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Introduction: A new national survey has been carried out by the Italian Centers for Cognitive Disorders and Dementias (CCDDs). The aim of this new national survey is to provide a comprehensive description of the characteristics, organizational aspects of the CCDDs, and experiences during the COVID-19 pandemic. Methods: A list of all national CCDDs was requested from the delegates of each Italian region. The online questionnaire is divided in two main sections: a profile section, containing information on location and accessibility, and a data collection form covering organization, services, treatments, activities, and any service interruptions caused by the COVID-19 outbreak. Results: In total, 511 out of 534 (96%) facilities completed the profile section, while 450 out of 534 (84%) CCDDs also completed the data collection form. Almost half of the CCDDs (55.1%) operated for 3 or fewer days a week. About one-third of the facilities had at least two professional figures among neurologists, geriatricians and psychiatrists. In 2020, only a third of facilities were open all the time, but in 2021, two-thirds of the facilities were open. Conclusion: This paper provides an update on the current status of CCDDs in Italy, which still shows considerable heterogeneity. The survey revealed a modest improvement in the functioning of CCDDs, although substantial efforts are still required to ensure the diagnosis and care of patients with dementia. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has exacerbated the pre-existing vulnerabilities and inequalities in societies. In this paper we analyse the categories that have suffered more than others from the pandemic and the restrictions on social life in terms of mental health. We rely on the Serendipity project based on a survey administered between November 2021 and February 2022 to a sample of Italian physicians (n = 1281). The survey aimed to assess the perception of general practitioners, paediatricians, geriatricians, and mental health specialists (psychiatrists, neurologists, child neuropsychiatrists), about changes in the mental health of the population as an effect of the COVID-19 pandemic and the lockdown. The strategies implemented by the doctors interviewed in terms of the intensity of the prevention, emergence, and treatment of mental health interventions, and their association with physicians' characteristics and their opinions on patient vulnerability have been illustrated by means of a multiple correspondence analysis. An overall result of the survey is the consensus of doctors on the worsening of mental health in general population, especially among their patients, due to the pandemic and on the onset of new discomforts. The most exposed individuals to the risk of onset or worsening of mental disorders include women, young people, and patients with psychiatric comorbidity. The paper also illustrates the interventions put in place by the physicians and deemed necessary from a public heath response perspective, that include providing psychoeducation to the general population, improving telehealth services, and increasing financial and human resources for community-based care. [ABSTRACT FROM AUTHOR]

Due to the dramatic health situation caused by the COVID-19 pandemic, in Italy the emergency remote teaching lasted longer than in other countries. The mandatory teaching modalities have required digital transformation processes in a framework where digital-divide is one of the limitations to school modernization. We believe that the experience can promote a deeper formatting of organizational process. The paper shows results of a multitarget research carried out during the Italian lockdown aiming at animating the debate around school from multi-actors perspectives and at supporting policies. The paper aims at showing the potentiality of a multivariate statistical method as a tool supporting school managers in identifying those challenges they have to face to improve the setting up of internal processes. The main result is a model supporting the decision making process at orienting school managers strategies. [ABSTRACT FROM AUTHOR]

In generalized linear models (GLMs), measures of lack of fit are typically defined as the deviance between two nested models, and a deviance-based R2 is commonly used to evaluate the fit. In this paper, we extend deviance measures to mixtures of GLMs, whose parameters are estimated by maximum likelihood (ML) via the EM algorithm. Such measures are defined both locally, i.e., at cluster-level, and globally, i.e., with reference to the whole sample. At the cluster-level, we propose a normalized two-term decomposition of the local deviance into explained, and unexplained local deviances. At the sample-level, we introduce an additive normalized decomposition of the total deviance into three terms, where each evaluates a different aspect of the fitted model: (1) the cluster separation on the dependent variable, (2) the proportion of the total deviance explained by the fitted model, and (3) the proportion of the total deviance which remains unexplained. We use both local and global decompositions to define, respectively, local and overall deviance R2 measures for mixtures of GLMs, which we illustrate—for Gaussian, Poisson and binomial responses—by means of a simulation study. The proposed fit measures are then used to assess, and interpret clusters of COVID-19 spread in Italy in two time points. [ABSTRACT FROM AUTHOR]

Despite the media are often described as critical for the success of the well-being agenda, there is wide dissatisfaction with their current level of interest. However, the media coverage of well-being metrics has been unresearched and, even when studies have been conducted, these employed unrobust methodologies, were limited to newspapers and to restricted samples of metrics. This paper fills such gap, providing also for the first time an analysis of radio and TV coverage of well-being metrics. The research was undertaken using Factiva (for newspapers) and TVEyes (for radio and TV) for the years of 2017–2021 and 2018–2021, respectively. The countries analysed are Scotland and Italy, both pioneers in the measurement of well-being. Findings reveal that media coverage of well-being metrics has been extremely low overall and that this was impacted negatively by the COVID-19 pandemic, which instead impacted positively on the reporting of GDP and related queries, showing that the main concern during the pandemic was the impact that this was going to have in terms of output, rather than in terms of well-being. Most composite indices, whose creation is often thought to help obtain greater media coverage, were almost if not even fully ignored by journalists, whereas metrics that lack an overall composite index but that are overseen by independent institutions and have been institutionalised were among the ones that were reported the most. [ABSTRACT FROM AUTHOR]

The dynamics of human mobility have been known to play a critical role in the spread of infectious diseases like COVID-19. In this paper, we present a simple compact way to model the transmission of infectious disease through transportation networks using widely available aggregate mobility data in the form of a zone-level origin-destination (OD) travel flow matrix. A key feature of our model is that it not only captures the propagation of infection via direct connections between zones (first-order effects) as in most existing studies but also transmission effects that are due to subsequent interactions in the remainder of the system (higher-order effects). We demonstrate the importance of capturing higher-order effects in a simulation study. We then apply our model to study the first wave of COVID-19 infections in (i) Italy, and, (ii) the New York Tri-State area. We use daily data on mobility between Italian provinces (province-level OD data) and between Tri-State Area counties (county-level OD data), and daily reported caseloads at the same geographical levels. Our empirical results indicate substantial predictive power, particularly during the early stages of the outbreak. Our model forecasts at least 85% of the spatial variation in observed weekly COVID-19 cases. Most importantly, our model delivers crucial metrics to identify target areas for intervention. [ABSTRACT FROM AUTHOR]

It is widely accepted that individual happiness is not, or not solely, related to material possessions, at least once basic needs are fulfilled. It has been demonstrated that interpersonal relationships and social capital matter too, and people whose values are more centred on material possessions have a greater probability of being less happy. Is this still true during the COVID-19 pandemic, when interpersonal relations, health and economic security are threatened and feelings of insecurity emerge? This is the issue that we address in this paper. We exploited the unique natural situation of the pandemic and lockdown in Italy to investigate the relationship between happiness and relational and material goods. Data collected by questionnaire during the lockdown suggests that the main direct effect of the pandemic on the happiness of respondents was related to the effect of the pandemic and lockdown on interpersonal relationships. Those who declared that COVID and lockdown had jeopardized their interpersonal relationships were significantly less likely to report higher levels of happiness, especially when controlling for other personal and contextual covariates. An important gender, religious and town size effect also emerged. Moreover, relational goods and good health were considered to be the most important determinants of happiness, though people were not so worried about their own health. [ABSTRACT FROM AUTHOR]

Italy was among the first countries to introduce drastic measures to reduce individual mobility in order to slow the diffusion of COVID-19. The first measures imposed by the central authorities on March 8, 2020, were unanticipated and highly localized, focusing on 26 provinces. Additional nationwide measures were imposed after one day, and were removed only after June 3. Looking at these watershed moments of the pandemic, this paper explores the impact of the adoption of localized restrictions on changes in individual mobility in Italy using a spatial discontinuity approach. Results show that these measures lowered individual mobility by 7 percentage points on top of the reduction in mobility recorded in the adjacent untreated areas. The study also fills a gap in the literature in that it looks at the changes in mobility after the nationwide restrictions were lifted and shows how the recovery in mobility patterns is related to various characteristics of local labour markets. Areas with a higher proportion of professions exposed to diseases, more suitable for flexible work arrangements, and with a higher share of fixed-term contracts before the pandemic are characterised by a smaller increase in mobility after re-opening. [ABSTRACT FROM AUTHOR]

This paper explores the effects of the pandemic on corruption and mismanagement in Italy, a country where the Covid-19 crisis is supposed to have significantly increased the risk of corruption. It proposes a novel operationalization of safeguards for accountability that are attached to the disbursement of recovery funds. Emergency law decrees and their implementing acts have been coded to assess whether the discretion in the allocation of recovery funds has been constrained by transparency requirements and enforcement provisions. Findings reveal that safeguards for accountability have been strengthened over time but that they have followed various patterns across recovery measures targeting businesses and people. [ABSTRACT FROM AUTHOR]

Nonlinear dynamics perspective is an interesting approach to describe COVID-19 epidemics, providing information to support strategic decisions. This paper proposes a dynamical map to describe COVID-19 epidemics based on the classical susceptible-exposed-infected-recovered (SEIR) differential model, incorporating vaccinated population. On this basis, the novel map represents COVID-19 discrete-time dynamics by adopting three populations: infected, cumulative infected and vaccinated. The map promotes a dynamical description based on algebraic equations with a reduced number of variables and, due to its simplicity, it is easier to perform parameter adjustments. In addition, the map description allows analytical calculations of useful information to evaluate the epidemic scenario, being important to support strategic decisions. In this regard, it should be pointed out the estimation of the number deaths, infection rate and the herd immunization point. Numerical simulations show the model capability to describe COVID-19 dynamics, capturing the main features of the epidemic evolution. Reported data from Germany, Italy and Brazil are of concern showing the map ability to describe different scenario patterns that include multi-wave pattern with bell shape and plateaus characteristics. The effect of vaccination is analyzed considering different campaign strategies, showing its importance to control the epidemics. [ABSTRACT FROM AUTHOR]

European countries struggled to fight against the second and the third waves of the COVID-19 pandemic, as the Test-Trace-Isolate (TTI) strategy widely adopted over the summer and early fall 2020 failed to contain the spread of the disease effectively. This paper sheds light on the effectiveness of such a strategy in two European countries (Spain and Italy) by analysing data from June to December 2020, collected via a large-scale online citizen survey with 95,251 and 43,393 answers in Spain and Italy, respectively. Our analysis describes several weaknesses in each of the three pillars of the TTI strategy: Test, Trace, and Isolate. We find that 40% of respondents had to wait more than 48 hours to obtain coronavirus tests results, while literature has shown that a delay of more than one day might make tracing all cases inefficient. We also identify limitations in the manual contact tracing capabilities in both countries, as only 29% of respondents in close contact with a confirmed infected individual reported having been contact traced. Moreover, our analysis shows that more than 45% of respondents report being unable to self-isolate if needed. We also analyse the mitigation strategies deployed to contain the second wave of coronavirus. We find that these interventions were particularly effective in Italy, where close contacts were reduced by more than 20% in the general population. Finally, we analyse the participants' perceptions about the coronavirus risk associated with different daily activities. We observe that they are often gender- and age-dependent, and not aligned with the actual risk identified by the literature. This finding emphasises the importance of deploying public-health communication campaigns to debunk misconceptions about SARS-CoV-2. Overall, our work illustrates the value of online citizen surveys to quickly and efficiently collect large-scale population data to support and evaluate policy decisions to combat the spread of infectious diseases, such as coronavirus. [ABSTRACT FROM AUTHOR]

Early warning tools are crucial for the timely application of intervention strategies and the mitigation of the adverse health, social and economic effects associated with outbreaks of epidemic potential such as COVID-19. This paper introduces, the Epidemic Volatility Index (EVI), a new, conceptually simple, early warning tool for oncoming epidemic waves. EVI is based on the volatility of newly reported cases per unit of time, ideally per day, and issues an early warning when the volatility change rate exceeds a threshold. Data on the daily confirmed cases of COVID-19 are used to demonstrate the use of EVI. Results from the COVID-19 epidemic in Italy and New York State are presented here, based on the number of confirmed cases of COVID-19, from January 22, 2020, until April 13, 2021. Live daily updated predictions for all world countries and each of the United States of America are publicly available online. For Italy, the overall sensitivity for EVI was 0.82 (95% Confidence Intervals: 0.75; 0.89) and the specificity was 0.91 (0.88; 0.94). For New York, the corresponding values were 0.55 (0.47; 0.64) and 0.88 (0.84; 0.91). Consecutive issuance of early warnings is a strong indicator of main epidemic waves in any country or state. EVI's application to data from the current COVID-19 pandemic revealed a consistent and stable performance in terms of detecting new waves. The application of EVI to other epidemics and syndromic surveillance tasks in combination with existing early warning systems will enhance our ability to act swiftly and thereby enhance containment of outbreaks. [ABSTRACT FROM AUTHOR]

We have further extended our compartmental model describing the spread of the infection in Italy. As in our previous work, the model assumes that the time evolution of the observable quantities (number of people still positive to the infection, hospitalized and fatalities cases, healed people, and total number of people that has contracted the infection) depends on average parameters, namely people diffusion coefficient, infection cross-section, and population density. The model provides information on the tight relationship between the variation of the reported infection cases and a well-defined observable physical quantity: the average number of people that lie within the daily displacement area of any single person. With respect to our previous paper, we have extended the analyses to several regions in Italy, characterized by different levels of restrictions and we have correlated them to the diffusion coefficient. Furthermore, the model now includes self-consistent evaluation of the reproduction index, effect of immunization due to vaccination, and potential impact of virus variants on the dynamical evolution of the outbreak. The model fits the epidemic data in Italy, and allows us to strictly relate the time evolution of the number of hospitalized cases and fatalities to the change of people mobility, vaccination rate, and appearance of an initial concentration of people positives for new variants of the virus. [ABSTRACT FROM AUTHOR]

Estimates of the real death toll of the COVID-19 pandemic have proven to be problematic in many countries, Italy being no exception. Mortality estimates at the local level are even more uncertain as they require stringent conditions, such as granularity and accuracy of the data at hand, which are rarely met. The "official" approach adopted by public institutions to estimate the "excess mortality" during the pandemic draws on a comparison between observed all-cause mortality data for 2020 and averages of mortality figures in the past years for the same period. In this paper, we apply the recently developed machine learning control method to build a more realistic counterfactual scenario of mortality in the absence of COVID-19. We demonstrate that supervised machine learning techniques outperform the official method by substantially improving the prediction accuracy of the local mortality in "ordinary" years, especially in small- and medium-sized municipalities. We then apply the best-performing algorithms to derive estimates of local excess mortality for the period between February and September 2020. Such estimates allow us to provide insights about the demographic evolution of the first wave of the pandemic throughout the country. To help improve diagnostic and monitoring efforts, our dataset is freely available to the research community. [ABSTRACT FROM AUTHOR]

In the fight against the COVID-19 pandemic, many brilliant results have been achieved, but the thermodynamics of the novel SARS-CoV-2 coronavirus has been completely neglected. This is a serious systematic error, which can compromise the results of the entire pandemic virus SARS-CoV-2 research. In the present work, we therefore study the thermodynamics of SARS-CoV-2 in its environment, from air to endosome and endosome-independent cell entry pathways. In the study of the thermodynamics of the new coronavirus SARS-CoV-2 in air, the presence of pollen, bacteria, other viruses, spores, dust, but more particularly, that of nanoparticles of health interest at the same scale threshold as the spike proteins of the pandemic virus, such as particulate matter, cannot be neglected. This work therefore starts from a comparative study of the air environments in China and Italy, the first countries affected by the infection. Currently, a correlation between the spread of infection and pollution is still very controversial. But our paper is not concerned with this. We propose some methodological notes which lead us to the formulation of a general mathematical apparatus (an energy landscape theory), suitable to explain at the molecular level the energetic configurations of the quasi-species of the pandemic virus SARS-CoV-2 in its environment. We focus on complexes between the viral particle and other objects in its environment at the scale threshold of the spikes of the viral particle. Then, we wondered if such complexes can lead to the generation of more aggressive viral variants and how to predict their populations and energy configurations, in order to plan an adequate prophylaxis. [ABSTRACT FROM AUTHOR]

Substantial research is available on detecting influencers on social media platforms. In contrast, comparatively few studies exists on the role of online activists, defined informally as users who actively participate in socially-minded online campaigns. Automatically discovering activists who can potentially be approached by organisations that promote social campaigns is important, but not easy, as they are typically active only locally, and, unlike influencers, they are not central to large social media networks. We make the hypothesis that such interesting users can be found on Twitter within temporally and spatially localised contexts. We define these as small but topical fragments of the network, containing interactions about social events or campaigns with a significant online footprint. To explore this hypothesis, we have designed an iterative discovery pipeline consisting of two alternating phases of user discovery and context discovery. Multiple iterations of the pipeline result in a growing dataset of user profiles for activists, as well as growing set of online social contexts. This mode of exploration differs significantly from prior techniques that focus on influencers, and presents unique challenges because of the weak online signal available to detect activists. The paper describes the design and implementation of the pipeline as a customisable software framework, where user-defined operational definitions of online activism can be explored. We present an empirical evaluation on two extensive case studies, one concerning healthcare-related campaigns in the UK during 2018, the other related to online activism in Italy during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Older adults are the main victims of the novel COVID-19 coronavirus outbreak and elderly in Long Term Care Facilities (LTCFs) are severely hit in terms of mortality. This paper presents a quantitative study of the impact of COVID-19 outbreak in Italy during first stages of the epidemic, focusing on the effects on mortality increase among older adults over 80 and its correlation with LTCFs. The study of growth patterns shows a power-law scaling regime for the first stage of the pandemic with an uneven behaviour among different regions as well as for the overall mortality increase according to the different impact of COVID-19. However, COVID-19 incidence rate does not fully explain the differences of mortality impact in older adults among different regions. We define a quantitative correlation between mortality in older adults and the number of people in LTCFs confirming the tremendous impact of COVID-19 on LTCFs. In addition a correlation between LTCFs and undiagnosed cases as well as effects of health system dysfunction is also observed. Our results confirm that LTCFs did not play a protective role on older adults during the pandemic, but the higher the number of elderly people living in LTCFs the greater the increase of both general and COVID-19 related mortality. We also observed that the handling of the crises in LTCFs hampered an efficient tracing of COVID-19 spread and promoted the increase of deaths not directly attributed to SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 emergency and the cities lockdown have had a strong impact on transport and mobility. In particular, travel demand has registered an unprecedented overall contraction, dramatically dropping down with peaks of - 90%-95% passengers for public transport (PT). During the re-opening phase, demand is gradually resuming the levels before the crisis, although some structural changes are observed in travel behaviour, and containment measures to reduce the risk of contagion are still being applied, affecting transport supply. Objective: This paper aims at assessing to what extent keeping a one-meter interpersonal distancing on-board trains is sustainable for public transport companies. Method: The analysis is based on travel demand forecasting models applied to two case-studies in Italy: a suburban railway line and a High-speed Rail (HSR) line, differentiated by demand characteristics (e.g. urban vs. ex-urban) and train access system (free access vs. reservation required). Results: In the suburban case, the results show the need of new urban policies, not only limited to the transport domain, in order to manage the demand peaks at the stations and on-board vehicles. In the ex-urban case, the outputs suggest the need for public subsidies in order for the railways undertakings to cope with revenue losses and, at the same time, to maintain service quality levels. [ABSTRACT FROM AUTHOR]

This paper studies the social and economic responses to the COVID-19 pandemic in a large sample of countries. I stress, in particular, the importance of countries' interconnections to understand the spread of the virus. I estimate a global VAR model and exploit a dataset on existing social connections across country borders. I show that social networks help explain not only the spread of the disease but also cross-country spillovers in perceptions about coronavirus risk and in social distancing behavior. In the early phases of the pandemic, perceptions of coronavirus risk in most countries are affected by pandemic shocks originating in Italy. Later, the USA, Spain, and the UK play sizable roles. Social distancing responses to domestic and global health shocks are heterogeneous; however, they almost always exhibit delays and sluggish adjustments. Unemployment responses vary widely across countries. Unemployment is particularly responsive to health shocks in the USA and Spain, while unemployment fluctuFations are attenuated almost everywhere else. [ABSTRACT FROM AUTHOR]

In this paper I discuss the ethical justifiability of the limitation of freedom of movement, in particular of the ban on running outdoors, enforced in Italy as a response to the COVID-19 outbreak in the spring of 2020. I argue that through the lens of public health ethics literature, the ban on running falls short of the criterion of proportionality that public health ethics scholars and international guidelines for the ethical management of infectious disease outbreak recommend for any measure that restricts essential individual freedoms, such as the freedom of movement. The public health ethics framework, however, falls short of explaining the widespread public support that the running ban has had in Italy. I discuss possible factors which could explain the public support for the ban in Italy. Finally, I raise the question of what societal implications the abandonment of the public health ethics framework based on proportionality might have. I conclude that if it is the case, as the history of pandemics teaches us, we will experience further waves of COVID-19 outbreaks, it becomes very important to raise these questions now, with an eye towards informing public health policies for the management of future COVID-19 outbreaks. This discussion should not become politicized along the lines of liberal pro-lockdown/conservative anti-lockdown. Instead, we should reflect on the trade-offs of lockdown policies according to a pluralist framework, in which COVID-19 related deaths are not the only possible value to pursue. [ABSTRACT FROM AUTHOR]

Background: During COVID-19 lockdown, non-urgent medical procedures were suspended. Grade of urgency of electroencephalography (EEG) may vary according to the clinical indication, setting, and status of infection of SARS-CoV-2 virus. "Italian Society of Clinical Neurophysiology" (SINC), "Italian League Against Epilepsy" (LICE), and the "Italian Association of Neurophysiology Technologists" (AITN) aimed to provide clinical and technical recommendation for EEG indications and recording standards in this pandemic era. Methods: Presidents of SINC, LICE, and AITN endorsed three members per each society to formulate recommendations: classification of the degree of urgency of EEG clinical indications, management and behavior of physicians and neurophysiology technologists, hygiene and personal protection standards, and use of technical equipment. Results: Scientific societies endorsed a paper conveying the recommendation for EEG execution in accordance with clinical urgency, setting (inpatients/outpatients), status of SARS-CoV-2 virus infection (positive, negative and uncertain), and phase of governmental restrictions (phase 1 and 2). Briefly, in phase 1, EEG was recommended only for those acute/subacute neurological symptoms where EEG is necessary for diagnosis, prognosis, or therapy. Outpatient examinations should be avoided in phase 1, while they should be recommended in urgent cases in phase 2 when they could prevent an emergency room access. Reduction of staff contacts must be encouraged through rescheduling job shifts. The use of disposable electrodes and dedicated EEG devices for COVID-19-positive patients are recommended. Conclusions: During the different phases of COVID-19 pandemic, the EEG should be reserved for patients really benefiting from its execution in terms of diagnosis, treatment, prognosis, and avoidance of emergency room access. [ABSTRACT FROM AUTHOR]