Rotavirus and the web: analysis of online conversations in Italy during 2020

Rotavirus is the most common cause of severe diarrhea among children worldwide. In 2017, Italy included rotavirus vaccination in its National Immunization Program. The use of social media monitoring, an efficient tool to understand vaccine hesitancy, has increased in recent years; however, only a few examples of such monitoring are available for Italy. Present study analyzed content on online sources, including social media, to identify factors contributing to Italian parents' decisions to vaccinate or not their children against rotavirus. Blogmeter Suite was used to search and analyze conversations related to rotavirus in Italian on online sources during 2020. These data were compared with data from 2019. There were 2250 mentions of "rotavirus" recorded; 1080 were related to the rotavirus vaccine. Terms and hashtags used were similar in both years. Facebook was the main source of influence, Instagram dominated the engagement (the sum of interactions related to a post), and Google Trends showed a 5-year upward trend in searches for rotavirus vaccine. Of 1270 sentiment opinions, 60.7% were negative. More parents were familiar with the disease and the vaccine in 2020 compared with 2019. Pediatricians were the most influential healthcare professionals (59.2% of mentions), followed by vaccination staff (33.4%). The most relevant factors for vaccine hesitancy were fear of adverse events, concerns about the vaccination schedule, and COVID-19. Present study represents the first web listening analysis of online discussions about rotavirus. The results can be used to inform targeted communication to counteract misinformation and raise awareness about rotavirus vaccination among parents

Relación entre la educación y el trabajo infantil en niños y adolescentes de Uruguay

Today arround the world, it is estimated that 152 million children and adolescents need to work to survive. The international regulation establishes that this kind of work can be categorized in Child Labor (CL) or Non-Child Labor (NCL), depending on the age and the labor conditions. It is considered CL if the child has not reached the age of 15 years or when has between 15 and 17 years and the working time exceeds 37 hours per week and/or the tasks to be performed are considered risky.CL will be the analized category in this research. Taking into account that education is one of the most effective tools to improve the conditions of children and adolescents in a CL situation, the objective of this research is to provide empirical results on the relationship between education and CL in Uruguay. The analyzed data came from the Encuesta Nacional de Trabajo Infantil (ENTI), conducted in Uruguay between September 2009 and May 2010, the analysis were made considering only the working group CL (n = 793). This survey is structured in 5 blocks: Education, Domestic tasks, Economic activity, occupational health and Begging situation. The main results of this research are: Education correlates positively with Domestic tasks and negatively with Economic activity,Occupational health and Begging situation. In addition, the highest scores in Education belong to women and the lowest to men. In summary, it is concluded that women in CL situation have better working conditions than men. From these results it is clear that, although it is not the only factor determinating the quality of the work of children and adolescents in anCL situation, education is an essential tool to improve the quality of work carried out by children and adolescents.Hoy en día, se estima que, en todo el mundo existen 152 millones de niños, niñas y adolescentes (NNA) que deben trabajar para sobrevivir. Teniendo en cuenta la normativa internacional vigente, dicho trabajo se puede categorizar como Trabajo Infantil (TI) o Trabajo No Infantil (TNI), dependiendo de la edad del NNA y de las condiciones de trabajo. Se considera TI siempre que el NNA no haya cumplido los 15 años o habiéndolos cumplido cuando la jornada laboral supere las 37 horas semanales y/o las tareas a realizar se consideren peligrosas. Esta será la categoría analizada en este trabajo. Teniendo en cuenta que la educación es una de las herramientas más eficaces para mejorar las condiciones de los NNA en situación de TI, esta investigación pretende proporcionar resultados empíricos sobre la relación existente entre la educación y el TI en Uruguay. Para esto, se utilizan los datos obtenidos en la Encuesta Nacional de Trabajo Infantil (ENTI), realizada en Uruguay entre los meses de septiembre de 2009 y mayo de 2010, considerando únicamente los NNA en situación de TI (n = 793). Esta encuesta se estructura en 5 bloques: Educación, Tareas domésticas, Actividad económica, Seguridad y salud laboral y Mendicidad. Los resultados más destacables de esta investigación son: Educación correlaciona positivamente con Tareas domésticas y negativamente con Actividad económica, Seguridad y salud laboral y Mendicidad. Además, las puntuaciones más altas en Educación pertenecen a mujeres y las más bajas a hombres. En síntesis, se concluye que las mujeres en situación de TI poseen mejores condiciones laborales que los hombres. De estos resultados se desprende que, si bien no es el único factor que puede determinar la calidad del trabajo de los NNA en situación de TI, la educación es una herramienta esencial para mejorar la calidad del trabajo realizado por los NNA

Disease activity states, reasons for discontinuation and adverse events in 1038 Italian children with juvenile idiopathic arthritis treated with etanercept

The advent of biologic medications has increased considerably the potential for treatment benefit in juvenile idiopathic arthritis (JIA), with clinical remission being now achievable in a substantial proportion of patients. However, there is a need of data from the real world of clinical practice to evaluate thoroughly the efficacy and safety profile of the biologic agents currently approved

A prediction rule for lack of achievement of inactive disease with methotrexate as the sole disease-modifying antirheumatic therapy in juvenile idiopathic arthritis

Background: To investigate the frequency of achievement of inactive disease (ID) in children with juvenile idiopathic arthritis (JIA) treated with methotrexate (MTX) as the sole disease-modifyng antirheumatic (DMARD) therapy and to develop a prediction model for lack of attainment of ID. Methods: The clinical charts of consecutive patients started with MTX as the sole DMARD between 2000 and 2013 were reviewed. Patient follow-up was censored at first episode of ID or, in case ID was not reached, at last follow-up visit or when a biologic DMARD was prescribed. The characteristic at MTX start of patients who achieved or did not achieve ID were compared with univariate and multivariable analyses. Regression coefficients (\u3b2) of variables that entered the best-fitting logistic regression model were converted and summed to obtain a "prediction score" for lack of achievement of ID. Results: A total of 375 patients were included in the study. During MTX administration, 8.8% were given systemic corticosteroids and 44.1% intra-articular corticosteroids. After MTX start, 229 (61%) patients achieved ID after a median of 1.7 years, whereas 146 patients (39%) did not reach ID after a median of 1.2 years. On multivariable analysis, independent correlations with lack of achievement of ID were identified for the disease categories of systemic arthritis, enthesitis-related arthritis (ERA) and polyarthritis and C-reactive protein (CRP) > 1.4 mg/dl. The prediction score ranged from 0 to 3 and its cutoff that discriminated best between patients who achieved or did not achieve ID was > 0.5. The categories of systemic arthritis or ERA, both of which had a score greater than 0.5, were sufficient alone to predict a lower likelihood to reach ID. Polyarthritis and increased CRP, whose score was 0.5, assumed a predictive value only when present in association. Conclusion: A conventional treatment regimen based on MTX as the sole DMARD led to achievement of ID in a sizeable proportion of children with JIA. Our findings help to outline the characteristics of patients who may deserve a synthetic DMARD other than MTX or the introduction of a biologic DMARD from disease outset

Disease status, reasons for discontinuation and adverse events in 1038 Italian children with juvenile idiopathic arthritis treated with etanercept

Background: Data from routine clinical practice are needed to further define the efficacy and safety of biologic medications in children with juvenile idiopathic arthritis (JIA). The aim of this analysis was to investigate the disease status, reasons for discontinuation and adverse events in Italian JIA patients treated with etanercept (ETN). Methods: In 2013, all centers of the Italian Pediatric Rheumatology Study Group were asked to make a census of patients given ETN after January 2000. Patients were classified in three groups: group 1 = patients still taking ETN; group 2 = patients discontinued from ETN for any reasons; group 3 = patients lost to follow-up while receiving ETN. All three groups received a retrospective assessment; patients in group 1 also underwent a cross-sectional assessment. Results: 1038 patients were enrolled by 23 centers: 422 (40.7%) were in group 1, 462 (44.5%) in group 2, and 154 (14.8%) in group 3. Median duration of ETN therapy was 2.5 years. At cross-sectional assessment, 41.8% to 48.6% of patients in group 1 met formal criteria for inactive disease, whereas 52.4% of patients in group 2 and 55.8% of patients in group 3 were judged in clinical remission by their caring physician at last visit. A relatively greater proportion of patients with systemic arthritis were discontinued or lost to follow-up. Parent evaluations at cross-sectional visit in group 1 showed that 52.4% of patients had normal physical function, very few had impairment in quality of life, 51.2% had no pain, 76% had no morning stiffness, and 82.7% of parents were satisfied with their child's illness outcome. Clinically significant adverse events were reported for 27.8% of patients and ETN was discontinued for side effects in 9.5%. The most common adverse events were new onset or recurrent uveitis (10.2%), infections (6.6%), injection site reactions (4.4%), and neuropsychiatric (3.1%), gastrointestinal (2.4%), and hematological disorders (2.1%). Ten patients developed an inflammatory bowel disease and 2 had a malignancy. One patient died of a fulminant streptococcal sepsis. Conclusions: Around half of the patients achieved complete disease quiescence under treatment with ETN. The medication was overall well tolerated, as only one quarter of patients experienced clinically significant adverse events and less than 10% had treatment discontinued for toxicity