February May Research Articles

Refraining from seeking dental care among the Sámi in Sweden: a cross-sectional study

BackgroundWhile equity in health care is the core of the Swedish health system, social inequalities in accessing health care, particularly regarding dental care, exist. There is however no information on how the Sámi population is affected. This study aimed to assess the prevalence and risk factors for refraining from seeking dental care among the Sámi in Sweden.MethodsA Sámi sample was constructed from three pre-existing registers. Among the 9,249 invitations for individuals aged 18–84 years old, 3,779 answered the survey during February–May 2021. We first calculated frequencies and proportions of the independent variables in terms of socio-economic, socio-demographic, and cultural-related factors as well as the outcome, refraining from dental care. Then, we summarized the magnitude of the association between the independent variables and self-reported refrain from dental care with the prevalence difference (PD) using the 95% confidence interval (95% CI) for inferential purposes.ResultsOverall, 17.5% of the participants refrained from seeking dental care despite self-reported need in the last three months, with almost the same proportion between men and women. Among the socio-demographic factors, being in the 30–44 years group (PD = 8.0; 95% CI: 3.59, 12.48), in the 45–64 group (PD = 7.3; 95% CI: 2.96, 11.61) and in the 65–84 group (PD = 5.4; 95% CI: 0.92, 9.78) as well as being divorced/widow-er (PD = 6.7; 95% CI: 2.73, 10.70) and unmarried (PD = 3.1; 95% CI: 0.23, 6.04) were statistically significantly associated with refraining from seeking dental care. Among the socio-economic variables, those in the middle-income quintile (PD = 5.3; 95% CI: 1.28, 9.35), in the poor (PD = 8.1; 95% CI: 3.64, 12.51) and poorest (PD = 8.0 95% CI: 3.48, 12.50) quintiles, and especially those experiencing economic stress once (PD = 9.2; 95% CI: 2.93, 15.48) and several times (PD = 26.5; 95% CI: 19.50, 33.43), were strongly associated with refraining.ConclusionsApproximately one in six of the Sámi participating in this study refrained from seeking dental care despite self-reported need in the last three months. Those who experienced economic difficulties were the most affected group. To achieve equity in dental health care in Sweden, policies removing economic barriers to access dental health care should be implemented.

Exploring virtual delivery of academic detailing to general practitioners compared with in-person delivery: a qualitative study

BackgroundInappropriate prescribing may have detrimental consequences for the patient and increase healthcare utilisation and costs. Academic detailing (AD) is an interactive outreach method to deliver non-commercial evidence-based medical information to...

Youth and young adult flavour expectancies for new ‘non-menthol’ cigarettes introduced following California’s ban on flavoured tobacco products

BackgroundFollowing California’s statewide law prohibiting the sale of flavoured tobacco products, some cigarette brands introduced new variants advertised as non-menthol, yet featuring design and text commonly found in menthol cigarette...

Influence of the Season of Year and Stage of Postharvest Processing on Anthracnose Severity in Bananas in a Savanna Climate in the Brazilian Northeast

ABSTRACTBanana cultivation has great socio‐economic importance in the Cariri region (state of Ceará), Brazil. This study aimed to monitor the severity of anthracnose (caused by Colletotrichum musae) in bananas (cv. Prata) collected at three postharvest processing steps (dehanding, first washing and second washing) in packinghouses of four producing companies (A, B, C and D) in the wet (February–May) and dry (September–December) seasons of production in 2019. Averaged across packing companies and processing stages, disease severity was higher in the wet season (42.4%) than in the dry season (19.6%), but disease variability, expressed by the coefficient of variation, was higher in the dry season. In most cases, there were significant (p ≤ 0.05) differences among processing stages within each packinghouse and season, but the stage with the highest disease severity was not consistent. In other words, there was no predictable change in disease severity from dehanding to first and second washing. It was impossible to identify a single pattern in the severity of anthracnose in banana fruits collected from different companies and stages of postharvest processing, and this may be associated with the management adopted in each production area.

Double testing with lateral flow antigen test devices for COVID-19: does a second test in quick succession add value?

Background/ObjectivesWe investigated if performing two lateral flow device (LFD) tests, LFD2 immediately after LFD1, could improve diagnostic sensitivity or specificity for detecting severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) antigen. Study DesignIndividuals aged ≥16 years attending UK community testing sites (February–May 2021) performed two successive LFD tests and provided a nose-and-throat sample for a polymerase chain reaction (PCR) test. Using the PCR result as the reference diagnosis, we assessed whether improvements could be achieved in sensitivity (by counting a positive result in either LFD as a positive overall test result) or specificity (by using LFD2 as confirmatory test). ResultsOverall, 2231 participants were included with 159 (7 %) having a positive PCR test. Of 2223 participants who completed both LFD tests, LFD results were highly concordant both with each other and with PCR tests (>97 %). The proportion of discord LFD results decreased significantly over the study period. Combined LFD usage achieved a sensitivity of 68.6 %, versus 67.1 % for either LFD individually. The specificity increased from 99.5 % to 99.8 % when using LFD2 as confirmatory test. Observed increases in sensitivity and specificity were not statistically significant. Void results were recorded for 31 (1.4 %) LFD1s, 19 (0.9 %) LFD2s and 6 (0.3 %) combined LFD tests. ConclusionsLFD tests were highly reproducible even when they were performed by untrained users following only written instructions and without supervision. While performing two LFD tests of the same type in quick succession marginally increased sensitivity or specificity, statistically significant improvements were not detected in our study.

Adaptation of trend analysis over a small-scale region for assessing climate change parameters

ABSTRACT Several natural and anthropogenic activities mainly escalate the demand for water and food and develop implications for their availability. Hence, it is necessary to analyse the natural and man-made changes for managing resources precisely. This study focuses on assessing the trends of climatic factors such as rainfall and temperature using the Mann–Kendall (MK) test and innovative trend analysis (ITA) for the agricultural cropping seasons. The findings revealed that a statistically insignificant increasing trend in rainfall is observed for all three cropping seasons (i.e.) Kuruvai/Samba (June–September), Thaladi/Navarai (October–January), and Sornavari (February–May), while the mean temperature shows a significantly increasing trend for all three cropping seasons. The results obtained using the MK test are compared with those of the ITA test to identify the reliable trend technique for climatic factor analysis of small regions. To manage the impacts of climate change and develop sustainable conditions in agriculture, this micro-level study assists the decision makers to prefer suitable trend analysis techniques and helps in identifying the climate change adaptation strategies for small regions. Also, this study is helpful for rural farmers to increase their adaptability conditions with regard to the climate change impacts as they are the frontline victims of climate change.

Evaluation of the climate models used by the IPCC based on the position of the ITCZ in the Equatorial South Atlantic

AbstractA number of the uncertainties in climate projections for the end of the century are due to the difficulty of general circulation models (GCMs) to represent large‐scale precipitating systems such as the Intertropical Convergence Zone (ITCZ) in the historical period. In this study, we evaluate the Coupled Model Intercomparison Project Phase 5 and 6 models based on the position of the ITCZ in the South Atlantic during the period in which it is climatologically further south (February–May). This period characterizes the rainy season of the Brazilian semiarid. The models were ranked according to two objective methods and validated through a qualitative analysis. The first method considered a success rate to evaluate the correct position of the areas with maximum precipitation and minimum pressure and meridional wind as representative of the mean position of the ITCZ. Among the 15 coupled GCMs analysed for each CMIP, those that best represented the position of the ITCZ were HADGEM.2‐AO, MIROC5 and CANESM2 from CMIP5 and CESM2 and MIROC6 from CMIP6. These models represented well the following characteristics of the ITCZ in February–May: maximum precipitation near the equator at the height of the coast of South America and with the wind convergence zone sloping north towards the African continent. The most common problem noticed in the other GCMs was to displace the ITCZ to the south of its observed mean position within the period February–May. Also, some GCMs presented a double ITCZ (GISS‐E2‐H, GDFL‐CM3 and IPSL‐CM5A‐LR from CMIP5 and INM‐CM5‐0 from CMIP6) following two high TSM cores. One GCM (ACCESS1‐3 from CMIP5) presented a relatively good performance, but the zone of greater precipitation was shifted to the east, being located in the centre of the Atlantic basin. Knowing how the GCMs represent the ITCZ is a criterion that must be considered when choosing the GCMs for climate change studies.

Near-Earth asteroids of cometary origin associated with the Virginid complex

The Virginid meteoroid streams produce a series of meteor showers active annually during February–May. A certain parent comet is not found but a related association of some showers with near-Earth asteroids was previously established and a cometary origin of these asteroids was suggested. We performed a new search for NEAs belonging to the Virginid asteroid–meteoroid complex. On the base of calculation of orbital evolution of a sample of NEAs and determination of theoretical features of related showers a search for observable active showers close to theoretically predicted ones was carried out. As a result, the predicted showers of 27 NEAs were identified with the showers of the Virginid complex. Revealed association points to a cometary nature of NEAs that are moving within the stream and may be considered as extinct fragments of a larger comet-progenitor of the Virginid asteroid–meteoroid complex.

Вл.С. Соловьев и «Новое время»: жанровое разнообразие философской публицистики

The traditional connection between philosophy, literature and journalism in Russian culture has led to increased interest in issues of social development, the meaning of human existence, morality and ethics on the pages of small periodicals, weekly and daily newspapers. Often judgments about new trends in literature (F. Bulgakov, N. Engelhardt, P. Weinberg, etc.) turned into independent philosophical and journalistic statements. The article updates the term “philosophical journalism” in the context of the turn of the 19th–20th centuries. The specificity and genre diversity of this phenomenon are revealed through the analysis of texts associated with the name of Vl. Solovyov in the newspaper “Novoye Vremya”. In this regard, special attention is paid to the controversy between S. Syromyatnikov and P. Parensov, which reflects not only the perception of the ideological and philosophical system of Vl. Solovyov by the authors of a popular periodical, but mainly one of the ways of forming philosophical journalism of the Silver Age. 510 issues of the newspaper “Novoye Vremya” (November–December 1902, February–December 1903, February–May 1904) were selected as sources.

Acting like a bot as a defiance of platform power: Examining YouTubers’ patterns of ‘inauthentic’ behaviour on Twitter during COVID-19

This article examines YouTubers’ ‘bot like’ behaviour on Twitter and conceptualises it as a defiance of platform power in delimiting the boundaries of ‘authenticity’. This entrepreneurial capture of ‘botness’ is understudied and deserves attention. We focus on a platform with a clear monetisation scheme, YouTube, and on patterns of ‘inauthentic’ behaviour in how people shared YouTube videos on Twitter during the early stages of the COVID-19 pandemic (February–May 2020). The global coronavirus crisis forced social media platforms to take unprecedented (mostly automated) steps to moderate content and to introduce new policies on ‘appropriate’ conduct, which we argue may have an impact on emerging social media content creators’ attempts to boost visibility online.

Quantifying effects of long-range transport of NO2 over Delhi using back trajectories and satellite data

Abstract. Exposure to air pollution is a leading public health risk factor in India, especially over densely populated Delhi and the surrounding Indo-Gangetic Plain. During the post-monsoon seasons, the prevailing north-westerly winds are known to influence aerosol pollution events in Delhi by advecting pollutants from agricultural fires as well as from local sources. Here we investigate the year-round impact of meteorology on gaseous nitrogen oxides (NOx=NO+NO2). We use bottom-up NOx emission inventories (anthropogenic and fire) and high-resolution satellite measurement based tropospheric column NO2 (TCNO2) data, from S5P aboard TROPOMI, alongside a back-trajectory model (ROTRAJ) to investigate the balance of local and external sources influencing air pollution changes in Delhi, with a focus on different emissions sectors. Our analysis shows that accumulated emissions (i.e. integrated along the trajectory path, allowing for chemical loss) are highest under westerly, north-westerly and northerly flow during pre-monsoon (February–May) and post-monsoon (October–February) seasons. According to this analysis, during the pre-monsoon season, the highest accumulated satellite TCNO2 trajectories come from the east and north-west of Delhi. TCNO2 is elevated within Delhi and the Indo-Gangetic Plain (IGP) to the east of city. The accumulated NOx emission trajectories indicate that the transport and industry sectors together account for more than 80 % of the total accumulated emissions, which are dominated by local sources (>70 %) under easterly winds and north-westerly winds. The high accumulated emissions estimated during the pre-monsoon season under north-westerly wind directions are likely to be driven by high NOx emissions locally and in nearby regions (since NOx lifetime is reduced and the boundary layer is relatively deeper in this season). During the post-monsoon season the highest accumulated satellite TCNO2 trajectories are advected from Punjab and Haryana, where satellite TCNO2 is elevated, indicating the potential for the long-range transport of agricultural burning emissions to Delhi. However, accumulated NOx emissions indicate local (70 %) emissions from the transport sector are the largest contributor to the total accumulated emissions. High local emissions, coupled with a relatively long NOx atmospheric lifetime and shallow boundary layer, aid the build-up of emissions locally and along the trajectory path. This indicates the possibility that fire emissions datasets may not capture emissions from agricultural waste burning in the north-west sufficiently to accurately quantify their influence on Delhi air quality (AQ). Analysis of daily ground-based NO2 observations indicates that high-pollution episodes (>90th percentile) occur predominantly in the post-monsoon season, and more than 75 % of high-pollution events are primarily caused by local sources. But there is also a considerable influence from non-local (30 %) emissions from the transport sector during the post-monsoon season. Overall, we find that in the post-monsoon season, there is substantial accumulation of high local NOx emissions from the transport sector (70 % of total emissions, 70 % local), alongside the import of NOx pollution into Delhi (30 % non-local). This work indicates that both high local NOx emissions from the transport sector and the advection of highly polluted air originating from outside Delhi are of concern for the population. As a result, air quality mitigation strategies need to be adopted not only in Delhi but in the surrounding regions to successfully control this issue. In addition, our analysis suggests that the largest benefits to Delhi NOx air quality would be seen with targeted reductions in emissions from the transport and agricultural waste burning sectors, particularly during the post-monsoon season.

Effect of human milk-based fortification in extremely preterm infants fed exclusively with breast milk: a randomised controlled trial

Mortality and severe morbidity remain high in extremely preterm infants. Human milk-based nutrient fortifiers may prevent serious complications and death. We aimed to investigate whether supplementation with human milk-based fortifier (HMBF), as compared to bovine milk-based fortifier (BMBF), reduced the incidence of the composite outcome of necrotising enterocolitis (NEC), sepsis, and mortality in extremely preterm infants exclusively fed human milk. In this multicentre, randomised controlled trial at 24 neonatal units in Sweden, extremely preterm infants born between gestational week 22+0 and 27+6 fed exclusively human breast milk (mother's own and/or donor milk), were randomly assigned (1:1) to receive targeted fortification with either HMBF or BMBF. Randomisation was conducted before the enteral feeds reached 100mL/kg/day, and was stratified by enrolment site, gestational age, singleton/twin, and sex. The allocation was concealed before inclusion, but after randomisation the study was not blinded for the clinical staff. For the NEC diagnosis, the study group was masked to an independent radiologist, and the final assessment of NEC and culture-proven sepsis was done by a blinded consensus panel review. The primary outcome was the composite of NEC stage II-III, culture-proven sepsis, and mortality from inclusion to discharge, no longer than postmenstrual week 44+0, in the intention-to-treat population (ClinicalTrials.gov, NCT03797157). Between February 21st, 2019, and May 21st, 2021, 229 neonates were randomly assigned (115 HMBF, 114 BMBF). After exclusion of one infant due to parents' withdrawal of consent, 228 infants were included in the intention-to-treat analysis. Of the 115 infants assigned to HMBF, 41 (35.7%) fulfilled the criteria of either NEC, sepsis, or death, compared with 39 (34.5%) of 113 infants assigned to BMBF (OR 1.05, 95% CI 0.61-1.81, p=0.86). Adverse events did not differ significantly between groups. Supplementation with HMBF, as compared with BMBF, did not reduce the incidence of the composite outcome of NEC, sepsis, or death. Our results do not support routine supplementation with HMBF as a nutritional strategy to prevent NEC, sepsis, or death in extremely preterm infants exclusively fed human milk. ALF grant, Prolacta Bioscience, Swedish Research Council, and Research Council for Southeast Sweden.

Implementing systematic melanoma risk assessment and risk-tailored surveillance in a skin cancer focussed dermatology clinic: A qualitative study of feasibility and acceptability to patients and clinic staff.

International bodies recommend that melanoma risk assessment should be integrated into skin cancer care provision, but evidence to support implementation is lacking. To explore the acceptability and feasibility of implementing personalised melanoma risk assessment and tailored patient education and skin surveillance within routine clinical care. This prospective qualitative implementation study was informed by the Theoretical Framework of Acceptability (TFA). Personalised, systematic melanoma risk assessment was implemented in the dermatology clinic at the Melanoma Institute Australia, Sydney, Australia February-May 2021. Pre- and post-implementation observations and semi-structured interviews with patients and staff were conducted (September 2020-March 2021). Observational notes and interview transcript data were analysed thematically using the TFA as a classifying framework. A total of 37 h of observations were made, and 29 patients and 12 clinic staff were interviewed. We found that the delivery of personalised melanoma risk estimates did not impact on patient flow through the clinic. Dermatologists reported that the personalised risk information enhanced their confidence in assessing patient risk and recommending tailored surveillance schedules. Most patients reported that the risk assessment and tailored information were a beneficial addition to their care. Among patients whose risk deviated from their expectations, some reported feeling worried, confused or mistrust in the risk information, including those at lower risk who were recommended to decrease surveillance frequency. It is feasible and acceptable to patients and clinic staff to calculate and deliver personalised melanoma risk information and tailored surveillance as part of routine clinical care within dermatology clinics.

Spatiotemporal Variability of Rainfall and Surface Salinity in the Eastern Pacific Fresh Pool: A Joint In Situ and Satellite Analysis During the SPURS‐2 Field Campaign

AbstractWe perform a statistical characterization of the 2016–2017 SPURS‐2 field campaign in situ data and coincident satellite data spanning 8°–12°N, 120°–130°W to quantify the spatial and temporal scales of variability of rain and near‐surface salinity in the Eastern Pacific Fresh Pool. Observations of rain rate and near‐surface to surface salinity are obtained from ships, moorings, autonomous platforms, and satellite remote sensing: Integrated Multi‐satellitE Retrievals for GPM (IMERG); and Soil Moisture Active Passive (NASA SMAP L3 V5). The integral length and time scales of rain and near‐surface salinity vary seasonally. In the rainy season (August–October) when the Intertropical Convergence Zone (ITCZ) migrates over the SPURS‐2 study site, the integral time scales of rain were about 30–60 min and those of near‐surface salinity were closer to that of the rain, 1–2 days, indicating forcing by rain. Meanwhile, the zonal integral length scale of in situ near‐surface salinity was twice as large as the meridional scale (50 vs. 20 km), consistent with the ITCZ's zonally‐propagating and ‐organized rain features. The magnitude and seasonal variation of the sea surface salinity integral time scale were not captured by SMAP since the rainy ITCZ‐period scales were smaller than SMAP resolution (70 km, 8‐day running mean). In the dry season (February–May), the in situ rain integral time scale reduced to less than 30 min while that of the near‐surface salinity increased to 1–5 days, the ocean mesoscale. IMERG overestimated the rain integral time scale by a factor of two to ten in both seasons.

Patient safety competence of nursing students and affecting factors

Objectives Patient safety competencies (PSC) of nursing students are, in particular, critical for quality and safe care. In the study, it was aimed to determine the PSC of nursing students and the factors affecting them. Methods This descriptive cross-sectional, relationship-seeking, and comparative study was conducted between February 1st and May 15th, 2022. The sample of the study consisted of 441 students studying at three universities. The data were collected online using the Sociodemographic Data Form and PSC Self-Evaluation Tool. Results In institutions where the study was conducted, students rated their level as above moderate in the PSC. Those aged 23 and over, and those who had received education on patient safety in patient care and drug administration were found to have a higher level of PSC. When the scores that all students obtained from the overall scale and its subscales were compared, it was determined that students of University C had statistically higher overall and subscale scores than those in the other two universities. Conclusion The assessment of PSC and the determination of the influencing variables may shed light on the regulations to be conducted in this regard. Patient safety courses should be included in the nursing curriculum as a compulsory course in two semesters at basic and advanced levels.

RISK QUOTIENT OF ZINC (Zn) AND CHROMIUM (Cr) LEVEL IN DUG WELL WATER IN THE COMMUNITY LIVING AROUND LANDFILL SITE

ABSTRACT Background: Zinc and chromium are heavy metals that can contaminate community-dug well water that is used by people around landfills, and can cause public health problems. This study aimed to analyze the risk level of zinc (Zn) and chromium (Cr) content in the dug well water of the community around Sukawinatan landfill site. Methods: This research was an observational study using a cross-sectional design with an environmental health risk analysis approach, It was conducted in February–May 2021. The sample was water from the dug wells of the community that lives around the Sukawinatan landfill. The examination of zinc and chromium level in dug well water was used the Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES) method. Results: Zinc and chromium level in community dug well water was found to range from 0.03 mg/l to 0.09 mg/l for zinc concentration and from 0.0030 mg/l to 0.04 mg/l for chromium concentration, respectively. The results of calculating the potential dose (intake) for the two metals are still below the dose reference value, and for calculating the level of risk, the result is less than 1, which can be interpreted as not being risky. Conclusion: Zinc and chromium level in the community's dug-well water around the landfill site was still below the quality standard. The potential dose (intake) and Risk Quotient were safe for the next few years.

Gambaran Burnout Akademik Mahasiswa Kedokteran Universitas Airlangga Angkatan 2021

A heavy academic burden puts medical students at a higher risk of experiencing academic burnout when compared to the general population. Academic burnout is a term used to describe emotional reactions in the form of fatigue, depersonalization, and decreased self-efficacy in students. This study aims to determine the description of academic burnout in Airlangga University medical students class of 2021. This study used an observational analytic study design with a cross-sectional research design to determine the description of academic burnout in medical study program students. This research was conducted at the Faculty of Medicine, Airlangga University in February–May 2023. Measurement of the level of academic burnout in students was carried out using an online school burnout inventory questionnaire via gform. Respondents who took part in the study amounted to 93 respondents with the majority of respondents 60 students (64.5%) were female and 33 students (35.5%) were male, the age of the respondents was 17-21 years. The most common category of academic burnout found in low category of academic burnout represented by 30 students (32.3%), 8 students (8.6%) with very low academic burnout, 28 students (30.1%) with medium academic burnout, 22 students (23.7%) with high academic burnout, and 5 students (5.4%) with very high academic burnout.

Source Apportionment of Atmospheric Aerosols in Kraków, Poland, before and during the COVID-19 Pandemic at a Traffic Monitoring Station

PM10 samples were collected at the Kraków air quality traffic monitoring station during two periods: February–May 2018 and February–June 2020. The PM10 concentrations dropped by 50% from 74 ± 29 µg/m3 to 37 ± 13 µg/m3 in 2018 and 2020, respectively. The elemental concentrations were determined by the energy-dispersive X-ray fluorescence (EDXRF) method, and the ion concentrations were determined by ion chromatography (IC). The concentration ratios in 2018 to 2020 were greater than 1.7 for the following elements: S, Cl, K, Zn, Br, and the ions SO42−, Na+, and NH4+. Similar concentrations were observed in 2018 and 2020 for the following chemical species: Ca, Ti, Mn, Ni, Rb, Sr, K+, Mg2+, Ca2+, and PO43−. The Cr concentration was higher in 2020 compared to 2018. Four source profiles were obtained from the PMF (Positive Matrix Factorization) modelling. The following sources were attributed to this: solid fuel combustion, secondary inorganic aerosols, traffic/industry/construction work, and soil. The contributions of solid fuel combustion and secondary inorganic aerosols (SIA) were significantly lower in February and March 2020 than in February and March 2018. The relative differences were in the range 70–98%. Traffic/industry/construction work contributions were 6% and 36% lower in March and May 2020 compared to the same months in 2018, respectively. Two factors affected the characteristics of PM10: one was the ban of using coal and wood for heating purposes introduced in Krakow in September 2019, observed mainly in February and March, and the COVID-19 pandemic that was observed mainly in April and May.

Social Networks, Use of Communication Technology, and Loneliness of Frail Older People Ageing in Place in Italy: The Impact of the COVID-19 Pandemic

The study explored how the lockdown, following the first wave of the COVID-19 pandemic in Italy (February–May 2020), impacted frail older people needing Long-Term Care (LTC) and living alone at home in Brescia and Ancona. These two urban cities were differently affected by the pandemic, with a major degree of infections and deaths in the former. In July–September 2020, a follow-up study of the IN-AGE research project (2019) was carried out in both cities, involving 41 older respondents by telephone, to detect the impact of the health emergency on their social networks, use of communication technology, social isolation, and loneliness. Findings showed that the use of communication tools was overall expanded, and seniors increased telephone (TEL) contacts, especially in Ancona. In both cities, fears for the infection emerged too, and mainly in Ancona than Brescia, several cases of worsened perceived loneliness were detected. Despite the exploratory/descriptive nature of the study, with a not-representative sample of the population and notwithstanding some differences among cities, the findings stressed the risk of isolation and loneliness for seniors living alone. This risk was buffered by the use of communication technology during the lockdown, but more interventions allowing sustainable healthy ageing (HA) in place and enhancing healthy behaviours, especially in emergency situations, are needed.

Youth and Young Adult Blunt Use Predicts Progression to Other Nicotine Product Use in the United States

Background Little cigars or cigarillos (LCCs) are frequently modified to smoke cannabis (“blunts”) by youth and young adults. This study investigated whether young blunt users who are otherwise nicotine-naïve are more likely to initiate other tobacco products compared to never blunt users. Methods and Materials Data were from four waves of the Truth Longitudinal Cohort (TLC), a national probability-based sample of youth and young adults (aged 15-24 years) in the United States (Wave 1: January—April 2017; Wave 2: February—May 2018; Wave 3: February—May 2019; Wave 4: September—December 2019). The sample was restricted to nicotine naïve respondents at Wave 1 with possible ever use of blunts (N = 5,284). Logistic regression analyses tested whether ever blunt use at Wave 1 predicted initiation of nicotine products by Wave 4, controlling for established risk factors. Results Compared to never-blunt users, ever users of blunts at Wave 1 had significantly higher odds of ever using cigars (OR: 4.74; 95% CI: 1.80-12.47; p = 0.002), e-cigarettes (OR: 4.66; 95% CI: 2.42-8.95; p < 0.001), cigarettes (OR: 3.02; 95% CI: 1.17-7.84, p = 0.023), or hookah (OR: 3.47; 95% CI: 1.07-11.29, p = 0.039) by Wave 4. Cannabis (never blunt) use by Wave 1 predicted ever use of e-cigarettes (OR: 3.45, 95% CI: 2.38-5.02, p < 0.001), cigarettes (OR: 3.81; 95% CI: 2.26-6.43, p < 0.001), or hookah (OR: 2.13; 95% CI: 1.12-4.05, p = 0.021) by Wave 4. Discussion Blunts are a point of nicotine initiation that places users at increased risk of progression to cigars, while the same relationship was not found for cannabis alone.