Search

Adherence to vaccination recommendations is a challenge for national immunization programs. We quantified adherence to COVID-19 vaccination recommendations in people with substance use disorders (SUDs) attending an outpatient addiction center in Rome, Italy; we investigated the determinants of adherence, and also analyzed patient risk perception and compliance with preventive measures. A multivariable logistic regression model identified predictors of adherence to vaccination recommendations, with statistical validity tested by estimating adjusted odds ratios (aORs) and 95% confidence intervals (CIs). From December 2021 to January 2022, 200 SUD patients completed a questionnaire, 80% of whom reported being vaccinated against SARS-CoV-2 (minimum one dose). Negative predictors of vaccine uptake included being non-Italian (aOR: 0.36, 95% CI: 0.13–0.97), having coexisting comorbidities (aOR: 0.35, 95% CI: 0.13–0.95), and previous use of heroin (aOR: 0.24, 95% CI: 0.08–0.71). No difference was found for cocaine use, demographic characteristics, previous COVID-19 infection, methadone therapy, or compliance with preventive measures. Major reasons for non-adherence to vaccination recommendations were fear of side effects, insufficient recognition of the importance of vaccination, bureaucratic issues, and lack of trust in the authorities. Given their vulnerability, additional efforts are needed to facilitate access to vaccination for people with SUDs, and to limit disinformation around vaccines.. [ABSTRACT FROM AUTHOR]

Growing evidence is emerging on the higher risk of infection and adverse outcomes for the most disadvantaged groups of the population, and COVID-19 vaccination campaigns worldwide are struggling to ensure equitable access to immunization for all. From 21 June 2021 to 15 October 2021, the Local Health Unit ASL Roma 1 adopted a tailored immunization strategy to reach socially vulnerable groups of the population with the primary vaccination course. This strategy was developed with a step-by-step, participatory approach. Through engagement with internal and external stakeholders, target groups were identified, potential barriers analyzed, solutions discussed, and tailored interventions designed. Over nine thousand individuals from among irregular migrants, homeless people and hard-to-reach communities were contacted and vaccinated. [ABSTRACT FROM AUTHOR]

The adoption of digital contact-tracing apps to limit the spread of SARS-CoV-2 has been sup-optimal, but studies that clearly identify factors associated with the app uptake are still limited. In April 2021, we administered a questionnaire to healthcare university students to investigate their attitudes towards and experiences of the IMMUNI app. A multivariable logistic regression model was built to identify app download predictors. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. We surveyed 247 students. Most respondents (65.6%) had not downloaded IMMUNI, reporting as the main reason the perceived app uselessness (32.7%). In the multivariable analysis, being advised to use the app (aOR: 3.21, 95%CI: 1.80–5.73), greater fear of infecting others (aOR: 1.50, 95%CI: 1.01–2.23), and greater trust in the institutional response to the emergency (aOR: 1.33, 95%CI: 1.00–1.76) were positively associated with the outcome, whereas greater belief in the "lab-leak theory" of COVID-19 was a negative predictor (aOR: 0.75, 95%CI: 0.60–0.93). Major technical issues were reported by app users. Targeted strategies aimed at improving awareness of digital health applications should be devised. Furthermore, institutions should invest in the development of these technologies, to minimize technical issues and make them accessible to the entire population. [ABSTRACT FROM AUTHOR]

In recent years, the rapid proliferation of genomic tests for use in clinical practice has prompted healthcare systems to use a health technology assessment (HTA) approach to distinguish valuable from unwarranted applications. In this study, we narratively review the Italian HTA mechanisms for medical devices (MDs), both at the national and regional levels, and discuss the opportunity and benefits of extending them to genomic technologies, for which a dedicated assessment path was advocated by the National Plan for Public Health Genomics in 2017. We found that the National Health Technology Assessment Program for MDs, completed in 2019, had developed a structured pathway for the HTA of MDs; it established a hub-and-spoke structure, run by a governmental institution, and put in place transparent methodological procedures to cover all four HTA phases (i.e., proposal and prioritization, assessment, appraisal, and dissemination). However, several factors have hindered its adoption, and the regions are at different stages of its implementation. For these reasons, efforts should be made to ensure its effective deployment, both at national and regional levels. In addition, we argue that to harmonize the institutional roles and methodological procedures adopted, the time has come to concentrate resources on a single pathway for the assessment of all technologies that include both MDs and genomic applications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The Handling Editor DT declared a past collaboration with the authors EP, GM, CD, CM, and PV., (Copyright © 2022 Pitini, Migliara, Baccolini, Isonne, Mazzalai, Turatto, Salerno, Pagano, Menzano, De Vito, Marzuillo and Villari.)

Background: Worldwide, concerns rise on how COVID-19 pandemic impacted heavily on women, even on those belonging to the scientific community. The Italian scientific production regarding the COVID-19 throughout the first months of the health emergency could help to understand the heft of female researchers in this unique period., Objectives: This study aims to investigate the gender gap in the scientific production on COVID-19 in Italy during the first months of the pandemic., Methods: A systematic search of the literature was conducted and, for each included study, first and last author's gender, type of study, number of co-authors, type of affiliation, journal's Impact Factor (IF) and specialization were extracted. Descriptive and univariate analyses were performed., Results: 22.2% of the articles were signed by a woman as first author, 18.1% as last authors. Female authorship was less frequent than male authorship regardless of the type of study, number of co-authors, type of affiliation and field of specialization., Conclusion: This analysis reveal a low prevalence of studies with a female first or last author and suggests that the low share of female authors publishing on COVID-19 during the considered timespan is a transversal issue throughout the Italian medical field., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Mazzalai, Turatto and De Vito.)

In this paper, we updated our 2018 systematic review aimed to identify and compare ad hoc designed frameworks for genetic testing evaluation. Overall, we identified 30 frameworks (29 in the first systematic review and one in the update): they were mainly based on the ACCE model, whereas a minority were adjustments of the more traditional Health Technology Assessment (HTA) approach. After discussing the strengths and weaknesses of the retrieved frameworks, this perspective calls for consensus on the assessment of genetic testing. In line with the recent European recommendations that encouraged the generation of comparable evidence across Member States, we believe that the time has come to align all the ideas that have emerged over the last few decades and find a sustainable and sharable tool for the evaluation of genetic and genomic applications. Therefore, we suggest stopping the evaluation of such technologies using ad hoc strategies-affected by validation, implementation, and adoption issues-and we propose to use a general HTA approach, particularly the European reference tool for the assessment of health technologies, the EUnetHTA HTA core model, that is built on solid theoretical and methodological principles and provides a comprehensive assessment of the technologies value., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Pitini, Baccolini, Migliara, Isonne, Sindoni, Mazzalai, Turatto, De Vito, Marzuillo and Villari.)