Antenatal care services and pregnancy outcomes during the COVID-19 pandemic in Milan, Lombardy

Background. During the COVID-19 pandemic maternity healthcare seeking and provision reduced worldwide. We explored the indirect effects of the pandemic on key pregnancy outcomes and access to antenatal care services.Methods. Observational cross-sectional study on all pregnancies between years 2019- 2020 in Milan metropolitan area (Lombardy, Italy). Multiple logistic regression analysis was used to assess the access to antenatal care (ANC) services (timing of first contact, ultrasound examinations (US) and ANC contacts) and pregnancy outcomes (preterm births, perinatal deaths and surgically treated ectopic pregnancies). Data were retrieved from both administrative (public healthcare) and self-reported sources (public and private services).Results. The first antenatal contact was slightly delayed in pandemic year 2020. Adequate levels of antenatal care were maintained according to self-reported data, though a decrease in public healthcare was noted (administrative data). Perinatal death and preterm birth risk did not worsen, while it increased for surgically managed ectopic pregnancies

Paternity and parental leave in Italy: the parents’ perspective

Background. Growing recognition of fathers’ role in childcare highlights paternity and parental leave policies. The aim of this study is to investigate the perspectives of parents in Italy on the paternity and parental leave utilisation by fathers.Materials and methods. A cross-sectional study was carried out, using web-based questionnaires targeting parents of children born between 2018 and 2023. Descriptive statistics and multivariate logistic regression models were used to analyse quantitative data, while qualitative content analysis was applied to open-ended responses.Results. A total of 3,811 mothers and 720 fathers responded. Paternity leave was used by 72.6% of fathers. Non-use was primarily attributed to ineligibility (58.4%). Fathers’ parental leave utilisation was low (20.4%). Most parents agreed that mothers need longer leave for the dyad’s needs, like breastfeeding. Living in southern Italy and having lower educational levels reduce the likelihood to take leave.Conclusions. Paternity and parental leave are underutilised by fathers in Italy. There is a need for better-paid and more accessible leave policies to promote active fatherhood and gender equality

Publications from International Organizations on Public Health

The Publications from International Organizations on Public Health section includes a wider selection of the most recent publications edited by the main international organizations active in the field of public health, such as: the European Food Safety Authority (EFSA), the Food and Agriculture Organization of the United Nations (FAO), the International Labour Organization (ILO), the Organisation for Economic Co-operation and Development (OECD), the United Nations Educational, Scientific and Cultural Organization (UNESCO), the United Nations Environment Programme (UNEP), the United Nations Programme on HIV/AIDS (UNAIDS), and the World Health Organization (WHO)

Can we trust administrative data in joint arthroplasty? A Validation study against the Italian Arthroplasty Registry data as a gold standard

Introduction. Hospital Discharge Data (HDD) can be a valuable source of information for epidemiological research, but in Italy its accuracy in arthroplasty has not yet been determined on a large scale. The aim is to assess Italian HDD accuracy in reporting clinical information on hip/knee arthroplasties, using RIAP data collected by the Italian Arthroplasty Registry (RIAP) as a reference.Methods. Coding systems for procedures and diagnoses in RIAP data and HDD for years 2007-2021 are mapped to a common list of items describing surgical procedures and related diagnoses. The ability of HDD in predicting procedures and diagnoses is evaluated by sensitivity, specificity and accuracy, while using RIAP data as a reference.Results. Surgical procedures and causes for elective and urgent arthroplasties are predicted by HDD with at least 96% sensitivity. Performances drop when evaluating procedures and diagnoses at fine-grain level and for rare events.Discussion. HDD reports reliable clinical information in arthroplasty and is an effective tool for epidemiological purposes. Nonetheless, a cautious approach must be considered when dealing with high-detail and rare event

Exploring perceptions of vaccine safety: an Italian national survey on different COVID-19 vaccine formulations

Objectives. COVID-19 vaccines have proven effective and safe, enabling the resumption of normal life. However, misinformation has hindered vaccination efforts. This study aimed to investigate perceptions of vaccine safety among Italians through an anonymousonline survey. Study design. An anonymous online survey was conducted from April to July 2022 and disseminated through social platforms, among adult individuals living in Italy.Results. A total of 1,329 individuals participated. Younger individuals and healthcare professionals showed greater trust in vaccines. Education level was significantly associated with perceived vaccine safety. Most respondents, including many healthcare workersand highly educated individuals, believed vaccines to be safe, with confidence levels of 39.5% for mRNA, 32.9% for viral vector, and 39% for protein subunit vaccines. Younger age and trust in institutions were linked to higher confidence in all vaccine types.Conclusions. These findings may be useful to further investigate the drivers of vaccine safety perceptions and their relationship with vaccine hesitancy and may help to develop more effective communication campaigns in the future

Monitoring of antibiotic residues in muscles, milk and eggs of food-producing animals in Umbria and Marche regions (Central Italy) during the period time 2012-2021

Introduction. The use of antibiotics in food-producing animals for infections treatment, metafilaxis and, although not allowed in Europe, as growth enhancer is responsible for the presence of antibiotic residues in animal derived foodstuffs. For this reason, it is veryimportant to perform a monitoring.Methods and results. Muscle samples from bovine, pig, poultry, turkey and fish, as well as bovine milk and hen’s egg samples, deriving from 444 farms of both Umbria and Marche regions (Italy) were analyzed by well-established and validated analytical methods in order to evaluate the presence or not of antibiotic residues (penicillins, quinolones, tetracycline and sulphonamides). The samples were collected during 2012-2021 period of time. In total, 15/2,354 samples resulted positive to the analyses. The amount of antibiotics found in the 15 samples resulted below the maximum residue limit fixed by EU Regulation 37/2010 and for this reason considered compliant.Conclusions. Despite irregular samples were not found, the presence of antibiotic residues in foodstuff represents a risk for public health as they are responsible for the selection of resistant strains contributing to antimicrobial resistance problem spread. In the present work, this aspect was evaluated in relation to the results obtained from the analyzed samples coming from Umbria and Marche regions

Organization and functioning of the Italian Departments of Mental Health in the pandemic and post-pandemic period

Introduction. The pandemic significantly affected mental health, leading to a reorganization of services. This study examines changes in Italy’s Departments of Mental Health (DMHs), comparing surveys from 2021 (during COVID-19) and 2023 (post-pandemic).Methods. The two surveys involved 19 Italian DMHs and covered variables related to mental health care (number of centres, available staff, services provided and intervention methods).Results. Between 2021 and 2023, services show structural stability with a solid territorial network. Organizational changes point to greater flexibility and customization, with a stronger semi-residential hospital offer. Human resources give mixed signals: psychologists and health care social workers are increasing, while social workers and psychiatric rehabilitation technicians are decreasing. Clinically, hospitalizations in General Hospital Psychiatric Units (GHPUs), Emergency Department (ED) visits, and self-harm cases are rising, while psychiatric and psychological visits decline. Remote nursing and psychosocial interventions are increasing. The growth in first psychological consultations and users taken into care suggests a gradual return to in-person access and partial prepandemic normality.Conclusions. The data substantiate the need for continuous attention and adequate support to address post-pandemic mental distress, highlighting the importance of reorganizing services to effectively respond to the new needs of the population

Sodium oxybate and acamprosate association for maintenance of alcohol abstinence: a case series

Background. Disulfiram, acamprosate (ACM), naltrexone, and nalmefene are medications currently approved for the treatment of Alcohol Use Disorder (AUD). Baclofen and sodium oxybate (SO) have been approved for the treatment of AUD and alcohol withdrawal syndrome in France and Italy, respectively. However, concerning the effectiveness of combined therapies for AUD, data from the current literature are contrasting.Aims. To investigate the outcomes of combined therapy of SO and ACM for the maintenance of alcohol abstinence.Methods. A sample of 48 AUD patients consecutively enrolled and treated with SO (50-100 mg/kg of body weight, t.i.d.) plus ACM (666 mg three times daily; with dosage reduced in patients with body weight <60 kg) was observed for 12 weeks.Results. At the 3-month visit, continuous abstinence from alcohol was maintained by 34 patients (70.8%). Fifteen patients (31.3%) reported side effects like nausea, dizziness, and abdominal pain, with no significant differences between abstinent and not abstinent patients.Conclusion. SO plus ACM may be an effective and safe pharmacological combination for maintaining alcohol abstinence in AUD patients. Future ad hoc clinical trials are needed to test this therapeutic association for AUD treatment

Does exceeding maximum waiting times of total hip replacement patients affect resource consumption? Evidence from a highly specialized orthopedic Italian hospital

Background. Long waiting times for elective surgeries are a common issue in publicly funded healthcare systems, raising concerns about their impact on patient outcomes. In Italy, the National Health System assigns priority classes to regulate waiting times, with class C patients expected to undergo surgery within 180 days. This study investigates whether exceeding this threshold affects surgical and hospitalization outcomes for patients undergoing total hip replacement (THR).Methods. We conducted a retrospective observational study on 1,872 class C patients who underwent THR between 2019 and 2022 at the Rizzoli Orthopedic Institute andaffiliated centers. Patients were categorized based on adherence to the 180-day waiting threshold. The study analyzed differences in surgical time, length of hospital stays and touch time. Additional analyses considered patient characteristics such as the American Society of Anesthesiologists (ASA) classification and Body Mass Index (BMI). Independent t-tests were used to assess statistical significance.Results. Patients exceeding the 180-day waiting limit did not show significantly longer hospital stays or surgical times compared to those operated on time (p>0.05). However, ASA classification and BMI influenced hospital stay duration, with high ASA (3-4) patients staying 1.7 days longer on average and obese patients (BMI ≥30) staying 0.4 days longer.Conclusions. The findings suggest that exceeding the maximum waiting time does not negatively impact surgical outcomes or hospital stay duration. However, clinical characteristics such as ASA and BMI play a significant role in postoperative recovery. Further research is needed to refine prioritization criteria to ensure optimal patient outcomes

Examining the "worried well" phenomenon: insights from Italy’s AIDS and STIs Helpline

Background. The fear of having contracted HIV or another sexually transmitted infection (STI), even in the absence of significant risk factors, is a globally observed phenomenon across diverse cultural, social, and healthcare settings. Helplines serve as a valuable observatory for this pattern, often described as “worried well” (WW). This study investigates the WW phenomenon with the objective of assessing whether the COVID-19 pandemic has acted as a compounding factor in its intensification.Methods. AIDS and STIs Helpline of the Italian National Institute of Health (Istituto Superiore di Sanità, ISS) extracted data from a structured database and analyzed patterns related to callers’ concerns.Results. Between 2018 and 2023, 4,703 calls were analysed, showing how WWs represent 8.1% of all users and questions asked by WWs accounted for 7.8% of the total number of questions received by the AIDS and STIs Helpline.Conclusions. While the COVID-19 pandemic may have contributed to an intensification of the WW phenomenon, its origins are more deeply rooted in factors such as psychological distress and limited health literacy