Search Results (171)

Dairy goat farming is a niche but relevant livestock system in alpine regions, yet its economic viability and environmental performance remain poorly quantified. This study assessed the relationship between profitability and environmental impacts in dairy goat farms in South Tyrol (Northern Italy). Data were collected from ten alpine dairy goat farms through on-farm interviews and accounting records and exploratorily analyzed using full-cost accounting and life cycle assessment (LCA). Given the small and purposive sample, all findings should be interpreted as preliminary and hypothesis-generating rather than statistically representative. Environmental impacts were evaluated from cradle to farm gate using two functional units: 1 kg of fat- and protein-corrected milk (FPCM) and 1 ha of agricultural land. Farm income per kg FPCM was highly variable, ranging from −€1.10 to €2.50, and depended strongly on herd size and subsidies. Average global warming potential was 2.96 ± 1.18 kg CO₂ eq per kg FPCM, but farm rankings changed when impacts were expressed per hectare. Pearson correlation and linear regression analyses showed a significant positive relationship between income and greenhouse gas emissions (r = 0.80, p < 0.05), indicating a trade-off between economic and environmental performance. Enteric methane and energy use were the main contributors to climate impacts. Improving productivity per animal rather than expanding herd size appears to be the most promising strategy to enhance profitability while limiting environmental burdens. Full article

This article investigates food poverty in South Tyrol, a generally affluent region, to understand how socio-economic changes—particularly the COVID-19 pandemic—have reshaped patterns of vulnerability within local food systems and challenged social sustainability. Using a qualitative approach, the study draws on interviews with institutional and third-sector actors, adults involved in local food networks, and focus groups to capture diverse perspectives on access to food. The findings reveal a coexistence of overall economic prosperity with hidden forms of food insecurity and unequal access to healthy and sustainable food. Although official statistics report relatively low levels of childhood overweight and obesity, certain groups—including elderly individuals, migrant families, and low-income households—face increasing challenges due to rising living costs and constrained access to nutritious food. The pandemic functioned as a temporary stressor that exposed pre-existing fragilities while also encouraging adaptive responses within local welfare systems. In particular, alternative food networks such as solidarity purchasing groups and emerging food cooperatives play a complementary role by promoting food autonomy, social support, and dignity-based assistance. These initiatives highlight forms of need not always captured by traditional welfare mechanisms. The study concludes that addressing food poverty in high-income contexts requires integrated, place-based strategies that combine social inclusion, nutritional education, intersectoral governance, and community-driven food practices. Full article

Background/Objectives: Artificial intelligence (AI) is integrated into diagnostic, therapeutic, administrative, and communicative healthcare domains in Italy under regulations requiring human oversight. Empirical evidence on AI attitudes, acceptance, and perceptions in Italian healthcare is rapidly accumulating but not systematically mapped. This scoping review aimed to (i) map empirical evidence on AI attitudes, acceptance, and perceptions in Italy by population and domain; (ii) identify measurement instruments used in studies and their origins; and (iii) characterize determinants, themes, and methodological gaps in the Italian evidence base. Methods: This review used Joanna Briggs Institute methodology, reported via PRISMA-ScR (protocol Open Science Framework doi: 10.17605/OSF.IO/TZRVF). PubMed and Embase were searched on 27 April 2026 from January 2018 in English, Italian, or German, combining controlled vocabulary and free-text terms across AI, attitudes-acceptance, and healthcare delivery, with an Italian-context qualifier; a complementary AI-assisted semantic search (Consensus Pro) was conducted to validate retrieval completeness. Eligibility criteria used the Population–Concept–Context mnemonic. Results: Of 1510 unique records screened, 35 empirical studies were retained, comprising 7 studies of Italian patients and the general population, 22 studies of healthcare professionals, 3 psychometric validation studies of AI-acceptance instruments, 1 mixed-population study, and 2 international comparator studies with substantial Italian sub-samples. Acceptance was consistently positive but conditional on physician oversight, training, and regulatory clarity. A recurrent optimism–knowledge gap and an absence of probabilistic, population-representative evidence were identified as principal gaps. Conclusions: Italian evidence on AI attitudes is expanding but methodologically narrow. Three Italian-validated acceptance instruments are now available. Population-representative, multilingual, and longitudinal evidence is required. Full article

Background: Gender differences in adolescent mental health are well documented; however, the extent to which modifiable behavioral and psychosocial factors account for the excess of mental health problems in females remains insufficiently quantified. Methods: Data from the 2025 Corona and Psyche South Tyrol (COP-S) survey comprised a base sample of 2428 adolescents aged 11–19 years (51.4% males) with valid self-reported data. Multivariable regression analyses were conducted on 1448–1603 adolescents (depending on the outcome) who provided complete responses to the relevant predictor and outcome measures. Gender differences in depressive symptom scores (PHQ-2), generalized anxiety symptom scores (SCARED-GAD), and emotional/behavioral difficulties (SDQ) were examined using Mann–Whitney U and chi-square tests. Multivariable linear regression models were used to assess the associations between mental health outcomes and the ten predictors. Gender effects were quantified by comparing standardized regression coefficients from unadjusted and adjusted models. Results: Female adolescents reported higher generalized anxiety symptoms (median 6 vs. 4; rank-biserial r = 0.24), depressive symptoms (r = 0.13), and emotional/behavioral (r = 0.08) scores than male adolescents. School stress, problematic Internet use, and sleep-onset difficulties were the factors most strongly associated with all three outcomes (all p < 0.001). After multivariable adjustment, gender remained significantly associated with generalized anxiety symptoms (β = 0.18) and depressive scores (β = 0.09) but no longer reached significance for emotional/behavioral scores (β = 0.04, p = 0.078). The attenuation of the gender effect ranged from 25.3% for generalized anxiety symptoms to 37.1% for depressive symptoms and 58.5% for emotional/behavioral difficulties. Conclusions: Gender differences in adolescent mental health were substantially attenuated after adjustment for modifiable behavioral and psychosocial factors, with the gender difference in emotional/behavioral scores no longer statistically significant after adjustment. Persistent gender disparities in generalized anxiety symptoms suggest that mechanisms beyond the measured behavioral correlates may contribute to this gender difference and warrant further investigation. Full article

Background/Objectives: Adolescence is a critical period in terms of mental health, with the family environment being a key determinant. Parental resilience, the ability to adapt and recover from stress, is a parental psychological resource that may shape the family context of adolescent development but population-based evidence is scarce. This study examined if parental resilience is linked to adolescent mental well-being, mediated by perceived family support, and whether it varies by sex or developmental stage. Methods: This population-based cross-sectional study analyzed data from 2004 adolescents aged 11–19 years from the COP-S Wave 4 survey in Italy. Parental resilience was assessed using a Brief Resilience Scale. Perceived social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS), and mental well-being was assessed across five outcomes: health-related quality of life (KIDSCREEN-10), emotional difficulties (SDQ), depressive symptoms (PHQ-2), anxiety symptoms (SCARED), and psychosomatic complaints (HBSC-SCL). Regression models were used to examine associations, and mediation analyses were conducted using the PROCESS macro with bootstrap confidence intervals (5000 resamples). Results: Parental resilience was independently associated with better health-related quality of life, lower emotional and behavioral difficulties, fewer depressive and anxiety symptoms, and fewer psychosomatic complaints, after adjusting for adolescent social support and demographics. Parental resilience showed weak positive associations with the MSPSS subscales; the hypothesis of the strongest family support association was unsupported. The analyses did not support family support as a mediator and no moderation by sex or development was found. Conclusions: In this population-based sample, parental resilience was associated with multiple dimensions of adolescent mental well-being that were distinct from adolescents’ perceptions of social support. These findings suggest that strengthening parental resilience may promote adolescent mental health at the population level. Full article

Background/Objectives: Franz Tappeiner (1816–1902) is often celebrated as a pioneer of alpine medicine and the founder of Tappeiner Promenade in Meran (South Tyrol, Italy). However, his legacy extends far beyond the scenic infrastructure, encompassing a comprehensive vision of physical activity as a public health intervention. His multidisciplinary practice anticipated the principles of contemporary rehabilitation, preventive medicine, and climate-sensitive public health. Methods: This historical public health analysis, combining biographical, contextual, and material–spatial approaches, reinterprets Tappeiner’s writings, institutional engagements, and civic projects through the lens of modern public health frameworks. Drawing on primary materials (e.g., published articles, autobiographical fragments, and commemorative texts) and recent evidence from rehabilitation and environmental health research, these contributions were contextualized. Results: Tappeiner’s early focus on infectious disease prevention (e.g., cholera and tuberculosis) transitioned into a strategic emphasis on recovery and behavioral therapy through environmental design. The walking therapy model of Max Joseph Oertel, locally realized in the Tappeiner Promenade, prefigured modern concepts such as structured green rehabilitation, walkability, and urban-health citizenship. His systematic integration of graded walking into civic infrastructure represents one of the earliest documented examples of embedding physical activity promotion at the population level. He contributed substantial personal funds to the path’s construction, embedding therapeutic gradients, curating vegetation, and promoting inclusive design to support convalescence. Contemporary research supports the intuition that green, low- to moderate-intensity walking improves cardiometabolic health, psychological well-being, and functional capacity. Moreover, his integrative ethos, merging clinical medicine, civic ethics, and spatial intervention, parallels contemporary eco-social models of public health. Conclusions: Franz Tappeiner’s career exemplifies a still-relevant model of physician leadership that is empirically grounded, socially accountable, and ecologically attuned, with physical activity promotion embedded as a central element of his public health vision. His work invites reflection on how medical professionals can shape not only individual care but also urban environments and collective health futures. Full article

Background/Objectives: Primary care faces transformation due to workforce shortages and reform. Italy’s Decree 77/2022 promotes Community Centers and extended care, while postgraduate training in general practice involves early clinical responsibility. In South Tyrol, trainees assume significant patient care duties early in a three-year program. This review examines traditional apprenticeship-based training and explores system-based supervision and AI as strategies for improving quality and safety. Methods: A narrative review synthesized the literature and policy on postgraduate general practice education, supervised autonomy, and AI tools in primary care. Searches used the PubMed and Consensus platforms, focusing on Italian primary care reform and South Tyrol. Evidence was analyzed using SANRA guidance. Results: Evidence consistently indicates that training quality depends less on individual supervisors and more on structured, system-based supervision frameworks, clear entrustment criteria, and supportive organizational contexts. Early supervised clinical autonomy in community-based primary care settings can accelerate competency development without compromising the quality of care when robust supervision and team structures are in place. AI-supported educational tools have the potential to augment feedback, assessment, and learning analytics, especially in settings with limited supervisory capacity; however, current evidence supports their use only as adjuncts to human supervision. Conclusions: Evidence supports system-based, competency-oriented supervision models over traditional apprenticeships in settings characterized by workforce constraints and distributed training sites. Integrated general-practitioner-led primary care settings offer favorable learning environments for postgraduate training, while service-oriented community hubs need careful governance as training sites. Though AI may support supervision, professional oversight remains essential for quality and safety. Full article

Background/Objectives: Parental health literacy is linked to child health outcomes, but the evidence relies mainly on parent proxy reports. This study examined the association between parental health literacy and proxy-reported mental health outcomes in children aged 6–10 years and assessed whether these associations reflect general reporting patterns. Methods: This study is a secondary analysis of data derived from a population-based cross-sectional survey conducted in South Tyrol, Italy, including proxy data from 3183 children aged 6–10 years. Parental health literacy was categorized as inadequate, problematic, adequate, or missing/insufficient. The outcomes included emotional and behavioral difficulties, psychosomatic complaints, and perceived social support. Linear regression models were estimated for each outcome, adjusted for children’s age, gender, parental age, education, family affluence, migration background, residential setting, and questionnaire language. Selective missingness and insufficient completion of parental health literacy data were examined using logistic regression analysis. Sensitivity analyses were used to adjust the mental health models for social support. Results: Higher parental health literacy was associated with lower emotional and behavioral difficulties (B = −1.40, 95% confidence interval [CI] −1.79 to −1.01), higher psychosomatic complaint scores (B = 0.61, 95% CI 0.40 to 0.081), and higher perceived social support (B = 0.14, 95% CI 0.02 to 0.26). The effect sizes were small. Missing or insufficient parental health literacy data showed social patterns by parental education and age, whereas no systematic predictors of early disengagement were observed among parents who partially completed the health literacy instrument. Sensitivity analyses attenuated but did not eliminate the associations between parental health literacy and child mental health outcomes. Conclusions: Parental health literacy is associated with proxy-reported psychosocial outcomes in children aged 6–10 years. The consistency of the effects across outcomes suggests that parental health literacy may influence how parents report child functioning, underscoring the importance of considering informant characteristics in proxy-based research. Full article

Background/Objectives: Socioeconomic stressors, such as financial strain, rising living costs, and perceived price burden, have gained relevance in the post-pandemic period and may adversely affect adolescent mental health. This study examined the association between subjective financial stress and symptoms of depression, anxiety, and emotional/behavioral difficulties among adolescents in Northern Italy. Methods: Data were obtained from the 2025 Corona and Psyche South Tyrol (COP-S) population survey. A total of 2554 adolescents aged 11–19 years and their parents participated; 1598 adolescents provided complete data for analyses of socioeconomic stressors (parent-reported Family Affluence Scale III, adolescent self-reported and parent proxy and self-reported burden due to price increases). Mental health outcomes included depressive symptoms (PHQ-2), generalized anxiety (SCARED-GAD), and emotional/behavioral difficulties (SDQ). Associations were assessed using chi-square tests, Kendall’s tau correlations, and two-factor ANOVA models. Results: Elevated depressive symptoms were present in 10.7% of adolescents, emotional/behavioral difficulties in 13.9%, and anxiety symptoms in 27.9% of adolescents. Female adolescents consistently showed higher symptom levels in all domains. Self-reported financial burden was the strongest and most consistent correlate of mental health problems, demonstrating small-to-moderate positive correlations with depressive symptoms (τ = 0.20, p < 0.001), emotional/behavioral difficulties (τ = 0.14, p < 0.001), and anxiety (τ = 0.25, p < 0.001). Parent-reported burden showed weaker and less consistent associations, and the Family Affluence Scale III was not significantly related to any of the mental health outcomes. ANOVA models indicated that adolescents’ own perception of financial burden significantly predicted anxiety levels in both age groups (11–14 and 15–19 years), whereas discrepancies between adolescent and parent burden perceptions were particularly relevant among younger adolescents. Conclusions: In this affluent European region, subjective financial strain, especially adolescents’ perception of burden due to rising prices, is a stronger determinant of depressive symptoms, anxiety, and psychosocial difficulties than parental burden reports or structural affluence indicators. Adolescents, especially females, appear to be particularly vulnerable. These findings underscore the importance of addressing subjective financial stress in adolescent mental health and public health strategies. Full article

Background/Objectives: Postoperative Delirium (POD) is a frequent complication in older patients undergoing elective surgery. Although multicomponent interventions are effective, deficits in interdisciplinary communication and intersectoral collaboration persist. This study developed and evaluated the “Geriatric Delirium Pass (GeDePa)”, a paper-based tool to systematically document risk factors for POD across care settings. Methods: A multi-method design was applied, comprising (i) a structured literature review, (ii) semi-structured expert interviews, and (iii) a standardized online survey utilizing the RAND/UCLA Appropriateness Method (RAM). A total of 21 healthcare professionals (general practitioners, geriatricians, anaesthetists, surgeons, and nurses) were recruited from Salzburg, Austria, and South Tyrol, Italy (2023–2024). Results: Healthcare professionals confirmed the GeDePa’s practical applicability for early POD risk detection across care settings. The expert rating using the RAM Disagreement Index (DI) method deemed all 45 risk factors as sufficiently relevant and, with the exemption of two risk factors (alcohol use, intraoperative complications), feasible. A detailed analysis provided a more differentiated picture, with full consensus reached for only 18 items. Several factors with uncertain consensus (e.g., cognitive impairment and polypharmacy) were retained based on strong evidence in the literature. Others were excluded despite high ratings if they were considered redundant or impractical (e.g., detailed intraoperative complications). In total, 38 of the 45 risk factors were retained. Conclusions: The GeDePa is a feasible and relevant tool for structured delirium risk assessment and enhancing interdisciplinary communication between primary and hospital care. The finalized German and Italian versions are now available and will undergo further testing and implementation in clinical practice. Full article

Out-of-hospital cardiac arrest (OHCA) is a major cause of death during mountain activities in the Alpine regions. Due to the time-critical nature of these emergencies and the logistical challenges of remote terrain, emergency medical services (EMS) are investigating the use of unmanned aerial vehicles (UAVs) to deliver automated external defibrillators (AEDs). This study presents a geospatial strategy for optimising AED delivery by UAVs in mountainous environments, using the Province of South Tyrol, Italy, as a model region. A Geographic Information System (GIS) framework was developed to identify suitable sites for vertical drone ports based on terrain, infrastructure, and regulatory constraints. A Low-Altitude-Flight Elevation Model (LAFEM) was implemented to generate obstacle-avoiding, regulation-compliant 3D flight paths using least-cost path analysis. The results identified 542 potential vertical-port locations, covering approximately 49% of South Tyrol within ten minutes of flight, and demonstrated significant time savings for AED delivery in field tests compared with manual and Euclidean routing. These findings show that integrating GIS-based vertical-port placement and terrain-adaptive UAV routing can substantially improve AED accessibility and response times in mountainous regions. The LAFEM model aligns with U-space airspace regulations and supports safe, automated AED deployment for improved outcomes in OHCA emergencies. Full article

Congenital patellar luxation (PL) and cranial cruciate ligament rupture (CCLR) are among the most prevalent hereditary musculoskeletal disorders in dogs. Despite their frequency, the microstructural alterations in the stifle joint capsule associated with these conditions remain poorly understood. This study aimed to characterize histomorphological changes in the joint capsule of dogs affected by PL and/or CCLR. Capsule samples were collected from dogs undergoing corrective surgery for PL or CCLR, while control tissue was obtained from dogs with unrelated orthopedic conditions. Histological evaluation assessed capsule thickness, the organization of its layers (stratum fibrosum, stratum subsynoviale, and stratum synoviale), synovial cell number, and villous or plicae formation. Associations with disease type, chronicity, sex, age, breed, and weight were analyzed. Dogs with PL and CCLR exhibited increased superficial synovial cell layers compared to controls, whereas chronic cases showed reduced villous formation (SEF = 2.46). Absence or marked reduction of the stratum subsynoviale correlated with PL and prolonged lameness. In PL cases, the stratum synoviale was frequently absent, whereas CCLR cases exhibited an increase in overall capsular thickness. These findings reveal distinct histomorphological remodeling in PL and CCLR, suggesting that chronic instability drives degenerative changes. Understanding these alterations may aid in early diagnosis, improve treatment strategies, and inform breeding programs targeting joint stability in predisposed breeds. Full article

Background/Objectives: Eating disorders (EDs) in adolescents are increasingly prevalent. In South Tyrol, a bilingual region in Northern Italy, not only actual gender and age prevalences can be compared to screening rates, but even the comparability of screening tools across languages can be examined. Methods: A cross-sectional analysis integrated clinical registry data with representative, online school-recruited adolescents (11 to 17) self-reports. 166 clinically diagnosed cases and 1465 screened adolescents (1246 German, 219 Italian), were examined. The SCOFF questionnaire (cutoff ≥ 2 for German and ≥3 for Italian), body mass index, body image perception, psychosocial and lifestyle indicators in proxy and self-reports were examined using descriptive statistics and logistic regression. Results: The clinical dataset for 2024 has a prevalence rate of 0.4%. The SCOFF screening tool identified symptomatic cases in 10.6%, and an age-increasing trend among females. The overall SCOFF-prevalence did not differ between language versions, although responses to individual items varied significantly. Predictors of ED included body image, psychosomatic complaints, problematic social media use, and low social support, with differences between genders. Parents tended to underestimate their children’s perception of being “too thick.” Conclusions: In early adolescence, preventive strategies are needed and targeted interventions in late adolescence. For early detection and intervention, gender-sensitive prevention and active parental involvement is needed. The SCOFF questionnaire demonstrates utility across both languages, but bilingual comparison highlights the need for culturally adapted tools and cross-language validation. Full article

Problematic Internet use is an emerging concern in adolescent mental health and is closely linked to psychological distress and emotional regulation. This cross-sectional study analyzed self-reported data from 1550 adolescents aged 11–19 years in South Tyrol, a linguistically and culturally diverse region in Northern Italy. Problematic Internet use was measured using the validated Generalized Problematic Internet Use Scale 2 (GPIUS-2), along with standardized instruments for depressive symptoms (PHQ-2) and anxiety (SCARED-GAD). Multivariable regression analysis revealed that depression and anxiety symptoms were the strongest independent predictors of higher GPIUS-2 scores. In contrast, demographic factors such as gender, family language, urbanization, migration background, and parental education were not significantly associated with PIU. Modest associations were observed between GPIUS-2 scores and both perceived economic burden and parental use of digital control tools. Perceived family support showed a small protective effect. These findings underscore the central role of emotional vulnerability in adolescent PIU and suggest that interventions should focus on supporting mental health and adaptive coping rather than solely targeting screen time or structural family characteristics. Full article

Background/Objectives: Engaging patients, caregivers, and community groups in health research priority-setting ensures that research agendas reflect genuine needs and enhance patient-centered care. Regions with cultural and linguistic diversity, such as South Tyrol in northern Italy, face challenges in achieving fair representation. This study aimed to identify health services research priorities in South Tyrol, a culturally and linguistically diverse region in Italy, through a bilingual participatory survey involving general practitioners (GPs) and patient and social interest organizations (PSIOs). Methods: A cross-sectional online survey (August–September 2025) was conducted among invited PSIOs (n = 64) and regional GPs (n = 290). A bilingual, self-developed questionnaire assessed organizational characteristics, priority ratings for predefined topics, experiences with research participation, and preferred participation modes. The data were analyzed descriptively. Group comparisons were performed using the Mann–Whitney U and chi-square tests with effect size calculation. Associations were examined using Spearman’s correlation. Free-text responses were thematically content-coded. Results: Ninety-five responses were analyzed, including nine general practitioners (9.5%) and 86 participants (90.5%) from patient and social interest organizations, of whom 27 (28.4%) held leadership or board positions. Across all groups, the highest-rated research priorities included children and adolescent mental health, palliative and end-of-life care, and continuity of primary care. Willingness to participate in future research was expressed by 38% of the respondents, with an additional 52% indicating conditional interest. Online surveys were the most preferred mode of participation, followed by workshops and board meetings. Conclusions: Participatory bilingual approaches are feasible in South Tyrol and highlight priorities that are highly relevant for patient-centered health services. Future initiatives should strengthen the structures for research participation, enhance GP engagement, and link identified priorities to research funding and policy action. Full article