Annali dell'Istituto superiore di sanita最新文献

Introduction: Onsite school-based intervention represents a key strategy to increase influenza vaccination uptake and improve knowledge of children, parents and school staff. This study aims to quantitatively describe an intervention in Local Health Authority Roma 1.

Methods: Vaccination was offered to children aged 2-6 years. A quantitative descriptive analysis of vaccination coverage and population variables was performed.

Results: 29 schools were included. Out of 2,424 eligible children, 405 were vaccinated (16.7%). Of these, 218 (53.8%) were male and 187 (46.2%) female, mean age 4.4 years old. 177 (43.7%) received one dose, while 228 (56.3%) were vaccinated for the first time. Of these, 150 students (65.8%) also received the second dose. 148 other people (parents, teachers and older children) decided to join the campaign, thus being vaccinated.

Conclusions: Community-based interventions in school settings increase adherence to health promotion campaigns. It is necessary to continue researching and investing in such activities.

Introduction: The recent guideline from the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA) on observational studies prompts a broader reflection on the impact of regulations on clinical research and real-world evidence. While regulations are necessary to ensure ethical and scientific standards, their effectiveness in improving research quality is unclear. It is also uncertain whether these regulations strengthen clinical research or create bureaucratic obstacles. This quantitative, "before and after" study investigates the impact of the 2008 AIFA guideline and the 2018 General Data Protection Regulation (GDPR) on the complexity of ethical evaluation processes. As a secondary outcome, we also aimed to investigate whether the duration and probability of suspensions were influenced by intrinsic study characteristics (study design, rare disease, genetic data, post-authorization safety study).

Materials: The study analyzed the ethical evaluation process of 112 observational multicenter studies with 2,875 submissions from 2002 to 2022, included in the database of Medineos srl. The number of suspensions observed in each evaluation process was a surrogate endpoint of complexity of evaluation process.

Methods: Descriptive analyses and survival analysis were used to evaluate the total evaluation time, and a logistic model was applied to assess the probability of receiving a suspension.

Results: The median (and interquartile range) evaluation time for "pre-AIFA" submissions was 70 (41-133) days, whereas it was 75 (45-122) days for "post-AIFA" submissions. The median evaluation time was 68 (41-113) days without suspension and 127 (84-180) days with suspension. Post-AIFA submissions had a higher likelihood of suspension. The median evaluation time for "pre-GDPR" submissions was 70 (42-123) days, whereas it was 90 (63-140) days for "post-GDPR" submissions. AIFA guidelines slightly increased evaluation time and the likelihood of suspension, suggesting improved quality control. GDPR increased evaluation time due to privacy evaluations but did not affect suspension probability. Intrinsic study factors did not impact evaluation duration or suspension probability.

Conclusions: Although more extensive analyses are necessary, this study suggests that past changes in Italian regulations have affected the evaluation by the Ethics Committee (EC) and have also impacted the conduct of the observational studies. The data generated can be useful for monitoring the future impact of the recently published new AIFA guideline.

Introduction: Neurocognitive disorders are typical of older people. Psychological distress increased during the pandemic, particularly in young people. Although often underestimated, the impact of psychological distress on neurological disorders should be considered. As part of a longitudinal study conducted by the Italian Twin Registry (ITR) on the health effects of COVID-19 pandemic, we explored the onset of lasting neurological symptoms in relation with pre-existing psychological symptoms and/or SARS-Cov-2 infection.

Methods: Online surveys on adult subjects of the ITR: in June 2020 we investigated symptoms of depression, anxiety and post-traumatic distress and, in December 2021, the onset of six persisting neurocognitive symptoms. SARS-CoV-2 infection was examined in both surveys. Associations of psychological symptoms and of viral infection with subsequent neurological manifestations were tested through logistic regression analysis.

Results: Among 1,784 participants (mean age 46.6), 42.8% reported neurological symptoms and 15.7% SARS-Cov-2 infection. Odds of neurological manifestations increased in participants with depressive or anxiety symptoms (ORs: 1.44 to 3.72), and in those with COVID-19 (ORs: 1.73 to 2.32). Anxiety symptoms explained more cases of cognitive symptoms (26.9% to 37.9%) than COVID-19 (9.1% to 15.5%). Smell/taste changes were strongly associated with viral infection (OR: 43.2).

Conclusions: During the pandemic, widespread psychological distress contributed more than COVID-19 to the appearance of some cognitive symptoms in a relatively young population. Our findings indicates that preservation of neurological well-being cannot ignore mental health interventions.

Objective: To describe screen exposure and its association with socio-economic characteristics in a large representative sample of children aged 0-2 years in Italy.

Materials and methods: Data from the 2022 Italian Surveillance of children aged 0-2 years, collected on 35,550 mothers, were analysed to estimate the prevalence of screen exposure. Logistic regression was used to investigate the association between exposure and potential predictors.

Results: Overall, 39.2% of children aged 2-15 months were exposed to digital screens. The exposure prevalence increased with age, ranging from 13.9% at 2-3 months to 61.9% at 13-15 months. Screen exposure was significantly more frequent among children of mothers with non-Italian citizenship, having lower levels of education, reporting economic difficulties, non-participating in antenatal classes (ACs), and residing in the center-south.

Conclusions: Most babies, particularly from low socio-economic status (SES) families, were exposed to screens in a period when this may interfere with responsive caregiving and thus with early child development. It is imperative to inform parents and caregivers about the risks of early exposure since the first months of life.

Background: Accurate evaluation of glucocorticoid concentrations during serial blood collection in rodents is often hampered by the stress response elicited by the procedure itself. The optimal method to minimize stress and impact on animal welfare remains debated.

Methods: Hence, we compared corticosterone concentrations in adult mice serially bled by using the retro-orbital sinus puncture or the tail vein incision methods, either with or without exposure to an acute restraint stress.

Results: Corticosterone concentrations were significantly affected by the sampling method, with higher peaks and sustained hypercortisolemia in mice bled with the retro-orbital sinus puncture, pointing to the tail vein incision method as preferable for serial blood collections. Mice bled using the tail vein incision reached similar corticosterone peaks regardless of exposure to acute stress.

Conclusions: Our findings suggest that tail vein incision can be used to evaluate neuroendocrine reactivity without exposing mice to restraint procedures. This would improve animal welfare practices in experimental protocols.

Introduction: With the global population projected to reach approximately 9 billion by 2050, there's a growing need to explore alternative food sources. Insects have emerged as a potential solution to meet food demand, offering a substitute for conventional livestock. However, a primary safety concern surrounding these novel foods is their allergenic potential, especially given the absence of standardized testing methodologies. To mitigate this risk, food irradiation has been explored as a method to reduce allergenicity in insects intended for human and animal consumption.

Material and methods: This study utilized an enzyme-linked immunosorbent assay to determine the allergenic proteins in specific insect types after irradiation treatment.

Results and discussion: Significant differences in detectable protein levels were observed between Tenebrio molitor and Acheta domesticus samples, but no significant differences in protein content were found between food and feed samples of both species under identical irradiation conditions. Further research is required to ensure the protocol's suitability for more complex food matrices.

Background: During the COVID-19 pandemic maternity healthcare seeking and provision reduced worldwide. We explored the indirect effects of the pandemic on key pregnancy outcomes and access to antenatal care services.

Methods: Observational cross-sectional study on all pregnancies between years 2019-2020 in Milan metropolitan area (Lombardy, Italy). Multiple logistic regression analysis was used to assess the access to antenatal care (ANC) services (timing of first contact, ultrasound examinations (US) and ANC contacts) and pregnancy outcomes (preterm births, perinatal deaths and surgically treated ectopic pregnancies). Data were retrieved from both administrative (public healthcare) and self-reported sources (public and private services).

Results: The first antenatal contact was slightly delayed in pandemic year 2020. Adequate levels of antenatal care were maintained according to self-reported data, though a decrease in public healthcare was noted (administrative data). Perinatal death and preterm birth risk did not worsen, while it increased for surgically managed ectopic pregnancies.

Introduction: Intimate partner violence (IPV) profoundly impacts women's health, increasing the risk of chronic and non-communicable diseases. Recent findings underscore the promise of epigenetic indicators to uncover the enduring effects of trauma on the human genome, especially concerning stress-related conditions such as post-traumatic stress disorder (PTSD).

Objectives: To evaluate the lasting health impacts of violence against women, developing a digital tool specifically structured to consolidate crucial details about the contexts of violence, the relationship between victim and perpetrator, and health outcomes.

Methods: A Microsoft Forms-based questionnaire was developed, organized into nine sections addressing socio-personal information, external conditions of violence, health statuses, and psychological evaluations, incorporating PTSD assessment via the International Trauma Questionnaire and depression measurement through the Center for epidemiologic studies depression scale revised (CESD-R) module. Data is securely archived, and participation includes optional consent for epigenetic analysis through blood samples.

Conclusions: The assessment tool presents a thorough tool for gathering information on IPV, evaluating health outcomes, and identifying PTSD and depression in survivors. It also aids in the collection of biological specimens for epigenetic exploration. This instrument could enhance intervention strategies and contribute to precision medicine methodologies, facilitating early detection of chronic health risks in women who have experienced violence.

Background: Persons with autism spectrum disorder (ASD) may face significant challenges during transition from adolescence to adulthood. This phase necessitates tailored support to address all needs, underscoring the importance of a comprehensive life project (LP) planning. This scoping review aims to identify methods and tools used in the development of LP for persons with ASD.

Methods: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) extension for scoping reviews was used. The literature search was performed across Embase, Scopus, Web of Science, PubMed, CINAHL, and PsycINFO. The selection process involved screening titles and s, followed by full-text reading, data extraction, and narrative synthesis of findings.

Results: A total of 899 records were identified, and 8 studies were included in the review. Preference assessment and ecological balance emerged as crucial elements in developing LP.

Conclusions: This review highlights the importance of tools that accurately capture individual preferences and support needs for persons with ASD but also reveals a gap in the literature concerning the development of tailored LP for this population.