Social and Health Research Center

Abstract Background in the 2020, the number of deaths increased substantially in Italy, mainly because of the COVID-19 pandemic; mortality was among the highest in Europe, with a clear heterogeneity among regions and socio-demographic strata. The present work aims at quantifying excess mortality variability over time and in relation to demographic and pre-existent chronic conditions and care setting in Emilia-Romagna region, Italy. Methods registry-based study, comparing the 2020 observed mortality with the figures of the previous 5 years by age, sex, month, place of death, and pre-existing chronic conditions and including 300 094 deaths referred to 18+ aged people resident in Emilia-Romagna region (Northern Italy). Results excess deaths were higher during the first pandemic wave, particularly among man in March. Age-adjusted risk was similar among both men and women (Mortality Rate Ratio 1.15; IC95% 1.14-1.16). The risk of dying was sensibly higher among females aged 75+ years, in Long-term Care Facilities and at home. Excluding COVID-19 related deaths, differences in the risk of dying estimates tended to disappear. Metabolic and neuropsychiatric diseases were more prevalent among those deceased in 2020 compared to the deaths occurred in 2015-19. Conclusions no particular differences of risk by sex and age were found, despite the heterogeneity of the effect in relation to the sub-periods. Metabolic and neuropsychiatric diseases have been confirmed as elements of increased frailty, such as being in Long-term Care Facilities or private home as place of death. Understanding the impact of the pandemic on overall mortality is relevant in a changing scenario.

IntroductionDespite the consistent evidence of the benefits of physical activity on preventing atherosclerotic cardiovascular diseases (ASCVD) and some cardiovascular risk factors, such as hypertension and dyslipidaemia, the prescription of drugs remains the most widely used approach to prevent ASCVD in clinical settings. The purpose of this study protocol is to provide a meta-synthesis methodology for comparing the effect of fixed-dose combination therapy and physical exercise on controlling cardiovascular risk factors and preventing ASCVD.Methods and analysisThis protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the recommendations of the Cochrane Collaboration Handbook. We plan to conduct a computerised search in Medline, Web of Science, Embase, Cochrane Database of Systematic Reviews and SPORTDiscus from inception to May 2020 for studies testing the effectiveness of physical exercise or fixed-dose combination drug therapy in preventing ASCVD, all-cause and cardiovascular mortality and controlling some cardiovascular risk factors (hypertension and dyslipidaemia). Since performing network meta-analyses (NMA) is a statistical approach that allows direct and indirect comparisons of interventions, where sufficient studies are included, we plan to perform the following NMA comparing the effect of fixed-dose combination therapy and physical exercise interventions on (1) improving lipid profile, (2) reducing blood pressure, (3) preventing cardiovascular events and all-cause and cardiovascular mortality and (4) improving compliance with the therapeutic strategy and reducing adverse events.Ethics and disseminationEthical approval will not be needed because data included in the NMA will be extracted from published trials that meet accepted ethical standards. The results will be published in academic peer-reviewed journals, and the evidence gathered by this project could be included in the preventive cardiovascular disease guidelines.PROSPERO registration numberCRD42019122794.

0787A The Physical Activity Questionnaire for Older Children (PAQ-C) is a validated selfreport measure of physical activity which has been widely used to assess physical activity in children (8–14 yrs). To date however, the instrument has been validated in largely Caucasian, Canadian samples. PURPOSE: To determine the psychometric properties of the PAQ-C for American Caucasian, Hispanic, and African-American youth. METHODS: Two independent samples were administered the PAQ-C in a classroom setting along with a step test for measurement of cardiovascular fitness. Heart rate was recorded immediately following the completion of the step test and at 1 and 2 minutes post, and then averaged to produce an average recovery heart rate. Lower heart rate response to the step test was considered indicative of better fitness. Sample one consisted of 600 (303M, 297F) Hispanic fifth grade children (11.3 ± .5 yrs). Sample two consisted of 108 Caucasian (8.8 ± .5 yrs) and 189 African-American (8.8 ± .6 yrs) third grade children (143M, 154F). RESULTS: For sample one, the PAQC demonstrated acceptable reliability for Hispanic children (α = .74). Furthermore, the PAQ-C was significantly correlated with average recovery heart rate (r = −.11, ñ < .01). For sample two, the reliability coefficients (α) were .68, and .60 for Caucasian and African-American children, respectively. Furthermore, the PAQ-C was significantly correlated with average recovery heart rate following the step test in Caucasian children (r = −.22, ñ < .05) and in African American children (r = −.14, ñ = .052). CONCLUSIONS: The PAQ demonstrated reliability and validity in all three major US ethnic groups. Research supported by NIH grants DK63391 & DK59213