bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and economic burden of major comorbidities in multiple sclerosis
Authors: Ponzio M , Borreli P , Monti MC , Amicizia D , Perotti P , Silva S , Ansaldi F , Mallucci G , Bergamaschi R , Montomoli C 
Published: October 2021

Abstract

Background
Although comorbidity is important in Multiple Sclerosis (MS), few validated methods for its assessment exist. Our aim is to estimate the prevalence and economic burden of major comorbidities in people with MS (pwMS) in two Northern Italy study areas (Pavia, PV and Genoa, GE), using routinely collected healthcare data.

Methods
We estimated prevalence of comorbid conditions in pwMS in the period 2012-2017. Anxiety, depression, cancer, leukemia, lymphoma, hypertension, heart disease, cerebrovascular diseases, vascular diseases, ischemic stroke, hyperlipidaemia, bronchopathy, diabetes, gastropathy, gastric ulcer, autoimmune diseases, chronic renal failure, connective tissue diseases and HIV/AIDS were identified by a specific algorithm currently used for monitoring prevalence of chronic diseases by Italian Local Health Authorities (BDA system). Direct healthcare costs were defined by regional and governmental contracts; the aggregated healthcare expenditure was compared between pwMS with/without comorbidities.

Results
The MS cases identified were 2983, 2035 in GE and 948 in PV. 55.6% of pwMS had at least one comorbidity (50.6% GE and 66.5% PV, p &lt; 0.001). The most prevalent comorbidities were: depression (32.9%), hypertension (18.0%), cancer (10.9%), heart disease (7.8%), cerebrovascular diseases (7.0%) and hyperlipidaemia (6.1%). Comorbidity ranking was similar in the two provinces, although we observed significant differences considering specific prevalence rates. The mean direct healthcare costs of MS were substantially higher for individuals with comorbidity (36,463 €vs 26,284 €, p &lt; 0.001), showing 39% of additive costs.

Conclusions
Our study provides evidence of the burden of comorbidities in MS. Comorbidity is common in MS and produce additive costs.

Key messages
The use of administrative data for tracking the MS comorbidity could help knowledge gaps. When additivity situation is involved, preventive policies could lead to monetary savings.
Economic hardship from the great recession and long-term changes in depression and quality of life
Authors: Bonaccio M , Costanzo S , Di Castelnuovo A , Gialluisi A , Bracone F , Persichillo M , Cerletti C , Donati MB , de Gaetano G , Iacoviello L 
Published: October 2021

Abstract

Background
Economic downturns may have detrimental effects on mental health. We investigated whether economic hardship resulting from the late 2000s great recession is associated with long-term changes in mental health over 12.8 years of follow up.

Methods
We analysed data on 2,001 participants from the CASSIOPEA Study, a sub-cohort of the larger Moli-sani study (2005-2010, Italy), who were re-examined between 2017-2020 (mean age at baseline 53±9 y; 55% women). Economic hardship possibly experienced since participants' first visit was assessed retrospectively by a questionnaire scoring the following domains: 1) change in employment status; 2) financial hardship and 3) financial hardship for health expenditures. An Economic Hardship Score (EHS) was computed (range 0-14), with highest values indicating higher economic hardship. Mental health was reflected by measurements of depression (Patients' Health Questionnaire; PHQ-2; higher values indicating more depressive symptoms) and mental quality of life assessed by the 36-Item Short Form Health Survey (increased values indicating improved quality of life). In this analysis, the exposure was economic hardship and the outcomes were changes in depression and mental quality of life measured after a 12.8-y period. Multivariable linear regression analysis (95%CI) was used.

Results
Mean PHQ-2 and SF36 changes over 12.8 years were -0.08 (±1.28) and 0.47 (±9.90), respectively.
In a multivariable-adjusted analysis including duration of follow-up, relevant sociodemographic factors, lifestyles, clinical factors and related life course changes, 1-point increment in EHS was associated with increased depression (β = 0.041; 95%CI 0.022, 0.060) and lower mental quality of life (β=-0.037; 95%CI -0.052, -0.021).

Conclusions
Economic hardship resulting from the great recession in late 2000s was associated with a deterioration of mental health, as reflected by increased depression levels and reduced mental quality of life.

Key messages
Economic hardship resulting from the recession in late 2000s is associated with a deterioration of mental health. These findings support the notion that economic downturns may have detrimental effects on mental health and support the need for adequate strategies for more vulnerable groups.
Monitoring of SARS-CoV 2 on primary production and manually processed foods in Northern Italy
Authors: Bertasi B , Galuppini E , Tilola M , Mangeri L , Meletti F , Righi F , Scarazzato A , Pavoni E , Losio MN 
Published: October 2021

Abstract

Background
SARS CoV2 pandemic has generated interest in research of virus spread sources, apart from human contagion. In particular different studies are performed to understand surfaces involvement; during the epidemic event, different types of studies on surfaces have been performed. However, there is little information regarding the presence of the virus in food; wastewater contamination and poor hygiene practices could be the sources of viral contamination in handled food products. The aim of this work was to analyze different types of food for Sars CoV 2 presence.

Methods
390 samples of molluscs, 353 vegetables, 10 meat, 72 water, 169 berries, 16 seafood products and ready-to-eat dishes were analysed (2020-2021). Samples were selected from those provided for routine analysis during the pandemic period. The preparation was done based on ISO 15216-2 indications, followed by extraction with Nuclisense®Minimag® system; real-time PCR was applied to detect the Sars CoV2 virus Open Reading Frame 1ab, with two different master mixes.

Results
All samples tested were negative for ORF1ab detection. Many hypothesis can be made about negative Results: it could be possible that contamination levels in water, or on surfaces in contact with food, are too low to generate a detection signal; again, handling practices may be sufficient to avoid the transmission of the virus to food. Otherwise, the selected genetic target and the Real-time PCR performed, could have been not so efficient in detecting virus as expected.

Conclusions
In this preliminary work, food does not seem to be a substrate for Sars CoV2 contamination; other food categories or transformation/production processes could be investigated to confirm the obtained results. Also, different targets and amplification systems would have to be evaluated to verify the rule of foodstuffs as Sars CoV2 vehicles.

Key messages
Primary production and manual processed food don't seem to be at risk for SARS CoV2 contamination. Food has not been identified as a source of Sars CoV2 spreading.
Portrait of Hungtinton’s Disease in the Valencian Region: a cross-sectional study
Authors: Cavero Carbonell C , Páramo-Rodríguez L , Moreno-Marro S , Barrachina-Bonet L , De la Natividad M , Guardiola-Vilarroig S , Zurriaga O 
Published: October 2021

Abstract

Background
Huntington Disease (HD) is a rare neurodegenerative disorder of the central nervous system characterized by involuntary choreic movements and behavioural/psychiatric disorders, which compromises the quality of life.

Objective
To identify the distribution of HD by sex, age and province in the Valencian Region (VR) and to determine its prevalence and mortality rate.

Methods
A cross-sectional epidemiological study was performed. HD's cases between 2010-2018 were identified from the Rare Disease Information System of the VR by selecting codes 333.4 (ICD9) and G10 (ICD10). A descriptive analysis was performed by country of birth, province of residence and sex. Median ages at diagnosis and at death, with interquartile range (IQR), and prevalence and mortality rate, with 95% confidence intervals (95%CI), were obtained.

Results
225 cases were identified: 50.2% women, 52.0% residents in the southernmost province, 92.9% born in Spain and 68.9% confirmed by clinical manifestations. Median age at diagnosis was 54.1 years (IQR:41.1-66.1): 54.7 (IQR:41.2-66.1) in men and 53.0 (IQR:40.5-65.8) in women. Prevalence in 2018 was 2.0/100000 inhabitants (95%CI:0.4-2.4), being higher in women [2.2 (95%CI:0.3-2.8)] than in men [1.8 (95%CI:0.3-2.3)]. Even an increasing trend was observed, significant differences weren't found. 49.8% of cases died during the study, being 51.8% men. The median age at death was 62.7 years (IQR:51.1-74.2), 61.1 (IQR:48.7-72.5) in men and 66.6 (IQR:53.3-76.8) in women. The mortality rate in 2018 in both sexes was 0.3/100000 inhabitants (95%CI:0.3-2.3), significant differences weren't found.

Conclusions
Most of confirmations at registry level were based on clinical manifestations, reinforcing that HD has a characteristic pattern of symptoms although most are unspecific. The slight difference between sexes in the median age of diagnosis was significantly increased in the age of death, with men being the group with the highest mortality and an earlier death.

Key messages
In the Valencian Region of Spain, men with Huntington Disease have a higher mortality rate and a lower median age at death (5.5 years earlier) than women. There is a pattern of symptoms which is characteristic of Huntington Disease, although most of them are unspecific.
Assessment of COVID-19 pandemic impact on guaranteeing food security in local school catering
Authors: Barocco G , Maggiore A , Calabretti A , Bogoni P , Longo T 
Published: October 2021

Abstract

Background
The Italian National Institute of Statistics (ISTAT) highlights that in 2020 10% of the Italian population could not afford an adequate meal every 2 days. Families with several children were more affected, for these children school meals represented the only access to a healthy diet. The European Commission Farm to Fork Strategy, concerning the COVID-19 pandemic (CP), underlines the need to act to ensure access to a sufficient supply of affordable food for all. In the Province of Trieste (PT) over 90% of pupils eat in school canteens (12,000 meals per day). The aims of the project were to verify the impact of CP on the food security of public school canteens (PSC) and determine any Nutritional Critical Points (NCPs) - Corrective Actions (CAs) to guarantee healthy equity meals for all pupils.

Methods
The content of Public food procurement and service polices for a healthy diet (PFP) published by the WHO and the Nutrient Analysis Critical Control Points (NACCP) process as indicated by the Ministry of Health were applied. In the first quarter of 2021, all food procurement contracts (n = 6) and all of the school kitchens (n = 45) of PT PSC were verified, the University of Trieste analysed the composition of fresh desserts administered in 7 consecutive weeks.

Results
The NACCP process showed NCPs on the low quality of afternoon snacks and on the quantitative/qualitative fat profile of fresh desserts, with a content of 69 to 72% of saturated fat, of 5 to 7% of trans fat and of 8 to 12% oxidized fat as a “dual quality” food. CAs were activated to support all PT PSC in reformulating fresh desserts, as well as in aiding the assessment of the food procurement landscape, activating regular monitoring of compliance and designing procurements adherent to PFP.

Conclusions
Project outcomes highlight the importance of taking action to continuously support PSC in order to ensure healthy and equitable food environments for all and to contribute to building a resilient food system.

Key messages
Guarantee healthy equity school meals for all pupils by developing on going processes to address the pandemic challenge. Ensure technical assistance to school catering to overcome the impact of COVID–19.
Women’s postnatal care satisfaction during COVID-19 pandemic in public hospitals in Northwest Greece
Authors: Koniari A , Kallianezos P , Bakola M , Kitsou KS , Charalambous G , Jelastopulu E 
Published: October 2021

Abstract

Background
Patient satisfaction is an important process for investigating patients' needs, views, and suggestions about the health services provided by a health care facility. The aim of this study was to investigate women's postnatal satisfaction with healthcare services during COVID-19 pandemic, provided at two regional public hospitals in Ioannina, Greece.

Methods
Using a purposive and snowball sampling technique, a cross-sectional study was performed among women who gave birth in two regional Greek hospitals, during October 2020. An online self-administered 32-item questionnaire was distributed personally, as well as, in social media groups related to young mothers and baby feeding.

Results
A total of 106 women answered the questionnaire, mean age 34 years old, 58.5% had higher education and for 40.6% it was the first birth. 63.2% declared having visited the same hospital already in the past for gynecological services and 69.6% being satisfied with doctors' and nurses' communication, their interaction, behavior giving guidance, and the time they dedicated to the mothers. 60% were satisfied with hospital cleanliness, organization, adequacy, easy access, orientation and 63.6% from the administrative services. 23.8% were not satisfied with waiting times between appointment schedule and medical examination; however, 61.6% indicated that they would either use or suggest the services again. Higher satisfaction was associated with being married and employed, having no previous experience, and being in good health status.

Conclusions
In general, a moderate satisfaction with various dimensions of provided health services was observed. The study highlights the importance of the postnatal care provided by healthcare professionals and health services. Improving the parameters which affect women's satisfaction would increase the quality of postnatal care.

Key messages
Assessing patient satisfaction is an important indicator of measuring the quality of health services.
Rehabilitation pathway for Covid and post-Covid patients
Authors: Madia A , Zilli E , Ruzzante B , Marchi M R , Galligioni P , Sambini M , Di Gregorio G , Giuriato P , Mazzon S , Mariotto A 
Published: October 2021

Abstract

A hospital rehabilitation service has been implemented in the Hospital of Cittadella, ULSS 6 Euganea - Health Trust (District of Padua) to offer hospitalized Covid and post-Covid patients a tailored rehabilitation pathway in the treatment of the different phases of the disease. The SARS-CoV-2 pandemic has determined the admission of a large number of acute patients in Intensive Care Units (ICU), Semi-Intensive Care Units (S-ICU) and non-critic hospital wards. Patients recovering from COVID-19 experience a wide range of impairments requiring the implementation of multidisciplinary rehabilitation care protocols; these include the assessment for anticipated impairments (especially for patients admitted to ICU, older patients, and patients showing indications of impairment); patients who had severe-critical disease usually require a period of inpatient rehabilitation. Between October 2020 and April 2021 at Cittadella Hospital 450 patients (ICU, S-ICU, non-critic hospital wards) were enrolled in the Rehabilitation pathway and followed daily by a team made by physiatrists, physiotherapists and speech therapists. Referral options (hospitalization, community based rehab or discharge with follow up), based on the conditions of the patients, were assessed. The reduction of surgery and orthopedics patients to rehabilitate and the decrease of outpatient rehab services during Covid emergency made it possible to convert Rehabilitation ward (20 beds) to Covid Rehabilitation; according to epidemiological scenarios, patients admitted to Rehabilitation ward were initially SARS-CoV-2 positive with mild, moderate and severe symptoms, then post-Covid SARS-CoV-2 negative discharged from Covid wards. The definition of a tailored rehabilitation pathway in the treatment of the different phases of Covid disease has represented an important professional and organizational challenge for the Hospital. Rehabilitation plays a pivotal role in the management of Covid and post-Covid patients.

Key messages
Patients recovering from COVID-19 experience a wide range of impairments requiring the implementation of multidisciplinary rehabilitation care protocols. The definition of a tailored rehabilitation pathway in the treatment of the different phases of Covid disease has represented an important professional and organizational challenge for the Hospital.
Public opinion on vaccines: the role of the scientific community in Italy
Authors: Paladini A , Regazzi L , Castagna C , Sapienza M , Rosano A , Ricciardi W , Cadeddu C 
Published: October 2021

Abstract

Background
After rising for years, vaccination rates in Italy fell until 2015 because of unfounded safety concerns, abetted by some government and court actions. Public education and a 2017 law on mandatory vaccination have boosted rates since then. So far only a few papers have examined the correlation between beliefs and attitudes towards vaccines and the level of trust in the scientific community regarding vaccinations in the general population.

Methods
Data were extracted from the Italian section of the last two editions of the European Social Survey (ESS), the first carried out between September and November 2017, the latter between December 2018 and March 2019. A descriptive analysis was conducted using survey data. In the two editions respectively 2,626 and 2,745 persons were interviewed. The main outcomes assessed was comparing the two surveys, so as to highlight the key changes in public opinion on vaccines.

Results
In the 2017 edition, 19% of the respondents believed in the harmfulness of vaccines, out of them 29% did not even have trust in the scientific community while those confident in the safety of vaccines were 50%. In the 2019 survey, the proportion of those who believed vaccines to be harmful fell to 15%, the undecided rose to 15%, those opposed to the idea that vaccines are harmful became 63%, not responding people were 8%. Correspondingly, trust in the scientific community about vaccines has increased from 57% in the first survey to 70% in the last one.

Conclusions
The scientific community and research bodies in the last years, in support of the Ministry of Health, have made a huge effort in the public debate on vaccines. This might play a role in increasing the public confidence in the safety of vaccines and the adherence to vaccination campaigns, changing the climate with regard to vaccination in general.

Key messages
Italians changed their opinions on vaccines between two ESS surveys. The scientific community had a relevant role in the public debate on vaccines.
Predictors of perceived pandemic preparedness among general practitioners
Authors: Stöcker A , Demirer I , Gunkel S , Hoffmann J , Mause L , Ohnhäuser T , Scholten N 
Published: October 2021

Abstract

Background
General practitioners (GPs) are essential for providing and maintaining health care during a pandemic. Pandemic preparedness (PP) of GPs can play a vital role in their management of a pandemic situation. This study aimed to examine the association stockpiled personal protective equipment (PPE) and knowledge of pandemic plans on perceived PP among German GPs. This analysis is part of the research project COVID-GAMS (Funding code: 01KI2099).

Methods
Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March-April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age.

Results
508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP across all models; the association of the knowledge of a pandemic plan was significant but considerably smaller. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP.

Conclusions
An adequate stockpile of PPE is essential for perceived pandemic preparedness among GPs. Pandemic plans are considered less important for GPs. General practitioners, health authorities, and policy makers should focus on stockpiling PPE for future pandemic emergencies.

Key messages
Sufficient stockpiled personal protective equipment is the most important factor influencing pandemic preparedness of general practitioners in Germany. Knowledge on a pandemic plan has a subordinate effect on pandemic preparedness of general practitioners; usefulness of a pandemic plan does not have a significant effect.
Trends in vaccination coverage against influenza in the pediatric population: an Italian overview
Authors: Lanza TE , D'Ambrosio F , Messina R , Pezzullo AM , Villani L , Rosano A , Ricciardi W , Cadeddu C 
Published: October 2021

Abstract

Background
Influenza is a major public health issue for its epidemiological, clinical and economic impact. Children are a relevant age group for the diffusion of the infection in the community as they shed the virus in greater amounts and for longer periods of time than adults of any age. Vaccination is the best strategy to fight the disease. In Italy, until last year, influenza vaccination for the pediatric population was offered free only to children in specific risk categories, while in the last season its was extended also to all subjects from 6 months to 6 years old. The purpose of this work is to analyze the trend of vaccination coverage among children in the last decade in Italy.

Methods
We retrieved vaccination coverage data by the Italian Ministry of Health relating to influenza vaccination in the age groups 0-2, 2-4, 5-8 and 9-14 in the years 2010-2020 and analysed trends in and between regions.

Results
A preliminary analysis shows that vaccination coverage in the age groups considered ranged from a minimum of 1.1% to a maximum of 4.5%. The highest average percentage reached was recorded in the season 2010-11 (3.8%), while the lowest in the 2015-16 (1.5%). The highest average values (12,9%; 10,5%) were found in Puglia and Toscana, while the lowest (0.3%) in Friuli Venezia Giulia. From 2010 to 2015 there was a progressive decline in vaccination coverage, while in the following years there was a slight increase, up to the year 2019-2020, in which the average percentage value was 3%. Further results are expected for next summer, when 2020-21 data will be available.

Conclusions
Our analysis shows that in the Italian regions influenza vaccination coverage in children is variable but still extremely low. Childhood vaccination could provide an opportunity to decrease the burden of disease in this age group but may also help to protect the population at risk of serious complications, such as the elderly, due to the social role children play in the spread of this virus.

Key messages
Influenza vaccination in children is a major public health issue. Additional efforts are needed to make vaccination available for children and improve the stakeholders’ awareness on this topic.