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We describe the first reported cases of invasive type e Haemophilus influenzae disease in Italy. All five cases occurred in adults. The isolates were susceptible to ampicillin and eight other antimicrobial agents. Molecular analysis showed two distinct type e strains circulating in Italy, both containing a single copy of the capsulation locus.

Background. A national project on Clostridium difficile infection (CDI), funded by the Center for Prevention and Control of Diseases of Italian Ministry of Health, was performed in 2012-2013. Microbiological laboratories of the National Public Heath System were invited by the Istituto Superiore di Sanità to provide information on CDI diagnostics through a closed answer questionnaire. Materials and Methods. In total, 14 regions and the independent province of Trento participated in and 278 filled questionnaires were sent back. The data obtained indicate that 87% of the laboratories routinely perform diagnostic assays for C. difficile. GDH detection is used as the first screening test by 33% of these laboratories. Most of them declared to use toxins enzyme immunoassays (88%), whereas a minority performs C. difficile culture (26%) or molecular assays (19%). Only 37% of the laboratories stated to adopt a diagnostic algorithm. The algorithms adopted are different and high heterogeneity in the combination of the assays used was observed. Results. Fifty eight percent of laboratories declared to type C. difficile strains, the majority (82%) sending faecal samples or strains to a reference laboratory. Sixty-two laboratories, routinely performing C. difficile culture, were invited by ISS to send five isolates for molecular typing. In total, 103 isolates from 22 hospitals were collected and 31 different PCR-ribotypes were identified. PCR-ribotype 356/607 was the most frequent (27%), followed by 018 (12%) and 027 (8%). The latter is a worldwide spread hypervirulent type only recently emerged in our country. A molecular characterization of the different PCR-ribotypes detected was also performed by Xpert® C. difficile. Conclusions. The study highlights the need for a more careful selection of diagnostic algorithms to improve CDI diagnosis and the urgency to implement a National Surveillance of CDI in Italy.

Purpose: With the purpose of predicting the problem of procrastination, we study how age, sex, type of studies and grade for admission to higher education influence the procrastination behavior of students. Design/methodology/approach: In a sample of 359 university students, the Pure Procrastination scale was applied, as well as data on sex, age, grade previous to join the university, grade completed and year of study (first to fourth). To identify underlying variables or factors that explain the configuration of correlations in the items of the scale used, an exploratory factor analysis was carried out (principal component analysis with Varimax normalization). Next, a multiple linear regression analysis was performed with the variables sex, age, and admission grade as independent variables and academic procrastination as the dependent variable. Findings: It has been possible to identify the variables that influence the procrastinating behavior of university students. From the identification of which students will possibly present procrastinating behaviors, the people responsible for university education will be able to implement intervention programs to deal with procrastination. Research limitations/implications: The sample is not representative of the universe of university students, although the results obtained are relevant enough to replicate the study in other university contexts. Our data could have included more instruments for collecting information, which in future studies would entail incorporating scales related to the perception of time management, motivation or self-regulation. Practical implications: Distinguishing, among university students, those who may present more procrastination tendencies will guide those responsible for the educational process of said students with respect to measures to alleviate the negative effects of procrastination through psycho-socio-educational intervention programs. Social implications: The knowledge derived from this work has practical implications for the students themselves who, in the case of being identified as a potential procrastinator, may benefit from a psycho-socio-educational intervention that will help them manage their time and reduce the discomfort derived from the procrastination. Originality/value: On the previous corpus of existing scientific knowledge, this work provides knowledge that allows optimizing, both at a public and private level, the academic, economic and social resources of university institutions in which procrastination can affect the preparation and the student performance.

Purpose: With the purpose of predicting the problem of procrastination, we study how age, sex, type of studies and grade for admission to higher education influence the procrastination behavior of students. Design/methodology: In a sample of 359 university students, the Pure Procrastination scale was applied, as well as data on sex, age, grade previous to join the university, grade completed and year of study (first to fourth). To identify underlying variables or factors that explain the configuration of correlations in the items of the scale used, an exploratory factor analysis was carried out (principal component analysis with Varimax normalization). Next, a multiple linear regression analysis was performed with the variables sex, age, and admission grade as independent variables and academic procrastination as the dependent variable. Findings: It has been possible to identify the variables that influence the procrastinating behavior of university students. From the identification of which students will possibly present procrastinating behaviors, the people responsible for university education will be able to implement intervention programs to deal with procrastination. Research limitations/implications: The sample is not representative of the universe of university students, although the results obtained are relevant enough to replicate the study in other university contexts. Our data could have included more instruments for collecting information, which in future studies would entail incorporating scales related to the perception of time management, motivation or self-regulation. Practical implications: Distinguishing, among university students, those who may present more procrastination tendencies will guide those responsible for the educational process of said students with respect to measures to alleviate the negative effects of procrastination through psycho-socio-educational intervention programs. Social implications: The knowledge derived from this work has practical implications for the students themselves who, in the case of being identified as a potential procrastinator, may benefit from a psychosocio-educational intervention that will help them manage their time and reduce the discomfort derived from the procrastination. Originality/value: On the previous corpus of existing scientific knowledge, this work provides knowledge that allows optimizing, both at a public and private level, the academic, economic and social resources of university institutions in which procrastination can affect the preparation and the student performance. [ABSTRACT FROM AUTHOR]

Objectives: To detect Tn916-like elements in Clostridium difficile clinical isolates from different time periods and to analyse the genetic structure of these elements, in particular the tet(M) region.Methods: Ninety C. difficile clinical isolates were examined by PCR assays for tet(M) and int, which are markers for the Tn916 family of elements. Positive isolates were typed by PCR-ribotyping, and tetracycline MIC values were evaluated by Etest. The genetic organization of the Tn916 elements was investigated by PCR mapping and hybridization assays. The tet(M) region of eight selected C. difficile isolates was sequenced.Results: Nineteen isolates were tet(M)/int positive and the majority (12/19) belonged to PCR-ribotype R, previously found to be predominant in clinical strains of more recent isolation. Eleven isolates were tetracycline resistant, three inducibly resistant and five susceptible. Fifty-eight per cent of the C. difficile isolates harboured one Tn916 element and 42% harboured two. Most isolates showed elements with a genetic organization very similar to that of Enterococcus faecalis DS16 Tn916. Sequence analysis highlighted variations in the leader peptide and six tet(M) variants were identified, five of which have never been described before.Conclusions: C. difficile isolates harbouring Tn916-like elements have mainly been isolated since 1997, suggesting a recent circulation of these elements among C. difficile strains in Italian hospitals. Molecular analysis of these Tn916-like elements showed that they may have different genetic structures and carry new tet(M) alleles. [ABSTRACT FROM AUTHOR]

Objectives: Haemophilus influenzae invasive disease is potentially life threatening and requires prompt antibiotic therapy. The aim of this study was to assess the antimicrobial susceptibility of H. influenzae strains isolated from invasive disease in Italy and to investigate ampicillin-resistant isolates by molecular biology techniques.Materials and methods: One-hundred and seventy-six invasive H. influenzae isolates, collected during 19982003, were analysed for susceptibility to ampicillin, azithromycin, chloramphenicol and ciprofloxacin. Ampicillin-resistant isolates were further tested against cefotaxime and imipenem. MICs were determined by Etest and interpreted according to NCCLS criteria. The ampicillin resistance genes, blaTEM and blaROB, were searched for by PCR. Genetic relatedness among ampicillin-resistant isolates was investigated by PFGE.Results: Overall, ampicillin resistance was 10.2% (all -lactamase producer strains). The prevalence of ampicillin-resistant isolates increased from 6.9% in 1998/1999 to 19% in 2002/2003. Resistance to azithromycin and chloramphenicol was 6.8% and 1.7%, respectively. No strains were resistant to ciprofloxacin. Co-resistance between ampicillin and chloramphenicol and between ampicillin and azithromycin was observed in three and one isolates, respectively. All ampicillin-resistant isolates were susceptible to cefotaxime and imipenem and all harboured the blaTEM gene. PFGE demonstrated that most of the ampicillin-resistant isolates showed little genetic homology.Conclusions: An upward trend in resistance to ampicillin due to -lactamase production was demonstrated In Italy. According to PFGE results, clonal dissemination of ampicillin-resistant isolates does not occur. Imipenem may represent an appropriate alternative for treatment of H. influenzae invasive disease caused by ampicillin-resistant isolates when third-generation cephalosporins cannot be used. [ABSTRACT FROM AUTHOR]

Elements carrying more than one antibiotic resistance gene have never been found in Clostridium difficile, one of the major causes of nosocomial diarrheic diseases. In this study, C. difficileisolates were investigated for a possible genetic linkage between tet(M) and erm(B), the most frequent genes found in strains resistant to tetracycline and erythromycin. In the majority of C. difficilestrains, tet(M) is carried by Tn5397. However, tet(M) genes carried by Tn916-like elements have been found in recent clinical isolates. As far as erythromycin resistance is concerned, the only completely characterized transposon harboring an erm(B) gene in C. difficileis Tn5398, even if ErmB determinants probably carried by other elements have been identified. Among the 100 C. difficileisolates screened in this study, 27 were positive for tet(M) and erm(B). Twenty five of these strains were positive for tndX, used as marker for Tn5397, whereas two were positive for int, used as marker for Tn916-like elements. The latter isolates showed two tet(M) genes one was carried by a Tn916-like element, able to transfer to a recipient C. difficilestrain, whereas the second was genetically linked to an erm(B) in a composite element probably unable to conjugate. Molecular analysis of C. difficilecd1911 tet(M)-erm(B) DNA sequence demonstrated that this region has arisen by recombination of DNA fragments from different plasmids and transposons. This is the first demonstration that C. difficileis able to accumulate and maintain antibiotic resistance genes, as observed in other pathogens. [ABSTRACT FROM AUTHOR]

Purpose: The present study identifies the professional skills profile that a Public Affairs (PA) practitioner of a major company or an organization representing the interests of various economic sectors should have in Spain. Design/methodology: The study uses a mixed qualitative and quantitative methodology. The initial identification of the competences, as well as the general functions of the profile to be evaluated, has been carried out using the in-depth interview technique with the directors of APRI (Association of Professionals of Institutional Relations of Spain), who defined these competencies from their expert perspective. Subsequently, through a survey of seventy-two managers, sufficient data were obtained to statistically process the information and obtain significant results in the identification of such competences. This information has been processed, firstly, through factorial analysis, which has made it possible to synthesize these competences. Once the analysis of factors was carried out, a cluster analysis is added for the classification of the respondents or managers. Findings: The perception of the interviewed executives has been determined regarding the functions that an institutional relations practitioner must fulfill. It should be noted that this is a profession for which there is no clarity about the role and the legitimacy of its members, particularly in Spain. In fact, it is associated with a function that is seen as exerting undue pressure on political power. A field study was conducted to determine the opinion of these managers on the competences that a professional in institutional relations should have. Originality/value: This study provides a description of the job position of a person responsible for institutional relations in Spain. Moreover, it adds a typology of managers, according to the competences defined for the person responsible for institutional relations.