Background/Aim. Inflammatory bowel disease (IBD) is a chronic disorder affecting patients’ quality of life and increasing their disability. The aim of our study was to evaluate clinical and pharmacological factors associated with impaired quality of life and disability in a large cohort of IBD patients during IBD treatment. Methods. We consecutively and prospectively recruited all IBD patients referred to the IBD Unit of the “Azienda Ospedaliera” of Padua. Demographics and clinical information were collected, and all patients completed the IBD questionnaire (IBDQ) and the IBD-Disability Index (IBD-DI) questionnaire. A multivariate regression model and Spearman’s rank correlation coefficient were applied for detecting IBD-related variables relevant to disability and quality of life. Results. We included 435 IBD patients. Multivariate regression modelling identified active disease, anaemia, presence of extraintestinal manifestations, and Crohn subtype as independent predictors for both disability and poor quality of life. We observed a strong positive correlation between IBD-DI and IBDQ (r=0.84, p<0.001), while there was no association with ongoing therapy or other clinical features disease-related. Conclusions. Our study showed that disability and quality of life are both associated with active disease, anaemia, presence of extraintestinal manifestations, and Crohn phenotype while ongoing therapy seems not to be associated with disability and QoL during disease management.

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Objectives Ulcerative colitis (UC) can give rise to several restrictions of patients' working and social activities. We aimed to determine the association between disease chronicity and the state of disability in a large population with UC. Methods We recruited consecutive patients with UC attending the inflammatory bowel disease (IBD) unit of the Azienda Ospedaliera of Padua between July and December 2017. We collected patients' characteristics and clinical information, and all participants completed the IBD questionnaire (IBDQ) for quality of life assessment and the IBD disability index (IBD‐DI) questionnaire. Using univariate logistic regression models we assessed whether the patients' characteristics and IBD‐related variables were associated with an IBD‐DI score ≤3.5. Statistically significant variables in the univariate analyses were then included in a multivariate regression model. Correlations between IBD‐DI and all the above mentioned characteristics were investigated using the Spearman's rank correlation coefficient. Results We included 201 patients. A positive correlation was observed between IBD‐DI and IBDQ (r = 0.82, P < 0.001). Multivariate regression modelling identified the following as independent factors related to disability: active disease (partial Mayo score ≥2) (odds ratio [OR] 6.54, 95% CI 3.21‐13.22), the presence of extraintestinal manifestations (EIM) (OR 2.48, 95%, CI 1.11‐5.54) and occasional alcohol consumption (OR 0.39, 95% CI 0.20‐0.76). Conclusions Impaired disability is mainly correlated with disease activity, the presence of EIM and no alcohol consumption. Moreover, there is a strong correlation with patients' quality of life. Therefore, in clinical practice, greater awareness of IBD‐related disability is needed to better manage patients' outcomes.

This study was aimed to identify intermediary organizations active in nature conservation initiatives by adopting a multi-level (ML) and network governance (NG) framework and using social network analysis (SNA). We identified 256 coordinating beneficiaries and 1090 associated beneficiaries connected through 8310 project relations and financed through the EU-funded LIFE Programme from 2014 to 2020. Our results evidence a central component of the network where organizations from Italy, Spain, and the United Kingdom play a central role. In contrast, peripheral components return a framework of partnerships mainly constituted by actors of the same country (68%). Moreover, the characterization by type of actor confirms the widespread implementation of a multi-level governance approach in LIFE-Nature (NAT) projects, evidencing the significant presence of non-governmental organizations and foundations, mainly at a national level, in nature conservation initiatives. Our findings reveal that the intermediary capacity of key actors should be further reinforced, particularly toward the promotion of transnational cooperation and cross-sector alliances, by encouraging the involvement of stakeholders operating at the ground level (i.e., provincial and municipal levels).

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