Gaia Surya Lombardi

Harmful algal blooms occurring in the marine environment cause a variety of human illnesses in Southeast Asians, who rely on the marine ecosystem for sustenance, yet there is limited public understanding of these disease risks. Due to a lack of awareness, diagnostic uncertainty, and fragmented surveillance, the burden of disease attributable to harmful algal blooms exposure remains unclear. This scoping review aimed to map surveillance and data collection mechanisms, and inter-organisational data flows concerning marine harmful algal bloom-related health outcomes in the Philippines, Malaysia and Indonesia. The review followed Arksey and O’Malley’s framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews reporting guidelines, searching PubMed, Web of Science and Scopus (1970–2024) and complementary searches in Google Scholar. Data extraction focused on intoxication types, data sources, reporting mechanisms and stakeholder collaborations. Twenty-three studies and records were included: 70% from the Philippines, 26% from Malaysia and 4% from Indonesia. Five main surveillance data sources were identified: (i) physician reports, (ii) healthcare facility records, (iii) local health authorities, (iv) Department of Health systems and (v) document-based and media-based data sources. However, key data infrastructure was poorly documented. The Philippines demonstrated the most diversified data pathways, emphasising multi-stakeholder collaborations. This review reveals that the infrastructure for harmful algal bloom-related health surveillance across the countries is largely absent or undocumented. Strengthening data systems and enhancing multisectoral collaboration are essential to mitigate the health threats posed by harmful algal blooms.

Background: The climate crisis greatly affects mental health, often leading to climate change anxiety. In Italy, there is a lack of research and school programs to help manage climate anxiety and other climate-related psychological consequences. The aim of the CAMBIO CLIMA project is to evaluate the levels of eco-anxiety and pro-environmental behaviours (PEBS) in a sample of Italian middle and high school students, before and after a tailored intervention on the climate crisis. Methods: The intervention involves one hundred middle and high school classes from three Italian regions. The students will complete a set of surveys, including psychometric scales and questions on socio-demographic factors and climate change awareness. The students will then participate in a two-hour online workshop. A video will be shown at the beginning to raise awareness about climate change. The instructor will ask the students which solutions could be found to solve specific problems caused by climate change. The instructor will then propose and explain a list of PEBS that students can implement to fight against climate change. Finally, students will be invited to put into action these behaviours. A week after the intervention, students will be asked to take part in a post-intervention survey, completing the same set of questionnaires they completed at enrolment. Results: Currently, the research team is in the preparatory stage, establishing contacts with schools and organizing materials for the online workshop. The intervention is scheduled for the upcoming school year. Conclusions: The intervention, focused on enhancing the sense of self-efficacy, is expected to increase the resilience of adolescents, making them less vulnerable to the impact, both direct and indirect, of climate change on mental health. The project is funded by PRIN: PROGETTI DI RICERCA DI RILEVANTE INTERESSE NAZIONALE - Bando 2022 (Prot. 2022N22J5F). Key messages: • Climate change has a disproportionate impact on young people. • It is essential to plan adequate school programs that stimulate the sense of awareness and encourage PEBS simultaneously.

Background: Respiratory Syncytial Virus (RSV) infection mainly affects newborns, infants and young children aged < 2 years. Since an RSV vaccine is in the European Medicines Agency’s waitlist validation, nowadays the prevention only includes passive immunization with monoclonal antibodies (mAb). In the present study we aimed at investigating Italian paediatricians’ knowledge, attitudes and behaviours towards RSV and its prevention. Methods: From February to May 2023, an anonymous online questionnaire, with answers based on the Likert scale, was administered to a sample of Italian paediatricians’ members of the Italian Society of Paediatrics. Descriptive and inferential statistical analyses were performed using STATA 17. Results: The paediatricians who answered the questionnaire were 507, mostly women (70.6%), aged 30–45 (33.1%), employed in hospitals in 66.6% of cases. The 10.8% of respondents reported that RSV is transmitted only among children younger than 2 years of age and 80.33% of participants that school-age children are not at risk of developing severe forms of RSV disease. The 25% of participants thought that active immunization is currently available to prevent RSV infection and 35.7% that does not exist passive immunization to prevent RSV for infants and newborns aged < 2 years. The 97.5% of physicians managed bronchiolitis cases and 65.6% of participants did not prescribe the administration of mAb. Higher age, seniority and RSV knowledge score were found to be associated with having a higher mAb knowledge score (p < 0.001) and having a higher RSV knowledge was associated with a higher mAb knowledge score (p < 0.001). The logistic regression model found that the odds of a positive attitude towards mAB knowledge score increased by over 3 times (OR 3.23, 95% CI [1.41, 7.40], p = 0.006) for being female and the odds of a positive attitude towards mAB knowledge score increased by almost 10 times (OR 9.73, 95% CI [3.06, 30.89], p < 0.001) for a one-unit increase in RSV knowledge score. Conclusions: Paediatricians’ limited knowledge or awareness could represent a barrier to the implementation of preventive strategies against RSV infection. Strategies to improve paediatricians’ education on RSV prevention are, therefore, crucial.

Aim: The present systematic review analyzes existing strategies and policies used for adult vaccination of seven countries of the European area, emphasizing weaknesses and strengths of immunization schedules. Selected countries were Germany, France, the United Kingdom, Italy, Spain, Sweden, and Romania. Subject and methods: Three main scientific databases (PubMed, Scopus, and Web of Science) were queried and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies assessing weaknesses or strengths factors, facilitators and barriers related to the adult vaccination plans were considered eligible. We included ten studies with a medium/high score at the quality assessment. Results: The main barriers and strength factors for vaccination can be divided into the following categories: financial aspects (e.g., if the vaccine has a funding mechanism); logistic factors (e.g., convenience, opening times); factors related to healthcare professionals (e.g., recommendations, provision by different categories of healthcare professionals). Conclusion: Substantial improvement in adult vaccination uptake is urgently necessary to decrease the burden of infectious disease on healthcare systems. Although decision-making regarding adult vaccination is complex and influenced by psychological and personal factors, addressing practical or logistical issues related to immunization plans can facilitate higher vaccination coverage.

While it has been shown that climate change anxiety (emotional distress response to climate change) can enhance pro-environmental behaviours (PEBs) in some subjects, in others it can induce eco-paralysis, thus leading individuals to avoid any form of engagement in actions against climate change. This study aims to clarify which factors influence the relationship between climate change anxiety and the disposition to PEBs, focusing on the role of self-efficacy as a mediating factor. A cross-sectional study was conducted on 394 healthy subjects living in Italy who completed the Pro-Environmental Behaviours Scale (PEBS), the General Self-Efficacy scale (GSE), and the Climate Change Anxiety Scale (CCAS). As a result, the mediation model showed a positive direct effect of the cognitive impairment subscale of CCAS on PEBS and an indirect negative effect of the cognitive impairment subscale of CCAS on PEBS mediated by GSE. These findings show that climate change anxiety has simultaneously two different effects on individuals: it directly encourages PEBs, and indirectly may have detrimental effects on PEBs such as eco-paralysis. Consequently, therapeutic approaches to treat climate change anxiety should not be aimed at rationalising irrational thoughts but rather at helping patients develop coping strategies such as PEBs which, in turn, foster self-efficacy.

Background: Microplastics (MPs) are defined as small particles less than 5 mm in size occuring in the environment as a consequence of plastic pollution. MPs are classified into primary MPs, which are created for industrial uses, and secondary MPs, that derive from the degradation of larger plastic items. With the global increase in plastic production, MPs have become widely distributed in the natural ecosystems and have been charged with causing several detrimental effects on both the environment and on human health. Moreover, plastics often include additives to improve their properties, which may produce additional toxic substances. Humans can be exposed to MPs through different pathways, including ingestion, inhalation and dermal contact. The aim of this systematic review is to synthesize whether inhaled microplastics and plastic additives have negative effects on human health. Methods: MEDLINE, Scopus and Web of Science were searched starting from December 2021. The systematic review was conducted according to the PRISMA guidelines. Eligible studies were primary studies which reported the effects of inhaled MPs on the respiratory system. Appropriate quality assessment tools were used according to the study design of primary studies. Results: 38 studies met the inclusion criteria. Most of the studies were conducted in vitro, while there was a scarcity of papers that investigated the effects of MPs in population cohorts. Preliminary results show that MPs can induce pro-inflammatory or pro-carcinogenic effects by different mechanisms, depending on particles’ concentration, size, type and surface charge. Conclusions: Literature has underlined several negative health concerns resulting from the absorption of microplastics and plastic additives. By gathering this information, this systematic review sheds light on the possible threats of MPs inhalation to human health and discusses whether an implementation of new public health policies for the foreseeable future is needed. Key messages: • Inhalation is a major route of exposure to microplastics. • Inhaled microplastics or plastic additives may have detrimental effects on human health, promoting respiratory diseases or carcinogenic processes.