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.

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.

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.

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.

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.