Background: Research has shown the substantial impact of the COVID-19 pandemic on healthcare workers’ (HCWs) mental health, however, it mostly relies on data collected during the early stages of COVID-19. The aim of this study is to assess the long-term trajectory of HCWs’ mental health and the associated risk factors. Methods: a longitudinal cohort study was carried out in an Italian hospital. At Time 1 (July 2020–July 2021), 990 HCWs took part in the study and completed the General Health Questionnaire (GHQ-12), the Impact of Event Scale (IES-R), and the General Anxiety Disorder (GAD-7)questionnaire. McNemar’s test measured changes in symptoms’ trajectories, and random effects models evaluated risk factors associated with scores above the cut-off. Results: 310 HCWs participated to the follow-up evaluation (Time 2; July 2021–July 2022). At Time 2, scores above cut-offs were significantly lower (p < 0.001) than at Time 1 for all scales (23% vs. 48% for GHQ-12; 11% vs. 25% for IES-R; 15% vs. 23% for GAD-7). Risk factors for psychological impairment were being a nurse (IES-R: OR 4.72, 95% CI 1.71–13.0; GAD-7: OR 2.82, 95% CI 1.44–7.17), a health assistant (IES-R: OR 6.76, 95% CI 1.30–35.1), or having had an infected family member (GHQ-12: OR 1.95, 95% CI 1.01–3.83). Compared to Time 1, gender and experience in COVID-19 units lost significance with psychological symptoms. Conclusions: data over more than 24 months from the pandemic onset showed improvement of HCWs’ mental health; our findings suggested the need to tailor and prioritize preventive actions towards healthcare workforce.

Background: The General Health Questionnaire (GHQ) is a widely used tool, both in clinical and research settings, due to its brevity and easy administration. Researchers often adopt a dichotomous measurement method, considering a total score above or below a certain threshold. This leads to an extreme simplification of the gathered data and therefore to the loss of clinical details. In a multi-step evaluation study aimed at assessing health care workers’ mental health during the Covid-19 pandemic, GHQ-12 proved to be the most effective tool to detect psychological distress compared to other scales adopted. These results led to deepen the understanding of GHQ-12 properties through a statistical study by focusing on items’ properties and characteristics. Methods: GHQ-12 responses were analyzed using Item Response Theory (IRT), a suitable method for scale assessment. Instead of considering the single overall score, in which each item accounts equally, it focuses on individual items’ characteristics. Moreover, IRT models were applied combined with the latent class (LC) analysis, aiming to the determination of subgroups of individuals according to their level of psychological distress. Results: GHQ-12 was administered to 990 health-care workers and responses were scored using the binary method (0-0-1-1). We applied the two-parameter logistic (2-PL) model, finding that the items showed different ways of responses and features. The latent class analysis classified subjects into three sub-groups according to their responses to GHQ-12 only: 47% of individuals with general well-being, 38% expressing signs of discomfort without severity and 15% of subjects with a high level of impairment. This result almost reproduces subjects’ classification obtained after administering the six questionnaires of the study protocol. Conclusions: Accurate statistical techniques and a deep understanding of the latent factors underlying the GHQ-12 resulted in a more effective usage of such psychometric questionnaire – i.e. a more refined gathering of data and a significant time and resource efficiency. We underlined the need to maximize the extraction of data from questionnaires and the necessity of them being less lengthy and repetitive.

Pain management in pediatric patients is a critical aspect of healthcare, yet there is limited research on the knowledge and approaches of medical students regarding this topic. This study investigates the approach to pediatric pain management among final-year medical students. A cross-sectional survey was administered to final-year medical students from six universities located in Northern, Central, and Southern Italy between May and July 2024. The questionnaire (16 items) assessed the students’ knowledge and attitudes toward acute pain management in pediatric patients. Descriptive and inferential statistics were used to analyze the data. A total of 321 students completed the survey. The majority (49%) of students reported limited training (< 1 h) in pediatric pain management during their studies. Only 42% of respondents believed that neonates feel pain more intensively than adults, while 38% thought the same for children up to 3 years. old While 81% recognized that pediatric pain can be measured with age-specific tools, 60% would avoid using opioids for severe pain in children. Seventy-five percent of students reported routinely using analgesia before painful procedures, but 33% would not treat abdominal pain before surgical evaluation in a suspected appendicitis case. Conclusion: There are relevant gaps in the education of medical students on pediatric pain management in Italy. Traditional old views on pain are widespread among final-year medical students. Targeted educational interventions are needed to address these issues and ensure that future healthcare providers are adequately prepared to manage pediatric pain. What is Known • Pediatric pain is often undertreated due to misconceptions among healthcare providers about their pain perception and the long-term consequences of untreated pain. • Studies investigating knowledge and attitudes toward pediatric pain management have primarily focused on physicians or nurses, with limited evidence on medical students' preparation in this area. What is New • This study reveals significant gaps in knowledge and outdated attitudes toward pediatric pain management among final-year medical students in Italy • Barriers to the use of opioids for severe pain management in children are already widespread among medical students

Background: The General Health Questionnaire-12 (GHQ-12) is a widely used screening tool for mental health assessment however its traditional scoring methods and cutoffs may not adequately capture the mental health complexities of younger populations. Methods: This study explores GHQ-12 responses from a sample of university students. Possible differences in means scores considering gender, age, academic field and degree course were assessed through t-test or one-way ANOVA as appropriate. To deeper understanding different levels of severity and individual item impact on general distress measurement, we applied Item-Response-Theory (IRT) techniques (two-parameters logistic model). We compared students’ population with a population of workers who underwent a similar psychological evaluation. Results: A total of 3834 university students participated in the study. Results showed that a significant proportion (79%) of students reported psychological distress. Females and younger students obtained significantly higher average scores compared to others. IRT analysis found item-specific variations in mental distress levels, with more indicative items for short-term fluctuations and potential severe mental health concerns. Latent class analysis identified three distinct subgroups among students (including 20%, 37%, 43% of the participants respectively) with different levels of psychological distress severity. Comparison with a population of adults showed that students reported significantly higher scores with differences in the scale behavior. Conclusion: Our results highlighted the unique mental health challenges faced by students, suggesting a reevaluation of GHQ-12 applicability and cutoff scores for younger populations, emphasizing the need for accurate instruments in mental health evaluation.

Background: Prevention is a key strategy for reducing the burden of food allergies (FA). The maternal diet during pregnancy and breastfeeding is increasingly recognized as a factor contributing to FA risk. Methods: We analyzed data from a sub‐cohort of the MEDALLION study to evaluate the association between maternal adherence to the Mediterranean Diet (MedDiet) and the development of FA in offsprings. Maternal dietary intake during pregnancy and lactation was assessed using a validated scale, i.e., the MedDiet Score, along with individual food group consumption. Multiple logistic regression models were performed. Results: A total of 430 mother‐offspring dyads were included in the analysis. Higher maternal adherence to the MedDiet was associated with reduced odds of FA in offspring during both pregnancy (adjusted OR 0.94, 95% CI 0.89–1.00) and lactation (adjusted OR 0.94, 95% CI 0.88–1.00). Increased weekly consumption of fruits and full‐fat dairy products during pregnancy, and vegetables during breastfeeding, was associated with reduced likelihood of FA in the offspring. Conversely, higher intake of poultry and red meat (> 3 servings/week) during both periods, and fish consumption during pregnancy (> 1 serving/week), were associated with increased odds of FA. Conclusions: This study points out that the MedDiet and, especially, some specific components, such as fruits, vegetables, and full‐fat dairy products, may contribute to lowering the risk of FA in infants, whereas a higher intake of poultry, red meat, and fish may increase it. These findings support the potential of maternal nutrition to reduce childhood FA.

Complementary feeding (CF) influences infants' long‐term dietary preferences, growth, and food allergy (FA) risk. However, guidance given to families and the implementation of FA prevention guidelines by healthcare professionals (HCPs) remain unclear. This study explored HCPs' perspectives and practices regarding CF strategies in the context of FA prevention across different regions and professional backgrounds. An online survey conducted by an EAACI task force between December 2023 and May 2024 assessed CF timing, allergenic food introduction, nutrient supplementation, and FA preventive measures. 550 HCPs (pediatricians, allergists, dietitians), 68% from Europe, participated. HCPs recommended CF initiation at a median of six months for breastfed infants and five months for formula‐fed and FA high‐risk infants. Atopic dermatitis (94%) and family history of allergies (87%) were the most recognized FA risk factors. Vitamin D (49%), probiotics (28%), and omega‐3 fatty acids (18%) were commonly recommended supplements. Regional, professional, and educational influences differences emerged, with Northern European HCPs favoring earlier CF and allergen introduction, often without structured guidance. Southern European HCPs preferred a structured sequence and later CF initiation. A flexible, evidence‐based framework is needed to guide FA prevention while accommodating cultural and geographical differences.