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Spondyloarthritis (SpA) is the most frequent extraintestinal manifestation in patients with inflammatory bowel diseases (IBD). When IBD and spondyloarthritis coexist, musculoskeletal and intestinal disease features should be considered when planning a therapeutic strategy. Treatment options for IBD and SpA have expanded enormously over the last few years, but randomized controlled trials with specific endpoints focused on SpA are not available in the IBD setting. To address this important clinical topic, the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) and the Italian Society of Rheumatology (SIR) jointly planned to draw updated therapeutic recommendations for IBD-associated SpA using a pseudo-Delphi method. This document presents the official recommendations of IG-IBD and SIR on the management of IBD-associated SpA in the form of 34 statements and 4 therapeutic algorithms. It is intended to be a reference guide for gastroenterologists and rheumatologists dealing with IBD-associated SpA.

The study investigates the evolution of financial literacy in Italian adults. Using three surveys from the years 2013, 2017, and 2020, we measure the financial literacy index and its components (financial knowledge, financial attitude, and financial behavior) using the OECD definition. The results show that financial literacy has decreased overall since 2013 in all three components. The gender gap persists, although the distance between the financial knowledge of women and men has shrunk. Moreover, results of the CART analysis show that the importance of the socioeconomic explanatory factors also changes over time; repeated baseline surveys of financial literacy of the adult population are therefore crucial for designing effective financial education programs.

In this paper two innovative procedures for the decomposition of the Pietra index are proposed. The first one allows the decomposition by sources, while the second one provides the decomposition by subpopulations. As special case of the latter procedure, the “classical” decomposition in two components (within and between) can be easily obtained. A remarkable feature of both the proposed procedures is that they permit the assessment of the contribution to the Pietra index at the smallest possible level: each source for the first one and each subpopulation for the second one. To highlight the usefulness of these procedures, two applications are provided regarding Italian professional football (soccer) teams.

The COVID-19 pandemic and the consequent precautions and dispositions adopted have triggered substantial changes in daily health-related behaviors, including food consumption habits. The psychological impact of the pandemic has been considered one of the factors affecting this transition and requiring consideration when targeting healthy-sustainable behavior preservation. The present study describes the results of a survey conducted on a convenience sample of Italian residents (n = 2272) during the first phases of pandemic. The aim was to explore the daily nutritional choices and behaviors and their transformations that occurred along with the associations with psychological factors (i.e., subjective well-being, and depression, anxiety and stress symptoms). An indicator for healthy-sustainable transition (HST index) was constructed and revealed diffused transformation in dietary habits, with a large segment of the sample adopting healthier and more sustainable dietary behaviors and others showing reduced healthy-sustainable food choices. Informative relationships with the psychological variables were then found from the correlational and regression analyses. Lower levels of anxiety, depression and stress symptomatology and higher perceived subjective well-being were significantly associated with healthier-sustainable food consumption behaviors. These findings shed light on the crucial areas to be considered in future institutional interventions, ultimately ensuring favorable conditions for both healthy diet behaviors and sustainable food consumption choices.

It is common practice for auditors to verify only a sample of recorded values to estimate the total error amount. Monetary-unit sampling is often used to over-sample large valued items which may be overstated. The aim is to compute an upper confidence bound for the total errors amount. Naïve bounds based on the central limit theorem are not suitable, because the distribution of errors are often very skewed. Auditors frequently use the Stringer bound which known to be too conservative. We propose to use weighted empirical likelihood bounds for Monetary-unit sampling. The approach proposed is different from mainstream empirical likelihood. A Monte–Carlo simulation study highlights the advantage of the proposed approach over the Stringer bound.

Patient quality of life (QoL) is a pivotal parameter, which is often used by clinicians to evaluate how treatments and therapies influence patients’ functionality and emotional state, aiming to ameliorate interventions and their outcomes. Currently, the majority of questionnaires assessing the QoL are designed with the main contribution of clinicians and, therefore, include items that are cantered on the disease rather than on its multifaceted impact on people’s life. The failure to truly grasp the patients’ perspective, their needs, aspirations, perceptions and emotional state, is a major drawback that sets medical care on clinical parameters alone. We aimed to bridge this gap by establishing an innovative patient-designed QoL index to provide a new, unbiased tool considering the patients’ perception of their own well-being. Based predominantly on patients’ contribution, we defined specific areas (physical, emotional, social, functional, economical) and the respective characterizing features, and applied a pseudo-Delphi methodology combined with customer-satisfaction techniques. For each feature, the degree of agreement and the importance were assessed on a Likert scale. A synthetic QoL index was created by weighting the importance of each item. The methodology tested led to the development of a valid patient-designed QoL index, providing a way forward that could potentially be applied to many different conditions. The areas and the features included are indeed common to all patients, irrespective of their disease. We found that the process of methodology development enhanced the patients’ awareness of their subjective experience with the disease, and enabled them to better present their situation to the clinicians. The patient-designed QoL index provides a descriptive model that can be helpful to patients, clinicians and third parties and that can be further integrated with clinical details to obtain an overall view of the course of treatment for each patient.

ICT engagement has become an important key driver regarding the competence for the adults, but even more for young people. As it was pointed out in 2015, ICT interest (a component of ICT engagement) is defined as “content-specific motivational disposition” and describes ”individuals’ long-term preference for dealing with topics, tasks, or activities related to ICT” (Goldhammer et al., 2017). Using data from 2018 Programme for International Student assessment (PISA), this work will show the gender difference in ICT interest for 15-years old students of 23 OECD countries. Moreover a three-level multilevel model will explain the effects of the characteristics of the student, of the school in which the student learns and of the country in which the student livis on the ICT interest.

The COVID-19 emergency and the consequent social distancing requirements have caused major disruptions in daily food-related practices at the household level. In this paper, we evaluate the transformations that occurred in the daily nutritional choices and behaviors of a convenience sample (n = 2288) of Italian residents during the first nation-wide lockdown (March–May 2020) to assess the impact on the health and socio-environmental sustainability of their diets. Results portray a scenario of wide-spread change, especially in relation to the quantity of daily food consumed, the composition of diets and the time and commitment devoted to home-cooking, with young individuals emerging as the most impacted generational cohort. Through the construction of an indicator for healthy–sustainable transition (HST index), we demonstrate that such changes unfold on a gradient, revealing that while for many respondents lockdown nutrition implied overeating and weight gain, a substantial segment of the population conversely improved the healthiness and sustainability of their daily nutritional patterns. In this sense, improvements are associated with young age, socio-economic status, frequency and enjoyment of cooking-from-scratch and, more generally, an attentive attitude towards the quality, provenance and materiality of food that, in turn, the COVID-19 crisis appears to have re-kindled. We conclude by highlighting five areas of institutional intervention (i.e., young people, time, tools, food supply at work, and local food chains) on which to focus in order to ensure the current crisis does not represent a missed opportunity for creating the necessary conditions for sustainable food production and consumption to take hold as the ‘new’ normal in the post-pandemic era

The Coxian phase-type distribution is a special case of phase-type distribution which represents the time to absorption of a finite Markov chain in continuous time. The distribution is able to capture subjects’ flow through a system but is unable to highlight if there are different pathways caused by an underlying latent factor. Identifying these different pathways will give healthcare providers a deeper insight and understanding of patient flow and allow them to identify and change any potential issues. This paper combines the Coxian phase-type distribution with the continuous-time hidden Markov model to highlight these paths. The theory of combining the Coxian phase-type distribution with the continuous-time hidden Markov model shall be presented along with a simulation study and an application using Italian healthcare data.

In the last years, the issue of health care for the elderly population is becoming increasingly relevant. Italy could be considered one among the oldest countries in Europe: in 2018 the population aged 65 and over is 22.6% of the Italian population with an aging index of 168.7%. Moreover, a high percentage (49.6%) of elderly people shows at least one of chronic/chronic degenerative disease. This situation, considering an increasing 65-year-old life expectancy, will lead the Italian Health System to cope with a significant increase in healthcare consumption. This work will analyse the ordinary acute admissions in the geriatric wards of the Italian hospitals using the Hospital Discharge Data with the aim is to identify the risk of inappropriateness of the hospitalisations.