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Coronavirus disease 2019 (COVID-19) first emerged in China in November 2019. Most governments have responded to the COVID-19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID-19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID-19 era (group activities, telemedicine, outpatients treatment, alcohol-related liver disease and liver transplantation, collecting samples); (d) AUD and SARS-CoV-2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID-19 disease will need implementation. Thus, the COVID-19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in-depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment., (© 2021 The Authors. Addiction Biology published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

This paper depicts a Covid science case, that of the AstraZeneca Vaxzevria vaccine, with specific focus on what happened in Italy. Given that we believe acknowledging the role of non‐evidential factors in medicine is an important insight into the recent philosophy of science, we illustrate how in the case of Vaxzevria, the interplay between facts, values (both epistemic and non‐epistemic) and cognitive biases may have possibly led to different institutional decisions based on the same evidence. The structure of the paper is as follows. First, we provide a glossary of the relevant terms involved, that is to say, epistemic values, non‐epistemic values and cognitive biases. Second, we sketch a timeline of Vaxzevria's approvals and suspensions by relevant institutional healthcare authorities with special focus on Italy and the Italian Medicines Agency. Then we show the interplay between the evidence base, epistemic as well as non‐epistemic values and cognitive biases using a narrative review of political decisions along with newspaper and social media content pertaining to Vaxzevria. We briefly compare Italy with other European countries to show that different political decisions were made on the basis of the same evidence. [ABSTRACT FROM AUTHOR]

This paper draws on a subsample (N = 851) of respondents to ITA.LI—Italian Lives—a recently established panel study on a probability sample of individuals aged 16+ living in Italy—to track changes in the affective (positive and negative emotions such as energy and sadness) and cognitive (life satisfaction) components of well‐being during different COVID‐19 policy phases, classified according to the severity of key government responses. An event‐study design is employed, which uses mixed‐effects ordered logistic models to investigate the change in SWB scores. Given the nested nature of the data, multilevel modeling is chosen as the most appropriate method of analysis. The results reveal the levels of affective and cognitive well‐being were significantly lower during the lockdown period than before the pandemic outbreak potentially reflecting both the direct effects of the confinement and other potential sources of distress, such as trends in infection rates and related media alarm. Once the lockdown was lifted, there was no evidence of an immediate and general improvement in well‐being. In the following policy phase, with the lifting of most containment measures, there were significant signs of full recovery concerning energy, but the scores for the other well‐being components remained relatively lower than those observed before the onset of COVID‐19. [ABSTRACT FROM AUTHOR]

This paper tries to examine how the COVID‐19 shock affects different countries through their regional integration and their exposure to Global Value Chains (GVCs). Using input–output tables from the EORA dataset, our contribution is threefold. First, we conceptually revise the approache to analyse input–output relationships and underline the difference between the bilateral flow of value added and trade and distinguish between the producers and consumers of value‐added. Second, we distinguish between the supply and demand channels through which these countries can be affected by the disruptions in GVCs. Third, we apply this empirical exercise on an understudied region, namely the Mediterranean region that is characterised by its involvement in several trade agreements that might boost their integration into GVCs. Our main findings show that, first, most of the countries have relatively larger backward GVC linkages than forward ones. Second, in the Northern shore of the Mediterranean, Italy and France are net suppliers of value added since they produce more value‐added absorbed abroad than the foreign value‐added they consume. Third, our results highlight also the limited integration between Southern shore partners, whose integration is almost completely driven by linkages with Southern European developed countries. [ABSTRACT FROM AUTHOR]

The prediction of the evolution of epidemics plays an important role in limiting the transmissibility and the burdensome consequences of infectious diseases, which leads to the employment of mathematical modeling. In this paper, we propose a stochastic particle filtering extended SEIRS model with repeated vaccination and time-dependent parameters, aiming to efficiently describe the demanding dynamics of time-varying epidemics. The validity of our model is examined using daily records of COVID-19 in Italy for a period of 525 days, revealing a notable capacity to uncover the hidden dynamics of the pandemic. The main findings include the estimation of asymptomatic cases, which is a well-known feature of the current pandemic. Unlike other proposed models that employ extra compartments for asymptomatic cases, which force the estimation of this proportion and significantly increase the model's complexity, our approach leads to the evaluation of the hidden dynamics of COVID-19 without additional computational burden. Other findings that confirm the model's appropriateness and robustness are its parameter evolution and the estimation of more ICU-admitted cases compared to the official records during the most prevalent infection wave of January 2022, attributed to the intensified increase in admissions that may have led to full occupancy in ICUs. As the vast majority of datasets contain time series of total recovered and vaccinated cases, we propose a statistical algorithm to estimate the currently recovered and protected through vaccination cases. This necessity arises from the attenuation of antibodies after vaccination/infection and is necessary for long-time interval predictions. Finally, we not only present a novel stochastic epidemiological model and test its efficiency but also investigate its mathematical properties, such as the existence and stability of epidemic equilibria, giving new insights to the literature. The latter provides additional details concerning the system's long-term behavior, while the conclusions drawn from the R0 index provide perspectives on the severity and future of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Conspiracy Beliefs (CB) are a key vector of violent extremism, radicalism and unconventional political events. So far, social-psychological research has extensively documented how cognitive, emotional and intergroup factors can promote CB. Evidence also suggests that adherence to CB moves along social class lines: low-income and low-education are among the most robust predictors of CB. Yet, the potential role of precarity-the subjective experience of permanent insecurity stemming from objective material strain-in shaping CB remains largely unexplored. In this paper, we propose for the first time a socio-functional model of CB. We test the hypothesis that precarity could foster increased CB because it undermines trust in government and the broader political 'elites'. Data from the World Value Survey (n = 21,650; Study 1, electoral CB) and from representative samples from polls conducted in France (n = 1760, Study 2a, conspiracy mentality) and Italy (n = 2196, Study 2b, COVID-19 CB), corroborate a mediation model whereby precarity is directly and indirectly associated with lower trust in authorities and higher CB. In addition, these links are robust to adjustment on income, self-reported SES and education. Considering precarity allows for a truly social-psychological understanding of CB as the by-product of structural issues (e.g. growing inequalities). Results from our socio-functional model suggest that implementing solutions at the socio-economic level could prove efficient in fighting CB., (© 2022 The Authors. British Journal of Social Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

This paper analyses the response to the COVID‐19 pandemic of inbound tourism to Italy looking at variation across countries and provinces. To this end, it uses weekly data on the number of foreign visitors in Italy from January 2019 until February 2021, as provided by a primary mobile telephony operator. We document a very robust negative relation at the province level between the local epidemic situation and the inflow of foreign travellers. Moreover, provinces with a historically higher share in art‐tourism, and those that used to be 'hotel intensive' were hit the most during the pandemic, while provinces with a more prevalent orientation to business tourism proved to be more resilient. Entry restrictions with varying degrees of strictness played a key role in explaining cross‐country patterns. After controlling for these restrictions, we observed that the number of travellers that could arrive by private means of transportation decreased proportionally less. Overall, this evidence emphasises that contagion risk considerations played a significant role in shaping international tourism patterns during the pandemic. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic, which has affected a significant number of individuals worldwide, is generating serious mental health issues. Recovered COVID‐19 patients have experienced traumatic events related to their symptoms, isolation, possible hospitalization, bereavement, fear of infecting loved ones and the physical consequences of COVID‐19. One effective psychological treatment for these patients is Eye Movement Desensitization and Reprocessing (EMDR). The aim of this paper is to describe the therapeutic intervention and effects of EMDR in a pool of COVID‐19 survivors referred to an integrated psychological/psychiatric outpatient service. Twelve patients, comprising of nine males and three females, underwent EMDR psychotherapy from October 2020 to February 2022. Each patient received 8–16 weekly treatment sessions. The standard EMDR protocol of eight stages was administered to enable desensitization and reprocessing of four main targets: first positive swab, hospitalization, isolation and fear for relatives' health. Efficacy of EMDR was demonstrated by the significant improvement at clinical scale for subjective distress caused by traumatic events. For the therapists, carrying out these treatments was an intense and challenging experience. In fact, the perceived distance between therapist and patient was less defined than in other hospital settings because the pandemic affects everyone equally. However, with the widespread availability of vaccines and although the pandemic is still ongoing with the emergence of new variants, a window of improvement in the mental health landscape is starting to open up. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has caused disruptive changes across different life experiences essential to children's growth and development, including early childcare services and schools, thus threatening precious opportunities for children in early childhood to learn. The pandemic has also undermined the collaborative and alliance relationship between childcare services and families which has been widely considered an important aspect of modern services. This paper presents and discusses results from a mixed‐method exploratory study with early childcare services for children between 0 and 6 years in Italy in 2021, involving both teachers and parents, to understand experiences, educational practices put in place in childcare services, feelings, resources and risks perceived by families and teachers. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has challenged nations states across the world. They have implemented lockdown and social distancing and with the development of vaccines have gone to great lengths to build herd immunity for their populations. As place managers, local government has played a variety of roles supporting central government edicts related to social distancing and supporting local businesses impacted by lockdowns. The research reported here comparing the role local government has played in Australia, Canada, Italy, and New Zealand shows that they have at different times and for different issues been policy takers from central government, policy shapers, and policy makers adapting national strategies. Local government plays an important complementary role with central governments in both unitary and federal systems of government. The paper contributes to the literature on multi‐level governance, place‐based decision‐making, and disaster and emergency management by offering a framework for analysing municipal roles in crises management both in their relationship with higher layers of government and in their acting as locally placed organisations. Points for practitioners: Cross‐national study: Australia, Canada, Italy, and New Zealand.Examination of local government responses to COVID‐19 pandemic as policy makers, takers, or shapers.Comparison of federal and unitary states. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic is a highly dramatic concern for mankind. In Italy, the pandemic exerted its major impact throughout the period of February to June 2020. To date, the awkward amount of more than 134,000 deaths has been reported. Yet, post‐mortem autopsy was performed on a very modest number of patients who died from COVID‐19 infection, leading to a first confirmation of an immune‐thrombosis of the lungs as the major COVID‐19 pathogenesis, likewise for SARS. Since then (June–August 2020), no targeted early therapy considering this pathogenetic issue was approached. The patients treated with early anti‐inflammatory, anti‐platelet, anticoagulant and antibiotic therapy confirmed that COVID‐19 was an endothelial inflammation with immuno‐thrombosis. Patients not treated or scarcely treated with the most proper and appropriate therapy and in the earliest, increased the hospitalization rate in the intensive care units and also mortality, due to immune‐thrombosis from the pulmonary capillary district and alveoli. The disease causes widespread endothelial inflammation, which can induce damage to various organs and systems. Therapy must be targeted in this consideration, and in this review, we demonstrate how early anti‐inflammatory therapy may treat endothelia inflammation and immune‐thrombosis caused by COVID‐19, by using drugs we are going to recommend in this paper. [ABSTRACT FROM AUTHOR]

During the COVID‐19 pandemic, families experienced new challenges related to reorganizing living spaces and the need to renegotiate domestic and care roles. This paper aims to understand how Italian families have reacted to this situation with respect to psychological well‐being, the management of domestic and care activities and solidarity networks of care. The participants were 560 Italian subjects who reported having a parental role. The protocol included a measure of well‐being (the General Health Questionnaire‐12) and some questions related to the time dedicated to domestic activities or to caring for people, the perception of conflict within the family and solidarity networks of care. The data underline how mothers continued to devote more time to home and care activities than fathers, despite the presence of both partners at home during the lockdown. The results also indicate that mothers participated to a greater extent than fathers in solidarity activities, confirming that this dimension is linked to gender. Furthermore, fathers and mothers perceived a lower condition of well‐being in relation to the pre‐pandemic period. [ABSTRACT FROM AUTHOR]

Background: The rapid spread of COVID‐19 forced many countries to adopt severe containment measures, transferring all didactic activities into virtual environments. However, the integration of technology in teaching may present difficulties, especially in some countries, such as Italy. Objectives: The present study analyzed how the two main factors of the Technology Acceptance Model (TAM), namely perceived usefulness and perceived ease of use, combined with online teaching self‐efficacy, were associated with the intention to use technology to teach. We posited a moderated moderation model in which perceived usefulness represented the main predictor, with self‐efficacy and perceived ease of use as moderators of intention to use technology to teach. Method: The model was tested through multiple regressions, using the PROCESS macro on SPSS 26 with a sample of 178 upper secondary school teachers in Italy. Results and conclusions: Regressions showed that each variable significantly predicted the intention to use technology. In addition, a moderation effect of self‐efficacy on the perceived usefulness of using technology was found for medium and high‐level of perceived ease of use of technology. Implications: The present study provides targeted implications for distance education policy and practice to promote its adoption (or the blended modality) in Italian upper schools. Lay Description: What is already known about this topic: The spread of COVID‐19 forced schools to transfer didactic activities into virtual environments. However, distance education presented difficulties in its implementation among teachers.Perceived usefulness, perceived ease of use and online teaching self‐efficacy played a crucial role in behavioural intention to use technology.Little was know about the relationship between these factors in fostering technology for distance teaching. What this paper adds: Based on the TAM model, our findings add a new way in which these variables can interact to promote the behavioural intention to use technology in teaching.The greatest level of behavioural intention to use was found when perceived usefulness, perceived ease of use and online teaching self‐efficacy presented high levels.A moderation effect of online teaching self‐efficacy on the perceived usefulness of using technology was described for medium and high level perceived ease of use of technology.High levels of self‐efficacy represented a key factor in promoting the use of distance teaching per se. Implications for practice and/or policy: Interventions and training courses should be implemented to promote perceived usefulness, online teaching self‐efficacy and to provide teachers with easy and straightforward technologies.These training courses may be particular crucial in encouraging teachers to manage distance education (or blended modality) if the spread of COVID‐19 may require a new period of lockdown and closure of schools.Teacher training on these topics is more necessary in countries where that integration of technology into teaching is low, such as in Italy. [ABSTRACT FROM AUTHOR]

Background: Since November 2020, Italy was the first country to carry out a protocol and use liver from COVID‐19 donors. We aimed to evaluate the medium‐term outcome of patients who underwent liver transplant (LT) with those grafts. Methods: We consecutively enrolled 283 patients who underwent first LT from November 2020 to December 2022 in our Center (follow‐up 468 days). Twenty‐five of 283 (8.8%, study population) received a graft from donors with previous (4%) or active (96%) SARS‐CoV‐2 infection, and 258/283 (91.2%, control group) received a graft from COVID‐19‐negative donors. SARS‐CoV‐2‐RNA was tested on graft tissue of COVID‐19 donors and their recipients underwent weekly evaluation of SARS‐CoV‐2‐RNA in nasal swabs for the first month after LT. Results: One‐year and 2‐year patient survival was 88.5% and 88.5% in study group versus 94.5% and 93.5% in control group, respectively (p =.531). In study population there was no evidence of donor‐recipient virus transmission, but three (12%) patients (vs. 7 [2.7%] of control group, p =.048) developed hepatic artery thrombosis (HAT): they were SARS‐CoV‐2‐RNA negative at LT and 1/3 grafts tested SARS‐CoV‐2‐RNA positive on liver tissue. COVID‐19 donor was independently associated with HAT (odds ratio (OR) = 4.85, 95% confidence interval (CI) 1.10–19.15; p =.037). By comparing study population with control group, acute rejection and biliary complication rates were not significantly different (16% vs. 8.1%, p =.26; 16% vs. 16.3% p =.99, respectively). Conclusions: Our 1‐year results of transplant strategy including liver grafts from COVID‐19 donors were favorable. HAT was the only complication with significantly higher rate in patients transplanted with COVID‐19 donors compared with control group. [ABSTRACT FROM AUTHOR]

COVID‐19 has altered adolescents' opportunities for developing and strengthening interpersonal skills and proficiencies. Using data from adolescents in Italy, the United States, and the United Kingdom, we examined the relation between internalizing symptoms assessed pre‐pandemic or when pandemic‐related restrictions were lifted (Time 1) and associated internalizing symptoms during a subsequent restrictive pandemic period (Time 2). Across all 3 countries, we found significant and consistent effect sizes in the relation between Time 1 and Time 2 internalizing symptoms. We further examined the direct and moderating impact of self‐efficacy and contextual supports for adolescents' internalizing symptoms. Higher self‐efficacy was associated with lower levels of internalizing symptoms at Time 2 in all 3 countries. Additionally, the relation between Time 1 and 2 internalizing symptoms was buffered by regulatory self‐efficacy and peer support in Italy, but in the U.S., higher levels of general self‐efficacy instead had an exacerbating effect on the relation between Times 1 and 2 internalizing symptoms. Results are discussed in the context of utilizing cross‐national datasets to examine similarities in adolescent well‐being over time and in the face of varying government responses to the pandemic. [ABSTRACT FROM AUTHOR]

The present study explores how Italian regions and their presidents employed Facebook during the Covid‐19 pandemic to encourage citizen engagement. To do so, it adopts quantitative methodologies. Our results show that most public actors increased their levels of social activity during the pandemic but mainly for promoting public communication and that citizens much prefer interacting with presidents. Moreover, citizen engagement was higher when posts were published during nonbusiness hours or weekends, while it decreased when posts contained photos or videos. [ABSTRACT FROM AUTHOR]

Summary: Splenectomy/asplenia is a condition associated with immune‐compromission and specific vaccines are recommended for these patients, including the anti‐COVID‐19 vaccine. Among the high‐risk group for which vaccination was prioritized in Italy, the immunocompromised patients after therapies or treatments were included. The Apulian regional archive of hospital discharge forms was used to define the list of splenectomized Apulian inhabitants, considering data from 2015 through 2020. The overall vaccination status of asplenic patients was assessed via data collected from the Regional Immunization Database. The history of SARS‐CoV‐2 infection and the infectious disease outcomes were extracted from the Italian Institute of Health platform "Integrated surveillance of COVID‐19 cases in Italy". 1219 Apulian splenectomized inhabitants were included; the incidence rate of SARS‐CoV‐2 infection was 15.0 per 100 persons‐year with a proportion of re‐infection equal to 6.4%; the proportion of hospitalization was 2.9%, with a case‐fatality rate of 2.6%. The vaccine coverage (VC) for the anti‐COVID‐19 vaccine basal routine was 64.2%, for the first booster dose was 15.4%, and for the second booster dose was 0.6%. A multifactorial approach is needed to increase the vaccination uptake in this sub‐group population and to increase the awareness of the asplenia‐related risks to patients and health personnel. [ABSTRACT FROM AUTHOR]

Introduction: Brugada syndrome (BrS) has a dynamic ECG pattern that might be revealed by certain conditions such as fever. We evaluated the incidence and management of ventricular arrhythmias (VAs) related to COVID‐19 infection and vaccination among BrS patients carriers of an implantable loop recorder (ILR) or implantable cardioverter‐defibrillator (ICD) and followed by remote monitoring. Methods: This was a multicenter retrospective study. Patients were carriers of devices with remote monitoring follow‐up. We recorded VAs 6 months before COVID‐19 infection or vaccination, during infection, at each vaccination, and up to 6‐month post‐COVID‐19 or 1 month after the last vaccination. In ICD carriers, we documented any device intervention. Results: We included 326 patients, 202 with an ICD and 124 with an ILR. One hundred and nine patients (33.4%) had COVID‐19, 55% of whom developed fever. Hospitalization rate due to COVID‐19 infection was 2.76%. After infection, we recorded only two ventricular tachycardias (VTs). After the first, second, and third vaccines, the incidence of non‐sustained ventricular tachycardia (NSVT) was 1.5%, 2%, and 1%, respectively. The incidence of VT was 1% after the second dose. Six‐month post‐COVID‐19 healing or 1 month after the last vaccine, we documented NSVT in 3.4%, VT in 0.5%, and ventricular fibrillation in 0.5% of patients. Overall, one patient received anti‐tachycardia pacing and one a shock. ILR carriers had no VAs. No differences were found in VT before and after infection and before and after each vaccination. Conclusions: From this large multicenter study conducted in BrS patients, followed by remote monitoring, the overall incidence of sustained VAs after COVID‐19 infection and vaccination is relatively low. [ABSTRACT FROM AUTHOR]

Background: During the Coronavirus disease 2019 (COVID‐19) pandemic, hospital visits were suspended and video calls were offered to connect patients with their family members, especially toward the end of life (EoL). Aim: The primary aim was to describe EoL care for COVID‐19 patients dying in an intensive care unit (ICU). The secondary aim was to explore whether making video calls and allowing visits was associated with lower death‐related stress in family members. Design: Single centre cross‐sectional study. The setting was the ICU of a COVID‐19 center in northern Italy, during the first year of the pandemic. Data on patients who died in the ICU were collected; death‐related stress on their family members was measured using the Impact of Event Scale‐Revised (IES‐R). The statistical association was tested by means of logistic regression. Results: The study sample included 70 patients and 56 family members. All patients died with mechanical ventilation, hydration, nutrition, analgesia and sedation ongoing. Resuscitation procedures were performed in 5/70 patients (7.1%). Only 6/56 (10.7%) of the family members interviewed had visited their loved ones in the ICU and 28/56 (50%) had made a video call. EoL video calls were judged useful by 53/56 family members (94.6%) but all (56/56, 100%) wished they could have visited the patient. High‐stress levels were found in 38/56 family members (67.9%), regardless of whether they were allowed ICU access or made a video call. Compared with other degrees of kinship, patients' offspring were less likely to show a positive IES‐R score (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.05 to 0.89). Conclusions: During the first year of the COVID‐19 pandemic, patients died without their family members at the bedside while on life‐sustaining treatment. Stress levels were high in most family members, especially in patients' spouses. Video calls or ICU visits were judged favourably by family members but insufficient to alleviate death‐related stress. Relevance for Clinical Practice: During a pandemic, ICU access by patients' family members should be considered, particularly as the time of death approaches. Although generally appreciated by family members, EoL video calls should be arranged together with other measures to alleviate death‐related stress, especially for the patient's spouse. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has deeply affected the mental health of millions of people. We assessed which of many leisure activities correlated with positive mental health outputs, with particular attention to music, which has been reported to be important for coping with the psychological burden of the pandemic. Questionnaire data from about 1000 individuals primarily from Italy, Spain, and the United States during May–June 2020 show that people picked music activities (listening to, playing, singing, etc.) most often as the leisure experiences that helped them the most to cope with psychological distress related with the pandemic. During the pandemic, hours of engagement in music and food‐related activities were associated with lower depressive symptoms. The negative correlation between music and depression was mediated by individual differences in sensitivity to reward, whereas the correlation between food‐related activities and improved mental health outputs was explained by differences in emotion suppression strategies. Our results, while correlational, suggest that engaging in music activities could be related to improved well‐being with the underlying mechanism being related to reward, consistent with neuroscience findings. Our data have practical significance in pointing to effective strategies to cope with mental health issues beyond those related to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

We explore how the Chinese diaspora state during the COVID‐19 pandemic in 2020 managed to transform a severe health crisis into a geo‐political opportunity for transnational nation‐building through diaspora governance based on extensive use of social media technologies. By adopting a multi‐scalar perspective, we analyse the intertwined nature of top‐down and bottom‐up processes of the Chinese Party‐state's diaspora mobilization. Based on discourse and ethnographic analysis, we argue that China's diaspora governance exposed a new and strong capacity for extra‐territorial governance. We explore how discursive hegemony, social control and diaspora mobilization were achieved by widely employing the Chinese social media application, WeChat. We also contend that this was facilitated by the Italian government's and media's pro‐China attitudes to emphasize the importance of considering transnational embeddedness when studying the implementation and impact of interactive online technology for diaspora governance in an illiberal political context. [ABSTRACT FROM AUTHOR]

Background: Occupational skin diseases (OSDs) are common in healthcare workers (HCWs). Objectives: To investigate and compare the incidence and clinical features of OSDs among HCWs before and during the COVID‐19 pandemic. Materials and Methods: Incident cases of OSDs were investigated in the cohort of HCWs at Trieste Hospitals from 1 July 2018 (3340 workers) to 31 October 2021 (137 532 person‐months). Results: The monthly incidence was ranging from 0 to 11.90 cases per 10 000 person‐months in pre‐COVID‐19 period (cumulative incidence 4.22; 95% confidence interval [CI]: 2.9–6.0) and from 0 to 13.61 cases per 10 000 person‐months in COVID‐19 period (cumulative incidence 5.06; 95% CI: 3.6–6.9). The incidence rate ratio (IRR) between COVID‐19 and pre‐COVID‐19 period was 1.22 (95% CI: 0.73–1.98). The incidence of OSDs in the COVID‐19 period was 6.1 (4.2–8.6) and 2.7 (95% CI: 1.1–5.6) cases × 10 000 person‐months for women and men, respectively, with an IRR of 2.25 (95% CI: 0.98–5.9). Incidence in nurses in the COVID‐19 period was 6.7 (95% CI: 4.2–10.2) cases × 10 000 person‐months. Conclusions: Incidence of OSDs was a little bit higher during the COVID‐19 pandemic compared to the previous period but fluctuation of numbers were mainly related to calendar period, with higher incidence in winter and spring. Incidence data were higher than that observed in 2004–2013 in the same cohort. Face dermatitis cases doubled after the start of COVID‐19 pandemic. Overall data demonstrated a non‐significant increase of OSDs in HCWs during the pandemic, probably due to the preventive strategies set up in our cohort over the years. [ABSTRACT FROM AUTHOR]

Aim: To compare the occurrence and the reasons for unfinished care among coronavirus disease (COVID‐19) and non‐COVID‐19 patients as perceived by nurses. Background: The recent pandemic has imposed tremendous changes in hospitals in all countries. Introduction: Investigating the occurrence of and the reasons for unfinished care as perceived by nurses working in COVID‐19 and non‐COVID‐19 units might help to gain insights and to address future pandemics. Methods: A comparative cross‐sectional study based on the STROBE guideline has been conducted during November 2020–January 2021. The Unfinished Nursing Care Survey, comprising part A (elements) and part B (reasons), was administered online to all 479 nurses working in medical and surgical units converted progressively into COVID‐19 and non‐COVID‐19 units. A total of 90 and 200 nurses participated, respectively. Results: No differences in the unfinished care occurrence have emerged at the overall level between nurses caring for COVID (2.10 out of 5; 95% confidence interval [CI], 1.94–2.27) and non‐COVID‐19 patients (2.16; 95% CI, 2.06–2.26). Reasons for unfinished care reported significant higher averages among nurses caring for COVID (2.21; 95% CI, 2.10–2.31) as compared with those caring for non‐COVID‐19 patients (2.07; 95% CI, 2.01–2.14; p = 0.030). Discussion: The overall occurrence of unfinished care was slightly higher compared with pre‐pandemic data in all patients. Conclusions: Reasons triggering unfinished care were slightly different and were due to priority setting and human resources issues, which were perceived at higher significance among nurses working in COVID‐19 compared with non‐COVID‐19 units. Implication for nursing and health policies: A clear map of action has emerged that might be valid in the post‐COVID‐19 era as well as in the case of future pandemics. [ABSTRACT FROM AUTHOR]

Italy was the first European country to be affected by the Covid‐19. To limit the contagion, an emergency protocol was triggered on March 10, 2020, which imposed a lockdown for 69 days. Many Italians considered the restrictions imposed by the government excessive and unnecessary. We hypothesized that agreement with government restrictions and compliance with imposed rules was positively correlated with trust in institutions, civic engagement, and the sense of community. To this end, during the lockdown period, we administered an online questionnaire to 189 Sicilians. The results showed that trust in institutional organizations and the attitude component of civic engagement facilitate the approval of limitations imposed during the lockdown period and the acceptance of future restrictions. Unexpectedly, the behavioral component of civic engagement leads to the rejection of restrictions and behaviors that could contain a further spread of the virus. Indeed, participants who declared that they were engaged in beneficial actions for their community disapproved of the measures already adopted and were unwilling to adopt future behaviors to limit the spread of the virus. [ABSTRACT FROM AUTHOR]

Background and purpose: Many single cases and small series of Guillain–Barré syndrome (GBS) associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection were reported during the coronavirus disease 19 (COVID‐19) outbreak worldwide. However, the debate regarding the possible role of infection in causing GBS is still ongoing. This multicenter study aimed to evaluate epidemiological and clinical findings of GBS diagnosed during the COVID‐19 pandemic in northeastern Italy in order to further investigate the possible association between GBS and COVID‐19. Methods: Guillain–Barré syndrome cases diagnosed in 14 referral hospitals from northern Italy between March 2020 and March 2021 were collected and divided into COVID‐19‐positive and COVID‐19‐negative. As a control population, GBS patients diagnosed in the same hospitals from January 2019 to February 2020 were considered. Results: The estimated incidence of GBS in 2020 was 1.41 cases per 100,000 persons/year (95% confidence interval 1.18–1.68) versus 0.89 cases per 100,000 persons/year (95% confidence interval 0.71–1.11) in 2019. The cumulative incidence of GBS increased by 59% in the period March 2020–March 2021 and, most importantly, COVID‐19‐positive GBS patients represented about 50% of the total GBS cases with most of them occurring during the two first pandemic waves in spring and autumn 2020. COVID‐19‐negative GBS cases from March 2020 to March 2021 declined by 22% compared to February 2019–February 2020. Conclusions: Other than showing an increase of GBS in northern Italy in the "COVID‐19 era" compared to the previous year, this study emphasizes how GBS cases related to COVID‐19 represent a significant part of the total, thus suggesting a relation between COVID‐19 and GBS. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has led to restrictions in our contact with others and the introduction of social distancing barriers. These rules can enhance the psychological mechanisms resulting from fear of contamination and may lead to exacerbating prejudiced attitudes towards certain social groups seen as possible carriers of infection. Fear of infection and ideas about cleanliness and dirtiness have indeed historically and culturally influenced the way we interact with other people, both on an inter‐personal and inter‐group level. The aim of the present research is to analyse whether the concern about COVID‐19 is linked to prejudices towards other social groups and whether this relationship is mediated by individual representations of cleanliness. Results on 251 Italian citizens showed that concerns about COVID‐19 are positively related to prejudicial attitudes towards immigrants and that such a relation is indeed mediated by so‐called cultural representations of cleanliness. Specifically, the so‐called cultural representations of hygiene—by which people and groups are categorized as being more or less civilized on the basis of their cleaning practices—was a significant mediator. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Objective: Data on COVID‐19 outcomes in persons with epilepsy (PWE) are scarce and inconclusive. We aimed to study the risk of hospitalization and death for COVID‐19 in a large cohort of PWE from March 1, 2020 to October 31, 2021. Methods: The historical cohort design (EpiLink Bologna) compared adult PWE grouped into people with focal epilepsy (PFE), idiopathic generalized epilepsy (PIGE), and developmental and/or epileptic encephalopathy (PDEE), and a population cohort matched (ratio 1:10) for age, sex, residence, and comorbidity (assessed with the multisource comorbidity score), living in the local health trust of Bologna (approximately 800 000 residents). Clinical data were linked to health administrative data. Results: In both cohorts (EpiLink: n = 1575 subjects, 1128 PFE, 267 PIGE, 148 PDEE, 32 other; controls: n = 15 326 subjects), 52% were females, and the mean age was 50 years (SD = 18). Hospital admissions for COVID‐19 in the whole period were 49 (3.1%) in PWE and 225 (1.5%) in controls. The adjusted hazard ratio (aHR) in PWE was 1.9 (95% confidence interval [CI] = 1.4–2.7). The subgroups at higher risk were PFE (aHR = 1.9, 95% CI = 1.3–2.8) and PDEE (aHR = 3.9, 95% CI = 1.7–8.7), whereas PIGE had a risk comparable to the controls (aHR = 1.1, 95% CI =.3–3.5). Stratified analyses of the two main epidemic waves (March–May 2020, October 2020–May 2021) disclosed a higher risk of COVID‐19‐related hospitalization during the first epidemic wave (March–May 2020; aHR = 3.8, 95% CI = 2.2–6.7). Polytherapy with antiseizure medications contributed to a higher risk of hospital admission. Thirty‐day risk of death after hospitalization was 14% in both PWE and controls. Significance: During the first 20 months since the outbreak of COVID‐19 in Bologna, PWE had a doubled risk of COVID‐19 hospital admission compared to a matched control population. Conversely, epilepsy did not represent a risk factor for COVID‐19‐related death. [ABSTRACT FROM AUTHOR]

From December 2019, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection has spread rapidly, leading to a global pandemic. Little is known about possible relationships between SARS‐CoV‐2 and other viruses in the respiratory system affecting patient prognosis and outcomes. This study aims to characterize respiratory virome profiles in association with SARS‐CoV‐2 infection and disease severity, through the analysis in 89 nasopharyngeal swabs collected in a patient's cohort from the Campania region (Southern Italy). Results show coinfections with viral species belonging to Coronaviridae, Retroviridae, Herpesviridae, Poxviridae, Pneumoviridae, Pandoraviridae, and Anelloviridae families and only 2% of the cases (2/89) identified respiratory viruses. Key Points: •The severe acute respiratory syndrome coronavirus 2 infection is considered a major global threat that is still spreading around the world.•Nasopharyngeal swabs samples were collected from the Campania region cohort of 89 Covid‐19 patients.•Descriptive analysis of respiratory virome was carried out with the HOME‐BIO pipeline, that performed viral taxonomy profiling.•It detected coinfections with viral species belonging to Coronaviridae, Retroviridae, Herpesviridae, Poxviridae, Pneumoviridae, Pandoraviridae, and Anelloviridae family.•Only 2% of the cases (2/89) identified respiratory viruses. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has placed considerable strain on healthcare workers showing high rates of stress and psychological health problems. Interventions are urgently needed to help healthcare workers perform under conditions of great risk and uncertainty. In particular, healthcare leadership is known to be critical to supporting healthcare workers to deal with an uncertain and distressing healthcare environment. This pilot study evaluated the impact of the R2 resilience program tailored for healthcare leaders working in a highly affected COVID‐19 area in Italy. Through two group cohorts, 21 healthcare leaders completed the intervention, with 17 participants providing pre‐ and post‐intervention assessment data. Sixty‐two staff members who benefitted from their coordinators' resilience‐focused leadership were also included in the study. Findings show that participation in R2 was associated with reduction in levels of perceived stress and burnout symptoms, and increases in rugged qualities, self‐efficacy and in social‐ecological resilience. Significant changes in rugged qualities, self‐efficacy and perceived stress were also detected in staff members. High rates of participants' program satisfaction have been detected. R2 is a promising intervention for healthcare professionals working in emergency settings designed to enhance the rugged qualities and resources required to deal with heightened exposure to stress. [ABSTRACT FROM AUTHOR]

Summary: A large body of evidence has documented the impact of the global COVID‐19 outbreak – and especially the lockdown period – on sleep quality and quantity. Here, we present the first Italian longitudinal study on sleep and COVID‐19 considering four different time points collected during lockdown (from 29 March 2020 to 3 May 2020) and a subsequent follow‐up period (October 2020). We used an online survey to collect socio‐demographic and COVID‐19 related information. Subjects were also asked to complete a sleep diary at each time point of the study. Our longitudinal sample included 147 participants. Statistical comparison across time intervals showed remarkable changes in sleep patterns during and after the lockdown. In particular, during lockdown we observed longer sleep latency, less ease of falling asleep, a higher total bedtime, and a lower dream frequency. The week‐by‐week evaluation described relatively stable patterns in the observed measures during the lockdown period, except for dream frequency, affected by a rapid increase in the early phase of lockdown. Our findings are in line with the current literature. Furthermore, the prospective longitudinal investigation comprising several time points offered the possibility of (a) observing the temporal dynamics and the different entities of such changes over time, and (b) reducing the typical memory bias for these studies. [ABSTRACT FROM AUTHOR]

This article analyses actual social dialogue experiences in Italy, Portugal and Spain in order to examine the social partners' participation in COVID‐19 crisis management. It considers the economic and political variables that have helped revitalize tripartism in all three countries relative to the previous economic crisis. The lack of austerity policies and responsibility‐sharing on the part of the social partners and governments paved the way for various agreements that, though differing in content and scope, attest to stronger peak‐level tripartite dialogue. [ABSTRACT FROM AUTHOR]

Resumen: Se aborda la participación de los agentes sociales en la gestión de la crisis de la COVID‐19 analizando las experiencias de diálogo social tripartito surgidas en España, Italia y Portugal. Se examinan las variables económicas y políticas que han podido favorecer la revitalización del tripartismo en estos tres países en comparación con la anterior crisis económica. En este sentido, la ausencia de políticas de austeridad y la asunción compartida de la responsabilidad por agentes sociales y gobiernos han impulsado la consecución de diferentes acuerdos que, aunque difieren en su contenido y alcance, evidencian un fortalecimiento del diálogo tripartito al máximo nivel. [ABSTRACT FROM AUTHOR]

Résumé: Les partenaires sociaux ont‐ils été associés à la gestion de la crise du COVID‐19? Pour le savoir, l'auteur observe les pratiques tripartites en Espagne, en Italie et au Portugal en 2020. Il recherche les variables économiques et politiques susceptibles d'avoir contribué au renouveau du dialogue social tripartite observé dans ces pays, par rapport à la crise économique précédente. L'abandon des politiques d'austérité et un sentiment de responsabilité partagé par les partenaires sociaux et les gouvernements semblent avoir contribué à la conclusion de plusieurs accords, de nature et de portée variables, mais qui permettent de conclure au renforcement du dialogue social au plus haut niveau. [ABSTRACT FROM AUTHOR]

Summary: Limited information is available on the impact of the COVID‐19 pandemic on the management of chronic myeloid leukaemia (CML). The Campus CML network collected retrospective information on 8 665 CML patients followed at 46 centres throughout Italy during the pandemic between February 2020 and January 2021. Within this cohort, we recorded 217 SARS‐CoV‐2‐positive patients (2·5%). Most patients (57%) were diagnosed as having SARS‐CoV‐2 infection during the second peak of the pandemic (September 2020 to January 2021). The majority (35%) was aged between 50 and 65 years with a male prevalence (73%). Fifty‐six percent of patients presented concomitant comorbidities. The median time from CML diagnosis to SARS‐CoV‐2 infection was six years (three months to 18 years). Twenty‐one patients (9·6%) required hospitalization without the need of respiratory assistance, 18 (8·2%) were hospitalized for respiratory assistance, 8 (3·6%) were admitted to an intensive care unit, while 170 (78%) were only quarantined. Twenty‐three percent of patients discontinued tyrosine kinase inhibitor (TKI) therapy during the infection. Twelve patients died due to COVID‐19 with a mortality rate of 5·5% in the positive cohort and of 0·13% in the whole cohort. We could also document sequelae caused by the SARS‐CoV‐2 infection and an impact of the pandemic on the overall management of CML patients. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic and consequent lockdown represent risk factors for the mental health of pregnant women. We explored the impact of COVID‐19 restriction policies on psychological health, analysing the predictive role of social support on maternal wellbeing. A total of 212 pregnant women recruited from two public hospitals in Italy were divided into two groups: (a) a pre‐COVID‐19 group composed of 141 expectant women (mean age = 34.6; SD = 4.3) at their third trimester before the national lockdown period; (b) a COVID‐19 group composed of 71 pregnant women (mean age = 33.3; SD = 4.5) at their third trimester during the COVID‐19 national lockdown. Participants completed two self‐report questionnaires: the Profile of Mood States and the Multidimensional Scale of Perceived Social Support. Moreover, the COVID‐19 group was asked to respond to an open question concerning worries about their pregnancies and COVID‐19. Results showed that pregnant women during COVID‐19 presented higher anxiety, depression and hostility, and lower vigour, than the pre‐COVID‐19 group. The main concerns were related to the effect of hospital restriction policies on childbirth and fears of contracting COVID‐19. Perceived partner social support represented a protective factor only for the pre‐COVID‐19 women. Limitations, strengths, and theoretical and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this article was to describe SARS‐CoV‐2 infection among pregnant women during the wild‐type and Alpha‐variant periods in Italy. The secondary aim was to compare the impact of the virus variants on the severity of maternal and perinatal outcomes. Design: National population‐based prospective cohort study. Setting: A total of 315 Italian maternity hospitals. Sample: A cohort of 3306 women with SARS‐CoV‐2 infection confirmed within 7 days of hospital admission. Methods: Cases were prospectively reported by trained clinicians for each participating maternity unit. Data were described by univariate and multivariate analyses. Main outcome measures: COVID‐19 pneumonia, ventilatory support, intensive care unit (ICU) admission, mode of delivery, preterm birth, stillbirth, and maternal and neonatal mortality. Results: We found that 64.3% of the cohort was asymptomatic, 12.8% developed COVID‐19 pneumonia and 3.3% required ventilatory support and/or ICU admission. Maternal age of 30–34 years (OR 1.43, 95% CI 1.09–1.87) and ≥35 years (OR 1.62, 95% CI 1.23–2.13), citizenship of countries with high migration pressure (OR 1.75, 95% CI 1.36–2.25), previous comorbidities (OR 1.49, 95% CI 1.13–1.98) and obesity (OR 1.72, 95% CI 1.29–2.27) were all associated with a higher occurrence of pneumonia. The preterm birth rate was 11.1%. In comparison with the pre‐pandemic period, stillbirths and maternal and neonatal deaths remained stable. The need for ventilatory support and/or ICU admission among women with pneumonia increased during the Alpha‐variant period compared with the wild‐type period (OR 3.24, 95% CI 1.99–5.28). Conclusions: Our results are consistent with a low risk of severe COVID‐19 disease among pregnant women and with rare adverse perinatal outcomes. During the Alpha‐variant period there was a significant increase of severe COVID‐19 illness. Further research is needed to describe the impact of different SARS‐CoV‐2 viral strains on maternal and perinatal outcomes. The rate of severe COVID‐19 disease increased during the Alpha‐variant period compared with the wild‐type period. Linked article This article is commented on by J G Thornton, p. 232 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.16981. [ABSTRACT FROM AUTHOR]

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic‐regression analysis. The incidence of acute HDV per 1‐million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991–1999 to 44 years in the decade 2010–2019 (p <.001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p =.003) and that of HBsAg positive acute hepatitis tested for by IgM anti‐HDV linearly decreased from 50.1% to 34.1% (p <.001). People born abroad accounted for 24.6% of cases in 2004–2010 and 32.1% in 2011–2019. In the period 2010–2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4–12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15–10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM‐anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come. [ABSTRACT FROM AUTHOR]

The transfer of a chemical product from its original container to an unlabelled secondary container by consumers is a potential health hazard that may result in unintentional exposures and intoxications. The aim of this study was to describe the pattern of prevalence of exposures to transferred products in Italy from year 2017, when the new European labelling regulation for chemicals became fully operative, to 2020, year of the coronavirus 19 disease first outbreak. Calls to the Poison Control Centre (PCC) of Policlinico Umberto I Hospital ‐ Sapienza University of Rome were analysed retrospectively for characteristics, clinical presentation and circumstances related to the event. We registered 198 cases of interest. There was a reduction in cases from 2017 (4.9%) to 2019 (2.2%), followed by an increased prevalence in 2020 (4.2%) mainly due to the months "post‐lockdown." The transferred product was very frequently diluted, and an empty drinking bottle was usually used as secondary container. Exposures were mostly of minor severity, and no deaths occurred. The study highlights the importance of PCCs data in the evaluation of the hazard communication to users through labels and advises for public campaigns to promote safe behaviours during future lockdowns to prevent exposures at a later period. [ABSTRACT FROM AUTHOR]

Background: The global pandemic of the coronavirus disease 2019 represents a major concern for health services worldwide, and has also induced major changes in cytopathology practice. Aim: We aimed to verify the diagnostic performance of cytological evaluation under a new safety protocol during the pandemic compared to the standard pre‐pandemic procedure. We also aimed to assess how cytological diagnoses and sampling were impacted during the pandemic period compared to the pandemic‐free period in 2019. Materials and methods: Cytological samples of peritoneal washings taken during the first 10 months of the pandemic emergency in Italy (March 11, 2020 to January 11, 2021) were compared to samples from the preceding 10‐month time frame (May 11, 2019 to March 10, 2020). Results: One hundred ninety‐five specimens were analysed in the present study. We observed no noticeable differences in cytological diagnoses during the pandemic period compared to the pre‐pandemic period. The case numbers by diagnostic category for the pre‐pandemic vs pandemic periods, respectively, were as follows: non‐diagnostic, 0 vs 0 cases; negative for malignancy, 86 vs 52 cases; atypia of uncertain significance, 7 vs 1 cases; suspicious for malignancy, 0 vs 2 cases; malignant, 42 vs 4 cases. Conclusion: While a consistent reduction in the number of cytological examinations has been observed during the COVID‐19 period, our institutional safety protocol for processing cytological samples did not affect the diagnostic reliability of peritoneal washing cytology. [ABSTRACT FROM AUTHOR]

Objective: The coronavirus disease 2019 (COVID‐19) outbreak has been declared a global pandemic of unprecedented proportions. Italy is a country which has been heavily affected. Cancer patients are at a higher risk owing to their intrinsic fragility related to their underlying disease and oncologic treatment. Against this backdrop, we conducted a survey to investigate how patients perceived their condition, clinical management and availability of information during the pandemic. Methods: Between 15 April and 1 May 2020 a survey was submitted to cancer patients at oncology departments in the Marche region. Questions regarding the perception of personal safety, continuity of cancer care, information quality and psychological distress. Results: Seven hundred patients participated in the survey; 59% were female and 40% were aged between 46 and 65. The majority of the participants perceived compliance with appropriate safety standards by cancer care providers and 80% were reassured about their concerns during the medical interview. 40% were worried of being at a higher risk of infection and 71% felt they were at a greater risk because of chemotherapy. 55% felt that postponing cancer treatment could reduce its efficacy, however 76% declared they did not feel abandoned at the time of treatment postponement. Patients between 46 and 65 years declared a significant reduction in sleep (p < 0.01) and in concentration (p = 0.03). Conclusions: The emergency care offered to cancer patients has been deemed satisfactory in terms of both safety standards and care management. However, the majority of participants perceived the mutual negative influence between their oncologic disease and the risk of infection highlighting the need for special measures to ensure safe continuity of care. [ABSTRACT FROM AUTHOR]

COVID‐19 spread throughout the world during 2020, bringing an increase in global financial risk. We use connectedness network to investigate the risk contagion among global stock markets during the COVID‐19 pandemic and analyse its source. Furthermore, we use spectrum analysis to explore the risk contagion effects on different frequency bands, which allows us to explore its speed and channels. We find that the United Kingdom and Italy are core transmitters of risks, and connectedness is mainly driven by low‐frequency components, which demonstrates that the risks are spread by affecting supply chains in global markets and investors' long‐term expectations for the economy. [ABSTRACT FROM AUTHOR]

Background and purpose: Multiple sclerosis (MS) is a complex chronic, autoimmune inflammatory disease involving multidisciplinary assessments and interventions. Access to outpatient specialist and home healthcare services was explored during the pandemic outbreak and the lockdown amongst MS patients in the Lazio region. Adherence to disease‐modifying therapies (DMTs) is also described. Methods: A population‐based study was conducted using regional healthcare administrative databases. A validated algorithm was used to identify MS cases over the period 2011–2018. The numbers of specialist and home‐based services were compared between 2019 and 2020. The medication possession ratio was used to measure adherence to DMTs. Results: A total of 9380 MS patients were identified (68% women). A decline in the number of outpatient care services between March and June 2020 compared to the previous year was observed, in particular for rehabilitation (−82%), magnetic resonance imaging (−56%) and neurological specialist services (−91%). Important year‐to‐year variations were observed in May and June 2020 in home‐based nursing and medical care (−91%) and motor re‐education services (−74%). Adherence to DMTs was higher in the first 4 months of 2019 compared to the same period of 2020 (67.1% vs. 57.0%). Conclusions: A notable disruption of rehabilitative therapy and home‐based services as well as in DMT adherence was observed. Since the pandemic is still ongoing and interruption of healthcare services could have a major impact on MS patients, it is necessary to monitor access of MS patients to healthcare resources in order to ensure adequate treatments, including rehabilitative therapies. [ABSTRACT FROM AUTHOR]

Aim: To ascertain a delay in attendances to the emergency department (ED) during 2020 lockdown. Methods: Area‐based cohort study on paediatric (0‐15 years) attendances resulting in hospital admission in Tuscany, Italy, in February‐May 2020, and the corresponding periods in 2018‐19. We analysed times from symptom onset to arrival, the odds of arriving late (>90th centile of time) and paediatricians' judgements of a late presentation by logistic models. Results: As expected, ED attendance fell sharply (−62%) in 2020 vs 2018‐19. As for cases studied (455 in 2020 and 1161 in 2018–19), we documented a delay in arrival to the ED in 2020 versus 2018–19 for several groups of diagnoses, namely gastroenteritis, sepsis, wounds, burns and infections overall. Time to presentation over 90th centile was also higher in 2020 (odds ratio, OR: 1.44; 95% confidence interval: 1.00, 2.06), as were paediatricians' judgements of a late arrival (18.9% of cases in 2020 vs. 13.4% in 2018‐19; OR: 1.58; 1.14, 2.19) Conclusion: In a population‐based cohort, delayed attendances to ED ascertained both subjectively and objectively convey the message to families and to paediatricians to seek hospital care in case of severe or unremitting symptoms and not to wait longer than they normally would. [ABSTRACT FROM AUTHOR]

The article discusses the importance of not generalizing data on Brugada syndrome (BrS) patients who have a low probability of major ventricular arrhythmic events. It states that an accurate stratification of patients remains crucial, and that implantable cardioverter defibrillator (ICD) implantation is the only therapy to protect against sudden cardiac arrest. Also noted is the importance of specific data in therapeutic indications.

This is a mini commentary on S Donati et al., pp. 222–231 in this issue. To view this article visit https://doi.org/10.1111/1471-0528.16980 [ABSTRACT FROM AUTHOR]