primary sensory areas; (ii) P200 rapidly travels as a cortical excitation; (iii) P200-like excitations when KCs are not evoked are detected over the scalp with significantly smaller amplitudes in fronto-central areas, compared to eKC P200s; and (iv) N550 latency mirrors its mean local steepness which is a function of topological proneness to bistability.From these results we can describe the emergence N550/P900 complex as the interplay between a waxing P200 cortical travel and higher fronto-central proneness to bistability.In conclusion, eKCs exhibit a physiological dichotomy: P200 acts as a traveling cortical excitation whose function is to induce the bistable cortical response (N550/P900), which in turn is crucial for maintaining sleep and unconsciousness.

Machine learning to identify a composite indicator to predict cardiac death in ischemic heart disease.

BACKGROUND: Machine learning (ML) employs algorithms that learn from data, building models with the potential to predict events by aggregating a large number of variables and assessing their complex interactions. The aim of this study is to assess ML potential in identifying patients with ischemic heart disease (IHD) at high risk of cardiac death (CD). METHODS: 3987 (mean age 68 ± 11) hospitalized IHD patients were enrolled. We implemented and compared various ML models and their combination into ensembles. Model output constitutes a new ML indicator to be employed for stratification. Primary variable importance was assessed with ablation tests. RESULTS: An ensemble classifier combining three ML models achieved the best performance to predict CD (AUROC of 0.830, F1-macro of 0.726). ML indicator use through Cox survival analysis outperformed the 18 variables individually, producing a better stratification compared to standard multivariate analysis (improvement of ∼20%). Patients in the low risk group defined through ML indicator had a significantly higher survival (88.8% versus 29.1%). The main variables identified were Dyslipidemia, LVEF, Previous CABG, Diabetes, Previous Myocardial Infarction, Smoke, Documented resting or exertional ischemia, with an AUROC of 0.791 and an F1-score of 0.674, lower than that of 18 variables. Both code and clinical data are freely available with this article. CONCLUSION: ML may allow a faster, low-cost and reliable evaluation of IHD patient prognosis by inclusion of more predictors and identification of those more significant, improving outcome prediction towards the development of precision medicine in this clinical field.

The effects of work on cognitive functions: a systematic review.

Introduction: Cognitive functions play a crucial role in individual's life since they represent the mental abilities necessary to perform any activity. During working life, having healthy cognitive functioning is essential for the proper performance of work, but it is especially crucial for preserving cognitive abilities and thus ensuring healthy cognitive aging after retirement. The aim of this paper was to systematically review the scientific literature related to the effects of work on cognitive functions to assess which work-related factors most adversely affect them. Method: We queried the PubMed and Scopus electronic databases, in February 2023, according to the PRISMA guidelines (PROSPERO ID number = CRD42023439172), and articles were included if they met all the inclusion criteria and survived a quality assessment. From an initial pool of 61,781 papers, we retained a final sample of 64 articles, which were divided into 5 categories based on work-related factors: shift work (n = 39), sedentary work (n = 7), occupational stress (n = 12), prolonged working hours (n = 3), and expertise (n = 3). Results: The results showed that shift work, occupational stress, and, probably, prolonged working hours have detrimental effects on cognitive functioning; instead, results related to sedentary work and expertise on cognitive functions are inconclusive and extremely miscellaneous. Discussion: Therefore, workplace health and well-being promotion should consider reducing or rescheduling night shift, the creation of less demanding and more resourceful work environments and the use of micro-breaks to preserve workers' cognitive functioning both before and after retirement. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023439172, identifier CRD42023439172.

Psychological Impact of a Prenatal Diagnosis of Congenital Heart Disease on Parents: Is It Time for Tailored Psychological Support?

The prenatal diagnosis of congenital heart disease (CHD) represents, for both parents, a particularly stressful and traumatic life event from a psychological point of view. The present review sought to summarize the findings of the most relevant literature on the psychological impact of prenatal diagnosis of CHD on parents, describing the most common mechanisms employed in order to face this unexpected finding. We also highlight the importance of counseling and the current gaps in the effects of psychological support on this population.

Interactions between immune, stress-related hormonal and cardiovascular systems following strenuous physical exercise.

Physical exercise represents a eustress condition that promotes rapid coordinated adjustments in the immune, stress-related hormonal and cardiovascular systems, for maintaining homeostasis in response to increased metabolic demands. Compared to the tight multisystem coordination during exercise, evidence of between-systems cross talk in the early post exercise is still lacking. This study was aimed at identifying possible interactions between multiple systems following strenuous physical exercise (Ironman race) performed by twenty well-trained triathletes. Cardiac hemodynamics, left ventricle systolic and diastolic function and heart rate variability were measured along with plasma concentrations of immune messengers (cytokines and C-reactive protein) and stress-related hormones (catecholamines and cortisol) both 24h before and within 20 min after the race. Observed changes in antiinflammatory pathways, stress-related hormones and cardiovascular function were in line with previous findings; moreover, correlating parameters' changes (post versus pre-race) highlighted a dependence of cardiovascular function on the post-race biohumoral milieu: in particular, individual post-race variations of heart rate and diastolic function were strongly correlated with individual variations of anti-inflammatory cytokines, while individual baroreflex sensitivity changes were linked to IL-8 increase. Multiple correlations between anti-inflammatory cytokines and catecholamines were also found according with the autonomic regulation of immune function. Observed post-race cytokine and hormone levels were presumptively representative of the increases reached at the effort end while the cardiovascular parameters after the race were measured during the cardiovascular recovery; thus, results suggest that sustained strenuous exercise produced a stereotyped cardiovascular early recovery, whose speed could be conditioned by the immune and stress-related hormonal milieu.

COVID-19 Pandemic and Internet Addiction in Young Adults: A Pilot Study on Positive and Negative Psychosocial Correlates.

Objective: During and after the lockdowns of the COVID-19 pandemic period, a strain was put on young adults who have taken refuge in the problematic use of internet, social media, gaming, and gambling. This paper aims to investigate possible correlates of Internet Addiction Disorder (IAD), hypothesizing anxiety, depression and perceived stress would promote addiction, while mindfulness skills, resilience and socialization would, conversely, hamper IAD, and promote, consequently, a more functional internet use. Method: A pilot study was carried out with a sample of 31 young adults, recruited through a snowball sampling using social networks. Participants filled out an online questionnaire including the following measures: Internet Use, Abuse and Addiction (UADI), Beck Depression Inventory (BDI-II); State-Trait Anxiety Inventory (STAI-Y); Perceived Stress Scale (PSS); Five Facet Mindfulness Questionnaire (FFMQ); Mindfulness Attention and Awareness Scale (MAAS); Resilience Scale (RS-14). It was also administered an ad hoc questionnaire for the assessment of socialization behaviour (6 items) and gambling (2 items). Results: All the measures, but socialization, showed adequate reliability. Our sample showed high levels of anxiety, stress, IA and gambling, while presenting low levels of resilience, the mindful skill of no-reactivity and socialization. The first hypothesis was confirmed, finding positive and significant correlations between Internet Addiction on one side and PSS, STAI-Y1, STAY-2, and BDI II on the other side. We also partially confirmed the second hypothesis about UADI negatively correlated with both RS-14 and Mindful Acting. Finally, no correlations were found between Gambling and IA. Conclusions: In conclusion, the more one perceives an emotional overload with less stress-control, high anxiety, and depression, and the less one can leverage on the skills of mindful acting and resilience, the more one uses the internet as a strategy to escape from a threatening reality.

Schoolteachers' well-being: A pilot study from the AVATAR project during COVID-19 school closure.

BACKGROUND: Teachers are a category at high risk for co-occurring mental diseases. OBJECTIVES: The purpose was to assess well-being of schoolteachers and psychological effects of coronavirus disease 2019 (COVID-19). METHOD: Data were collected in April 2021, during the partial re-opening of public schools in Italy, from 838 schoolteachers who complete a battery of psychological tests on a multimedia platform. RESULTS: In females, school closure increases anxiety (BAI, p < 0.001), depression (BDI-II, p < 0.05), stress-related insomnia (FIRST, p < 0.001), and perceived stress (PSS, p < 0.05). In males, on the contrary, rises perceived health (p < 0.001) and vitality (p < 0.001), also in terms of total score (PWBI p < 0.05). In addition, having a family member with COVID in the past month increased anxiety (BAI, p < 0.05), reduced perceived physical health (PWBI, p < 0.05) and vitality (PWBI, p < 0.05). CONCLUSION: The main results of this pilot study showed that female teachers had a worse well-being perception with respect to men, in terms of health and vitality and an increase in negative emotional reactivity, that impaired when a family member was affected by COVID. The results emphasize the need to invest in prevention and wellness promotion programs in this professional category.

An Entangled Relationship between Bullying Perception and Psychosocial Dimensions in a Sample of Young Adolescents.

BACKGROUND: Bullying is a hostile behavior repeated over a time period, affecting children and adolescents in different social settings, mainly small and stable ones like school, with negative effects on mental and physical health. In this study, we aimed to provide the degree of impairment of different variables related to health and well-being in bullying conditions, with attention to sex differences. METHODS: Data were obtained from 5390 adolescents (mean age 13.08 ± 1.89; male 2729), and health-related quality of life (HRQoL) was assessed using the KIDSCREEN-52 questionnaire. RESULTS: In all students, mood and emotion, self-perception, and parental relationships are the dimensions more compromised in bullying conditions, while lifestyle habit is the variable less involved. Bullied girls show a significant impairment of all HRQoL variables both with respect to the socially accepted counterpart and to the male population. CONCLUSIONS: Our study highlights the strict association between bullying and emotional and social dimensions, suggesting that enhancing them preventively could facilitate earlier detection of problems, thereby reducing health risks.

Relationship between eating disorders perception and psychosocial profile in school-dropout adolescents.

BACKGROUND: In body-mind relationship field, eating disorders (ED) are considered disabling disorders that can alter physical health status, inducing profound alterations in psychosocial, cognitive and emotional dimensions. These disorders, characterized by a strong comorbidity with other diseases, usually begin during childhood or adolescence, and include anorexia nervosa, bulimia nervosa and binge eating. Aim of this study was to investigate the associations between eating disorders perception and dimensions of health-related quality of life (HRQoL) and well-being perception (WBP) in school-dropout adolescents. METHODS: Data were collected in 450 adolescents (19 ± 2 years, male 308), and HRQoL, WBP, and ED were assessed by means a battery of standardized questionnaire. RESULTS: EDs are more pronounced in females than in males (p < 0.05) and are associated with lower HRQoL (p < 0.001) and lower well-being perception (p < 0.001). EDs are associated with an impairment of physical (p < 0.05) and psychological well-being perception (p < 0.001), emotional responses (p < 0.001), self-perception (p < 0.001), and a reduction of general well-being (p < 0.05). CONCLUSIONS: Although it is complicated to distinguish between causes and consequences, these findings suggest a complex and multifaceted, association between ED and HRQoL domains. Thus, multiple factors need taking into account in the policy of EDs prevention, identifying all the components of well-being to focus and personalize healthy programs in adolescences.

Adolescence is a transitional period from childhood to adulthood during which important biological, cognitive and social changes are experienced. In this phase, characterized by increased psychological vulnerability, classic risk behavior can develop, including altered eating behavior leading to eating disorders (EDs). EDs represent a varied group of pathological conditions influenced by various individual factors, including emotional state, cognitive functioning, and social context, probably associated to physical, emotional, and social changes that in young people can lead to great instability. Our results shown that is complicated to distinguish between causes and consequences that cause EDs, suggesting a complex and multifaceted association between ED and psychological domains. This is important in order to develop preventive and early intervention programs in the schools and in other educational institutions, focusing on what are considered potential predictor of EDs.

A Close Association between Body Weight, Health-Related Quality of Life, and Risk Behaviors in a Sample of Italian High School Students.

INTRODUCTION: Adolescents experience rapid physical, cognitive, and psychosocial growth with different factors contributing to health and well-being. In this view, an important role is played by body weight and related perceptions. The purpose was to determine, in a sample of Italian high school students, whether health-related quality of life (HRQoL) is associated with the different weight status categories (underweight, normal weight, overweight, obese), even considering sex differences. MATERIAL AND METHODS: Data were collected from 1826 adolescents (n = 735 males). HRQOL was analyzed using the Italian version of KIDSCREEN-52. RESULTS: Overweight adolescents showed reductions in psychological well-being (p < 0.05) and self-perception (p < 0.05) compared with individuals in other BMI categories. Subjects with obesity reported increased bullying victimization (p < 0.05) and reductions in self-perception and eating disorders (p < 0.001), while underweight individuals were characterized by altered adherence to the Mediterranean diet (p < 0.001), eating disorders (p < 0.001), and problematic use of social media (p < 0.05). No sex differences were found, except for socio-economic status perceptions, where underweight girls reported higher economic well-being than boys (p < 0.05). CONCLUSIONS: Our findings may suggest that there is an association between weight status categories and HRQoL that is more pronounced in underweight and overweight adolescents. The association between BMI categories and psychosocial dimensions opens the need to define specific domains on which such preventive interventions should focus, always through a personalized perspective.

Synchronization between music dynamics and heart rhythm is modulated by the musician's emotional involvement: A single case study.

In this study we evaluated heart rate variability (HRV) changes in a pianist, playing in a laboratory, to investigate whether HRV changes are guided by music temporal features or by technical difficulty and/or subjective factors (e.g., experienced effort). The pianist was equipped with a wearable telemetry device for ECG recording during the execution of 4 classical and 5 jazz pieces. From ECG we derived the RR intervals series (tachogram), and, for each piece, analyzed HRV in the time (RR, RMSSD, Stress Index) and frequency domains (Total spectral power) and performed non-linear analysis (Multiscale Entropy). We also studied the correlation (Pearson) between the time course of music volume envelope and tachogram. Results showed a general reduction of parasympathetic and an increase of sympathetic activity, with the greatest changes during the classical pieces execution, the pianist appraised as more demanding than the jazz ones. The most marked changes occurred during the most technically/emotionally demanding piece, and correlation analysis revealed a negative association between music volume envelope time course and tachogram only for this piece, suggesting a modulation of the limbic system on the synchronization between heart rhythm and music temporal features. Classical music was also associated with the increase of entropy (1st scale) with respect to rest, indicating its effectiveness in driving flexible, healthy, heart dynamics. In conclusion, HRV seems modulated not only by the music temporal features, but also by the pianist's emotional involvement, which is greatly influenced, in a non-trivial manner, by the technical demands and musician expertise.

Gender Differences for Health Indicators in a Sample of School Dropout Adolescents: A Pilot Study.

Background: The ever-increasing prevalence of school dropout (SD) highlights the need to gain insight into risk factors for dropout causes and consequences. The aim of this study was to evaluate the gender differences for health indicators in a sample of school dropout adolescents. Methods: Data were collected regarding 450 adolescent's SD (19 ± 2 years; 308 males), and health-related quality-of-life (HRQoL) and risk behaviors were assessed by means of a standardized questionnaire. Results: The results revealed that the female population was characterized by a compromised health indicator profile in terms of both risk behaviors and HRQoL dimensions. Conclusion: These findings indicate that SD is a multidimensional phenomenon, for which the implementation of multiple educational, social, and psychological policies aimed at mitigating the issue are recommended.

The Impact of Unhealthy Behaviors on Personalized Well-Being Index in a Sample of School Dropout Adolescents.

(1) Background: here is a growing need for integrated and multidimensional approaches to health, especially in a particular category of populations, school-dropout (SD) adolescents, who are traditionally more prone to risky behavior. This study aimed to describe the association between possible risk factors (substance use, eating disorders, social addiction) and well-being perception through the application of a personalized well-being index (PWBI) in SD youths. (2) Methods: Data were collected in 450 school-dropout adolescents (19 ± 2 years, male 308); the health-related quality of life (HRQoL) and risk behaviors were assessed by means of a battery of standardized questions. (3) Results: The results revealed an altered perception of well-being in association with eating disorders (p < 0.001), the use of psychotropic drugs (p < 0.001), and the amount of their consumption (p < 0.05). In particular, there was a decrease in emotional state (p < 0.001) and PWBI (p < 0.001) in the presence of eating disorders, and an impairment in all PWBI components, emotional states (p < 0.001), lifestyle habits (p < 0.05), and social contexts (p < 0.001) when taking psychotropic drugs. (4) Conclusions: risk or unhealthy behaviors significantly worsen individual well-being. This study highlights the change of paradigm from a disease-oriented model to an educationally strength-based model when monitoring psychosocial well-being in order to define preventive and health promotion strategies in a vulnerable category of the population.

Environment in Children's Health: A New Challenge for Risk Assessment.

In the last few years, many studies have focused on the effects of environmental contaminant exposure during the prenatal period or infancy as predictors of health outcomes in the future. In these time windows, due to their rapid growth, and physiologic and metabolic development, we can observe a higher vulnerability to the effects of environment, with respect to adulthood. The evidence of possible influences, partly mediated by epigenetic mechanisms, involve neurobehavioral responses and immune, endocrine, and respiratory systems, acting directly on the child or indirectly when mediated by placental transfer or breast feeding. In particular, due to a greater intake of air, food, and fluids relative to body weight, crawling behaviors and short stature, the risk of excessive exposure is greater in children. However, data on the long-term implications of early exposures are scarce. Additionally, so that physicians and institutions for child care and assistance of pregnant women can take actions to counteract the effects of chemical pollution (i.e., by educational opportunities), a risk assessment perspective that responds to the biocomplexity of the human being is needed. The present paper provides an overview of physiologic and behavioral characteristics during the perinatal period and in childhood, suggesting in a more integrated way, the need of a new risk-assessment approach to managing chronic disease in pediatric patients.