Italian Population Research Articles

Are Methylation Patterns in the KALRN Gene Associated with Cognitive and Depressive Symptoms? Findings from the Moli-sani Cohort.

The KALRN gene (encoding kalirin) has been implicated in several neuropsychiatric and neurodegenerative disorders. However, genetic evidence supporting this implication is limited and targeted epigenetic analyses are lacking. Here, we tested associations between epigenetic variation in KALRN and interindividual variation in depressive symptoms (PHQ9) and cognitive (MoCA) performance, in an Italian population cohort (N = 2409; mean (SD) age: 67 (9) years; 55% women). First, we analyzed the candidate region chr3:124584826-124584886 (hg38), within the KALRN promoter, through pyrosequencing of 1385 samples. Then, we widened the investigated region by analyzing 137 CpGs annotated to the whole gene, rescued from epigenome-wide (Illumina EPIC) data from 1024 independent samples from the same cohort. These were tested through stepwise regression models adjusted for age, sex, circulating leukocytes fractions, education, prevalent health conditions and lifestyles. We observed no statistically significant associations with methylation levels in the three CpGs tested through pyrosequencing, or in the gene-wide association analysis with MoCA score. However, we observed a statistically significant association between PHQ9 and cg13549966 (chr3:124106738; β (Standard Error) = 0.28 (0.08), Bonferroni-corrected p = 0.025), located close to the transcription start site of the gene. This association was driven by a polychoric factor tagging somatic depressive symptoms (β (SE) = 0.127 (0.064), p = 0.048). This evidence underscores the importance of studying epigenetic variation within the KALRN gene and the role that it may play in brain diseases, particularly in atypical depression, which is often characterized by somatic symptoms.

Validation and convergent validity of the Boston cognitive assessment (BOCA) in an Italian population: a comparative study with the Montreal cognitive assessment (MoCA) in Alzheimer's disease spectrum.

The Boston Cognitive Assessment (BOCA) is a self-administered online test developed for cognitive screening and longitudinal monitoring of brain health in an aging population. The study aimed to validate BOCA in an Italian population and to investigate the convergent validity with the Montreal Cognitive Assessment (MOCA) in healthy ageing population and patients within the Alzheimer Disease spectrum. BOCA was administered to 150 participants, including cognitively healthy controls (HC, n = 50), patients with mild cognitive impairment (MCI, n = 50), and dementia (DEM, n = 50). The BOCA reliability was assessed using (i) Spearman's correlation analysis between subscales; (ii) Cronbach's alpha calculation, and (iii) Principal Component Analysis. Repeated-measures ANOVA was employed to assess the impact of the sequence of test administrations between the groups. BOCA performance between HS, MCI and DEM and within different severity subgroups were compared using Kruskall Wallis test. Furthermore, a comparison was conducted between MCI patients who tested positive for amyloid and those who tested negative, utilizing Mann Whitney's U-test. Test scores were significantly different between patients and controls (p < 0.001) suggesting good discriminative ability. The Cronbach's alpha was 0.82 indicating a good internal consistency of the BOCA subscales and strong-to-moderate Spearman's correlation coefficients between them. BOCA total and subscores differ across different MoCA severity subgroups and demonstrated strong correlation with MoCA scores (rho = 0.790, p < 0.001). The Italian version of the BOCA test exhibited validity, feasibility, and accurate discrimination closely performing as MoCA.

Genotypic and Allelic Frequencies of Degenerative Myelopathy in an Italian Canine Population.

Canine degenerative myelopathy is a fatal neurodegenerative disorder that affects the spinal cord. It is a late-onset disease, with symptoms becoming evident later in life at approximately 8 years of age. The principal aim of this study was to retrospectively evaluate allelic and genotypic frequencies of the c.118G > A and c.52A > T mutations located on the SOD1 gene in an Italian canine population to provide detailed information on the prevalence of the mutations in the country. The genetic data of different breeds were collected through DNA tests over a nine-year period in the Italian canine population. For each dog, the breed, sex, age, and DNA test results were recorded. Allelic and genotypic frequencies were calculated. A total of 1667 DNA tests for the c.118G > A and c.52A > T mutations were carried out on 84 breeds. For the analysis of prevalence, only breeds counting more than 20 subjects have been considered, for a total of 1410 DNA tests obtained from 13 different breeds. In the population tested for the c.118G > A mutation, 65.47% (n. 893) of the subjects were clear, 25.59% (n. 349) were heterozygous carriers, and 8.94% (n. 122) were homozygous for the mutated allele. The mutation showed the highest frequency in Pembroke Welsh Corgis (55.49%) and the lowest frequencies in Poodles (6.32%) and Australian Shepherds (7.14%). The allelic frequency of the c.52A > T mutation was 7.61% in the Bernese Mountain dog. Neither variant differed between females and males in genotypic frequencies. The present study provides insights into the allelic and genotypic frequencies of canine degenerative myelopathy in different dog breeds in Italy.

Dietary Habits, Physical Activity and Body Mass Index in Transgender and Gender Diverse Adults in Italy: A Voluntary Sampling Observational Study.

Transgender and gender-diverse (TGD) individuals continue to experience harassment and discrimination across various aspects of life, significantly impacting their physical and mental health. The scarcity of data on their general health, particularly regarding dietary habits, remains a challenge in developing effective healthcare strategies for this population. To address this gap, we analyzed selected dietary habits, physical activity (PA), and body mass index (BMI) among Italian TGD adults compared to the Italian general population (IGP). An online anonymous survey was conducted via the Computer Assisted Web Interviewing technique from June 2020 to June 2021. Participants were enrolled through clinical centers and TGD organizations. Data from 959 TGD adults were analyzed using chi-squared tests and logistic regression models. Key findings indicated that approximately 70% of TGD individuals consumed fewer servings of fruit and vegetables (FV) than recommended (five or more servings per day). Although red meat consumption was lower overall, a greater percentage of TGD individuals reported consuming more than three servings per week. Additionally, 58% of TGD participants indicated that they did not engage in any PA, compared to 36% of the IGP. Notably, significant differences in BMI were identified, with higher rates of overweight and obesity among TGD individuals assigned female at birth. These results underscore the urgent need for tailored nutritional guidelines and inclusive public health strategies to meet the specific health needs of the Italian TGD population. Expanding access to targeted interventions could contribute to improving overall well-being in this marginalized group.

Apolipoprotein E and Alzheimer's Disease in Italian Population: Systematic Review and Meta-Analysis.

Objective: This meta-analysis with a systematic review was undertaken to assess the association between APOE allelic genotypes and the risk of Alzheimer's disease (AD) in the Italian population. Methods: The Web of Science, PubMed, and Scopus databases were searched until 15 November 2023. The odds ratio (OR) with a 95% confidence interval (CI) was calculated using fixed and random effect models, depending on the I2 statistic value. The systematic review and meta-analysis were conducted in agreement with the PRISMA guideline and registered with PROSPERO (CRD42023492580). Results: Our meta-analysis based on 15 studies revealed a higher risk of AD among Italian individuals carrying the APOE ε4 allele (OR = 3.60, 95% CI [2.90-4.47], p < 0.0001). The association of AD genotype APOE ε2ε4 (OR = 1.36, 95% CI [0.76-2.41], p = 0.29) was not statistically significant, while APOE ε3ε4 (OR = 3.43, 95% CI [2.95-3.99], p < 0.0001) has a high risk of AD development; the risk is more notably in the APOE ε4ε4 genotype (OR = 7.08, 95% CI [4.22-11.86], p < 0.0001). The APOE ε2 allele has a protective effect (APOE ε2 (OR = 0.47, 95% CI [0.29-0.74], p = 0.0013)), and similar results were achieved by APOE ε3 (OR = 0.49, 95% CI [0.37-0.65], p < 0.0001). Subgroup analysis of three areas of Italy (southern, northern, and center) revealed that that APOE ε4 allele was a risk factor with a higher OR in northern Italy (OR 4.22; 95% CI [3.46-5.16], p < 0.0001) compared to southern and center Italy (OR 3.02; 95% CI [2.28-4.01], p < 0.0001 and OR 3.97; 95% CI [1.37-11.56], p < 0.0001, respectively). As well, APOE ε4ε4 genotype carriers had a significantly higher OR in northern Italy (OR 9.69; 95% CI [4.94-18.99], p < 0.0001) compared to in southern and center Italy (OR 4.38; 95% CI [1.54-12.47], p < 0.0001 and OR 3.59; 95% CI [0.87-14.86], p < 0.0001, respectively). Conclusions: This systematic review with a meta-analysis of the Italian population on APOE alleles, genotyping, and AD incidence, highlights that individuals harboring APOE ε4 have a higher risk of developing AD compared to those with other alleles. It also supports the protective effect of the APOE ε2 allele against the progress of AD. The qualitative analysis on the complex genetic interactions influencing Alzheimer risk emphasizes the need for further research on genetic and environmental factors for effective prevention strategies.

The structure of motivation: Assessing readiness to change dimensions and their predictive value with the network validation of the Italian version of the Anorexia Nervosa Stages of Change Questionnarie.

Motivation to change is an important predictor for treatment outcomes in individuals with anorexia nervosa (AN), however, the existence and clinical relevance of distinct motivational dimensions are understudied. This study aimed to structurally validate the AN Stage of Change Questionnaire (ANSOCQ) in the Italian adult AN population to identify separate motivational dimensions and their association with clinical variables and outcomes. Inpatients and outpatients with AN (N=300) completed the ANSOCQ and measures assessing eating and depressive psychopathology. Unique Variable Analysis and Exploratory Graph Analysis were employed to identify dimensions in the network structure of ANSOCQ. Cross-sectional associations with clinical variables were assessed in the whole sample. Predictive value on weight and psychopathology was assessed in inpatients. Two dimensions were identified, one comprising items relative to weight gain, and the second items regarding attitudes towards eating, body, and emotional problems. Feelings associated with eating resulted as most central in the network. Higher scores in the first dimension and ANSOCQ total predicted weight gain during hospitalisation. No significant predictors emerged for changes in eating psychopathology. These findings confirm the robust psychometric properties of ANSOCQ and provide support for the use of its subdimensions in clinical practice.

Personal experiences with the national healthcare system and institutional trust in times of COVID‐19

AbstractWe conducted two studies to analyze the relations between dissatisfaction with experiences with the national healthcare system and trust in political (political parties and parliament), super partes (judiciary and police), and international (European Union [EU] and United Nations [UN]) institutions via the mediation of trust in the national healthcare system. Study 1 (longitudinal study on a quota sample of the Italian adult population, N = 689, surveyed in April 2021, T1, and in April 2022, T2) showed that dissatisfaction with experiences with the national healthcare system was negatively associated with trust in the national healthcare system, which, in turn, was positively associated with an increase in trust in political, super partes, and international institutions. Study 2 (between‐participant experimental design, N = 285) showed that priming a negative versus a positive experience with the national healthcare system decreased trust in this system, which, in turn, was positively associated with trust in political, super partes, and international institutions. The strengths, limitations, and possible development of this research are discussed.

RHO Variants and Autosomal Dominant Retinitis Pigmentosa: Insights from the Italian Genetic Landscape.

Autosomal dominant retinitis pigmentosa (AD-RP) is caused by several genes, among which RHO is one of the most investigated. This article will be focused on RHO and its role in explaining AD-RP cases in the Italian population, taking advantage of the experience of the Genomic Medicine Laboratory UILDM at the Santa Lucia Foundation IRCCS. The retrospective evaluation of the distribution of RHO variants in the Italian patients with a clinical suspicion of RP pointed out eight variants. Of them, four variants (c.632A>T, c.1040C>T, c.1030C>T, c.383_392del) were pathogenic and made it possible to confirm the diagnosis of AD-RP in nine affected patients, highlighting a lower frequency (17%) of RHO variants compared to previous studies (30-40%). In addition, this study identified four variants classified as Variants of Uncertain Significance (VUS). In conclusion, the experience of the Genomic Medicine Laboratory provides an overview of the distribution of RHO variants in the Italian population, highlighting a slightly lower frequency of these variants in our cases series compared to previous reports. However, further studies on RHO variants are essential to characterize peculiar RP phenotypes and extend the spectrum of disease associated with this gene.

Resistance to acetyl-CoA carboxylase (ACCase)-inhibiting herbicides in Lolium multiflorum Lam. populations of Argentina.

Italian ryegrass (Lolium multiflorum Lam.) is one of the most troublesome grass weeds in Argentina. The extensive and repetitive use of acetyl-CoA carboxylase (ACCase)-inhibiting herbicides has induced resistance in this weed species. The objectives of this study were to quantify the resistance levels to ACCase-inhibiting herbicides in two resistant populations and to identify the target-site mutations associated with their resistance. Two resistant Italian ryegrass populations, Roldán and H2, were studied. Roldán was a suspected haloxyfop-resistant population, located in a wheat field from Santa Fe province with a history of ACCase-inhibiting herbicide use. The H2 population was obtained from the susceptible Hernandarias population (H0) after two cycles of selection with the herbicide quizalofop-ethyl. Whole-plant dose-response assays revealed that the resistant populations exhibited a high resistance to haloxyfop, with resistance factors (RF) exceeding 97-fold. Additionally, both populations showed a moderate resistance to pinoxaden (RF > 7), while maintaining susceptibility to clethodim. Partial chloroplastic ACCase sequences revealed isoleucine-to-asparagine substitution at position 2041 (Ile-2041-Asn) in both resistant populations. This work provides a better understanding of cross-resistance to ACCase-inhibiting herbicides in L. multiflorum populations and represents the first report of the target-site mutation Ile-2041-Asn conferring resistance in populations from Argentina. © 2024 Society of Chemical Industry.

Health risk assessment for dietary exposure to 3-monochloropropane-1,2-diol, 2-monochloropropane-1,2-diol, and glycidol for Italian consumers

3-Monochloropropane-1,2-diol (3-MCPD), 2-monochloropropane-1,2-diol (2-MCPD) and 2,3-epoxy-1-propanol (glycidol), in their free form or esterified to fatty acids, are food contaminants formed during the refinement of oils and fats. We conducted a survey to quantify the levels of these compounds in 130 food items, in order to assess the exposure to them in food and the consequent health risk for consumers. Food samples, including infant formula, were analysed by gas-chromatography mass spectrometry with the indirect method, and we used the latest open access food consumption database for the Italian population for a probabilistic assessment of exposure. We adopted an in silico approach to fill the gap for the toxicity of 2-MCPD. The occurrence values for the three contaminants in food were in most cases lower than or comparable to those reported in previous surveys. Exposure assessment for the most exposed individuals (95thpercentiles of consumers only) of different age groups, gave values below the tolerable daily intake recommended by the European Food Safety Authority for 3-MCPD and below the simulated or predicted toxicity thresholds for 2-MCPD, indicating a negligible risk due to dietary exposure to these contaminants. For glycidol, however, estimated exposure indicated a non-negligible increase in cancer risk, and a margin of exposure <25,000 for younger population groups, indicating a potential health concern.

Long-term psychological implication of the COVID-19 pandemic: a network analysis among the Italian population

The enduring psychological impact of the COVID-19 pandemic is a subject of growing concern. Despite existing research highlighting immediate challenges, there is a lack of comprehensive studies elucidating specific pathways through which psychological variables contribute to the pandemic’s long-lasting implications. Through a network analysis approach, we aimed to investigate the mutual relationships and associations between eating disorder symptoms, guilt- and shame-proneness, psychopathological symptoms, self-esteem, defence mechanisms, and mentalization and understand how they might interact two years after the pandemic's outbreak. From March to August 2022, 651 Italian young adults (females = 593, 91.1%) aged between 18 and 38 (Mage = 23.84, SD = 3.74) were recruited online and completed a digital booklet of self-report questionnaires. A weighted, undirected graphical LASSO network was performed to investigate the structure of the nodes. A stable and accurate network structure showed that the most interconnected nodes were psychoticism, interpersonal sensitivity, obsessive-compulsive symptoms, depression, anxiety, paranoid ideation, and immature defences, suggesting their central role in the network functioning. Findings emphasized the enduring psychological impact of the pandemic, elucidating the complex interplay and dynamic impact of key psychopathological symptoms and defence mechanisms. The network tested also provides valuable insights for developing targeted interventions and effective strategies to address post-pandemic mental health challenges.

Awareness of cholesterol levels in 46,309 Italian children and adolescents unveils the tip of the iceberg.

Cardiovascular diseases (CVD) risk factors include high cholesterol. Childrenwith total cholesterol (TC) levels ≥ 170mg/dLare usually considered hypercholesterolemic. This study aimed at investigating the awareness of TC levels in a large Italian paediatric population and at looking for a possible correlation between their TC and TC in their parents' blood. A survey was carried out in 46,309 subjects (mean age 9.7 ± 2.3years; age range 6-14years) to check the awareness of their own TC levels by using a personal and family medical history questionnaire. In 95.67% of the sample TC value was unknown. In 2.69% TC was < 170mg/dL, whereas 1.64% were hypercholesterolemic (TC ≥ 170mg/dL). A statistically significant correlation was found between children with normal TC values and physiological TC values in both parents (p < 0.0001). Again, a significant association between children with high TC and their parents with high TC was detected when parents were analysed separately (i.e. children with TC ≥ 170mg/dl vs maternal TC ≥ 200mg/dL: OR 2.01 (95% CI 1.61-2.49, p < 0.001); children with TC ≥ 200mg/dl vs maternal TC ≥ 240mg/dL: OR 3.14 (95% CI 2.14-4.6, p < 0.001); children with TC ≥ 170mg/dl vs paternal TC ≥ 200mg/dL: OR 2.39 (95% CI 1.91-2.98, p < 0.001); children with TC ≥ 200mg/dl vs paternal TC ≥ 240mg/dL: OR 3.85 (95% CI 2.70-5,.50, p < 0.001). Just a minority of the investigated young patients knew their TC. This is worrisome. Children with normal TC values are more likely to be born from healthy parents with physiological TC. In addition, high TC in the enrolled subjects is significantly associated with high TC in their parents. Overall, these findings seem to highlight the importance of health education and genetics in TC pathogenesis.

A new species of yellow acorn ant discovered in Italy via integrative taxonomy (Temnothorax luteus-complex, Formicidae)

The Mediterranean, a global hotspot for rare ant species, hosts a significant representation of the global diversity of the mainly Holarctic ant genus Temnothorax. However, several groups still require significant taxonomic efforts. The taxonomy of the T. luteus complex species was revised in 2014 when morphometrics allowed distinguishing two valid species and two synonyms out of four taxa that had been originally described from France. The two species recognized since then are T. luteus, distributed from Iberia to the Alps, and the largely sympatric but much more xerothermophilic T. racovitzai. In Italy, only a few records of the complex were ever published, and the identity of the Italian population was never thoroughly assessed. We combined morphometrics with phylogenomic data to assess the identity of the T. luteus populations that spanned from Sicily to the Italian Alps and discovered that all Italian samples belong to a new cryptic species, which we describe as T. apenninicussp. nov. whose glacial refugium was probably in the southern Apennines.

What are the predictors of political incivility perceptions?

Incivility in public discourse has become a central concern. This research develops an approach based on citizens’ perceptions of incivility to assess predictors of such perceptions. Starting from a definition of the concept in a multidimensional sense, we identified different types of incivility that can be easily translated into operational terms (using vulgar/insulting language, referring to another politician with racist/sexist/religious epithets, lying/inventing facts to attack political opponents, and resorting to violence against political opponents). Through a survey of a representative sample of the Italian population, we found that citizens’ perception of incivility is not uniform but varies depending on the context and individual characteristics (socio-demographic variables, news consumption and relationship with politics). Overall, the importance of disentangling the concept into different types has emerged, because continuing to speak of ‘incivility’ in a broad sense does not help to clarify the phenomenon nor to identify the consequences for citizens’ relationship with politics.

Beyond population size: whole-genome data reveal bottleneck legacies in the peninsular Italian wolf.

Preserving genetic diversity and adaptive potential while avoiding inbreeding depression is crucial for the long-term conservation of natural populations. Despite demographic increases, traces of past bottleneck events at the genomic level should be carefully considered for population management. From this perspective, the peninsular Italian wolf is a paradigmatic case. After being on the brink of extinction in the late 1960s, peninsular Italian wolves rebounded and recolonized most of the peninsula aided by conservation measures, including habitat and legal protection. Notwithstanding their demographic recovery, a comprehensive understanding of the genomic consequences of the historical bottleneck in Italian wolves is still lacking. To fill this gap, we sequenced whole genomes of thirteen individuals sampled in the core historical range of the species in Central Italy to conduct population genomic analyses, including a comparison with wolves from two highly-inbred wolf populations (i.e., Scandinavia and Isle Royale). We found that peninsular Italian wolves, despite their recent recovery, still exhibit relatively low genetic diversity, a small effective population size, signatures of inbreeding, and a non-negligible genetic load. Our findings indicate that the peninsular Italian wolf population is still susceptible to bottleneck legacies, which could lead to local inbreeding depression in case of population reduction or fragmentations. This study emphasizes the importance of considering key genetic parameters to design appropriate long-term conservation management plans.

Trust under development: The Italian validation of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ) for adolescents.

In recent years, the concept of epistemic trust has emerged as a critical factor in understanding psychopathology, particularly within the context of personality disorders. A self-report instrument, the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ), has demonstrated its validity among English and Italian adult populations. However, extending its applicability to adolescents is essential for comprehending the role of epistemic trust in the development of mental disorders. The aim of this study was to validate the ETMCQ within the Italian adolescent demographic. Data were gathered from a wide selection of middle and high schools across Italy. The data collection started on 01/03/2022 and ended on 30/06/2022. Besides the ETMCQ (Study 1 = 662 participants, 12-18 years old, M = 15.56, SD = 2.20; 324 females, 338 males), we also administered other self-report instruments measuring mentalization, emotional dysregulation, general levels of psychopathology, and interpersonal trust in a smaller groups (Study 2 = 417 participants, aged from 12-19 years old, M = 15.64; SD = 2.08; 249 females, 168 males). Our findings provide empirical validation for the theoretical framework concerning the role of epistemic trust in psychological functioning and substantiate the validity of ETMCQ as a measure to assess it among teenagers. The ETMCQ is a valid and promising instrument for adolescent populations; its ease and brevity of administration could make it a valuable tool both in clinical and research contexts, shedding light on the role of epistemic trust in mental health.

Long-term effects of COVID-19 pandemic on physical activity and eating behaviour of the Italian population: a longitudinal study.

Restrictive measures due to the Covid-19 pandemic strongly impacted lifestyle and daily behaviour. The purpose of this longitudinal retrospective study was to investigate short-term and long-term effects of Covid-19 pandemic on physical activity and eating habits of the Italian population investigating three time periods: pre-, during- and post-lockdown. A sample of 2773 adults recruited through social media provided data by an online survey administered from July to October 2023. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Mediterranean Diet Adherence Screener (MEDAS) and provided information about eating habits, socio-demographic and anthropometric characteristics. There was a significant increase (p < 0.001) in mean BMI from pre-pandemic period (24.53 ± 5.34 Kg/m2) to post-pandemic period (25.22 ± 6.0 Kg/m2). Physical Activity significantly decreased during the pandemic period compared to the pre-pandemic period (χ² = 271.97; p < 0.001; φ = 0.31) with an increase in inactive subjects from 25.7% to 52.8%. In the post pandemic period, there was an increase in the level of Physical Activity compared to the pandemic period (χ² = 413.61; p < 0.001; φ = 0.39) with a reduction of inactive subjects from 52.8% to 25.6%. Adherence to Mediterranean Diet score significantly (p < 0.001) increase from pre-pandemic (7.18 ± 1.58) to during-pandemic (7.29 ± 1.69) and post-pandemic (7.75 ± 1.63) periods with significant differences emerged in the consumption of single MEDAS items during the pandemic period by different BMI classes. Consumption of seasonal fruit and vegetables, water intake, the preparation/consumption of traditional or local dishes and the time dedicated for dinner and lunch significant increase (p < 0.001) during pandemic. The Covid-19 pandemic changed people's lifestyles, but in different ways for Physical Activity and diet. During the pandemic there was a negative effect for PA that decreased while the time spent sitting increased. This seems to be a temporary effect as, after the end of the phase of mandatory restrictions, it returns to the original level. The lockdown period improved the quality of the Italian population's eating habits, with an increase in adherence to the Mediterranean diet even after the end of the pandemic showing a rediscovery of traditional dishes, increase in consumption of seasonal products, greater preference for local products and more time spent preparing meals.

Declining number of general practitioners can impair influenza vaccination uptake among Italian older adults: Results from a panel analysis

BackgroundSeasonal influenza vaccination coverage in Italian older adults is insufficient and well below the minimum target of 75%. In Italy, most influenza vaccine doses are administered by general practitioners (GPs), whose number has been declining. In parallel, the number of patients per GP and GP workload increased dramatically, which theoretically may impair vaccination counselling. In this ecological study, we aimed to assess whether influenza vaccination coverage in older adults is associated with the density of GPs having high number of patients.MethodsThe study outcome was the influenza vaccination coverage rate in adults aged ≥ 65 years and registered in 20 Italian regions over the last 23 years. The independent variable of interest was the proportion of GPs with more than 1,500 adult patients, which is an imposed normative ceiling. This latter variable was considered as a proxy of GP overload. By adopting a panel regression approach, different specifications of fixed- and random-effects models were run to assess the association of interest, when adjusted for several social structural, economic and healthcare-related variables.ResultsOver the last two decades, most regions showed a negative association between influenza vaccination coverage rates and the density of GPs with a high number of patients. This latter negative association was confirmed (P < 0.05) in different panel model specifications. In particular, in the fully adjusted two-way fixed-effects model, each 10% increase in the number of GPs with more than 1,500 patients was associated with a 1.7% decrease in influenza vaccination coverage. However, this association was present only in region-years where at least 18% of GPs were deemed overloaded.ConclusionsIn the upcoming years, the number of Italian GPs is projected to decline further. At the same time, the aging Italian population will determine an even greater workload for GPs. This study demonstrated that increased GP workload may partially explain the spatiotemporal variation in influenza vaccination uptake in the Italian elderly. With the imperative of increasing or at least maintaining influenza vaccination coverage rates, several short- and mid-term initiatives should be implemented in order to optimize GP workload during seasonal immunization campaigns.

Executive functions and addictions: a Structural Equation Modeling Approach and the Italian validation of the Adult Executive Functioning Inventory (ADEXI)

Introduction the work aims to observe the associations between psychoactive substance use and gambling and executive functioning as well as to validate the Italian version of the “Adult Executive Functioning Inventory” (ADEXI) scale. Methods data were collected through a representative cross-sectional study among 5,160 people (18-84 years old) called IPSAD® (Italian Population Survey on Alcohol and Other Drugs). Structural Equation Modeling (SEM) was performed to explore the associations between ADEXI and other behaviors measured with standardized questionnaires. Cronbach α has been performed to investigate the psychometric properties of the Italian version of the ADEXI scale. Results SEM showed that both WM and INH were correlated with problematic cannabis use (WM r = 0.112; INH r = 0.251) and gambling (WM r = 0.101; INH r = 0.168), while problematic alcohol use was correlated only with INH (r = 0.233). Cronbach α for the WM subscale was 0.833 (CI 0.826-0.840), while for INH was 0.694 (CI 0.680-0.708). Conclusion results pointed out a strong correlation between addictions (substance-related and non-substance-related) and WM and INH impairments among the adult general population. Moreover, the ADEXI scale could be considered a valuable tool for general population surveys to detect working memory and inhibition characteristics.

Monitoring of pathogenic Leptospira infection in wolves (Canis lupus) from Spain and Italy

Leptospirosis is a bacterial disease of worldwide distribution with relevant implications for animal and human health. Different large wild carnivore species can act as reservoirs of this zoonotic pathogen. This study aimed to evaluate the circulation of Leptospira spp. in free-ranging wolves (Canis lupus) from southern Europe. A total of 281 kidney samples of wolves from Spain and Italy were collected between 2017 and 2023. The presence of Leptospira DNA was analysed by real-time PCR and phylogenetic analyses were carried out using a Bayesian approach. The overall prevalence was 3.2 % (9/281; 95 %CI: 1.1–5.3). Leptospira DNA was detected in nine of the 180 wolves from Spain (5.0 %; 95 %CI: 1.8–8.2), but not in the Italian wolf population (0 %; 0/101). Molecular analyses revealed high homology between the sequences obtained in the present study and isolates of Leptospira interrogans and Leptospira borgpetersenii from different rodent and domestic ungulate species. Our results provide evidence of a low and spatially heterogeneous circulation of this pathogen in wolf populations of southern Europe. The detection of zoonotic Leptospira species in this survey supports the need to consider wolf populations in monitoring programs for leptospirosis with a One Health approach.