Reflections on the use of persuasion tools in emergency management and vaccination policy

Behavioral sciences offer important tools to manage the violent Covid 19 pandemic and also represent an interesting point of view for jurists to understand whether the measures adopted by the Government can be framed in the so-called “nudge”. The paper aims to reconstruct prospect theory to evaluate its possible application to pandemic management both on the side of prevention tools and on the side of vaccines. © 2022, Societa Editoriale Federalismi s.r.l.. All rights reserved.

Results from Scotland's 2021 report card on physical activity and health for children and youth: Grades, secular trends, and socio-economic inequalities.

Background: The 2021 Active Healthy Kids Scotland Report Card aimed to identify secular trends and socio-economic inequalities, and to assess the physical activity and health of children and youth prior to COVID-19. Methods: An expert panel searched for data published in 2018-2020. Grades were assigned to nationally representative data using the Active Healthy Kids Global Alliance methodology. Results: The expert panel, following national consultation, awarded the following grades: Community/Environment B-, Organized Sport and Physical Activity B-, Government/Policy C-/C+, Active Transportation C-, Family/Peers D-, Recreational Screen Time F. Five indicators were graded inconclusive (INC): Overall Physical Activity; Active Play; Physical Fitness; Diet; Obesity. Grades have remained stable or declined, and surveillance has reduced, increasing the number of INC grades. There were marked socio-economic inequalities for eight indicators (Recreational Screen Time; Overall Physical Activity; Organized Sport & Physical Activity; Active Transportation; Diet; Obesity; Family/Peers; Community/Environment). Conclusions: Despite a decade of favorable policy, physical activity and health of children and youth has not improved, and marked socio-economic inequalities continue to persist in Scotland. There is a clear need for greater monitoring of physical activity and health, and improved policy implementation and evaluation, particularly as many indicators and related inequalities may have worsened following the COVID-19 pandemic.

MORAL SUASION AND ANTITRUST LAW

As a result of the economic crisis caused by the Covid-19 pandemic, the Italian Competition Authority, following other countries, has increased the use of moral suasion. In the context of antitrust law, this observation allows, on the one hand, to assess the impact of alternative instruments to the classic method that is usually applied in antitrust law: legislation, violation, formal warning, sanction. On the other hand, it suggests shifting attention from rules to behaviour, based on the belief that behavioural dynamics between the logical and mandatory contents of the rules and the actual consequences are underestimated. © 2022, University of Urbino. All rights reserved.

First wave of COVID-19 pandemic and caesarean delivery rate in Italy

INTRODUCTION When COVID-19 first spread in Europe, it was unclear if the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could be transmitted from mother to fetus. Hence, doubts arose as the best way to deliver considering that caesarean delivery (CD) indeed could prevent vertical transmission. METHODS We calculated CD rate in 5 Italian regions (Lombardy, Emilia-Romagna, Tuscany, Umbria, Sardinia) differently affected by the first wave of the pandemic. Data were retrospectively obtained from each birth center and aggregated by areas (provinces). Data related to March-April 2020, corresponding to first COVID-19 peak in Italy, were compared with the March-April 2019 as well with November-December 2019, and odds ratio (ORs) were calculated. RESULTS A total of 24 provinces were included, covering 21.8% of the Italian population. Overall CD rate did not differ in the three examined periods: neither in the comparison of March-April 2019 (reference period) versus November-December 2019 (OR: 0.98 95% CI 0.93-1.05) nor in the comparison of the reference period versus March-April 2020 (OR: 1.03;95 % CI 0.98-1.09). CD rate did not change even in areas with the highest incidence of COVID-19. Only 17 out of 3.257 CDs was due to direct COVID-19 complications (0.5%;95% CI 0.3-0.8). No pregnant women with COVID-19 proven infection died. CONCLUSIONS The first wave of COVID-19 pandemic did not significantly affect delivery mode in Italy, even in areas with the highest infection rates.

Psychological impact on health workers of Covid-19 outbreak in the early emergency period: a brief and quick systematic review

The outbreak caused by a novel coronavirus (Covid-19) is a newly emerged disease started in Hubei province of China as a cluster of pneumonia cases with unknown aetiology. Due to rapid spread and severity of the infection, on March 2020 the World Health Organization (WHO) declared officially Covid-19 outbreak as a pandemic. In front of this public health concern, medical staff is affected both physically and psychologically. The Covid-19 outbreak has caused severe psychological stress, as anxiety, depression, sleep disorders and emotional distress in frontline healthcare workers which were exposed to severe emotional reactions often without psychological support. This review aimed to investigate the existing literature about psychological impact of Covid-19 pandemic on healthcare workers. The literature search was conducted in the following databases: Google Scholar, PubMed, Web of Science, Scopus, PsycInfo. All types of articles published from March 2020 to the end of April 2020 which were relevant to the issue were searched. A total of 39 articles were selected by initial search and 11 of them were included in the final work. PRISMA guidelines were followed. The current review suggests that healthcare workers exposed to the battle against novel coronavirus disease reported considerable levels of depression, anxiety, fear, distress and insomnia. For this reason, it is necessary to highlight that it is essential to provide adequate training and psychological support to medical staff engaged in the emergency in order to minimize the risk of chronicizing the reported symptoms.

Pregnant woman infected by Coronavirus disease (COVID-19) and calcifications of the fetal bowel and gallbladder

COVID-19 was declared to be a pandemic due to the rapid increase of cases around the world, including the number of pregnant women. Data about vertical transmission of COVID-19 are still limited and controversial: in most cases, although a positive mother, the virus could not be isolated in amniotic fluid, cord blood, breast milk or neonatal throat swab in these patients. No data have been published about possible intrauterine sonographic signs of infection. A pregnant woman was diagnosed with SARS-CoV-2 at 35 t5 weeks of gestation and managed conservatively at home. At transabdominal ultrasound at 38+3 weeks, fetal bowel and gallbladder calcifications were noted. CMV and other infectious agents were ruled out an iterative caesarean section was performed at 38+5 weeks without complications. Placenta resulted negative for SARS-CoV-2;the umbilical cord blood sample was IgG positive and IgM negative as per maternal infection. The baby developed respiratory distress syndrome requiring endotracheal surfactant administration and nasal-CPAP for one day but nasopharyngeal swabs at birth and after 48 hours were SARS-CoV-2 negative. Neonatal abdominal ultrasound showed normal liver, acalculous gallbladder with mild parietal thickening. The baby was discharged in good conditions. Although gallbladder calcifications and echogenic bowel are highly suspicious of viral infection and were thought to be due to the vertical transmission of SARS-CoV-2, these findings were not corroborated by the results of our diagnostic tests;these sonographic findings might represent a false positive of fetal infection in mother affected by COVID-19 since vertical transmission appears to be rare.

Pregnant woman infected by Coronavirus Disease (COVID-19) and calcifications of the fetal bowel and gallbladder: a case report

INTRODUCTION: COVID-19 was declared pandemic due to the rapid increase of cases around the world, including the number of pregnant women. Data about vertical transmission of Covid-19 are still limited and controversial: in most cases, although a positive mother, the virus could not be isolated in amniotic fluid, cord blood, breast milk or neonatal throat swab in these patients. No data have been published about possible intrauterine sonographic signs of infection. CASE PRESENTATION: A pregnant woman was diagnosed with SARS-CoV2 at 35+5 weeks of gestation and managed conservatively at home. At transabdominal ultrasound at 38+3 weeks, fetal bowel and gallbladder calcifications were noted. CMV and other infectious agents were ruled out;an iterative Caesarean Section was performed at 38+5 weeks without complications. Placenta resulted negative for SARS-CoV-2;the umbilical cord blood sample was IgG positive and IgM negative as per maternal infection. The baby developed respiratory distress syndrome requiring endotracheal surfactant administration and nasal-CPAP for one day but nasopharyngeal swabs at birth and after 48 hours were SARS-Cov2 negative. Neonatal abdominal ultrasound showed normal liver, acalculous gallbladder with mild parietal thickening. The baby was discharged in good conditions. CONCLUSIONS: although gallbladder calcifications and echogenic bowel are highly suspicious of viral infection and were thought to be due to the vertical transmission of SARS-CoV-2, these findings were not corroborated by the results of our diagnostic tests;these sonographic findings might represent a false positive of fetal infection in mother affected by COVID-19 since vertical transmission appears to be rare.