National Centre for Disease Prevention and Control

Frailty influences the risk, phenotypic expression, and course of highly prevalent neurological conditions. However, the structural, functional, and pathological changes in the brain associated with frailty remain insufficiently explored. This narrative review examines existing evidence on the functional and pathological brain correlates of frailty in both healthy adults and patients with neurological conditions, encompassing findings from neuropathology, fluid biomarkers, neuroimaging, and neurophysiology. Autopsy studies suggest that individuals experiencing frailty may exhibit decreased resistance and resilience to neuropathological changes, along with heightened cognitive vulnerability, even in the presence of low levels of pathology. The accumulation of brain pathology may, in turn, play a role in accelerating frailty progression. Numerous MRI-based studies have shown that frailty is associated with vascular brain damage, mostly consisting of increased white matter hyperintensity volumes, and with reduced gray matter volumes. Additionally, variations in cerebrospinal fluid and plasma biomarkers of Alzheimer's disease pathology have been documented. Furthermore, frailty-related changes in EEG/MEG signals and brain plasticity suggest potential widespread neural dysfunction. Future research is needed to elucidate the pathophysiological mechanisms underlying the neurological correlates of frailty. This exploration should encompass key aspects of aging, such as inflammation, mitochondrial dysfunction, and impaired proteostasis. Gaining a deeper understanding of the relationship between frailty and brain function and pathology could pave the way for discovering novel biomarkers and intervention targets, ultimately impacting the prevention and management of age-related neurological conditions.

INTRODUCTIONMild cognitive impairment (MCI) represents a transitional state between normal aging and dementia, with 30%–50% of cases progressing to dementia. However, some individuals remain stable over time, even when presenting biomarker profiles that indicate high risk. Understanding the neural mechanisms underlying this resilience is essential for developing targeted preventive strategies.METHODSWithin the Italian INTERCEPTOR project, we investigated electroencephalography (EEG) markers of resilience in MCI individuals who exhibited reduced hippocampal volume and abnormal fluorodeoxyglucose‐positron emission tomography (FDG‐PET) at baseline but remained stable and did not progress to dementia after 36 months. Two MCI subgroups were compared: those who do not convert (sMCI‐resilient) and those who converted (cMCI) to dementia. A third group of cognitively healthy, age‐ and education‐matched older adults served as controls. Baseline EEG analyses examined spectral power, delta/alpha ratio, functional connectivity, and graph‐theoretical network properties.RESULTSCompared with sMCI‐resilient subjects, cMCI individuals exhibited increased frontal delta power, reduced posterior alpha power, and an elevated delta/alpha ratio in the right temporal region, consistent with cortical dysfunction. In contrast, sMCI‐resilient subjects showed stronger frontal and temporal alpha‐band connectivity and higher small‐world (SW) index values in the alpha‐2 band, suggesting more efficient network organization.DISCUSSIONSpecific EEG signatures—characterized by adaptive spectral patterns, preserved connectivity, and efficient network topology—may represent neurophysiological correlates of resilience in high‐risk MCI. These findings highlight the potential of EEG markers for early intervention and stratification strategies in individuals at risk of dementia.HighlightsElectroencephalography (EEG) markers differentiate resilience and progression in mild cognitive impairment (MCI) individuals with high‐risk biomarker profiles.Converters (cMCI) show increased delta power, reduced alpha activity, and higher delta/alpha ratios, indicating cortical dysfunction.Resilient MCI (sMCI) maintain healthy delta profiles, enhanced frontal alpha power, and stronger anterior connectivity.Graph‐theoretical analysis reveals higher small‐world (SW) index in resilient MCI, suggesting efficient and flexible network organization.EEG is a non‐invasive, accessible tool to capture both risk and resilience factors, with potential for early diagnosis and personalized interventions.

Globally research centres in healthcare sector express the excellence in the translational medicine, from the evidence-based medicine to the evidence-based practice. In Italy, Institutes of Hospitalization and Healthcare with Scientific Goal (called IRCCS) are recognized as the driving force of innovation within healthcare sector. It is reasonable to expect that health professionals working within IRCCS institutions should embody professional excellence in a setting characterized by technological and organizational excellence. Nevertheless, in Italian public IRCCS, the personnel are selected by public competitions without any specific requirements in relation with the specific working context. According to the current state-of-art, this research aims to investigate the characteristic of healthcare professionals currently employed within Italian IRCCS facilities. IRCCS University Hospital of Bologna was chosen as suitable case study due to the enlargement of top management within the Healthcare Professions Directorate, that manifests a particular sensibility toward healthcare professionals growing. Dataset on personnel included sociodemographic information (age, sex, place of birth, residence, domicile), professional details (job category, role, working hours, training, allowances, contribution), and training status (household composition, number of children, number of dependents, physical limitations). The detailed description of healthcare professionals employed within the case study supports evidence-based decision-making for the development of corporate welfare policies and of targeted management strategies, useful and applicable in each healthcare research centre worldwide.

Most governments worldwide introduced containment measures to protect people from the risk of SARS-CoV-2 virus infection which also affected children. The COVID-19 pandemic and the resulting confinement at home may have affected physical health and mental well-being especially among vulnerable young people, widening health disparities. Therefore, the aim of the EPaSS-ISS study was to study the changes in physical activity and sedentary behaviours among 8-9 years old Italian students during the pandemic of COVID-19 compared with before the pandemic. Data were collected using a web questionnaire. The target population was parents of children attending third-grade primary schools and living in Italy. A cluster sample design was used. Logistic regression models were used to explore changes between the pre-pandemic and pandemic periods in children's studying hours, active play and screen time. The possible effects of gender, geographical area of residence, parents' nationality and educational level, family structure, family-perceived wealth, availability of home outdoor spaces and house size were investigated. A stratification by sociodemographic characteristics of children and parents was also included in the analysis. 4863 children were included: 47.9% were females, the average age was 8 years and 9 months (SD ± 5 months). The parents reported that 44.3% of their children increased the time spent studying at home, 52.7% the screen time for non-educational purposes on weekdays, and 47.3% at weekends; 44% of the children decreased their time spent playing actively outside school hours on weekdays and 39.3% at weekends. A larger increase of sedentary lifestyle was found among children with at least one parent with a medium (OR:2.57; 95%CI:1.78-3.72) or high educational level (OR:3.32, 95%CI:2.29-4.82), with low family-perceived wealth (OR:1.21; 95%CI:1.03-1.41), with both Italian parents (OR:1.44; 95%CI:1.10-1.90), resident in Centre (OR:1.25; 95%CI:1.04-1.50) or South (OR:1.26; 95%CI:1.05-1.51) Italy. No outdoor spaces (OR:2.14; 95%CI:1.82-2.51) and home size < = 90m2 (OR:1.41; 95%CI:1.05-1.68) had also a negative effect on children's behaviours. In Italy physical activity decreased and sedentary behaviours increased among 8-9 years old children during the COVID 19 pandemic.

Background/Objectives: The increasing incidence of cancer during pregnancy is a growing public health concern, driven by delayed parenthood and rising maternal age. Pregnancy-associated cancer (PAC) presents complex clinical challenges, necessitating a balance between maternal cancer treatment and fetal safety. Historically considered incompatible with favorable pregnancy outcomes, evidence now suggests that pregnancy can often proceed without affecting cancer prognosis. A 2022 study in Italy provided the first population-based PAC estimates by linking cancer registries (CRs) and hospital discharge records (HDRs). This study aimed to update PAC estimates to 2019, covering 30% of the Italian population and addressing prior data limitations. Methods: A retrospective longitudinal analysis was conducted on women aged 15-49 diagnosed with malignant cancers between 2003 and 2019. Data from 21 Italian CRs were linked with HDRs to identify PAC cases, defined as obstetric hospitalizations occurring for women diagnosed with cancer in our study cohort in the period spanning from one year before to two years after a cancer diagnosis. All malignant cancers, excluding non-melanoma skin cancers, were analyzed. PAC rates were calculated per 1000 pregnancies, and trends were assessed using log-linear and JoinPoint regression models. Results: Among 131,774 women diagnosed with cancer, 6329 PAC cases were identified, with a PAC rate of 1.43 per 1000 pregnancies, consistent with global estimates. Thyroid (24.4%) and breast cancer (23.2%) were the most common. Analyzing the PAC rate by pregnancy outcome, in the period 2015-2019, this increased for both childbirths and miscarriages but decreased for voluntary terminations. Most hospitalizations (54%) occurred pre-diagnosis, peaking at diagnosis, especially for breast cancer (69%). Conclusions: PAC incidence is rising, particularly for live births and miscarriages, underscoring the need for multidisciplinary care and robust epidemiological insights to guide clinical management.

The European Directorate for the Quality of Medicines & HealthCarehas been co-ordinating an external quality assessment programme for blood establishment (BE) laboratories since 2010. To further expand the study portfolio, a new bacterial blood proficiency testing scheme (B-PTS) for platelet components (PCs) has been developed and validated in a pilot study. Sterile samples and those containing a low-count quantity of bacteria were prepared in spiking devices. Suitability of storage and shipping conditions for the samples was evaluated under different environmental conditions. Participants received the spiking devices, prepared the potentially contaminated PCs on site and tested them according to their routine screening procedures. Humidity compromised the quality of the samples. Optimized storage of the samples by adding a desiccant ensured satisfactory quality. In the pilot study, 9 of the 11 participants correctly identified the positive samples as being bacterially contaminated. The newly developed bacterial B-PTS was successfully implemented in a pilot study. It enables an inter-laboratory comparison to determine the performance of BEs for the testing of bacterial contaminations in PCs.

Abstract Background International comparisons provide essential benchmarks for evaluating perinatal health policies, but these rely on the availability of routine national birth data. This study aimed to describe population birth data sources in Europe by their ability to provide core perinatal health indicators. Methods The Euro-Peristat Network collected routine national data on a recommended set of core indicators from 2015 to 2021 using a federated protocol based on a common data model with 17 data items. Data providers filled in an on-line questionnaire to describe the sources used in each country. We classified countries by the number of data items they provided (all 16, 15-14, &amp;lt;14). Results 28 out of the 31 countries that provided data responded to the survey. Routine data sources included birth certificates (14 countries), electronic medical records (EMR) from delivery hospitalizations (14 countries), direct entry by health providers (9 countries), EMR from other care providers (6 countries) and Hospital Discharge Summaries (7 countries). Completeness of population coverage was at least 98%, with 15 countries reporting 100%. These databases most often included mothers giving birth on the national territory, regardless of nationality or place of residence (19 countries). In 20 countries, routine sources were linked, including linkage between birth and death certificates (15 countries). Countries providing all 16 items (N = 8) were more likely to use EMRs from delivery hospitalizations, 88%, compared to 50% and 13% in countries with 15-14 items (N = 13) and &amp;lt;14 items (N = 8). Linkage was also more common in these countries, 100%, versus 75% and 50% respectively. Other data source characteristics did not differ by the ability to provide data for the common data model. Conclusions There is high diversity in the data sources used to construct perinatal health indicators in Europe. Countries using EMR with linkage to other sources had the best data availability. Key messages • There is high diversity in the data sources used to construct perinatal health indicators in Europe. • Countries using Electronic Medical Records with linkage to other sources had the best data availability.

The wait for the upcoming disease-modifying therapies (DMT) for Alzheimer's disease in Europe is raising questions about the preparedness of national healthcare systems to conduct accurate diagnoses and effective prescriptions. In this article, we focus on the current situation in Italy. The primary goal is to propose a profile of the Italian Centers for Cognitive Disorders and Dementias (CCDDs) that could be taken into consideration by regional and autonomous provincial authorities when deciding on the prescribing centers for DMT. Based on responses to a national survey on CCDDs in Italy, we identified the CCDDs that meet the requirements for effective prescription: 1) Multidisciplinary team; 2) Minimum Core Test for the neuropsychological assessment; 3) PET, CSF, and Brain MRI assessments. Univariate and multivariate comparisons were conducted between CCDDs that met the criteria and the others. Only 10.4% of CCDDs met the requirements for effective DMT prescription, mainly located in Northern Italy. They are also characterized by longer opening hours, a higher number of professionals, a university location, and a higher frequency of conducting genetic tests, and could potentially result in prescribing centers. The findings suggest that the Italian national healthcare system may benefit from further enhancements to facilitate the effective prescription of DMTs. This could involve initiatives to reduce fragmentation, ensure adequate resources and equipment, and secure sufficient funding to support this aspect of healthcare delivery.

SynopsisAll pregnant women at risk should be screened for Chagas disease, as recommended by the Italian National Institute of Health.

This study explores burnout among nursing students in Bangalore, India, focusing on Exhaustion and Disengagement scores. A cross-sectional design was applied using the Oldenburg Burnout Inventory modified for nursing students, collecting data using a survey that was conducted between October and December 2023. The sample consisted of 237 female nursing students from the Bachelor of Science in Nursing program at Bangalore College of Nursing, South India. The study integrated the t-distributed Stochastic Neighbor Embedding (t-SNE) procedure for data simplification into three t-SNE components, used in a hierarchical clustering analysis, which identified distinct student profiles: "High-Intensity Study Group" and "Altruistic Aspirants". While burnout scores were generally high, students with high study hours ("High-Intensity Study Group") reported greater Exhaustion, with a mean score of 26.78 (SD = 5.26), compared to those in the "Altruistic Aspirants" group, who reported a mean score of 25.00 (SD = 4.48), demonstrating significant differences (p-value = 0.005). Conversely, those motivated by altruism ("Altruistic Aspirants") showed higher Disengagement, with a mean score of 19.78 (SD = 5.08), in contrast to "High-Intensity Study Group", which reported a lower mean of 17.84 (SD = 4.74) (p-value = 0.002). This segmentation suggests that burnout manifests differently depending on the students' academic load and intrinsic motivations. This study underscores the need for targeted interventions that address specific factors characterizing the clusters and provide information for designing future research and interventions. This study was not registered.