Routine immunization of older adults and frail people during the SARS-COV2-pandemic in Italy: a national survey by Italia Longeva

Despite the availability of safe and effective vaccines, older adults and frail people (OAFs) remain far from accomplishing the recommended coverage targets. The SARS-CoV-2 pandemics strongly affected the supply and coverage of routine vaccines, especially for OAFs, but it also suggested innovative solutions to catch up with the immunization schedules we were late with. Italia Longeva, the National Association for Active Longevity established in 2011 by the Ministry of Health, realized this research aiming to collect and share local good practices for the routine immunization of OAFs implemented during the SARS-CoV-2 pandemic. We surveyed 12 local health directors from 9 Regions (with a potential covered area of about 24 million inhabitants) between January and March 2021. Starting from the 2018 Thomas and Lorenzetti’s Cochrane Review, a “snowball” search of scientific and grey literature was performed to create and validate a 27-items semi-structured questionnaire used to collect information during the interviews. Full methods are available online (https://www.italialongeva.it/). A wide range of organizational models and settings for immunization supply to OAFs were found across regions. The local implementation of the 27 interventions to increase vaccination coverage among OAFs identified through the literature review ranges from 0% to 100%, with higher rates for interventions targeting the professionals (i.e. audits), lower when aimed to increase the vaccine offer (i.e. active calls) or its accessibility (i.e. home vaccination). Seven good local practices have been identified and described: Mass Vaccination Centre; drivethrough Vaccination; Mobile vaccination clinics; co-administration; collaboration within different organization; Electronic immunization registries; standardized immunization pathways. Literature suggests many effective interventions to improve immunization of OAFs, but their implementation at local level shows huge heterogeneity. Providers should combine several interventions adequate to the specific context (organizational models, interoperability, urban or rural context, etc) and share good practice

Effects of perennial stripcropping on aggregation and organic carbón of semiarid soils of the pampean región, Argentina

El cultivo en franjas es una práctica adecuada para el control de la erosión eólica, economía del agua y protección de cultivos en los suelos de la región semiárida. Sin embargo, el excesivo uso agrícola de las franjas cultivadas cuando las mismas no entran en rotación produce una degradación física y química acelerada de los suelos. En el presente estudio se evaluaron cambios en la agregación en seco, agregación en húmedo y carbono orgánico por efecto de los manejos contrastados entre franjas: agricultura continuada y pasto llorón (Eragrostis curvula). Por acción de la agricultura se han observado reducciones significativas en el diámetro medio de agregados en húmedo, cambio de diámetro medio y carbono orgánico total, siendo las mismas del 21,45 y 29% respectivamente. No se apreciaron cambios por el manejo en el diámetro medio de los agregados tamizados en seco. La materia orgánica juega un papel fundamental en la estabilidad de los agregados de estos suelos, ya que un modelo de regresión exponencial explica casi el 75% de las variaciones del cambio de diámetro medio geométrico.Stripcropping is an adequate soil practica for wind erosión control, water storage and crop protection in the Argentine semiarid región. However, continuous agriculture without strip rotation. produces accelerated physical and Chemical degradation of soils. This study evaluates the changes in dry and wet aggregation and soil organic carbón, resulting from two contrasting field management between strips, namely a permanent agriculture strip and a weeping lovegrass pasture (Eragrostis curvula) strip, 20 years oíd. Significant reductions due to agricultural practicas were observed in wet aggregate mean diameter, change of mean diameter and total organic carbón, which were respectively of 21, 45 and 29%. No changes in mean diameter were observed with dry sieving of aggregates. Organic matter plays a fundamental role in the aggregates stability in these soils, as an exponential regression model accounts for almost 75% of mean diameter variations.Facultad de Ciencias Agrarias y Forestale

Medical workforce planning in a changing health context: Comparison between Italy and Europe

An increasing need for healthcare workers as been estimated worldwide. To provide a comprehensive framework of the medical workforce in Italy, we investigated the post-lauream medical workforce training supply and demand. Further, a comparison of the medical workforce between Italy and other European Countries with a similar epidemiological and/or demographic context was performed. The distribution of pre-and post-lauream medical educational providers and post-lauream resources in place in Italy was analyzed among Italian macro-areas in the academic years 2015-2016, 2016-2017 and 2017-2018.Italy and the European countries in study were compared in term of post-lauream funding and number of active physicians by specialization per 1,000 inhabitants. Open access data from official Italian and European institutional sources were used. The most of medical schools were distributed in the North, followed by South, islands and Central Italy, while the highest enrolment rate in the pre-lauream medical education was reported in Central Italy, followed by South & islands and North. The total number of active residency programs increased from 1092 to 1286 in the three considered academic years, while number of post-lauream training contracts decreased from 11.0 to 10.2 per 100,000 inhabitants. A misalignment between contracts assigned to residency programs and grants assigned to general practitioners specific courses was observed. Furthermore, when compared to the EU countries in study, Italy documented the lowest number of post-graduated training positions in 2015, with a rate of 12.1/100,000 inhabitants. Also, an excess of medical specialists (3.06 per 1,000 inhabitants) with a simultaneous shortage of general practitioners (0.89 per 1,000 inhabitants) was reported. On the contrary, Italy documented the highest number of paediatric practitioners. More efforts, including the implementation of adequate tools, are required both at national and regional level in order to provide a medical workforce planning in line with a continuously changing health context

Feedborne Salmonella enterica Serovar Jerusalem Outbreak in Different Organic Poultry Flocks in Switzerland and Italy Linked to Soya Expeller

Poultry feed is a leading source of Salmonella infection in poultry. In Switzerland, heat-treated feed is used to reduce Salmonella incursions into flocks in conventional poultry production. By contrast, organic feed is only treated with organic acids. In 2019, the Swiss National Reference Center for Enteropathogenic Bacteria identified the rare serovar S. Jerusalem from samples of organic soya feed. Further, in July 2020, the European Union’s Rapid Alert System for Food and Feed published a notification of the detection of S. Jerusalem in soya expeller from Italy. During 2020, seven S. Jerusalem isolates from seven different poultry productions distributed over six cantons in Switzerland were reported, providing further evidence of a possible outbreak. Using whole-genome sequencing (WGS), S. Jerusalem isolates from feed and from animals in Switzerland were further characterized and compared to S. Jerusalem from organic poultry farm environments in Italy. WGS results showed that feed isolates and isolates from Swiss and Italian poultry flocks belonged to the sequence type (ST)1028, grouped in a very tight cluster, and were closely related. This outbreak highlights the risk of spreading Salmonella by feed and emphasizes the need for a heat-treatment process for feed, also in organic poultry production

Medical workforce planning in a changing health context: Comparison between Italy and Europe

An increasing need for healthcare workers as been estimated worldwide. To provide a comprehensive framework of the medical workforce in Italy, we investigated the post-lauream medical workforce training supply and demand. Further, a comparison of the medical workforce between Italy and other European Countries with a similar epidemiological and/or demographic context was performed. The distribution of pre-and post-lauream medical educational providers and post-lauream resources in place in Italy was analyzed among Italian macro-areas in the academic years 2015-2016, 2016-2017 and 2017-2018.Italy and the European countries in study were compared in term of post-lauream funding and number of active physicians by specialization per 1,000 inhabitants. Open access data from official Italian and European institutional sources were used. The most of medical schools were distributed in the North, followed by South, islands and Central Italy, while the highest enrolment rate in the pre-lauream medical education was reported in Central Italy, followed by South & islands and North. The total number of active residency programs increased from 1092 to 1286 in the three considered academic years, while number of post-lauream training contracts decreased from 11.0 to 10.2 per 100,000 inhabitants. A misalignment between contracts assigned to residency programs and grants assigned to general practitioners specific courses was observed. Furthermore, when compared to the EU countries in study, Italy documented the lowest number of post-graduated training positions in 2015, with a rate of 12.1/100,000 inhabitants. Also, an excess of medical specialists (3.06 per 1,000 inhabitants) with a simultaneous shortage of general practitioners (0.89 per 1,000 inhabitants) was reported. On the contrary, Italy documented the highest number of paediatric practitioners. More efforts, including the implementation of adequate tools, are required both at national and regional level in order to provide a medical workforce planning in line with a continuously changing health context

Avoidable blindness and value based healthcare: More value with a population approach

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Comparación de dos morfotipos de Zuccagnia punctata (Fabaceae) en los Valles Calchaquíes en Argentina

Zuccagnia punctata Cav. (Fabaceae) is a medicinal aromatic shrub, a monotypic species with a wide distribution in Argentina. Two morphotypes were found in Valles Calchaquíes, one with yellow fruits (YF) and other with red-brown fruits (RBF). The color of fruits varies between individuals within a population, with some plants producing red-brown fruits and other yellow fruits. The cytogenetic differentiation was determined using root tips. Leaves and fruits were used to analyze chemical composition by HPLC-DAD and HPLC/MS/MS. The number of chromosome (2n = 24) was reported for the first time for the genus. The yellow fruits and red-brown fruits morphotypes showed different karyotypes. The compounds common to both morphotypes were identified in leaves and fruits as chalcones, compounds with biological activity and biomarkers used for quality control of Z. punctata products. Two chemotypes related to the color of the fruits, were detected. An anthocyanin, cyanidin 3-glucoside was found in red-brown fruits (4.75 mg.g-1 fruits) but not in yellow fruits. These is the first report on yellow fruits morphotype of Z. punctata and on presence of anthocyanins in Z. punctata red-brown fruits morphotype. This work contributes to the knowledge of Z. punctata, a native plant from Argentina with high economic potential to promote the regional economy.Zuccagnia punctata Cav. (Fabaceae) es un arbusto aromático medicinal monotípico con amplia distribución en Argentina. En los Valles Calchaquíes se encontraron dos morfotipos, uno con frutos amarillos y otro con frutos marrón rojizo. El color de los frutos varía entre individuos de una misma población, observándose plantas que tienen frutos de color marrón rojizo y otras con frutos de color amarillo. La diferenciación citogenética fue determinada usando puntas de raíces mientras que las hojas y frutos se usaron para analizar la composición química por HPLC-DAD y HPLC/MS/MS. Se informó por primera vez el número cromosómico (2n = 24) para el género Zuccagnia. Ambos morfotipos mostraron diferentes cariotipos. Se identificaron chalconas como compuestos comunes en las hojas y frutos de ambos morfotipos. Las chalconas son consideradas biomarcadores en el control de calidad de productos a base de Z. punctata. Se detectaron dos quimiotipos relacionados al color de los frutos. La antocianina, cianidin 3-glucosido se encontró en frutos marrón rojizos (4.75 mg.g-1 fruto) pero no en frutos amarillos. Este es el primer informe sobre un morfotipo de Z. punctata con frutos amarillos y sobre la presencia de antocianinas en el morfotipo de frutos rojos. Este trabajo contribuye al conocimiento de Z. punctata, una planta nativa de Argentina con alto potencial económico para promover el desarrollo regional.Fil: Álvarez, María A.. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Correa Uriburu, Florencia Maria. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Barrera, María Celina. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Enrico, Roxana Judith. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; Argentina. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo; ArgentinaFil: Andrada, Aldo Rubén. Instituto de Genetica y Microbiologia ; Direccion de Biologia Integrativa ; Fundacion Miguel Lillo;Fil: Silenzi Usandivaras, Gabriela M.. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo; Argentina. Instituto de Genetica y Microbiologia ; Direccion de Biologia Integrativa ; Fundacion Miguel Lillo;Fil: Páez, Valeria A.. Instituto de Genetica y Microbiologia ; Direccion de Biologia Integrativa ; Fundacion Miguel Lillo;Fil: Caro, María S.. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo; Argentina. Instituto de Genetica y Microbiologia ; Direccion de Biologia Integrativa ; Fundacion Miguel Lillo;Fil: Zampini, Iris Catiana. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; Argentina. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo; ArgentinaFil: Isla, Maria Ines. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; Argentina. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo; Argentin

SARS-CoV-2 genomic surveillance of migrants arriving to Europe through the Mediterranean routes

Background The implementation genomic-based surveillance on emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in low-income countries, which have inadequate molecular and sequencing capabilities and limited vaccine storage, represents a challenge for public health. To date, there is little evidence on molecular investigations of SARS-CoV-2 variants in areas where they might emerge. We report the findings of an experimental SARS-CoV-2 molecular surveillance programme for migrants, refugees, and asylum seekers arriving to Europe via Italy through the Mediterranean Sea. Methods We descriptively analysed data on migrants collected at entry points in Sicily from February 2021 to May 2022. These entry points are integrated with a network of laboratories fully equipped for molecular analyses, which performed next-generation sequencing and used Nextclade and the Pangolin coronavirus disease 2019 (COVID-19) tools for clade/lineage assignment. Results We obtained 472 full-length SARS-CoV-2 sequences and identified 12 unique clades belonging to 31 different lineages. The delta variant accounted for 43.6% of all genomes, followed by clades 21D (Eta) and 20A (25.4% and 11.4%, respectively). Notably, some of the identified lineages (A.23.1, A.27, and A.29) predicted their introduction into the migration area. The mutation analysis allowed us to identify 617 different amino acid substitutions, 156 amino acid deletions, 7 stop codons, and 6 amino acid insertions. Lastly, we highlighted the geographical distribution patterns of some mutational profiles occurring in the migrants’ countries of origin. Conclusions Genome-based molecular surveillance dedicated to migrant populations from low-resource areas may be useful for forecasting new epidemiological scenarios related to SARS-CoV-2 variants or other emerging pathogens, as well as for informing the updating of vaccination strategies

Rilevazione nazionale in tema di formazione specifica di medicina generale in Italia

Physicians have to get a \u201cspecific\u201d diploma attending a threeyear training course provided by each regional health service in order to practice as General Practitioners in Italy. In the last years, there has been an ongoing debate about the need to evolve the specific regional courses into integrated specialization training courses, organized and managed by universities with the contribution of regional health services. The Italian Junior Doctors Association and the Giotto Movement carried out a national survey with the aim to identify strengths and weaknesses of the specific regional training courses. Three-hundred-two junior General Practitioners in training (61,2% females) answered to a web administered questionnaire. Only about half of the recruited trainees has defined as at least \u201csufficient\u201d the training provided by the regional courses. The survey documented in the Italian General Practitioners trainees the need to satisfy an educational demand in order to implement their primary care and general practice skills. In conclusion, this cross-sectional study provided sufficient evidences supporting the evolution of the regional training courses into general practice and primary care specialization schools