Random time-change with inverses of multivariate subordinators: governing equations and fractional dynamics

It is well-known that compositions of Markov processes with inverse subordinators are governed by integro-differential equations of generalized fractional type. This kind of processes are of wide interest in statistical physics as they are connected to anomalous diffusions. In this paper we consider a generalization; more precisely we mean componentwise compositions of $\mathbb{R}^d$-valued Markov processes with the components of an independent multivariate inverse subordinator. As a possible application, we present a model of anomalous diffusion in anisotropic medium, which is obtained as a weak limit of suitable continuous-time random walks.Comment: 24 page

Immunization against Hepatitis B Surface Antigen (HBsAg) in a Cohort of Nursing Students Two Decades after Vaccination: Surprising Feedback

Health-care students can be exposed to biological risks during university training. The persistence of long-term immunogenicity against hepatitis B virus (HBV) was analyzed in a cohort of nursing students two decades after primary vaccination. A total of 520 students were enrolled at the University of Palermo and were evaluated for levels of anti-HBsAg antibodies. ThestudentswereexaminedduringthefirstyearoftheirDegreeCourseandwerecheckedtwoyears later. All students with anti-HBsAg <10 mIU/mL during their first or third year were boosted within onemonth. Theproportionofstudentsthatwerevaccinatedduringadolescenceshowinganti-HBsAg ≥10 mIU/mL was higher than that observed in students who were vaccinated during infancy (69% versus31.7%;p-value<0.001). ReceivingHBVvaccinationatadolescencewassignificantlyassociated with a fourfold increased possibility of having anti-HBsAg titers≥10 mIU/mL (adj-OR = 4.21, 95% CI: 2.43–7.30). Among the students who were checked at the third year and boosted after the first year (n = 279), those who were vaccinated during infancy showed a higher percentage of antibody titers <10 mIU/mL (20.3% versus 8.7% among vaccinated during adolescence; p < 0.01). This study confirms that HBV vaccination at adolescence might determine a higher long-term persistence of anti-HBsAg titers≥10 mIU/mL and that anti-HBV booster could increase levels of anti-HBsAg over a relatively short period, especially in subjects who were vaccinated during infancy

Influenza vaccination in high-risk groups: a revision of existing guidelines and rationale for an evidence-based preventive strategy

Influenza, an infectious respiratory disease, is one of the main causes of excess winter deaths (EWDs) in Europe. Annual flu epidemics are associated with high morbidity and mortality rates, especially among the elderly, those with underlying health conditions and pregnant women. Health Care Workers (HCWs) are also considered at high risk of both contracting influenza and spreading the virus to vulnerable patients. During the 2014/2015 season, the excess winter mortality rates observed in countries of the northern hemisphere (EuroMOMO network) and in Italy (+13%) were strongly related to the intensity of influenza circulation. Influenza vaccination is the most important public health intervention to prevent seasonal influenza transmission and infection. However, to date, influenza vaccination coverage reported in Europe (including high-risk groups) is still largely unsatisfactory. This study analyzes some international and European guidelines on influenza vaccination and the rationale that underlies evidence- based public health intervention for the prevention of influenza among the principal high-risk groups: a) the elderly (subjects aged 65 years or older); b) subjects with underlying health conditions; c) pregnant women; d) healthcare workers. Only by achievement recommended influenza vaccination coverage among high-risk groups in all European countries can we reduce the burden of disease

Rationale of the WHO Document on Risk communication and community engagement (RCCE) readiness and response to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and of the Italian Decalogue for Prevention Departments

Not applicabl

The relevance for Public Health of the mid-term and interim analyses of seasonal influenza vaccination effectiveness

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WILLINGNESS TO RECEIVE COVID-19 VACCINATION IN COSTUMERS ACCESSING COMMUNITY PHARMACIES IN THE PROVINCE OF PALERMO, ITALY

In Italy, vaccination against COVID-19 began on December 27, 2020. To date, 13,713,224 people in Italy are fully vaccinated, which accounts for 25.3 % of the general population, and 44.8% received at least one vaccination dose. The present study aim to investigate willingness to receive COVID-19 vaccination in costumers accessing a sample of community pharmacies in the Province of Palermo, Italy. A self-administered and anonymous questionnaire was carried out among costumers older than 18 years old between December 2020 and March 2021. Three hundred and sixty-three subjects were enrolled in the study, 259 (71.3%) expressed their willingness to receive COVID-19 vaccination. The main determinants associated with vaccination acceptance resulted “trust in safety and effectiveness of vaccinations” and the absence of any previous negative vaccination experience. Unfavourable information on COVID-19 vaccination obtained through internet/media/social media and lack of confidence in COVID-19 vaccines and in the Italian national healthcare system are the main determinants associated with vaccine refusal. Male gender, younger age classes and influenza vaccination acceptance due to the impact of COVID pandemic were significantly associated with willingness to be vaccinated against COVID-19. In order to promote COVID-19 vaccination campaign accurate, informative and communicative campaign dedicated to subjects that are more hesitant regarding COVID-19 vaccination (e.g. female sex, adults, people that usually do not adhere to influenza vaccination campaign) should be implemented

Hospitalization rates for intussusception in children aged 0–59 months from 2009 to 2014 in Italy

The real cause of intussusception is not fully understood and a variety of conditions have been associated with it (Meckel diverticulum, polyps, duplication cysts, parasites, Henoch-Schönlein purpura, cystic fibrosis, hemolytic-uremic syndrome and infectious gastroenteritis). Furthermore few European countries, following WHO recommendation to monitor baseline incidence of intussusception before implementation of immunization program for rotavirus, used intussusception rate as a baseline value to compare the same figures in the period before and after introduction of vaccination. In this study, data of intussusception hospitalizations occurred among Italian children aged 0 through 59 months from 2009 to 2014 were analyzed. A total amount of 3,088 children were included, accounting for a hospitalization rate of 20.2 per 100,000. Overall, the hospitalization rate for intussusception had a slight increase in trend from 2009 to 2014 (18%). In particular children 0–11 months had a hospitalization rate higher than 12–59 months with an aggregate value of 36 Vs. 16 per 100,000 respectively. Among all children hospitalized for intussusception a total of 239 (7.7%) had also a previous or concomitant hospitalization for gastroenteritis. This study demonstrates that Italian hospitalizations for intussusception are increasing by time and the role played by different risk factors, including acute gastroenteritis, have to be investigated in the future. These data could be useful to monitor intussusception hospitalization in the perspective of anti-rotavirus vaccination introduction in Italy

Cost analysis of the first two year of universal mass vaccination against rotavirus in Sicily

Background Rotavirus vaccination (RV) is recognized by international health authority as the best strategy to prevent rotavirus gastroenteritis (RVGE) in children. Costs of RVGE were estimated in several studies and were classified into direct and indirect costs, that should be further divided into Health care and social perspective. This study aims to evaluate RVGE hospitalization costs in Sicily, before and after universal mass RV (UMRV) introduction. Methods Cases of RVGE were defined as all hospitalizations with an ICD-9-CM diagnosis code of 008.61 on any diagnosis position among children aged 0 to 59 months. Data were obtained from Hospital discharge records (HDR) of the Health Regional Office from 2009 to 2014. Direct and indirect costs of RVGE hospitalization for health care and social perspective were calculated on data reported in the REVEAL study. RV costs was extrapolated from a budget impact analysis published in 2013 by Vitale et al. Results In Sicily, during the pre-vaccination era (2009-2012) were reported 963 RVGE hospitalizations per year with a mean HDR cost of 1,521E (1,465,000E per year) , against 511 RVGE cases per year (mean HDR cost of 1,321E; 675,000E per year) after UMRV introduction (direct hospitalization Health care costs). Moreover, direct and indirect hospitalization costs for social perspective was estimated 1.5 times bigger than direct hospitalization health care cost (pre-vaccination era 2,255,000E per year, post-vaccination era 1,020,000E per year). Finally, cost of RV vaccine in Sicily in 2013 and 2014 was 1,300,000E per year (mean vaccination coverage 37%). In Sicily after RV introduction, every year was estimated a 46% reduction of RVGE hospitalizations and a 700,000E benefit for Regional fund. Conclusions Despite low vaccination rate and even though the inability to evaluate the impact of RV vaccination on primary care and emergency access for RVGE, our study demonstrated the high cost-effectiveness of UMRV on hospitalization rate and costs in Sicily