OP0082-PARE THE EFFECT COVID-19 HAS ON THE MENTAL HEALTH OF PEOPLE LIVING WITH RHEUMATIC DISEASES. FROM DATA TO INTERVENTIONS.

Background:Covid-19 has had an important impact on the mental health conditions of over 5 million Italians suffering from one of the over 150 rheumatic diseases. In order to understand the psychological impact of the Covid-19 emergency and the restrictions imposed to counter it, the Italian National Association of People with Rheumatic and Rare Diseases – APMARR APS launched the research "Living with a rheumatic pathology".Objectives:Gather data directly from Italian patients about the impact of the COVID-19 and consequent restrictions on their mental health and feelings; evaluate the most effective intervention to be implemented to face the pandemic by Patients organization.Methods:A qualitative-quantitative survey was carried out through a questionnaire administered throughout the national territory to a sample of N = 1,001 people. The people invited to complete the questionnaire were women (55,9%) and men (44,1%), aged 18-85 years (age 18-41=26,7%; age 42-65=64%; age >65=9,3%) with at least one rheumatic pathology. The questionnaire was made up of 39 questions, of which 29 were closed and 10 were open. For the administration of the questionnaires, the CAWI (Computer Aided Web Interview) methodology of on-line survey was used. The 1,001 interviews were carried out from 7 to 14 August 2020.Results:More than 4 out of 10 people (total sample 44.2%; male 60%, female 35,7%; age 18-41=39,1%; age 42-65=45,9%; age >65 = 50%) declared that the emergency period has somehow caused a worsening of their health condition. People declared that the deterioration of their health is due to the emergency period for the following reasons: 1) Psychological: such as stress and anxiety: "Too much stress and anxiety made the symptoms worse."; "The stress of the quarantine affected my problem"; "Insomnia. Nervousness. General ailments. Depression. Strong stress" 2) Inability to perform physiotherapy and motor activities due to the lockdown 3) Postponement of examinations, visits and checks 4) remote working, in some cases described as harmful for people's mental and physical health: "Due to Covid19 I had to do remote working and I worked even 12 hours a day including holidays to the detriment of my family life".Furthermore, from January 31, 2020 a significant increase emerged in communication problems with rheumatology specialist compared to the period before the emergency due to Covid-19. The sharp increase may be due to the situation of severe psychological stress to which also the doctors were subjected in the emergency phase: people could not find the comfort of being empathically listened to.Conclusion:The research shows that the most frequent symptoms among people with rheumatic diseases were depression and high levels of anxiety due to strong emotional stress. Psychological malaise caused direct effects in worsening the symptoms of rheumatic disease as well as other related effects, for example, insomnia. The forced isolation due to the lockdown has made people lack the social support that is fundamental for the psychological well-being especially for those suffering from some chronic pathology. Starting from the data collected, APMARR promptly activated a completely free psychological support service with 6 professional psychologists, two of them specialized in emergency psychology. The service is accessible online and is still going on for all who are not able to overcome the anxiety and fear related to the pandemic and its evolution. Thousands of accesses to the service have been measured to date.References:S Mingolla1, A Celano1, M Santopietro2[1]NATIONAL ASSOCIATION OF PEOPLE WITH RHEUMATIC AND RARE DISEASES - APMARR APS[2]WeResearch. Ricerche di marketingDisclosure of Interests:None declare

Correlation of EGFR, pEGFR and p16INK4 expressions and high risk HPV infection in HIV/AIDS-related squamous cell carcinoma of conjunctiva

Background: Squamous cell carcinoma of conjunctiva has increased tenfold in the era of HIV/AIDS. The disease pattern has also changed in Africa, affecting young persons, with peak age-specific incidence of 30-39 years, similar to that of Kaposi sarcoma, a well known HIV/AIDS defining neoplasm. In addition, the disease has assumed more aggressive clinical course. The contributing role of exposure to high risk HPV in the development of SCCC is still emerging. Objective. The present study aimed to investigate if immunohistochemical expressions of EGFR, pEGFR and p16, could predict infection with high risk HPV in HIV-related SCCC. Methods. FFPE tissue blocks of fifty-eight cases diagnosed on hematoxylin and eosin with SCCC between 2005-2011, and subsequently confirmed from medical records to be HIV positive at the department of human pathology, UoN/KNH, were used for the study. Immunohistochemistry was performed to assess the expressions of p16INK4A, EGFR and pEGFR. This was followed with semi-nested PCR based detection and sequencing of HPV genotypes. The sequences were compared with the GenBank database, and data analyzed for significant statistical correlations using SPSS 16.0. Ethical approval to conduct the study was obtained from KNH-ERC. Results: Out of the fifty-eight cases of SCCC analyzed, twenty-nine (50%) had well differentiated (grade 1), twenty one (36.2%) moderately differentiated (grade 2) while eight (13.8%) had poorly differentiated (grade 3) tumours. Immunohistochemistry assay was done in all the fifty eight studied cases, of which thirty nine cases (67.2%) were positive for p16INK4A staining, forty eight cases (82.8%) for EGFR and fifty one cases (87.9%) showed positivity for p-EGFR. HPV DNA was detected in 4 out of 40 SCCC cases (10%) in which PCR was performed, with HPV16 being the only HPV sub-type detected. Significant statistical association was found between HPV detection and p16INK4 (p=0.000, at 99% C.I) and EGFR (p=0.028, at 95% C.I) expressions, but not pEGFR. In addition, the expressions of these biomarkers did not show any significant association with tumor grades. Conclusion: This study points to an association of high risk HPV with over expressions of p16INK4A and EGFR proteins in AIDS-associated SCCC. © 2014 Mwololo et al.; licensee BioMed Central Ltd

Physicians’ Perceptions of Clinical Utility of a Digital Health Tool for Electronic Patient-Reported Outcome Monitoring in Real-Life Hematology Practice. Evidence From the GIMEMA-ALLIANCE Platform

Digital health tools are increasingly being used in cancer care and may include electronic patient-reported outcome (ePRO) monitoring systems. We examined physicians’ perceptions of usability and clinical utility of a digital health tool (GIMEMA-ALLIANCE platform) for ePRO monitoring in the real-life practice of patients with hematologic malignancies. This tool allows for the collection and assessment of ePROs with real-time graphical presentation of results to medical staff. Based on a predefined algorithm, automated alerts are sent to medical staff. Participating hematologists completed an online survey on their experience with the platform. Of the 201 patients invited to participate between December 2020 and June 2021 (cut-off date for current analysis), 180 (90%) agreed to enter the platform and had a median age of 57 years. Twenty-three hematologists with a median age of 42 years and an average of 17 years of experience in clinical practice were surveyed. All hematologists agreed or strongly agreed that the platform was easy to use, and 87%, agreed or strongly agreed that ePROs data were useful to enhance communication with their patients. The majority of physicians (78%) accessed the platform at least once per month to consult the symptom and health status profile of their patients. The frequency of access was independent of physician sex (p=0.393) and years of experience in clinical practice (p=0.404). In conclusion, our preliminary results support the clinical utility, from the perspective of the treating hematologist, of integrating ePROs into the routine cancer care of patients with hematologic malignancies

Usefulness of bronchoalveolar lavage in suspect COVID-19 repeatedly negative swab test and interstitial lung disease

The diagnosis of coronavirus disease 2019 (COVID-19) relies on nasopharyngeal swab, which shows a 20–30% risk of false negativity [1]. Bronchoalveolar lavage (BAL) is reported to be useful in patients with pulmonary interstitial infiltrates on high-resolution computed tomography (HRCT). We investigated the usefulness of BAL in symptomatic patients with positive HRCT and a repeatedly negative swab test (‘grey zone’)

Logística reversa: como as empresas comunicam o descarte de baterias e celulares?

The Law 12305 requires cell phones manufacturers to organize Reverse Logistics programs and comunicatte customers on how to handle pos-consumption appliances. The objective of this research was to analyse, based on the principles of Integrated Marketing Communication, Reverse Logistics Programs communication at mobile phones manufacturers operating in Brazil. Therefore, a resesarch was conducted from a consumer perspective, focused on information available to consumers in different communication channels. Results show that the companies surveyed are not aligned with current legislation. None of the Reverse Logistics programs effectively communicate consumers in order to estimulate their participation in the reverse flow of post-consumption products. The research also revealed a mismatch between behavioral intention and behavior of consumers increased by the communication deficiencies identified here

A Partnership for the Climate Adaptation: Urban Agenda for the EU

The EU Ministers Responsible for Urban Matters, meeting held in Amsterdam in 2016, established the Pact of Amsterdam: Urban Agenda for the EU. The Pact of Amsterdam defines Climate Adaptation as one of the priority themes to be addressed by the Urban Agenda. The Climate Adaptation Partnership was set up in 2017 and represents a multilevel and cross-sectoral cooperation instrument for the priority theme Climate Adaptation. The Action Plan developed by Urban Agenda for the EU Climate Adaptation Partnership is the result of a participatory process involving key stakeholders from the EU institutions, national governments, regional and local authorities. Climate Adaptation Partnership members are coming from all EU macro-regions, ensuring broad geographic representation including cities representative of different city size. Among them the Potenza Municipality, played a key role of Action Plan of the Climate Adaptation Partnership. This paper investigates the action promoted by the Potenza Municipality as a preliminary work to prepare the New Urban Agenda (2021–2027) for the development of the town according to a climate responsive perspective

Small Municipalities Engaged in Sustainable and Climate Responsive Planning: Evidences from UE-CoM

The Covenant of Mayors (CoM), a volunteer movement of local administrators established in 2008, has supported Municipalities to develop their Sustainable Energy and Climate Action Plans (SECAPs) and become energy and climate proof Municipalities. SECAP intended as an urban planning tool, allowed to EU Municipalities to develop adaptation/mitigation actions, facing the climate-change. Compared to this, the CoM started a new season of urban planning coupling the planning demand in terms of reduction of CO2 emissions and the adaptation/mitigation to climate-change with the implementation of sustainable territorial development objectives. The European Signatories of CoM at May 2021 are 6789, and the 4312 of them (in percentage 63%) are small municipalities (i.e. under 10000 inhabitants). This high percentage of small Municipalities related to total has highlighted how SEAPs have been intended as instruments used to plan and provide funding for ordinary interventions in the urban areas instead of institutional instruments (i.e., urban planning regulations, operational plans and programs established by National policies). Therefore, the paper suggests an overview at European level to exploit the engagement of the small Municipalities, specifying the commitment and the SECAP’s sectors chosen. It represents a useful framework interpreting the general results derived from the CoM official data and improving procedures related to the adaptation/mitigation climate-change in urban areas