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Background: The spread of SARS-CoV-2 required virtually all governments to employ non-pharmaceutical infection containment measures such as quarantine and generalised lockdowns. Several authors raised warnings about potential negative changes in alcohol-related behaviours due to the lockdowns. The objective of the present systematic review was to summarise available evidence on trends of alcohol consumption temporally associated with COVID-19 lockdowns. Methods: We performed a systematic review in PubMed, Scopus, Web of Science and EMBASE, using the search terms ‘coronavirus’, with either ‘alcohol drinking’, ‘alcoholism’, ‘alcoholic beverages’, and ‘alcohol intoxication’. Studies were included if they evaluated the change in alcohol consumption prevalence or frequency both before and during the lockdowns, or if they assessed changes in alcohol use retrospectively. The outcomes were changes in prevalence of alcohol consumption, or in its frequency. Results: A total of 128 records were retrieved, and 24 studies met eligibility criteria. Most samples were drawn from either the general population (e.g. social media users), university students, or regular drinkers. The outcomes measurements varied widely, and multiple scales were also used for the assessment of harmful alcohol use. The majority of the studies found that alcohol consumption prevalence increased during lockdowns (e.g. +25.7% in UK). Also, increased frequencies were reported by 14.0% in Poland and 32.1% in China. Finally, one study from Australia observed no overall changes, while one from Cyprus reported decreased alcohol consumption frequency. Conclusions: Understanding the impact of lockdowns on alcohol consumption is essential for countering possible increases in harmful use, and a consensus should be reached for performing standardised and comparable assessments. Key messages: Alcohol consumption increased in many countries during the COVID-19 lockdowns, with local variations. Assessments used a great variety of outcomes, hindering a comprehensive assessment of this phenomena. [ABSTRACT FROM AUTHOR]

After a peak of 68.3% during the 2005-06 season, influenza vaccine coverage among Italian elderly showed an unprecedented, prolonged decline. According to the National surveillance network, the vaccination coverage was ≤50% during two of the last three seasons (2014-17). In parallel, influenza-like illness (ILI) rates increased from 2.71% in the triennium 2005-08, to 4.24% in the last triennium. A significant association was found between ILI rise and vaccine coverage decline (P = 0.036), and according to a conservative estimation, each 1% increase in coverage may prevent ≥2690 ILI cases among the elderly. A reinforcement of influenza immunization policies is strongly needed in Italy.

Background: : The misuse of antibiotics is one of the leading causes of antibiotic resistance. Paediatric patients are highly involved in this issue, as they are those who receive the largest amount of prescriptions of these drugs. Therefore, this study aimed to investigate the general knowledge regarding the use of antibiotics, as well as the attitudes related to the administration of these drugs to children, amongst parents of children in the paediatric age-group. : In 2014, a multicentre cross-sectional study was conducted amongst parents of children aged 0-14. A questionnaire made up of 33 items was administered in waiting rooms of outpatient departments. Multivariable logistic regression models were performed, in order to assess the potential predictors of a better knowledge about antibiotics. : A total of 1247 parents took part to the survey. Around 33% of the samples declared that antibiotics are useful for viral infections, 20.6% that antibiotics are useful for every kind of pain and inflammation, while 14% of the parents stated that they stop giving antibiotics to their children when they start feeling better. Multivariable models showed that males, unemployed and those with lower levels of education are less prone to answer correctly to the questions about antibiotics. : The present study demonstrates that parents have a lack of knowledge regarding the use of antibiotics, which results in bad habits and inappropriate attitudes when it comes to giving antibiotics to their children. Attention should be particularly focused on disadvantaged parents., (© The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: We performed a systematic review and proportion meta-analysis in order to investigate the prevalence and the adverse effects of the self-medication among the teenagers., Methods: We selected observational studies published from January 1990 until January 2014 that examined the use of self-medication in the adolescents (aged from 13 to 18 years). Keywords used on PubMed, ISI Web of Knowledge and Scopus were 'self medication', 'adolescent*', 'self prescription', 'over the counter preparations' and 'self administration'., Results: Finally, 15 articles met the inclusion criteria, for a total of 143 213 subjects involved. Overall, 50% of adolescents use to take drugs without consulting a physician. Further analyses stratified by number of drugs used demonstrated that in the studies reporting that adolescents use more than one type of drug the prevalence rises up to 63%. Only one study reported the possible adverse effects related to the inappropriate use of drugs, which were experienced by 31.1% of the females and 19.6% of the males., Conclusions: Self-medication use among adolescents is a widespread phenomenon. It would be advisable to give more attention on this public health concern and to promote initiatives, such as mass media campaigns and governmental actions, in order to make the citizens more aware to the risks related to the consumption of drugs without medical consultation. Further studies on adverse effects are urgently needed., (© The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: Outside the USA, Agency for Healthcare Research and Quality (AHRQ) prevention quality indicators (PQIs) have been used to compare the quality of primary care services only at a national or regional level. However, in several national health systems, primary care is not directly managed by the regions but is in charge of smaller territorial entities. We evaluated whether PQIs might be used to compare the performance of local providers such as Italian local health authorities (LHAs) and health districts., Methods: We analysed the hospital discharge abstracts of 44 LHAs (and 11 health districts) of five Italian regions (including ≈18 million residents) in 2008-10. Age-standardized PQI rates were computed following AHRQ specifications. Potential predictors were investigated using multilevel modelling., Results: We analysed 11 470 722 hospitalizations. The overall rates of preventable hospitalizations (composite PQI 90) were 1012, 889 and 988 (×100 000 inhabitants) in 2008, 2009 and 2010, respectively. Composite PQIs were able to differentiate LHAs and health districts and showed small variation in the performance ranking over years., Conclusion: Although further research is required, our findings support the use of composite PQIs to evaluate the performance of relatively small primary health care providers (50 000-60 000 enrollees) in countries with universal health care coverage. Achieving high precision may be crucial for a structured quality assessment system to align hospitalization rate indicators with measures of other contexts of care (cost, clinical management, satisfaction/experience) that are typically computed at a local level., (© The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association.)

Background: Healthcare professionals play a key role in tobacco use prevention because they are considered as model by patients. This multicenter study was aimed to evaluate smoking prevalence, knowledge and attitudes towards tobacco among Italian hospital professionals., Methods: A cross-sectional study was carried out using a questionnaire administered to healthcare professionals in seven Italian hospitals, to investigate personal and occupational data, knowledge, attitudes, job setting, clinical activities, smoking habits and pattern for current smokers. Potential predictors of current smoking habits were evaluated using multiple logistic regressions., Results: Sample population was comprised of 1082 health professionals (51.4% females; mean age was 37.3 years: 25.3% were nurses, 24.5% medical doctors, 17.1% students and 33.1% other healthcare workers). Smoking prevalence was 44%. Among responders, 67.7% considered healthcare professional as a model for citizens, 90.5% declared to see colleagues smoking cigarettes inside the hospital (47.4% in the dependents' toilets, 33.4% in the department kitchens and 4.7% in the patient room). Multivariate analysis showed that healthcare professionals working in Naples had a higher risk to be smokers in comparison to Rome [odds ratio (OR) = 2.29; 95% confidence interval (CI) 1.40-3.73]. Compared to medical doctors, post-graduate students (OR = 3.42; 95% CI: 1.81-6.44), nurses (OR = 2.48; 95% CI 1.51-4.08), nursing students (OR = 1.91; 95% CI 1.08-3.38) and auxiliary personnel (OR = 2.72; 95% CI 1.51-4.88), showed a higher likelihood of smoking., Conclusions: Among Italian hospital personnel there is a paradoxically large prevalence of smokers, higher than in the general population. Interventions aimed for the development of an adequate culture of health promotion, among these professionals, are urgently needed.