Evaluation of flu vaccination coverage among healthcare workers during a 3 years’ study period and attitude towards influenza and potential covid-19 vaccination in the context of the pandemic

(1) Background: vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs, ensure patient’s safety and to maintain essential health care services during influenza epidemics. With the present study we aimed to evaluate the efficacy of incremental bundles of measures implemented during the last three flu campaigns and to assess the attitudes towards influenza vaccination and a potential vaccine against COVID-19 among HCWs, in a large university hospital in Pisa, Italy. (2) Methods: We described measures implemented during 2018/2019, 2019/2020 and 2020/2021 and assessed their impact on flu vaccine coverage (VC) among employees and residents in Pisa university hospital. We considered sex, profession and ward to investigate differences in uptake. In addition, in 2020 a survey was developed and distributed to all employees to evaluate flu and COVID-19 vaccines attitudes. (3) Results: during the 2018/19 and 2019/20 flu campaigns the overall VC rate among HCWs was, respectively, 10.2% and 11.9%. In 2020/21 the overall VC rate jumped to 39.3% (+230.6%). Results from the survey indicated a more positive attitude towards flu vaccine as compared to COVID-19 vaccines among the 10.6% of the staff members who responded to the survey. In addition, 70.97% of HCWs totally agreed that being vaccinated against influenza would be more important than the previous years because of COVID-19 emergency. (4) Conclusions: a significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years. The COVID-19 pandemic positively influenced flu vaccination uptake during the 2020/21 season

Forecasting House Prices in Germany

In the academic debate there is a broad consensus that house price fluctuations have a substantial impact on financial stability and real economic activity. Therefore, it is important to have timely information on actual and expected house price developments. The aim of this paper is to measure the latest price movements in different real estate markets in Germany and forecast near-term price developments. Therefore we construct hedonic house price indices based on real estate advertisements on the internet platform ImmobilienScout24. Then, starting with a naive AR(p) model as a benchmark, we investigate whether VAR and ARDL models using additional macroeconomic information can improve the forecasting performance as measured by the mean squared forecast error (MSFE). While these models reduce the forecast error only slightly, forecast combination approaches enhance the predictive power considerably.Die Finanz- und Wirtschaftskrise hat erneut gezeigt, dass Preisfluktuationen am Immobilienmarkt nicht nur einen substanziellen Einfluss auf die Finanzmarktstabilität sondern auch auf die gesamtwirtschaftliche Aktivität ausüben. Demnach ist es aus makroökonomischer Sicht wichtig, Immobilienpreisentwicklungen frühzeitig erkennen und akkurat prognostizieren zu können. Ziel dieser Arbeit ist es, Preisentwicklungen für Deutschland in verschieden Segmenten des Immobilienmarktes am aktuellen Rand zu erfassen und für die kurze Frist von bis zu sechs Monaten zu prognostizieren. Basierend auf monatlich verfügbaren Immobilieninseraten auf der Internetplattform von ImmobilienScout24 werden dazu in einem ersten Schritt hedonische Preisindizes gebildet. In einem zweiten Schritt wird die Entwicklung dieser Preisindizes prognostiziert. Beginnend mit einem einfachen AR(p)-Prozess wird der Informationsgehalt verschiedener zusätzlicher Indikatoren mit Hilfe von VAR und ARDL-Modellen untersucht. Während sich der durchschnittliche quadratische Schätzfehler in den einzelnen Modellen im Vergleich zum AR-Modell nur geringfügig verringert, zeigt sich, dass mit Hilfe von geeigneten Prognosekombinationen die Prognosegüte signifikant verbessert werden kann

An average/deprivation/inequality (ADI) analysis of chronic disease outcomes and risk factors in Argentina

<p>Abstract</p> <p>Background</p> <p>Recognition of the global economic and epidemiological burden of chronic non-communicable diseases has increased in recent years. However, much of the research on this issue remains focused on individual-level risk factors and neglects the underlying social patterning of risk factors and disease outcomes.</p> <p>Methods</p> <p>Secondary analysis of Argentina's 2005 <it>Encuesta Nacional de Factores de Riesgo </it>(National Risk Factor Survey, <it>N </it>= 41,392) using a novel analytical strategy first proposed by the United Nations Development Programme (UNDP), which we here refer to as the Average/Deprivation/Inequality (ADI) framework. The analysis focuses on two risk factors (unhealthy diet and obesity) and one related disease outcome (diabetes), a notable health concern in Latin America. Logistic regression is used to examine the interplay between socioeconomic and demographic factors. The ADI analysis then uses the results from the logistic regression to identify the most deprived, the best-off, and the difference between the two ideal types.</p> <p>Results</p> <p>Overall, 19.9% of the sample reported being in poor/fair health, 35.3% reported not eating any fruits or vegetables in five days of the week preceding the interview, 14.7% had a BMI of 30 or greater, and 8.5% indicated that a health professional had told them that they have diabetes or high blood pressure. However, significant variation is hidden by these summary measures. Educational attainment displayed the strongest explanatory power throughout the models, followed by household income, with both factors highlighting the social patterning of risk factors and disease outcomes. As educational attainment and household income increase, the probability of poor health, unhealthy diet, obesity, and diabetes decrease. The analyses also point toward important provincial effects and reinforce the notion that both compositional factors (i.e., characteristics of individuals) and contextual factors (i.e., characteristics of places) are important in understanding the social patterning of chronic diseases.</p> <p>Conclusion</p> <p>The application of the ADI framework enables identification of the regions or groups worst-off for each outcome measure under study. This can be used to highlight the variation embedded within national averages; as such, it encourages a social perspective on population health indicators that is particularly attuned to issues of inequity. The ADI framework is an important tool in the evaluation of policies aiming to prevent or control chronic non-communicable diseases.</p

Comparación de hallazgos electrocardiográficos y clínicos a la radiografía de tórax en pacientes portadores de CIA con o sin repercusión hemodinámica ecocardiográfica

Background: Atrial septal defect (ASD) is the most frequent congenital heart disease reaching adulthood without diagnosis. It can be presented as a heart anorganic murmur. Some ASD require surgical closure, before irreversible pulmonary hypertension and / or arrhythmias. Objective: Describe imagenologic, electrocardiographic and clinical findings in patient with ASD with or without hemodynamic repercussion. Methods and Materials: We reviewed medical records of patients with echocardiographic ASD in Félix Bulnes Hospital, in a 1 year period. ASD was considered as ≥ 3 millimeters diameter septal defects, without associated heart disease, hemodynamic repercussion was considered as right ventricular enlargement. We also analyzed: reason for referral, sex, age, cardiologic examination, electrocardiography, chest radiography, treatment and outcome. Results: We analyzed 56 patients, 59% female. The median diagnosis age was 5 months. Of the total referral causes, 70% was heart murmur and 30% for other reasons. Ten showed hemodynamic repercussion, most of them referred for heart murmur, 2 for radiological cardiomegaly, 7 had ECG changes. Eight required treatment, three of them surgical. Conclusions: The most common finding in children with ASD diagnosis is heart murmur. Timing on referral is important, especially if the murmur is associated with ECG changes and/or radiological cardiomegaly, because in these cases is more frecuent to find hemodynamic repercution and some may require a faster and specific treatment

Semisolid formulations containing dimethyl sulfoxide and alpha-tocopherol for the treatment of extravasation of antiblastic agents

The topical treatment with dimethyl sulfoxide (DMSO) and/or alpha-tocopherol (alpha-T) is widely used in order to prevent the local complications of extravasation of cytostatic drugs and protect patients against skin ulceration. Till now, DMSO and alpha-T have been mainly used in solution. The goal of this study was to formulate semisolid preparations for cutaneous application diVering in the hydrophilic and lipophilic properties and containing DMSO and alpha-T in combination. With respect to solutions, the use of semisolid preparations containing DMSO and alpha-T could be advantageous in patients having extravasation as DMSO and alpha-T can remain in contact with the skin over an extended period of time. As a consequence, the action of the active principles can be limited specifically on the injured skin area, reducing the cutaneous irritative effects of DMSO. The following types of semisolid formulations containing 50% m/m DMSO and 2.5% m/m alpha-T were prepared: hydrophilic ointment, o/w emulsion, hydrophilic gel and lipophilic gel. The ex vivo skin permeation of DMSO and alpha-T was evaluated by using modified Franz\u2019s diffusion cells and human stratum corneum and epidermis (SCE) as a membrane. The permeated and retained amounts of DMSO and alpha-T were determined. The oleogel preparation, the hydrophilic gel and the o/w emulsion were uniform in colour and aspect, without any evidences of phase separation over the period of the study. Hydrophilic ointments were discarded as they showed phase separation after 12 h. All formulations had a diVerent behaviour in terms of skin permeability. In particular, hydrogel and o/w emulsion showed the best control on the drug release considering the interactions of the vehicle components with the SCE and the drugs partition between the vehicle and the SCE. The DMSO permeated amount after 24 h was 4.1 mg/cm2 for hydrogel and 2.5 mg/cm2 for emulsion while the permeated amount of pure DMSO after 24 h was 47.5 mg/cm2. Therefore, aiming to reduce side eVects after the topical application of the antidotes DMSO and alpha-T, these results suggested that hydrogel and o/w emulsion could be considered the most promising formulations for further clinical evaluations in managing of extravasation of anthracycline

Psychiatric support of healthcare workers undergoing periodic health assessment

Abstract INTRODUCTION: An integrated mental health surveillance program was developed by the department of occupational medicine at S. Chiara University Hospital in Pisa, Italy, in order to better assist and treat hospital staff suffering from psychiatric disorders in a preventive medical setting. MATERIAL AND METHODS: During the occupational medical surveillance of 4000 employees of S. Chiara Hospital in Pisa (Italy), 30 health care workers with psychiatric disorders were included in our program, which provided psycho-educational support and pharmacological treatment. Measures of effectiveness were: Clinical Global Impression (CGI scale) and a comparison between the average number of lost workdays due to mental illness before and after treatment. RESULTS: At the end of the observation period there was a decrease in the CGI severity score with a improved CGI score ranging from 1 to 2 and a reduction in absenteeism, from an annual average of 36.70 to 25.10 lost workdays. CONCLUSION: Our outcome measures data seem to indicate that a preventive medicine setting can offer effective psychiatric support that is better accepted and tolerated by health care workers and that this approach may reduce absenteeism