Implementation of community health care services to counter the SARS-CoV2 pandemic.

BACKGROUND: The COVID-19 pandemic has ravaged many countries worldwide since December 2019. The high infection rates, and the need for health care assistance for individuals with comorbidities, strained the national health care systems around the world. Outbreak peaks increased the burden on hospitals that where perceived as high-risk places by people, who often decided to cancel or defer hospital visits. Thus, Italian Local Health Authorities had to develop new organizational models to meet the increased health care needs of the population. The aim of this study is to assess the impact of strengthened community health services on the hospital burden. METHODS: We analysed the number of Emergency Department access at the Hospital De Lellis covered by the Local Health Authority in Rieti, from March 2020 to November 2021. We then assessed the effects of community health services: the Special District Continuing Care Units (SDCUs) and the the COVID hub, on the COVID-19-related ED access, admission and mortality rates. A Chi-squared test for trend and three multivariable logistic regression models were used to investigate the trends and the possible predictors of COVID ED access, COVID hospital admissions, and deaths. RESULTS: Being male (OR = 1.41, CI95% 1.05-1.90; p = 0.022) and older age (OR = 1.03, CI95% 1.02-1.04; p < 0.0001) increase the likelihood of hospitalisation for Sars-CoV-2. The implementation of the nursing and medical SDCUs contributed to reducing COVID-19-related deaths (OR = 0.09, CI95% 0.03-0.29; p < 0.0001). The simultaneous implementation of the COVID hub and of the nursing SDCUs had a synergistic effect in reducing the likelihood of hospitalisation (OR = 0.24, CI95% 0.09-0.65; p = 0.005). The subsequent implementation of the medical SDCUS has further contributed to lowering the admission rates. These protective effects persisted also after potential cofounders, such as age, sex, clinical condition on admission, and the immunisation status, were adjusted. CONCLUSIONS: These measures have helped in the management of patients in a complex context such as that of a pandemic by reducing the hospital load and playing an important role in the management of the pandemic. Further studies could assess the transferability of this model in a non-pandemic context.

Vaccination status among COVID-19 patients and duration of Polymerase Chain Reaction test positivity: evaluation of immunization schedule and type of vaccine.

Background: The introduction of the vaccine against SARS-CoV-2 has represented a cornerstone in the containment of the pandemic. Our aim was to assess the vaccination schedules in relation to the infection free interval and to the duration of positivity in case of infection. Study design: This study involves the SARS-CoV-2 infected people managed by the Local Health Authority ASL 1 Abruzzo. The data collected included: vaccine administration date, vaccine type, information on the Polymerase Chain Reaction test positivity, and demographic variables, such as age and sex. Methods: The duration of Polymerase Chain Reaction test positivity was assessed in relation to the vaccination status, the vaccine type and the time interval between the last vaccination dose and the first nasopharyngeal positive swab over the considered period. Results: The infection duration (DAYS) was significantly shorter in subjects vaccinated with a booster dose than unvaccinated subjects (12.8 vs 14.6; p<0.0001) and subjects vaccinated with the primary series only (12.8 vs 14.1; p<0.0001). Duration of PCR positivity was shorter with heterologous immunisation than with other vaccination schedules (p=0.0317). Conclusions: This study highlights, in a large cohort of patients, the association between vaccination schedule and the response to infection.

Distance education during COVID 19: an Italian survey on the university teachers' perspectives and their emotional conditions.

BACKGROUND: Following the COVID-19 pandemic, distance education (DE) replaced traditional "face-to-face" teaching and has become the main method of teaching. The aim of this study was to 1) evaluate the impact of DE by teachers in our department during the second semester of the 2019-20 academic year following the March-May 2020 Italian national lockdown and 2) evaluate the relationship between DE and the emotional well-being of teachers during the period of home confinement. METHODS: Ninety-seven university teachers (51.5% women; most represented age group 60-69 years range, 40.2%) responded to an anonymous online cross-sectional survey between July 15 - September 30, 2020, on the advantages and disadvantages of DE, developed by one online teacher focus group. The emotional conditions were assessed by a short version of the Beck Depression Inventory-II (BDI-II). The internal consistency reliability survey and the 10-item BDI-II were measured by Cronbach's alpha. A correlation analysis (r-Pearson) was conducted between the overall evaluation of the experience of DE and the variables included in the study. RESULTS: Teachers reported difficulties in technical aspects, and in psychological factors, as the discomfort of "speaking in the void" (64.7%). The absence of "face-to-face" eye contact with the students was complained by 81% of teachers. Significant impairments in sleep patterns and loss of energy were reported, with female teachers having greater difficulty concentrating than their male colleagues. A quarter of teachers showed depressive symptoms of varying severity. The most satisfied teachers were those most stimulated by DE (r = 0.752, p < 0.000), who showed a lower impact of depressive symptoms (r = - 0.289, p = 0.005). The teaching load in hours influenced the perception of disadvantages (r = 0.214, p = 0.035) and contributed to a lower appreciation of the challenges of DE. The more significant the manifestation of depressive symptoms during the lockdown was, the greater the subjective recovery of a good emotional condition once the domestic confinement was over (r = 0.344, p = 0.001), despite maintaining DE. CONCLUSIONS: Our study highlights the impact of technical, didactic, and psychological difficulties of DE, reported by our teachers. The appreciation of their new learning promoted by DE seemed related to better emotional well-being of university teachers accepting this "challenge" in their important role in the high-education system, influencing good learning and promoting students' professional success.

Knowledge and beliefs on vaccines among a sample of Italian pregnant women: results from the NAVIDAD study.

BACKGROUND: Vaccine hesitancy is an emerging phenomenon in European countries and leads to decreasing trends in infant vaccine coverage. The aim of this study was to analyze the level of confidence and correct awareness about immunizations, which are crucial for the success of vaccination programmes. METHODS: As part of the NAVIDAD multicentre study, we examined vaccination confidence and complacency among a sample of 1820 pregnant women from 14 Italian cities. The questionnaire assessed the interviewee's knowledge, beliefs and misconceptions, as well as their socioeconomic status, information sources about vaccines and confidence in the Italian National Healthcare Service. RESULTS: Only 9% of women completely believed to the efficacy, necessity and safety of vaccinations. Almost 20% of them had misconceptions on most of the themes. There was a significant difference in the level of knowledge considering educational level: women with a high educational level have less probability of obtaining a low knowledge score (odds ratio (OR) 0.43 [95% confidence interval (CI) 0.34-0.54]). The level of knowledge was also influenced by the sources of information: women who received information from their general practitioner (GP) and from institutional websites had a significantly lower chance of having misconceptions (OR 0.74 [95% CI 0.58-0.96]; OR 0.59 [95% CI 0.46-0.74]). Finally, the results underlined the influence of trust in healthcare professional information on the likelihood of having misconceptions (OR 0.49 [95% CI 0.27-0.89]). CONCLUSIONS: The data suggest the efficacy of GPs and institutional websites as a source of information to contrast misconceptions and underline the importance of confidence in the healthcare system to increase complacency and confidence in vaccines.

Early genotoxic damage through micronucleus test in exfoliated buccal cells and occupational dust exposure in construction workers: a cross-sectional study in L'Aquila, Italy.

AIM: The city of L'Aquila (central Italy) was hit by a strong earthquake in 2009 that caused the collapse of several buildings, deaths and injured people. In the following years, a great number of building sites were activated, building workers resulted intensely exposed and represent a relevant target for research on environmental mutagenesis and epidemiological surveillance. Cells of buccal mucosa are considered an appropriate site for early detecting of cytogenetic damage, since it represents the first barrier in inhalation or ingestion and can metabolize carcinogenic agents into reactive chemicals. Our study is aimed 1) at comparing the early genotoxic damage as measured by the buccal mucosa micronucleus test in two subgroups of workers defined by different occupational exposure and 2) at evaluating possible confounding variables such as lifestyle factors. METHODS AND RESULTS: A cross-sectional study was conducted in L'Aquila, on 24 outdoor workers (OWs) highly exposed on the construction sites and 26 indoor workers (IWs), all subjected to the compulsory occupational surveillance system, in the period 2017-2018. Buccal cells samples were collected and, based on the Micronucleus test, the exfoliated cells were classified in respect of nuclear changes observed. Moreover, a self-report questionnaire composed of 84 items, was administered to the workers. RESULTS: Significant differences were observed between Exp+ (OWs) and Exp- (IWs) in the number of the analyzed cells (expressed as mean value out of 1000 cells): respectively 954.46 vs 990.06 normal cells, (p < 0.001); 19.79 vs 4.95 micronucleated cells, as marker of chromosomal damage (p < 0.001); 13.93 vs 8.96 binucleated cells, as marker of failed cytokinesis (p < 0.001); 2.09 vs 1.18 karyolytic cells, as marker of cell death and damaged DNA (p < 0.05). According with a multivariate regression analysis, in addition to the job exposure (OW vs IW, beta = 12.221, p < 0.001), the only variable independently associated with an increase in Micronuclei (MNs) is the smoking habit (OWs vs IWs, beta = 6.683, p < 0.001) which, even if not associated with dust exposure, worsens cell integrity. Moreover, this worsening effect is weaker in workers not exposed to the site dust (moderation effect). Within social demographic factors, the high educational level only apparently seems to affect MNs number: even if unbalanced in favor of IWs vs OWs, this variable resulted a confounder, since its effect disappears when the interaction between these two factors is considered, because it is a covariate of smoking habit as well as of the job condition. CONCLUSION: Despite some limitation, our findings clearly confirm the role of occupational exposure as a marker of cytogenetic damage associated with MNs number in construction workers. Moreover, smoking status appears as the only other investigated factor independently associated to the outcome. The statistical model, in addition, highlights possible moderation and confounding effects, such as interaction between smoking and occupational exposure and the unbalanced school education level in workers. Micronucleus test in exfoliated buccal cells would be considered a suitable method for studying the early genotoxic damage in the construction occupational setting as well as in evaluating the efficacy of preventive practices.

Initial plans for a large-scale investigation into the chronic health effects of earthquakes in Italy: building on Barbara Pacelli's legacy.

Barbara Pacelli, a young Italian epidemiologist, passed away unexpectedly in September 2019. During her prolific professional life, she gave several scientific contributions to natural disaster epidemiology, particularly in relation to the medium and long-term health effects of earthquakes. In this opinion paper, we reflect on Barbara's legacy and outline potential actions that could arise from her work. Particularly, availability of electronic health records would enable a systematic and large-scale investigation into the long-term health effects of earthquakes in Italy, a country with high seismic risk. This effort would have high societal value as it would likely enable mitigation of substantial morbidity and mortality in areas affected by earthquakes. In this paper, we define scope, objectives, potential data sources, and analysis methods that could be used to systematically assess the chronic health effects of recent earthquakes in Italy. Keywords: earthquakes; chronic diseases; electronic health records; retrospective cohort; case crossover study.

[Health status perception among the elderly of L'Aquila after the 2009 earthquake]. / Percezione dello stato di salute negli anziani della città dell'Aquila dopo il sisma del 2009.

OBJECTIVES: to evaluate the health status' perception in relation to the displacement in the over-65-year population of L'Aquila, about three years after the earthquake of April 6th, 2009. DESIGN: a cross-sectional observational study was performed using a structured interview with a questionnaire divided into 36 closed and multiple questions. SETTING AND PARTICIPANTS: interviews were conducted in the offices of general practitioners and at the Department of prevention - vaccinations service. The respondents were 569 elderly, equally represented by gender; 57% was 65-74 years old, 25% was 75-79 years old, and 18% was more than 80 years old. RESULTS: the study showed that the negative perception of health status is significantly associated with delocalization, female gender, more advanced age, low education, and living with a person not belonging to the family unit. Among people who perceive health in a negative way and live in temporary housing, the inability to perform daily activities, and therefore a lower degree of self-sufficiency, was detected more frequently. Even the presence of certain chronic degenerative diseases (even if self-reported) contributes to the negative perception. This is associated with a decrease in the ability to perform daily activities. CONCLUSIONS: the living conditions and the traditional determinants of old age negatively affect the perception of health status. Relocation and the absence of infrastructure change everyday life and affect judgment on one's health.

Professional competencies in health promotion and public health: what is common and what is specific? Review of the European debate and perspectives for professional development.

According to the Nairobi Call to Action, the growth of practitioners' skills can be favoured by setting accreditation standards and by reorienting professional competencies of current and future health workers. This will make it possible to develop a critical mass of competent practitioners, foster training, and increase visibility of the professional field. Through a review of the literature, the authors offer an overview of competency-based strategies for professional development in health promotion. The main research questions discussed were as follows: Is there a shared definition of public health?; Is there a shared definition of health promotion?; Who are the main stakeholders for public health and health promotion in Europe?; What is the meaning of professional competencies in education and practice for public health and health promotion?; Is there a shared system of professional core competencies in public health and health promotion?;What is common and what is specific between the two systems of professional competencies?; Is it useful and feasible to create specific strategies of professional development for public health and health promotion? A transformative use of competencies makes it possible to inform students, professionals, employers, and political decision-makers about what is expected from a specific profession and its values.

[Accident prevention in agriculture in the ASL1 Abruzzo Local Health Service: protection facilities for tractors]. / Prevenzione degli infortune in agricoltura nella ASL1 Abruzzo: strutture di protezione nei trattori agricoli.

BACKGROUND: The ASL1 workplace prevention and safety service in Abruzzo has been conducting workplace inspections on agricultural and livestock farms in the province of L'Aquila since 2011, mainly in the areas of Avezzano, Sulmona and L'Aquila. The agricultural sector in Abruzzo is characterized by high rates of accidents and the ratio of fatal injuries/total injuries is higher than the industry and services sector. OBJECTIVES: To evaluate the presence or absence of safety devices , i.e. compliance or otherwise with regulations for tractors, and of any variable factor that could be associated with the safety of the vehicle. METHODS: Between 2011 and 2013, 98 farms in the province of L'Aquila were inspected. The data resulting from the inspections was collected by the use of a checklist. An univariate logistic regression analysis was conducted in which the vehicles that complied with regulations were considered as the dependant variable, and the age of the tractor owner, the acres of worked land and the type of farm were considered as explanatory variables. Statistical elaboration was carried out using the Stata 12 programme. RESULTS: Out of a total of 298 tractors that were checked, 64.8% did not comply with regulations due to absence or unsuitability of one or more safety devices such as: a protective device in case of overturning; retention system of the driver; mounting and dismounting from the vehicle; protection of moving parts and hot parts; PTO (Power Take Off) protection device. A significant association between non-compliance of vehicles and the age of the owner and acres worked was observed, whereas no statistical significance was observed for the association with the farm type variable. CONCLUSION: Our study showed that farms where the owner's age is between 50 and 64 years and where more acres of land are worked are those where the agricultural or forestry tractors had lower levels of compliance with regulations.

Well-being and perceived quality of life in elderly people displaced after the earthquake in L'Aquila, Italy.

On 6 April 2009, the city of L'Aquila was hit by a violent earthquake that destroyed almost all of its medieval centre, and the surviving inhabitants were evacuated and relocated in temporary quarters or undamaged homes. The aim of this study was to investigate the perceived quality of life of the elderly population 3 years after the earthquake in relation to the social and logistic issues of new housing. The study was carried out between October 2011 and March 2012, and involved 571 subjects aged over 65 years living in the municipality of L'Aquila. The interviews took place in the surgeries of general practitioners and the city's Department of Prevention and Vaccination in the anti-influenza immunisation period. The instrument used was a 36-item questionnaire with closed, multiple choice answers divided into the following sections: demographics, everyday activities, health and perceived health, and the quality of life in the city. The results show that, 3 years after the earthquake, the elderly population living in the new towns and temporary housing of L'Aquila have a worse perception of their quality of life than the others. They feel a certain social isolation and wish to live elsewhere. Governments faced with the problems arising from a natural calamity should take into account all of the elements making up a good quality of life and, before making choices whose impact cannot be changed, consider both their immediate and long-term social consequences.

Occupational risk perception of construction workers: a cross sectional study.

Introduction: Construction workers are often exposed to significant injury risk. The aim of our study is to assess their occupational hazards and injury risk perception. Methods: We administered 256 questionnaires to construction workers. The survey was aimed at collecting information regarding occupational risk and hazard exposure perception, risk control and behavioral self-assessment. We analyzed the data obtained in order to highlight any associations between injury risk perception and anamnestic, occupational, behavioral or perceptual factors. Results: Participants were prevalently males (92.37%) aged 21-60 years (94%). They showed a job seniority level of 21.3 (11.51) on average and, ranging from a 1 to 10 score, a danger awareness of 6.8 (2.9), a lack of prevention measures 6.0 (3.3), an improper behavior of 7.3 (2.7), an unpredictable fate of 6.0 (2.9). These factors resulted significantly associated with the injury risk perception. Multivariable analysis highlighted that the injury risk perception was associated with the lack of prevention measure and unpredictable fate. On the other hand, we found a negative association with the workers' improper behaviors. Conclusion: Workers' perception showed fairly uniform average values even when occupational risk was demonstrated. Our analysis suggests a positive correlation between injury risk perception and the idea that injuries are due both to fate and to chance; it also shows a negative correlation between injury risk perception and the idea that injuries are due to improper behavior. A lack of fully comparable studies confirms the need for further studies on the injury risk perception of construction workers.

Assessing the Physical and Psychological Well-being of Construction Workers During the COVID-19 Pandemic: A Prospective Study in Italy.

OBJECTIVE: This prospective study aimed to assess the physical and psychological health of construction workers and examine the relationship between their well-being and the preventive measures implemented against SARS-CoV-2. METHODS: During occupational visit, the workers were invited to participate the survey. Two measurements were made and compared: after the Italian lockdown and on the second wave of COVID-19 pandemic. RESULTS: Fifty-three workers participated in the study. The percentage of workers who considered themselves in good health increased from 66.0% to 81.1%, and there was a significant decrease in the 12-item General Health Questionnaire score (16.8 vs 14.0, P = 0.0003). This reduction was associated with a higher perception of security by preventive measures. CONCLUSIONS: The study highlights the importance of addressing the health and safety concerns of construction workers during the pandemic, and the positive impact of effective preventive measures.

Study on Psychological Stress Perceived among Employees in an Italian University during Mandatory and Voluntary Remote Working during and after the COVID-19 Pandemic.

OBJECTIVE OF THE STUDY: This cross-sectional study examined the perceived psychological well-being of administrative/technical employees and researchers/lecturers at the University of L'Aquila (Italy) during the COVID-19 pandemic. The study was carried out in two different periods of 2022: April 2022, when remote working was still mandatory, and December 2022, when the pandemic emergency had ended and, in Italy, remote working had become voluntary for two days a week and exclusively for administrative staff. MATERIALS AND METHODS: Perceived psychological well-being was investigated using the GHQ-12 (Global Health Questionnaire, short-form with 12 items), a self-administered questionnaire created on Google Forms and sent via email to all the employees of the University of L'Aquila. Statistical analysis was conducted using means, standard deviations, and frequency tables for the descriptive analysis of socio-demographic data, while the t-test or Wilcoxon test and the Χ2 test were used to verify the statistical difference and association between categorical variables. RESULTS: Overall, 365 employees, including 118 administrative/technical and 247 research/teaching staff, participated in the survey in April 2022 when remote working was mandatory. Among them, 219 (52.8%) were female and 196 (47.2%) were male. In December 2022, 266 employees engaged in voluntary remote working, including 184 (69.2%) women and 82 (30.8%) men, took part in the study. The most represented age group was 50-59 years old (36.3% of study participants). During mandatory remote working, 83.4% of lecturers reported a perceived level of psychological distress ranging from moderate to severe versus 69.5% of technicians. The percentage of self-reported psychological distress was higher among the technicians forced to work from home (n. 118-42.9%) vs. the technicians working from home on a voluntary basis (n. 157-57.1%), with GHQ score being >14 in 65.5% of enforced remote workers vs. 62.3% of voluntary remote workers. During mandatory remote working, there was a significant difference in the GHQ-12 score between administrative and research staff, particularly related to items such as loss of self-confidence, emotional pressures, and diminished productivity. Moreover, from the comparison between the group of administrative staff engaged in mandatory remote working and those in voluntary remote working for specific GHQ-12 items, a statistically significant difference emerged concerning the perception of not being able to overcome difficulties; the GHQ-12 score was higher in the first group. Significant differences in the overall GHQ-12 score were evident between male and female lecturers, as the latter reported higher levels of perceived stress during mandatory remote working. DISCUSSION: The results confirm that remote working could be associated with a better psychological state of administrative university staff, especially in the case of voluntary remote working. During mandatory remote working, a difference was observed between teaching and administrative staff, with higher stress in the first group and among women. Therefore, our sample appears fragmented in the self-assessment of psychological well-being during remote working, possibly due to profound differences in the organization of work activities between lecturers and administrative employees. Additionally, the increased perception of stress by female lecturers compared to males may reflect gender disparities, as women working from home during the pandemic experienced an increased workload including domestic activities. CONCLUSIONS: Remote working is a type of working that has both advantages and disadvantages. An advantage is undoubtedly a better work-life balance; however, the risks of technostress, workaholism, increased sedentary behaviour, and social isolation are negative aspects. This study provides an indicative overview of the psychological state related to remote working in a university setting during the SARS-CoV-2 pandemic. The study might therefore serve as a starting point for further research on the impact of remote working on self-reported psychological well-being, especially in the university environment.

Vaccine Acceptance in Patients with Inflammatory Bowel Disease: Lessons Learned from the COVID-19 Pandemic.

BACKGROUND: Immunomodulating therapies, which are commonly used in patients with Crohn's disease (CD) and ulcerative colitis (UC), have been linked to an increased risk of contracting opportunistic infectious diseases, the majority of which are preventable through vaccination. Nonetheless, vaccination rates in these patients are suboptimal, and frequently lower than in the general population. The COVID-19 immunization schedule provided a new scenario for investigating vaccine acceptance in patients with inflammatory bowel disease (IBD), with uncertainty and concerns emerging and the number of subjects receiving the third and fourth doses of the vaccine gradually decreasing. This study investigated IBD patients' attitudes towards previous COVID-19 vaccine programs and identified the factors that influence their adherence. It considered demographic and disease-related factors as well as the role of gastroenterologists and primary care physicians (PCPs). METHODS: Data were collected through a self-completed questionnaire administered to all adult IBD patients (age > 18) who visited the Gastroenterology, Hepatology, and Nutrition division at the University of L'Aquila (Italy) for a regular follow-up between November 2021 and December 2022. Non-IBD gastroenterological outpatients who visited during the same period were included as a control group. RESULTS: A total of 178 patients were included in the analysis. The IBD group consisted of 77 patients, 48.1% with CD and 51.9% with UC; the mean age was 49.5 years and 51.9% were female. Overall, 94.8% of IBD patients had undergone at least one vaccine dose and 79.2% had received two doses, versus 8% of the control group (p < 0.0001). A total of 84.4% of IBD patients reported their propensity towards COVID-19 vaccination, with an average agreement score significantly higher than the controls (p = 0.0044). The trust of IBD patients in the effectiveness of the COVID-19 vaccine (p < 0.0001) and its role in hastening pandemic resolution (p < 0.0001) is strongly related to motivation and propensity. Concerns about the safety of the COVID-19 vaccine in IBD (p = 0.0202) and fear of vaccine-induced flare-ups (p = 0.0192) were reported as the main barriers. No correlation was found between COVID-19 vaccine propensity and clinical features like the type of IBD, years of disease, activity, and ongoing treatment. Regarding the recommendations received from physicians to get vaccinated against COVID-19, IBD patients relied heavily on their gastroenterologists for advice, while the control group relied mainly on their PCPs. CONCLUSIONS: The overall positive attitude towards vaccinations reported in our study was better than that observed for other vaccines. The relationship of trust with the gastroenterologist should be used to boost vaccination against other preventable diseases in IBD patients. Our findings add information on the factors influencing vaccine propensity, which can be used to improve current vaccination strategies.

Factors associated with chronic pelvic pain in women with endometriosis: A national study on clinical and sociodemographic characteristics, lifestyles, quality of life, and perceptions of quality of care, during the COVID-19 pandemic.

BACKGROUND: Endometriosis is a persistent inflammatory condition that affects women of reproductive age and causes pelvic pain. Chronic pelvic pain is a chronic regional pain syndrome involving the pelvic area. OBJECTIVES: This survey aimed to characterize the clinical and sociodemographic characteristics, lifestyles, quality of life, and perceptions of quality of care in women with endometriosis who reported chronic pelvic pain during the Covid pandemic. DESIGN: We conducted a cross-sectional survey among the Italian population from July to September 2021. METHODS: Snowball sampling was used to interview a large sample of adult women who reported a diagnosis of endometriosis, through a self-reported questionnaire. Univariate and multivariable logistic regression analyses were performed to identify the factors associated with chronic pelvic pain. The primary outcome was describing women who reported chronic pelvic pain. RESULTS: A total of 661 out of 1045 (63%) women who responded to the survey reported chronic pelvic pain. The multivariable analysis evidenced that chronic pelvic pain was related to physical and mental quality perception, pelvic floor disorders (adjusted odds ratio = 1.58; 95% CI = 1.10-2.27; p = 0.012), dyspareunia (adjusted odds ratio = 1.87; 95% CI = 1.31-2.65; p < 0.001), adhesions syndrome (adjusted odds ratio = 1.49; 95% CI = 1.05-2.11; p = 0.026), and the delay in diagnosing endometriosis (adjusted odds ratio = 1.04; 95% CI = 1.00-1.09; p = 0.034). The only social factor associated with chronic pelvic pain was marital status (adjusted odds ratio = 0.66; 95% CI = 0.46-0.93; p = 0.019). CONCLUSION: In the pandemic period, there was a very high prevalence of chronic pelvic pain in women with endometriosis in Italy. The pandemic highlighted the need for careful attention to diagnose endometriosis and the need for psychological and partner support, which would allow better pain management and prevent chronicity.

Investigating Unhealthy Behaviors Associated with SF-36 Domains in Women with Endometriosis-Findings from a Web-Based Survey Data Set.

Unhealthy behaviors may contribute to the development and the progression of chronic diseases with negative consequences on patients' quality of life. The present study aimed to investigate the relationship between unhealthy behaviors (physical inactivity, tobacco consumption, and alcohol consumption) and health-related quality of life, measured with the SF-36 questionnaire, in women with endometriosis. To achieve this, data from a previous cross-sectional web survey among Italian adult women were analyzed. A total of 1045 responses were included in the analysis. Among the SF-36 subscales, the lowest score was recorded in the energy/fatigue domain: mean = 35.536 (Standard Deviation = 18.452). Smoking and physically inactive women had lower scores than non-smoking and physically active women, respectively, in each SF-36 domain. Women who drank more than one unit of alcohol a day, on average, reported lower scores than women with an alcohol intake <1 unit a day, for the following SF-36 domains: role limitations due to physical health, role limitations due to emotional problems, and emotional well-being. The multivariable analysis evidenced that employment, physical inactivity, and tobacco consumption were significant predictors for each SF-36 domain (p < 0.05). Physical inactivity and tobacco consumption had negative effects on the SF-36 subscales. Our results showed the need to monitor unhealthy behaviors to improve the overall well-being of women with endometriosis. Tailored strategies addressing smoking cessation, promoting physical activity, and moderating alcohol intake may aid in enhancing health-related quality of life in this vulnerable population.

Occurrence and congener profiles of dioxins (PCDDs), furans (PCDFs) and polychlorinated biphenyls (PCBs) in ovine and caprine milk samples collected in a very polluted site in Central Italy.

Concentrations of 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs) and 18 polychlorinated biphenyls (PCBs), including 12 dioxin-like (DL-PCBs) and 6 non-dioxin-like PCBs (NDL-PCBs) were measured in 16 ovine and caprine milk samples collected in the territory of Bussi sul Tirino, central Italy, a Site of National Interest (SNI) due to its high and widespread environmental pollution. All the analyzed samples were compliant with the maximum levels fixed by Commission Regulation (EU) 1259/2011 for the content of PCDD/Fs and the sum of PCDD/Fs and DL-PCBs. In two cases, contamination levels of the sum of PCDD/Fs and DL-PCBs were higher than the action levels fixed by EU Recommendation 663/2014. The statistical analysis, performed by Principal Component Analysis (PCA), revealed that the differences in contamination profiles of the different milk samples were independent of the distance of the farms from the Bussi illegal landfill but likely related to local emission sources influencing the exposure to POPs of studied animals.

Community pharmacists' perceptions and experiences of stress during COVID-19.

BACKGROUND: Pharmacists play a crucial role in the COVID-19 pandemic scenario, performing frontline roles for the community, and supporting the healthcare system. This study aimed at investigating stress and its correlates among this category of workers at a high risk of SARS-CoV-2 infection. METHODS: The participants for this study were employees of the "Municipal Pharmaceutical Company" of L'Aquila (Italy). Data were collected using an anonymous, web-based, self-administered questionnaire. Two independent surveys were conducted, from June to July 2020, and in January 2021. RESULTS: Two separate groups of respondents were involved: a total of 37 workers participated in the first survey (mean age 44.9 ± 10.7, 75.7% women) and 18 in the second survey (mean age 45.9 ± 9.2, 94.4% women). The average total scores of the perceived stress (GHQ-12 score) increased significantly from 15.5 to 18.2 (p = 0.0438), showing a moderate level of stress in the category investigated. CONCLUSIONS: We observed a strong emotional exhaustion in the study sample of pharmacists, who reported high-risk perceptions and fear. A comprehensive assistance should be granted to support the well-being of healthcare workers who provide an essential service, despite the high risk of infection.

The Perception of the Quality of Professional Healthcare Assistance for the Management of Endometriosis: Findings from a National Survey in Italy.

(1) Background: endometriosis is included in the list of chronic and disabling pathologies. This study aimed to examine patients' points of view about the quality of care for endometriosis during the COVID-19 pandemic; (2) Methods: we conducted a survey on knowledge about endometriosis, management of endometriosis, perceived mental and physical well-being, and perceived changes in the quality of care during the pandemic; (3) Results: out of 1065 participants, 875 were included in the analysis, with an average age of 34. Overall, patients had positive perceptions of care accessibility and cleanliness (95%), but less satisfaction with visit hours (86%). Those with better physical and psychological health were more satisfied with service hours, while those treated at specialised centres were more content with cleanliness. Satisfaction with clarity was linked to specialist treatment, and perceived availability to listen correlated with age, complications, and overall health status; (4) Conclusions: patients' perspectives are crucial for patient education and advocate for specialised interdisciplinary networks to support endometriosis management and patients' well-being. These findings highlight the importance of considering patient viewpoints, particularly in the context of the COVID-19 pandemic's impact on healthcare systems and suggest a need for further research from the patient's perspective.

SARS-CoV-2 Emergency Management in the ASL 1 Abruzzo Companies, Italy: An Autumn 2022 Cross-Sectional Investigation.

BACKGROUND: The SARS-CoV-2 pandemic still represents a public health emergency that affects workplaces and forces employers to develop technical, organizational and procedural measures safeguarding workers' health, particularly 'fragile' ones. This research aimed to assess employers' adherence to the emergency measures planned by the Italian government to hinder COVID-19 during Autumn 2022. METHODS: A cross-sectional study was conducted in Autumn 2022, with an 18-item questionnaire derived from the Italian State's governmental indications, sent by email to 51 companies of Marsica and Peligna Valley, L'Aquila, Southern Italy. RESULTS: A total of 20 recruited companies (65% were micro-enterprises, belonging to the food and financial sector) responded to the questionnaire within a mean time of 18 days (±11.64), which was lower for medium- and large-sized companies as well as for banking sector ones (p < 0.05). As regards intervention strategies, sanitization (92.7% of positive answers) and specific training (83.3%) showed almost full compliance in contrast to working organization (47.5%) and social distancing (61.7%). The companies that reported managing fragility (50%) belong almost exclusively to the banking sector, with predominantly office-based tasks. CONCLUSIONS: The study provided insight into critical issues relating to compliance with national legislative directives and the crucial role of occupational physicians as global advisors for all workplaces.