Climate change (CC) has a significant impact on human health, resulting in both physical and mental illnesses. Eco-anxiety—the excessive and pervasive fear about the consequences of CC—is the most studied psychoterratic state. This study presents the validation of Italian versions of Hogg’s Eco-Anxiety Scale (HEAS) and the Eco-Paralysis Scale. It also investigates the effects of worry on eco-anxiety and eco-paralysis. The study was conducted on 150 Italian individuals who responded to the two scales and to other questionnaires to make comparisons with the two above. Internal consistency and factorial structure were assessed through Cronbach’s alpha, Confirmatory Factor Analysis and Exploratory Factor Analysis. A median regression was used to assess the association between the EPS and the HEAS and Climate Change Worry Scale (CCWS) and their interaction. HEAS and EPS showed good psychometric properties: HEAS resulted in good internal consistency (Cronbach’s α = 0.986), and the Eco-Paralysis scale had good test-retest reliability (r = 0.988). In both cases, a one-factor structure was suggested to be retained. The interaction terms between HEAS and CCWS (β = −0.02; 95% CI: −0.03, −0.01; p < 0.001) and between HEAS and education (β = −0.05; 95% CI: −0.08, −0.02; p < 0.001) were significant. Therefore, the feeling of worry seems to act as a moderator between climate change anxiety and eco-paralysis since it may appear to influence individuals and their ability to transform anxiety into action. Education plays a role in reducing the risk of Eco-Paralysis in subjects affected by climate change anxiety. Thus, data suggest that working on reinforcing a more cognitive concern might result in more problem-solving-focused strategies to face climate change anxiety and eco-paralysis.

Background: The World Health Organization identified alcohol and tobacco consumption as the risk factors with a greater attributable burden and number of deaths related to non-communicable diseases. A promising technique aimed to modify behavioral risk factors by redesigning the elements influencing the choice of people is nudging. Methodology: A scoping review of the literature was performed to map the literature evidence investigating the use of nudging for tobacco and alcohol consumption prevention and/or control in adults. Results: A total of 20 studies were included. The identified nudging categories were increasing salience of information or incentives (IS), default choices (DF), and providing feedback (PF). Almost three-quarters of the studies implementing IS and half of those implementing PF reported a success. Three-quarters of the studies using IS in conjunction with other interventions reported a success whereas more than half of the those with IS alone reported a success. The PF strategy performed better in multi-component interventions targeting alcohol consumption. Only one DF mono-component study addressing alcohol consumption reported a success. Conclusions: To achieve a higher impact, nudging should be integrated into comprehensive prevention policy frameworks, with dedicated education sessions for health professionals. In conclusion, nudge strategies for tobacco and alcohol consumption prevention in adults show promising results. Further research is needed to investigate the use of nudge strategies in socio-economically diverse groups and in young populations.

Background: Cities contribute to and are affected by the climate crisis, determining significant health issues in urban settings. Educational institutions have a privileged position to contribute to achieving the transformations needed for a healthier future, so Urban Health education is fundamental to empowering the health of the youth living in cities. This study aims to measure and raise the awareness of Urban Health among students attending a high school in Rome (Italy). Methods: An interactive educational intervention, consisting of four sessions, was conducted in a Roman high school during spring 2022. Overall, 319 students aged between 13 and 18 attended the sessions and were asked to complete a 11-items questionnaire before and another after the interventions. Data was gathered anonymously and analyzed using descriptive and inferential statistics. Results: Fifty-eight percent of respondents improved their post-intervention questionnaire score, while 15% did not improve and 27% got worse. The mean score significantly improved after the intervention (p < 0.001; Cohen’s d = 0.39). Conclusions: The results suggest that school-based interventions using interactive approaches on Urban Health could be effective in increasing students’ awareness and promoting health especially in urban settings.

Timely primary percutaneous coronary intervention (pPCI) is the most important treatment to improve outcomes in ST-segment elevation myocardial infarction (STEMI), with a strong relationship between treatment delays and morbidity and mortality. The present study aims to define the main steps for setting up a real-time digital monitoring dashboard to improve the clinical performance of STEMI management and to evaluate the impact of its implementation on the proportion of patients receiving primary percutaneous coronary intervention (pPCI) within 90 min. The set-up of the digital monitoring system required the definition of detailed algorithms for the diagnosis, treatment, and rehab/follow-up phase. For each patient with a diagnosis of STEMI included in the clinical pathway (CP) a multidisciplinary working group identified i) rules for flagging patients alongside the CP, based on specific risk scores; ii) the critical points of the CP to be monitored, such as door-to-balloon time, intensive care unit length of stay, and total hospital length of stay. An interrupted time series analysis and multivariable logistic regression models were performed to assess for changes in the outcome (pPCI within 90 min) after the platform implementation, adjusting for temporal and individual confounders. After the introduction of the dashboard, the proportion of timely pPCI improved from 40 % pre-implementation to 65 % post-implementation. Adjusted models indicated a twofold increase in the odds of meeting the 90-minute benchmark (OR = 2.00; 95 % CI: 0.99-4.12). The real-time monitoring system showed a positive impact on the timely management of STEMI, highlighting the potential for improving healthcare efficiency and patient outcomes.

Background and Objective: Italy is considered a hotspot for climate change in the Mediterranean region and people living in it are already affected by environmental modifications. Medical doctors have a key role in tackling with the consequences of this threat by providing direct care and...

Background and Objective: Cardiovascular and respiratory diseases are among the leading causes of death in Italy. There is currently growing evidence of the association between exposure to fire smoke and the occurrence of cardiopulmonary diseases. According to the 2017 ARPA Piedmont (regional...