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Hepatic encephalopathy (HE) is a major problem in patients treated with TIPS. The aim of the study was to establish whether pre-TIPS covert HE is an independent risk factor for the development of HE after TIPS. Eighty-two consecutive cirrhotic patients submitted to TIPS were included. All patients underwent the PHES to identify those affected by covert HE before a TIPS. The incidence of the first episode of HE was estimated, taking into account the nature of the competing risks in the data (death or liver transplantation). Thirty-five (43%) patients developed overt HE. The difference of post-TIPS HE was highly significant (P=0.0003) among patients with or without covert HE before a TIPS. Seventy-seven percent of patients with post-TIPS HE were classified as affected by covert HE before TIPS. Age: (sHR 1.05, CI 1.02-1.08, P=0.002); Child-Pugh score: (sHR 1.29, CI 1.06-1.56, P=0.01); and covert HE: (sHR 3.16, CI: 1.43-6.99 P=0.004) were associated with post-TIPS HE. Taking into consideration only the results of PHES evaluation, the negative predicting value was 0.80 for all patients and 0.88 for the patients submitted to TIPS because of refractory ascites. Thus, a patient with refractory ascites, without covert HE before a TIPS, has almost 90% probability of being free of HE after TIPS. Psychometric evaluation before TIPS is able to identify most of the patients who will develop HE after a TIPS and can be used to select patients in order to have the lowest incidence of this important complication.

Emerging evidence suggests that diets rich in plant-based foods and beverages may exert plausible effects on human health tackling the risk of chronic diseases. Although the data are promising for numerous outcomes, including cardiovascular diseases, the data on mental health are limited. The aim of this study was to investigate the association between individual polyphenol-rich beverages intake and mental health outcomes, such as perceived stress, depressive symptoms, and sleep quality, among adult individuals living in the Mediterranean area. The demographic and dietary characteristics of a sample of 1572 adults living in southern Italy were analysed. Multivariate logistic regression analyses, controlling for confounding factors, were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of the association between individual polyphenol-rich and alcoholic beverages containing polyphenols and mental health outcomes. The multivariate model adjusted for background covariates and the Mediterranean diet showed that individuals with a moderate intake (up to 1 cup/glass per day) of coffee and tea were less likely to have high perceived stress (OR = 0.61, 95% CI: 0.45–0.84) and depressive symptoms (OR = 0.56, 95% CI: 0.39–0.80), respectively. Furthermore, regular coffee and moderate/regular red wine drinkers were less likely to have depressive symptoms (OR = 0.72, 95% CI: 0.54–0.95 and OR = 0.74, 95% CI: 0.54–0.99, respectively). No significant associations were retrieved for the intake of polyphenol-rich and alcoholic beverages and sleep quality. In conclusion, the results of the present study suggest that polyphenol-rich beverages may be associated with mental health, in terms of depressive symptoms and perceived stress. Nonetheless, further research exploring how the polyphenol-rich beverages impact brain health and what the optimal patterns of consumption are for different populations are warranted.

This study provides an empirical assessment of the socioeconomic factors that determine household exclusion from consumer financial services. A unique microeconomic data set, of interview data, collected from a representative cross-sectional sample of 1005 households is analysed using logistic regression techniques. In investigating exclusion from consumer financial services, both financial self-exclusion and institutional-led financial exclusion are examined. Indicators of financial self-exclusion include the absence of a savings account or home contents insurance, whilst indicators of institutional-led financial exclusion include the use of “doorstep lenders.” Findings show that both measures of financial self-exclusion are determined by income, education, age, housing tenure, and social participation, whilst financial exclusion is generally associated with socioeconomic characteristics such as age, gender, housing tenure, working status, income, disability, and the presence of young people in household but not with respondents’ residential area, education level, internet use, and social participation. These results offer useful insights to policy makers and financial services providers in terms of the range and mix of policies and instruments that local and central Government can deploy to address exclusion.

Population-based cancer registries are crucial to monitor health system performance, inform policy makers and allocate resources effectively. We updated Italian survival estimates for children and adolescents, analysing temporal and geographical differences to evaluate improvements. Cases were from the Association of Italian Cancer Registries and codified according to the International Classification of Childhood Cancer, 3rd edition. Thirty-one cancer registries provided 9142 incident cases (2013–2017) and 15 cancer registries contributed data for 12,447 incident cases (1998–2017) for trend analysis. We used the period approach to estimate survival in children (0–14 years) and adolescents (15–19 years) during the period 2013–2017. Survival was estimated by age, sex and geographical area of residence. Survival improved over time in both children and adolescents. Among children, significant progress was observed for acute myeloid leukaemia, non-Hodgkin lymphomas, ependymomas, Ewing sarcoma, and acute lymphoid leukaemia. For adolescents, notable improvements were found in non-Hodgkin lymphomas and skin melanomas. However, disparities emerged across Italy, with major differences observed for central nervous system neoplasms and osteosarcoma in children, as well as for acute lymphatic leukaemia and soft tissue sarcomas in adolescents. Increased survival was observed in many Italian children and adolescents with tumours and differences emerged across Italian regions. We will investigate the reasons for these discrepancies in collaboration with clinicians. •In Italy, 5-year survival reached 85 % in children, 89 % in adolescents.•Progress has been observed in leukaemia, lymphomas, and certain solid tumours.•Survival improved in children with acute myeloid leukaemia and non-Hodgkin lymphomas.•In adolescents, survival increased mainly for lymphomas.•Cancer registries are essential to monitor trends and guide health policies.