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This paper focuses on four e-initiatives that were precipitated by the coronavirus outbreak in Italy. These experiences played a relevant role in developing multilevel solidarity (from the local to the global level) both online and offline. They are represented by the hashtags "#iorestoacasa" (I stay at home) and "#andràtuttobene" (everything will be alright), "performances on the balcony," "influencers' campaigns," and "altruism and e-parochialism." These experiences represent revealing examples essential to understand the benefits that a mediated form of solidarity can produce. This is particularly important given the challenges that solidarity faces due to the technological acceleration imposed by the pandemic, which is likely to influence social relationships even in the post-pandemic era. Four lessons can be learned from these expressions of e-solidarity related to the capacity of information and communication technologies to (1) promote unconditioned altruism; (2) fight "parochialism" when the same disadvantaged condition is shared; (3) their capacity to develop a multilevel sense of community by connecting the local experience to the global dimension; and (4) to mediate between institutional sources and people, and connect family members, friends, vulnerable people with neighbors, and the global community. This last point suggests that the pandemic has offered fertile ground for both mechanical and organic forms of solidarity to emerge. On the one hand, it created a collective conscience based on shared vulnerabilities and interdependence. On the other hand, it is based on individualization and diversity. Indeed, these examples of Durkheimian collective effervescence show the paradox of a form of collective individualized and mediated solidarity, which is typical of contemporary society. [ABSTRACT FROM AUTHOR]

In February 2020, Italy has been the first country in Europe fighting against COVID-19. In March 2020, Italian government declared national lockdown. Until May 4th, people stayed in home confinement and only the so-called essential works and activities were continued. Like in other countries, both for the disease severity and for the risk of death, the higher the age of people the higher the risk. In the first months of 2020, Italy saw a very high number of deaths related to COVID-19, with a huge age effect. There is an agreement on the view that there had been also an excess of mortality and on the role of mortality as a correct way to reflect the dynamics of the virus's spread. In this paper we briefly discuss the trends of mortality during the first 4 months of 2020 according to the data by the Italian National Institute of Statistics. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of an e-learning online event, created for supporting resident's training during the slowdown of surgical and clinical activities caused by COVID-19 pandemic. An overview of PubMed literature depicting the state of the art of urology residency in the COVID-19 era was performed as well, to contextualize the issue. Methods: An online learning event for residents was set up at the beginning of the pandemic; the faculty consisted of experts in urology who provided on-line lectures and videos on surgical anatomy, procedures, updates in guidelines, technology, training. The audience was composed of 30–500 attendees from Italy, USA, India and Belgium. A questionnaire to analyze relevance, satisfaction and popularity of the lessons was mailed to 30 local residents. Results and limitations: Almost all residents defined the web environment suitable to achieve the learning outcomes; the method, the number and the competence of the faculty were appropriate/excellent. Most of the younger residents (81.8%) stated their surgical knowledge would improve after the course; 72.7% declared they would take advantage into routine inpatients clinical activity. Nineteen more expert residents agreed that the course would improve their surgical knowledge and enhance their practical skills; almost all stated that the initiative would change their outpatients and inpatients practice. Overall, 44 articles available in PubMed have addressed the concern of urological learning and training during the pandemic from different standpoints; four of them considered residents' general perception towards web-based learning programs. Conclusions: The paper confirms residents' satisfaction with e-learning methods and, to our knowledge, is the first one focusing on a specific event promptly settled up at the beginning of the outbreak. Web-based educational experience developed during the pandemic may represent the very basis for the implementation of prospective on-site training and overall scientific update of future urologists. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has affected and is still deeply affecting all aspects of public life. World governments have been forced to enact restrictive measures to stem the contagion which have led to a decrease in the movement of people within national territory and to a redirection of health care resources with a suspension of nonurgent procedures. In Italy, a lockdown was imposed from March 9th to May 3rd, 2020. As a result, a significant reduction in the overall operative volume of orthopedic trauma was expected, but it was not possible to predict a similar trend regarding fragility fractures of the proximal femur in the elderly. Methods: The aim of this paper was to examine the impact of COVID-19 on the operating volume for trauma surgeries and to determine how the pandemic affected the management of fragility hip fractures (FHFs) in non-COVID patients at a single Institution. Results: The first result was a statistically significant reduction in the overall operative volume of orthopedic trauma during the period of the first lockdown and an increase in the mean age of patients undergoing surgery, as expected. As regard to the second aim, the incidence of FHFs remained almost unchanged during the periods analysed. The population examined were superimposable in terms of demographics, comorbidities, type of fracture, peri-operative complications, percentage of operations performed within 48 hours from hospitalization and 1-year outcome. Discussion: Our results are in line with those already present in the Literature. Conclusions: Our study revealed a significant impact of the restrictive anticontagion measures on the overall orthopedic surgical volume, but, at the same time, we could affirm that the pandemic did not affect the management of FHFs in non-COVID patients, and their results. [ABSTRACT FROM AUTHOR]

As a form of education, distance learning currently shows great promise and the role of online libraries in delivering off-campus information services increases. This paper presents a comparative analysis of measures undertaken by traditional academic libraries in China and Italy in response to pandemic restrictions on educational operations during the lockdown period. The study utilized a specially developed questionnaire, carried out through an online survey, as a means of collecting data from library users (students and teachers). The study population includes 102 random library patrons, including 64 students and 38 teachers who were using services of academic libraries in China at the time. Through comparison with other studies, the quarantine responses of Chinese libraries were identified. The results of the study show that COVID-19 responses of libraries in China went in a direction similar to those in Italy, but the final decisions varied because of different levels of technological development. This knowledge may be used by libraries to identify areas for improvement. The results show that Chinese libraries were more effective in overcoming quarantine restrictions than those in Italy. The overwhelming majority of respondents reported that they had positive experience learning remotely and would not mind if distance learning programs continue to function after the pandemic is over. [ABSTRACT FROM AUTHOR]

Background: The novel coronavirus disease is an ongoing pandemic that started in China in December 2019. This paper is aimed at estimating the first two infections waves in Italy in relation to adopted health policies. Design and methods: We moved deaths of the Italian COVID-19 registry from recorded to infection date by the weighted moving average. We considered two infection fatality ratios related to the effective or saturated health system, we estimated the likely incidence curve from the resulting deaths and evaluated the curve shape before and after the national health policies. Results: From the 24th of February 2020 to the 7th of February 2021, we estimated 6,664,655 (4,639,221-9,325,138) cases distributed on two waves. Suitable daily infection fatality rates were 2.53% within the first wave and 1.15% within the second one. The first wave (February-July 2020) had its peak on the 14th of March 2020 (26,575). The second wave (August 2020-February 2021) was fatter with the peak on the 12th of November (60,425) and a hump in December before decreasing to 26,288 at the end. Adopted health policies were followed by changes in the curve rate. Conclusions: Tracing infection contacts and quarantining asymptomatic people reduced virus lethality in the second wave. Restriction on population mobility is effective within a suppression strategy, distance learning reduces contacts among families. Removal of restrictions should be implemented by sequential steps for avoiding a quick rising of incident cases. A reasonable public health daily goal to control both virus spread and lethality could be to find at least 87 cases for each death. [ABSTRACT FROM AUTHOR]

The outbreak of COVID-19 in early 2020 created dangerous public health conditions which pressured governments and health systems to respond in a rapid and effective manner. However, this type of rapid response required many governments to bypass standing; bureaucratic structures of health sector administration and political governance to quickly take; essential measures against a rapidly evolving public health threat. Each government's particular; configuration of governmental and health system decision-making created specific structural and functional challenges to these necessary centrally developed and coordinated strategies. Most East Asian governments (except Japan) succeeded relatively quickly in centralizing essential disease control and treatment initiatives in a timely manner. In contrast, a number of European countries, especially those with predominantly tax-based financing and politically managed health delivery systems, had greater difficulty in escaping bureaucratic governance and management constraints. Drawing on data about these governments' early stage COVID-19 control experiences, this article suggests that structural changes will be necessary if low-performing governments are to better respond to a pandemic. This paper also summarizes other relatively successful strategies. By adopting such strategies, nations can help overcome structural bureaucratic and administrative obstacles in responding to further waves of COVID-19 or similar future pandemic events. [ABSTRACT FROM AUTHOR]

Post-vaccine olfactory and gustatory disorders are very rare and were reported in patients who received influenza vaccines. In this article, we report 6 cases of post-coronavirus disease 2019 (COVID-19) vaccine olfactory and gustatory disorders in patients with negative nasal swabs. Precisely, olfactory and gustatory dysfunctions were reported in 5 and 1 patients, respectively. Sense disorders occurred after the first injection of AstraZeneca (n = 4) or the second injection of Pfizer (n = 2) vaccines. In 4 cases, the olfactory or gustatory disorder was confirmed with psychophysical evaluations. The duration of chemosensory dysfunction ranged from 4 to 42 days. None of the patient reported mid- or long-term olfactory or gustatory disorder. The occurrence of olfactory and gustatory dysfunctions in adults benefiting from COVID-19 vaccines is still rare but has to be known by otolaryngologists. [ABSTRACT FROM AUTHOR]

In 2020/2021, the EU and its member states had to tackle the largest shock of the twenty-first century yet, the COVID-19 pandemic. COVID-19 led to an unprecedented health and economic crisis. In this article, we analyse public opinion on redistributive EU measures based on an original survey in Austria, Germany and Italy and ask whether EU citizens support a common aid package, common debt and redistribution to those countries that are economically most in need. Testing the influence of three explanatory concepts – self-interest, justice attitudes and general support of European integration – we find that all three explanatory concepts have predictive power. However, we find stronger effects on support for EU-level redistribution for citizens' instrumental calculations concerning whether their country benefits from EU aid, and on general support for EU integration, than for justice attitudes. [ABSTRACT FROM AUTHOR]

We propose a general modular approach to support decision‐makers' response in the early stages of a pandemic with resource expansion, motivated by the shortage of Covid‐19‐related intensive care units (ICU) capacity in 2020 in Italy. Our approach uses (1) a stochastic extension of an epidemic model for scenarios of projected infections, (2) a capacity load model to translate infections into scenarios of demand for the resources of interest, and (3) an optimization model to allocate this demand to the projected levels of resources based on different values of investment. We demonstrate this approach with the onset of the first and second Covid‐19 waves in three Italian regions, using the data available at that time. For epidemic modeling, we used a parsimonious stochastic susceptible‐infected‐removed model with a robust estimation procedure based on bootstrap resampling, suitable for a noisy and data‐limited environment. For capacity loading, we used a Cox queuing model to translate the projected infections into demand for ICU, using stochastic intensity to capture the variability of the patient arrival process. Finally, we used stochastic dynamic optimization to select the best policy (when and how much to expand) to minimize the expected number of patients denied ICU for any level of investment in capacity expansion and obtain an efficient frontier. The frontier allows a trade‐off between investment in additional resources and the number of patients denied intensive care. Moreover, in the panic‐driven early days of a pandemic, decision‐makers can also obtain the time until which they can postpone action, potentially reducing investment costs without increasing the expected number of denied patients. [ABSTRACT FROM AUTHOR]

This article analyses the potential implications of the COVID-19 pandemic for the infrastructure of social services in Italy and Spain. Drawing from the policy capacity framework and focusing on childcare and elderly care, we investigate how the National Recovery and Resilience Plans are likely to impact the core functions of the social investment approach. Through document analysis, the article shows that, whereas the infrastructure of the social service system remains characterised by a 'marble cake' type of institutional arrangement combining national and subnational responsibilities, attempts have been made by the central governments to steer the social investment policy capacity at the organisational and systemic levels. We argue that the pandemic represents a window of opportunity to rethink the overall system of intergovernmental relations in the field of social services. [ABSTRACT FROM AUTHOR]

Background: Italy was the first European country to be involved with the COVID-19 pandemic. As a result, many healthcare professionals were deployed and suddenly faced end-of-life care management and its challenges. Aims: To understand the experiences of palliative care professionals deployed in supporting emergency and critical care staff during the COVID-19 first and second pandemic waves. Research design: A qualitative descriptive design was adopted, and in-depth interviews were used to investigate and analyse participants' perceptions and points of view. Participants and research context: Twenty-four healthcare professionals (physicians, nurses, psychologists, physiotherapists, and spiritual support) from the most affected areas of Italy were recruited via the Italian society of palliative care and researchers' network. Ethical considerations: The University Institutional Board granted ethical approval. Participants gave written informed consent and agreed to be video-recorded. Findings: The overarching theme highlighted participants' experience supporting health professionals to negotiate ethical complexity in end-of-life care. Crucial topics that emerged within themes were: training emergency department professionals on ethical dimensions of palliative and end-of-life care, preserving dying patients' dignity and developing ethical competence in managing end-of-life care. Conclusions: Our study showed palliative care teams' challenges in supporting health professionals' ethical awareness in emergencies. However, while they highlighted their concerns in dealing with the emergency staff's lack of ethical perspectives, they also reported the positive impact of an ethically-informed palliative care approach. Lastly, this study illuminates how palliative care professionals' clinical and ethical competence might have assisted a cultural change in caring for dying patients during COVID-19 and future emergencies. [ABSTRACT FROM AUTHOR]

The article focuses on how the actors of industrial relations acted at firmlevel in multi-national company, Danone, in two different institutional contexts (Italy and France), in order to set rules and procedures aimed to mitigate the negative psycho-social consequences of remote working adopted during Covid-19 pandemic. In particular, it examines what was the role of firm-level industrial relations in setting specific oriented actions and what were the relations between these, global policies of the company and national level policies about health and safety and in general the institutional context. It emerges the importance of informality of relations between actors in helping to face an emergency together with the role of global policies of the company that seems to overcomes the different national institutional contexts. [ABSTRACT FROM AUTHOR]

While at first the fear of COVID-19 disease spread was limited by the fact that the pandemic appeared to be confined to China, the growing emergency in Italy and the rapid escalation in positive cases and deaths have made the threat of this disease a national as well as global phenomenon. In the present research, a questionnaire was collected both before (n = 396) and during (n = 250) the outbreak of the pandemic in Italy. The aim of the research was to analyze the possible mediation of binding moral foundations on the relationship between concerns over COVID-19 and prejudice vis-à-vis immigrants. As hypothesized, the results show that concerns over COVID-19 increased greatly after the start of the Italian pandemic. Moreover, both before and during the pandemic, the relationship between concerns over COVID-19 and prejudice toward immigrants is mediated by binding moral foundations. [ABSTRACT FROM AUTHOR]

Background: The success of vaccination campaigns against COVID-19 infection is vital for moving from a COVID-19 pandemic to an endemic scenario. We aimed to unravel the influence of the risk perception of epidemics along with individual and contextual factors on adherence to COVID-19 vaccination campaigns in Italy and Sweden. Methods: We compared the results of two nationwide surveys carried out in August 2021 across four domains of epidemic risk perception: perceived likelihood, perceived impact on the individual and perceived individual and authority knowledge. The roles of individual and contextual determinants were also explored. Results: The survey included 2144 participants in Sweden (52.3% women) and 2010 in Italy (52.6% women). In both countries, we found that trust in authorities was one of the main drivers of this process, with two-fold increased odds of being vaccinated. Being highly educated and having a higher relative income were associated with a higher adherence to the vaccination campaign (for relative income OR = 1.44, 95% CI 1.23–1.67 in Sweden and OR = 1.18, 95% CI 1.04–1.34 in Italy; for education OR = 1.90, 95% CI 1.30–2.77 in Sweden and OR = 1.47, 95% CI 1.09–1.97 in Italy), whereas a right and centre-right compared with a left and centre-left political orientation was negatively related to vaccination adherence (OR = 0.41, 95% CI 0.25–0.67 in Sweden and OR = 0.47, 95% CI 0.33–0.68 in Italy). Conclusions: Increasing trust in authorities, along with an equal global distribution of vaccine doses, can contribute to accelerating vaccination campaigns around the world and, in turn, to move towards an endemic scenario. [ABSTRACT FROM AUTHOR]

This study explores intimate partner violence (IPV) evolution during the lockdown with a sample of 238 women (44% cohabitating and 56% not cohabitating with the perpetrator), attending five antiviolence centers in Italy (June–September 2020). Questions included 12 items on IPV and, for each item, a question about whether violence increased/stayed the same/decreased during lockdown; an indicator of IPV modifications was constructed. Two distinct patterns, confirmed after adjustment for socio-demographic factors, emerged: IPV increased for 28% of cohabitating and decreased for 56% of non-cohabitating women. Such results suggest the efficacy of physical distancing—strictly controlled by the State—in the prevention of IPV. [ABSTRACT FROM AUTHOR]

Background: The current COVID-19 pandemic is affecting mental health of global population and, particularly, of people suffering from preexisting mental disorders. Aims: This study aims to report on findings from a phone-based clinical follow-up conducted in two large catchment areas in Italy and Paraguay, during the COVID-19 lockdown, in order to provide psychiatric assessments and measure the level of stress related to the quarantine in a large sample of psychiatric outpatients. Methods: A clinical phone-based follow-up has been conducted in two large catchment areas in the province of Chieti (Vasto, Italy) and City of Asunción (Paraguay), during the COVID-19 national lockdown. The following rating scales have been employed: Hamilton Anxiety Rating Scale (HAM-A); Hamilton Depression Rating Scale (HAM-D); 18-items Brief Psychiatric Rating Scale (BPRS-18). The psychological distress related to the outbreak has been assessed employing the Impact of Event Scale – Revised (IES-R). Results: A total of 110 outpatients were consecutively included and followed among those reporting a stable phase of illness before the COVID-19 lockdown. Findings confirmed a significant increase of general psychopathology, anxiety and fear as well as mild levels of stress related to the quarantine. Also, significant weight gain during the lockdown was detected among patients. Conclusions: This study confirmed the impact of COVID-19 lockdown on mental health of people suffering from psychiatric disorders and may also add evidence on the employment of digital psychiatry in the current pandemic. [ABSTRACT FROM AUTHOR]

From the societal approach of the Theory of Social Representations, this study aimed to investigate the social representations of coronavirus/COVID-19 among the Italian population. By means of an online questionnaire, 599 individuals participated in the research, with a mean age of 38.09 years (SD = 14.44), 62.1% being women. The instrument was composed of sociodemographic questions, free association technique for the inductive term "coronavirus/COVID-19" and scales on conspiracy beliefs, vaccine hesitancy, and psychological dimension. The results allowed us to identify four social representations: "Citizens driven by Social Representations anchored to factual Covid-19 pandemic data," with lower vaccine hesitancy and conspiracy beliefs, and greater faith in science; "Citizens with low confidence in anti-pandemic preventive measures by government," with lower agreement with restriction measures; "Emotional people," with higher agreement with restriction measures and expression of psychological distress; and "Minority group of Citizens driven by denial of Covid-19," with higher vaccine hesitancy and conspiracy beliefs. We discuss the different social representations identified from the psychological and psychosocial anchoring processes in the context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to analyze the specificity, accuracy and sensitivity of a simple, easy to calculate, prognostic score for hospitalized COVID19 patients developing deep vein thrombosis. Methods: From March 1st to April 28th, 942 COVID-19 patients with severe symptoms were admitted to the hospital San Matteo of Pavia-Italy. Thirty two patients (3.4%) developed deep vein thrombosis during hospitalization. In all patients hemostatic and inflammatory parameters were abnormal. A simple prognostic score was developed based on the presence of specific co morbidities and D-dimers levels (quick San Matthew Score-quick SMS): Results: Nine patients died in a condition of multiple organ failure, 23 patients (71.9%) survived and left the hospital in good general conditions. The developed score was based simply on two parameters: 1) presence of four specific co morbidities and 2)systemic levels of D-Dimers. The quick San Matthew Score resulted in a sensitivity, specificity and overall accuracy of more than 90% (94%, 92%,93% respectively) and compared favorably with other scores. The score was prospectively validated in 100 COVID19 patients who developed deep vein thrombosis collected from the literature and prospectively confirmed in our hospital. Conclusions: The findings of our study underline the importance of an immediate aggressive therapeutic approach for moderate and high-risk patients with COVID19 infection. The quick SMS score may help to identify patients at high risk for mortality and to follow the clinical outcome of the patient. A simple, easy to calculate prognostic score may also facilitate communication among health workers. [ABSTRACT FROM AUTHOR]

Hospitals play a critical role in providing essential care during emergencies; however, this essential care can overwhelm the functional capacity of health systems. In Italy, substantial cuts in funding have drastically reduced the resources of the National Health Service (NHS) and contributed to the expansion of the private health sector which, unlike the public health system, does not have the capacity to deal with a health emergency such as coronavirus disease 2019 (COVID-19). The purpose of this article is to show how the privatization of the NHS contributed to making Italy more vulnerable and unprepared to tackle the COVID-19 pandemic. The available capacity and resources in the public and private emergency services systems in Italy are compared, including a focus on the numbers of hospital staff, hospitals, and hospital beds. The reduced funding and subsequent shortfalls in services in the NHS are reasons why extreme measures were needed to increase these resources during the COVID-19 pandemic. A public NHS in Italy would be better prepared for future health emergencies. The lessons learned from the COVID-19 pandemic can help to inform future health systems strategies, to halt the current financial decline and performance loss of national health systems, and to enable better preparation for future health emergencies. [ABSTRACT FROM AUTHOR]