Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study

Burnout syndrome (BOS) is a work-related constellation of symptoms characterized by emotional exhaustion, depersonalization, and personal accomplishment. A cross-sectional survey was performed to study the prevalence of BOS among a randomly selected sample of 280 Italian Red Cross volunteers. A socio-demographic questionnaire and the Maslach Burnout Inventory (MBI)-HSS were used to collect data. 241 volunteers participated (response rate: 86.1%). A significant proportion of the workers had BOS subscale scores in the highest tertile: emotional exhaustion 8.0%, depersonalization 35.9% and perceived lack of accomplishment 23.5%, respectively. Volunteers in emergency care reported higher levels of emotional exhaustion (p=0.004) and depersonalization (p=0.001), and lower level of personal accomplishment (p=0.042) than volunteers engaged in non-healthcare social and administrative duties. These findings support the opportunity of a set of administrative, organizational and individual preventive interventions for emergency volunteers' mental health.

Effects of Bariatric Surgery on COVID-19: a Multicentric Study from a High Incidence Area

Introduction

The favorable effects of bariatric surgery (BS) on overall pulmonary function and obesity-related comorbidities could influence SARS-CoV-2 clinical expression. This has been investigated comparing COVID-19 incidence and clinical course between a cohort of patients submitted to BS and a cohort of candidates for BS during the spring outbreak in Italy.

Materials and Methods

From April to August 2020, 594 patients from 6 major bariatric centers in Emilia-Romagna were administered an 87-item telephonic questionnaire. Demographics, COVID-19 incidence, suggestive symptoms, and clinical outcome parameters of operated patients and candidates to BS were compared. The incidence of symptomatic COVID-19 was assessed including the clinical definition of probable case, according to World Health Organization criteria.

Results

Three hundred fifty-three operated patients (Op) and 169 candidates for BS (C) were finally included in the statistical analysis. While COVID-19 incidence confirmed by laboratory tests was similar in the two groups (5.7% vs 5.9%), lower incidence of most of COVID-19-related symptoms, such as anosmia (p: 0.046), dysgeusia (p: 0.049), fever with rapid onset (p: 0.046) were recorded among Op patients, resulting in a lower rate of probable cases (14.4% vs 23.7%; p: 0.009). Hospitalization was more frequent in C patients (2.4% vs 0.3%, p: 0.02). One death in each group was reported (0.3% vs 0.6%). Previous pneumonia and malignancies resulted to be associated with symptomatic COVID-19 at univariate and multivariate analysis.

Conclusion

Patients submitted to BS seem to develop less severe SARS-CoV-2 infection than subjects suffering from obesity.

Wearable Exoskeletons on the Workplaces: Knowledge, Attitudes and Perspectives of Health and Safety Managers on the implementation of exoskeleton technology in Northern Italy

BACKGROUND

Exoskeleton technology (ExT) has potential to significantly improve occupational health and safety. However, studies on stakeholders' perspectives are lacking. To facilitate the implementation of ExT on the workplaces, a study was undertaken exploring specific knowledge, attitudes and perspectives (KAP) of Health and Safety Consultants (HSC).

METHODS

An online survey with quantitative and qualitative components was conducted with HSC participating to a series of qualification courses focusing on new technologies in occupational settings. Respondents rated whether they would use or recommend an exoskeleton, being assessed regarding their knowledge on ExT through a specifically designed knowledge test. Design features (n = 16) and expected benefits (n = 12) were rated and compared in terms of their importance. Regression analysis was used to identify factors significantly affecting the propensity towards the implementation of ExT.

RESULTS

A total of 59 HSC participated to the survey (participation rate, 90.8%): of them, 20 (33.9%) were somehow favorable towards the use of ExT on the workplaces. The most highly rated reason for potential use/recommendation of ExT was reducing the stress on joints and tendons (74.6%), followed by reducing muscle fatigue (71.2%). Among design features, higher ratings were identified for: comfort (4.53 ± 0.68), ease of setup (4.37 ± 0.72), portability (4.32 ± 0.97), minimization of falls risk (4.31 ± 0.93), ease of putting on/taking off the device (4.12 ± 1.16), and amount of physical energy needed for use (4.14 ± 0.92). Overall knowledge of ExT was quite low (knowledge score 43.2% ± 18.2), with high rate of false beliefs on the protective role of ExT on musculoskeletal disorders and physical efforts, positive effects on productivity. In multivariate analysis, age < 50 years and being an internal HSC were identified as significant effectors for a positive attitude towards ExT.

CONCLUSIONS

This study emphasizes the opportunity to spread better knowledge of actual ExT features among potential stakeholders. Moreover, design of future exoskeleton should focus on devices comfortable, highly portable, ease to setup, with a reduced risk of falls.

Occupational Eye Injuries in the agricultural settings: a retrospective study from North-Eastern Italy

Background: Occupational Eye Injury (OEI) represents a common world-wide event accounting for between 3.3% and 6.1% of all occupational compensation claims. In this retrospective study we evaluated all the recorded OEI which occurred in the Autonomous Province of Trento (APT) during the period 2000-2013. Methods: Data on OEI for all of APT were retrieved an institutional archive and the analysis included demographics of the injured, as well as characteristics and settings of the OEI. In order to assess the risk of OEI in Agricultural Workers (AWs) vs. all other Occupational groups, a multivariate analysis was eventually performed through a logistic regression analysis. Results: A total of 141,139 work-related injuries were recorded, including 5,065 (3.6%) OEI. 91.9% of all cases occurred in males, of Italian origin (77.2%), with a mean age of 38.4±11.7 years. The industrial sector reported the higher share of OEI (70.7%), whereas higher incidence rates were reported among AWs (6.04 vs. 3.85/1,000 workers/year). Agricultural OEI occurred in older workers (45.6±13.3 vs. 37.1±11.0 years), being more likely associated with “contusions” (OR 2.042, 95% 1.602-2.602) and “lacerations” (OR 2.386, 95%CI 1.877-3.033), and less frequently with exposures to chemicals, gases and vapours (OR 0.478, 95%CI 0.279-0.817). Conclusions: Despite a relatively low frequency of OEI, AWs were affected with a seemly higher incidence than that reported in other occupational groups. OEI in AWs exhibited a specific pattern, both in terms of lesion, and settings of the events, recommending tailored interventions in order to improve promotion strategies. (www.actabiomedica.it)

Incomplete hippocampal inversion and epilepsy: A systematic review and meta-analysis

OBJECTIVE

Incomplete hippocampal inversion (IHI) is a relatively frequent radiological finding at visual inspection in both epilepsy and healthy controls, but its clinical significance is unclear. Here, we systematically retrieve and assess the association between epilepsy and IHI using a meta-analytic approach. Additionally, we estimate the prevalence of IHI in patients with malformation of cortical development (MCD).

METHODS

We systematically searched two databases (Embase and PubMed) to identify potentially eligible studies from their inception to December 2019. For inclusion, studies were population-based, case-control, observational studies reporting on epilepsy and IHI. The risk of developing epilepsy in IHI (estimated with odds ratio [ORs]) and the frequency of IHI among patients with MCD are provided.

RESULTS

We screened 3601 records and assessed eligibility of 2812 full-text articles. The final material included 13 studies involving 1630 subjects. Seven studies (1329 subjects: 952 epileptic and 377 nonepileptic) were included for the estimation of the risk of developing epilepsy in the presence of IHI. The estimated OR of active epilepsy in IHI was 1.699 (95% confidence interval = 0.880-3.281), with moderate heterogeneity across studies (I²  = 71%). Seven studies (591 patients) provided information about the frequency of IHI in MCD. Up to one third of patients with MCD (27.9%) presented coexistent IHI.

SIGNIFICANCE

The present findings confirm that IHI is commonly observed in patients with MCD especially in periventricular nodular heterotopia or polymicrogyria. However, the estimated OR indicates overall weak increased odds of epilepsy in people with IHI, suggesting that the presence of isolated IHI cannot be considered a strong independent predictor for epilepsy development. Clear-cut neuroradiological criteria for IHI and advanced postprocessing analyses on structural magnetic resonance imaging scans are recommended to highlight differences between epileptogenic and nonepileptogenic IHI.

Factors influencing the willingness to perform bystander cardiopulmonary resuscitation on the workplace: a study from North-Eastern Italy

Background:

Early bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival. However, few data are available regarding the willingness to perform CPR among First Aid Attendants on the Workplace (FAAWs) in Italy. The present study was performed in order to identify current attitudes of Italian FAAWs towards CPR.

Methods:

Between February and June 2017, FAAWs from the Autonomous Province of Trento were asked about their willingness to perform CPR through a structured questionnaire assessing their knowledge about CPR, and the reasons for hesitancy. A cumulative knowledge score (KS) was eventually calculated.

Results:

A total of 123 FAAWs (male 57.7%, mean age 45.2 years ± 10.1) completed the questionnaire. About 1/3 of participants (32.5%) had previously performed First Aid procedures. Overall, 77.2% exhibited willingness to perform CPR, and such attitude was more frequently reported by subjects younger than 40 years (29.5% vs. 10.7% in older subjects; p=0.045), perceiving First Aid training as useful (98.9% vs. 84.7%, p=0.002), and exhibiting a better knowledge of CPR (KS≥75%: 47.4% vs. 15.3%). The reasons for the unwillingness were inadequate knowledge and doubt regarding whether they could perform the techniques effectively. Eventually, KS was identified as the main predictor for willingness to perform CPR (OR 4.450, 95%CI 1.442-14.350).

Conclusions:

Willingness to perform CPR was seemingly high, and knowledge of CPR techniques was its main predictor. These findings emphasize the importance for an accurate CPR training, as well as for the surveillance of the quality of qualification courses.(www.actabiomedica.it)

Understanding leprosy in a nonendemic area: a pilot study on knowledge, attitudes, beliefs of medical professionals from North-Western Italy

Background:

Describing knowledge, attitudes and beliefs about leprosy amongst Medical Professionals in a nonendemic area (Parma Province, North-Western Italy).

Methods:

A cross-sectional study was carried among a sample of Medical Professionals (MP; No. 242) during June and July 2019 as an on-line self-administered questionnaire including 21 true/false items about epidemiology, diagnosis, and clinical characteristics of leprosy. Effectors of better knowledge status (KS) and higher risk perception (RP) were assessed through calculation of respective multivariate odds ratios (OR) and 95% confidence intervals (95%CI) in two logistic regression analysis models.

Results:

A total of 102 questionnaires were retrieved (participation rate 42.1%; 67.6% of respondents <50 year-old). Of them, 10.8% had previously interacted with at least one leprosy case. Knowledge status (KS) was unsatisfying (59.7% correct answers), and also RP was relatively low, as 91.2% of them acknowledged leprosy as a severe disease, but only 42.2% identified leprosy as highly communicable. Knowledge gaps affected particularly understanding of epidemiology and non-dermatological issues. Moreover, 30.4% of respondents ignored that a treated leprosy case may remain in the community before disease eradication. The main effector of KS was having interacted with a leprosy case (OR 4.881 95%CI 1.245-36.905), while RP was negatively associated with a better KS (OR 0.094 95%CI 0.027-0.334), and working as general practitioner (OR 0.133 95%CI 0.031-0.562).

Conclusions:

While individual expertise of European MP on leprosy slowly disappears, significant knowledge gaps and the high share of misconceptions collectively stress that refresher training may improve early diagnosis and management of incident cases. (www.actabiomedica.it)

Surgery vs. chemotherapy for ovarian cancer recurrence: what is the best treatment option

Nowadays, the best treatment option for ovarian cancer recurrence is often subjective, can vary in the different centers and depend on personal experience. Arbeitsgemeinschaft Gynaekologische Onkologie (AGO)-DESKTOP studies have identified a population of patients who could benefit from secondary surgery. The results of the Gynecologic Oncology Group (GOG)-0213 study were recently published, which showed no advantage in terms of overall survival (OS) in patients with platinum-sensitive recurrent epithelial ovarian undergoing secondary cytoreductive surgery (SCS) compared to chemotherapy alone. Aim of this narrative review is to summarize the best aspects that can make ovarian cancer recurrence patients suitable for SCS. A narrative review analyzing all the literature of the past 30 years has been performed. PubMed, Scopus, Web of Science and Ovid MEDLINE were used for research. All non-English-language articles have been excluded. The following keywords were searched: 'recurrent ovarian cancer', 'secondary surgery', 'secondary cytoreductive surgery', 'platinum-sensitive ovarian cancer', 'platinum-resistant ovarian cancer'. We divided eligible patients for secondary cytoreduction in relation to the following factors: platinum-sensitivity, AGO-score or Tian model, unresectable lesions, surgical generic contraindication, woman's personal choice. The selection of truly suitable patients for surgery seems an essential requirement for the patient's best therapeutic choice. In case of absent post-surgical residual tumor, good performance status, single recurrence, and platinum-sensitive ovarian recurrence, surgery could be performed.

Vaccine hesitancy in COVID-19 times. An update from Italy before flu season starts

The COVID-19 pandemic and response caused a worrying decline in vaccine uptake around the world. In Italy, the immunization coverage targets set in the 2017-19 National Immunization Prevention Plan (PNPV) have been met only partially. The current public health emergency is likely to have negatively impacted on immunization , with the risk of re-occurrence of Vaccine-Preventable Diseases (VPDs) outbreaks. As flu season approaches, both National Health Institutions  and the scientific community in Italy have taken action. Well in advance as compared to previous years, the Ministry of Health released  the Circular to launch the 2020-2021 influenza immunization campaign which this year is longer (starting on October 2020) and extends flu vaccine recommendations to more  "at risk" subgroups, offered the vaccine free of charge. In addition, some Italian Regions have recently tried to make  flu vaccination compulsory for all Healthcare Workers (HCWs). Since 2017, when the law on childhood vaccination in Italy was passed, compulsory vaccination has proved to be a successful strategy towards coverage increase.

Prevalence of Parkinson Disease in Italy: a systematic review and meta-analysis

Introduction:

Parkinson’s disease (PD) is a common disease of unknown etiology. Even though accurate information on the epidemiology of PD is critical for defining appropriate health policies, epidemiological data on Parkinson’s disease (PD) in Italy are often defined as scant or conflicting. Our study attempted to provide an overview on the prevalence of (PD) by means of a systematic review and metanalysis of existing data.

Material and methods:

We searched into two different databases (PubMed and EMBASE), focusing on studies reporting the prevalence of PD in Italy. Data were extracted using a standardized assessment form, and results of such analyses were systematically reported, summarized and compared.

Results:

A total of 16 studies were eventually included in the analyses, with a prevalence rate of 193.7/100,000. Available reports were heterogeneous both in design and in eventual figures, and also prevalence estimates were affected by substantial heterogeneity. Interestingly, prevalence rates ranged from 37.8/100,000 inhabitants in subjects aged 0 to 64 years, to 578.7 in age group 65 to 75 years, and 1235.7 in age group 75 years or older. PD was significantly associated with male sex, but only in older age groups (i.e. Odds Ratio, OR 1.37 95%CI 1.22-1.53, and OR 1.31, 95%CI 1.21-1.42 for age groups 65-74 years and 75 years or more, respectively).

Discussion and conclusion:

While the observed variations in prevalence rates may result from environmental or genetic factors, differences in methodologies for case ascertainment and diagnostic criteria may have significantly affected our estimates. As a consequence, the comparability of existing studies is limited.

RT-qPCR assays based on saliva rather than on nasopharyngeal swabs are possible but should be interpreted with caution: results from a systematic review and meta-analysis

BACKGROUND AND AIM OF THE WORK

The ongoing pandemic has elicited an increasing interest regarding the SARS-CoV-2 viral RNA detection in saliva specimens rather than through nasopharyngeal swabs. Our aim was to conduct a meta-analysis on the sensitivity and specificity of SARS-CoV-2 viral RNA detection through RT-qPCR based on salivary specimens compared to conventional nasopharyngeal swabs.

METHODS

We reported our meta-analysis according to the PRISMA statement. We searched Pubmed, Embase, and pre-print archive medRxiv.og for eligible studies published up to June 1st, 2020. Raw data included true/false positive and negative tests, and the total number of tests. Sensitivity and specificity data were calculated for every study, and then pooled in a random-effects model. Heterogeneity was assessed using the I2 measure. Reporting bias was assessed by means of funnel plots and regression analysis.

RESULTS

The systematic review eventually retrieved 14 studies including a total of 15 estimates, the were included in quantitative synthesis. We found a pooled specificity of 97.7% (95%CI 93.8-99.2) and a pooled sensitivity of 83.4% (95%CI 73.1-90.4), with an overall agreement assessed by means of Cohen's kappa equals to 0.750, 95%CI 0.62-0.88 (i.e. moderate agreement), with high heterogeneity and risk of reporting bias.

CONCLUSIONS

In conclusion, diagnostic tests based on salivary specimens are somewhat reliable, but relatively few studies have been carried out. Moreover, such studies are characterized by low numbers and low sample power. Therefore, the of salivary samples is currently questionable for clinical purposes and cannot substitute other more conventional RT-qPCR based on nasopharyngeal swabs.

Knowledge, Attitudes, Practices (KAP) of Italian Occupational Physicians towards Tick Borne Encephalitis

Tick-Borne Encephalitis (TBE) is an occupational health threat with increasing incidence in the geographic area of Italy. Despite this, TBE vaccination rates have ranged from 10% to 40% in Italy, even in at-risk workers. The reasons for this low rate are investigated in this present study of the knowledge, attitudes, and practices of occupational physicians (OP) regarding TBE disease and vaccination in at-risk workers. A total of 229 OP participated in an internet-based survey by completing a structured questionnaire. Adequate general knowledge of TBE disease was found in 58% of OP. Accurate perception of TBE risk in occupational settings was found in 20%. TBE vaccination for at-risk workers was recommended by 19%. Willingness to recommend TBE vaccination was more likely by OP practicing in endemic areas (Odds Ratio 3.10, 95% confidence intervals 1.47–6.55), who knew the existence of the term “arboviruses” (3.10, 1.29–7.44), or exhibited a better understanding of TBE (2.38, 1.11–5.12)—and were positive predictors for promoting TBE vaccine, while acknowledging that TBE as a severe disease was a negative one. Tick-borne disorders in Italy are a still rare (but increasing) occupational health threat, and vaccination gaps for TBE virus may find an explanation in OP incomplete knowledge of evidence-based recommendations.

Air temperatures and occupational injuries in the agricultural settings: a report from Northern Italy (Po River Valley, 2013-2017)

Introduction:

High environmental temperatures are associated with an increased risk for occupational injuries (OIs), particularly where environmental exposure and heat sources in the workplace, are associated with internal heat generation by strenuous muscular work. As a consequence, Agricultural Workers (AWs) are among the most heavily affected occupational groups.

Methods and aims:

The aim of this study was to assess the relationship between environmental temperatures and OIs in AWs from the Po River Valley in the Northern Italy (27,736,158 total inhabitants; mean agricultural workforce of 312,195.6 individuals). Data about OIs from 2013 to 2017, and daily weather for the administrative unit of occurrence were retrieved. Days were classified by a) mininum (Tmin) / maximum (Tmax) air temperatures; b) average day temperature (Tday); c) daily temperature variation (TV), d) relative humidity. Risk for daily OIs was calculated as correspondent Odds Ratios (OR) through a Poisson regression model.

Results:

Estimated incidence for OIs was 66.3/1,000 workers-year. In regression analysis, for every Tday percentile increase equal to 2.5, an OR 1.007 (95% CI, 1.003 to 1.010) was reported. More precisely, higher risk for OIs was associated to Tmax > 25°C (OR 1.143, 95%CI 1.125-1.160) and to Tmax > 25°C + Tmin > 20°C (OR 1.158, 95%CI 1.138-1.179), Tmin < 0°C were associated with a significantly reduced risk (OR 0.879, 95%CI 0.850-0.910), with the notable exception of older age groups (OR 1.348, 95%CI 1.254; 1.449). During timeframes characterized by Tmax > 35°C (i.e. HW time period), the risk was higher during the first day (OR 1.266; 95%CI 1.206-1.330), and again from the fourth day onwards (OR 1.090; 95%CI 1.048 – 1.133). Analysis of TV identified an increased risk for occupational injuries in days characterized by higher variability, and particularly for TV ranging 4.0 – 4.9 (OR 1.042, 95%CI 1.017 – 1.068), and equals to 5.0 or greater (OR 1.143, 95%CI 1.118 – 1.167). Also increased relative humidity was associated with higher risk for OIs (OR 1.096, 95%CI 1.081-1.126, and OR 1.154, 95%CI 1.135-1.173 for relative humidity 70 – 89%, and ≥ 90%).

Conclusions:

Our findings recommend policymakers to develop appropriate procedures and guidelines, in particular for the HW time periods. (www.actabiomedica.it)

COVID-19 knowledge prevents biologics discontinuation: Data from an Italian multicenter survey during RED-ZONE declaration

SARS‐CoV‐2 become pandemics and there is still a dearth of data about its the potentially among dermatological patients under biologics. We aimed to assess health literacy, disease knowledge, treatment dissatisfaction and biologics attitudes toward COVID‐19. We performed a cross‐sectional, questionnaire‐based survey on 98/105 consecutive dermatological patients treated with biologics—51 suffering from plaque psoriasis, 22 from atopic dermatitis, and 25 from hidradenitis suppurativa. An ad hoc, validated questionnaire has 44 items investigating the following domains: knowledge of COVID‐19 related to (a) epidemiology, (b) pathogenesis, (c) clinical symptoms, (d) preventive measures, and (e) attitudes. Patients data and questionnaires were collected. Despite only 8.1% thought that biologics may increase the risk of COVID‐19, 18.4% and 21.4% of the patients were evaluating the possibility to discontinue or modify the dosage of the current biologic therapy, respectively. Globally, male patients (P = .001) with higher scholarity level (P = .005) displayed higher knowledge of COVID‐19. Patients with lower DLQI (P = .006), longer disease duration (P = .051) and lower scholarity (P = .007) have thought to discontinue/modify autonomously their biologic therapy. At the multivariate logistic regression, only the knowledge of epidemiology and preventive measures resulted independent predictors of continuation vs discontinuation and modification vs no modification, respectively. Dermatologists should promote COVID‐19 knowledge to prevent biologics disruption.

Point-of-Care Diagnostic Tests for Detecting SARS-CoV-2 Antibodies: A Systematic Review and Meta-Analysis of Real-World Data

SARS-CoV-2 is responsible for a highly contagious infection, known as COVID-19. SARS-CoV-2 was discovered in late December 2019 and, since then, has become a global pandemic. Timely and accurate COVID-19 laboratory testing is an essential step in the management of the COVID-19 outbreak. To date, assays based on the reverse-transcription polymerase chain reaction (RT-PCR) in respiratory samples are the gold standard for COVID-19 diagnosis. Unfortunately, RT-PCR has several practical limitations. Consequently, alternative diagnostic methods are urgently required, both for alleviating the pressure on laboratories and healthcare facilities and for expanding testing capacity to enable large-scale screening and ensure a timely therapeutic intervention. To date, few studies have been conducted concerning the potential utilization of rapid testing for COVID-19, with some conflicting results. Therefore, the present systematic review and meta-analysis was undertaken to explore the feasibility of rapid diagnostic tests in the management of the COVID-19 outbreak. Based on ten studies, we computed a pooled sensitivity of 64.8% (95%CI 54.5-74.0), and specificity of 98.0% (95%CI 95.8-99.0), with high heterogeneity and risk of reporting bias. We can conclude that: (1) rapid diagnostic tests for COVID-19 are necessary, but should be adequately sensitive and specific; (2) few studies have been carried out to date; (3) the studies included are characterized by low numbers and low sample power, and (4) in light of these results, the use of available tests is currently questionable for clinical purposes and cannot substitute other more reliable molecular tests, such as assays based on RT-PCR.

Stop playing with data: there is no sound evidence that Bacille Calmette-Guérin may avoid SARS-CoV-2 infection (for now)

Since the beginning of the COVID-19 epidemic, a possible explanation for the high heterogeneity of infection/mortality rates across involved countries was hinted in the prevalence of tuberculosis vaccination with Bacille Calmette-Guérin (BCG). A systematic review was therefore performed on May 2, 2020. A total of 13 articles were ultimately retrieved, 12 of them as preprint papers. All articles were ecological studies of low quality. Most of them did not include main confounding factors (i.e. demographic of the assessed countries, share of people residing in urban settings, etc.), and simply assessed the differences among incidence/mortality of COVID-19 with vaccination rates or by having vs. having not any vaccination policy for BCG. Even though all studies shared the very same information sources (i.e. international registries for BCG vaccination rates and open source data for COVID-19 epidemics), results were conflicting, with later studies apparently denying any true correlation between COVID-19 occurrence and BCG vaccination rates and/or policies. As a consequence, there is no sound evidence to recommend BCG vaccination for the prevention of COVID-19. (www.actabiomedica.it)

Point-of-Care diagnostic of SARS-CoV-2: knowledge, attitudes, and perceptions (KAP) of medical workforce in Italy

INTRODUCTION

The present study aims to characterize knowledge, attitudes and beliefs in a sample of medical professionals towards point-of-care (POC) rapid tests for SARS-CoV-2 in Italy (April 2020).

MATERIAL AND METHODS

A total of 561 professionals (42.6% males, 26.9% ≥ 50-year-old) compiled a specifically designed web questionnaire on characteristics of POC rapid tests. They were asked whether they would change daily practice and make clinical decisions according to POC tests. Multivariate odds ratios (aOR) for predictors of propensity towards the aforementioned behavioral outcomes were calculated through regression analysis.

RESULTS

Overall, only 51.9% knew the official recommendations of the Italian Health Authorities for POC tests, while 26.0% of respondents considered POC tests for COVID-19 highly reliable. Still, 40.3% of respondents would change daily practice because of such tests, and 38.5% would make clinical decisions based of their results. Actual understanding of specificity and sensitivity of POC tests was not associated with assessed behavioral outcomes: main positive effectors were identified in perceived reliability and usefulness of rapid tests, acknowledging the existence of official recommendations, understanding the limited clinical implications of POC tests, and working as occupational physicians were characterized as negative effectors.  Conclusions. Propensity of sampled professionals towards POC tests for COVID-19 was diffusely unsatisfying. While actual understanding of accuracy of such tests was not a main effector of propensity, previous experiences with other POC tests in daily practice, particularly among occupational physicians may have impaired overall acceptance of such instruments.

Prevalence of Huntington Disease in Italy: a systematic review and meta-analysis

Worldwide prevalence of Huntington’s disease (HD) is quite heterogenous. As Italy is characterized by significant genetic heterogeneity, with presumptive differences between Italian regions, this review was undertaken to define available data of HD prevalence in Italy, to assess geographic heterogeneity, and reconcile possible variation in HD prevalence rates with the availability of genetic testing.

Vaccines are underused in pregnancy: what about knowledge, attitudes and practices of providers?

Introduction.

To investigate actual knowledge of official recommendations towards seasonal influenza (SID), and Tetanus-diphtheria acellular-pertussis (Tdap) vaccines in obstetrics/gynecologists (OBGYN).

Methods.

PubMed and EMBASE databases were searched. A meta-analysis was performed to calculate odds ratio (OR) and 95% confidence interval (CI) among case controls, cross-sectional studies, either questionnaire or laboratory exams based.

Results.

A total of 6 studies met inclusion criteria, including 1323 OBGYN from 5 different countries. Overall, around 99% of sampled professionals were aware that official recommendations towards SID in pregnancy do exist, compared to 92% for Tdap, with significant heterogeneity (I² > 95%, p < 0.001). Concerns about vaccine safety was reported by 10% of respondents for Tdap, and by 6.0% for SID, but again available studies were substantially heterogenous (I² = 86.7% and 86.0%, p < 0.001). Eventually, 93% of respondents actively recommended SID in pregnancy, compared to 88% for Tdap (I² 98.8% and I² 95.9%, respectively p < 0.001). The evidence of significant publication bias was initially subjectively identified from the funnel plot, and then objectively confirmed through the regression test for all analyses.

Conclusions.

These results suggest an appropriated understanding of official recommendation among sampled OBGYN, with high shares of professionals actively promoting vaccination practices among their patients. Despite the high heterogeneity and the significant publication bias we identified, our results also hint towards extensive knowledge gaps of OBGYN, and particularly regarding unmotivated concerns about vaccine safety. As a consequence, appropriate information and formation campaigns should be appropriately tailored. (www.actabiomedica.it)