Comparison of emotional approaches of medical doctors against COVID-19 pandemic: Eastern and Western Mediterranean countries

Background: Pandemics are states of disease that occur worldwide and sharply increase in populations. It causes life events which trigger anxiety, depression, anger, sleep deprivation, emotional distress and stress. World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, pointing to the over 118,000 cases in over 110 countries. Many healthcare workers became ill during the pandemic and some among them died. In this study, we aimed to evaluate and compare level of stress against COVID-19 pandemic among doctors from Turkey and Italy. Methods: This research is a cross-sectional study in which Perceived Stress Scale (PSS-10) and Secondary Traumatic Stress Scale (STSS) are administered online via social networks. All data collection tools were delivered to individuals between 1 and 15 June 2020 and filled in online with Google Forms application. In total, 618 individuals were included in this study and all of them were medical doctors. Results: Higher PS and STS levels were found related to female gender, being married, working in pandemic hospital and older ages. Stress levels were found statistically higher in Turkish doctors when compared to Italian doctors for both stress scales (Turkish/Italian PSS:20.18 ± 7.90/ 19.35 ± 6.71, STSS: 44.19 ± 13.29/ 38.83 ± 13.74). Conclusion: The number of doctors per 1000 of population is lower and per capita visits to a physician are higher in Turkey when compared to Italy. Besides pandemic, these heavier working conditions, increased weekly working hours can cause stress for Turkish doctors. Reporting information such this study is important and international collaborations are essential to plan future prevention strategies. We need to strengthen international ties and build more international collaborations rather than staying within our national silos. Additionally, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented

Age-Period-Cohort Analysis of 1990–2003 Incidence Time Trends of Childhood Diabetes in Italy: The RIDI Study

OBJECTIVE - To investigate age-period-cohort effects on the temporal trend of type 1 diabetes in children age 0-14 years in Italian registries. RESEARCH DESIGN AND METHODS - This report is based on 5,180 incident cases in the period 1990-2003 from the Registry for Type 1 Diabetes Mellitus in Italy (RIDI). Multilevel (random intercept) Poisson regression models were used to model the effects of sex, age, calendar time, and birth cohorts on temporal trends, taking into account the registry-level variance component. RESULTS - The incidence rate was 12.26 per 100,000 personyears and significantly higher in boys (13.13 [95% CI 12.66-13.62]) than in girls (11.35 [10.90-11.82]). Large geographical variations in incidence within Italy were evident; incidence was highest in Sardinia, intermediate in Central-Southern Italy, and high in Northern Italy, particularly in the Trento Province, where the incidence rate was 18.67 per 100,000 person-years. An increasing temporal trend was evident (2.94% per year [95% CI 2.22-3.67]). With respect to the calendar period 1990-1992, the incidence rates increased linearly by 15, 27, 35, and 40% in the following time periods (P for trend < 0.001). With respect to the 1987-1993 birth cohort, the incidence rate ratio increased approximately linearly from 0.63 (95% CI 0.54-0.73) in the 1975-1981 cohort to 1.38 (1.06-1.80) in the 1999-2003 cohort. The best model, however, included sex, age, and a linear time trend (drift). CONCLUSIONS - Large geographical variations and an increasing temporal trend in diabetes incidence are evident among type 1 diabetic children in Italy. Age-period-cohort analysis shows that the variation over time has a linear component that cannot be ascribed to either the calendar period or the birth cohort

MANAGING PIZZA MARGHERITA WITH INSULIN PUMP. ANALYSIS OF GLUCOSE RESPONSE AFTER CONSUMPTION OF PIZZAS WITH DIFFERENT KINDS OF FERMENTATION, USING A SIMPLE WAVE BOLUS

Background and Aims Pizza is considered a "junk food", because of high content of fat and carbohydrates. The glycaemic response to pizza could change according to the fermentation of the dough. Dual-wave bolus is usually used to manage pizza meal. Aim of our study was to evaluate glycemic response in a pediatric population with T1DM, after consumption of pizzas made with two different kinds of fermentation but the same Italian recipe,with a simple wave bolus. Method We enrolled 18 patients with T1DM on CSSI to evaluate their glycaemic response to the short and the long fermented pizza (less than 8 hours or more than 24 hours). Results We observed that glucose values were between 70 and 180 mg/dl for a good percentage of time in both types of pizza during all the periods of observation. For male patients the mean percentage of time between 70-180 mg/dl, for 2 hours after bolus, was 71% for the first pizza and 95% for the second (p=0·044). Considering the same time window, there was a significant difference as far as percentage of time is concerned for patients with metabolic compensation ”not in target” with SG<70mg/dl (p=0·045) and between 70mg/dl and 180mg/dl (p=0·009). About the AUC of hypoglycemic events, we observed a statistically significant difference for the subset of prepuberal patients (p=0·05) and for the patients with metabolic compensation “not in target” (p=0·024). Conclusion Pizza can generate a good post-prandial glycemic response.Evaluating the fermentation time of the dough can help the diabetic patient in choosing the type of insulin bolus to self-administer