Background COVID-19 pandemic has stretched healthcare system capacities worldwide and deterred people from seeking medical support at Emergency Departments (ED). Nevertheless, population-based studies examining the consequences on children are lacking. Methods All ED visits from 2019 to 2020 in Veneto, Italy (4.9 million residents) were collected. Anonymized records of pediatric (≤14 years) ED visits included patient characteristics, arrival mode, triage code, clinical presentation, and discharge mode. Year-on-year variation of the main ED visit characteristics, and descriptive trends throughout the study period have been examined. Results Overall, 425,875 ED presentations were collected, 279,481 in 2019, and 146,394 in 2020 (− 48%), with a peak (− 79%) in March–April (first pandemic wave), and a second peak (below − 60%) in November–December (second pandemic wave). Burn or trauma, and fever were the two most common clinical presentations. Visits for nonurgent conditions underwent the strongest reduction during both pandemic waves, while urgent conditions reduced less sharply. ED arrival by ambulance was more common in 2020 (4.5%) than 2019 (3.5%), with a higher proportion of red triage codes (0.5%, and 0.4% respectively), and hospitalizations following ED discharge (9.1%, and 5.9% respectively). Conclusion Since the beginning of the COVID-19 pandemic, pediatric ED presentations underwent a steeper reduction than that observed for adults. Lockdown and fear of contagion in hospital-based services likely deterred parents from seeking medical support for their children. Given COVID-19 could become endemic, it is imperative that public health experts guarantee unhindered access to medical support for urgent, and less urgent health conditions, while minimizing infectious disease risks, to prevent children from suffering direct and indirect consequences of the pandemic.

Vaccination against SARS-CoV-2 will likely be the most promising way to combat the pandemic. Even if mass vaccination is urgent, it should still always be supported by appropriate patient safety management. The aim of this study, based on failure mode, effects and criticality analysis (FMECA), was to identify possible failures and highlight measures that can be adopted to prevent their occurrence. A team of resident doctors in public health from the University of Padua and specialists in risk analysis in public health examined the mass vaccination process. A diagram was drafted to illustrate the various phases of mass vaccination, analyze the process, and identify all failure modes. Criticalities were ascertained by rating the severity, frequency and likelihood of failure detection on a scale of 1 to 10. We identified a total of 71 possible faults distributed over the various phases of the process, and 34 of them were classified as carrying a high risk. For the potentially high-risk failure modes, we identified 63 recommended actions to contain the cause of their occurrence or improve their detection. For the purpose of detecting potential failures, FMECA can be successfully applied to mass vaccination, which should be considered a high-risk process.

Background Stress and negative emotions may impact on appetite, inducing some individuals to eat less and others to eat more. This behavior has been implicated in the onset of bodyweight problems and eating disorders in childhood. The aim of our study is to evaluate factors potentially associated with emotional eating in children. Methods The present cross-sectional study derives from a survey conducted in 2021 on 8–9 years old children attending 11 primary schools. A questionnaire was administered that contained multiple-choice items relating to the children and their mothers, and touching on all the factors thought to be associated with emotional eating as behavioral traits or adherence to Mediterranean diet. A multivariable logistic regression was performed to test the association. Results Emotional undereating was positively associated with emotional symptoms (OR 1.72; 95% CI 1.11–2.67); emotional overeating was positively associated with both emotional symptoms (OR 2.01; 95% CI 1.29–3.13) and hyperactivity (OR 2.80; 95% CI 1.59–4.92), and inversely associated with peer problems (OR 0.50; 95% CI 0.25–0.99). Emotional undereating was also positively associated with the number of siblings (OR 1.50; 95% CI 1.03–2.18), and inversely associated with a good adherence to the Mediterranean diet (OR 0.25; 95% CI 0.08–0.84). Conclusions The study found children’s emotional eating associated with both dietary patterns and behavioral traits (in particular emotional symptoms, hyperactivity and peer problems). It could be useful to improve parents’ awareness so that they can anticipate and pay more attention to this issue. Adherence to the Mediterranean diet should also be reinforced, by means of health promotion interventions at school, for example.

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BackgroundLong-term survivors of cutaneous malignant melanoma (CMM) risk subsequent malignancies due to both host-related and environmental risk factors. This retrospective population-based study differentially assesses the risk of synchronous and metachronous cancers in a cohort of CMM survivors stratified by sex.MethodsThe cohort study (1999–2018) included 9,726 CMM survivors (M = 4,873, F = 4,853) recorded by the cancer registry of all 5,000,000 residents in the Italian Veneto Region. By excluding subsequent CMM and non-CMM skin cancers, the incidence of synchronous and metachronous malignancies was calculated according to sex and tumor site, standardizing for age and calendar year. The Standardized Incidence Ratio (SIR) was calculated as the ratio between the number of subsequent cancers among CMM survivors and the expected number of malignancies among the regional population.ResultsIrrespective of the site, the SIR for synchronous cancers increased in both sexes (SIR = 1.90 in males and 1.73 in females). Both sexes also demonstrated an excess risk for synchronous kidney/urinary tract malignancies (SIR = 6.99 in males and 12.11 in females), and women had an increased risk of synchronous breast cancer (SIR = 1.69). CMM male survivors featured a higher risk of metachronous thyroid (SIR = 3.51, 95% CI [1.87, 6.01]), and prostate (SIR = 1.35, 95% CI [1.12, 1.61]) malignancies. Among females, metachronous cancers featured higher SIR values than expected: kidney/urinary tract (SIR = 2.27, 95% CI [1.29, 3.68]), non-Hodgkin’s lymphoma (SIR = 2.06, 95% CI [1.24, 3.21]), and breast (SIR = 1.46, 95% CI [1.22, 1.74]). Females had an overall increased risk of metachronous cancers in the first 5 years after CMM diagnosis (SIR = 1.54 at 6–11 months and 1.37 at 1–5 years).ConclusionAmong CMM survivors, the risk of metachronous non-skin cancers is higher than in the general population and differs significantly by sex. These results encourage sex-tailored interventions for metachronous secondary cancer prevention.