Internet use and physical and mental health in old age during the COVID-19 pandemic: Evidence from partners in SHARE

Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigate whether individuals aged 65 and older who were internet users prior to the COVID-19 pandemic experienced better physical and mental health, during the pandemic, than age peers who did not use the internet. We consider three health outcomes: self-reported health, overweight/obesity and depression. To account for household-shared determinants of health and reverse causality, we estimate household fixed effects regressions on samples of individuals grouped into households of cohabiting partners who exhibited identical pre-pandemic health outcomes. On average, our estimates point towards a non-significant effect of internet use on all health outcomes. The probability of depression varied by age: pre-pandemic internet users in the age-range 65-70 were more likely to experience depression, whereas those aged over 80 were less likely to be depressed, compared to internet nonusers in the same age-range. Moreover, we find that, among older pre-pandemic internet nonusers, those with stronger social ties had better access to remote medical consultations during the pandemic; this result suggests that social capital may play a protective role and may contribute to bridging the digital divide. We conclude that, although internet use holds significant potential benefits for older adults, its impact, particularly on mental health, is complex and multifaceted. Future interventions should be tailored to address these nuances, promoting beneficial uses of digital technology while mitigating its adverse effects

EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on Dietary reference values for water

This Opinion of the EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) deals with the setting of dietary reference values for water for specific age groups. Adequate Intakes (AI) have been defined derived from a combination of observed intakes in population groups with desirable osmolarity values of urine and desirable water volumes per energy unit consumed. The reference values for total water intake include water from drinking water, beverages of all kind, and from food moisture and only apply to conditions of moderate environmental temperature and moderate physical activity levels (PAL 1.6). AIs for infants in the first half of the first year of life are estimated to be 100-190 mL/kg per day. For infants 6-12 months of age a total water intake of 800-1000 mL/day is considered adequate. For the second year of life an adequate total water intake of 1100-1200 mL/day is defined by interpolation, as intake data are not available. AIs of water for children are estimated to be 1300 mL/day for boys and girls 2-3 years of age; 1600 mL/day for boys and girls 4-8 years of age; 2100 mL/day for boys 9-13 years of age; 1900 mL/day for girls 9-13 years of age. Adolescents of 14 years and older are considered as adults with respect to adequate water intake. Available data for adults permit the definition of AIs as 2.0 L/day (P 95 3.1 L) for females and 2.5 L/day (P95 4.0 L) for males. The same AIs as for adults are defined for the elderly. For pregnant women the same water intake as in non-pregnant women plus an increase in proportion to the increase in energy intake (300 mL/day) is proposed. For lactating women adequate water intakes of about 700 mL/day above the AIs of non-lactating women of the same age are derive

The impact of school closure intervention during the third wave of the COVID-19 pandemic in Italy: Evidence from the Milan area

Background: In February 2021, the spread of a new variant of SARS-CoV-2 in the Lombardy Region, Italy caused concerns about school-aged children as a source of contagion, leading local authorities to adopt an extraordinary school closure measure. This generated a debate about the usefulness of such an intervention in light of the trade-off between its related benefits and costs (e.g. delays in educational attainment, impact on children and families' psycho-physical well-being). This article analyses the epidemiological impact of the school closure intervention in the Milan metropolitan area. Methods: Data from the Agency for Health Protection of the Metropolitan City of Milan allowed analysing the trend of contagion in different age classes before and after the intervention, adopting an interrupted times series design, providing a quasi-experimental counterfactual scenario. Segmented Poisson regression models of daily incident cases were performed separately for the 3-11-year-old, the 12-19-year-old, and the 20+-year-old age groups, examining the change in the contagion curves after the intervention, adjusting for time-varying confounders. Kaplan-Meier survival curves and Cox regression were used to assess the equality of survival curves in the three age groups before and after the intervention. Results: Net of time-varying confounders, the intervention produced a daily reduction of the risk of contagion by 4% in those aged 3-11 and 12-19 (IRR = 0·96) and by 3% in those aged 20 or more (IRR = 0·97). More importantly, there were differences in the temporal order of contagion decrease between the age groups, with the epidemic curve lowering first in the school-aged children directly affected by the intervention, and only subsequently in the adult population, which presumably indirectly benefitted from the reduction of contagion among children. Conclusion: Though it was not possible to completely discern the effect of school closures from concurrent policy measures, a substantial decrease in the contagion curves was clearly detected after the intervention. The extent to which the slowdown of infections counterbalanced the social costs of the policy remains unclear

Analysis and Theoretical Exploration of Low Response Rate and Socioeconomic Bias in Survey Non-Response in Milan, Italy

This article presents the findings of a web survey aimed at collecting new neighborhood-level information on individual and contextual health-related risk factors in Milan, Italy. The study utilized the Social Determinants of Health and Urban Health approaches to design data-driven health prevention and promotion interventions tailored to the local community. However, the survey experienced a significantly low response rate (6.2%) with a skewed re- presentation of middle-aged, well-educated, white-collar individuals located in affluent city areas. As a result, the collected data was deemed unusable for public health and research purposes. The article discusses the rationale, structure, and development of the project and evaluates the magnitude of non-response and non-response bias due to socioeconomic characteristics. The issues of low survey participation and socioeconomic inequalities in re- sponse rates are explored in connection with sociological theories and exist- ing empirical evidence from the literature

A Comparison Between Omicron and Earlier COVID-19 Variants' Disease Severity in the Milan Area, Italy

Background: In the context of the fourth wave of the COVID-19 pandemic in Italy, which occurred in correspondence with the outbreak of the Omicron variant, it became fundamental to assess differences in the risk of severe disease between the Omicron variant and the earlier SARS-CoV-2 variants that were still in circulation despite Omicron becoming prevalent. Methods: We collected data on 2,267 genotyped PCR-positive swab tests and assessed whether the presence of symptoms, risk of hospitalization, and recovery times were significantly different between Omicron and the earlier variants. Multivariable models adjusted for sex, age class, citizenship, comorbidities, and symptomatology allowed assessing the difference in outcomes between Omicron and the earlier variants according to vaccination status and timing of administration. Results: Compared to the earlier variants in the same period, Omicron was less symptomatic, resulted in fewer hospital admissions for those who were unvaccinated and for those who were already immunized after the booster dose, and was associated with quicker recovery, yet not in subjects with three vaccination doses. Conclusion: Despite being milder, Omicron's higher transmissibility and vaccine resistance should not lead to underrating its damage potential, especially with regard to hospital and health service saturation

Neighbourhood property value and type 2 diabetes mellitus in the Maastricht study: A multilevel study

Objective Low individual socioeconomic status (SES) is known to be associated with a higher risk of type 2 diabetes mellitus (T2DM), but the extent to which the local context in which people live may influence T2DM rates remains unclear. This study examines whether living in a low property value neighbourhood is associated with higher rates of T2DM independently of individual SES. Research design and methods Using cross-sectional data from the Maastricht Study (2010\u20132013) and geographical data from Statistics Netherlands, multilevel logistic regression was used to assess the association between neighbourhood property value and T2DM. Individual SES was based on education, occupation and income. Of the 2,056 participants (aged 40\u201375 years), 494 (24%) were diagnosed with T2DM. Results Individual SES was strongly associated with T2DM, but a significant proportion of the variance in T2DM was found at the neighbourhood level (VPC = 9.2%; 95% CI = 5.0%\u201316%). Participants living in the poorest neighbourhoods had a 2.38 times higher odds ratio of T2DM compared to those living in the richest areas (95% CI = 1.58\u20133.58), independently of individual SES. Conclusions Neighbourhood property value showed a significant association with T2DM, suggesting the usefulness of area-based programmes aimed at improving neighbourhood characteristics in order to tackle inequalities in T2DM

Le disuguaglianze socioeconomiche individuali e territoriali nel Diabete Mellito di Tipo 2 nella città di Milano: uno studio multilivello

This article investigates the presence of a territorial heterogeneity and of a contextual effect in Type 2 Diabetes Mellitus in the City of Milan. Type 2 Diabetes Mellitus is a growing health problem worldwide, whose onset is largely determined by an unhealthy lifestyle, as defined by an unbalanced diet and poor physical activity. Being such habits and behaviours more rooted in the most socially, economically, and culturally disadvantaged people, a clear social gradient is visible, with the disease mostly occurring in subjects of lower socioeconomic status. The onset is also determined by the characteristics of the urban environment of residence, such as green spaces, walkability, the food environment, and the availability of services and amenities. To date, there is no empirical evidence concerning the Milanese case. This study aims at shedding light on the phenomenon investigated by integrating administrative healthcare data from the Health Protection Agency of the Metropolitan City of Milan with data from the most recent population census. Multilevel regression models show higher risk of onset in the most disadvantaged areas, regardless the socioeconomic and demographic profile of their inhabitants. This highlights the needs to conceive territorial policies in order to tackle the spread of the disease and its related inequalities

Numerical simulation of barge impact on a continuous girder bridge and bridge damage detection

Vessel collisions on bridge piers have been frequently reported. As many bridges are vital in transportation networks and serve as lifelines, bridge damage might leads to catastrophic consequences to life and economy. Therefore it is of great importance to protect bridge structures, especially bridge piers, against vessel impacts. Many researches have been conducted to predict vessel impact loads on bridge piers, and to design bridge piers or additional protective structures to resist such impact loads. Studies on assessing the bridge conditions after a vessel impact are, however, very limited. Current practice basically uses visual inspections, which not only requires very experienced engineers to perform the inspection in order to obtain creditable assessment, but also is often very difficult to inspect the underwater pier conditions. Therefore it is necessary to develop methods to give efficient, quantitative and reliable assessment of bridge conditions under ambient conditions after a vessel impact. This study explores the feasibility of using vibration measurements to quickly detect bridge conditions after a vessel impact.The study consists of three parts. First, a detailed numerical model of an example bridge structure is developed to calculate the vibrations under ambient hydrodynamic force. Then the model is used to simulate vessel impact on bridge pier and predict the pier damage. The vibration response analysis of the damaged bridge model is performed again in the third step to simulate vibration responses of the damaged bridge under ambient conditions. Using the vibration data obtained before and after vessel impact, the bridge vibration parameters such as vibration frequencies and mode shapes are extracted by using the frequency domain decomposition method. The bridge condition will then be identified through the changes in bridge vibration parameters and compared with the damage observed in the impact simulation. It is found that this method is capable of estimating bridge damage condition after barge impact accident

Association between autoimmune diseases and COVID-19 as assessed in both a test-negative case–control and population case–control design

Background: COVID-19 epidemic has paralleled with the so called infodemic, where countless pieces of information have been disseminated on putative risk factors for COVID-19. Among those, emerged the notion that people suffering from autoimmune diseases (AIDs) have a higher risk of SARS-CoV-2 infection. Methods: The cohort included all COVID-19 cases residents in the Agency for Health Protection (AHP) of Milan that, from the beginning of the outbreak, developed a web-based platform that traced positive and negative cases as well as related contacts. AIDs subjects were defined ad having one the following autoimmune disease: rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjogren disease, ankylosing spondylitis, myasthenia gravis, Hashimoto's disease, acquired autoimmune hemolytic anemia, and psoriatic arthritis. To investigate whether AID subjects are at increased risk of SARS-CoV-2 infection, and whether they have worse prognosis than AIDs-free subjects once infected, we performed a combined analysis of a test-negative design case-control study, a case-control with test-positive as cases, and one with test-negative as cases (CC-NEG). Results: During the outbreak, the Milan AHP endured, up to April 27th 2020, 20,364 test-positive and 34,697 test-negative subjects. We found no association between AIDs and being positive to COVID-19, but a statistically significant association between AIDs and being negative to COVID-19 in the CC-NEG. If, as likely, test-negative subjects underwent testing because of respiratory infection symptoms, these results imply that autoimmune diseases may be a risk factor for respiratory infections in general (including COVID-19), but they are not a specific risk factor for COVID-19. Furthermore, when infected by SARS-CoV-2, AIDs subjects did not have a worse prognosis compared to non-AIDs subjects. Results highlighted a potential unbalance in the testing campaign, which may be correlated to the characteristics of the tested person, leading specific frail population to be particularly tested. Conclusions: Lack of availability of sound scientific knowledge inevitably lead unreliable news to spread over the population, preventing people to disentangle them form reliable information. Even if additional studies are needed to replicate and strengthen our results, these findings represent initial evidence to derive recommendations based on actual data for subjects with autoimmune diseases