Annali dell'Istituto Superiore di Sanità
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Anti-SARS-CoV-2 antibodies persistence after natural infection: a repeated serosurvey in Northern Italy
Get PDFIntroduction. To evaluate the decline of antibodies induced by SARS-CoV-2 infection, the individuals resident in 5 municipalities of the Autonomous Province of Trento, Northern Italy, who resulted IgG positive for anti-SARS-CoV-2 nucleocapsid (NC) in May 2020, were tested four months later.Methods. Anti-SARS-CoV-2 NC antibodies were detected using the Abbott SARSCoV-2 IgG assay. Samples that gave a negative result were re-tested using the Liaison SARS-CoV-2 IgG assay to assess anti-spike (S) S1/S2 antibodies. The fifty-percent tissue culture infective dose (TCID50) neutralizing assay was performed on a subgroup of formerly positive sera. Statistical analysis was performed by STATA version 16.1 (STATA Corp., College Station, Texas, USA).Results. Overall, 480 out of 1159 participants became seronegative for anti-NC IgG antibodies. Age above 70 years and cough were associated with persistent anti-NC IgG levels. Most anti-NC IgG negative sera were positive for anti-S IgG (77.9%). The neutralization assay showed high concordance with anti-S antibodies positivity.Conclusion. In conclusion, a decline of anti-NC IgG values was recorded four months after the first evaluation. A high proportion of anti-NC seronegative individuals were positive for anti-spike IgG antibodies, which appear to persist longer and to better correlate with neutralization activity
Community waterborne outbreak linked to a Firefighting Response during the COVID-19 emergency: Waterborne outbreak linked to Firefighting
No full textBackground. On 6 March 2020, a big fire in a village forced the firefighters to drawwater simultaneously from many sources, including the Adige river. From 9 March, anincreasing number of inhabitants reported gastrointestinal symptoms. We describe theoutbreak and the challenges linked to the concurrent COVID-19 spread.Methods. Residents with enteric symptoms and their relatives were interviewed andsamples from some of the patients and public water pipelines were tested for entericpathogens with microbiological and molecular methods.Results. By 20 March, 182 people reported symptoms and 131 met the case definition.Norovirus GI/GII and other pathogens were found in human and water samples.Conclusions. Contamination of the public water network with sewage-contaminatedriver water through the firefighters pressurized water tank was the suspected source ofthe outbreak. The investigation was partly hampered due to the SARS-CoV-2 emergency.Control measures included avoiding tap water, alternative water supplies and chlorinationof public water
Breastfeeding promotion and support: a quality improvement study
Get PDFBackground. Breastfeeding success is determined by early skin to skin contact, early initiation of breastfeeding, rooming-in, baby-led breastfeeding, creation of a favorable environment, specific training of health professionals, and continuity of care.Objective. To investigate the women’s satisfaction regarding the care and support re-ceived in the first days after childbirth. MaterialandMethods. A questionnaire of 24 items was administered to mothers be-fore discharge, from May to September 2019 at the University Hospital of Modena.Results. The predictive variables of exclusive breastfeeding were the delivery mode, age at birth and parity. The multivariate analysis showed that a high satisfaction score was associated with vaginal birth (OR=2.63, p=0.005), rooming-in during the hospitalization (OR=8.64, p<0.001), the skin to skin contact (OR=6.61, p=0.001) and the first latch-on within 1 hour after birth (OR=3.00, p=0.02). Conclusions. Mothers’ satisfaction is one of the important factors of positive experience during hospital stay and of better health outcomes
Suicidal Ideation among Italian medical students: prevalence and associated factors from a multicenter study: Italian Med Students: suicidal ideation
No full textObjectives. To estimate Suicidal Ideation (SI) prevalence among Italian medical students and explore associated factors.Methods. Multicentre cross-sectional study (2018). Students were enrolled through convenience sampling (sample size=2513). Questionnaires included socio-demographic items and Beck Depression Inventory-II, which has an item on SI. A multivariable regression was performed (p-value<0.05 significant).Results. SI prevalence was 13.7%. Among students with and without depression SI prevalence was 36.0% and 4.3%. Being female, being in a relationship, good/excellent family cohesion, perceived good economic status were significantly associated with lower SI. Increasing age, bisexual/asexual orientation, psychiatric family history, negative judgmenton medical school choice, competitive/hostile climate and unsatisfying friendships among classmates, being worried about not measuring up to the profession significantly increased SI.Conclusion. There was a high SI prevalence among Italian medical students, consistently with worldwide data. Demographic, relational, and motivational factors seem to influence SI. Determinants should be further investigated to plan university-level interventions
COVID-19 and digital competencies among young physicians: are we (really) ready for the new era? A national survey of the Italian Young Doctors Association
No full textBackground. Digital health (DH) is nowadays fundamental for physicians. Despite the improvement of Information and communications technology (ICT) Italian medical doctors’ (MDs) education system seems not adequate in this area. Moreover, given the Covid-19 outbreak, societies are waking up to their limitations in this regard. Aim of this paper is to analyze the Italian status quo in DH.
Methods.The Italian Young Medical Doctors Association (SIGM) proposed a web based survey to assess the status quo of awareness and training in terms DH among young doctors. The investigated areas were: Big Data, -omics technology and predictive models, Artificial Intelligence (AI), Internet of Things, Telemedicine, social media, blockchain and clinical-data storage.
Results.
A total of 362 participants answered to the survey. Only 13% had any experience in big data during clinical or research activities, 13% for -omics technology and predictive models, 13% for AI, 6% had experience in Internet of Things, 22% experienced at least one telemedicine tool and 23% of the participants declared that during their clinical activities data collection is paper-driven.
Conlclusions.For any investigated area, three categories of MDs were described: the high-tech, the low-tech and the no-tech one. An urgent integration of pre- and post- graduation training in DH is required to provide a homogeneous and adequate medical education
Attitude of potential biobank donors screened for depression towards disclosure of individual health results
Get PDFBackground. Research based on biological material with linked health and clinical data may produce new strategies for disease prevention, diagnosis and treatment. A survey was conducted among individuals previously screened for major depressive disorder (MDD) to explore participants’ attitude towards research biobanking. Methods. The survey used self-report questionnaires about donation for research biobanks, self-perceived health and life satisfaction. Means and percentages were compared across groups by using t test, ANOVA and chi-square test. Results. Of 416 subjects who underwent the MDD screening, 51 (12.2%) responded to the survey, with the majority of them (42) agreeing to the use of their biological samples only in absence of feedbacks about health or diseases. Agreement towards biobanking was not affected by life satisfaction or self-perceived health. Conclusions. Our findings show a prevailing preference against health results disclosure among MDD-screened subjects, suggesting a role of personal – particularly psychosocial – factors in research biobanking individuals’ contribution
The cost of caring during recent epidemics: a rapid review of risk factors, psychological manifestations, and strategies for its treatment. Running head: The cost of caring during pandemics
No full textBackground. During pandemics, Healthcare Workers (HCWs) are particularly exposed to the risk of secondary trauma. If not effectively addressed, the consequences of such psychological distress can progress to more severe conditions.
Methods. A systematic search of several databases on the effect of SARS, MERS, and COVID-19 pandemics on the mental health of HCWs was performed according to both the Cochrane Handbook for Systematic Reviews of Interventions and the WHO Rapid Review Guide for Health Policy and Systems Research.
Results. The 77 reviewed studies highlighted that work organization and individual characteristics can add to mental health risk. Providing adequate training to prevent infection and prepare HCWs to handle the epidemic, strengthening team work to improve organization, and ensuring appropriate protective equipment is available can help prevent the risk of psychiatric illness.
Conclusions. Monitoring and addressing through tailored interventions the mental health consequences of pandemics in HCWs is necessary
Mortality risk in a population of patients treated for Gambling Disorders: results of a follow-up study: Gambling disorders and mortality risk
No full textAims To examine mortality risk and causes of death in a cohort of a population of patients treated for gambling disorders in northern Italy from 1992 to 2019.
Methods: Cohort study
Results: Half of the patients were diagnosed with psychiatric disorders, substance use disorder or alcohol dependence. The excess mortality compared to the general population (SMR) was 1.16 (0.85-1.58), more elevated among females aged 40 to 59 and males aged 20 to 29. Females had higher SMRs for all cancers and suicide; males for malignant neoplasm of liver, of lung, of prostate, and of bladder.
Conclusions: Despite patients increasing, subjects who most turn to the services are the most serious ones, in older age, with comorbid mental disorders and with a compromised health status. This is reflected in the high risk of death for all cancers.
How can we manage the COVID-19 infodemics? A case study targeted to health workers in Italy: Covid 19 Contents
No full textIntroduction. The Istituto Superiore di Sanità (ISS) has been asked for rapid technical and scientific advice to the State and Regions during Sars-CoV-2 pandemic preparedness. Methods. An ad hoc Working Group on Scientific Literature updates (WG SL) was set up at ISS (March-May 2020) to screen pre-prints and peer reviewed papers from arXiv, medRxiv, bioRxiv, and Pubmed to provide a real time knowledge and empirical evidence addressed to health-workers. Results. The WG SL screened a total of 4,568 pre-prints and 15,590 peer reviewed papers, delivered as daily summary report of pre-print selection for ISS President activity in the National Scientific Technical Committee framework and a weekly open access publication (COVID Contents) on peer-reviewed papers of interest for health professionals, monitored by a satisfaction questionnaire. Conclusions. Promoting heath literacy, with a cross-cutting approach is a powerful heritage of Public Health Institutes and a proven effective non pharmacological intervention. INTRODUCTIO