Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Pet Grief: Tools to Assess Owners’ Bereavement and Veterinary Communication Skills

In Italy, there are still very few studies on the psychological impact of losing a pet. The need to fill this gap springs from the fact that pet loss counseling services are increasingly being activated. The aim of this study is the Italian adaptation of instruments for veterinary counseling services. The survey instruments adapted were: Pet Bereavement Questionnaire (PBQ) to describe the individual experience of pet-grief; Regret of Bereaved Family Members (RBFM) to assess the family regret; Shared Decision-Making Questionnaire (SDM-Q-9) for decision making in end of life; Consultation and Relational Empathy Measure (CARE) to assess the veterinarian relational empathy during clinical encounters. All the instruments obtained good internal reliability, and the results of the confirmative factor analysis of all the Italian versions were in accordance with the original ones. The correlational analysis among the variables evidenced the following aspects: the more the owner feels involved by the veterinarian in the decision making process the more the veterinarian is perceived by the owner as empathetic; when the veterinarian is perceived as empathic and the decision making is shared the owners’ pet bereavement distress and regrets are reduced; negative dimensions of bereavement (grief, guilt, anger, intrusive thoughts and decisional regrets) are strictly linked to each other, therefore if one dimension increases or decreases the others do too. The path analysis suggests that developing a veterinary relationship-centered care practice may be beneficial for pet owners facing end-of-life issues and the death of their companion animals since it showed that shared-decision making strategies and empathic communication may reduce negative dimensions of bereavement that may complicate grief. Interestingly, adopting shared decision-making strategies may contribute to be perceived as more empathic. These aspects may be taken into consideration in end-of -life communication training in veterinary medicine

Borders, Migration and Globalization. An Interdisciplinary Perspective

Nowadays the reality of migrations defines the policies both of host and origin countries, invades the everyday life of all of us, dominates the pubòic language, builds new borders, and destroys others. The borders are a multifaceted concept that adapts to different disciplinary languages , that includes and covers unlike realities and for this reason represents a useful gimmick to deal with a theme, migrations, that in turn needs numerous perspectives of analysis to be adequately faced. borders can have the concreteness of geographical, political and bureaucratic barriers, or they may be methaphorical barrierrs: identity, prejudices, culture. through territories and consciences, they mark a space that includes and excludes at the same time

Disegnare, attraversare, cancellare i confini. una prospettiva interdisciplinare

Il concetto di confine è un concetto poliedrico , che si adatta a linguaggi disciplinari diversi , che comprende e copre realtà dissimili e per tale ragione rappresenta un escamotage utile per affrontare un tema, quello delle migrazioni, che a sua volta reclama , per essere adeguatamente affrontato, prospettive di analisi molteplici