North-eastern Italian Region Research Articles

Integration of Epidemiological and Genomic Data to Investigate H5N1 HPAI Outbreaks in Northern Italy in 2021-2022.

Between October 2021 and April 2022, 317 outbreaks caused by highly pathogenic avian influenza (HPAI) H5N1 viruses were notified in poultry farms in the northeastern Italian regions. The complete genomes of 214 strains were used to estimate the genetic network based on the similarity of the viruses. An exponential random graph model (ERGM) was used to assess the effect of 'at-risk contacts', 'same owners', 'in-bound/out-bound risk windows overlap', 'genetic differences', 'geographic distances', 'same species', and 'poultry company' on the probability of observing a link within the genetic network, which can be interpreted as the potential propagation of the epidemic via lateral spread or a common source of infection. The variables 'same poultry company' (Est. = 0.548, C.I. = [0.179; 0.918]) and 'risk windows overlap' (Est. = 0.339, C.I. = [0.309; 0.368]) were associated with a higher probability of link formation, while the 'genetic differences' (Est. = -0.563, C.I. = [-0.640; -0.486]) and 'geographic distances' (Est. = -0.058, C.I. = [-0.078; -0.038]) indicated a reduced probability. The integration of epidemiological data with genomic analyses allows us to monitor the epidemic evolution and helps to explain the dynamics of lateral spreads casting light on the potential diffusion routes. The 2021-2022 epidemic stresses the need to further strengthen the biosecurity measures, and to encourage the reorganization of the poultry production sector to minimize the impact of future epidemics.

Mutual Role Expectations by Patients and General Practitioners-A Mixed Methods Study on Complementarity.

Background: Changes in public attitudes toward “authorities” in general, as well as shifts in medical practice toward participative models of diagnosis and treatment, imply fundamental transformations in the patient–doctor relationship. However, consistency in reciprocal role expectations cannot be assumed, and this study reveals significant discrepancies in attitudes and behaviors in primary health consultations. Methods: We conducted a study in the tri-lingual northeastern Italian region of South Tyrol to determine whether perceptions of the patient’s role were congruent or differed. In a mixed method approach, the quantitative research part consisted of a survey with 34 identical questions for general practitioners (n = 109) and adult primary care patients (n = 506) on verbal communication, self-initiative and health literacy, interpersonal and social qualities of the patient–physician relationship, and formal aspects of the consultation. Patients were interviewed via telephone, and general practitioners responded online. In the qualitative part, 26 semi-structured in-depth interviews were conducted with the patients and analyzed. Results: General practitioners considered patients’ communicative efforts (p < 0.001), self-initiative (p < 0.001), compliance (p = 0.0026), and openness regarding psychosocial issues (p < 0.001) to be significantly more important, whereas patients showed a tendency to give increased importance to formal aspects such as politeness and hygiene (p < 0.001). Perception of the patient’s role differed significantly between the Italian and German linguistic groups. Conclusions: Patients and general practitioners differ in their understanding of patients’ roles. These data suggest that a considerable proportion of the population lacks a clear and tangible idea of the active role they could play in consultations. Targeted information on the identified aspects of patient–provider communication may facilitate participatory behavior and positively impact the longitudinal quality of the patient–general practitioner relationship.

Belenus, Cybele, and Attis: Echoes of their Cults through the Centuries

There are two interesting cases of the worship of Roman period deities in the north-eastern Italian and Pannonian regions, which in one way or another seem to have survived through the early medieval to modern times. The first is the cult of Belenus, the well-known Celtic and most notably Norican and Aquileian god. The second case is that of Cybele and Attis, the so-called eastern deities, whose cult became highly influential in the mentioned areas – as well as elsewhere – in the second and third centuries AD. Interestingly, a deity called “holy Belin” was documented in the second half of the 19th century in the area of Tolmin in Slovenia (the hinterland of Aquileia), as a traditional folk belief. In Pannonia, traces of the cult of Cybele and Attis seem to have survived from antiquity in Prekmurje and Porabje (Slovenia, Hungary), reflected in the unusual and still existing custom of the “wedding with a pine-tree”.

SARS-CoV-2 transmission by asymptomatic healthcare workers positive to screening swab: an Italian study.

BackgroundSARS-CoV-2 spreads primarily through respiratory droplets of symptomatic individuals. With respect to asymptomatic individuals, there are conflicting results in the literature and a lack of studies specifically examining transmission in healthcare settings.MethodsThe aim of this retrospective study, conducted in a northeastern Italian region, was to estimate the contagiousness of asymptomatic healthcare workers (HCWs) who tested positive for SARS-CoV-2. Asymptomatic HCWs who tested positive for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (rRT-PCR) at a regular screening nasopharyngeal or oropharyngeal swab between 1 February 2020 and 15 September 2020 were considered index cases. Contacts who were at high risk of infection and had follow-up swabs were included. Contacts were considered infected if they had a positive follow-up swab and/or symptoms associated with COVID-19 confirmed by a positive test within 14 days of exposure. Information was taken from records previously collected to identify contacts. Infectivity was estimated using the attack rate (AR) with a 95% confidence interval (95% CI).ResultsThirty-eight asymptomatic HCWs who were positive at the screening swab and 778 contacts were identified. Contacts included 63.8% of colleagues, 25.6% of patients, 7.7% of family members and 3.0% of other contacts. Seven contacts tested positive for SARS-CoV-2 (AR: 0.91%, 95% CI: 0.89–0.93). Five of them were family members (AR: 8.3%), one was a colleague (0.2%) and one was a contact of other type (4.2%).ConclusionsViral spread by asymptomatic HCWs was less than in other settings. Identification of risk factors for transmission and reliable indicators of infectivity would be important to prioritize preventive measures.

Telemedicine: first steps in a north-eastern Italian region during first year of pandemic

BackgroundCovid-19 pandemic imposed searching for innovative solutions to ensure safety access to outpatient services. In March 2020 first cases were reported in Friuli Venezia Giulia (FVG) region, in Italy; in April 2020 FVG included teleconsultation in the healthcare offer. This study evaluated in-presence medical consultations (IPCs) delivered in FVG before and after first cases reported in region and correlation between IPCs, teleconsultations and new admissions to Covid-19 wards during pandemic.MethodsIPCs were analysed dividing in pre (February 1st, 2019-February 29th, 2020) and post (March 1st, 2020-March 31st, 2021) Covid-19 emergency period and comparing mean months values with t-test. IPCs and teleconsultations delivered during emergency (March 1st, 2020-March 31st, 2021) were divided in months and correlated with new admissions to Covid-19 wards in the same period with Pearson test.ResultsIPCs delivered in pre-Covid-19 period compared with post were 1,105,823 vs 973,350 (-12%), peaking in October (98,980 vs 86,821; -12.3%) and minimum in April (82,061 vs 61,523; -25.1%). Pre-Covid-19 mean IPCs were significantly different compared to post (85,063 vs 74,873; p=.003). Focusing on emergency period, IPCs were negatively related to teleconsultations (973,350 vs 2140; r=-.43; p=.13). The negative correlation found between new admissions to Covid-19 wards (9154) and IPCs was weak and not significant (r=-.12; p=.69), while a positive and significant correlation was found between teleconsultations and new admissions to Covid-19 wards (r=.59; p=.03).ConclusionsResults showed a significant reduction of post-Covid-19 IPCs compared to pre and a significant correlation between teleconsultations and new admissions to Covid-19 wards in FVG during first year of Covid-19 emergency. Contagion containment measures and fear probably influenced access to outpatient services while teleconsultation should be considered as an alternative to face-to-face during pandemic period.Key messages A reduction of in-presence medical consultations was found in a north-eastern Italian region during first year of pandemic.Teleconsultation could be a valid solution in case of increasing Covid-19 hospitalizations.

The role of Natura 2000 in relation to breeding birds decline on multiple land cover types and policy implications

The Natura 2000 network of protected sites is the pillar of biodiversity conservation in Europe. Although the Natura 2000 network directly addresses birds, these have shown worrying declining trends. It is therefore crucial to assess the potential contribution of Natura 2000 conservation measures. In this paper, we use a replicable method to model bird trends in the period 2000–2015 and the effects of Natura 2000 protection, across land cover classes, on regional abundances and local species richness and diversity. We model bird trends in Veneto, a North-Eastern Italian Region with areas among the richest in bird species in Italy. Bird data were derived from the national breeding bird monitoring scheme. Breeding birds showed declining trends at the regional level, confirming national and continental trends, particularly on agricultural and natural areas. The land cover class, rather than Natura 2000, mostly influenced population trends; however, it was possible to observe slightly higher estimates of species richness and diversity in Natura 2000 sites. Despite the absolute higher estimates of richness and diversity over the investigated period, farmland and woodland bird species had steeper declining trends inside Natura 2000 than outside, matching the values of the areas outside the network at the end of the survey period. We conclude that the Natura 2000 network capacity to buffer biodiversity loss and act as a species-pool for non-protected areas is decreasing over time, mainly with regards to farmland and woodland birds. Natura 2000 implementation must be improved: conservation objectives and measures, management, and monitoring should be better integrated into existing plans and funding should be made more efficiently available for Natura 2000.

High-school students and self-injurious thoughts and behaviours: clues of emotion dysregulation

BackgroundSuicide attempts and self-harm in adolescence are a major public health concern: they are among the main causes of disability-adjusted life-years worldwide, with severe long-term health consequences in terms of mental illness and psychiatric hospitalisation and a significantly increased risk of suicide. Several studies recently focused on the hypothesis that adolescents may be particularly vulnerable to emotional dysregulation and on the relation between problems with emotion regulation and suicidal and self-harming behaviours.Italian epidemiological data about prevalence of these behaviours at the community level are lacking.Our study aimed to estimate the prevalence of self-injurious thoughts and behaviours (SITBs) in a representative sample of community adolescents, and to examine the association between SITBs and the emotional and behavioural profiles.MethodsAnonymous self-report questionnaires were completed by 1507 students aged 11–18 years from 24 high schools in the North-eastern Italian region of Friuli Venezia Giulia. Information was collected on SITBs, on the socio-environmental context, and on the psychological profile (‘Achenbach’s YSR questionnaire 11–18, Multidimensional Test of Self-harm and Multi-Attitude Suicide Tendency Scale).ResultsOverall, 11.1% of adolescents reported self-harming behaviours without suicide ideation or attempts, 6.4% declared having thought to suicide without acting a suicide attempt or self-harm, 1.4% declared having attempted suicide and really thought to take away their life. Access to health services following a suicide thought, a self-harming behaviour or suicide attempt was infrequent, particularly for suicide ideation. At the YSR, all the SITBs groups reported high scores in almost all scales, with the most evident differences in the self-harming groups in which adolescents reported significantly higher scores in all scales, both internalising and externalising. An emotion dysregulation profile was found in almost all the groups.ConclusionsThis study provides us with an estimate of the prevalence of SITBs in the adolescent population and confirms the importance of further investigating the association between SITBs and emotion dysregulation. The naturalistic setting of community studies appears to be useful for studies in this field, and it allows to approach the onerous and often neglected issue of adolescent suicidality.

A Wide Range of Strategies to Cope with Healthcare Workers' Vaccine Hesitancy in A North-Eastern Italian Region: Are They Enough?

The recent pandemic reminded the world of the high risk of healthcare workers (HCWs) and patient contagiousness along with the healthcare services disruption related to nosocomial outbreaks. This study aims at describing vaccination campaigns within healthcare institutions of a North-Italian Region and comparing their effectiveness in term of vaccination coverage. In December 2019, we surveyed all healthcare institutions of Friuli Venezia Giulia Region throughout an email questionnaire with 15 questions investigating strategies adopted for the vaccination of HCWs against influenza and other vaccine-preventable diseases (VPDs), along with actions put in place in case of a VPD exposure. We found a strong heterogeneity in VPDs prevention and control policy and practice for HCWs, along with responsibility attribution ranging among different stakeholders. Strategies adopted to promote vaccination included a wide range of methods, but HCWs’ influenza vaccination coverage still ranged from 17.0 to 33.3%. Contact tracing after a VPD exposure did not always include medical residents and students and visitors/caregivers/extra personnel as possible contacts. Even if knowledge and complacency gaps among HCWs could be faced with education activities, more efforts should be done in identifying and implementing effective vaccination strategies, and mandatory vaccination for HCWs could be introduced to achieve host, herd, and healthcare immunity preventing possible hospital outbreaks.

Health issues in female Moldovan migrants in a north-eastern Italian region

Abstract Background Migration from Eastern Europe to Italy is still massively expanding, with a subsequent increase of migrants in the job market who are traditionally employed in low specialized and high strain jobs. In this context Health Literacy is a known factor contributing to immigrant health disparities. The purpose of this study was to evaluate the health status of a population of migrant Moldovan women and their access to health care services in northern Italy by age class and health literacy level. Methods We administered an ad-hoc questionnaire to adult Moldovan women to assess their lifestyles, employment status, reported health status, access to Health Services and Health Literacy. Moreover, the study compared our data with a sample of Italian women of the same age range living in North-Eastern region interviewed in 2015. Analysis employs descriptive statistics. Results The sample included 170 Moldovan women (age 46.5 ±12.3). Prevalence of active smokers was found double in women with a low Health Literacy. Health Literacy status also determined the different access to Public Health Services, with women with higher literacy using more programmed health services and screening programs, and women with lower literacy conversely using more emergency health services. Overall reported health status was found worse in our sample than in Italian women and reported disease prevalence among age ranges was different than Italian ones with an increased probability for allergies, lumbar diseases and depression. Conclusions Some diseases have a higher prevalence in Moldovan than in Italian women. Health literacy is associated with lifestyles and use of health care services also in migrants, as previously demonstrated for native population. Key messages Tailored prevention programs and intervention should be designed in Moldovan women to address high prevalence diseases in this population. Strategy to improve health literacy should involve immigrants. Some diseases resulted well-spread over the whole sample and not influenced by age or employment; the difficulties migrants have to overcome might influence their health status.

PMS74 - THE ROLE OF MONITORING COMPLIANCE TO GUIDELINES IN PREVENTING THE RISK OF SECOND FRACTURE AND DEATH IN PATIENTS WITH OSTEOPOROSIS: A RETROSPECTIVE ADMINISTRATIVE DATABASE ANALYSIS.

To assess the relationship between osteoporosis-related pharmacological treatment use, patterns and adherence and risk of second fracture or death in an Italian real-world setting. A retrospective cohort analysis using a north-eastern Italian region’s administrative database was conducted. Osteoporotic patients with a first hospitalization for fracture of femur with replacement or vertebral column between 1 January 2011 and 30 June 2015 were included. The use of post-fracture treatment, treatment patterns, among antiosteoporosis medication (AOM) and supplementation with calcium or vitamin D (Ca/VitD), and adherence using Medication Possession Ratio(MPR) were analyzed. Cox regression models were used to estimate the risk of incidence of osteoporosis-related re-fractures, among femur with replacement, vertebral column, radius and ulna, and all-cause death from the hospitalization-index until 30 June 2016. Follow-up costs were calculated per patient per year (PPPY). 7,391 patients had a first fracture, mean (SD) age was 80 (10) years, 89% were female.After the hospitalization-index, 5,702 (71.9%) patients had osteoporosis-related treatment: 380 (4.8%) had AOM only, 2,549 (32.1%) AOM and Ca/VitD and 2,773 (35.0%) Ca/VitD only. Over a median follow-up of 2.3 years, re-fracture rate was 27/1000 patient-years and death rate was 105/1000 patient-years. Risk of re-fracture decreased among treated patients(HR=0.42, 95%CI 0.35-0.51), those withCa/VitD in addition to AOM (HR=0.64, 95%CI 0.43-0.94) and those adherent (MPR≥80%) to treatment (HR=0.16, 95%CI 0.11-0.24). Risk of mortality decreased among treated patients (HR=0.38, 95%CI 0.34-0.41), those with AOM and Ca/VitD (HR=0.41, 95%CI 0.33-0.50)and increased for adherent patients(HR=1.63, 95%CI 1.38-1.92). On average,PPPY costs resulted €6,884.75 among not treated patients, and €5,477.71, €4,258.16 and €4,626.03,for AOM only, AOM and Ca/VitD and Ca/VitD only groups, respectively. This real-world study suggests that the relevance of monitoring of compliance to guidelines in terms of treatment use, patterns and adherence may improve patients' prognosis.

Distance to the Pediatric Emergency Department and Nonurgent Visits in Friuli Venezia Giulia, Italy.

Our objective was to assess how the distance from home to the closest pediatric emergency department (ED) affects nonurgent emergency room visits among the child population of the Northeastern Italian region of Friuli Venezia Giulia. The study was based on the administrative databases of the Regional Health Information System of Friuli Venezia Giulia. For the year 2014, we abstracted the records of all white-triage-tag visits of children younger than 16 years from the databases of the 3 regional pediatric EDs located in the 3 main cities. Those records were individually linked to the regional population's georeferenced address database through an anonymous univocal identifier. For each child younger than 16 years living within 20 km from an ED, we calculated the linear distance between the ED and home address. Distances were grouped into 7 circular distance bands: less than 2, 2 to 4, 4 to 6, 6 to 8, 8 to 10, 10 to 15, and 15 to 20 km. Within each band, we calculated the rate of ED visits during the year. In 2014, there were 12,055 white-triage-tag visits accounting for 24.7% of all visits in the regional pediatric EDs. Although the overall rate of ED visits was different among the EDs, it decreased significantly with increasing distance to the ED, with a 6-fold difference between the innermost and the outermost bands. In Friuli Venezia Giulia, short distance is a prompter for inappropriate pediatric ED attendance. Further research is needed in this region to understand the parental standpoint to implement strategies promoting uniform behaviors within the regional boundaries.

Isolated rectal cancer surgery: a 2007-2014 population study based on a large administrative database.

Rectal resection is technically one of the most demanding laparoscopic procedures, requiring additional training and expertise of both surgeons and institutions. The literature has shown that laparoscopic procedures can be appropriate for the treatment of rectal cancer (RC), in terms of safety, outcome and efficiency, but results may not always be directly transferable to the general population. This study aimed to investigate the use of laparoscopic rectal cancer resections in a north-eastern Italian region (the Veneto) and to see how the characteristics of patients and hospitals are associated with the use of laparoscopy. This was a retrospective cohort study based on administrative data collected from 2007 to 2014 in the Veneto region (north-east Italy). In the period considered (2007-2014), 4953 rectal resections were performed for RC in Veneto hospitals, accounting for 35% of the total 14,243 surgical procedures involving the rectum, and resulting in 76,739days in hospital [mean length of stay-post-operative (MLOS) 15.5±11.1days]. Patients were a mean 67.9±11.7years old (68±12.7 for women, 67.9±11 for men), while the subgroup of patients undergoing laparoscopic procedures was on average 2years younger (66.5±11.8 vs 68.8±11.5; p<0.05). The four main findings of this study are: (1) the increasing rates of laparoscopic procedures for RC resection at all the hospitals in our geographical area, rising up to 52% in 2014. This is probably related to not only to availability of better equipment but surely to a growing expertise of surgeons; (2) the esteem of proportion of laparoscopically treated RC; (3) the significant difference between the laparoscopic and open surgical approach in terms of mean length of hospital stay after RC resection, making the laparoscopic approach cost-effective generally speaking; and (4) the disparities in hospitals' use of laparoscopy by patients' age group: Laparoscopic surgery is safe also in the elderly population but it is not so widely offers in Veneto Region hospitals, and it's probably due to the lack of experience about this approach in frail/old patients.

Exopolis reloaded: fragmented landscapes and no man’s lands in a North-Eastern Italian border region

This paper examines a ‘landscape of power’ in the marginal northeastern corner of Italy, near the Italian-Slovenian border. The landscape is centred around the small town of Gradisca and its highly contested centres for asylum seekers and marked by the concomitant presence of a giant shopping mall, the largest Italian war memorial, and an aestheticised wine district. The result of participant observation, visual and textual analysis, and selected interviews, this study reflects on the transformation of a former cold war border area into a mix of carceral, hospitality, commercial, residential, rural spatialities that seem to be entirely disconnected with each other and linked instead to broader regional, national and international geographies. This fragmented landscape, dominated by massive ‘fortified’ enclosures and with gradually deterritorialised in-between spaces, described here as no man’s land, may be provocatively analysed as an Italian exopolis.

Colon Cancer Surgery: A Retrospective Study Based on a Large Administrative Database.

Laparoscopic colectomy (LC) for colon cancer is considered as safe and effective as open colectomy. It has many benefits in terms of postoperative pain, length of hospital stay, and esthetic results. There is evidence in the United States of a positive trend in the proportion of oncologic patients undergoing LC. Our aim is to confirm this trend in Europe and identify factors associated with a greater use of LC. A retrospective cohort study based on hospital discharge records (HDR) collected from 2008 to 2013 in a north-eastern Italian region (Veneto). The sample included all HDR with colon cancer as their principal or secondary diagnosis, treated with partial or total colectomy. To establish the overall regional trend of LC, we standardized cases by age, referring to the number of procedures performed by age group in 2010. We calculated the annual percent change from the slope of the regression model over a given time interval. Out of 14,085 colectomies, 29% were completed laparoscopically. The age-adjusted rates of LC by year ranged from 23.8% (2008) to 36.0% (2013). The mean annual increase in the LC rate was 2.4% overall (P<0.001). Factors associated with a higher proportion of LC were younger age (39% LC in patients below 65 y vs. 25% in those above 65 y), public hospitals (odds ratio: 1.71; 95% confidence interval, 1.51-1.94; P<0.05) and elective admissions (odds ratio: 4.19; 95% confidence interval, 3.76-4.67; P<0.05). Although the proportion of LC is growing, there are factors that influence the likelihood of this procedure being conducted. Future efforts to extend the use of LC to all eligible patients and avoid disparities should target both surgeons and patients, promoting the development and dissemination of appropriate guidelines.

Interpretation of colposcopy in population-based cervical screening services in north-eastern Italy: an online interregional agreement study

ObjectiveAn innovative web-based colposcopy quality assurance programme was implemented in population-based cervical screening services in three north-eastern Italian administrative regions with different colposcopists’ training background. In this study, the levels of intra- and interregional intercolposcopist diagnostic agreement were evaluated. Study designOf the 158 registered colposcopists, 125 accessed the website of the programme, logged-in, viewed a posted set of 50 digital colpophotographs selected by an expert steering committee, and classified them for the colposcopic impression, the visibility of the squamocolumnar junction, and the need for biopsy. Anonymous data were downloaded and analysed using the crude, or observed, proportion of agreement and the kappa coefficient. ResultsThere were 113 eligible colposcopists. Overall, crude agreement on the colposcopic impression, the visibility of the squamocolumnar junction, and the need for biopsy was 0.72, 0.72, and 0.87, with kappa values of 0.60, 0.36, and 0.69, respectively. The homologous kappa values were 0.61, 0.41, and 0.69 in one region, 0.57, 0.36, and 0.69 in another, and 0.66, 0.38, and 0.74 in the third. Total intra- and interregional agreement were nearly identical, with kappa values of 0.59 and 0.60 for the colposcopic impression, 0.38 and 0.35 for the visibility of the squamocolumnar junction, and 0.69 and 0.69 for the need for biopsy. The width of 95% confidence intervals around the above kappa values was ≤0.01. ConclusionsThe levels of agreement varied between moderate and substantial both within and between regions. Regional differences in training background had minor effects. The interpretation of colposcopy is potentially well-reproducible.

Multi-Criteria Analysis of Suitability for Energy Crops under Structural and Environmental Constraints: A Case Study in a Northeastern Italian Region

Abstract. This article assesses the potential of introducing energy crops for the biofuel chain in rural areas based on a land suitability analysis. The most suitable areas for cultivation of energy crops were evaluated using a geographic information system (GIS) based on a cartographic database merged with pedoclimatic and structural factors. The land evaluation model was integrated into a multi-criteria framework for classifying the land on the basis of pedoclimatic and structural opportunities and constraints in a multidisciplinary approach. The model was applied to a case study in the province of Ferrara, northeastern Italy, considering three crops (sunflower, rapeseed, and soybean) for the production of biofuels as an alternative to traditional crops. The results indicated that, while the structural factors (farm size, mechanization level, and road network) presented intermediate and severe limitations in most of the territory, the agronomic and pedoclimatic factors showed no limiting values for the crops. The matching of pedoclimatic and structural factors determined that the most suitable crop was sunflower, with more than half of the area (55.3%) very suitable, while soybean was the crop most penalized by pedoclimatic factors.

Epidemiology of animal poisoning: An overview on the features and spatio-temporal distribution of the phenomenon in the north-eastern Italian regions

In the present paper we analyze and discuss about the records referring to animal poisonings and poisoned baits cases covering the period between 2007 and 2013 and submitted for diagnostic investigations to the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), which is the public veterinary health institute competent for the north eastern Italian regions.All data were gathered by a passive surveillance system based on voluntary reporting, which became mandatory in 2009 after a decree of the Italian Ministry of Health had come into force. This prohibited the use and detention of poisoned baits and ordered to selected institutions and professionals to carry out standardized surveys to assess suspect and/or confirmed reported cases; all the necessary anatomopathological and toxicological investigations to confirm the reported cases were then performed for free by public veterinary health institutes whenever a veterinarian diagnosis or clinical suspicion were provided.Totally, 1831 suspected animals poisoning and 698 cases of supposed poisoned baits recovery episodes were registered. 642/1831 (35.1%) animal poisoning cases were confirmed and the presence of toxic agents was verified in 292/698 baits (41.8%). The most severely affected territories were the ones with the highest level of urbanization and those most densely populated in the study area. Dogs and cats seemed to be greatly affected by poisoning cases and a characteristic seasonal trend was noticed, with an increase of episodes in late Winter/early Spring and in Autumn. Carbamate insecticides resulted to be the main cause for animal poisoning, while anticoagulants rodenticides played a primary role among toxicants found in poisoned baits. The presented results emphasize that malicious animal poisoning is a widespread problem in north-eastern Italy. The still relevant number of reported poisoning events caused by some banned pesticides poses the problem of identifying where these substances come from and brings to light the popular knowledge about the high toxicity of these compounds. Moreover, the noticeable increase of the number of episodes registered in 2009 pointed out how the above mentioned decree may have contributed to reveal a number of hidden cases which had not been investigated before, probably due to economic reasons related to the costs of toxicological analyses.

The incidence rate and prevalence of pediatric type 1 diabetes mellitus (age 0-18) in the Italian region Friuli Venezia Giulia: population-based estimates through the analysis of health administrative databases.

The main objective of this study was to estimate the incidence rate and prevalence of pediatric type 1 diabetes mellitus (T1DM; population 0-18years of age) in the northeastern Italian region Friuli Venezia Giulia and to characterize the subjects affected by the disease. This was a retrospective population-based study conducted through the individual-level linkage of several health administrative databases of the Friuli Venezia Giulia region. The incidence rate and prevalence were calculated in the population 0-18years of age. Using the Mid-p exact method, 95% confidence intervals for rates were calculated. The incidence rate of pediatric T1DM in the years 2010-2013 was 15.8 new cases/100,000 person-years, peaking in the age class 10-14years. The rate has increased substantially as compared with the previous regional estimate that dated back to 1993. We observed a seasonal pattern both in the date of birth of the incident cases and in the date of onset of the disease. In the region in 2013, there were 294 prevalent cases (15.1/10,000 inhabitants). Most of them had at least one glycated hemoglobin test in the year. More than 15% had co-existing autoimmune comorbidities. The incidence rate of pediatric T1DM in Friuli Venezia Giulia has increased in the last years, and the disease is a relevant public health issue in the region.

Wildlife conservation through forestry abandonment: responses of beetle communities to habitat change in the Eastern Alps

Research on changes in biodiversity due to the abandonment of forestry is important in understanding the role of reserves in conservation. The aim of this study was to investigate whether changes have occurred in species richness, abundance and composition of ground, longhorn and bark beetles due to habitat changes as a result of the cessation of forest management. We surveyed ten managed and ten abandoned forest plots in two watersheds located in the north-eastern Italian alpine region, which share a common history of use, climate regimes, stand structure and topography. Ground beetles, and longhorn and bark beetles were collected with pitfall and flight-intercept window traps, respectively, from May to mid-October 2010. The three beetle taxa responded differently to changes in habitat features and management cessation. Differences in individual species responses between the two watersheds may indicate a role of management abandonment through its impact on forest habitat structure. For instance, ground beetle species mainly responded negatively to soil moisture and positively to understorey vegetation cover. Unexpectedly, saproxylic species responded variably, and often negatively, to deadwood features in these forests, but did respond positively to the volume of standing Abies alba trees. The assemblages of carabids and bark beetles differed between the two watersheds. Our results confirmed that 50 years of forest management cessation resulted in changes in the biodiversity of beetles in alpine forests, likely due to their response to changes in habitat structure. Moreover, we expect that where the unplanned abandonment of forestry practices and habitat rewilding are undergoing, like in many marginal areas of Europe, similar habitat structure dynamics and beetle responses are likely to occur spontaneously.

Four year longitudinal study of Mycobacterium tuberculosis complex isolates in a region of North-Eastern Italy

Recent reports have suggested a change of Mycobacterium tuberculosis complex genetic diversity in Western Europe due to an increasing proportion of imported cases of tuberculosis (TB). This study analyzed a total of 705 M. tuberculosis strains isolated from 2006 to 2009 in Veneto, a North-Eastern Italian region, to see the impact of foreign-born cases vs. Italian patients on prevailing TB epidemiology. Strains were genotyped using spoligotyping followed by comparison with international genotyping database SITVIT2. Six spoligotyping clusters with suspected phylogeographical specificity for imported cases, were typed by 15-loci MIRUs for a finer characterization. Overall, 410 (58.16%) strains were isolated from foreign-born patients, while 295 (41.84%) were isolated from Italian patients. Older patients (>70years, i.e., 46.4% of cases) predominated among Italians while younger age groups prevailed among foreign-born patients. Our results suggest that despite a high proportion of reactivation of latent TB infection in elderly Italian-born patients, active TB transmission between foreign-born and Italian patients may be ongoing, and argue in favor of an increased TB surveillance among immigrants to combat TB epidemic in Italy.