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Drawingvoice 2.0 is an instructional method of collaborative pencil and paper drawing to use in the school classroom, followed by Facebook interaction on the drawing produced in class. It is based on a participatory and meta reflective approach, explicitly aimed at deconstructing, negotiating, and reconstructing the meaning that students attribute to themselves regarding their professional expectations and educational pathways. In particular, the collaborative pencil and paper drawing allows for the student's emotional symbolisation processes underlying their educational pathway. Drawingvoice 2.0 induces a multidimensional cognitive and meta-cognitive process further supported by the following interaction on Facebook. Therefore, the World Wide Web is the added resource for sharing and deepening the classmates' discussion. Finally, Drawingvoice 2.0 supported structural group interaction and was an important supportive and instructional method to bring about transformational and developmental training practices. As the main result, in our experience, psychology students increased their reflectivity about their strengths and threats in being psychologists within their cultural contexts and potential positive resources underlying their choice. Drawingvoice 2.0 thus enhanced their self-awareness about the lights and shadows of their training and future professional career.

The perception of mattering, worthiness, and being meaningful for others is a fundamental condition for the human being. During young adulthood, mattering is particularly significant for the identity consolidation and well-being. This study aims to investigate the effect of relationships with parents on multidimensional well-being of young adults, mediated by mattering. A total of 1249 young Italian adults (age range 18–35) were involved, filling an online questionnaire. Data were analyzed with Structural Equation Modeling (SEM). The results showed that maternal support has a significant direct relationship just with interpersonal well-being, while paternal support with community well-being. Only through the mediation of mattering, both maternal and parental supports have a positive effect on all the well-being dimensions. The results suggest the importance of promoting a sense of mattering in significant interpersonal contexts for young adults to guarantee their well-being when they are involved in facing demanding challenges that the transition to adulthood requires. [ABSTRACT FROM AUTHOR]

Purpose: Despite the evidence of higher effectiveness of psychological interventions for insomnia compared to pharmacological ones, drug prescriptions for insomnia remain frequent. This study has assessed patterns of prescriptions of BZDs for insomnia before and after the delivery of a training in psychological interventions to professionals working in the services of a Department of Mental Health in northern Italy. Methods: The intervention consisted in two training sessions about psychological interventions for insomnia delivered to professionals of the participating services. The prevalence of users with a prescription of BZDs for insomnia in an index period after the delivery of the training was compared to the prevalence in an index period before the training. Results: Among 727 people assessed for BZDs prescription at pre-intervention, 306 (42.1%, 95% CI 0.39–0.46) had a prescription, and 344 (49.2%, 95% CI 0.45–0.53) had a prescription among 699 people assessed at post-intervention, corresponding to a significant odds ratio of 1.33 to be prescribed with BZDs in the second index period compared to the first one. Psychological interventions were offered to a small group of patients. Conclusion: Prescribing attitudes of BZDs for insomnia were not modified after the training and delivery of a psychological intervention in a mental healthcare outpatient setting. Prescribing habits should be addressed more directly in training, and professionals should be more aware of risks of BZDs assumption. The failure in changing drug prescriptions in this study should prompt more real-world studies of the application of evidence-based strategies, particularly in outpatient mental health settings. [ABSTRACT FROM AUTHOR]

The research investigates the antecedents of immunisation intentions during the COVID‐19 pandemic, including information‐related factors (conspiracy beliefs, immunisation knowledge and health communication perception) and confidence‐related factors (trust in healthcare institutions and vaccine risk perception). Data were collected online from two samples of Italian (N = 324) and Serbian (N = 486) participants. Path analyses confirmed a mediation mechanism: trust in health institutions and vaccine risk perception mediate the relationship between information‐related factors and vaccination intentions, both towards COVID‐19 and other diseases, with a few exceptions and differences between the samples. Findings show a glimpse into the inner psychological mechanisms of vaccination intentions. During times of crisis, such as pandemics, compliance toward vaccination can be fostered through the quality of information and the promotion of citizens' trust towards health institutions and vaccines. [ABSTRACT FROM AUTHOR]

Discriminatory attitudes towards women are still widespread and have also pervaded the digital world. They are often connected with the propensity to view and treat women as sexual objects, which sometimes leads to negative and harmful behaviours, such as the sharing of intimate images without the partner's consent. The present study aims at investigating the non‐consensual sharing of intimate images in relation to benevolent and hostile sexism, direct and mediated by female sexual objectification. The sample was recruited through the snowball sampling technique and was made up of 2,305 young Italian adults aged between 18 and 35. Analysis was carried out using structural equation modelling and the multigroup mediation model, allowing us to detect any gender differences. For both, males and females, results show that benevolent sexism has neither a direct nor indirect correlation with non‐consensual sharing of sexts. Instead, hostile sexism has an indirect relation with non‐consensual sharing mediated by the sexual objectification of the woman's body. Results do not show differences between male and female groups and highlight the need to focus on the socio‐cultural context that enables the non‐consensual sharing of intimate images, which is a variety of cyberviolence against women. Practical implications of the results will be extensively discussed. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Background: Primary human papillomaviruses (HPV) cervical cancer screening can be strengthened by offering home-collection of biological specimen as a valuable option to increase screening coverage. As recommended by World Health Organization (WHO), screening programs should consider whether the inclusion of HPV self-sampling as a complementary option within their existing screening algorithms could address the gaps in current coverage. However, few HPV screening tests are validated for self-sampling according to international guidelines. This study aimed to test a self-sampling-based screening strategy, complementary to the main screening program based on clinician-collected cervical samples. The study took place in Trieste, Italy, and it aimed to evaluate the feasibility of self-testing at home under an opt-in system during COVID-19 pandemic in order to exploit self-sampling to reduce the screening delay generated by the lockdown. Methods: 500 women, who should have received the screening call in 2020, were asked, via phone call, to participate in the study. To whom agreed, a home-collection kit, including a vaginal dry swab for specimen collection, was sent. The recipients performed the sample self-collection and sent back the swab through traditional mail using a prepaid envelope. Once received by the hospital, the samples were analyzed with HPV Selfy (Ulisse BioMed, Italy), a CE-IVD HPV screening test specifically validated for self-collection. Results were further compared using cobas® 4800 HPV (Roche, Switzerland). Results: 80% women sent back their swab, showing one of the highest return rate obtained in comparable studies. 34 HPV-positive women were followed up and underwent the Pap test, that revealed 8 low squamous intraepithelial lesions (LSIL) cases, later triaged to colposcopy. HPV Selfy was confirmed to be an adequate test for self-sampling-based screening. Conclusions: This study further confirmed the feasibility of self-test at home screening strategy based on self-sampling with an opt-in system as a support method to enhance cervical cancer screening coverage in Italy. Enrolled women showed a high appreciation for this approach. HPV Selfy test demonstrated to be a valuable assay for cervical cancer screening based on home self-collection. Trial registration: ASUGI Trieste n. 16008/2018 and amendment 02-11/09/2020. [ABSTRACT FROM AUTHOR]

Landslides represent a severe geohazard in many countries. The availability of inventories depicting the spatial and temporal distribution of landslides is crucial for assessing landslide susceptibility and risk for territorial planning or investigating landscape evolution. Nevertheless, these inventories are usually affected by limitations due to their nonpublic availability and inhomogeneities in characterization and mapping. Such problems are fully recognizable by the analysis of the multiple landslide inventories of the Campania region, which is one of the Italian regions with the highest exposure to landslide hazard and risk. On this basis, a revised Landslide Inventory of the Campania region (LaICa), resulting from the processing of multiple existing landslide inventories, has been reconstructed. It aims to (i) provide a new geodatabase that is able to overcome issues derived from the coexistence of multiple inventories and (ii) provide a methodological paradigm able to support the reorganization of existing official inventories. The implication of LaICa, with its 83,284 records, will possibly improve the assessment of landslide susceptibility and then reassess the related risk. Measurement(s) landslide Technology Type(s) Data Set [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused abrupt and profound changes to teaching and learning. The present study seeks to understand adolescents' experiences of the emergency adoption of online school learning (OSL) during the first national lockdown in Italy. Sixty-four students in their final two years of high school were interviewed and content analysis was performed. The findings describe students' views of the changes related to OSL according to structural, individual and relational dimensions. Schools' lack of organization, overwhelming demands, as well as experience of difficulties in concentration, stress and inhibited relationships with teachers and classmates were among the challenges evidenced in the transition. OSL, however, has also made it possible to experience a new flexibility and autonomy in the organization of learning. The study stresses the importance of fostering adaptation of teacher-student relationships and collaborative learning in order to improve schools' preparedness for digital transitions in and out of emergencies. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, migrants arriving in host countries irregularly have not infrequently been perceived as increasing the COVID-19 burden. Italy is a transit and destination country for migrants who cross the Central Mediterranean route and, during the pandemic, all migrants who landed on Italian shores were COVID-19 tested and quarantined. Our study aimed to investigate the impact of the SARS-CoV-2 infection among migrants who landed on the Italian coasts by analyzing both incidence and health outcomes. Methods: A retrospective observational study has been designed. The population of interest was represented by 70,512 migrants (91% male, 99% <60 years old) who landed in Italy between January 2021 and 2022. SARS-CoV-2 incidence rate per 1,000 (with 95%CI) in migrants and the resident population in Italy of the corresponding age group was computed. The incidence rate ratio (IRR) was used to compare the incidence rates in migrants and the resident population. Results: 2,861 migrants out of those landed in Italy during the observation period tested positive, with an incidence rate of 40.6 (39.1–42.1) cases per 1,000. During the same period, 177.6 (177.5-177.8) cases per 1,000 were reported in the resident population, with an IRR of 0.23 (0.22–0.24). 89.7% of cases were male and 54.6% belonged to the 20–29 age group. 99% of cases reported no symptoms, no relevant comorbidities were reported and no cases were hospitalized. Conclusions: Our study found a low rate of SARS-CoV-2 infection in migrants reaching Italy by sea with an incidence rate that is roughly a quarter of that of the resident population. Thus, irregular migrants who arrived in Italy during the observation period did not increase the COVID-19 burden. Further studies are needed to investigate possible reasons for the low incidence observed in this population. [ABSTRACT FROM AUTHOR]

Background:. In the last decades some studies observed a moderate progressive decrease in short-term mortality in incident hemodialysis patients. The aim of the study is to analyse the mortality trends in patients starting hemodialysis using the Lazio Regional Dialysis and Transplant Registry. Methods:. Patients who started chronic hemodialysis between 2008 and 2016 were included. Annual 1-year and 3-year Crude Mortality Rate*100 Person Years (CMR*100PY) overall, by gender and age classes were calculated. Cumulative survival estimates at 1 year and 3 years since the date of starting hemodialysis were presented as Kaplan-Meier curves for the three periods and compared using the log-rank test. The association between periods of incidence in hemodialysis and 1-year and 3-year mortality were investigated by means of unadjusted and adjusted Cox regression models. Potential determinants of both mortality outcomes were also investigated. Results:. Among 6,997 hemodialysis patients (64.5% males, 66.1% over 65 years old) 923 died within 1 year and 2,253 within 3 years form incidence; CMR*100PY were 14.1 (95%CI: 13.2–15.0) and 13.7 (95%CI: 13.2–14.3), respectively; both remained unchanged over the years. Even after stratification by gender and age classes no significant changes emerged. Kaplan-Meier mortality curves did not show any statistically significant differences in survival at 1 year and 3 years from hemodialysis incidence across periods. No statistically significant associations were found between periods and 1-year and 3-year mortality. Factors associated with a greater increase in mortality are: being over 65 years, born in Italy, not being self-sufficient, having systemic versus undetermined nephropathy, having heart disease, peripheral vascular disease, cancer, liver disease, dementia and psychiatric illness, and receiving dialysis by catheter rather than fistula. Conclusions:. The study shows that the mortality rate in patients with end-stage renal disease starting hemodialysis in the Lazio region was stable over 9 years. [ABSTRACT FROM AUTHOR]

The study presents the Italian adaptation of the Personal and General Belief in a Just World (P-BJW and G-BJW) Scales. Dalbert and colleagues developed these scales to capture the belief in a just world for oneself and a just world in general. After the translation and back-translation, the P-BJW and G-BJW scales were administered first to a pilot sample of 213 university students and then to a national sample of 2683 Italian people. Results showed that it was necessary to make some revisions to the predicted two correlated factor structure. These changes entailed correlating the error terms for some manifest variables and removing the first item of the P-BJW factor. The final structure of the P-BJW and G-BJW scales presented satisfactory indexes of model fit as well as high reliability and moderate validity values. Additionally, this structure proved to fit the data better than an alternative one-factor or a bi-factor model with two orthogonal-specific factors. As predicted, well-being strongly predicted scores on the BJW, but age and gender did not. Multigroup comparisons among Northern, Central, and Southern Italy respondents indicated that Italian people interpret scale items equivalently, regardless of their geographical location. Introducing the P-BJW and G-BJW scales to the Italian justice scholarship is very useful to unpack the reasons why Italy reports lower levels of social justice than other European countries and also to investigate the link between justice, well-being, and other socio-psychological variables. [ABSTRACT FROM AUTHOR]

Transitioning to adulthood is a fundamental yet challenging phase in human development. Despite its relevance, the literature has paid little attention to the impact that transitioning to adulthood has on multiple aspects of individual well‐being. This is one of the few attempts that has employed a sequential explanatory mixed‐methods study to explore how the path to adulthood impacted on the psychological and overall well‐being of Italian young adults. In the quantitative phase, we employed two‐step cluster analysis to assign 45 young adults, who had completed the Italian I COPPE scale of multidimensional well‐being, to three clusters based on their level of change in psychological and overall well‐being. Results from mixed design ANCOVA revealed that participants belonging to the high change cluster showed the highest significant positive change over time with respect to well‐being. In the qualitative phase, 17 individuals took part in focalized narrative interviews, which aimed at exploring significant events, barriers, and facilitators, which had impacted on their well‐being during the transition to adulthood. The textual material was analysed through the Grounded Theory Methodology. It emerged that the state of transition was associated with some triggering events and a temporary negative impact on the interviewees' well‐being. However, findings also revealed that people assigned to different clusters had put in place or learned several resources, skills, and copying strategies, which led to different transitional and well‐being outcomes. [ABSTRACT FROM AUTHOR]

For decades, scientific literature has highlighted the discomfort and delay of the transition to adulthood of the young generations of southern Italy. This article examines the experience of the current young generation, strongly disadvantaged by structural factors of their environment, like crime and unemployment, and by a familistic culture. This study involved 160 young people (age range = 18-34; sd = 4.242) living in the metropolitan area of Naples. They were asked to describe their emotional relations with their community of belonging, their family bonds and their aspirations for the future. Data were collected qualitatively and analyzed through a psychological textual analysis (Emotional Textual Analysis) aimed at capturing the emotionality through which these youths attribute meaning to their reality and make decisions. Results show a generation left alone with its goals; in fact, the presence of crime inhibits the ability to plan the future, while the family of origin is mostly focused on keeping the younger generations inside to defend themselves against the instability of the outside world. In these circumstances, relations with peers and higher education function exclusively as a condition of pervasive presentification, in which to continue living within the role of eternal young people and students. [ABSTRACT FROM AUTHOR]

This study reconstructed London' (UK) place identity in young Italian immigrants who have settled in this metropolitan city. The aim was to detect their representation of the hosting society and to investigate their migration experience. Interviews to 10 young Italian migrants (mean age: 27.7; SD: 4.084) were collected and analyzed through thematic analysis. The interviews showed that their individual and social identity had been influenced by the attitudes of the hosting context and its specific feature, highlighting the cultural richness of the town and its relational and work opportunities. Their hope for a decent job and the multicultural richness of the receiving town supported their settlement decision. However, their poor knowledge of the language and the little opportunity for effective acceptable decent work together with homesickness made this experience just a long-term temporary solution. [ABSTRACT FROM AUTHOR]

Background: Both SARS-CoV-2 mRNA-based vaccines [BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)] have shown high efficacy, with very modest side effects in limiting transmission of SARS-CoV-2 and in preventing the severe COVID-19 disease, characterized by a worrying high occupation of intensive care units (ICU), high frequency of intubation and ultimately high mortality rate. At the INT, in Naples, only the BNT162b2/Pfizer vaccine has been administered to cancer patients and healthcare professionals aged 16 and over. In the present study, the antibody response levels and their decline were monitored in an interval of 6–9 months after vaccine administration in the two different cohorts of workers of the INT – IRCCS "Fondazione Pascale" Cancer Center (Naples, Italy): the group of individuals previously infected with SARS-CoV-2 and vaccinated with a single dose; and that of individuals negative for previous exposure to SARS-CoV-2 vaccinated with two doses 21 days apart. Methods: Specific anti-RBD (receptor-binding domain) titers against trimeric spike glycoprotein (S) of SARS-CoV-2 by Roche Elecsys Anti-SARS-CoV-2 S ECLIA immunoassay were determined in serum samples of 27 healthcare workers with a previously documented history of SARS-CoV-2 infection and 123 healthcare workers without, during antibody titers' monitoring. Moreover, geometric mean titers (GMT) and relative fold changes (FC) were calculated. Results: Bimodal titer decline was observed in both previously infected and uninfected SARS-CoV-2 subjects. A first rapid decline was followed by a progressive slow decline in the 6/9 month-period before the further vaccine boost. The trend was explained by 2 different mathematical models, exponential and power function, the latter revealing as predictive of antibody titer decline either in infected or in not previously infected ones. The value of the prolonged lower vaccine titer was about 1 log below in the 6/9-month interval after the single dose for previously infected individuals with SARS-CoV-2 and the two doses for those not previously infected. The titer change, after the boost dose administration, on the other hand, was ≥ 1.5 FC higher than the titers at the 6/9-month time-points in both cohorts. A similar quantitative immune titer was observed in both cohorts 8 days after the last boost dose. The subsequent immunoresponse trend remains to be verified. Discussion: The results show that a very rapid first decline, from the highest antibody peak, was followed by a very slow decline which ensured immune protection lasting more than 6 months. The apparent absence of adverse effects of the rapid decline on the vaccine's immune protective role has been related to a large majority of low avidity antibodies induced by current vaccines. High avidity antibodies with prolonged anti-transmission efficacy show a longer half-life and are lost over a longer interval period. The cellular immunity, capable of preventing severe clinical diseases, lasts much longer. The unbalanced dual activity (cellular vs humoral) while effective in limiting ICU pressure and overall mortality, does not protect against transmission of SARS-CoV-2, resulting in high circulation of the virus among unvaccinated subjects, including the younger population, and the continuous production of variants characterized by changes in transmissibility and pathogenicity. The high mutation rate, peculiar to the RNA virus, can however lead to a dual opposite results: selection of defective and less efficient viruses up to extinction; risk of more efficiently transmitted variants as the current omicron pandemic. Conclusions: In conclusion the current bimodal antibody-titer decline, following BNT162b2 mRNA anti-SARS-CoV-2 vaccination, needs a further extended analysis to verify the protective borderline levels of immunity and the optimal administration schedule of vaccine boosters. Our current results can contribute to such goal, besides a direct comparison of other FDA-approved and candidate vaccines. [ABSTRACT FROM AUTHOR]

A systematic analysis of the mortality of immigrant residents throughout Italy has never been carried out. The present study aimed to evaluate differences in mortality by immigrant status. A longitudinal study of the Italian resident population (native and immigrants) recorded in the 2011 National Institute of Statistics Census was conducted. This cohort was followed up from 2012 to 2018 until death, emigration, or end of the study period. The exposure variable was the immigrant status, measured through citizenship, dichotomized into Italian and immigrant. The main outcome was overall and cause-specific mortality. Age-standardized mortality ratios (SMRs) were calculated. The SMRs among immigrants were half that of Italians, both for men (SMR 0.52) and women (SMR 0.51), with the lowest SMRs observed for subjects from North Africa and Oceania. For some causes of death, mortality was higher among immigrants: tuberculosis in both men (SMR 4.58) and women (SMR 4.72), and cervical cancer (SMR 1.58), complications of pregnancy, childbirth, and puerperium (SMR 1.36), and homicide (SMR 2.13) for women. A multivariable quasi-Poisson regression analysis, adjusted for age and macro area of residence in Italy, confirmed a lower all-cause mortality for immigrants compared to Italians, both for men (RR 0.46) and women (RR 0.44). Although immigration to Italy is no longer a recent phenomenon, and the presence of immigrants is acquiring structural characteristics, our study confirms their health advantage, with a lower mortality than that of Italians for almost all causes of death and for all areas of origin. [ABSTRACT FROM AUTHOR]

Following an ecological perspective, reactions to a disaster—such as the COVID‐19 pandemic—should be analysed in the interdependence between individual and community dimensions. The present study aims to analyse individual emotional dimensions (anxiety, joy, fear or depressive feelings) and their community dimensions (connectedness, emotional sharing and solidarity) with a longitudinal approach among university students from Italian universities. Participants were 746 university students at t1 (during the lockdown) and 361 at t2 (after the lockdown) recruited in six Italian universities from different areas of Italy. Comparing emotional dimensions in the two times, t2 is characterized by a generalized ambiguity: both happiness or joy because of the end of limitations and a kind of 'post‐lockdown anxiety' because of a sense of individual inadequacy in facing the return to normality, conducting daily activities and attending community spaces. Data confirms that after the so‐called 'honeymoon phase' in community dimensions (first phase of t1 time), a sort of 'depressive reaction' arises at t2: Italian university students seem more aware of the need for individual and social responsibility and that many events are not under their personal control. The reconstruction phase and exit from the emergency are perceived as necessary but also as a difficult and risky period. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

The aim of this study is to present a short form of the I COPPE scale of multidimensional well‐being. We conducted two studies, which include four samples collected across three countries, namely United States, Argentina, and Italy. In the pilot study we tested during the data analysis phase whether it was feasible to reduce the full I COPPE scale by omitting the items dealing with past well‐being. Prompted by the positive results of the pilot study, we launched a final validation study with a sample of 2682 Italian people who completed the I COPPE scale short form, which is designed without items referring to past well‐being. Results from a series of confirmatory factor analyses show that the I COPPE scale short form presents acceptable levels of construct validity and reliability. Moreover, the 7‐factor correlated‐trait model proved to be the best fit for the data. We discuss advantaged of using the I COPPE scale short form along with limitations and future recommendations. [ABSTRACT FROM AUTHOR]

The study investigates how the territorial community can influence the individual and social well-being of lesbian, gay, bisexual (LGB) youth and especially the recognition of their feelings and the construction of their own identity as well as their needs to be socially recognized. This research focuses on the experiences of 30 LGB individuals (23 males and 7 females), with a mean age of 25.07 years (SD = 4,578), living in urban and rural areas of Southern Italy. Focalized open interviews were conducted, and the Grounded Theory Methodology, supported by the Atlas.ti 8.0 software, was used for data analysis. The textual material was first coded, and then codes were grouped into five macro-categories: Freedom of identity expression in the urban and rural context, identity construction and acceptance process, need of aggregation and identification with the LGB community, role of the interpersonal relationship in the process of identity acceptance, socio-cultural context, and LGB psychological well-being. The results showed a condition common to the two contexts that we can define as "ghettoization." The young LGB is alone in the rural area due to a lack of places and people to identify with and greater social isolation. On the contrary, although there are more opportunities in the urban area, young people feel stigmatized and ghettoized because "their places" are frequented exclusively by the lesbian, gay, bisexual, transexual, queer (LGBTQ) community. The work will extensively discuss the limitations of the research, future proposals, and the practical implications of the results. [ABSTRACT FROM AUTHOR]

This work presents the outcomes of the geomorphological investigation and mapping carried out within the Cinque Terre National Park (38 km2), an outstanding example of a human-modified landscape. Over the centuries, the natural landscape of Cinque Terre has been almost completely modified by slope terracing for agricultural purposes. Extensive field surveys, topographic maps examination and aerial photographs interpretation have led to the production, within a GIS environment, of a new geomorphological map at 1:18,000 scale which outlines the main genesis and related landforms and deposits: (i) gravity-induced features, (ii) fluvial and runoff features, (iii) coastal features and (iv) anthropogenic features. Special attention has been given to the mapping of terraced slopes, which at present are extremely vulnerable to gravity-driven processes and running water because of extensive farmland abandonment. The output map is a fundamental basis for future activities of hazard assessment and zonation and the definition of land management strategies. [ABSTRACT FROM AUTHOR]

This study investigates the mediating role of transactive memory system (TMS) in the relationship between perception of innovation value (VIN) and team innovation, as well as the moderating effect of age diversity for the TMS -- team innovation relationship. The study of this moderated- mediation model concerning VIN, TMS, and team diversity as a contextual factor, is especially relevant in military teams which are directly concerned by military values, have high needs of effective coordination, and naturally are composed by young soldiers working with older leaders. To test our model, we evaluated 453 employees composing 48 military units from Italy's Air Force. Results confirmed that VIN is positively related to TMS, and that the latter has a positive effect on team innovation except at high levels of age diversity where the effect is reduced and non- significant. These findings highlight the importance of identifying and managing age differences, sharing common and distributed expertise, and promoting innovative initiatives in the military. Theoretical backgrounds, results, limitations, and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Compared with natives, immigrants have lower all-cause mortality rates, despite their lower socioeconomic status, an epidemiological paradox generally explained by the healthy migrant effect. Another hypothesis is the so-called salmon bias effect: "statistically immortal" subjects return to their country of origin when they expect to die shortly, but their deaths are not registered in the statistics of the country of residence. This underestimation of deaths determines an artificially low immigrant mortality rate. We aimed to estimate the potential salmon bias effect on differences in mortality rates between Italians and immigrants. We used a national cohort of all Italians registered in the 2011 census and followed up for mortality from 2012 to 2016. Mortality data were retrieved from the Causes of Death Register, which included all deaths occurring in the country and the Resident Population Register, which collects also the deaths occurring abroad. We assumed as a possible salmon bias event the death of an immigrant resident in Italy that died in his/her country of origin. Considering the deaths occurring in the country of origin, we observed an 18.1% increase in the overall mortality rates for immigrants and an increase of 23.7% in the age-standardized mortality rate. Mortality rates of immigrants resident in Italy, calculated without taking into account the deaths occurring in the country of origin, are certainly underestimated. However, the salmon bias only partly explains the difference in mortality rates between immigrants and Italians. [ABSTRACT FROM AUTHOR]

The spread of COVID-19 in Italy resulted in the implementation of a lockdown that obligated the first time the general populace to remain at home for approximately two months. This lockdown interrupted citizens' professional and educational activities, in addition to closing shops, offices and educational institutions. The resulting changes in people's daily routines and activities induced unexpected changes in their thoughts, feelings and attitudes, in addition to altering their life perceptions. Consequently, the present study explores how young adults perceived their lives under lockdown during the final week of March 2020, when the reported number of daily coronavirus infections reached its peak in Italy. The research was carried out among 293 university students (234 women and 59 men) with an average age of 20.85 years old (SD = 3.23). The researchers asked participants to describe the emotions, thoughts and experiences that characterized their time under lockdown. The study analyzed specific narratives related to time and space using grounded theory methodology, which was applied using Atlas 8 software, leading to the creation of 68 codes. The study organized these codes into three specific categories: confined in the present, confined in the past, and striving toward one's goals. Finally, the researchers also created a core-category labeled "continuity of being." The results showed that the closure of open spaces caused a division in participants' perceptions of time continuity, with many viewing themselves as feeling fragmented and as living the present in a static and fixed way. Additionally, participants also saw the present as being discontinuous from the past, while, simultaneously, projecting toward the future and the changes it might bring. Finally, this study examined further implications surrounding individual projecting among young people in greater depth. [ABSTRACT FROM AUTHOR]

Background: The process of immigration is associated with poor mental and physical health. While the workplace represents an important context of social integration, previous studies evaluating the effect of discrimination experienced in the workplace found worse mental health status among immigrants. The aim of this study was to investigate whether self-perceived workplace discrimination has any role in the mental health status of immigrants living and working in Italy, evaluating the contribution of other personal experiences, such as loneliness and life satisfaction. Methods: A cross-sectional study was conducted on a sample of 12,408 immigrants (aged 15-64) living and working in Italy. Data were derived from the first national survey on immigrants carried out by the Italian National Institute of Statistics (Istat). Mental health status was measured through the Mental Component Summary (MCS) of the SF-12 questionnaire. A linear multivariate linear regression was carried out to evaluate the association between mental health status, self-perceived workplace discrimination, and sociodemographic factors; path analysis was used to quantify the mediation effect of self-perceived loneliness, level of life satisfaction, and the Physical Component Summary (PCS). Results: Mental health status was inversely associated (p < 0.001) with self-perceived workplace discrimination (ß:-1.737), self-perceived loneliness (ß:-2.653), and physical health status (ß:-0.089); it was directly associated with level of life satisfaction (ß:1.122). As confirmed by the path analysis, the effect of self-perceived workplace discrimination on MCS was mediated by the other factors considered: self-perceived loneliness (11.9%), level of life satisfaction (20.7%), and physical health status (3.9%). Conclusions: Our study suggests that self-perceived workplace discrimination is associated with worse mental health status in immigrant workers through personal experiences in the workplace and explains the effect of the exposure to workplace discrimination on immigrants' psychological well-being. Our findings suggest that an overall public health response is needed to facilitate the social integration of immigrants and their access to health services, particularly those services that address mental health issues. [ABSTRACT FROM AUTHOR]

Background: Global migration toward Europe is increasing. Providing health assistance to migrants is challenging because numerous barriers limit their accessibility to health services. Migrants may be at a greater risk of developing asthma and receiving lower quality healthcare assistance than non-migrants. We aim to investigate whether immigrants as children and adolescents have higher rates of potentially avoidable hospitalization (PAH) for asthma compared to Italians.Methods: We performed a retrospective longitudinal study using six cohorts of 2-17-year-old residents in North and Central Italy from 01/01/2001 to 31/12/2014 (N = 1,256,826). We linked asthma hospital discharges to individuals using anonymized keys. We estimated cohort-specific age and calendar-year-adjusted asthma PAH rate ratios (HRRs) and 95% confidence intervals (95%CIs) among immigrants compared to Italians. We applied a two-stage random effect model to estimate asthma PAH meta-analytic rate ratios (MHRRs). We analyzed data by gender and geographical area of origin countries.Results: Three thousand three hundred four and 471 discharges for asthma PAH occurred among Italians and immigrants, respectively. Compared to Italians, the asthma PAH cohort-specific rate was higher for immigrant males in Bologna (HRR:2.42; 95%CI:1.53-3.81) and Roma (1.22; 1.02-1.45), and for females in Torino (1.56; 1.10-2.20) and Roma (1.82; 1.50-2.20). Asthma PAH MHRRs were higher only among immigrant females (MHRRs:1.48; 95%CI:1.18-1.87). MHRRs by area of origin were 63 to 113% higher among immigrants, except for Central-Eastern Europeans (0.80; 0.65-0.98).Conclusion: The asthma PAH meta-analytic rate was higher among female children and adolescent immigrants compared to Italians, with heterogeneity among cohorts showing higher cohort-specific PAH also among males, with some differences by origin country. Access to primary care for children and adolescent immigrants should be improved and immigrants should be considered at risk of severe asthma outcomes and consequently targeted by clinicians. [ABSTRACT FROM AUTHOR]

Italy and worldwide are experiencing an outbreak of a new coronavirus-related disease, named COVID-19, declared by the WHO COVID-19 a pandemic. The fragility of cancer patients is well-known, with many cases affecting aged patients or those with several comorbidities that frequently result in a loss of independency and functionality. Therefore, cancer patients have been greatly affected by this health emergency and, due to their vulnerability to COVID-19, oncologic patient visits have been often delayed or canceled leading to possible under-treatment. Different solutions can be adopted for reducing travels to cancer screening centers and the overall impact of cancer screening visits. As a consequence, it has been recommended that, when possible, the follow-up visits for cancer patients treated with oral anticancer drugs could be performed telematically. Furthermore, many patients refuse hospital visits, even if necessary, because of fear of contagion. Moreover, in some regions in Italy even the very first non-urgent visits have been postponed with the consequent delay in diagnosis, which may negatively affect disease prognosis. For these reasons, new approaches are needed such as the telemedicine tool. Throughout organized and appropriate tools, it would be possible to manage patients' visits and treatments, to avoid the dangerous extension of waiting lists when the standard activities will resume. In this context, a number of hospital visits can be substituted with visits at small local health centers, and general practitioners'office, taking in turn, advantage of well-defined telemedicine path which will be developed in the post-emergency phase. [ABSTRACT FROM AUTHOR]

Olaparib is the first poly(ADP-ribose) polymerase inhibitor approved as maintenance therapy of recurrent ovarian cancer (OC) patients with a BRCA mutation. To achieve the maximum clinical benefit, adherence to olaparib must be persistent. However, in clinical practice, this is challenged by the frequent suboptimal management of toxicities. In view of the expanding use of olaparib also in Italy, physicians must learn how to adequately and promptly manage drug toxicities not to unnecessarily interrupt or reduce the dose. The experts agreed that nausea,vomiting, anemia, and fatigue are the most frequent events experienced by OC patients on olaparib, and that these toxicities usually develop early during treatment, are mainly of grade 1-2 and transient and can be managed with simple non-pharmacological interventions. By sharing their real-world experiences, the panel prepared, for each toxicity, an algorithm organized by grade and besides the procedures indicated in the local label, included supportive care interventions based also on nutritional and lifestyle modifications and psycho-oncology consultation. Moreover, in view of the tablet entry into the Italian market, the full and reduced dosages of capsules and tablets were compared. This practical guidance is intended to be a tool to support especially less-experienced physicians in the management of these complex patients, with the aim to help preventing the worsening of patients' conditions and the unnecessary interruption/reduction of olaparib dosage, which may jeopardize treatment efficacy. [ABSTRACT FROM AUTHOR]

Background: Higher levels of hospital admissions among people with lower socioeconomic level, including immigrants, have been observed in developed countries. In Europe, immigrants present a more frequent use of emergency services compared to the native population. The aim of our study was to evaluate the socioeconomic and citizenship differences in the hospitalisation of the adult population in Italy. Methods: The study was conducted using the database created by the record linkage between the National Health Interview Survey (2005) with the National Hospital Discharge Database (2005–2014). 79,341 individuals aged 18–64 years were included. The outcomes were acute hospital admissions, urgent admissions and length of stay (1–7 days, > = 8 days). Education level, occupational status, self-perceived economic resources and migratory status were considered as socioeconomic determinants. A multivariate proportional hazards model for recurrent events was used to estimate the risk of total hospital admissions. Logistic models were used to estimate the risk of urgent hospitalisation as well as of length of stay. Results: Low education level, the lack of employment and negative self-perceived economic resources were conditions associated with the risk of hospitalisation, a longer hospital stay and greater recourse to urgent hospitalisation. Foreigners had a lower risk of hospitalisation (HR = 0.75; 95% CI:0.68–0.83) but a higher risk of urgent hospitalisation (OR = 1.36; 95% CI:1.18–1.55) and more frequent hospitalisations with a length of stay of at least eight days (OR = 1.19; 95% CI:1.02–1.40). Conclusions: To improve equity in access, effective primary, secondary and tertiary prevention strategies must be strengthened, as should access to appropriate levels of care. [ABSTRACT FROM AUTHOR]

This study investigated the goals and achievements of women members of organizations active within the city and province of Naples in recent years to detect how they acted in their local context to promote community health and wellbeing. Therefore, 39 representatives from feminist-oriented associations were interviewed to depict the effectiveness of women's activities and their social impact. The textual materials, obtained by their transcripts, were categorized according to the ecological well-being model. The interviews revealed that whilst the active involvement of women in associations served to empower their wellbeing at both individual and relational levels, their action had poor effects on the collective context to which they belonged. This research, therefore, offers some useful indications regarding the actions of women in active groups and the related individual wellbeing, but at the same time, highlighted their potential ineffectiveness in having a transformative role at the collective community level. [ABSTRACT FROM AUTHOR]

In many contexts, individuals with lower socioeconomic status, especially immigrants, have a higher burden of negative alcohol-related consequences and a higher probability of receiving a psychiatric diagnosis. This study aimed at exploring sociodemographic and clinical characteristics associated with harmful use of alcohol (HUA) among immigrant patients. A cross-sectional study was conducted in Rome (Italy) on a sample of 330 immigrant patients admitted to the gastroenterology outpatient clinic of the INMP (March 2013–October 2014). HUA was evaluated through the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. The presence of psychiatric disorders was diagnosed through SCID I–II interviews. The association between sociodemographic characteristics and psychiatric disorders and HUA was evaluated through a multivariate log-binomial regression model. HUA was associated with unemployment, longer stay in Italy, mood disorder and not being married, especially among African immigrants. We provide original findings about a selected, hard-to-investigate population, suggesting priorities in interventions on HUA among specific vulnerable subgroups. [ABSTRACT FROM AUTHOR]

Summary: Metronomic-chemotherapy (M-CHT) has been rarely assessed in non-Hodgkin-lymphoma (NHL). Therefore, in 2011 we started experimenting a new all-oral M-CHT schedule termed DEVEC (Deltacortene®, etoposide, vinorelbine, cyclophosphamide, +/-Rituximab) in diffuse-large-B-cell lymphoma (DLBCL) patients. Methods Patients with stage Ib-IV were enrolled as follows: 1) treatment-naïve, frail ≥65y, or unfit ≥85y; and 2) relapsed/refractory (R/R) ≥55y. Data were prospectively collected from six Italian centres and compared for efficacy to two reference groups, treated with established iv Rituximab-CHT in 1st and 2nd line respectively. Results from April-2011 to March-2018, 17/51(33%) naïve, 21/51(41%) refractory and 13/51(25.5%) relapsed patients started DEVEC; 39/51(76.5%) were de-novo DLBCL; 10/51(19.6%) transformed-DLBCL and 2/51(3.9%) unclassifiable-DLBCL/classical-Hodgkin-lymphoma. The median age was 85y (range=77-93) and 78y (range=57-91) in naïve and R/R respectively and overall the DEVEC patients had very poor features compared to the reference. The rate of grade≥3 haematological-AEs was 43%(95CI=29-58%): G3-neutropenia was the most frequent; grade≥3 extra-haematological-AEs was 13.7% (95%CI=5.4-25.9%), the most frequent was infection. One-year OS and PFS were 67% and 61% for naive, 60% and 50% for reference-naïve respectively; Cox proportional hazard ratio (Cox-PH-ratio) for OS and PFS were 0.69 (95%CI=0.27-1.76;p=.441) and 0.68 (95%CI=0.28-1.62;p=.381) respectively. One-year OS and PFS were 48% and 39% in the R/R, 36% and 17% in the reference-R/R respectively; Cox-PH-ratio for OS and PFS, were 0.76 (95%CI=0.42-1.40; p=.386) and 0.48 (95%CI=0.28-0.82; p=.007) respectively. Conclusion The favourable activity of DEVEC compared to a real-life series and the convenience of an oral administration, may possibly lay the groundwork for a paradigm-shift in the treatment of elderly DLBCL. [ABSTRACT FROM AUTHOR]

Background: The effects of the recent global economic and financial crisis especially affected the most vulnerable social groups. Objective of the study was to investigate variation of self-perceived health status in Italians and immigrants during the economic global crisis, focusing on demographic and socioeconomic factors. Methods: Through a cross-sectional design we analyzed the national sample of multipurpose surveys "Health conditions and use of health services" (2005 and 2013) conducted by the Italian National Institute of Statistics (ISTAT). Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, derived from SF-12 questionnaire, were assumed as study outcome, dichotomizing variables distribution at 1st quartile. Prevalence rate ratios (PRR) were estimated through log-binomial regression models, stratified by citizenship and gender, evaluating the association between PCS and MCS with surveys' year, adjusting for age, educational level, employment status, self-perceived economic resources, smoking habits, body mass index. Results: From 2005 to 2013 the proportion of people not employed or reporting scarce/insufficient economic resources increased, especially among men, in particular immigrants. Compared with 2005 we observed in 2013 among Italians a significant lower probability of worse PCS (PRR = 0.96 both for males and females), while no differences were observed among immigrants; a higher probability of worse MCS was observed, particularly among men (Italians: PRR = 1.26;95%CI:1.22-1.29; immigrants: PRR = 1.19;95%CI:1.03-1.38). Self-perceived scarce/insufficient economic resources were strongly and significantly associated with worse PCS and MCS for all subgroups. Lower educational level was strongly associated with worse PCS in Italians and slightly associated with worse MCS for all subgroups. Being not employed was associated with worse health status, especially mental health among men. Conclusions: Our findings support the hypothesis that economic global crisis could have negatively affected health status, particularly mental health, of Italians and immigrants. Furthermore, results suggest socioeconomic inequalities increase, in economic resources availability dimension. In a context of public health resources' limitation due to financial crisis, policy decision makers and health service managers must face the challenge of equity in health. [ABSTRACT FROM AUTHOR]

Radiological examination of the abdomen is critical to the diagnosis of necrotising enterocolitis (NEC). Previous studies on the reproducibility of radiological findings have been limited in size and based only on infants with the disease. We conducted a study among a sample of high-risk infants with and without the diagnosis of NEC: (1) to measure the degree of inter-observer agreement of NEC radiological diagnosis and signs and (2) identify a profile of radiological signs which led the observers to make a diagnosis of NEC. We collected 297 X-rays from a sample of 57 newborns admitted in 1999 to neonatal intensive care and neonatal surgery units in Rome, Italy. Three specialists in paediatric radiology examined the films independently and without any clinical information about patients. The analyses were conducted on a total of 891 forms filled in by the observers. Kappa values were calculated to measure the inter-observer reliability. To identify the profiles of radiological signs, a multidimensional analysis, binary segmentation, was carried out. The reproducibility of radiographic signs was 0.55 ( P < 0.01) for diffuse gaseous intestinal distention, 0.22 ( P < 0.01) for bowel wall thickening, 0.10 ( P < 0.01) for presence of portal venous gas and 0.29 ( P < 0.01) for pneumatosis intestinalis. The agreement for radiographic diagnosis suspected/confirmed of NEC was 0.31 ( P < 0.01). Among the 23 possible combinations of radiographic signs, the three radiologists indicated four profiles that produced a diagnosis of NEC containing, respectively, two, three, four and five signs. Our study found, in a large sample of radiographs selected from a population of infants with and without NEC, a poor reliability for NEC diagnosis and individual radiological signs among three expert radiologists. Clinical information and the presence of more than one radiological sign can reduce the margin of observer's error that inevitably exists when dealing with a diagnosis as difficult as NEC. [ABSTRACT FROM AUTHOR]

Background: Hill-Sachs lesions are compression fractures that result from shoulder dislocation. They involve ‘‘engaging'' thehumeral head on the anterior glenoid rim when the arm is abducted and externally rotated. The defect grows as the numberof dislocations increases.Hypothesis: Arthroscopic remplissage and anterior Bankart repair do not significantly affect infraspinatus strength while ensuringhealing of the capsulotenodesis.Study design: Cohort study; Level of evidence, 3.Methods: Sixty-one patients with traumatic anterior shoulder instability treated by arthroscopic Bankart repair and Hill-Sachsremplissage at least 24 months previously were compared with a control group of 40 healthy participants. Preoperative imagingincluded magnetic resonance imaging for Bankart lesion identification and computed tomography to quantify the humeral headdefect. Active range of motion and clinical scores (Walch-Duplay, Constant-Murley, and Rowe) were assessed. External rotation(ER) and internal rotation (IR) were measured with arm at the side (ER1 and IR1) and abducted at 90 (ER2 and IR2). Infraspinatusstrength was assessed with the scapula free (infraspinatus strength test [IST]) and retracted (infraspinatus scapula retraction test[ISRT]). Infraspinatus tenodesis and posterior capsulodesis healing were evaluated by ultrasound (US).Results: The follow-up median was 39.5 months (range, 24-56 months). One patient experienced a recurrence of instability at 34months. In the remplissage patients, ER1 was significantly lower in the affected compared with the unaffected shoulder (P\.001).Mean IST and ISRT strength values did not show differences between sides. The mean Constant-Murley score rose from 62.9 67.1 to 90 6 5.2 (P \ .0001). The Walch-Duplay and Rowe scores were excellent in 23 (78.6%), good in 6 (17.8%), and poor in 1patient (both scores). The remplissage group had significantly lower ER1 (P\.001), ER2 (P\.001), and IR2 (P\.01) values comparedwith the control group. Differences in IST and ISRT between the groups were not significant. Capsulotenodesis healing andfilling of the Hill-Sachs defect were confirmed by dynamic US in all subjects.Conclusion: Arthroscopic remplissage is a reliable approach to Hill-Sachs lesions. The ER and IR restriction does not significantlyaffect quality of life. Infraspinatus strength recovery is satisfactory even compared with healthy subjects. Ultrasound examinationallows accurate evaluation of capsulotenodesis healing. [ABSTRACT FROM AUTHOR]

Issue: Italy represents a well-known European transit and destination country for Migrants and Refugees (M&Rs) with more than 77.000 migrants currently hosted in the reception system. Pandemic did not impact the M&Rs’ influx with more than 30.000 disembarked in 2020. In line with the WHO and international organizations alerts to protect the health of M&Rs, Italy included M&Rs in its pandemic response. Description of the practice: With the mandate of the Ministry of Health and thanks to the collaboration with the Ministry of the Interior and other institutional and governmental bodies, the Italian National Institute for Health, Migration and Poverty developed a comprehensive strategy to protect M&Rs’ health in Italy during the COVID-19 pandemic, either into the reception system and outside. Results: Interim evidence - based operating procedures including instructions regarding the early detection and the management of potential suspected and confirmed COVID-19 cases, from the first arrival throughout the entire reception system path, have been published. A national survey on the incidence of COVID-19 cases in the reception system has been performed in 2020. Dedicated information flows on the incidence of COVID-19 cases at the arrival in Italy and in the reception system and a periodic monitoring of the implementation of the afore-mentioned operating procedures have been established in 2021. Data collected have shown a daily mean incidence ratio lower for migrants hosted in the reception system than for the general population, as well as the same regarding the new COVID-19 cases among newly arrived migrants. Lessons: The strategy adopted was found to be effective in protecting M&Rs’ health during the pandemic. In particular, the Italian reception system has globally shown a good performance in limiting the COVID-19 spread. Moreover, the influx of newly arrived migrants did not represent an additional epidemiological risk in terms of burden of infection. Key messages: • The production of evidence-based procedures and the establishment of effective information flows have proved to be effective in managing and monitoring the pandemic in regards to M&Rs. • The Italian reception system has turned to play as a protective factor in limiting the COVID-19 spread and the systematic screening of newly arrived M&Rs did not shown an additional COVID-19 burden. [ABSTRACT FROM AUTHOR]

In this study, we present a model for the implementation of agro-energy chains based on the actual availability of forest biomass and the real demand for energy (heat) in the area of the Basilicata region, Italy. The demand for energy has been estimated by drawing on the database of the Ministry of Economic Development or by calculating the Annual Energy Requirement (AER) index, while for the estimate of the available forest biomass, reference was made to the public forest lands managed according to forestry management plans. The collected data were cross-checked with a view to detecting the technical and economic feasibility of district heating systems. The technical evaluation has mainly focused on the energetic and plant aspects, while the economic assessment was directed to defining the cost effectiveness criteria [Net Present Value (NPV), Internal Rate of Return (IRR), Payback Period] that can measure the profitability of the investment. In the economic evaluation we also included the national public incentives, designed to encourage the production of energy from renewable sources in compliance with the international agreements signed by Italy for the reduction of greenhouse gases (GHGs). [ABSTRACT FROM AUTHOR]

Introduction: The addition of the direct renin inhibitor aliskiren is demonstrated to improve blood pressure (BP) control rate and reduce progression of organ damage in treated hypertensive patients in clinical trials with a relatively short follow-up period. Aim: The objective of this study was to assess the effectiveness, safety and tolerability of aliskiren as an add-on antihypertensive therapy in high-risk, treated, hypertensive patients, who were not controlled with concomitant treatment with at least two antihypertensive drugs under 'real-life' conditions, during a planned observation and treatment period of at least 12 months in Italy. Methods: Clinical data were derived from medical databases of treated, uncontrolled, hypertensive patients followed by specialized physicians operating in different clinical settings (hospital divisions or outpatient clinics) in Italy. Aliskiren was added to stable antihypertensive treatment, including at least two drug classes (independently of class or dosage) and unable to achieve BP control. Follow-up visits for measuring clinic BP levels and collecting data on drug safety and tolerability were planned at time intervals of 1, 6 and 12 months. At each predefined follow-up visit, aliskiren could be up-titrated from 150 to 300 mg daily if BP control was not achieved. Results: From May 2009 to June 2011, a total of 1186 treated, uncontrolled, hypertensive patients (46.3% female, aged 65.2 ± 11.7 years, mean duration of hypertension 13.2 ± 9.3 years, mean clinic BP levels 156.5 ± 15.9/90.3 ± 9.5mmHg) were enrolled. Systolic and diastolic BP levels were 141.1/82.4, 134.9/79.8 and 133.6/78.9 mmHg at 1-, 6- and 12-month follow-up visits, respectively (p < 0.0001 vs baseline for all comparisons). These effects were consistent in all predefined subgroups, including those with left ventricular hypertrophy, renal disease, diabetes mellitus, coronary artery disease or cerebrovascular disease. Reduced levels of microalbuminuria were also reported, without affecting other renal and electrolyte parameters. Overall, compliance to study medication was high (93.0%), with a very low proportion of patients experiencing adverse events leading to drug discontinuation (3.6%). Conclusions: In this observational, prospective, open-label, multicentre study, we reported the 12-month clinical effectiveness, safety and tolerability of adding aliskiren to treated, uncontrolled, hypertensive patients in a 'real-life' setting in Italy. This strategy leads to a significantly improved BP control rate and low incidence of drug-related side effects or discontinuations. [ABSTRACT FROM AUTHOR]

Background: Concerns about the hepatitis C virus (HCV) are due to the high risk of chronic liver disease and poor treatment efficacy. Synthesizing evidence from multiple data sources is becoming widely used to estimate HCVinfection prevalence. This paper aims to estimate the prevalence of HCV infection, and the hepatic and extrahepatic sequelae in at-risk groups, using routinely collected data in the Lazio region, Italy. Methods: HCV laboratory surveillance and dialysis, hospital discharge, and drug-user registers were used as information sources to identify at-risk groups and to estimate HCV prevalence and sequelae. Full name and birth date were used as linkage keys for the various health registries. Prevalence was estimated as the percentage of cases within the general population and the at-risk groups, with 95% confidence intervals (95% CI) from 1997 to 2001. The risk of sequelae was estimated through a follow-up of hospital discharges up to December 31, 2004 and calculated as the prevalence ratio in HCV-positive and HCV-negative people, within each at-risk group, with 95% CI. Results: There were 65,127 HCV-infected people in the study period; the prevalence was 1.24% (95%CI = 1.23%-1.25%) in the whole population, higher in males and older adults. Drug users (35.1%; 95%CI = 34.6-35.7) and dialysis patients (21.1%; 95%CI = 20.2%-22.0%) showed the highest values. Medical procedures with little exposure to blood resulted in higher estimates, ranging between 1.3% and 3.4%, which was not conclusively attributable to the surgical procedures. Cirrhosis, hepatocellular carcinoma and encephalopathy were the most frequent hepatic sequelae; cryoglobulinaemia and non-Hodgkin's lymphoma were the most frequent extrahepatic sequelae. Conclusions: Synthesising data from multiple routine sources improved estimates of HCV prevalence and sequelae in dialysis patients and drug users, although prevalence validity should be assessed in survey and sequelae need a welldefined longitudinal approach. [ABSTRACT FROM AUTHOR]

Abstract: Ischia volcano, in Central Italy, has long been known for its copious surface hydrothermal manifestations, signs of a pervasive circulation of hot fluids in the subsurface. Because of the significant chemical heterogeneity of fumarolic gas discharges and hot spring discharges, evidences of a complex hydrothermal setting, a definite model of fluid circulation at depth is currently unavailable, in spite of the several previous efforts. Here, we report on the chemical and isotopic composition of 120 groundwater samples, collected during several sampling surveys from 2002 to 2007. The acquired data suggest that the composition of surface manifestations reflect contributions from meteoric water, sea water, and thermal fluids rising from two distinct hydrothermal reservoir, with equilibrium temperatures of respectively ~150 °C and ~270 °C, and depths of 150–300 m and >300 m (but possibly >1000 m). We also make use of an isotopic characterization of the dissolved gas phase in thermal waters to demonstrate that the Ischia hydrothermal system is currently supplied by a deep-rising gas component (DGC), characterized by CO2 ~97.7±1.2 vol.% (on a water-free basis), δ 13CCO2 =−3.51±0.9‰, and helium isotopic ratio of about 3.5 Ra (3He/4He ratio normalized to the air ratio, R a), likely magmatic in origin. An assessment of the thermal budget for Ischia hydrothermal system is also presented, in the attempt to derive a first estimate of the size and rate of degassing of the magmatic reservoir feeding the gas emissions. We calculate that a heat flow of about 153–222 MW presently drives hydrothermal circulation on the island, which we suggest is supplied in convective form (e.g., by the ascent of a high-T magmatic vapour phase) by complete degassing of 2.2–3.3·107 m3 yr−1 of trachytic magma (with ~2.1 wt.% dissolved H2O content). If extrapolated to entire period of quiescence lasting since the Arso eruption in 1302 A.D., this volume corresponds to 1.6–2.3·1010 m3 of magma degassed in about 700 years of quiescent activity. [Copyright &y& Elsevier]

The extraordinary nature of Garibaldi's life is reflected in his involvement in parliamentary activities across a number of countries (Uruguay, Kingdom of Sardinia, Roman Republic, Kingdom of Italy, French Republic). After the national unification, Parliament became a kind of great sounding board in Garibaldi's strategy thanks in part to the fact that in the Chamber he could count on a group of followers who were always ready to support any issue vaguely to do with memories of the Risorgimento or irredentist aspirations. His failure to steer the new state in the desired direction through the legislative process certainly influenced Garibaldi's negative opinion of parliamentary work. Garibaldi could not however recognize as an expression of popular sovereignty a parliament in whose election only 2 per cent of the population were allowed to participate. His main political battle was the fight for universal suffrage which was intended to enfranchise all Italians, thus turning subjects into citizens and finally making parliamentary institutions nationally representative and democratically legitimate. [ABSTRACT FROM AUTHOR]

Patients with end-stage kidney disease represent a frail population and might be at higher risk of SARS-CoV-2 infection. The Lazio Regional Dialysis and Transplant Registry collected information on dialysis patients with a positive swab. The study investigated incidence of SARS-CoV-2 infection, mortality and their potential associated factors in patients undergoing maintenance hemodialysis (MHD) in the Lazio region. Method: The occurrence of infection was assessed among MHD patients included in the RRDTL from 1 March to 30 November 2020. The adjusted cumulative incidence of infection and mortality risk within 30 days of infection onset were estimated. Logistic and Cox regression models were applied to identify factors associated with infection and mortality, respectively. Results: The MHD cohort counted 4942 patients; 256 (5.2%) had COVID-19. The adjusted cumulative incidence was 5.1%. Factors associated with infection included: being born abroad, educational level, cystic renal disease/familial nephropathy, vascular disease and being treated in a dialysis center located in Local Health Authority (LHA) Rome 2. Among infected patients, 59 (23.0%) died within 30 days; the adjusted mortality risk was 21.0%. Factors associated with 30-day mortality included: age, malnutrition and fever at the time of swab. Conclusions: Factors associated with infection seem to reflect socioeconomic conditions. Factors associated with mortality, in addition to age, are related to clinical characteristics and symptoms at the time of swab. [ABSTRACT FROM AUTHOR]

• High heterogeneity in the first-dose vaccine coverage within immigrant's population. • Immigrants from Eastern Europe showed lowest first-dose vaccine coverage. • Gender differences in first-dose vaccine coverage emerged for migrants from Africa. Immigrants are commonly considered disadvantaged and at high risk of not receiving appropriate care, including vaccination. This study aimed to evaluate the access to SARS-CoV-2 vaccination in immigrants, by geographical area of origin, compared with Italian citizens. We also evaluated sex differences in vaccine's coverage by geographical area of origin. We performed a retrospective observational study in four Italian regions, including all resident subjects aged 5–69 years, and undergoing first dose SARS-CoV-2 vaccination in the period 28th December 2020- 3rd April 2022. We estimated cumulative coverage percentages, by age class and geographical area. To compare first-dose vaccine coverage by geographical area of origin, we estimated, through a Poisson analysis, Vaccine Coverage Ratios (VCR) with 95 % confidence intervals (95 %CI), adjusting for age and sex. We included 16,294,785 Italian citizens and 2,534,351 immigrants aged 5–69 years and resident in the four regions considered. Regarding the geographical area of origin, 40.7 % of immigrants came from Eastern Europe, 13.5 % from North Africa and 13.1 % from Western Asia. A great variability in the first dose vaccine coverage emerged. We documented substantial heterogeneity in the first-dose vaccine coverage within immigrant's population, expressed with Italy as a reference, ranging from 0,768 (95 %CI: 0,766–0,769) in Eastern Europe countries to 1,013 (95 %CI: 1,009 – 1,018) in Eastern Asia. The chance of being vaccinated was found higher in males compared with females for African countries (VCR 1.07, 95 %CI 1.06–1.08) and Western Asian countries (VCR 1.08, 95 %CI 1.07–1.09). We observed substantial heterogeneity in first-dose SARS-CoV-2 vaccination coverage in immigrants, suggesting a different propensity to vaccines according to the geographical area of origin. These data can help define appropriate and tailored strategies in order to improve vaccine coverage in some specific immigrant groups at the local health district level. [ABSTRACT FROM AUTHOR]

Natural hazards such as landslides, soil erosion and floods are increasingly affecting many regions of the world in relation to ongoing climate change and the abandonment of rural areas. In the last decades, the need to mitigate such phenomena and preserve natural resources, including landscapes, has motivated a number of local and national authorities to promote the use of soil bioengineering techniques. Consequently, these techniques have been increasingly used with variable success rates. This study analysed the efficiencies of different bioengineering structures to mitigate geo-hydrological risks by examining the interventions installed between 2007 and 2013 in the Avellino Province southern Italy. To this end, a specific project consistency analysis and functionality classification were carried out and the causes of inefficiencies were identified. The analysis showed that after a few years, only a small number of the installed bioengineering structures were fully functional and efficient. Overall, the installed structures were generally affected by maintenance issues and in many cases they suffered from design and execution issues, inducing a generally lower degree of efficiency, with most of them classified as 'not very efficient'. The conclusions of this work are that i) the long-term efficiency of a bioengineering structure is related to its correct design, installation, and maintenance; ii) the design of a bioengineering structure should account for the geological, geotechnical and hydrological characteristics of the area of interest, and iii) maintenance must not affect the short-term efficiency of a structure, but may affect the long-term efficiency. • The efficiency of bioengineering structure was analysed. • Bioengineering structure functionality was estimated three years after the installation. • A matrix-based approach accounting for causes of inefficiency was used. • Only 7% of the interventions were fully working and integrated with the landscape. • Most of the bioengineering structures were affected by design and installation issues. [ABSTRACT FROM AUTHOR]

• Undocumented immigrants are highly prevalent in a Chinese community (over 50 %). • It is in this group that new diagnoses of risk factors were mainly detected. • Registration with NHS was associated with higher level of awareness and rate of treatment for T2DM. The aim of this study was to examine main risk factors of undocumented Chinese migrants living in Italy when compared with Chinese migrants registered with National Health Service (NHS). A cohort of 3435 Chinese first-generation immigrants living in Prato underwent blood pressure (BP) measurement and blood tests. Hypertension was diagnosed for BP ≥ 140/90 mmHg at 2 visits, and/or antihypertensive drug use; type 2 diabetes (T2DM) for fasting glucose ≥ 126 mg/dL at 2 visits, and/or use of hypoglycemic drugs; hypercholesterolemia (HC) for cholesterol ≥ 240 mg/dL and/or statins use. Subjects diagnosed with hypertension, T2DM, or HC unaware of their condition were considered newly diagnosed. Comparisons were performed using multivariable adjusted logistic regression analysis. A large proportion of Chinese migrants were undocumented (1766, 51 %); newly diagnoses of risk factors were performed especially among undocumented migrants; registration with NHS was associated with higher level of awareness for hypertension and T2DM and with 6 times higher rate of treatment for T2DM. Only a small minority of subjects with high cholesterol were treated with statins. Undocumented immigrants had high prevalence of risk factors with lower levels of awareness than migrants registered with the NHS. Health policies targeting this hard-to-reach population needs to be improved. [ABSTRACT FROM AUTHOR]

[Display omitted] • A new procedure for Groundwater Flooding Hazard (GFH) assessment has been developed. • A newly developed MATLAB™ code for hazard mapping has been provided. • The procedure is based on a probability model depicting long-term water table fluctuation. • A sixty-two-years piezometric time series and basement depths data were used. • The procedure has been tested and validated in a semi-urban aquifer. Many areas of the world are experiencing groundwater flooding (GF) events with serious impacts on the environment and human health. In Europe, GF has received specific attention with the Directive 2007/60/EC, which requires Member States to map GF hazard and risk and propose mitigation measures. In Italy, despite the commitment assigned by the Legislative Decree 49/2010 to River Basin District Authorities, no models have been developed for groundwater flooding hazard (GFH) evaluation also for the lack of standard methods based on commonly available data. In this paper, a new method has been developed through a specific procedure that accounts for i) probability of GF events estimation based on available time series of groundwater levels and ii) probability mapping through a newly developed MATLAB™ code, high-resolution topographic data and groundwater table model. The methodology has been tested and validated in the Metropolitan City of Naples (Italy), affected by GF since 2010, for which i) sixty-two-year long time series of groundwater levels, ii) high-resolution Digital Elevation and Digital Terrain Models and iii) basement/building geometry, are available. The results show that about 59% of the buildings present in the study area have potentially floodable underground structures. In the 2010–2021 period, only 2% of these buildings were flooded and most of them were built in the period 1980–2000, when the piezometric levels were deeper due to over-pumping of the groundwater. The obtained GFH map shows that only 2% of the built area is involved by 1- to 2- year events, while 6% is affected by 1- to 10- year events. A good spatial correspondence between the return period and locations of GF events occurred during 2010–2021 period was observed, thus indicating the significant performance of the model. The obtained GFH map output can support decisions of authorities and policy-makers to reduce the GF risk. [ABSTRACT FROM AUTHOR]

Abstract: Aims of the study and methods: Recent studies suggested the existence of significant regional variations, in Italy, for cancer survival. For most neoplasms, survival rates tended to be lower in Southern regions versus Northern areas; for colorectal tumours, 5-year survival was 60% in Northern regions, but ranged between 40% and 50% in the South. Main purpose of the present study was to find out possible reasons which might explain such differences. To reach this objective, we compared the main epidemiological and clinical data in two areas covered by cancer registration: Modena, in the North, and Naples in the South of Italy. Results: The results of the study suggest that differences in colorectal cancer survival can be mainly attributed to a different stage at diagnosis, which was less favourable in a larger fraction of cases diagnosed in Southern Italy. This could be the consequence of an insufficient diffusion of screening procedures. Type of surgery, medical treatment and follow-up seem to play little or no role. The study also shows that incidence rates of colorectal cancer are significantly higher in the North than in the South of the country, and that the excess of cases seen in Modena is limited to the age group 55–75+ years, while age-specific incidence is virtually identical in the younger age classes. Conclusion: This high-resolution study confirms the paramount importance of stage at diagnosis in the management of colorectal cancer, and suggests that social and economic factors are of relevance, even in Western countries, for reducing inequalities in cancer care. [Copyright &y& Elsevier]

[Display omitted] • Mapping and monitoring of slow-moving landslides. • Remote Sensing, statistical and ground-based measurements have been combined. • Integration of Machine Learning and InSAR techniques for landslide risk assessment. This paper describes a novel methodology where Machine Learning Algorithms (MLAs) have been integrated to assess the landslide risk for slow moving mass movements, processes whose intermittent activity makes challenging any risk analysis worldwide. MLAs has been trained on datasets including Interferometric Synthetic Aperture Radar (InSAR) and additional remote sensing datasets such as aerial stereo photographs and LiDAR and tested in the Termini-Nerano landslides system (southern Apennines, Italy). The availability of such a wealth of materials allows also an unprecedented spatio-temporal reconstruction of the volume and the kinematic of the landslides system through which we could generate and validate the hazard map. Our analysis identifies fifteen slow-moving phenomena, traceable since 1955, whose total area amounts to 4.1 × 105 m2 and volume to ~1.4 × 106 m3. InSAR results prove that seven out of the fifteen slow-moving landslides are currently active and characterized by seasonal velocity patterns. These new insights on the dynamic of the landslides system have been selected as the main independent variables to train three MLAs (Artificial Neural Network, Generalized Boosting Model and Maximum Entropy) and derive the landslide hazard for the area. Finally, official population and buildings census data have been used to assess the landslide risk whose highest values are located in the crown area, south of Termini village, and nearby Nerano. This new methodology provides a different landslide risk scenario compared to the existing official documents for the study area and overall new insights on how to develop landslide risk management strategies worldwide based on a better understanding of slope processes thanks to the latest satellite technologies available. [ABSTRACT FROM AUTHOR]

Italy is a destination country for a growing international migration, accounting for 8.4% of the total population. The COVID-19 pandemic has increased the difficulties in accessing healthcare services among immigrants, and barriers due to linguistic and cultural differences had a significant impact during the pandemic. This paper presents the methodology used in the project 'Epidemiological surveillance and control of COVID-19 in metropolitan urban areas for the containment of SARS-CoV-2 circulation in the immigrant population in Italy', carried out with the technical and financial support of the Italian Ministry of Health. This methodology is aimed to identify and select statements available in the literature, transferable to the Italian context, on the topic of interventions deemed useful in reducing the impact of the COVID-19 pandemic on the foreign population in urban/metropolitan settings.In February 2022, a systematic search was conducted in databases such as Medline, Embase, and Web of Science, as well as on national and international websites (WHO, Italian Institute of Health, and CDC), and on 'RecMap' (included in the 'COVID19 Recommendations' website) to identify guidelines containing recommendations on the management and prevention of COVID-19 among immigrants. The selected recommendations were divided into intervention areas (infection control, vaccination, screening, planning and monitoring, healthcare systems). In the first phase, a group of researchers independently assessed the inclusion of recommendations through three rounds of consensus. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was used to assess the quality of the included guidelines. In the second phase, an external group of experts independently evaluated the relevance of the included recommendations using a Likert scale. The document is the result of a collaborative work based on evidence from the literature available until that time. The adaptation and adoption of recommendations already formulated by other international organizations on the topic of preparedness and response to the COVID-19 pandemic, evaluated through a consensus process with experts, can be a valid method aimed at producing documents to inform and guide those involved in the care of immigrants in Italy, as well as promoting inclusive forms of prevention in emergency contexts.

Background: the spread of SARS-CoV-2 in the population has amplified the effects of health inequalities, particularly in the most vulnerable groups such as immigrants and refugees. An assessment of the intervention to contain the COVID-19 in these population groups was essential to define new strategies for more equitable, inclusive, and effective health policies to on health., Objectives: to provide a systematic synopsis of the impact of interventions to contain the spread of SARS-CoV-2 in immigrants., Methods: data sources included major bibliographic databases. Using a study protocol, already shared with the international scientific community, two independent researchers reviewed the citations, selected and evaluated the interventions studies. Due to the heterogeneity of the interventions, a narrative synthesis was carried out., Results: three eligible studies were identified. The first study modelled the incidence of the disease in a refugee camp in Greece, based on an intervention of sectorialization of people that accessed to services, the use of masks, the early identification and isolation of cases and their family members, and the limitation of movements within the camp. The second evaluated the impact of preventive pharmacological interventions such as the use of hydroxychloroquine, ivermectin, povidone-iodine, zinc, and vitamin C, in different dosages and combinations, to a group of immigrant workers in a city dormitory in Singapore. The third study evaluated an intervention to increase vaccination coverage within a Latino immigrant community in the United States, moving the location of vaccine supply throughout the most frequented contexts by the immigrant community to access the city services. The results of the first and second studies suggest impacts for some of the proposed interventions even if they have been partially overcome due to the use of mass vaccination. The third showed a reduction in vaccine hesitancy and an increase in vaccination uptake and a snowball effect., Conclusions: the systematic review identified few heterogeneous studies, preventing any generalization of the results. Probably, the low scientific production does not reflect the successful experiences implemented. In the case of a possible resumption of the epidemic or new emergencies, it will be necessary to rely on indirect evidence and the scientific community should consider more the responsibility to evaluate and make available the experiences gained in the field. A constant monitoring activity of the evidence that will be necessary to updating the results for suggest consolidated prevention measures to for controlling the incidence of COVID-19 in immigrants during a possible resumption of the epidemic and for application in other similarly emergency contexts.