Vaccine hesitancy and refusal during the Covid-19 pandemic in Italy: Individualistic claims or repoliticisation?

The Covid-19 pandemic highlighted new (or renewed) forms of conflict within a longer path of distrust and dissatisfaction towards politics and growing scepticism towards ‘official truths' and ‘official science'. Italy was the first European and Western country in which the pandemic spread in February 2020, and also one that adopted particularly stringent measures to contain the virus. In this scenario, a country in which political distrust was particularly diffused experienced an increase in institutional trust, accompanied by a strong demand for security from above. At the same time, radicalisation and distrust have grown among larger strata of the Italian population, leading to a significant polarisation of the public sphere. This essay critically embraces the perspective of the vast and plural universe of vaccine hesitancy and refusal (VHR) and, more generally, the materialisations of conflict concerning vaccines and policies aimed to address the Covid-19 pandemic. In the media and public debate, these protests have been mainly regarded as populist, driven by individualistic claims nurtured by indifference towards the collective good. We specifically explore whether VHR should be viewed exclusively as a sign of selfishness and populism or also as a form of repoliticisation around new issues and, in particular, as an expression of critical citizenship manifesting doubts about the decisions made by politicians, affirming a critique of the model of instrumental rationality, and advocating a pluralist debate on complex issues which directly affect individual life-choices and the body. Our study is based on 67 qualitative interviews with VHR citizens and a focus group with four key figures of the ‘Movimento 3V' (3VM), a minor Italian party advocating freedom of choice in relation to vaccines. © 2022 - University of Salento, SIBA

The von willebrand disease aging and bleeding correlation (VWD ABC) study

Introduction It is well established that von Willebrand factor (VWF) levels increase with age among healthy adults. Recently, there is emerging research demonstrating this may also occur in patients with von Willebrand disease (VWD), particularly type 1 VWD, and may be related to comorbidities. Despite increasing VWF levels, it remains unclear as to whether or not this alters bleeding phenotype. It is also unclear why this occurs most commonly in patients with type 1 VWD, but VWF mutation status may play a role. Older patients commonly undergo invasive procedures, and all VWD patients require periprocedural VWD-specific therapy to ensure appropriate hemostasis. If older type 1 VWD patients have experienced normalization of VWF levels, and no longer have an increased risk of bleeding, VWD-specific therapy may increase thrombosis risk, especially among patients with underlying cardiovascular disease or related risk factors, subject the patient to other adverse reactions such as hyponatremia, and is unnecessarily costly. For these reasons, investigation into the effect of age on VWF levels and bleeding risk in type 1 VWD patients is sorely needed. Methods This is an NHLBI-funded K23 multicenter, cross-sectional study to determine the effect of age on VWF levels and bleeding risk in patients with type 1 VWD, and to determine if pathogenic VWF mutations alter this effect.Individuals with a new or historical diagnosis of type 1 VWD (defined as clinical symptoms consistent with VWD and VWF antigen level or ristocetin cofactor activity <0.50 IU/mL) and age 18 or older are enrolled during routine clinic visits at participating Hemophilia Treatment Centers (HTCs). Following enrollment, pertinent medical history is obtained;the condensed MCMDM-1 VWD Bleeding Assessment Tool is administered, with bleeding history based on bleeding symptoms during the past 5 years;and blood samples are collected for the following: VWF antigen (VWF:Ag) level, VWF ristocetin cofactor activity, factor VIII activity, blood type, and VWF gene sequencing. We hypothesize age is associated with increased VWF:Ag levels and lower condensed MCMDM-1 VWD bleeding scores in patients with type 1 VWD, and this association is weaker among those with a pathogenic VWF mutation. In addition, we hypothesize multimorbidity partially explains the association between age and VWF:Ag levels, and VWF:Ag levels partially explain the association between age and condensed MCMDM-1 VWD bleeding scores in patients with type 1 VWD. A sample size of 250 participants provides 90% power to detect an effect size of Beta=±0.032 points per year of age, which is much smaller than the observed effect size, Beta=-0.080, from preliminary data. The primary analyses will be based on multivariable linear regression models with adjustment for blood type O, exogenous estrogen therapy, multimorbidity (defined as 2 or more of the core set of 20 chronic conditions, i.e., cancer, hypertension, stroke, etc., as selected by the United States Department of Health and Human Services), and medications (aspirin, nonsteroidal antiinflammatory drugs, and anticoagulants). In the regression models, two-sided t-tests will be used with an alpha=0.05. Results This multicenter, cross-sectional study consists of seven HTCs: Hemophilia Center of Western Pennsylvania, Children's Hospital of Pennsylvania, Mary M. Gooley Hemophilia Center, Ohio State University, Bleeding & Clotting Disorders Institute, Mayo Clinic, and University of California, San Diego. During the first year of the study, site initiation visits were conducted, regulatory approval obtained, and contracts executed. Delays in these activities occurred in large part due to the COVID-19 pandemic. As the first year of the study concludes, all sites are now active and enrolling participants. Thus far, 43 participants have been enrolled (Table 1). No barriers to enrollment have been encountered and very few patients have declined study participation. Discussion In conclusion, this ongoing multicenter, cross-section study seeks to determine the effect ge has on VWF levels and bleeding risk in patients with type 1 VWD while exploring the role of VWF mutations and multimorbidity in this process. The results will be used to justify a longitudinal study, which is the ideal approach to research the effects of aging in this population.

Le conseguenze socio-economiche della pandemia di Covid-19 in Italia e il ruolo del Terzo settore

This paper is focused on the mechanisms that could potentially allow the Italian Third Sector to develop innovative responses to the old and new needs and vulnerabilities emerging during and after the Covid-19 pandemic. The pandemic, according to the authors, exacerbated preexisting inequalities and vulnerabilities, linked at least to the 2008 Great Recession of social capital. During the Covid-19 crisis, the Third Sector confirmed its ability to respond in an innovative way to emerging social problems and its propensity to question the causes of the problems. By virtue of this ability, the Third Sector could be able to play a leading role in an overall rethinking of the social protection system. The principles of empowerment, the enhancement of social relations, the centrality of the person, are part of the Third Sector's DNA and today find expression in social innovation, capable of affirming an innovative reconciliation between efficiency and solidarity. © 2021 Franco Angeli Edizioni. All rights reserved.

Covid-19 and the Structural Crisis of Liberal Democracies. Determinants and Consequences of the Governance of Pandemic

The pandemic caused by the rapid spread of the Covid-19 virus has revealed impacts well beyond those linked to health. Indeed, it has established itself as what Mauss called a "total social fact", that is, an event that affects every single aspect of society. In this editorial we present some initial reflections on the myriad ways in which the pandemic will affect the State and the relationship between States and citizens as played out in spheres of everyday life. We begin with a brief historical overview of pandemics and the patterns, contradictions and lessons they have left, before looking at the crisis context in which the current pandemic is unfolding. We then take a look at the myriad ways in which the pandemic underlines, emphasises and exacerbates a fundamental rift in the relationship between states and citizens by discussing risk, expertise, communication, de- and re-politicisation and more. We conclude by asking ourselves if beyond the liberal democracy vs autocracy dichotomy - the Post-Covid scenario may conduce toward a new social contract. Finally, we look to existing sociological work that might provide fruitful in moving forward to address this rift, and provide brief overviews of the contributions in this direction from the authors in this special issue.