Trends in Adolescent Health Risk Behaviors and Wellbeing: A 10 Year Observation from the EDIT Surveillance of Tuscany Region, Italy.

Background: The aim of this study was to evaluate the trends of prevalence of health risk behaviors (HRBs) and health conditions over a 10 year period (2008-2018) in a representative sample of adolescents of Tuscany Region, Italy. Methods: This was a repeated cross-sectional (four survey waves) study. The prevalence of 17 HRBs and health conditions were analyzed by age, sex, and socioeconomic status (SES). Results: A total of 21,943 students were surveyed. During the study period, decreases in smoking participation, cocaine use, driving under the influence of alcohol and drugs, and problem gambling were observed, while alcohol abuse and at-risk sexual behaviors remained unchanged or increased. Males resulted more frequently involved in most of the HRBs, while females more frequently reported physical inactivity, regular smoking, and not using a condom. Female participation in smoking and alcohol abuse behaviors, fruit and vegetable consumption, and bullying worsened over the study period. Smoking, poor dietary habits, physical inactivity, high distress level, and obesity were more frequently observed in low-SES students than in high-SES students. Conclusions: The findings showed different tendencies in adolescent participation in HRBs over the last decade; concerning trends in at-risk sexual behaviors and alcohol consumption and females' risk-taking behavior on the rise require careful monitoring.

The Prevalence of Several Risky Driving Behaviors and Associated Crash Risk in Adolescent: A Population-Based Study of Tuscany Region.

Objectives: To evaluate the prevalence of numerous risky driving behaviors (RDBs) and the associated risk of road traffic accidents (RTA) in a population-based sample of adolescent drivers (14-19 years) of Tuscany, Italy. Methods: The frequency of participation -by age and sex- often RDBs were investigated: Multivariable analyses were performed to evaluate the association between RDBs and the risk of RTA and severe RTA. Results: 2,737 adolescents were included in the study. Talking to passenger(s), listening to loud music, speeding, and texting showed the highest weekly participation rates. For all the considered RDBs, the frequency of participation significantly increased with age. Males reported a significantly higher participation in speeding, DUI of alcohol or drugs; while females reported listening to loud music and talking to passenger(s) more frequently. All the considered RDBs were significantly associated with the risk of RTA and severe RTA. Conclusion: The prevalence of RDBs and the associated risk of RTA largely varied in adolescents. Findings provide evidence for tailoring prevention interventions and suggest the need to include common- but traditionally overlooked- RDBs in road safety campaigns.

Profiles of Risky Driving Behaviors in Adolescent Drivers: A Cluster Analysis of a Representative Sample from Tuscany Region (Italy).

(1) Background: Research on patterns of risky driving behaviors (RDBs) in adolescents is scarce. This study aims to identify distinctive patterns of RDBs and to explore their characteristics in a representative sample of adolescents. (2) Methods: this is a cross-sectional study of a representative sample of Tuscany Region students aged 14-19 years (n = 2162). The prevalence of 11 RDBs was assessed and a cluster analysis was conducted to identify patterns of RDBs. ANOVA, post hoc pairwise comparisons and multivariate logistic regression models were used to characterize cluster membership. (3) Results: four distinct clusters of drivers were identified based on patterns of RDBs; in particular, two clusters-the Reckless Drivers (11.2%) and the Careless Drivers (21.5%)-showed high-risk patterns of engagement in RDBs. These high-risk clusters exhibited the weakest social bonds, the highest psychological distress, the most frequent participation in health compromising and risky behaviors, and the highest risk of a road traffic accident. (4) Conclusion: findings suggest that it is possible to identify typical profiles of RDBs in adolescents and that risky driving profiles are positively interrelated with other risky behaviors. This clustering suggests the need to develop multicomponent prevention strategies rather than addressing specific RDBs in isolation.

Covid-19 and the role of smoking: the protocol of the multicentric prospective study COSMO-IT (COvid19 and SMOking in ITaly).

The emergency caused by Covid-19 pandemic raised interest in studying lifestyles and comorbidities as important determinants of poor Covid-19 prognosis. Data on tobacco smoking, alcohol consumption and obesity are still limited, while no data are available on the role of e-cigarettes and heated tobacco products (HTP). To clarify the role of tobacco smoking and other lifestyle habits on COVID-19 severity and progression, we designed a longitudinal observational study titled COvid19 and SMOking in ITaly (COSMO-IT). About 30 Italian hospitals in North, Centre and South of Italy joined the study. Its main aims are: 1) to quantify the role of tobacco smoking and smoking cessation on the severity and progression of COVID-19 in hospitalized patients; 2) to compare smoking prevalence and severity of the disease in relation to smoking in hospitalized COVID-19 patients versus patients treated at home; 3) to quantify the association between other lifestyle factors, such as e-cigarette and HTP use, alcohol and obesity and the risk of unfavourable COVID-19 outcomes. Socio-demographic, lifestyle and medical history information will be gathered for around 3000 hospitalized and 700-1000 home-isolated, laboratory-confirmed, COVID-19 patients. Given the current absence of a vaccine against SARS-COV-2 and the lack of a specific treatment for -COVID-19, prevention strategies are of extreme importance. This project, designed to highly contribute to the international scientific debate on the role of avoidable lifestyle habits on COVID-19 severity, will provide valuable epidemiological data in order to support important recommendations to prevent COVID-19 incidence, progression and mortality.

[Risk factors associated with road accidents among young people in Tuscany (Italy): a cross sectional study]. / Fattori di rischio associati agli incidenti stradali nei giovani toscani: uno studio trasversale.

In most countries, national statistics institutes either do not measure or underestimate the impact of behavioral aspects as causes of road accidents. To bridge this gap, the Regional Health Agency of Tuscany (Italy) created the EDIT project, which evaluates driving behaviors and other lifestyle risk factors in a sample of secondary school students. Study results show that driving while under the influence of alcohol or drugs or while being distracted by cigarette smoking or the use of mobile phones are the risk factors most frequently associated with traffic accidents.

[Injury-related Emergency Department visits in Tuscany (Italy)]. / Accessi ai Pronto Soccorso toscani per cause traumatiche.

The frequency of injuries underscores the need for planning and implementing efficient injury surveillance systems. Emergency Departments represent the preferred source of data on injuries but information regarding emergency department visits is not always available. We examined the feasibility of utilizing emergency department data to monitor the occurrence of injuries in Tuscany. Each of the 52 public hospital emergency departments operating in the 12 local health units of Tuscany were asked to provide yearly data on the numbers and types of injury-related visits since the year 2003. They were also asked whether attendance records were computerised. This data was used to estimate the number of injury-related visits by cause of injury, at the regional level. The results of this study were combined with those of a previous study to estimate the number of hospital admissions for motor vehicle accidents in Tuscany in 2004. The latter was then compared to corresponding data from the hospital discharge abstract database. In 2002, the number of emergency departments with computerised attendance records was only 27 while in 2005 it was 43 and a greater number of emergency departments were able to codify each type of injury-related visit. A slight decrease was observed in the total number of visits for all causes, between 2002 and 2004 (respectively 1.314.874 and 1.256.509). In 2002, motor vehicle accidents were the most frequent cause of injury-related ED visit (8%), followed by home injuries (7.2%) and workplace accidents (6%). In 2004, home injuries were the most frequent type of injury (7.5%) followed by motor vehicle accidents (6.9%) and workplace injuries (5%). We estimated 6836 hospital admissions for the year 2004, while only 4800 admissions were registered in the discharge abstract database in the same year. Computerisation of attendance records and improvement in codification of data are a good starting point in utilizing emergency department data for epidemiological surveillance of injuries.