Search

The role of immunization in public health is crucial, offering widespread protection against infectious diseases and underpinning societal well-being. However, achieving optimal vaccination coverage is impeded by vaccine hesitancy, a significant challenge that necessitates comprehensive strategies to understand and mitigate its effects. We propose the integration of Population Health Management principles with Immunization Information Systems (IISs) to address vaccine hesitancy more effectively. Our approach leverages systematic health determinants analysis to identify at-risk populations and tailor interventions, thereby promoting vaccination coverage and public health responses. We call for the development of an enhanced version of the Italian National Vaccination Registry, which aims to facilitate real-time tracking of individuals’ vaccination status while improving data accuracy and interoperability among healthcare systems. This registry is designed to overcome current barriers by ensuring robust data protection, addressing cultural and organizational challenges, and integrating behavioral insights to foster informed public health campaigns. Our proposal aligns with the Italian National Vaccination Prevention Plan 2023–2025 and emphasizes proactive, evidence-based strategies to increase vaccination uptake and contrast the spread of vaccine-preventable diseases. The ultimate goal is to establish a data-driven, ethically sound framework that enhances public health outcomes and addresses the complexities of vaccine hesitancy within the Italian context and beyond.

Background: A wide range of conditions, including mixed depressive symptoms, hyperactivity, cognitive impairment (CI) might be expressions of Bipolar Spectrum Disorder (BSD) according to the neo-Kraepelinian perspective, even in advanced age. CI, which has a high prevalence in the elderly population, when it occurs in comorbidity with depression further hinders therapy response and functional ability. The present study aims to explore risk factors associated with CI in elderly individuals experiencing a depressive episode during lockdown a period marked by significant stressors and rhythm disruption. Methods: A case-control study analyzed data from a previous RCT (secondary analyses) on elderly individuals living at home, assessing depressive symptoms, cognitive performance, hyperactivity, and hypertension before (T0) and during lockdown (T1). Results: Participants with lower pre-pandemic cognitive performance were more prone to lockdown depression compared to those with higher baseline function (F = 6.074; p = 0.016). Among those experiencing lockdown depression without prior depression, those with low cognitive performance were more prevalent than the control group without depression (OR = 11.8; p = 0.015). Conclusion: This study highlights a potentially vulnerable subgroup within the elderly population that requires targeted interventions and support during stressful events. Future research should explore the underlying mechanisms linking cognitive decline and depression in older adults, particularly those with a possible bipolar spectrum predisposition.

Medical, nursing, and other healthcare students undergo specific stressors. Their mental health represents a priority for universities and the entire community. This review aimed to gather evidence about the effectiveness of individual psychological counselling offered by universities to healthcare students. A systematic review was conducted by searching PubMed, Scopus, and APA PsycInfo. A total of 1906 records were identified. The selection resulted in six studies published between 1994 and 2014. The most common design was quasi-experimental. Half focused on medical students and often interventions comprised other elements. Outcomes were related to mental health issues, academic performance, or both. The results showed statistically significant improvements, with some exceptions. The present review highlighted some specific characteristics that must be considered in order to fill the existing gap in this field, such as widening the range of studied outcomes, improving the description of the intervention, and planning randomized controlled trials (RCT) to compare strategies.

Background. This study aimed to assess the performance of ChatGPT, a large language model (LLM), on the Italian State Exam for Medical Residency (SSM) test to determine its potential as a tool for medical education and clinical decision-making support. Materials and methods. A total of 136 questions were obtained from the official SSM test. ChatGPT responses were analyzed and compared to the performance of medical doctors who took the test in 2022. Questions were classified into clinical cases (CC) and notional questions (NQ). Results. ChatGPT achieved an overall accuracy of 90.44%, with higher performance on clinical cases (92.45%) than on notional questions (89.15%). Compared to medical doctors’ scores, ChatGPT performance was higher than 99.6% of the participants. Conclusions. These results suggest that ChatGPT holds promise as a valuable tool in clinical decision-making, particularly in the context of clinical reasoning. Further research is needed to explore the potential applications and implementation of large language models (LLMs) in medical education and medical practice.

Background: Candida auris (CA) is an emerging fungus, classified as an urgent global health threat, that resists common antifungal drugs and decontamination procedures; identification requires specific tools; transmissibility and mortality are high in healthcare settings. Infection and colonisation can be long-lasting, leading to problems in isolation procedures and the risk of outbreaks. This study aims to evaluate publication and citation related metrics, identify major keywords and topics, and assess geographic distribution of published articles. Methods: A list of all publications containing ''Candida auris'' in all fields was extracted from Web Of Science on date 2023/01/02. Bibliometric analysis was conducted using the bibliometrix and biblioshiny packages on RStudio. Results: Total publications (TP) were 1283 with an annual growth rate of 53.91%. Total citations were 27854, with an average of 21.71 citations per paper. The core sources are 9 out of 322, according to Bradford's law. In only 42 countries where CA was identified, articles on the topic were published (89%). The origin of TP is concentrated in high-income countries (68.22%). Trending topics about CA include epidemiology, identification and resistance. Conclusion: Our analysis shows a growing interest in scientific literature on the topic of CA, led by Europe. In some countries where CA has been identified, no papers have been published. Despite the multidrug-resistance of CA, the topic of therapy is not much debated. Our findings highlight the need to increase focus on CA in order to promote health systems’ preparedness and to properly address the spread of this worrisome pathogen.

In recent decades, the rise of zoonotic diseases has emerged as a significant human health concern, highlighting the interconnectedness of human and animal health within the framework of the “One Health” (OH) concept. This study, conducted in Italy in 2023, sought to gauge the general population’s awareness of OH and zoonotic diseases while identifying influencing factors. Additionally, it aimed to assess awareness of an Mpox virus vaccine, particularly pertinent due to the 2022 outbreak across Europe. The online cross-sectional study encompassed 1058 participants, revealing that 54.26% were unfamiliar with OH and zoonoses. Median knowledge scores were 12 points (IQR = 9–15) for zoonoses and 8 points (IQR = 6–11) for OH. Notably, factors such as age, economic situation, healthcare employment, educational level, and health literacy significantly influenced knowledge scores. Merely 26.8% of participants were aware of the existence of an Mpox vaccine, with healthcare workers, individuals engaged in animal-related work, and non-heterosexual men demonstrating higher awareness. The findings underscored a limited public understanding of zoonotic diseases and One Health, with variations observed across specific demographic groups. Given the potential impact on public health, urgent educational initiatives are warranted. Moreover, the study highlighted a low awareness of the Mpox vaccine, emphasizing the necessity for targeted awareness campaigns directed at both professionals and the general public.

BackgroundThe impact of seasonal influenza vaccination (SIV) on mortality is still controversial; some studies have claimed that increasing vaccination coverage rates is beneficial, while others have found no significant association. This study aimed to construct a granular longitudinal dataset of local VCRs and assess their effect on pneumonia- and influenza-related (P&I) mortality among Italian adults aged ≥ 65 years.MethodsNUTS-3 (nomenclature of territorial units for statistics) level data on SIV coverage were collected via a survey of local data holders. Fixed- and random-effects panel regression modeling, when adjusted for potential confounders, was performed to assess the association between local SIV coverage rates and P&I mortality in older adults.ResultsA total of 1,144 local VCRs from 2003 to 2019 were ascertained. In the fully adjusted fixed-effects model, each 1% increase in vaccination coverage was associated (P < 0.001) with a 0.6% (95% CI: 0.3–0.9%) average over-time decrease in P&I mortality. With an annual average of 9,293 P&I deaths in Italy, this model suggested that 56 deaths could have been avoided each year by increasing SIV coverage by 1%. The random-effects model produced similar results. The base-case results were robust in a sensitivity analysis.ConclusionOver the last two decades, Italian jurisdictions with higher SIV uptake had, on average, fewer P&I deaths among older adults. Local policy-makers should implement effective strategies to increase SIV coverage in the Italian senior population.

Background: This study aimed to evaluate the knowledge, attitudes, and practises (KAP) of individuals living with HIV (PLWH) regarding vaccines and their trust in the Italian national health system (NHS). Methods: A cross-sectional survey was conducted at Amedeo di Savoia Hospital in Turin, Italy, involving 160 HIV-positive patients. Descriptive statistics were utilised to analyse variables such as vaccination status and intention, perceived risk of infection, and disease severity. The infections were categorised into sexually transmitted diseases and other vaccine-preventable diseases. Results: Except for the perceived severity of infection, there were no significant differences in the percentages between the two infection groups for the variables examined. Concerning patients’ perception of the Italian NHS, a high percentage of the sample believed in the information provided by healthcare workers (HCWs) (95.6%) and considered HCWs up-to-date on vaccines (93.1%). However, a considerable proportion expressed concerns about insufficient information on vaccine risks from HCWs (33.3%), perceived judgement by HCWs for vaccine refusal (40.3%), and suspected financial interests of HCWs in vaccination (19.5%). Conclusions: Some HIV+ patients may hesitate to be vaccinated or hold misconceptions about the severity of certain infectious diseases. Additionally, there are concerns about trust in the Italian NHS and communication by HCWs.

Abstract Background Knowledge resources are in most productive sectors distinctive in terms of competitiveness. Still, in the health sector, they can have an impact on the health of the population, help make the organisations more efficient and can help improve decision-making processes. The purpose of this paper is to investigate the Intellectual Capital impact on healthcare organization’ performance in the Italian healthcare system. Methods The theoretical framework linked to intellectual Capital in the health sector and the performance evaluation related to efficiency supports the analysis carried out in two stages to determine the right placement of resources and the exogenous variables that influence performance level. The evaluation of the impact of the ICs on performance is determined through the Data envelopment analysis. The incidence of the exogenous variables has been established through linear regression. Results Empirical results in Italy show some IC components influence organization ‘performance (Essential Levels of Assistance) and could be used for defining the policy of allocation of resources in healthcare sector. The efficiency of 16 regions considered in 2016 based on Slack-Based-Model constant returns-to-scale (SBM-CRS) and Slack-Based-Model variable returns-to-scale (SBM-VRS) identifies a different ability to balance IC and performance. Current healthcare expenditure and the number of residents is correlated with the identified efficiency and performance levels. Conclusions This paper embeds an innovative link between healthcare performance, in term of efficiency and IC which aligns resource management with future strategy. The study provides a new decision-making approach.

Objective: Socio-economical changes in Europe are leading to the rise of new issues regarding the labour market and health of young workers. Job insecurity is a widely studied phenomenon that involves an increasing number of young workers. We investigated its association with mental health and hazardous behaviours. Method: In this pilot study, 504 subjects aged between 18 and 40 were interviewed. STROBE guidelines were used. Socio-economic factors were evaluated. Adapted forms of validated scales were used to assess depression, anxiety disorder, alcohol and drug abuse and smoking habit. Univariate and multivariate analyses were performed. Results: Job insecurity appeared to be partially connected with the type of employment. Most respondents with a permanent contract felt their situation was secure, while this proportion was reduced when referring to temporary jobs and other kinds of contract (p

Objectives The health effects of work-time arrangements have been largely studied for long working hours, whereas a lack of knowledge remains regarding the potential health impact of reduced work-time interventions. Therefore, we conducted this review in order to assess the relationships between work-time reduction and health outcomes.Design Systematic review of published studies. Medline, PsycINFO, Embase and Web of Science databases were searched from January 2000 up to November 2019.Outcomes The primary outcome was the impact of reduced working time with retained salary on health effects, interventional and observational studies providing a quantitative analysis of any health-related outcome were included. Studies with qualitative research methods were excluded.Results A total of 3876 published articles were identified and 7 studies were selected for the final analysis, all with a longitudinal interventional design. The sample size ranged from 63 participants to 580 workers, mostly from healthcare settings. Two studies assessed a work-time reduction to 6 hours per day; two studies evaluated a weekly work-time reduction of 25%; two studies evaluated simultaneously a reduced weekly work-time reduction proportionally to the amount of time worked and a 2.5 hours of physical activity programme per week instead of work time; one study assessed a reduced weekly work-time reduction from 39 to 30 hours per week. A positive relationship between reduced working hours and working life quality, sleep and stress was observed. It is unclear whether work time reduction determined an improvement in general health outcomes, such as self-perceived health and well-being.Conclusions These findings suggest that the reduction of working hours with retained salary could be an effective workplace intervention for the improvement of employees’ well-being, especially regarding stress and sleep. Further studies in different contexts are needed to better evaluate the impact of work-time reduction on other health outcomes.

Gender medicine is crucial to reduce health inequalities. Knowledge about students' attitudes and beliefs regarding men, women and gender is important to improve gender medicine courses. The aim of this study is to evaluate gender stereotypes and its predictors in Italian medical students. We performed an online cross-sectional study among students from the University of Turin. We used the validated Nijmegen Gender Awareness Scale in Medicine scale to explore gender sensitivity and stereotypes. Multivariable logistic regression model was performed to explore potential predictors of gender awareness. We enrolled 430 students. Female sex, a better knowledge on gender medicine and having had a tutor aware of gender issues are associated with higher gender sensitivity. Older age, a better knowledge on gender medicine and having had a tutor sensitive to gender issues were predictors of more stereotyped opinions towards patients. Having had a tutor aware of gender medicine, male sex and older age were associated with more stereotypes towards doctors. Italian students have high gender sensitivity and low gender stereotypes. Age, higher knowledge of gender medicine and having had a tutor that considered gender were associated with higher gender stereotypes. Focusing on gender awareness in medical schools can contribute to a better care.

Introduction: The aim of this study was to investigate knowledge and practices about influenza among patients on dialysis services of Italian hospitals at risk of severe influenza infection and vaccine and to identify predictive factors to vaccination adherence. Methods: A cross-sectional observational study was carried out from January 2017 to July 2017 after the 2016/2017 influenza vaccination campaign. The questionnaire was administered to all patients treated in seven large Italian dialysis services. It consisted of influenza vaccination coverage, knowledge about influenza and its vaccination, perceived risk of influenza complications, recommendations on influenza uptake received by general practitioner (GP) and nephrologist. Results: Response rate was 90% (703/781). Patients’ knowledge about influenza infection and vaccine were detected by nine closed questions: 35.6% of responders answered correctly to ≥ 6 sentences, 47.5% of them reported that “influenza vaccine can cause influenza” and 45.7% believed that “antibiotics are a correct strategy to treat influenza”. Levels of perceived risks of hospitalisation and death were low in 39.3% and 16.5% of patients respectively. The adherence to the last seasonal influenza vaccination was 57.5%. The multivariate predictors of influenza vaccination uptake resulted: age ≥65, male, consulting TV/radio, asking information to GP and/or nephrologist. Conclusions: The study reveals the low adherence to influenza vaccination and the subotpimal level of knowledge in dialysis patients. Different strategies, including a greater alliance among nephrologists and GPs to prevent influenza should be encouraged to improve the adherence to influenza vaccination in this at risk group.

The phenomenon of bacterial antimicrobial resistance (AMR) is a rapidly growing global problem. Overuse and misuse of antibiotics as well as self-prescription are among the most important causes contributing to the growth of antibiotic resistance in humans. This systematic review describes the phenomenon of antibiotics self-medication (ASM) in children. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist by searching PubMed, Scopus, and Web of Science until July 2022. Published English language studies containing information regarding parents knowledge, attitudes, and behaviors in self-administration of antibiotics in children were included. A total of 702 articles were identified, and 57 were selected. A higher prevalence of ASM among children was found in the Middle-East (34%), Africa (22%), Asia (20%) and South America (17%), while the lowest prevalence was found in Europe (8%). High distance from hospital, and low income, such as having more than one child, are related with an increased risk of ASM in children. Fever and cough can also promote the misuse of antibiotics by parents. A greater attention to the regulation of the sale of antimicrobial drugs can certainly limit the risk of self-medicating behavior.

Background: This study aims to evaluate knowledge, attitudes and practices (KAP) of HIV-patients about COVID-19 vaccination. Methods: A cross-sectional study was conducted by administering questionnaires to 160 patients followed by Amedeo di Savoia Hospital in Turin. Statistical analyses were performed in order to identify predictors of infection and severity of COVID-19 disease risk perception. Results: The 86.2% of patients were vaccinated for COVID-19, while 7.6% do not intend to be vaccinated; 50.7% thought that there is a minimal risk to get COVID-19; 85.8% thought that COVID-19 is a serious illness. The 56% and the 36.5 thought that seropositivity carries a greater risk to develop respectively COVID-19-related complications or vaccine complications. At the multivariate analysis having a job, proactive research of vaccine information and being HIV+ for several years are related to a lower risk perception of infection. The perception of COVID-19 severity is influenced by age, by being LGB and by believing that HIV+ status correlates with a higher risk of developing complications from COVID-19. Conclusions: as the pandemic can adversely impact the HIV care with increasing loss to follow-up, vaccination is essential to contrast infection in HIV+ patients. Our findings suggested that some HIV+ patients refuse vaccination against COVID-19.

Upper-respiratory-tract infections (URTIs) are among the main causes of antibiotic prescriptions in pediatric patients. Over one-third of all antibiotic prescriptions for URTIs in children are estimated to be inappropriate, as the majority of URTIs are caused by viral agents. Several strategies, including clinical scoring algorithms and different point-of-care tests (POCTs) have been developed to help discriminate bacterial from viral URTIs in the outpatient clinical setting. A systematic review of the literature was conducted following PRISMA guidelines with the objective of summarizing evidence from health–economic evaluations on the use of POCT for URTIs in pediatric outpatients. A total of 3375 records identified from four databases and other sources were screened, of which 8 met the inclusion criteria. Four studies were classified as being of high reporting quality, and three were of medium quality. Five out of eight studies concluded in favor of strategies that included POCTs, with an additional study finding several POCTs to be cost-effective compared to usual care but over an acceptable WTP threshold. This review found POCT could be a valuable tool for antimicrobial stewardship strategies targeted towards childhood URTIs in primary care.

Background: This study explores the impact of the pandemic on children's mental health. It examined the understanding of parents regarding their children's mental condition and their ability to identify issues, 2 years post the outbreak of the COVID-19 pandemic. Methods: Using a cross-sectional design, 507 Italian parents reported on their youngest child aged between 2 and 17, totaling 507 children. The outcomes focused on were parental perception of children's mental health deterioration, scores on the Strengths and Difficulties Questionnaire (SDQ) above the clinical cut-off, and parental under-recognition of mental health issues. Descriptive analyses and multivariable logistic regression models were executed (significance at p < 0.05). Results: Parents were 88.1% women (median age 41 years, interquartile range [IQR] = 36-47). Their children were 50.3% female [median age 6 years (IQR = 4-11)]. The data revealed 21.1% of parents perceived a deterioration in their children's mental health, while 44.2% had SDQ scores above the cut-off. Parental under-recognition of mental issues was found in 20.1% of cases. Significant correlations were found between parental perception of deterioration, SDQ scores, and factors like parental mental distress and children's sleep issues. Implications: The findings suggest that schools and verified websites can serve as critical conduits for providing parents with reliable information. By promoting early identification and intervention, such mechanisms can help ensure mental health equity for children. Conclusions: The research highlights the effect of the pandemic on children's mental health and the issue of parental under-recognition. The results underscore the importance of public health initiatives that enhance mental health information accessibility and reliability for parents.

BackgroundSchistosomiasis is a highly prevalent parasitic disease in Senegal. The early symptoms are hematuria and dysuria. Children's comprehension of the disease is fundamental to preventing the infection.ObjectivesThe aim of this study was to investigate the knowledge attitudes, and practices related to schistosomiasis among schoolchildren in 2 rural villages in Northern Senegal and to evaluate their impact on the disease.MethodsA cross-sectional study was conducted. Data about children's knowledge of schistosomiasis, behavior, and preventive measures were collected through a questionnaire.FindingsQuestionnaire responses from 575 schoolchildren were analyzed. Correct answers about risky behavior for schistosomiasis were associated with early symptoms ('P' = 0.010). Wearing shoes and washing hands with soap were associated with not having hematuria and dysuria ('P' = 0.007 and 0.049, respectively). Playing in rivers was associated with the aforementioned symptoms (P < 0.001). Children who had good knowledge of schistosomiasis reportedly did not have symptoms ('P' = 0.002). A logistic regression model showed that female sex (odds ratio = 0.35; 'P' = 0.01) and attending a primary school (odds ratio = 0.13; 'P' < 0.001) were significant predictors of a lower risk of the early symptoms of urinary schistosomiasis.ConclusionsThis study revealed that the level of knowledge among children in North Senegal about the causes, transmission, prevention, and treatment of schistosomiasis warrants implementing educational intervention.

BACKGROUND:Four percent of the world's population suffers from depression, which is a major public health issue. Medical students are at risk, as their depressive symptoms (DS) prevalence is reported to be approximately 27% worldwide. Since few data on Italian medical students exist, this study aimed to estimate their DS prevalence and assess risk and protective factors. METHODS:The PRIMES was a multicentre cross-sectional study performed in 12 Italian medical schools. Questionnaires were self-reported and included 30 sociodemographic items and the Beck Depression Inventory-II (BDI-II). The primary outcome was the presence of DS (BDI-II score≥14). The main analyses were chi-squared tests and multivariable logistic regressions with a p-value

The general practitioner (GP) has a significant role in primary care, being more than a gatekeeper to health services access. In Italy, if a citizen moves for studies for at least 3 months, he/she can choose temporarily another GP in the new city (the so-called “Healthcare Domicile” (HD)). The aims were to estimate the university students’ knowledge about the HD, evaluate the frequency of the transition to another GP, and assess the university students’ attitudes towards the primary care services. In 2018, a cross-sectional pilot study was performed in study rooms among students attending the University of Turin Participation was voluntary, anonymous, and without compensation. A 25-item questionnaire collected information about the sociodemographic characteristics, health services use, health conditions and medications, HD knowledge, and HD use. The outcomes were having the GP far away, knowing HD, and not moving the GP even if aware of HD. Chi-square test, Mann–Whitney U-test, and logistic regression analyses were performed. The significance level was p≤0.05. Participants were 388 and those who knew HD were 45.36%. Among those who moved to Turin (44.85%), 77.67% knew HD but did not move the GP anyway. The 72.68% used medications without prescription (the most taken: nonsteroidal anti-inflammatory drugs and antibiotics). Age, nationality, and degree course type could be predictors for outcomes considered. HD knowledge was associated with a different use of healthcare resources. The data of the present paper suggest that further studies are required to better understand the framework connected with the university students’ access to primary healthcare. Our results highlighted the need to implement campaigns targeted to university students to spread information about the HD and a more appropriate use of the healthcare services and medications.

An amendment to this paper has been published and can be accessed via the original article.

Data about self-perceived food choice (FC) changes and their determinants during COVID-19 lockdowns are limited. This study investigated how the Italian lockdown affected self-perceived food purchases (FP), occurrence of impulse buying (IB), household food waste production (HFWP) and their determinants. A web-based cross-sectional survey was distributed in May 2020, collecting an opportunistic sample of the Italian population. A total of 1865 (70% females) people were enrolled, the median age was 29 (IQR 16.0). Most of the sample increased overall FP (53.4%), food consumption (43.4%), reduced HFWP (53.7%) and halved the prevalence of IB (20.9%) compared to the period before the lockdown (42.5%). Baking ingredients, fresh vegetables, fresh fruit and chocolate had the largest sales increase by individuals, while bakery products, fresh fish and salted snacks purchases highly decreased. Increased FP was associated with the occurrence of IB (adjOR 2.48, p < 0.001) and inversely associated with not having worked during lockdown (adjOR 0.71, p = 0.003). Multivariable logistic regressions revealed occurrence of IB was associated with low perceived dietary quality (adjOR 2.22, p < 0.001), resulting at risk, according to the Emotional Overeating Questionnaire (EOQ, adjOR 1.68, p < 0.001), and inversely associated with decreased HFWP (adjOR 0.73, p < 0.012). Reduced HFWP was associated with higher perceived dietary quality (adjOR 2.27, p < 0.001) and negatively associated with low score at WHO-5 Well-Being Index (adjOR 0.72, p = 0.002). The Italian lockdown highly affected FC behaviours, leading to positive and sustainable habits towards food purchase and consumption. Public health interventions are needed to keep these new positive effects and avoid negative consequences in case of future lockdowns.

Orthorexia Nervosa (ON) is an eating disorder marked by an excessive control over the quality of the food eaten. Some groups present a higher prevalence of ON and people practicing sports seems to be a population at risk. The aim of this study is to assess the prevalence of ON in endurance athletes and to compare their prevalence with the ones recorded in the sedentary population and in athletes playing other sports. A cross-sectional survey was carried in Piedmont and Valle d'Aosta, among 549 participants in local sports events aged between 18 and 40 years old. The questionnaire assessed socio-demographic characteristics, physical activity, nutrition and diet, the ORTO-15 questionnaire and Eating Habits Questionnaire (EHQ). The sample was stratified according to the minutes of sport practiced in a week and the type of sport played. Crosstab chi-square analyses to determine group differences on categorical variables (e.g. gender), and ANOVAs or t tests to determine group differences on continuous variables were performed. When required, post hoc analyses were performed. Linear and logistic regressions were performed in order to investigate potential predictors of orthorexia. The EHQ mean scores ware significantly higher in people who practice sports >150 minutes/week. EHQ score resulted to be positively correlated with endurance sport practice >150 minutes/week, with a coefficient of 2.407 (I.C.95% [0.27;4.54], p = 0.027). Analyses carried out suggested a correlation between endurance sport practice and ON. Further studies should be performed to identify diagnostic criteria and to compare different questionnaire used to assess them.

New scenarios are emerging in the European and worldwide context: the ageing of society, the climate changes, the increasing of health inequalities and the financial crisis. In this context, the scientific community and the decision-makers agree on the role of health in all policies (HiAP) strategy in improving the population’s health. The HiAP takes into account factors not strictly related to health but with important health consequences. To bring public health in all policies a change is needed, but there are some obstacles to overcome: for instance, the lack of evidence regarding the governance tools and frameworks for HiAP, the difficulty of convincing stakeholders and producing a cultural change in the political positioning of decision-makers. Consequently, it is necessary: i) to implement stronger and responsible decision-support approaches, such as health impact assessment and health technology assessment; ii) to encourage and coordinate all relevant sectors in playing their part in reducing health gaps within the European Union; iii) to strengthen cooperation and make better use of existing networks and existing public health and related institutions. The final aim will be to monitor the impact of the health determinants in order to promote the effective implementation of HiAP approach.

Since antibiotic resistance has become a worldwide public health concern and is in part related to physicians' lack of knowledge, it is essential to focus our attention on healthcare profession students. The present study aims at evaluating the knowledge and attitudes of the School of Medicine's students towards antibiotic usage and antibiotic resistance.In December 2013, a cross sectional study was conducted amongst medical, dental, nursing and other health care profession students of the School of Medicine at the University of Torino. Students of all the academic years took part in this study. Questionnaires were submitted during regular lectures (only students who attended courses on one specific day were surveyed) and the data collected was analyzed using StataMP11 statistical software.Overall, 1,050 students were interviewed. The response rate was 100%. Around 20% of the sample stated that antibiotics are appropriate for viral infections and 15% of the students that they stop taking those drugs when symptoms decrease. Results of the multivariate analyses showed that females were more likely than males to take antibiotics only when prescribed (OR 1.43, 95% CI 1.04-1.98). Interestingly, students with a relative working in a health-related field, as well as those who took at least one course of antibiotics in the last year, had a lower probability of taking those drugs only under prescription (OR = 0.69 95% CI: 0.49-0.97 and OR = 0.38 95% CI: 0.27-0.53, respectively).The present paper shows how healthcare profession students do not practice what they know. Since those students will be a behavioral model for citizens and patients, it is important to generate more awareness around this issue throughout their studies. It would be advisable to introduce a specific course and training on antibiotics in the core curriculum of the School of Medicine.

Background. TEN-D by Night is an international, multicentre, cross-sectional portal survey conducted on a large sample of young people in six European countries. This paper aims to investigate the alcohol and psychoactive drug consumption of this sample, with a focus on the prevalence of binge drinking and the poly-drug habits of the TEN-D cohort. Design and Methods. The study population consisted of 4695 young people attending recreational sites on weekend nights. The intervention included two questionnaires and two psychoactive substance detection tests performed at the entry and exit of the recreational sites. A multivariate logistic regression model was used to predict the probability of binge drinking. Results. Binge drinking was reported by 20% of the males and 13% of the females (P=0.001) before entry into the recreational sites and by 18% of the males and 11% of the females before entry into the clubs (PConclusions. Our survey showed that it is possible to identify individuals and groups at higher risk of binge drinking. This identification would allow for a focus on specific targets and would facilitate the redesign of prevention programmes. The increased use of psychoactive substances among youths should be studied extensively to promote successful prevention campaigns.

Objective: This study is aimed to explore severe mental illness (SMI), mental well-being (MWB), and Mediterranean Diet adherence (MedDiet) among university students. Participants: University students in Northern Italy (sample size = 502) Methods: Cross-sectional survey was conducted in 2019. The questionnaires included Warwick-Edinburgh Mental Well-Being Scale for MWB, K6 for SMI, Mediterranean Diet Adherence Screener for MedDiet. Multivariable regressions were mainly performed (p < 0.05 as significant). Results: MWB was high in 3.93% of the participants and low in 23.97%. SMI was probable in 21.87%. MedDiet adherence was high in 2.19% and low in 35.06%. Mainly, poor/very poor perceived health, Economics/Legal/Strategic Sciences courses, and not being on time with exams showed associations with both lower MWB and probable SMI. Gender and some lifestyle, dietary, and university factors predicted MedDiet. MWB and MedDiet were positively associated. Conclusions: This study found high levels of mental issues and low MedDiet. Modifiable factors at university level should be investigated to design preventive interventions.

Objective: This study aimed to investigate the interest in online and in‐person psychological support services in Italy during the COVID‐19 pandemic, stimulated by the implementation of the government‐issued 'bonus psicologo' for psychotherapy sessions. Methods and Measures: Public interest was measured using data from Google Trends, a resource that offers open access to actual search requests, within the time frame of 2 July 2017 to 13 November 2022. These data were stratified for Italian regions to explore regional differences. We conducted interrupted time series analyses to assess changes in interest before, during and after the lockdown. Results: Results indicated a significant increase in interest in online psychological support during the lockdown, which was sustained over time and was positively correlated with the implementation of the 'bonus psicologo' (p <.001). Interest in in‐person support decreased during the lockdown but began to rise post‐lockdown (p =.028), with no notable impact from the economic incentive. High interest in online support continued in certain regions even 1 year post‐lockdown, warranting further analysis. Conclusion: The study underscores a heightened post‐pandemic interest in psychological support, both online and in person, in comparison with pre‐pandemic levels. Google Trends emerges as a valuable tool for monitoring public interest during specific events, though the findings must be interpreted with care, given the study's time frame and reliance on relative search volume as a measure. Future research is needed to validate these findings and to compare them against epidemiological data. [ABSTRACT FROM AUTHOR]

Enteropathogenic (EPEC), necrotoxigenic (NTEC), and Shiga-toxin producing Escherichia coli (STEC) are pathotypes responsible for severe clinical forms in humans and animals. They can be shed in the feces of animals with consequent environmental contamination. This study evaluated the antibacterial activity of essential oils (EOs) from oregano (Origanum vulgare), savory (Satureja montana), thyme (Thymus vulgaris), and their blend against EPEC, NTEC, and STEC strains previously isolated from avian fecal samples. Minimum inhibitory concentration values between 0.039% and 0.156% were found with O. vulgare EO, between ≤0.0195% and 0.156% with both S. montana and T. vulgaris EOs, and between 0.039% and ≤0.0195% with the blend. The mixture with equal parts of EOs from oregano, savory and thyme seems a promising alternative product to combat pathogenic E. coli strains responsible for environmental contamination.

Wild animals are recognized as significant reservoirs for various zoonotic pathogens, including antibiotic-resistant bacteria. This study aimed to investigate the presence of Staphylococcus spp. strains in fallow deer (Dama dama) inhabiting a natural preserve in Central Italy and to examine the phenotypic and genotypic antimicrobial resistance and the presence of some virulence genes among the isolates. During July and December 2022, nasal swabs were collected from 175 fallow deer, which were then analyzed through bacteriological cultures. In total, 176 Staphylococcus spp. strains were isolated and subsequently identified using MALDI-TOF mass spectrometry. S. aureus was the most abundant species with 66 (37.5%) strains, followed by S. hyicus, 34 (19.31%) strains, S. sciuri, 32 (18.18%) strains, S. chromogenes, 27 (15.34%) strains, S. xylosus, 11 (6.25%) strains, S. warneri, 5 (2.84%) strains, and S. devriesei, 1 (0.56%) strain. Antimicrobial susceptibility was assessed for each isolate via the agar disk diffusion method, testing a panel of 13 molecules belonging to 9 antimicrobial classes. The highest resistance rates were detected for penicillin (29.55%), rifampicin (22.73%), and amikacin (20.45%). Notably, intermediate susceptibility was observed for erythromycin (61.93%), enrofloxacin (28.41%), and ceftiofur (21.02%). Conversely, the strains exhibited particularly high susceptibility to amoxicillin/clavulanic acid (99.43%), cefoxitin (97.73%), and vancomycin (96.02%). Based on the results, 32 (18.18%) isolates were classified as multidrug-resistant (MDR). Two strains of S. chromogenes and one strain of S. xylosus, both resistant to penicillin, tested positive for the blaZ gene. No methicillin-resistant strains were found, and none of the isolates harbored genes associated with enterotoxin and toxic shock syndrome toxin production. This study highlights the potential role of wildlife, particularly fallow deer, as reservoirs of antibiotic-resistant Staphylococcus spp. strains. Such findings underscore the importance of monitoring wildlife for antimicrobial resistance, which could have implications for public health and veterinary medicine.

Previous investigations have explored the involvement of wolves in parasitic and viral diseases, but data on the zoonotic bacteria are limited. The aim of this study was to assess the occurrence of bacterial zoonotic agents in 16 wolf (Canis lupus italicus) fecal samples collected in a protected area in Central Italy. Campylobacter spp., Salmonella spp., Yersinia spp., Listeria monocytogenes, and Shiga Toxin-Producing Escherichia coli (STEC) were investigated by culture, while polymerase chain reaction (PCR) was employed to detect Coxiella burnetii, Mycobacterium spp., Brucella spp., and Francisella tularensis. The presence of Extended Spectrum β-Lactamase (ESBL)- and carbapenemase-producing Enterobacteriaceae was also evaluated, using selective isolation media and detection of antimicrobial resistance genes. All samples were negative for Campylobacter spp., Salmonella spp., C. burnetii, Mycobacterium spp., Brucella spp., F. tularensis, and carbapenemase-producing Enterobacteriaceae. One sample tested positive for Yersinia aldovae and three for Yersinia enterocolitica BT1A. One L. monocytogenes (serogroup IIa) and one STEC, carrying the stx1 gene, were isolated. Two ESBL isolates were detected: one Serratia fonticola, carrying blaFONA-3/6 gene, and one Escherichia coli, carrying blaCTX-M-1 gene. Both ESBL isolates were resistant to different antimicrobials and therefore classified as multi-drug-resistant. Our data suggest that wolves are potential carriers of zoonotic bacteria and may contribute to the environmental contamination through their feces.

Seagulls are synanthropic wild birds that can contaminate, through their droppings, beaches, urban and peri-urban environments. This concern is more serious when seagulls eliminate antimicrobial-resistant pathogenic bacteria. This study analyzed the fecal samples from 137 yellow-legged seagulls (Larus michahellis) from Central Italy. A total of 218 Escherichia coli strains were isolated and analyzed for phenotypic and genotypic antimicrobial resistance and to identify the virulence genes characterizing different pathotypes. The disk diffusion method on all isolates found relevant resistance rates to ampicillin (38.99%), tetracycline (23.85%), and enrofloxacin (21.10%). On the basis of all results obtained with this test, 62 (28.44%) isolates were classified as multidrug-resistant (MDR) and 6 (2.75%) as extensive drug-resistant (XDR). Molecular analyses conducted on the strains phenotypically resistant to carbapenems, cephalosporins, and penicillins found 9/37 (24.32%) strains positive for blaOXA-48, 52/103 (50.49%) for blaTEM, 12/103 (11.65%) for blaCMY2, 3/103 (2.91%) for blaCTX, and 1/103 (0.97%,) for blaSHV. PCR to detect virulence genes characterizing different pathotypes found that 40 (18.35%) isolates had the astA gene, indicative of the enteroaggregative (EAEC) pathotype, 2 (0.92%) had cnf1, 2 (0.92%) had cnf2, and 1 (0.46%) had cdt-IV. All five (2.29%) strains were reportable as necrotoxigenic (NTEC), while 4 (1.83%) had both eaeA and escV, reportable as enteropathogenic (EPEC). Measures to limit seagulls’ access where humans and other animals reside are pivotal to reduce the risk of infection with antimicrobial-resistant and pathogenetic E. coli strains.