Italian Situation Research Articles

Burden of COVID-19 and Vaccination Coverage in the Italian Population as of October 2021.

Following the pandemic scenario, researchers from all over the world, including Italians, have undertaken fervent research activity using the epidemiological data available on the sites of government and national and international research institutes. The objectives of our study were: (1) to analyze the load and trend of the COVID-19 pandemic in Italy, from the beginning to October 2021; (2) to analyze vaccination coverage by age groups and types of vaccines administered and check how the vaccination campaign has influenced the course of the disease and deaths; (3) to evaluate the Italian situation in the European context, comparing the incidence and mortality of Italy with respect to European countries; (4) finally, to evaluate how much vaccination coverage may have had an effect on mortality in the various European countries. Databases were structured to archive Italian and European COVID-19 data provided by Our World in Data, and data came from the Ministry of Health, to evaluate percentage of vaccines administered. The monthly trend of the cumulative incidence per 100,000 inhabitants in the period January 2020–October 2021 was evaluated. It is important to underline 3 peaks of incidence and mortality rates that occurred during the three waves of COVID-19: March–April–May 2020, October–November–December 2020, and March–April–May 2021. There is a slight increase in incidence in August 2021 and in mortality in September 2021. The three mortality rate peaks, related to the three waves of COVID-19, are always higher in Italy than in Europe, particularly in April 2020, December 2020, and March 2021. From May 2021 to October 2021, the mortality trend reversed, and it turned out to be higher in Europe than in Italy. Regarding vaccination, Italy currently has an important coverage, not only in the most fragile population, where it exceeds 90%, but also in the 12–19 age group, with percentages above 65%. The Pfizer/BioNTech vaccine was used widely in all age groups (first and second dose), with highest administration in 12–19 age groups and 80+, while the lowest was recorded in the 70–79 age group. In conclusion, these data confirm the importance of vaccination in the management of the COVID-19 pandemic.

Towards a Power Production from 100% Renewables: The Italian Situation

Towards a Power Production from 100% Renewables: The Italian Situation

Long-term relationship estimation and coupling/decoupling analysis between motorway traffic and Gross Value Added. Specification of an ARDL cointegration approach and application to the Italian case study

As transportation is an activity derived from spatial complementarities between a certain supply at an origin and a certain demand at a destination, according to a general axiom it seems that economic activities entail transport de-mand. In this perspective, an essential analysis deals with the quantification of the relationships between transport demand and certain socioeconomic variables. Elasticity is a concept widely used in transport economics as a measure of the responsiveness of transport demand concerning different factors represented as independent variables in an econometric model and coupling/decoupling concepts have been proposed in literature. This paper deals with the estimation of elasticities of motorway traffic demand based on Gross Value Added (GVA), and the consequent investiga-tion of coupling/decoupling situation. The analysis is based on the application of an Autoregressive-Distributed Lag (ARDL) cointegration model with the F-bound test and of the related Error Correction model. Starting from the general ARDL model and the methodology for the verification of its robustness, the same model is applied to the Italian toll road network. The time series of GVA for goods and services and the overall length of the toll network from 1995 to 2019 are considered as explanatory variables of the total annual distance traveled by light and heavy vehicles. The various tests in the ARDL framework show a cointegration between the variables, under the fulfillment of all the diag-nostic requirements. In this way, the long-term elasticities and the short-term adjustment dynamics are estimated sepa-rately for the goods and services components of GVA, and light and heavy vehicles. Starting from stable estimates of elasticities, the long-term coupling and decoupling effects between motorway traffic of light and heavy vehicles and the national production of goods and services can be shown. The paper, as well as providing an updated picture of the Italian situation, identifies a methodological framework that can be transferred to other contexts for a sector of great interest to investors, such as the motorway sector. All this can be useful to meet the needs of numerous stakeholders, who want to deepen the links between the economic cycle and traffic demand on toll motorways.

Insurance coverage in long-term health care for dependent persons.

Surveying the elderly population appears to be strategic and decisive for the economy of a country. Deciding or planning how many years of work are sufficient to be able to retire, determining who will be affected by public health policies (e.g. exemptions for drugs and visits in certain income brackets) or free vaccination campaigns, are some examples of why there is such interest on the part of scholars, but above all on the part of governments who must make informed choices. The aim of this work/report is to investigate the role of insurance companies and the Italian situation as regards long-term health care for dependent persons, as well as a comparison with other leading countries, such as the United States, the United Kingdom, France and Germany.

Insurance coverage in long-term health care for dependent persons.

Surveying the elderly population appears to be strategic and decisive for the economy of a country. Deciding or planning how many years of work are sufficient to be able to retire, determining who will be affected by public healthpolicies (e.g. exemptions for drugs and visits in certain income brackets) or free vaccination campaigns, are someexamples of why there is such interest on the part of scholars, but above all on the part of governments who mustmake informed choices.The aim of this work/report is to investigate the role of insurance companies and the Italian situation as regards longterm health care for dependent persons, as well as a comparison with other leading countries, such as the UnitedStates, the United Kingdom, France and Germany

Adult ADHD: a study on evaluation and treatment pathways in Italian Mental Health Services.

Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that often persists into adulthood. The Italian situation regarding the clinical management of childhood ADHD shows some criticalities, despite the high prevalence rate: diagnostic assessments are often inaccurate, protocols for transition from childcare services are almost non-existent and the Italian National Registry for ADHD in childhood was drawn up only in 2007, hence the first specialized services were created later than the rest of Europe. On the basis of these issues, we investigated the Italian situation with regard to disorders in adulthood, comparing the different European operational models, assuming that these critical issues are reflected in the clinical management of the disorder in adulthood. In fact, unlike other European countries, there are no official guidelines governing the clinical management of the disorder in adulthood and evidence-based pharmacotherapies, available in most European countries, are off-label or not allowed in Italy. The aim of the study is to evaluate the current state of knowledge and working method in relation to adult ADHD in the Italian background and to identify the main evaluation and treatment pathways in Italian Mental Health Services. The study is also an attempt to clarify which services are operational on the Italian territory, with the aim of improving the quality of interventions for the clinical population. Three hundred thirty-eight services have been identified in all Italian Regions and Autonomous Provinces, including Mental Health Centres (CSM), Pathological Addition Services (SERD), Psychiatric Diagnosis and Treatment Services (SPDC). An ad-hoc survey with closed-ended questions was administered by telephone to each selected centre and the results were compared with the European literature.

Human Papilloma Virus Vaccination: Focus on the Italian Situation.

Human papilloma virus (HPV) is a viral agent whose transmission occurs mainly by sexual means. It causes different pathological conditions in both males and females, ranging from benign pathologies up to cancers. The introduction of vaccination has certainly had a major impact in terms of reducing the incidence of both HPV infections and diseases but in the European Union and the European Economic Area (EU/EEA) there are still about more than 13,000 deaths due to cervical cancer each year. To date in Europe and in Italy there are three vaccines available (bi-, tetra-, and nonvalent vaccines). The vaccination campaign started irregularly in Europe and Italy in 2007, with pre-adolescent girls as the primary target. Later, other cohorts were introduced such as 12-year-old boys, additional cohorts of >25-year-old women, women who already underwent cervical surgery and other subjects entitled to free vaccination. The COVID-19 pandemic has strongly impacted on public health services, particularly on vaccinations that, especially during the first pandemic phase, have been often delayed and/or canceled. The most affected vaccinations by the pandemic have been the non-mandatory ones, particularly those addressing the adolescent and adult population, such as immunization against papillomavirus. To date the achievement of the coverage target set by the Italian National Immunization Plan (NIP) has not yet been achieved. The aim of this work is to summarize the current situation in Italy and to discuss the strategies that have been implemented to increase overall vaccination coverage rates.

Controversies and Challenges of Mass Vaccination against SARS-CoV-2 in Italy: Medico-Legal Perspectives and Considerations.

The worldwide spread of SARS-CoV-2 and the pandemic has resulted in a serious global crisis in the health, social and economic spheres. After an initial period of enthusiasm related to the efficacy of vaccines, in many European countries, a growing distrust in the population has matured, due to the reporting of severe adverse effects. Throughout the world, some cases of adverse events after the administration of the vaccine have been reported. In this communication, we want to discuss all the medico-legal aspects related to the global vaccination companion in terms of medical professional responsibility, informed consent and vaccination obligation, with particular attention to the Italian situation. Health professionals are tasked with promoting confidence in vaccination for the general population. Complete and detailed information and reliance on scientific research is essential to understand the great importance of the vaccination campaign. From a criminal point of view, we must avoid blaming health professionals in the case of side effects. At the same time, we must protect the population, ensuring compliance with the indications, guidelines, and an adequate method of administration. On the other hand, from a civil law perspective, it is correct to ensure full protection of those rare cases in which the administration of the vaccine is related to adverse events. Without a broad and global vaccination campaign, it will be impossible to overcome COVID-19.

Compulsory Vaccination for Healthcare Workers in Italy for the Prevention of SARS-CoV-2 Infection.

The European Convention on Human Rights (ECHR) judgement no. 116(2021) of 8 April 2021 establishes the principle of mandatory vaccination, indicating the criteria that national legislation must comply with, following the principle of non-interference in the private life of the individual. Vaccination for the prevention of SARS-CoV-2 infection appears to be an essential requirement for providing healthcare assistance. The European experience with compulsory vaccinations, offers a composite panorama, as the strategy of some European countries is to make vaccinations compulsory, including financial penalties for non-compliance. As in other countries, there is a clear need for Italy to impose compulsory vaccination for healthcare workers, in response to a pressing social need to protect individual and public health, and above all as a defense for vulnerable subjects or patients, for whom health workers have a specific position of guarantee and trust. The Italian Republic provided for mandatory vaccinations for health professionals by Decree-Law of 1 April 2021 no. 44, to guarantee public health and adequate safety conditions. As stated by ECHR, the Italian State, despite having initially opted for recommendation as regards to SARS-CoV-2 vaccination, had to adopt the mandatory system to achieve the highest possible degree of vaccination coverage among health professionals to guarantee the safety of treatments and protection of patients’ health. We present the Italian situation on vaccine hesitation in healthcare workers, with updated epidemiological data as well as the doctrinaire, social, and political debate that is raging in Italy and Europe.

Beyond the webs of ideology: Orson Welles’s Othello in post-war Italy

This article focuses on Orson Welles’s filmic adaptation of Othello (1951) with attention to how the filmic form interacts with the historical background of post-war Italy. The country where the director first took refuge after being virtually blacklisted from Hollywood did not seem to welcome his controversial style either. Taking the hint from the biased responses of most Italian critics to Othello, the article explores Welles’s revision of Shakespeare’s tragedy in relation to the early-1950s Italian landscape. I shall analyse how the visual techniques of the film create a challenging style that ensnares and engages the audience. The dominant imagery of entrapment can have a meta-cinematographic effect that disturbs the mimetic function of the screen. The resulting formal inconsistency and disunity of the film defies a totalizing notion of the work of art and invites the viewers to question and go beyond ideologically biased interpretations of the sociopolitical scenario it springs from. My aim is to show that Othello offers an intellectual engagement that goes beyond the webs of ideology which trapped the Italian post-war situation and leads to a more complex confrontation with the most urgent issues in the country.

An Overview about the Current Situation on C&D Waste Management in Italy: Achievements and Challenges

The disposal volume of material for Construction and Demolition in Europe is increasing each year, that the European Union has decided to take control of the matter unifying practices and goals to achieve. This article analyses how waste management works in Italy adjusting its system to the European Union, regarding Construction and Demolition, taking into consideration the disposal of material coming from C&D (Construction and Demolition) production. In Italy, the disposition may differ according to the regions in which it is divided, and this must be taken into consideration when analysing information that reflects the different logistical aspect linked to the territory. It is also necessary to consider how the volume of waste can vary according to the size of the region considered and the type of industrial development to which it belongs. The analysis of the Italian situation shows their achievements regarding reaching a good level of recycling waste volume; indeed, their amount of C&D recycled waste after 2010 was always up to the 70% value established by the European Union, though barriers are still present in the field of waste management. Through data collecting, it has been seen the different volume that is generated in construction-related activities in the country, along with the recovered waste volume. Thus, the goal of this paper is to deepen the general knowledge on waste produced by Construction and Demolition in Italy and waste management practices adopted according to the European Union.

A proposal for modifying coppicing geometry in order to reduce soil erosion in the forest areas

A key factor to reduce soil erosion and soil instability is the conservation of forest areas. In the last years, in all Europe, forest logging has increased. The Italian situation is paradigmatic because more than 70% of the broadleaved forests are managed as coppices and new exploitations concerning biomass for energy production have tripled since 2001. The common coppicing method leaves standards uniformly distributed on the ground, but this geometry has proven to not play an effective role in soil erosion control. In this paper, we propose a different method for coppicing geometry, aimed to decrease the soil erosion risk. In particular, the theoretical framework of the model is presented here, employing the USLE framework and discussing a real case study, while the results of the experimental tests, which are in progress, will be discussed in future papers. The theoretical results seem to demonstrate the method’s validity, which is expected to reduce soil erosion amount in the range 29-42%.

The Loss of Chance Doctrine in a Comparative Perspective

1. Introduction: a first map of Common Law systems and their contrasts - 2. A glance at the Italian situation - 3.The more likely than not in Common Law systems - 4.The position of the House of Lords - 5.The several theses of North American Formants - 6. Special cases: unexpected survival and autonomy of chance in the Australian system - 7.Conclusions

A Control Based Mathematical Model for the Evaluation of Intervention Lines in COVID-19 Epidemic Spread: The Italian Case Study

This paper addresses the problem of describing the spread of COVID-19 by a mathematical model introducing all the possible control actions as prevention (informative campaign, use of masks, social distancing, vaccination) and medication. The model adopted is similar to SEIQR, with the infected patients split into groups of asymptomatic subjects and isolated ones. This distinction is particularly important in the current pandemic, due to the fundamental the role of asymptomatic subjects in the virus diffusion. The influence of the control actions is considered in analysing the model, from the calculus of the equilibrium points to the determination of the reproduction number. This choice is motivated by the fact that the available organised data have been collected since from the end of February 2020, and almost simultaneously containment measures, increasing in typology and effectiveness, have been applied. The characteristics of COVID-19, not fully understood yet, suggest an asymmetric diffusion among countries and among categories of subjects. Referring to the Italian situation, the containment measures, as applied by the population, have been identified, showing their relation with the government’s decisions; this allows the study of possible scenarios, comparing the impact of different possible choices.

Management Models Applied to the Human-Wolf Conflict in Agro-Forestry-Pastoral Territories of Two Italian Protected Areas and One Spanish Game Area.

Simple SummaryConservation practices in the nature of some animal species are very difficult when they are in conflict with anthropogenic activities. In order to make possible the coexistence of a predator such as the wolf with animal breeding activities in the wild, the EU has produced solid and structured legislation through the Natura 2000 network. The application of the Habitats Directive allows the various member countries to choose biodiversity management actions as long as they maintain their resilience. Our work compares two different management methods developed in Spain and Italy with the aim of evaluating a possible difference in the conservation of wolf packs present in their respective territories. The results obtained show that both in Spain and Italy, the presence of the wolf causes damage to livestock. The economic damage is quite substantial and affects, in different ways, sheep, goat, bovine, and equine breeding. Nevertheless, wolf populations are stable in Spain, where hunting is allowed, and slightly increasing in Italy, where the species is particularly protected.Our work shows that, despite the persistence of persecutory actions, conservation activity has proved successful for the return of numerous wild mammals to different habitats, including the wolf. The human-wolf conflict is still described in all countries where the wolf is present. This is evidenced by the high number of damages on livestock, and the corpses of wolves found both in protected areas and in those where hunting is permitted. The diagnosis of road accidents, together with poisoning and poaching, are major causes of mortality. Although hunting records the highest percentage of kills in Spain, the demographic stability reported by the censuses suggests that this activity does not have a consistent influence on the Iberian wolf population’s survival. In Italy, where wolf hunting is prohibited, wolf populations are to be increasing. In some Italian situations, wolf attacks on horses seem to cause unwanted damage to foals, but they represent a very precious source of information about the habits of carnivores. A simple management plan would be sufficient to help the coexistence between the productive parts and the ecosystem services ensured by the presence of the wolf. The presence of hybrids is a negative factor.

Twenty-five years of unidentified bodies: an account from Milano, Italy.

The identification of decedents has always been a central issue in forensic pathology, for ethical, criminal, and administrative reasons, but today, it needs more attention due to issues related not only to migration but also to the weakening of family ties. This article presents a descriptive study discussing the Italian regulatory situation developed in the last decade to face the many identification issues, with all its improvements and flaws. Hence, data gathered in 25years of at the Institute of Legal Medicine of Milan and the epidemiology of unidentified decedents are illustrated. Briefly, from 1995 to 2019, the number of unidentified human remains with no identity or requesting verification of identity amounts to 726, i.e., 3% circa of all autopsies performed at the Institute, with an average of 29 individuals per year. In total, 528 (72.7%) individuals were successfully identified, 100 (13.8%) remained without an identity, and 98 (13.5%) individuals remained with suspected yet unconfirmed identities. Percentages for each identification technique are displayed, with insight into the role of forensic anthropology and odontology compared to genetics, and into the misuse of non-scientific methods allowed by Public Prosecutors. All the data is compared, as much as possible, with the very few recent studies concerning the problem worldwide. Finally, the article aims to show the Italian experience in dealing with unidentified bodies, in order to provide food for thought for other countries toward a discussion regarding a global issue which is sometimes taken for granted and underestimated.

The Problems and Contradictions Inherent in Analytic Training and the Ultimate Requirement: Working with Uncertainty.

In this essay, the author's aim is to outline the specificsof psychoanalytic intervention and its current relevance. She explores the boundaries of the clinician's identity, (whether psychotherapist or psychoanalyst), examines the training itself, as well as how and where one can develop the skills necessary to engage in this profession. She specifically assesses the Italian situation. For the construction of the identity of the therapist/psychoanalyst it is fundamental to learn how to tolerate uncertainty, seen here asa value, not a limitation,in contrast with the certainties which characterize other forms of psychotherapy. The complexity of psychoanalytic training is thus demonstrated as a function of two particularities, that of methodological rigor, incorporating all the necessary theoretical knowledge, and the delicate skill of being able to maneuver within the world of passion, regulated by the personal identity of the clinician.

Management of patients with cancer during the COVID-19 pandemic: The Italian perspective on the second wave

The novel coronavirus disease 2019 (COVID-19) pandemic has been an overwhelming challenge for worldwide health systems. Since the beginning of year 2020, COVID-19 has represented a potential harm for cancer patients and has often hindered oncology care. The Collegio Italiano dei Primari Oncologi Medici (CIPOMO) is an Italian association of head physicians in oncology departments, which promotes working and research activities in oncology on a national basis. During the second wave of COVID-19 pandemic, the CIPOMO promoted a national survey aiming to evaluate the impact of COVID-19 on oncologists' clinical activity and what changes have been made compared with the Italian situation during the first wave of the pandemic. Overall, 138 heads of medical oncology departments participated in this survey: 75 (54%) from the North, 24 (17%) from the Centre and 39 (28%) from the South of Italy and islands. This survey provides an overview of Italian oncologists facing the second wave of COVID-19 pandemic. The lesson learned during the first wave of COVID-19 pandemic has led to a better organisation of clinical activities, and regular testing among healthcare practitioners, with better chances to grant patients' protection. However, the lack of standardised informatic platforms results in serious challenges in replacing frontal visits, often making a concrete reduction of patients' hospital accesses unfeasible.Oncologists need to keep preserving the continuum of care of patients. Standardisation of safety measures, together with the implementation of informatic platforms, can significantly improve oncology pathways during this second wave of COVID-19 pandemic.

Bishops and People: Looking for Local Religious Life in Late Antiquity


 The religiosity of late antique and early medieval communities in the Mediterranean world has been vigorously examined and debated. This religious life has been called (among many other terms) ‘popular Christianity,’ ‘local Christianity,’ the ‘second church,’ ‘Religion zweiter Ordnung,’ and ‘the third paganism.’ In my article, I analyse late antique religious life from the viewpoint of encounters—between the ideals of the ecclesiastical elite and the people’s local cultic practices. These practices, embedded in the local communities, varied by regions but we can see similarities in the interaction of bishops with their local population. I will show how the ecclesiastical writers portrayed local cultic practices in negative terms as another religion (‘paganism,’ ‘idolatry,’ ‘demonic/ diabolic practices’), divergent from their own (‘Christianity’), or even as a distortion beyond ‘proper’ religion (‘magic’, ‘superstition’, ‘sacrilege’). In my analysis, I discuss and test various approaches that scholars have developed to understand the tensions between the bishops and the local people: David Frankfurter (local religion), Rubina Raja and Jörg Rüpke (local lived religion), and Nicola Denzey Lewis (magic as lived religion), Lisa Kaaren Bailey (lay religion) and Lucy Grig (popular culture). My focus is on the western Mediterranean world from the fourth to sixth centuries, and the cases of polemical encounters I analyse come from the writings of North Italian, Gallic and Hispanic bishops (Paulinus of Nola, Maximus of Turin, Philaster of Brescia, Caesarius of Arles, and Martin of Braga). I also compare the North Italian, Gallic and Hispanic situations with those in North Africa depicted by Augustine of Hippo.

The challenging task to select Salmonella target serovars in poultry: the Italian point of view.

According to the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC) annual report, human salmonellosis is mostly related to consumption of contaminated poultry products. Since 2003 in Europe, the Salmonella serovars considered relevant for human health and subject to control in breeding hens of Gallus gallus are: S. Enteritidis, S. Typhimurium (including the monophasic variant), S. Infantis, S. Hadar and S. Virchow. Herein, we investigated the Italian epidemiological situation from 2016 to 2018, comparing Salmonella serovar distributions in humans and poultry, in order to identify the target Salmonella serovars that, if controlled, would potentially have the largest public health impact in Italy. The results showed that control of S. Virchow and S. Hadar does no longer seem to be a priority in Italy and that S. Napoli and S. Derby, which are not included in the group of EU target serovars, are among the most frequent serovars isolated from humans in Italy. While S. Derby has its main reservoir in pigs, S. Napoli does not have a specific reservoir. However, because this serovar is frequently isolated from breeding poultry flocks and is characterised by causing severe human illness, it is a potential target Salmonella serovar in breeding hens of Gallus gallus in Italy.