172 research outputs found
Social distancing measures for COVID-19 are changing winter season
Health authorities worldwide have
adopted measures of social distancing
and movement restrictions, in addition
to other public health measures to reduce
exposure and to suppress interhuman
SARS-CoV-
2 transmission. In Italy, a
national lockdown with school closure
was introduced from March to May 2020.
From November 2020, Italy has been
divided into zones according to regional
epidemiological data, with primary
schools reopened, associated with the
mandatory use of face masks and different
levels of social distance measures. For
children with symptoms suggestive of
COVID-19, the surveillance mechanism
for the control of SARS-CoV-
2 infection
is based on the performance of a real-time
PCR on a nasopharyngeal swab. A
diagnostic test has been introduced at the
tertiary-level
university hospital, Institute
for Maternal and Child Health, IRCCS
\u201cBurlo Garofolo\u201d of Trieste, consisting of
a multiple nucleic acid amplification assay
for 13 common viral respiratory pathogens
on nasopharyngeal swab (Respiratory
Flow Chip assay (Vitro, Sevilla,
Spain), including SARS-CoV-
2, influenza
A and B, adenovirus, other coronaviruses,
parainfluenza virus 1\u20134, enteroviruses,
bocavirus, metapneumovirus, respiratory
syncytial virus (RSV), rhinoviruses, Bordetella
pertussis, Bordetella parapertussis
and Mycoplasma pneumoniae. Before
routine utilisation, international standard
quality control samples for each pathogen
were used for test validation, and no
cross-detection
was found between the
different pathogens. Criteria for testing
referral did not change during the study
period. Weekly variability of the number
of total tests performed was due to the
normal variations of acute illness. During
the last winter season, from September
2020 (week 39) to February 2021 (week
7), 1138 nasopharyngeal swabs were
tested for patients younger than 17 years
old (figure 1). No influenza A or B nor
RSV was detected during this period.
The most common pathogen was rhinovirus
(n=505), followed by adenoviruses
(n=131), other coronaviruses (n=101)
and SARS-CoV-
2 (n=57). Our data show
that common winter pathogens circulation
changed, and influenza virus and RSV
did not produce a seasonal epidemic in
the 2020\u20132021 winter season. These data
suggest that social distancing measures
and mask wearing profoundly changed
the seasonality of winter paediatric respiratory
infections that are mainly spread
by respiratory droplets. The reasons why
rhinovirus remains the main pathogen
despite social distancing and face mask
use are still a matter of debate. Similar
data showing a decrease of common viral
respiratory infections during the winter
season have recently been reported in the
southern hemisphere.1\u20134 Our data refer
to a single institute, covering paediatric
population of the Trieste Province (about
230 000 inhabitants), limiting the generalisation
of our findings. However, our
results highlight the need for continuing
surveillance for the delayed spread of such
viruses during spring and summer
Mortality and cause of death among psychiatric patients: a 20-year case-register study in an area with a community-based system of care
How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy
BACKGROUND:
Quality of working life includes elements such as autonomy, trust, ergonomics, participation, job complexity, and work-life balance. The overarching aim of this study was to investigate if and how quality of working life affects Compassion Fatigue, Burnout, and Compassion Satisfaction among mental health practitioners.
METHODS:
Staff working in three Italian Mental Health Departments completed the Professional Quality of Life Scale, measuring Compassion Fatigue, Burnout, and Compassion Satisfaction, and the Quality of Working Life Questionnaire. The latter was used to collect socio-demographics, occupational characteristics and 13 indicators of quality of working life. Multiple regressions controlling for other variables were undertaken to predict Compassion Fatigue, Burnout, and Compassion Satisfaction.
RESULTS:
Four hundred questionnaires were completed. In bivariate analyses, experiencing more ergonomic problems, perceiving risks for the future, a higher impact of work on life, and lower levels of trust and of perceived quality of meetings were associated with poorer outcomes. Multivariate analysis showed that (a) ergonomic problems and impact of work on life predicted higher levels of both Compassion Fatigue and Burnout; (b) impact of life on work was associated with Compassion Fatigue and lower levels of trust and perceiving more risks for the future with Burnout only; (c) perceived quality of meetings, need of training, and perceiving no risks for the future predicted higher levels of Compassion Satisfaction.
CONCLUSIONS:
In order to provide adequate mental health services, service providers need to give their employees adequate ergonomic conditions, giving special attention to time pressures. Building trustful relationships with management and within the teams is also crucial. Training and meetings are other important targets for potential improvement. Additionally, insecurity about the future should be addressed as it can affect both Burnout and Compassion Satisfaction. Finally, strategies to reduce possible work-life conflicts need to be considered
Cost-effectiveness of adherence therapy versus health education for people with schizophrenia: randomised controlled trial in four European countries.
BACKGROUND: Non-adherence to anti-psychotics is common, expensive and affects recovery. We therefore examine the cost-effectiveness of adherence therapy for people with schizophrenia by multi-centre randomised trial in Amsterdam, London, Leipzig and Verona. METHODS: Participants received 8 sessions of adherence therapy or health education. We measured lost productivity and use of health/social care, criminal justice system and informal care at baseline and one year to estimate and compare mean total costs from health/social care and societal perspectives. Outcomes were the Short Form 36 (SF-36) mental component score (MCS) and quality-adjusted life years (QALYs) gained (SF-36 and EuroQoL 5 dimension (EQ5D)). Cost-effectiveness was examined for all cost and outcome combinations using cost-effectiveness acceptability curves (CEACs). RESULTS: 409 participants were recruited. There were no cost or outcome differences between adherence therapy and health education. The probability of adherence therapy being cost-effective compared to health education was between 0.3 and 0.6 for the six cost-outcome combinations at the willingness to pay thresholds we examined. CONCLUSIONS: Adherence therapy appears equivalent to health education. It is unclear whether it would have performed differently against a treatment as usual control, whether such an intervention can impact on quality of life in the short-term, or whether it is likely to be cost-effective in some sites but not others. TRIAL REGISTRATION: Trial registration: Current Controlled Trials ISRCTN01816159.Quality of Life and Management of Living Resources Programme of the European Union (grant
number QLG4-CT-2001-01734
Liver stiffness measurement by transient elastography predicts early recovery from acute hepatitis
Increased use of high-flow nasal cannulas after the pandemic in bronchiolitis: a more severe disease or a changed physician’s attitude?
After the SARS-CoV-2 pandemic, we noticed a marked increase in high-flow nasal cannula use for bronchiolitis. This study aims to report the percentage of children treated with high-flow nasal cannula (HFNC) in various seasons. The secondary outcomes were admissions for bronchiolitis, virological results, hospital burden, and NICU/PICU need. We conducted a retrospective study in four Italian hospitals, examining the medical records of all infants (< 12 months) hospitalized for bronchiolitis in the last four winter seasons (1 September–31 March 2018–2022). In the 2021–2022 winter season, 66% of admitted children received HFNC versus 23%, 38%, and 35% in the previous 3 years. A total of 876 patients were hospitalized in the study periods. In 2021–2022, 300 infants were hospitalized for bronchiolitis, 22 in 2020–2021, 259 in 2019–2020, and 295 in 2018–2019. The percentage of patients needing intensive care varied from 28.7% to 18%, 22%, and 15% in each of the four considered periods (p < 0.05). Seventy-seven percent of children received oxygen in the 2021–2022 winter; vs 50%, 63%, and 55% (p < 0.01) in the previous 3 years. NIV/CPAP was used in 23%, 9%, 16%, and 12%, respectively. In 2021–2020, 2% of patients were intubated; 0 in 2020–2021, 3% in 2019–2020, and 1% in 2018–2019. Conclusion: This study shows a marked increase in respiratory support and intensive care admissions this last winter. While these severity indexes were all driven by medical choices, more reliable indexes such as intubation rate and length of stay did not change. Therefore, we suggest that there is a more aggressive treatment attitude rather than a more severe disease.What is Known:• COVID-19 pandemic deeply impacted bronchiolitis epidemiology, reducing hospitalizations to onetenth. In the 2021-2022 winter, bronchiolitis resurged to pre-pandemic numbers in Europe.What is New:• Bronchiolitis hospitalization rose much faster in the 2021-2022 winter period, peaking at a higher level. Respiratory supports and high-flow nasal cannula increased significantly compared to the pre-pandemic era
Correction to: Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations (vol 18, 215, 2020)
Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations
One-machine job-scheduling with non-constant capacity — Minimizing weighted completion times
Effect of COVID-19 pandemic on utilisation of community-based mental health care in North-East of Italy: A psychiatric case register study
Aims: WHO declared that mental health care should be considered one essential health service to be maintained during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to describe the effect of lockdown and restrictions due to the COVID-19 pandemic in Italy on mental health services' utilisation, by considering psychiatric diagnoses and type of mental health contacts. Methods: The study was conducted in the Verona catchment area, located in the Veneto region (northeastern Italy). For each patient, mental health contacts were grouped into: (1) outpatient care, (2) social and supportive interventions, (3) rehabilitation interventions, (4) multi-professional assessments, (5) day care. A 'difference in differences' approach was used: difference in the number of contacts between 2019 and 2020 on the weeks of lockdown and intermediate restrictions was compared with the same difference in weeks of no or reduced restrictions, and such difference was interpreted as the effect of restrictions. Both a global regression on all contacts and separate regressions for each type of service were performed and Incidence Rate Ratios (IRRs) were calculated. Results: In 2020, a significant reduction in the number of patients who had mental health contacts was found, both overall and for most of the patients' characteristics considered (except for people aged 18-24 years for foreign-born population and for those with a diagnosis of schizophrenia. Moreover, in 2020 mental health contacts had a reduction of 57 096 (-33.9%) with respect to 2019; such difference remained significant across the various type of contacts considered, with rehabilitation interventions and day care showing the greatest reduction. Negative Binomial regressions displayed a statistically significant effect of lockdown, but not of intermediate restrictions, in terms of reduction in the number of contacts. The lockdown period was responsible of a 32.7% reduction (IRR 0.673; p-value <0.001) in the overall number of contacts. All type of mental health contacts showed a reduction ascribable to the lockdown, except social and supportive interventions. Conclusions: Despite the access to community mental health care during the pandemic was overall reduced, the mental health system in the Verona catchment area was able to maintain support for more vulnerable and severely ill patients, by providing continuity of care and day-by-day support through social and supportive interventions
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