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BackgroundVaccination adherence among healthcare workers (HCWs) is fundamental for the prevention of vaccine-preventable diseases (VPDs) in healthcare. This safeguards HCWs' well-being, prevents transmission of infections to vulnerable patients and contributes to public health.AimThis systematic review and meta-analysis aimed to describe interventions meant to increase HCWs' adherence to vaccination and estimate the effectiveness of these interventions.MethodsWe searched literature in eight databases and performed manual searches in relevant journals and the reference lists of retrieved articles. The study population included any HCW with potential occupational exposure to VPDs. We included experimental and quasi-experimental studies presenting interventions aimed at increasing HCWs' adherence to vaccination against VPDs. The post-intervention vaccination adherence rate was set as the main outcome. We included the effect of interventions in the random-effects and subgroup meta-analyses.ResultsThe systematic review considered 48 studies on influenza and Tdap vaccination from database and manual searches, and 43 were meta-analysed. A statistically significant, positive effect was seen in multi-component interventions in randomised controlled trials (relative risk (RR) = 1.37; 95%â¯CI: 1.13-1.66) and in observational studies (RR = 1.43; 95%â¯CI: 1.29-1.58). Vaccination adherence rate was higher in community care facilities (RR = 1.58; 95%â¯CI: 1.49-1.68) than in hospitals (RR = 1.24; 95%â¯CI: 0.76-2.05).ConclusionInterventions aimed at increasing HCWs' adherence to vaccination against VPDs are effective, especially multi-component ones. Future research should determine the most effective framework of interventions for each setting, using appropriate study design for their evaluation, and should compare intervention components to understand their contribution to the effectiveness.
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Vacunas contra la Influenza , Gripe Humana , Enfermedades Prevenibles por Vacunación , Humanos , Vacunación , Personal de Salud , Gripe Humana/prevención & controlRESUMEN
Pediatric oncohematological patients frequently require PICU admission during their clinical history. The O-PEWS is a specific score developed to predict the need for PICU admission of oncohematological children. This study aimed at i) describing the trend of the O-PEWS in a cohort of patients hospitalized in the Pediatric Oncohematology ward and transferred to the PICU of Padua University Hospital, measured at different time-points in the 24 hours before PICU admission and to evaluate its association with mortality and presence of organ failure; ii) investigating the association between the recorded O-PEWS, and PIM3, number of organ failure and the need for ventilation, dialysis and inotropes.This retrospective single-center study enrolled oncohematological children admitted to the PICU between 2017 and 2021. The O-PEWS, ranging between 0 and 15, was calculated on the available medical records and the TIPNet-Network database at 24 (T-24), 12 (T-12), 6 (T-6) and 0 (T0) hours before PICU admission.RESULTS: 101 PICU admissions, related to 80 children, were registered. During the 24 hours prior to PICU admission, the O-PEWS progressively increased in all the patients. At T-24 the median O-PEWS was 3 (IQR 1-5), increasing to a median value of 6 (IQR 4-8) at T0. The O-PEWS was positively associated with mortality, organ failure and the need for ventilation at all the analyzed time-points and with the need for dialysis at T-6.The O-PEWS appears as a useful tool for predicting early clinical deterioration in oncohematological patients and for anticipating the initiation of life-support treatments.
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Unidades de Cuidado Intensivo Pediátrico , Humanos , Masculino , Niño , Femenino , Estudios Retrospectivos , Preescolar , Lactante , Adolescente , Puntuación de Alerta Temprana , Deterioro Clínico , Cuidados Críticos/métodos , Neoplasias Hematológicas/terapia , Neoplasias Hematológicas/mortalidadRESUMEN
Promotion of self-care is an important issue in the treatment of chronic diseases such as venous leg ulcers, as adequate self-care can prevent complications and ulcer recurrence. However, only a few tools have been developed and tested to assess the knowledge of patients with venous leg ulcers. This study aimed to translate, adapt and validate in an Italian language and context a questionnaire to assess the knowledge of patients with venous leg ulcers about their disease (pathophysiology, risk factors, lifestyle changes due to ulcer) and the proper management of the ulcer to prevent recurrence. This is a cross-sectional study divided into two phases: (1) translation and cross-cultural adaptation of the 'Educational Interventions in Venous Leg Ulcer Patients' tool in a six-stage process and (2) validation and reliability study with patients with active ulceration. There was great agreement for the English-to-Italian translation. In content validation, the tool showed good applicability among experts. Adjustments were made to improve semantic equivalence, and the questionnaire was made to be easy and quick to administer. The results of the target population showed a low level of knowledge among the patients. Knowing the deficiencies of the patients makes it possible to create educational projects to improve their abilities. Now more than ever, it is necessary to improve self-care and patient knowledge, allowing home care, improving autonomy, and avoiding hospital care that results in higher costs and risks. This questionnaire could be used in future studies to identify topics that need to be reinforced through education and to improve the awareness and self-care of these patients.
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Úlcera de la Pierna , Úlcera Varicosa , Humanos , Úlcera , Pacientes Ambulatorios , Reproducibilidad de los Resultados , Estudios Transversales , Cicatrización de Heridas , Úlcera Varicosa/terapiaRESUMEN
The purpose of this study was to introduce a novel instrument aimed at stratifying the risk of falling in postpartum patients. The research was a survey of a sample of 460 midwives working at different hospitals, mainly in Northern Italy, except for a hospital in Rome (Italy). The survey, consisting of 70 items, was conducted among midwives and asked them to express their opinion regarding the increased risk of falling in puerperal women on a Likert scale according to the characteristics listed in the questionnaire. Items were derived from the synthesis of scales available in the literature from settings other than the postpartum period, and interviews were conducted with midwives with great experience in this area. A shortened version was obtained using principal component analysis. A 30-item final scale was obtained, the SLOPE (riSk of faLling in pOst-Partum womEn), ranging from 0 to 100. The scale allows stratification of postpartum women at low (0-10), intermediate (10-20) and high risk (>20) of falling. The development of the SLOPE scale is the first step towards more rational evidence-based management of the risk of falling in postpartum women in current clinical practice.Impact statementWhat is already known on this subject? Falls occurring in the postnatal period are not limited to women because infants are often involved in this adverse event, with several significant consequences. There is a lack of information on this issue due to the absence of both registries and scales for the prevention of falls.What do the results of this study add? The main result of this study is the development of a novel scale to assess the falling risk in postpartum women.What are the implications of these findings for clinical practice and/or further research? The development of this novel scale, even if based on midwives' experience and not on patients' data, is a first step towards a more rational evidence-based management of the risk of falling in postpartum women.
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Accidentes por Caídas/prevención & control , Atención Posnatal/métodos , Periodo Posparto , Medición de Riesgo/métodos , Adulto , Femenino , Humanos , Italia , Partería , Embarazo , Encuestas y CuestionariosRESUMEN
Blood banking is a long and complex process requiring an accurate screening of potential donors and high-quality control systems. Previous studies in literature investigated factors potentially determining a higher cell levels with the aim of optimizing donors' selection and improving banking process. This study aims to identify factors associated with the concentration of stem cells in umbilical cord blood, so increasing the probability of bankability, focusing on the possible implications in terms of obstetric and resources management. This is a retrospective study conducted in the Obstetric Units of two Italian Hospitals in Montebelluna and Castelfranco Veneto. Study has been conducted on cord blood units banked between 1999 and 2015. Data on medical histories and clinical characteristics of mother and baby have been retrieved via a retrospective examination of medical records. A total of 869 cord blood units were studied. At multivariable analysis, in agreement with literature, birthweight and placental weight have been found to be associated with higher concentration of total nucleated cells. As additional factor, amount of fluid infused was associated with cord blood units' count. This study is the first one to clearly identify the role of fluid infusion on cord blood units' counts in addition to placental weight and delivery. Some non-modifiable features can help in predicting bankability from pre-natal aspects to factors more related with obstetric management is suggested.
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Almacenamiento de Sangre , Sangre Fetal/citología , Células Madre/citología , Peso al Nacer , Almacenamiento de Sangre/métodos , Femenino , Humanos , Recién Nacido , Embarazo , Estudios RetrospectivosRESUMEN
PURPOSE: The aim of this study was to estimate the proportion of bleedings that occurred among warfarin users attributable to the concomitant use of other medications. A general approach for measuring the impact of the prescriptive inappropriateness on drug adverse outcomes at the population level is described. METHODS: A meta-analysis was conducted to obtain summary relative risks of bleeding associated with concurrent use of warfarin and other medications compared to warfarin use alone. A population-based investigation was performed, in an Italian cohort of cardiopathic patients aged 65 years or older, to estimate the prevalence of concurrent users of warfarin and other medicaments. The population attributable fraction was computed by combining data on summary relative risks and prevalence of concurrent users. RESULTS: Concomitant use of warfarin and cotrimoxazole, amiodarone, quinolones, macrolides, platelet aggregation inhibitors, SSRIs, NSAIDs, and lipid-lowering agents was associated with an increased risk of bleeding. The corresponding attributable fractions were 3% (95% CI 2 to 4%), 21% (1 to 41%), 21% (17 to 25%), 9% (8 to 10%), 14% (12 to 16%), 6% (5 to 8%), 10% (1 to 20%), and 8% (0 to 18%), respectively. CONCLUSIONS: More than half of bleeding events occurring among frail elderly using warfarin are attributable to a concomitant use of warfarin with certain drugs. Because some of these drugs appear to be essential for the treatment/prevention of cardiovascular conditions, and their concomitant use with warfarin could be acceptable in some cases, proper INR-monitoring and warfarin dose adjustments are requested.
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Hemorragia/inducido químicamente , Warfarina/efectos adversos , Factores de Edad , Anciano , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Interacciones Farmacológicas , Quimioterapia Combinada , Femenino , Humanos , Masculino , Warfarina/administración & dosificaciónRESUMEN
BACKGROUND AND OBJECTIVE: Researchers commonly use automated solutions such as Natural Language Processing (NLP) systems to extract clinical information from large volumes of unstructured data. However, clinical text's poor semantic structure and domain-specific vocabulary can make it challenging to develop a one-size-fits-all solution. Large Language Models (LLMs), such as OpenAI's Generative Pre-Trained Transformer 3 (GPT-3), offer a promising solution for capturing and standardizing unstructured clinical information. This study evaluated the performance of InstructGPT, a family of models derived from LLM GPT-3, to extract relevant patient information from medical case reports and discussed the advantages and disadvantages of LLMs versus dedicated NLP methods. METHODS: In this paper, 208 articles related to case reports of foreign body injuries in children were identified by searching PubMed, Scopus, and Web of Science. A reviewer manually extracted information on sex, age, the object that caused the injury, and the injured body part for each patient to build a gold standard to compare the performance of InstructGPT. RESULTS: InstructGPT achieved high accuracy in classifying the sex, age, object and body part involved in the injury, with 94%, 82%, 94% and 89%, respectively. When excluding articles for which InstructGPT could not retrieve any information, the accuracy for determining the child's sex and age improved to 97%, and the accuracy for identifying the injured body part improved to 93%. InstructGPT was also able to extract information from non-English language articles. CONCLUSIONS: The study highlights that LLMs have the potential to eliminate the necessity for task-specific training (zero-shot extraction), allowing the retrieval of clinical information from unstructured natural language text, particularly from published scientific literature like case reports, by directly utilizing the PDF file of the article without any pre-processing and without requiring any technical expertise in NLP or Machine Learning. The diverse nature of the corpus, which includes articles written in languages other than English, some of which contain a wide range of clinical details while others lack information, adds to the strength of the study.
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Procesamiento de Lenguaje Natural , Humanos , Almacenamiento y Recuperación de la Información/métodos , Niño , Algoritmos , Masculino , Minería de Datos/métodos , FemeninoRESUMEN
Despite its decrease in many Western countries, cannabis remains the most used illicit substance among adolescents. This study aims to summarize cannabis consumption during the last two decades and project trends among 15-year-olds in the 2021-22 HBSC survey. A Bayesian semi-parametric hierarchical model was adopted to estimate the trend of cannabis consumption using data of about 287,000 adolescents from the 2001/2002 to the 2017/2018 HBSC wave and the 38 countries that met the inclusion criteria. Data show an overall decline in most countries for both boys and girls. However, in 22 countries of 38 cannabis use is expected to increase again in our projection. The discussion of these findings should take into account cultural, policy, social factors and unpredictable events such as the Covid-19 pandemic, that can significantly impact future trends leading to discrepancies between the projected and observed values. However, these discrepancies can provide insight into understanding the potential impact of preventive strategies and the underlying processes responsible for changes in cannabis use over time.
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Conducta del Adolescente , Cannabis , Masculino , Femenino , Humanos , Adolescente , Teorema de Bayes , Pandemias , Encuestas y CuestionariosRESUMEN
The COVID-19 outbreak involved a spread of prediction efforts, especially in the early pandemic phase. A better understanding of the epidemiological implications of the different models seems crucial for tailoring prevention policies. This study aims to explore the concordance and discrepancies in outbreak prediction produced by models implemented and used in the first wave of the epidemic. To evaluate the performance of the model, an analysis was carried out on Italian pandemic data from February 24, 2020. The epidemic models were fitted to data collected at 20, 30, 40, 50, 60, 70, 80, 90, and 98 days (the entire time series). At each time step, we made predictions until May 31, 2020. The Mean Absolute Error (MAE) and the Mean Absolute Percentage Error (MAPE) were calculated. The GAM model is the most suitable parameterization for predicting the number of new cases; exponential or Poisson models help predict the cumulative number of cases. When the goal is to predict the epidemic peak, GAM, ARIMA, or Bayesian models are preferable. However, the prediction of the pandemic peak could be made carefully during the early stages of the epidemic because the forecast is affected by high uncertainty and may very likely produce the wrong results.
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BACKGROUND: Reliable post-approval surveillance of implantable cardioverter-defibrillator (ICD) lead performance remains a challenge. In the past, two ICD leads were recalled due to a high frequency of failures. In this meta-analysis, we sought to provide a combined estimate of failure-free rate for ICD leads by reconstructing individual patient data from published Kaplan-Meier (KM) curves and to investigate whether estimates could be influenced by the characteristics of the study. METHODS: Observational studies assessing failure-free estimates of transvenous ICD leads with KM method, were identified through a systematic search up to November 2021. RESULTS: Forty-four studies were eligible that included 41,870 (63.1%) non-recalled leads and 24,493 (36.9%) recalled leads. The 8-year cumulative failure-free rate was 94.1% (CI, 93.6% - 94.6%) for contemporary non-recalled leads and 81.2% (80.3% - 82.0%) for recalled leads (hazard ratio [HR], 3.15 [2.85-3.47], p < 0.001). Failure-free rate was lower in single-center studies in both the non-recalled (HR, 0.28 [0.15-0.51], p < 0.001) and recalled (HR, 0.54 [0.33-0.88], p = 0.014) group compared with multicenter studies. Similarly, estimates were significantly lower in small (i.e. extracted KM curve with <312 leads) versus large studies (HR non-recalled group, 0.54 [CI, 0.33-0.89], p = 0.015; HR recalled group, 0.62 [CI, 0.43-0.89], p = 0.009). CONCLUSIONS: In this meta-analysis including >66,000 leads, we provide pooled survival curves that may play a role in generating evidence-based standards for assessing clinically acceptable failure rates for ICD leads. Lead performance was underestimated with single-center and small-sized studies; multicenter studies remain the main tool to reliably conduct post-market surveillance of ICD leads.
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Desfibriladores Implantables , Humanos , Estudios Retrospectivos , Modelos de Riesgos Proporcionales , Estudios Observacionales como AsuntoRESUMEN
The study aims to evaluate the health profile of first- and second-generation Romanian immigrants living in Italy compared to their adolescent peers in the country of origin (Romania) and the host population (Italian-borns). Analyses were performed on the 2013/2014 Health Behaviour in School-aged Children (HBSC) survey data. Romanian natives showed lower levels of health complaints and higher life satisfaction than Romanian migrants, who were similar to the host population, especially the second-generation ones. A comparable prevalence of being bullied was registered among Romanians, both native and immigrant, with significantly lower levels among Italian natives. Bullying others showed the second-generation migrants share a similar prevalence with the host population. The prevalence of liking school a lot was three times higher among the Romanian natives than among their peers living in Italy. Thanks to the HBSC data, this study is the first to examine the health of adolescent migrants from both the perspective of the host country and the population of origin. The results highlight the need for a more nuanced approach to studying immigrant populations, taking into account both the host country's perspective and the health patterns of the population of origin.
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Emigrantes e Inmigrantes , Niño , Humanos , Adolescente , Italia/epidemiología , Rumanía/epidemiología , Encuestas y Cuestionarios , Asunción de RiesgosRESUMEN
Adolescence is a critical period for engaging in health risk behaviors. Migrant adolescents may face unique challenges due to acculturation stress. This study aims to monitor substance use and problem gambling among migrant adolescents living in Italy. Data from the 2017/18 Health Behavior in School-Aged Children survey in Italy were analyzed. The 18,794 participants included 15-year-olds, categorized as native or migrants, with ethnic backgrounds from Western, Eastern European, or non-Western/non-European countries. Girls had higher smoking rates, while boys exhibited higher prevalence of alcohol-related risk behaviors, cannabis use, and gambling. Boys from Eastern European countries displayed a greater risk of drunkenness (OR: 1.58, 95% CI: 1.06-2.37), particularly in the first generation, while those from Western countries showed a higher risk of multiple substance use (OR: 1.44, 95% CI: 1.05-1.96). Girls from Eastern European and non-Western/non-European countries had a lower risk of alcohol consumption (OR: 0.50, 95% CI: 0.29-0.85; OR: 0.55, 95% CI: 0.33-0.91, respectively). Finally, boys, especially those from Eastern European and non-Western/non-European countries, had a significantly higher risk of problem gambling (OR: 1.83, 95% CI: 1.04-3.22; OR: 2.10, 95% CI: 1.29-3.42, respectively). This disparity was more pronounced in the first generation, possibly due to acculturation challenges and socio-economic factors. Risk behaviors in adolescents are influenced by complex interplays of gender, cultural factors, and migration generation. Preventive strategies should consider these factors to effectively address substance use and gambling in this heterogeneous population.
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(1) Background: In Italy, the components of adolescents' mental well-being (psychological symptomatology and cognitive perception of life satisfaction) showed different temporal trends, suggesting the adoption of a multidimensional conceptualization. We aimed to assess temporal patterns and provide additional insights into Italian adolescents' mental well-being in the last decade by adopting the Dual Factor Model; (2) Methods: We used nationally representative samples of Italian students (n = 165,000) aged 11, 13, and 15 years across the three more recent Italian Health Behaviour in School-aged Children (HBSC) surveys. Two measures of mental well-being were used: life satisfaction (LS, indicator of positive subjective well-being) and psychological health complaints (PHC, indicator of mental illness); (3) Results: Our study showed that the overall sample has been moving from a Complete Mental Health (Flourishing) to an Incomplete Mental Illness (Struggling) condition. Among 13- and 15-year-old girls, a jump from one to the other mental condition was observed in the 2014-2018 and 2010-2014 time periods, respectively; (4) Conclusions: Our findings suggest that Italian adolescents, especially older girls, have been shifting from Complete Mental Health to Incomplete Mental Illness in the last decade. Further research is needed to investigate this breaking up of the connection between psychological symptomatology and cognitive perception of life satisfaction.
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Recent studies have examined how the environment can influence obesity in young people. The research findings are conflicting: in some studies, green spaces have shown a protective association with obesity and urbanization has turned out to worsen this condition, while other studies contradicted these results. The aim of the study was to examine the relationships between greenness, urbanization, and weight status among Italian adolescents. Student data (11-13 years old) on weight and height, physical activity (PA), and demographic characteristics were extracted from the 2018 Health Behaviour in School-aged Children (HBSC) survey in Piedmont, Northwest of Italy. Data on Normalized Difference Vegetation Index (NDVI) and urbanization were obtained from satellite images and the National Institute of Statistics (ISTAT). A multilevel regression model was used to assess the association between NDVI, urbanization, and obesity, controlling for PA. Students living in greener areas reported a lower likelihood of being obese [OR = 0.11, 95% CI 0.02-0.56, p = 0.007], while students living in areas with a higher level of urbanization showed a significantly increased risk of obesity [OR = 2.3, 95% CI:1.14-4.6, p = 0.02]. Living surrounded by higher amounts of greenness and lower levels of urbanization may positively influence health status through lower risk of obesity among youth.
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Obesidad , Urbanización , Adolescente , Índice de Masa Corporal , Niño , Estudios Transversales , Humanos , Obesidad/epidemiología , Instituciones AcadémicasRESUMEN
INTRODUCTION: Favoring innovation by making timely medical technology available to people and by securing patients' safety is a challenge. AREAS COVERED: The new European Medical Device Regulation (MDR) will have a central implication in the development of new devices and could affect their innovation and availability, as well as discourage investment in research within Europe. EXPERT OPINION: Start-ups and small companies might not be able to cope with the increasing complexity and the required changes of perspective. Health-care institutions are facing an increasing availability of complex technologies, while data on their clinical efficacy and cost-effectiveness are rarely provided. A partnership/collaboration between health-care institutions, academia, and private industries will enhance their own specific interests with the common goal of improving overall health and quality of life. The complexity of the subject combined with the variety of specialists and stakeholders involved requires the implementation, in hospital centers of clinical excellence, of units dedicated to the whole path of the medical device innovation. Stakeholders should quickly provide adequate measures to facilitate the complex medical device innovation path under the more stringent MDR aimed to increase safety and quality of care.
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Atención a la Salud , Calidad de Vida , Humanos , Europa (Continente) , Universidades , Legislación de Dispositivos MédicosRESUMEN
(1) Aim: To summarize alcohol trends in the last 30 years (1985/6-2017/8) among 15-year-olds in Health Behaviour in School-aged Children (HBSC) countries (overall sample size: 413,399 adolescents; 51.55% girls) and to forecast the potential evolution in the upcoming 2021/22 HBSC survey. (2) Methods: Using 1986-2018 prevalence data on weekly alcohol consumption among 15-year-olds related to 40 HBSC countries/regions, a Bayesian semi-parametric hierarchical model was adopted to estimate trends making a clusterization of the countries, and to give estimates for the 2022 HBSC survey. (3) Results: An overall declining trend in alcohol consumption was observed over time in almost all the countries. However, compared to 2014, some countries showed a new increase in 2018 and 2021/22 estimates forecast a slight increase in the majority of countries, pointing out a potential bounce after a decreasing period in frequent drinking habits. (4) Conclusions: The clusterization suggested a homogenization of consumption habits among HBSC countries. The comparison between 2022 observed and expected data could be helpful to investigate the effect of risk behaviour determinants, including the pandemic impact, occurring between the last two waves of the survey.
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Conducta del Adolescente , Consumo de Bebidas Alcohólicas , Adolescente , Consumo de Bebidas Alcohólicas/epidemiología , Teorema de Bayes , Niño , Femenino , Humanos , Masculino , Prevalencia , Encuestas y CuestionariosRESUMEN
A shortage of COVID-19 vaccines and reports of side-effects led several countries to recommend a heterologous regimen for second vaccine doses. This study aimed to describe the reasons behind individuals' choices of a homologous or a heterologous second vaccination. This cross-sectional study enrolled individuals under 60 who had received a first dose of Vaxzevria and could choose between a homologous or heterologous regimen for their second dose. Quantitative (socio-demographic, clinical characteristics) and qualitative data were collected and analysed through a generalized linear model and thematic analysis, respectively. Of the 1437 individuals included in the analysis, the majority (76.1%) chose a heterologous second dose of the COVID-19 vaccination. More females chose a heterologous vaccination regimen (p = 0.003). Younger individuals also tended to choose heterologous vaccination (p < 0.001). The main motivation in favour of heterologous vaccination was to follow the Italian Ministry of Health recommendations (n = 118; 53.9%). This study showed that most individuals, mainly younger people and females, chose a heterologous dose of COVID-19 vaccination after their first viral vector vaccine. Heterologous vaccinations could be an effective public health measure to control the pandemic as they are a safe and efficient alternative to homologous regimens.
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Vacunas contra la COVID-19 , COVID-19 , COVID-19/prevención & control , Estudios Transversales , Femenino , Humanos , SARS-CoV-2 , VacunaciónRESUMEN
(1) Aims: To explore temporal trends 2010-2018 of well-being among Italian adolescents and to evaluate potential explanatory factors. (2) Methods: Italian nationality representative samples of students aged 11, 13, and 15 years were recruited in 2010, 2014, and 2018; Health Behaviour in School-aged Children (HBSC), for an overall number of 165,000 teenagers. Multivariable logistic regression models were performed to fit the trends over time of life satisfaction (LS), psychological (PSY-HC) and somatic health complaints (SOM-HC) considering the contextual factors: school work pressure, social support (family, school, peers), socioeconomic status, geographic area, and immigration background; (3) Results: From 2010 to 2018 while LS was steady, health complaints increased, mainly for PSY-HC, in all age and gender groups. Trend of PSY-HC affected mainly 15-years-olds: rates among boys varied from 29.6% to 35.9% (OR: 1.13, 95%CI: 1.02-1.25); among girls from 49.1% to 63.3% (OR: 1.56, 95%CI: 1.42-1.72). High school work pressure and poor social support play a central role in worsening well-being outcomes; (4) Conclusions: Our findings pictured a remarkable worsening trend of teenagers' well-being, especially among 15-year-old girls. Further research will be required to investigate this breaking up of the connection between psychophysical symptomatology and cognitive perception of life satisfaction.
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Salud Mental , Instituciones Académicas , Adolescente , Niño , Femenino , Humanos , Italia/epidemiología , Masculino , Clase Social , Estudiantes/psicologíaRESUMEN
Heterologous vaccination regimens could contribute to broadening vaccination coverage. To date, there is little evidence on the effectiveness of a combination of adenoviral COVID-19 vaccines with a second dose of mRNA vaccines. This study aims to evaluate the antibody response to the SARS-CoV-2 spike protein 25 weeks after vaccination with mRNA-1273 after a first dose of ChAdOx1. A cross-sectional study was conducted collecting sociodemographic data, clinical characteristics, and serological data from among the general population. Antibody levels were expressed as binding antibody units (BAU) per mL (cutoff = 33.8 BAU/mL). Linear regression models were used to assess the relationship between the subjects' characteristics and anti-SARS-CoV-2 antibody levels. A total of 229 participants were followed up after a median time of 173 days. The overall anti-SARS-CoV-2 IgG antibody titer was 729.0 BAU/mL. The multivariable analysis showed that the only factor associated with anti-SARS-CoV-2 IgG levels was the BMI (p = 0.007), with decreases within the healthy range weight and increases in under- or overweight people. Our results support the use of heterologous COVID-19 vaccination regimens, as they can guarantee a sustained immune antibody response. More studies are needed to understand the link between BMI and body composition and the immune response to COVID-19 vaccinations.
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Population aging is related to a huge growth in healthcare and welfare costs. Therefore, wearable devices could be strategic for minimizing years of disability in old age and monitoring patients' lifestyles and health. The purpose of this study was to assess the feasibility of using smart devices to monitor patients' physical activity in a primary care setting. To assess the acceptance of this novel technology from the point of view of both patients and healthcare professionals, two questionnaires (one paper-based and one ex-novo developed) were administered to 11 patients with type 2 diabetes mellitus and a non-compliant behavior towards the therapeutic indications of their general practitioner (GP). Seven participants would continue to use a wearable activity tracker to monitor their health. We observed that 75% of patients reported a device's characteristics satisfaction level of over 80% of the total score assigned to this dimension. No differences were observed in the questionnaire's scores between the two professionals categories (GPs and nurses). Three dimensions (equipment characteristics, subjective norm, perceived risks, perceived ease-of-use and facilitating conditions) correlated > 0.5 with the device's acceptability level. Some weak correlations were observed between healthcare professionals' perception and patients' parameters, particularly between the dimensions of collaboration and web interface ease-of-use and patients' median number of steps and hours of sleep. In conclusion, despite the limited number of subjects involved, a good acceptance level towards these non-medical devices was observed, according to both patients' and healthcare professionals' impressions.