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Objective: To evaluate the impact of COVID‐19 pandemic among a sample of Italian dentists in terms of infection, strategies for infection control, organization of the dental clinic, attitude, and behavior. Material and Methods: This was a cross‐sectional survey. The sample consisted of 8000 Italian dentists selected among 63,375 using a computerized random sampling method. An electronic informed consent had to be signed. The questionnaire categories were on demographic, infection risk management, organization, and dentists' attitude and behavior. Geographic macro‐areas were used for subgroup analysis. Results: Among 8000 invited dentists, 2443 agreed to participate to the survey (30.6%). Mean age was 51.2 years, women were 34.5%. A total of 6.1% self‐reported COVID‐19 experience and higher rate of infection was reported in north Italy compared to the south (p < 0.05). FFP2/FFP3 respirators (97.1%) and visors (97.4%) were used by almost all dentists. While, natural ventilation and mouthwashes were the most frequent approaches used to reduce the infection risk. Most of the dentists reported positive attitude, nevertheless 83.6% felt an increased responsibility. Conclusion: The self‐reported COVID‐19 prevalence was 6.1% with some differences among geographic areas. COVID 19 had a deep impact on preventive strategies, dental office organization, and behavior within this sample. [ABSTRACT FROM AUTHOR]

Background: Falls in older adults significantly impact overall health and healthcare costs. Intrinsic capacity (IC) reflects functional reserve and is an indicator of healthy aging. Aims: To explore the association between IC and recent falls (≤ 90 days) in community-dwelling octogenarians from the Aging and Longevity in the Sirente geographic area (IlSIRENTE) study. Methods: The Minimum Data Set for Home Care (MDS−HC) and supplementary questionnaires and tests were used to assess the five IC domains: locomotion, cognition, vitality, psychology, and sensory. Scores in each domain were rescaled using the percent of maximum possible score method and averaged to obtain an overall IC score (range 0−100). Results: The study included 319 participants (mean age 85.5 ± 4.8 years, 67.1% women). Mean IC score was 80.5 ± 14.2. The optimal IC score cut-off for predicting the two-year risk of incident loss of at least one activity of daily living (ADL) was determined and validated in a subset of 240 individuals without ADL disability at baseline (mean age 84.7 ± 4.4 years, 67.1% women). Participants were then stratified into low (< 77.6) and high (≥ 77.6) IC categories. Those with high IC (63.9%) were younger, more often males, and had lower prevalence of recent falls, disability, multimorbidity, and polypharmacy. Logistic regression models including IC as a continuous variable revealed a significant association between higher IC and lower odds of falls. This association was significant in the unadjusted (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.94–0.98, p < 0.001), age- and sex-adjusted (OR 0.96, 95% CI 0.94–0.98, p < 0.001), and fully adjusted models (OR 0.96, 95% CI 0.93–0.99, p = 0.003). When considering IC as a categorical variable, unadjusted logistic regression showed a strong association between high IC and lower odds of falls (OR 0.31, 95% CI 0.16–0.60, p < 0.001). This association remained significant in both the age- and sex-adjusted (OR 0.30, 95% CI 0.15–0.59, p < 0.001) and fully adjusted models (OR 0.33, 95% CI 0.16–0.82, p = 0.007). The locomotion domain was independently associated with falls in the unadjusted (OR 0.98, 95% CI 0.97–0.99, p < 0.001), age- and sex-adjusted (OR 0.97, 95% CI 0.96–0.99, p < 0.001), and fully adjusted model (OR 0.98, 95% CI 0.96–0.99, p < 0.001). Discussion: This is the first study using an MDS−HC-derived instrument to assess IC. Individuals with higher IC were less likely to report recent falls, with locomotion being an independently associated domain. Conclusions: Lower IC is linked to increased odds of falls. Interventions to maintain and improve IC, especially the locomotion domain, may reduce fall risk in community-dwelling octogenarians. [ABSTRACT FROM AUTHOR]

Objectives: Commonly, general anesthesia (GA) with endotracheal intubation is the standard anesthesiology approach in gynecological laparoscopic surgery; neuraxial anesthesia (NA) can also be used, but its application is very low and limited to few indications. This study assessed NA feasibility for almost all kinds of gynecologic laparoscopies. Materials and Methods: Data on laparoscopic surgeries performed under NA were collected retrospectively. A total of 76 patients had laparoscopic interventions at the Donatello Clinic in Florence, Italy, between October 2019 and August 2022. Adnexectomies, ovarian cyst enucleations, multiple myomectomies, total hysterectomies, radical hysterectomies with sentinel lymph-node biopsies, and complete excisions of endometriosis and adhesiolysis were performed under regional anesthesia. All procedures but 1 were completed with no change from NA. Results: All cases but 1 were completed under NA. There were (1) spontaneously breathing patients; (2) no pulmonary complications; (3) satisfactory muscle relaxation; (4) fast postoperative bowel function recovery; (5) reduced postoperative pain; (6) reduced postoperative narcotics use; and (6) absence of postoperative nausea and vomiting. Conclusions: These procedures appear to comprise the largest series of complex gynecologic laparoscopies performed under NA reported in the literature. Preliminary data seems to support the concept that this approach might be feasible and safe in selected and motivated patients, but further research is needed to confirm these encouraging data. (J GYNECOL SURG 20XX:000) [ABSTRACT FROM AUTHOR]

The article presents a research paper on the link between physical performance and long-term survival in a cohort of community-dwelling older people from the "Aging and Longevity in the Sirente Geographic Area" study. Topics discussed include the methods used in the study, the definition of long-term survival, and the implications of the study for assessing mortality risk in octogenarians.

Background: Autologous haematopoietic stem cell transplantation (AHSCT) is a highly effective one-off treatment for relapsing–remitting multiple sclerosis (RR-MS), potentially representing an optimal front-loading strategy for costs. Objective: Exploring cost/effectiveness of AHSCT and high-efficacy disease-modifying treatments (HE-DMTs) in RR-MS, estimating costs at our centre in Italy, where National Health Service (NHS) provides universal health coverage. Methods: Costs (including drugs, inpatient/outpatient management) for treatment with AHSCT and HE-DMTs were calculated as NHS expenditures over 2- and 5-year periods. Cost-effectiveness for each treatment was estimated as "cost needed to treat" (CNT), i.e. expense to prevent relapses, progression, or disease activity (NEDA) in one patient over n-years, retrieving outcomes from published studies. Results: Costs of AHSCT and HE-DMTs were similar over 2 years, whereas AHSCT was cheaper than most HE-DMTs over 5 years (€46 600 vs €93 800, respectively). When estimating cost-effectiveness of treatments, over 2 years, mean CNT of HE-DMTs for NEDA was twofold that of AHSCT, whereas it was similar for relapses and disability. Differences in CNT were remarkable over 5 years, especially for NEDA, being mean CNT of HE-DMTs €382 800 vs €74 900 for AHSCT. Conclusions: AHSCT may be highly cost-effective in selected aggressive RR-MS. Besides priceless benefits for treated individuals, cost-savings generated by AHSCT may contribute to improving healthcare assistance at a population level. [ABSTRACT FROM AUTHOR]

Since October 2022, alerts have spread from several countries about the increase in invasive group A streptococcal (iGAS) and scarlet fever cases affecting young children. We aim to analyze the epidemiology of GAS infections in the last 12 years in our hospital and identify the clinical features of invasive cases observed in 2023. We conducted a retrospective study enrolling children and adolescents hospitalized at our pediatric clinic from January to December 2023 for a definitive diagnosis of iGAS infection. Clinical, laboratory, and imaging data were collected and analyzed. Comparing 2016 and 2023, we observed a similar number of GAS infections (65 vs. 60 cases). Five children with iGAS infection were hospitalized between March and April 2023. The median age was five years. At admission, all patients showed tachycardia disproportionate to their body temperature. Vomiting was a recurrent symptom (80%). Laboratory tests mostly showed lymphopenia, hyponatremia, and high inflammatory markers. The number of pediatric iGAS cases significantly increased in 2023. Clinical (pre-school-aged children with high fever, unexplained tachycardia, and vomiting) and laboratory parameters (high procalcitonin levels, hyponatremia, and lymphopenia) could help identify and suspect a potential iGAS infection. [ABSTRACT FROM AUTHOR]

Objective: Multiple sclerosis (MS) is a complex disorder in which environmental and genetic factors interact modifying disease risk and course. This multicentre, case–control study involving 18 Italian MS Centres investigated MS course by ethnicity and native-country economic status in foreign-born patients living in Italy. Methods: We identified 457 MS patients who migrated to Italy and 893 age- and sex-matched native-born Italian patients. In our population, 1225 (93.2%) subjects were White Europeans and White Northern Americans (WENA) and 89 (6.8%) patients were from other ethnical groups (OEG); 1109 (82.1%) patients were born in a high-income (HI) Country and 241 (17.9%) in a low-middle-income (LMI) Country. Medical records and patients interviews were used to collect demographic and disease data. Results: We included 1350 individuals (973 women and 377 men); mean (SD) age was 45.0 (11.7) years. At onset, 25.45% OEG patients vs 12.47% WENA (p = 0.039) had > 3 STIR spine lesions. At recruitment, the same group featured mean (SD) EDSS score of 2.85 (2.23) vs 2.64 (2.28) (p = 0.044) reached in 8.9 (9.0) vs 12.0 (9.0) years (p = 0.018) and underwent 1.10 (4.44) vs. 0.99 (0.40) annual MRI examinations (p = 0.035). At disease onset, patients from LMI countries had higher EDSS score than HI patients (2.40 (1.43) vs 1.99 (1.17); p = 0.032). Discussion: Our results suggested that both ethnicity and socio-economic status of native country shape MS presentation and course and should be considered for an appropriate management of patients. To the best of our knowledge, this is the first study reporting on the impact of ethnicity in MS at an individual level and beyond an ecological population-perspective. [ABSTRACT FROM AUTHOR]

Objective Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity—a risk factor for suicidal ideation per se—could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation. Methods In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected. Results 3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation. Discussion The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to assess the diagnostic accuracy and the inter‐rater agreement among general dentists when staging and grading periodontitis cases with the aid of a software application (SA) developed by the Italian Society of Periodontology and Implantology. Materials and methods: Ten general dentists were asked to independently assess 25 periodontitis cases using the SA. Accuracy was estimated using quadratic weighted kappa and examiners' percentage of agreement with a reference diagnosis provided by a gold standard examiner. Inter‐rater agreement was evaluated using Fleiss kappa statistics. Results: The overall case definition agreed with the reference diagnosis in 53.6% of cases. The agreements for each general dentist's pairwise comparisons against the reference definition were at least substantial in 100% of cases for stage, in 70% of cases for grade and in none of the cases for extent. Fleiss kappa was 0.818, 0.608, and 0.632 for stage, extent, and grade, respectively. The study recognized possible reasons that could lead to decreased accuracy using the SA. Conclusions: Supported by the SA, general dentists have reached substantial inter‐rater agreement and highly accurate assignments of stage and grade. However, complete case definitions were correctly diagnosed in slightly over half of the cases. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical management of stage IV periodontitis patients among clinicians within the Italian Society of Periodontology and Implantology. Methods: A cross‐sectional study was designed on a web‐based anonymous survey. Comparison between ordinary members (OMs) versus active and certified members (ACMs) and comparison between members with at least 10 years of experience in periodontology (Ov10) and members with less than 10 years of experience in periodontology (Un10) were performed. Results: A total of 324 out of 1362 members (response rate of 24%) responded to the questionnaire. ACMs and Ov10 more often reported their teams hold adequate skills to manage cases. Step I and II periodontal therapy took more time in the ACMs and Ov10 groups. ACMs used different strategies to perform step I‐II therapy, and antibiotics were used less frequently than OMs. Unresponsive sites were treated more often with surgery by ACMs compared to OMs. ACMs adopted different treatment sequences compared to OMs. Ov10 group used more often CBCT, lateral cephalogram, and wax‐up while Un10 group tend to avoid orthodontic therapy. Conclusions: More experienced members spent more time in step I and II of periodontal therapy, used more diagnostic tools, and performed more often surgery and orthodontics in the treatment of stage IV periodontitis patients. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate long-term functional, sexual, and cosmetic outcomes in adult patients who underwent hypospadias repair during childhood at a national highly specialized pediatric hospital. Methods: Medical records of pediatric patients who had undergone surgical repair of hypospadias between 1993 and 2004 at Meyer Children Hospital of Florence were reviewed. Adult patients were contacted by telephone between July and August 2021 and invited to participate. Long-term surgical outcomes were assessed focusing on complications and reinterventions, and 3 validated questionnaires on urinary function, erectile function, and penile cosmetic appearance were administered. Results: From January 1993 to December 2004, a total of 799 patients with hypospadias underwent repair surgery. Two hundred thirty-nine patients gave consent to be included in the study. Follow-ups occurred between 17 and 28 years after the first surgery. Most patients had anterior localization of hypospadias (210/239) and associated penile curvature (132/239). The most frequent surgery for hypospadias repair was meatal advancement and glanduloplasty incorporated (MAGPI) (88/239), and the most used surgical treatment for penile curvature was the Nesbit technique (49/132). The complication rate was 27% (65/239) in an average time of 4.7 years, and 48 surgical procedures have been performed to treat them. At follow-up, the mean IPSS was 0.96 ± 1.97, the mean IIEF-5 score was 24.10 ± 1.02, and the mean HOSE score was 15.47 ± 0.45. Patients who underwent reintervention reported a lower IPSS than those who underwent only 1 surgery (0.29 vs. 1.16). [ABSTRACT FROM AUTHOR]

Pressure injuries (PIs) are a common complication in patients with spinal cord injury/disorder (SCI/D), and deep PIs require surgical treatment consisting of wide debridement and adequate reconstruction. We conducted a retrospective observational study at a tertiary rehabilitation hospital for SCI/D in Italy with the aim of describing the incidence and associated risk factors of postoperative complications in individuals with SCI/D presenting with chronic deep PIs, treated with a specific flap selection algorithm based on the site of the defect, the presence of scars from previous surgeries, and the need to spare reconstructive options for possible future recurrences. Medical records of surgical procedures performed on SCI/D patients with fourth-degree PIs, according to NPUAP classification (National Pressure Ulcer Advisory Panel), between July 2011 and January 2018 were reviewed. A total of 434 surgical procedures for fourth-degree PIs in 375 SCI/D patients were analyzed. After a mean follow-up of 21 months (range 12–36), 59 PIs (13.6%) had minor complications, and 17 (3.9%) had major complications requiring reoperation. The sacral site and muscular and musculocutaneous flaps were significant risk factors for postoperative complications. Six patients (1.4%) had a recurrence. The choice of flap correlates with the outcome of decubitus reconstruction. Therefore, reconstructive planning should be based on established principles. [ABSTRACT FROM AUTHOR]

Regular engagement in physical activity (PA) or physical exercise (PE) is effective at improving physical performance and body composition in older adults. Less is known about the benefits that may be obtained through combining PA with PE and whether the effects of activity habits differ between men and women. This study cross-sectionally investigated the association of PA and/or PE with physical performance and anthropometric measures in a large and relatively unselected sample of older adults enrolled in the Longevity Check-up (Lookup) 7+ project. Participants were individuals 65 years and older living in the community who were recruited in unconventional settings across Italy. Adherence to PA or PE was operationalized as involvement in light walking or various types of exercise, respectively, at least twice weekly for a minimum of 30 min per session throughout the last 12 months. Physical performance measures included handgrip strength and five-time sit-to-stand (5STS) tests. Lower-limb muscle power and appendicular skeletal muscle mass (ASM) were estimated through validated equations. We analyzed data of 4119 participants, of whom 2222 (53.4%) were women. The mean age was 72.8 ± 5.8 years in men and 72.1 ± 5.4 years in women. Regular engagement in PA + PE was reported by 139 (7.3%) men and 100 (4.5%) women. Results indicated that regular walking activity and/or PE were significantly associated with better physical performance and greater ASM with sex-specific patterns. Associations were also influenced by the type of activity, physical performance assessment tool, and anthropometric parameters. Men engaged in PA + PE performed better on the 5STS test and had greater handgrip strength, ASM, and relative and specific muscle power than those practicing either PA or PE. In women, the combination of PA and PE was associated with greater handgrip strength. The findings of this study indicate that older adults regularly practicing PA + PE had better physical performance than those who only engaged in either modality. In men, the combination of PA and PE was also associated with greater ASM. [ABSTRACT FROM AUTHOR]

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Background: Lifestyle habits have a key role in cardiometabolic health. The effects of combined aerobic training (AT) and high protein intake (HPI) on cardiometabolic parameters in older adults are not well established. Aims: To investigate the association of AT and HPI with blood pressure (BP), blood glucose, and total blood cholesterol levels in a sample of Italian older adults enrolled in the Longevity Check-up 7 + (Lookup 7 +) study. Methods: Lookup 7 + is an ongoing project started in June 2015 and conducted in unconventional settings (e.g., exhibitions, malls, health promotion campaigns) across Italy with the aim of fostering adoption of healthy lifestyles in the general population. For the present investigation, analyses were conducted in participants 65 + years and with body mass index values ≥ 18.5 kg/m2 (n = 3219). Systolic (SBP) and diastolic BP (DBP), blood glucose, and total blood cholesterol were measured. Protein intake was estimated using a 12-item food frequency questionnaire. HPI was operationalized as a daily protein intake ≥ 0.8 g/kg of body weight. AT was operationalized as the practice of running and/or swimming for 60 + minutes at least twice weekly during the previous year. Results: The mean age of the 3219 participants was 72.7 ± 5.7 years, and 55.2% were women. Adherence to AT combined with a HPI was negatively and independently associated with SPB (β: − 4.976; 95% confidence interval: − 9.8 to − 0.08). No other significant associations were observed. Discussion and conclusions: Our results indicate that AT combined with HPI was negatively associated with SBP in a large and relatively unselected sample of Italian older adults living in the community. These findings need confirmation by ad hoc designed studies. [ABSTRACT FROM AUTHOR]

Purpose: Environmental impacts associated with the fashion industry concern society and require commitment to sustainable development goals from leading companies. The role of the luxury sector in setting trends and negotiating power within the supply chain can lead this industry towards sustainability. This study constructs a comprehensive operational flux inventory attributed to an Italian luxury garment brand, aiming to investigate and propose feasible strategies to reduce potential impacts coupled with their products. Methods: Under the operational control criteria, a whole year of activities was tracked using mainly primary data from its management system. According to ISO 14064–1:2019, potential greenhouse gas emissions were classified, organized, and processed into six categories. The analysis, at the company level, covered the product's complete life cycle, i.e., from cradle to the grave. The ecoinvent database considered preferentially local geography, and the cut-off system approach, therefore assigning emissions to the primary user. Results and discussion: Results showed that the only unit in central Italy where the headquarter is located (excluding retail stores), producing 485,193 women's clothing in a year, emitted 9804 t CO2 eq. Most of these impacts (69% or 6752 t CO2 eq) can be associated with indirect emissions related to raw products and materials, and about 93% of this amount results from the high-quality products used by the company. Transportation represents 14% of the total emissions, while the use phase accounts for about 13%. As a final step, six different mitigation scenarios were proposed and analyzed by focusing on non-core production activities, i.e., upstream, and downstream operations, and consumers' habits. Once combined, these strategies can potentially reduce by about 25% the study case company overall emissions. Conclusions: As a conclusion, exploring possible alternatives through environmental assessment tools can support strategies for achieving impact reduction. While aggressive changes can be done in non-core activities with excellent results, changes perceived by the customers can also be well desired to mark innovation and advances in the business mindset. [ABSTRACT FROM AUTHOR]

Objectives: To examine the relationships between protein intake from various food sources and cardiometabolic risk markers in Italian older adults. Design: Cross-sectional study. Setting: Unconventional settings across Italy (e.g., exhibitions, health promotion campaigns). Participants: People 65+ years who provided a written informed consent. Measurements: Blood pressure (BP), blood glucose, total blood cholesterol, and anthropometric indices were assessed. Daily protein intake was estimated for 12 food items listed in a food frequency questionnaire. Results: Three-thousand four-hundred twenty-four older adults (mean age: 72.7 ± 5.7 years; 55% women) were included in the study. Results of linear regression analysis indicated that protein intake from several food sources was negatively associated with BP, waist and hip circumferences, and waist-to-hip ratio in both sexes. Blood glucose levels were inversely associated with many protein sources in women. Positive associations were observed between some protein sources and total blood cholesterol in both men and women. Conclusion: Our findings suggest that dietary protein is differentially associated with cardiometabolic risk factors depending on sex and food sources. [ABSTRACT FROM AUTHOR]

Background : Nutritional status is a critical factor throughout COVID-19 disease course. Malnutrition is associated with poor outcomes in hospitalized COVID-19 patients. Aim : To assess the prevalence of malnutrition and identify its associated factors in COVID-19 survivors. Methods: Study cohort included 1230 COVID-19 survivors aged 18–86 attending a post-COVID-19 outpatient service. Data on clinical parameters, anthropometry, acute COVID-19 symptoms, lifestyle habits were collected through a comprehensive medical assessment. Malnutrition was assessed according to Global Leadership Initiative on Malnutrition (GLIM) criteria. Results : Prevalence of malnutrition was 22% at 4–5 months after acute disease. Participants who were not hospitalized during acute COVID-19 showed a higher frequency of malnutrition compared to those who needed hospitalization (26% versus 19%, p < 0.01). Malnutrition was found in 25% COVID-19 survivors over 65 years of age compared to 21% younger participants (p < 0.01). After multivariable adjustment, the likelihood of being malnourished increased progressively and independently with advancing age (Odds ratio [OR] 1.02; 95% CI 1.01–1.03) and in male participants (OR 5.56; 95% CI 3.53–8.74). Malnutrition was associated with loss of appetite (OR 2.50; 95% CI 1.73–3.62), and dysgeusia (OR 4.05; 95% CI 2.30–7.21) during acute COVID-19. Discussion : In the present investigation we showed that malnutrition was highly prevalent in a large cohort of COVID-19 survivors at 4–5 months from acute illness. Conclusions : Our findings highlight the need to implement comprehensive nutritional assessment and therapy as an integral part of care for COVID-19 patients. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the consequent need to socially distance has prompted nonprofits to rely more on their institutional websites to reach donors and seek financial support. In this study, we use qualitative comparative analysis to explore which different combinations of information on organizational profile, governance, performance, and finances are deemed most suitable by Italian community foundations to encourage charitable giving. The results highlight two different paths, suggesting that organizational profile, performance, and governance information matter most to Italian community foundations for retaining donors and donations, or attracting new ones, whereas financial information is not considered relevant for designing effective online disclosure. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the psychological impact of the COVID-19 pandemic on healthcare workers (HCWs) in geriatric settings. Design: Online cross-sectional survey. Settings and Participants: 394 geriatric HCWs in Italy. Measurements: The survey was developed by a multidisciplinary team and disseminated in April 2022 to the members of two geriatric scientific societies (Italian Society of Geriatrics and Gerontology and Italian Association of Psychogeriatrics). The survey examined the experiences related to the COVID-19 pandemic, as well as psychological burden and support. Work-related anxiety and distress related to the pandemic were studied using the SAVE-9 scale (Stress and Anxiety to Viral Epidemics). Results: Three hundred sixty-four participants (92.4%) changed their job activity during the pandemic and about half (50.9%) failed to cope with this change, 58 (14.7%) had increased work-related anxiety, and 39 (9.9%) work-related stress levels. Three hundred forty (86.3%) participants reported acute stress reaction symptoms, including irritability, depressed mood, headache, anxiety, and insomnia, and 262 (66.5%) required psychological support, mainly from friends/relatives (57.9%) and/or colleagues (32.5%). Furthermore, 342 participants (86.8%) recognized they would benefit from informal and formal psychological support in case of future similar emergencies. Conclusions: This study highlights the high psychological burden experienced by geriatric HCWs in Italy during the COVID-19 pandemic and emphasizes the need for supportive interventions. [ABSTRACT FROM AUTHOR]

Purpose: This research focuses on the relationship between Top Management Team heterogeneity (TMT) and University Spin-Offs (USOs) economic performance according to a micro-foundational perspective. The purpose consists in exploring whether a high academic representation in TMTs may improve USOs' performance and how their competencies and backgrounds affect USOs' economic success. Design/methodology/approach: The authors employed data from the Italian platform Netval to identify the entire population of USOs in southern Italy. They selected both pure and hybrid spin-offs that had at least one academic member on the TMT. Applying these conditions to our sample selection, the authors came to a population of 136 firms. They applied a hierarchical regression analysis to test the hypotheses. Findings: Our main findings reveal that the USOs' economic performance improves with more academicians in the TMT and even in the same scientific field. Our data also shows that CEO duality has a negative impact on economic performance. Originality/value: This work takes for the first time a micro-foundational perspective to analyze individual-level factors that affect USOs' performance. The authors tried to bridge a research gap in the USO literature, shedding light on the relationship between TMT composition and new venture performance, considering some significant interactions between team members. Our expected findings also contribute to the general literature on entrepreneurial teams in new ventures and suggest a means to reconcile some inconsistent literature results on TMT heterogeneity and USO performance. [ABSTRACT FROM AUTHOR]

The psychosocial stressors related to the ongoing COVID-19 pandemic and associated lockdowns have been shown to lead to an exacerbation of suicide risk. The present study aims to examine (a) the contribution of mental pain intensity to psychological distress and suicidal ideation during the COVID-19 pandemic and (b) the protective role of mental pain tolerance in buffering these adverse mental health effects. A total of 652 adults (74.2% female, M = 33.99 years, SD = 13.74) were assessed through an online survey during the first mandatory lockdown in Italy. Participants completed measures of mental pain intensity and tolerance, psychological distress, and suicidal ideation. Results showed that mental pain intensity significantly predicted increases in psychological distress and suicidal ideation while mental pain tolerance significantly buffered the adverse effects of mental pain intensity on psychological distress and suicidal ideation. The findings highlight that tolerance for mental pain may act as a powerful protective factor during the pandemic. Evidence-based public health interventions fostering tolerance for mental pain during a pandemic are needed in order to effectively reduce suicide in potential risk groups. [ABSTRACT FROM AUTHOR]

The present study was conducted to test the association between adherence to specific exercise modalities and sarcopenia severity in Italian older adults. Data were collected as part of the ongoing Longevity Check-Up 7+ (Lookup 7+) project. Lookup 7+ began in June 2015 and has since been conducted in unconventional settings (e.g., exhibitions, malls, social events) throughout Italy. In the present study, we used data on adults 65 years and older. Sarcopenia was identified according to the simultaneous presence of dynapenia and low appendicular muscle mass. Muscle strength was measured by isometric handgrip and sit-to-stand (STS) testing. Sarcopenia was categorized as severe if participants reported difficulty or inability to walk 400 m. Engagement in running and/or swimming (RS) or strength training with or without stretching (SS) was used to define exercise modalities. Analyses were conducted in 3289 participants (mean age: 72.7 ± 5.7 years; 1814 women). The results of the binary regression showed negative associations between RS and the presence of STS-based sarcopenia in women, and between RS and STS-based severe sarcopenia in men. Collectively, these findings indicate that RS is negatively associated with the presence of sarcopenia in large sample of relatively unselected Italian older adults. [ABSTRACT FROM AUTHOR]

Due to its geographical position and a highly variable orography, Italy is characterized by several climatic areas and thus, by many different dairy cow farming systems. Brown Swiss cattle, in this context, are a very appreciated genetic resource for their adaptability and low metabolic requirement. The significant heterogeneity in farming systems may consist of genotype by environment (G × E) interactions with neglected changes in animals' rank position. The objective of this study was to investigate G × E for heat tolerance in Brown Swiss cattle for several production traits (milk, fat, and protein yield in kilograms; fat, protein, and cheese yield in percentage) and 2 derivate traits (fat-corrected milk and energy-corrected milk). We used the daily maximum temperature-humidity index (THI) range, calculated according to weather stations' data from 2008 to 2018 in Italy, and 202,776 test-day records from 23,396 Brown Swiss cows from 639 herds. Two different methodologies were applied to estimate the effect of the environmental variable (THI) on genetic parameters: (1) the reaction norm model, which uses a continuous random covariate to estimate the animal additive effect, and (2) the multitrait model, which splits each production pattern as a distinct and correlated trait according to the first (a thermal comfort condition), third (a moderate heat stress condition), and fifth (a severe heat stress condition) mean THI value quintile. The results from the reaction norm model showed a descending trend of the additive genetic effect until THI reached the value of 80. Then we recorded an increase with high extreme THI values (THI 90). Permanent environmental variance at increasing THI values revealed an opposite trend: The plot of heritability and the ratio of animal permanent environmental variance to phenotypic variance showed that when the environmental condition worsens, the additive genetic and permanent environmental component for production traits play a growing role. The negative additive genetic correlation between slope and linear random coefficient indicates no linear relationship between the production traits or under heat stress conditions, except for milk yield and protein yield. In tridimensional wireframe plots, the extreme margin decreases until a minimum of ∼0.90 of genetic correlation in the ECM trait, showing that the magnitude of G × E interaction is greater than the other traits. Genetic correlation values in Brown Swiss suggest the possibility of moderate changes in animals' estimated breeding value in heat stress conditions. Results indicated a moderate G × E interaction but significant variability in sire response related to their production level. [ABSTRACT FROM AUTHOR]

An accumulating body of evidence supports an independent association between high blood pressure (BP) and periodontitis, possibly mediated by low‐grade inflammation. This joint report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) working group on Hypertension and Periodontitis (Hy‐Per Group) provides a review of the evidence on this topic encompassing epidemiology, biological plausibility, relevance, magnitude, and treatment management. Consensus recommendations are provided for health professionals on how to manage BP in individuals showing signs of poor oral health. In summary, (1) large epidemiological studies highlight that individuals with periodontal diseases have increased risk for high/uncontrolled BP independent of confounders; (2) mechanistically, low‐grade inflammation might have a causal role in the association; (3) BP profile and control might benefit from periodontal treatment in pre‐hypertensive and hypertensive individuals; (4) oral health status should be evaluated as a potential risk factor for high/uncontrolled BP, and effective oral care should be included as an adjunct lifestyle measure during hypertension management. Further research is needed to optimize BP management in individuals with poor oral health. [ABSTRACT FROM AUTHOR]

The present study was conducted to test the association between protein intake and blood pressure, glucose levels, and blood cholesterol in a large sample of Italian older adults. Longevity Check-up 7+ (Lookup 7+) is an ongoing project that started in June 2015. The project is conducted in unconventional settings (e.g., exhibitions, malls, health promotion campaigns) across Italy with the aim of fostering adoption of healthy lifestyles in the general population. For the present study, participants were eligible if they were 65+ years and provided written informed consent. Systolic (SBP) and diastolic blood pressure (DBP), and blood glucose and cholesterol levels were assessed. Protein intake was estimated using a 12-item food frequency questionnaire. Three-thousand four-hundred and four older adults were included in the study. The results of the linear regression showed an inverse association between protein intake (as a continuous variable) and DBP, and a positive correlation with blood cholesterol levels. The findings of the present study indicate that a high intake of protein was negatively associated with DBP and positively associated with total blood cholesterol levels in a large cohort of Italian older adults, after adjustment for numerous covariates. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic forced social workers to rethink how they perform their functions. This process was particularly challenging for child protection social workers, who had to understand how to continue to support families and children despite social distancing rules and the suspension of some activities. Three online focus groups were conducted with 18 child protection social workers to explore the Italian child protection social workers' functions during the Covid-19 pandemic. This study presents the reflections shared by these social workers on their experiences and the new awareness they acquired while performing their work in support of families during the pandemic. [ABSTRACT FROM AUTHOR]

A comparative analysis of the riparian vegetation dominated by Alnus glutinosa in Italy and Tyrrhenian islands, based on literature data and unpublished relevés, is presented. A total of 456 phytosociological relevés were processed. For the definition of plant communities and alliances, hierarchical clustering was performed by using Bray-Curtis coefficient and Detrended Correspondence Analysis ordination methods. Identification of diagnostic species of the vegetation units was performed by means of the phi fidelity index. Quantum GIS software version 3.6 was used for the interpolation of the bioclimatic variables and A. glutinosa communities. Overall, a total of 18 A. glutinosa-riparian wood communities were distinguished for Italy and Tyrrhenian islands, of which two new associations and one new subassassociation are described. The classification of the relevés showed two main vegetation groups: the first one including the plant communities of the Osmundo-Alnion alliance, and the other including the vegetation of the Ligustro vulgaris-Alnion glutinosae alliance. This latest includes the riparian meso-thermophilous communities of central and northern Italy. Within the Osmundo-Alnion alliance, two subgroups can be recognized: the first one includes the thermophilous communities of the Hyperico hircini-Alnenion glutinosae sub-alliance, mainly spread in the Tyrrhenian islands, while the second group includes the mesophilous communities attributed to the new suballiance Struthioptero-Alnenion glutinosae, widespread in central Italy and the Corsican mountains. The present paper provides the first comprehensive and exhaustive scheme of the A. glutinosa riparian woodlands diversity in Italy and Corsica. [ABSTRACT FROM AUTHOR]

Background: This case study describes and analyses an action research initiative undertaken by management, staff and World Health Organization (WHO) at the IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Italy. The initiative utilised staff engagement approaches developed during the COVID-19 pandemic to rethink and reshape future development plans. The initiative provides a 'how-to' case study for complex health facilities on ways to create similar multisectoral, inclusive and holistic processes in planning structural, functional and organizational solutions for their 'hospitals of tomorrow.' Methods: The case study utilised an action research approach coordinated by a team of WHO facilitators in close collaboration with the Board of Hospital Directors. Heterogeneous and multidisciplinary working groups were created, with members from different levels of the hospital staff. In the context of facilitated group meetings held weekly over a one-year period, participants were asked to review topics of interest to future plans of the hospital and make recommendations on effective/innovative ways of addressing these in the short and long term. Working groups focused on different challenges. Results: The initiative was successful in creating and sustaining broad staff engagement in the future planning processes. 80% groups maintained high staff participation throughout the entire project year. Participating staff reported enhanced communication and cooperation between departments represented in different groups. 87% of the proposed plans suggested by the working groups were approved by the Board for implementation. Conclusion: Key factors contributing to the high approval rate of plans, strong engagement record of staff and enhanced cooperation between involved departments; included: multisectoral/cross hierarchal staff involvement, group attention to defining time-bound contextual goals, flexible implementation monitoring approaches, personnel skills and profiles of participants, direct and open communication at all levels and times, member commitment and clear exit strategy. The case study is presented as a model to stimulate similar actions in other complex healthcare facilities. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the proportion of COVID‐19 infections among a population of Italian Dental workers across different geographical area of Italy and to analyze the impact of both the preventive measures/strategies adopted and the psychological influences. Subjects and Methods: The current cross‐sectional survey was administered with a web‐based form. To be eligible for the study, participants had to be 18 years and being dentists or dental hygienists members of the Italian Society of Periodontology and Implantology (SIdP). A 23‐item questionnaire concerning positiveness to COVID‐19, clinical strategies and psychological attitude within the pandemic was administered. Sub‐group analysis was conducted according to geographical macro‐area. Results: A total of 790 dentists and dental hygienists were included. A total of 4.7% participants developed a positive diagnosis to COVID‐19. The Northwest of Italy experienced almost double of COVID‐19‐positive participants (p < 0.05). Preoperatory mouthwashes together with natural air change/ventilation were the most frequent approaches used to prevent COVID‐19 outbreak. Positive and proactive attitudes were predominant among participants. Only a reduced proportion feels some concerns for the future. Conclusions: Prevalence of positive COVID‐19 among dental workers in Italy was double in Northwest area in comparison with the whole country proportion. Preventive strategies comprise mainly ultrasound reduction and preoperative mouthwashes. [ABSTRACT FROM AUTHOR]

This contribution is focused on the "Casa Esagono" realized in 1957 by Vittorio Giorgini in Baratti (LI), Italy. The research objective is to lay the foundations for a restoration plan of this experimental wooden architecture, which is now in precarious conditions due to its location near the sea, and whose constructive features, has always raised great questions about the technical feasibility of a full restoration. The paper describes the workflow for the implementation of the H-BIM model, aimed to organise all the data deriving from the historical and on-site research, and the restoration programme. The historical analysis about the house and the architect was the basis for the geometric survey and the analysis of building materials. All building components were subjected to visual analysis aimed to identify deterioration forms. The proposed conservation approach aims to maintain as much of the original elements as possible, while increasing their durability. H-BIM revealed to be the ideal tool to manage the entire restoration process, whose ultimate goal is to celebrate Giorgini's work, to exploit the potential of the house as a cultural attraction. [ABSTRACT FROM AUTHOR]

'Asprinio' is a white dry wine characteristic for its acidity and aromatic flavour, known as emerging DOP wine in Southern Italy. Nevertheless, little information is available on the metabolomic profile of this wine. Thus, in this paper we evaluated the colourimetric parameters, 1H NMR profiles and free amino acids content of 'Asprinio' wines, bottled by two different wineries (hereafter 'Asprinio_A' and 'Asprinio_B') collected in 2019 and 2020, using 'Greco di Tufo' for comparison. The colourimetric parameters are similar for both 'Asprinio' wines and differ from 'Greco di Tufo' wines. On the other hand, both 1H NMR and free amino acid content profiles show different chemometric profiles among the three wines analysed, although the profiles are similar for both vintages. Moreover, the multivariate analyses carried out highlight differences between 'Asprinio_A' and 'Asprinio_B', which exbibit also different residual yeast and plant DNA. Overall, considering that the two-manufacturing wineries use 100% 'Asprinio' grape, the difference retrieved between the two 'Asprinio' wines could be explained by the different grapevine training systems: 'vite maritata' (training system inherited from Etruscans) for 'Asprinio_A' and 'guyot' for 'Asprinio_B'. [ABSTRACT FROM AUTHOR]

Simple Summary: Super-high density olive orchards are spreading in Italy to reduce production costs and increase yields per hectare. The objective of this study was to assess the orchards' effect on the soil nematode community in five sites located in the main Italian olive cultivation areas compared to the adjacent traditional olive orchard system. Super-high density olive orchard management combined with conventional tillage and mineral fertilization decreased total organic carbon compared to traditional management. The soil nematode community was affected by the depletion of organic matter, especially for plant-parasitic nematodes, which increased. Moreover, this investigation evidenced that the Super-high density olive orchard management system could change the soil plant-parasitic nematode composition of olive orchards. In fact, the families Telotylenchidae, Paratylenchidae, Meloidogynidae, and Criconematidae were favored in the Super-high density olive orchard system, while Longidoridae, Heteroderidae, and Pratylenchidae were disadvantaged. However, conservative and sustainable soil management might maintain or improve the soil nematode community functionality and reduce plant-parasitic nematodes. The soil nematode community plays an important role in ecosystem services. The objective of this study was to assess the effect of Super-high density (SHD) olive orchards on the nematode community in five sites with different soils, climates, and cultivars. At each site, the SHD management system was compared to the adjacent olive orchard traditional (TRAD) system, in which the same soil management and phytosanitary measures were applied. Soil management was assessed by total organic carbon content (TOC), while the soil nematode community was evaluated using the nematode taxa abundances and soil nematode indicators. TOC was significantly decreased in the SHD olive orchard system compared to TRAD in the sites characterized by conventional tillage and mineral fertilization. The two-way ANOSIM analysis on nematode abundance showed no difference between the two olive management methods, instead showing only a significant difference per site mainly due to variabilities in plant-parasitic nematode assemblage. However, a negative impact of SHD management was evident in environments stressed by summer droughts and conventional tillage: the ratio of obligate plant-parasites to bacterivores and fungivores (Pp/(B+F)) was significantly higher in SHD than in the TRAD olive orchard system, and the prey-to-predator θ mass ratio showed the lowest values in the sites under organic fertilization or green manure. The canonical correspondence analysis showed that the free-living nematodes were only slightly affected by SHD olive orchards; instead, the presence of plant-parasitic nematodes families such as Telotylenchidae, Paratylenchidae, Meloidogynidae, and Criconematidae was favored, in comparison to Longidoridae, Heteroderidae, and Pratylenchidae. [ABSTRACT FROM AUTHOR]

Background Cardiovascular disease still represents the leading cause of death worldwide. Management of risk factors remains crucial; despite this, hypercholesterolemia, which is one of the most important modifiable cardiovascular risk factor, is still high prevalent in general population. The aim of this study is to determine the prevalence of dyslipidemia and hypercholesterolemia awareness in a very large population. Methods More than 65 000 users completed the online, self-administered survey. It was structured like a 'journey' where each stage corresponded to a cardiovascular risk factor: blood pressure, body mass index, cholesterol, diet, physical exercise, smoke and blood sugar. At the end, the user received a final evaluation of his health status. Results The mean age was 52.5 years (SD 13.9, range 18–98), with 35 402 (53.7%) men. About 56% of all participants believed to have normal cholesterol values, when only 40% of them really showed values <200 mg/dl. Only about 30% of all participants self-predicted to have abnormal cholesterol values whereas we found high cholesterol levels in about 60% of people. Conclusions Dyslipidemia is very prevalent and half of the people with high cholesterol is not aware of having high values. [ABSTRACT FROM AUTHOR]

The term "gifted" refers to individuals who give evidence of higher performance in specific fields or domains considered relevant for his/her culture of origin. The teachers' opinion is a valuable aid in identifying giftedness, thanks to the privileged perspective from which they can observe students. The standardized assessment scales compiled by teachers are functional in a multi-informant and multimethod process of evaluation, because they are highly suitable for grasping the complexity that constitutes intellectual giftedness. The present study investigated the psychometric characteristics of the Italian version of the GATES-2, a tool to identify talented and gifted students, in a sample of 925 students, who participated in the Italian adaptation of the instrument. Statistical analyses were conducted to test internal consistency, score stability, and the discriminative validity. The excellent reliability and validity measures of the GATES-2 confirmed its usefulness in recognizing the talent of students. The GATES-2 represents an ideal aid, as it evaluates the five characteristics of giftedness recognized in national definitions. [ABSTRACT FROM AUTHOR]

Background: The MuSC-19 project is an Italian cohort study open to international partners that collects data on multiple sclerosis (MS) patients with COVID-19. During the second wave of the pandemic, serological tests became routinely available. Objective: To evaluate the seroprevalence of anti-SARS-CoV-2 antibodies according to the use of disease-modifying therapy (DMT) in a subset of patients included in the MuSC-19 data set who had undergone a serological test. Methods: We evaluated the association between positive serological test results and time elapsed since infection onset, age, sex, Expanded Disability Status Scale score, comorbidities and DMT exposure using a multivariable logistic model. Results: Data were collected from 423 patients (345 from Italy, 61 from Turkey and 17 from Brazil) with a serological test performed during follow-up. Overall, 325 out of 423 tested patients (76.8%) had a positive serological test. At multivariate analysis, therapy with anti-CD20 was significantly associated with a reduced probability of developing antibodies after COVID-19 (odds ratio (OR) = 0.20, p = 0.002). Conclusion: Patients with MS maintain the capacity to develop humoral immune response against SARS-COV-2, although to a lesser extent when treated with anti-CD20 drugs. Overall, our results are reassuring with respect to the possibility to achieve sufficient immunization with vaccination. [ABSTRACT FROM AUTHOR]

Reliable biomarkers allowing early patients' stratification for the risk of adverse outcomes in COVID-19 are lacking. Gas6, together with its tyrosine kinase receptors named TAM, is involved in the regulation of immune homeostasis, fibrosis, and thrombosis. Our aim was to evaluate whether Gas6, sAxl, and sMerTK could represent early predictors of disease evolution either towards a negative (death or need of ICU admission) or a positive (discharge and/or clinical resolution within the first 14 days of hospitalization) outcome. To this purpose, between January and May 2021 (corresponding to third pandemic wave in Italy), 139 consecutive SARS-CoV-2 positive patients were enrolled in a prospective observational study. Plasma levels of these molecules were measured by ELISA at the time of hospitalization and after 7 and 14 days. We observed that higher plasma Gas6 concentrations at hospital admission were associated with a worsening in clinical conditions while lower sMerTK concentrations at baseline and after 7 days of hospitalization were associated with a more favorable outcome. At multivariate analysis, after correction for demographic and COVID-19 severity variables (NEWS2 and PiO2/FiO2), only Gas6 measured at baseline predicted an adverse prognosis with an odds ratio of 1.03 (C.I. 1.01-10.5). At ROC curve analysis, baseline Gas6 levels higher than 58.0 ng/ml predicted a severe disease evolution with 53.3% sensitivity and 77.6% specificity (area under the curve 0.653, p = 0.01 , likelihood ratio of 2.38, IQR: 1.46-3.87). Taken together, these results support the hypothesis that a dysregulation in the Gas6/TAM axis could play a relevant role in modulating the course of COVID-19 and suggest that plasma Gas6 may represent a promising prognostic laboratory parameter for this condition. [ABSTRACT FROM AUTHOR]

We present a comprehensive study integrating satellite observations of ozone pollution, in situ measurements, and chemistry-transport model simulations for quantifying the role of anthropogenic emission reductions during the COVID-19 lockdown in spring 2020 over Europe. Satellite observations are derived from the IASI + GOME2 (Infrared Atmospheric Sounding Interferometer + Global Ozone Monitoring Experiment 2) multispectral synergism, which provides better sensitivity to near-surface ozone pollution. These observations are mainly analysed in terms of differences between the average on 1–15 April 2020, when the strictest lockdown restrictions took place, and the same period in 2019. They show clear enhancements of near-surface ozone in central Europe and northern Italy, as well as some other hotspots, which are typically characterized by volatile organic compound (VOC)-limited chemical regimes. An overall reduction of ozone is observed elsewhere, where ozone chemistry is limited by the abundance of NOx. The spatial distribution of positive and negative ozone concentration anomalies observed from space is in relatively good quantitative agreement with surface in situ measurements over the continent (a correlation coefficient of 0.55, a root-mean-squared difference of 11 ppb , and the same standard deviation and range of variability). An average difference of ∼ 8 ppb between the two observational datasets is observed, which can partly be explained by the fact the satellite approach retrieves partial columns of ozone with a peak sensitivity above the surface (near 2 km of altitude over land and averaging kernels reaching the middle troposphere over ocean). For assessing the impact of the reduction of anthropogenic emissions during the lockdown, we adjust the satellite and in situ surface observations for subtracting the influence of meteorological conditions in 2020 and 2019. This adjustment is derived from the chemistry-transport model simulations using the meteorological fields of each year and identical emission inventories. Using adjustments adapted for the altitude and sensitivity of each observation, both datasets show consistent estimates of the influence of lockdown emission reduction. They both show lockdown-associated ozone enhancements in hotspots over central Europe and northern Italy, with a reduced amplitude with respect to the total changes observed between the 2 years and an overall reduction elsewhere over Europe and the ocean. Satellite observations additionally provide the ozone anomalies in the regions remote from in situ sensors, an enhancement over the Mediterranean likely associated with maritime traffic emissions, and a marked large-scale reduction of ozone elsewhere over ocean (particularly over the North Sea), in consistency with previous assessments done with ozone sonde measurements in the free troposphere. These observational assessments are compared with model-only estimations, using the CHIMERE chemistry-transport model. Whereas a general qualitative consistency of positive and negative ozone anomalies is observed with respect to observational estimates, significant changes are seen in their amplitudes. Models underestimate the range of variability of the ozone changes by at least a factor 2 with respect to the two observational datasets, both for enhancements and decreases of ozone. Moreover, a significant ozone decrease observed at a large hemispheric scale is not simulated since the modelling domain is the European continent. As simulations only consider the troposphere, the influence from stratospheric ozone is also missing. Sensitivity analyses also show an important role of vertical mixing of atmospheric constituents, which depends on the meteorological fields used in the simulation and significantly modify the amplitude of the changes of ozone pollution during the lockdown. [ABSTRACT FROM AUTHOR]

This study refined the conceptualisation of youth caregiving by testing the tripartite model of youth caregiving proposed by Pakenham and Cox, comprising caregiving responsibilities, experiences, and tasks. We also investigated convergent validity of the model by examining the unique and joint contributions of the three youth caregiving components to youth adjustment outcomes. A total of 681 Italian youth, 325 young carers and 356 non-carers, aged 11 to 24 years participated in a cross-sectional study. Participants completed a questionnaire assessing demographics, youth caregiving, and psychosocial adjustment. Confirmatory factor analyses revealed that compared to a one-factor model, the three-factor youth caregiving model provided a better fit to the data in the young carer and non-carer subgroups. The three youth caregiving components predicted variations in youth adjustment. Caregiving experiences were the strongest predictor of poorer youth adjustment while caregiving tasks predicted improvement in two youth adjustment outcomes in diverse youth caregiving contexts. Findings support the validity of a three-factor model of youth caregiving, indicating that caregiving responsibilities, experiences, and tasks represent empirically distinct but related youth caregiving components. Interventions should mitigate the adverse and cultivate the positive effects of youth caregiving. [ABSTRACT FROM AUTHOR]

Aim: Recently, there has been increasing interest in providing Personal Health Budgets (PHBs) to patients with severe mental illness. However, information on implementing PHB initiatives is still limited. Aim of this observational study was to evaluate the applicability of a PHB intervention model in a sample of Italian adults with first‐episode psychosis (FEP) across a 2‐year follow‐up period. Methods: Participants (n = 104; 18–50 years) were recruited within the 'Parma‐Early Psychosis' program and completed the brief psychiatric rating scale (BPRS), the health of nation outcome scale (HoNOS) and the global assessment of functioning (GAF). Mixed‐design analysis of variance (ANOVA) and Kaplan‐Maier survival analysis (as drop‐out measure) were performed. Results: A significant effect of time on all BPRS, HoNOS and GAF scores along the follow‐up was observed in both the FEP subgroups (i.e., with [n = 49] and without [n = 55] PHB intervention). Mixed‐design ANOVA results showed a significant 'time x group' interaction effects on BPRS 'Disorganization', HoNOS 'Psychiatric Symptoms' and GAF scores in FEP participants with PHB. Kaplan‐Meyer survival analysis showed a longer survival mean for FEP patients with PHB. Conclusions: Our results support the applicability of a PHB model within an 'Early Intervention in Psychosis' program in public community mental health services. [ABSTRACT FROM AUTHOR]

Olive (Olea europaea L.) is a traditional crop of great socioeconomic importance in the Mediterranean Basin. In 2021, a survey was performed in an Italian nursery located in Central Italy where unusual symptoms and widespread dieback had been observed on young potted olive trees. Twigs and branches of all plants affected by dryness showed the presence of the alien bark beetle Xylosandrus compactus. Woody tissues colonized by X. compactus were transferred into the laboratory and several fungi such as Cladosporium perangustum and Neofusicoccum parvum were then identified. In addition to these species, Geosmithia pallida was also reported for the first time in Italy on this plant. Studies on this bark beetle and its associated fungi are currently in progress to further evaluate potential risks for olive cultivation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this exploratory study is to investigate why and how public health agencies employed social media during coronavirus disease 2019 (COVID-19) outbreak to foster public engagement and dialogic accounting. Design/methodology/approach: The authors analysed the official Facebook pages of the leading public agencies for health crisis in Italy, United Kingdom and New Zealand and they collected data on the number of posts, popularity, commitment and followers before and during the outbreak. The authors also performed a content analysis to identify the topics covered by the posts. Findings: Empirical results suggest that social media has been extensively used as a public engagement tool in all three countries under analysis but – because of legitimacy threats and resource scarcity – it has also been used as a dialogic accounting tool only in New Zealand. Findings suggest that fake news developed more extensively in contexts where the public body did not foster dialogic accounting. Practical implications: Public agencies may be interested in knowing the pros and cons of using social media as a public engagement and dialogic accounting tool. They may also leverage on dialogic accounting to limit fake news. Originality/value: This study is one of the first to look at the nature and role of social media as an accountability tool during public health crises. In many contexts, COVID-19 forced for the first time public health agencies to heavily engage with the public and to develop new skills, so this study paves the way for numerous future research ideas. [ABSTRACT FROM AUTHOR]

Background: Functional motor disorders (FMDs) are prevalent and highly disabling conditions in young adults that can result in reduced independence. Despite advances in diagnosis and treatment, the economic burden of FMDs is largely unknown. Objective: This pilot retrospective study provides a real-world overview of the economic costs related to delayed diagnosis of FMDs from a cohort of patients of a specialized clinic in Italy, based on Italian healthcare costs. Methods: Sociodemographic data, clinical history, healthcare service utilization, and associated direct costs were collected for a period of up to 5 years before a definite diagnosis of FMDs in 40 patients. Results: The mean time lag between the onset of FMDs symptoms and diagnosis was 6.63 years (±8.57). The mean annual use of recourses per patient was three specialist visits (95% CI 2.4–3.4) and three diagnostic examinations (95% CI 2.2–3.6) that made up a total of six investigations and over seven (95% CI 5.5–9.7) rehabilitation contacts per year per patient were used before a diagnosis of FMDs was established. In more than 50% of the cases, patients had been hospitalized or made an ER visit at least once before receiving the correct diagnosis. The average annual costs for delayed diagnosis, taking into account only direct healthcare costs (without medications), was about €2,302 (CI 95% €1,570–2,830) per patient [€1,524 covered by the NHS (CI 95% €1,214–1,834) and € 778 by the patient (CI 95% €606–960)]. Hospitalization accounted for €916 (CI 95% €670–1,160) per patient per year, followed by rehabilitation €493 (CI 95% €345–641) and diagnostic tests € 387 (CI 95% €314–460). Conclusion: These preliminary results shed some light on the high healthcare services volume and direct healthcare costs from clinic to clinic for visits, unnecessary tests, and prescribed treatments in a real-world overview from a cohort of patients of a specialized clinic in Italy. It may represent a starting point for future studies to statistically test and quantify cost reduction after implementing appropriate healthcare pathways. [ABSTRACT FROM AUTHOR]

An accumulating body of evidence supports an independent association between high blood pressure (BP) and periodontitis, possibly mediated by low-grade inflammation. This joint report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) working group on Hypertension and Periodontitis (Hy-Per Group) provides a review of the evidence on this topic encompassing epidemiology, biological plausibility, relevance, magnitude, and treatment management. Consensus recommendations are provided for health professionals on how to manage BP in individuals showing signs of poor oral health. In summary, (1) large epidemiological studies highlight that individuals with periodontal diseases have increased risk for high/uncontrolled BP independent of confounders; (2) mechanistically, low-grade inflammation might have a causal role in the association; (3) BP profile and control might benefit from periodontal treatment in pre-hypertensive and hypertensive individuals; (4) oral health status should be evaluated as a potential risk factor for high/uncontrolled BP, and effective oral care should be included as an adjunct lifestyle measure during hypertension management. Further research is needed to optimize BP management in individuals with poor oral health. [ABSTRACT FROM AUTHOR]

Background: Although hand and upper limb malformations are quite frequent, up to now very few reports have been published on epidemiology. The aim of this study is to evaluate the number of infants who presented with hand and upper limb malformations from 2010 to 2015 in Italy. Methods: A retrospective analysis of a pediatric population presenting with hand and upper extremity malformations was carried out, gathering reports achieved from eight Italian Centers of pediatric hand surgery. Other factors such as gender, date and region of birth, family distribution of malformations and associated syndromes, were analysed. Results: Out of 3,100,421 live births, 765 children presented with hand and upper limb malformations. The incidence was 2,5/10,000 live births with a predominance of males and the right side. Radial polydactyly was the anomaly with the highest percentage, closely followed by simple syndactyly, simbrachidactyly and complex syndactyly. Less common conditions were the triphalangic thumb, thumb in palm, proximal radioulnar synostosis and Sprengel deformity. Inheritance of and familial predisposition to those malformations was recorded in 25 cases, while 84 children presented with syndromes related to hand anomalies. Conclusions: In conclusion the incidence of hand and upper extremity malformations in Italy is lower than that registered in other countries. The retrospective nature of the study combined with the fact that some defects frequently evade pediatric hand surgeon consultations are some possible limitations of the study. However, our data confirmed that, in spite of the decrease in the birth rate in Italy, the trend of congenital hand disorders maintained a stable trend. We aim to integrate this study with a prospective analysis and to involve the institutional health authorities in other countries so as to register the correct incidence of hand and upper extremity defects. [ABSTRACT FROM AUTHOR]

The assessment of the ecosystem state is fundamental to understand the success of ecological rehabilitation, especially in the long term. We aim to evaluate the rehabilitation success of a unique Mediterranean dune system site along the Tyrrhenian coast of Italy which underwent a dune consolidation intervention and species planting at the beginning of the twentieth century after the destruction of the natural ecosystem. We used three nearby non‐rehabilitated protected coastal sites with different degrees of disturbance as reference sites encompassing different potential rehabilitation outcomes of the target site. To assess the overall result of the intervention, we used several plant characteristics and measured taxonomic and functional beta‐diversity between all sites. We compared the proportions of typical and ruderal species of dune habitat types across sites. We further used the species–area relationship to examine if the number of observed species in our sites differed from the expected. Our analyses revealed that the rehabilitated site was taxonomically and functionally more similar to the least disturbed site. We suggest that plant characteristics arising from botanical inventories can be fruitfully used in rehabilitation assessment as they value the taxonomic and functional species diversity at the community scale. We conclude that plant characteristics compared across sites are useful tools in ecosystem state assessment if they reflect the ecological functions and conservation values of the natural ecosystems. [ABSTRACT FROM AUTHOR]

Inequalities in effective access to healthcare are present among countries and within the same country. Despite in Italy exist the principle of equity in access to health system, there are evidence of different access rates in the form of unequal waiting time within the country. Waiting times are an instruments to ration healthcare services dealing with resource scarsity. Theoretically, it is a fair tool because waiting times should depend only on health needs and not on the ability to pay. However, a growing literature has pointed out that belonging to a particular socioeconomic status leads to waiting times inequalities for healthcare services. Many countries have socioeconomic disparities among regions, and healthcare organizations need to take into account these differences. The increasing power of Regional Health Authorities in decentralized health systems, as in the case of Italy, has generated different organizational ways to provide health care, possibly leading to different access rates in the form of unequal waiting time within the country. This paper aims to understand if the administrative area (Regional Health Authorities) in charge of health services affects waiting times lowering or strengthening health care access inequalities. Using a series of logistic regression models, this work suggests the presence of two vectors: socioeconomic inequalities and regional inequalities. Health organizations need to implement different kinds of answers for each vectors of inequalities. [ABSTRACT FROM AUTHOR]

Academic research is generally seen as one of the most important goals of a university, but universities are being called upon simultaneously to assist in building a local entrepreneurial ecosystem and contributing to economic growth. Universities can be the source of startups based on academic research results and thereby influence a given industrial context. This paper investigates the impact of academic entrepreneurship on the economic performance of university spin-offs (USOs) and, in particular, how the composition of the founding team, the diversity of academic ownership, CEO duality, and the presence of women on the board of directors affect USO success. We study these relationships with a cross-sectional sample of 136 firms in southern Italy. Our findings highlight that governance and ownership can influence various indicators that are often used for measuring enterprise success in different ways and that, based on the specific success metrics, managers or policymakers should consider different aspects to better understand a USO's potential for success. [ABSTRACT FROM AUTHOR]

Objective: Personal Health Budget has been provided to consumers with severe mental illness within a policy shift toward a person-tailored mental healthcare treatment based on individual unmet needs. Evidence of beneficial effects of Personal Health Budget is still scarce. The aim of this study was to provide preliminary data on clinical and social benefits of adding Personal Health Budget to a standard pharmacotherapy in patients with severe mental illness across a 24-month follow-up period. Methods: Participants (n = 137) were individuals with severe mental illness, aged 18–50 years, recruited in one of the adult mental health services of the Parma Department of Mental Health. They completed the Global Assessment of Functioning scale, the Health of the Nation Outcome Scale and the Brief Psychiatric Rating Scale. This age range was chosen to limit Personal Health Budget interventions to adults with a non-prolonged illness duration. Friedman's test for repeated measure was used to assess the longitudinal stability of functioning and clinical parameters. A linear regression analysis was also performed. Results: A significant decrease in all Global Assessment of Functioning scale, Health of the Nation Outcome Scale and Brief Psychiatric Rating Scale scores along the 24 months of follow-up was observed. Regression analysis results specifically showed a relevant association between a Personal Health Budget multiaxial intervention and the longitudinal reduction in Brief Psychiatric Rating Scale 'Negative Symptoms' and Health of the Nation Outcome Scale 'Social Problems' subscores. Conclusion: Our findings support the useful implementation of a Health of the Nation Outcome Scale approach for severe mental illness patients within the Italian mental health service network. [ABSTRACT FROM AUTHOR]