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Objectives: The purposes of this study are to describe the epidemiology of pericardial and tunica vaginalis testis mesothelioma and assess the role of asbestos exposure for these rare diseases. Methods: Based on incident pericardial and tunica vaginalis testis mesothelioma cases collected from the Italian national mesothelioma registry (ReNaM) in the period 1993–2015, incidence rates, survival median period and prognostic factors have been evaluated. A case–control study has been performed to analyze the association with asbestos exposure (occupational and non-occupational) for these diseases. Results: Between 1993 and 2015, 58 pericardial (20 women and 38 men) and 80 tunica vaginalis testis mesothelioma cases have been registered with a mean annual standardized (world standard population as reference) incidence rates of 0.049 (per million) in men and 0.023 in women for the pericardial site, and 0.095 for tunica vaginalis testis mesothelioma. Occupational exposure to asbestos was significantly associated with the risk of the diseases [odds ratio (OR) 3.68, 95% confidence interval (CI) 1.85–7.31 and OR 3.42, 95% CI 1.93–6.04 in pericardial and tunica vaginalis testis mesothelioma, respectively]. The median survival was 2.5 months for pericardial and 33.0 months for tunica vaginalis testis mesotheliomas. Age was the main predictive factor for survival for both anatomical sites. Conclusions: For the first time in an analytical study, asbestos exposure was associated with pericardial and tunica vaginalis testis mesothelioma risk, supporting the causal role of asbestos for all anatomical sites. The extreme rarity of the diseases, the poor survival and the prognostic role of age have been confirmed based on population and nationwide mesothelioma registry data.

Background: Understanding parents’ hesitancy against COVID-19 vaccination for their children is useful. Methods: A self-administered online survey was conducted among 394 parents with at least one child aged 12–18years in Italy. Results: The mean perceived risk that their child can be infected by the SARS-CoV-2, measured on a 10-point Likert-type scale, was 7.7 and it was higher if at least one parent/partner cohabitant have had COVID-19, in those who believed that COVID-19 is a serious illness, and in those who had not vaccinated their child. 82.1% respondents were willing to vaccinate their child and this was more likely among those who believed that this vaccine is useful and who did not need additional information. 12.4% were, according to the 5-item Parent Attitudes About Childhood Vaccines Survey (PACV-5) score, high-hesitant toward anti-COVID-19 vaccination. Respondents not graduated, those who did not believe that this vaccination was useful, those who did not get this vaccine, those who did not obtain information from physicians, and those who needed additional information were more likely to be high-hesitant. Conclusions: Communication and public health interventions must be intensified to enhance the attitude and to help parents in deciding on COVID-19 vaccination of their children.

Background: This study aims to evaluate the antimicrobial prescribing practices in hospital settings in Italy, focusing on the appropriateness of antibiotic use. Methods: This study was carried out through a retrospective review of medical records of patients admitted in three public hospitals located in Campania Region (Italy) between 1 January and 31 December 2018. Results: More than one third (34.2%) of patients received at least one inappropriate antibiotic prescription (antibiotic administered and not indicated). Being female, having a >1 Charlson comorbidity index score, and having a longer hospital stay were significant determinants of an inappropriate antibiotic prescription. Instead, patients who had had a non-urgent hospital admission, an infection on hospital admission, and a microbiological culture test during hospital stay were significantly less likely to have an inappropriate prescription. When the antibiotic prescriptions were analyzed, in 26.6% of cases they were not indicated, while among the 687 antibiotic prescriptions with indication, incorrect choice of antibiotics (36.8%) was the most common reason of the inappropriateness. Conclusions: The findings of the study indicate that the inappropriate use of antibiotics continues to be a relevant issue in the hospital setting and specific interventions are needed to encourage a wider utilization of diagnostic tools to practice targeted therapies and to counter the antimicrobial resistance.

Background: Understanding healthcare workers (HCWs) willingness to receive a future vaccination against coronavirus disease 2019 (COVID-19) may be useful. Methods: Cross-sectional study, conducted in Italy from September 14th to November 30th, 2020, among 811 HCWs who undergo a voluntary antibody-testing for anti-SARS-CoV-2. Results: The perceived risk level of developing COVID-19, measured on a Likert-type scale ranging from 1 to 10, was 6.6 and it was higher among females, older HCWs, and in those who agreed that COVID-19 is a severe disease. Married/cohabitant, not physicians, and those who needed additional information regarding the vaccination against COVID-19 were more likely to be concerned that COVID-19 vaccination might not be safe. Males, physicians, those who did not have had any symptom compatible with COVID-19, those who agreed that COVID-19 is a severe disease, those who perceived to be at higher risk of developing COVID-19, those who were not concerned about the vaccine's safety, and those who had received information regarding the COVID-19 vaccination from scientific journals expressed willingness to receive vaccination against COVID-19. Conclusions: Communication and education targeted to groups with lowest willingness are needed to raise awareness regarding the safety and benefits of the vaccination and to improve vaccine uptake.

Background: This cross-sectional survey aimed to determine the knowledge, attitudes, and behaviors regarding vaccinations among schoolteachers in Italy. Methods: Data were collected through an online questionnaire from September 2020 to May 2021 from a sample of schoolteachers in the Campania region of southern Italy. Results: Only 27% of the participants had good knowledge about the vaccinations recommended for schoolteachers. Females who had children, who were unsatisfied by their health status, and not needing additional information about vaccinations were more likely to have good knowledge. Moreover, 61.5% perceived that vaccinations are useful in preventing infectious diseases, and 44.5% agreed or strongly agreed that vaccinations should be mandatory for schoolteachers. The results of multivariate logistic regression showed that schoolteachers who perceived that vaccinations are useful in preventing infectious diseases, who considered the recommended vaccinations to be useful to protecting their own and their students’ health, who believed that information received about vaccination was useful, and who needed additional information about vaccinations recommended for schoolteachers, were significantly more likely to agree or strongly agree that vaccinations should be mandatory for schoolteachers. Conclusions: These findings suggest the need for education strategies to ensure that schoolteachers are better informed about vaccinations recommended for their profession.

Background: This study explored the extent of COVID-19 vaccination coverage and investigated drivers and barriers to COVID-19 vaccine uptake among people in prison. Methods: This cross-sectional study was conducted from July to October 2021 among 517 detained people in the Campania region of South Italy. Results: In total, 47.1% of participants expressed a high concern about contracting COVID-19 after vaccination, whereas 60.6% and 53.8% of respondents reported a positive attitude towards usefulness and safety of COVID-19 vaccines, respectively. Adherence to the active offer of COVID-19 vaccination involved 89.7% of detained subjects. COVID-19 vaccination uptake was significantly higher in females, and in those who reported influenza vaccination uptake, had received information about COVID-19 vaccination from media and newspapers, did not express need of additional information about COVID-19 vaccine, believed that COVID-19 vaccine is safe, were involved in working activities in the prison, and had a high school or university degree. Conclusions: These findings showed a high self-reported COVID-19 vaccination coverage in detained subjects, supporting the effectiveness of the strategy aimed at giving priority to COVID-19 vaccinations in prisons. Further efforts are needed to contrast the hesitancy of those who refused vaccination to increase their confidence about usefulness and safety of COVID-19 vaccines.

Tattooing and piercing may lead to health complications. The present multicenter cross-sectional study aimed to assess awareness and knowledge of health risks related to body art and to identify their possible determinants among a large sample of undergraduates in Italy. A web-based questionnaire collecting information on socio-demographic characteristics, awareness, knowledge, and some potential predictors was administered to undergraduates attending twelve Italian universities. The level of knowledge was expressed as the number of correct answers (0–11 for tattooing, 0–14 for piercing). A total of 2985 participants (mean age 23.15 ± 3.99, 73.9% F) participated in the study. Although 95.4% of the respondents were aware of possible health consequences of body art, a low level of specific knowledge was registered for both tattooing (mean number of correct answers 5.38 ± 2.39) and piercing (5.93 ± 3.12) consequences. Lower knowledge was associated with the attendance of non-life science course and with lower duration of academic education for both tattoo and piercing. Lower knowledge of tattooing risks was related with commuter status, while lower knowledge of piercing risks was associated with lower father’s education. These findings highlight the need to enhance information campaigns targeted to youths to increase their awareness of possible health risk of body art.

Understanding the potential impact of COVID-19 on receiving influenza vaccination among healthcare workers (HCWs) is of utmost importance. The purposes of the present cross-sectional study were to describe the characteristics and to explore the predictors of receiving influenza vaccination among a large cohort of Italian HCWs in hospital settings. Information was collected through an anonymous questionnaire from December 2020 through January 2021. General and practice characteristics, perceived risk of seasonal influenza, attitudes towards efficacy and safety of influenza vaccination, and reasons behind the decision to be vaccinated against influenza were explored. Fewer than half (46.2%) of HCWs agreed that influenza is a serious illness and perceived the risk of getting infected with influenza, and concerns about the safety of the vaccination were significant positive predictors. Fewer than half of the respondents were not concerned at all about the efficacy (48.6%) and safety (49.8%) of influenza vaccination, and 51.9% reported that they have not received a seasonal influenza vaccine during the previous season. The most mentioned reason for receiving the influenza vaccine in the current season was that influenza and COVID-19 share some similar symptoms. Study results will aid policymakers in developing vaccination education programs, promotion of trust to address negative misconceptions, and to achieve future high coverage among this high-risk group.

In recent years, food waste has received great attention and is now considered the cause of many negative effects, including health, economic, social and environmental issues. A cross-sectional study was conducted among a sample of 762 inpatients at three hospitals of Campania region in Italy. The purpose of this study was to evaluate the amount of food waste occurring in these hospitals using a structured questionnaire and asking inpatients about the average percentage of food they had disposed of in the previous three days. The overall food wasted amounted to 41.6%. The main plates, first (pasta or rice), second plate (meat or fish), resulted in similar amounts of waste (38.5% and 39.7%, respectively). The side plate (vegetable or potatoes), however, generated the greatest amount of waste (55.0%), 40.7% of patients totally discarded this part of their meals. The type of food wastage among the three hospitals reflected similar patient behaviours, with the amount of food wasted never falling below 30%. Females tended to waste more food than males (59.1% vs. 38.2%, p = 0.000). Other variables were correlated with less food waste, such as having a good opinion of the food&rsquo, s quality (RR = 1.91, 95% C.I. = 1.68&ndash, 2.17) and satisfaction with the foodservice in general (RR = 1.86, 95% C.I. = 1.64&ndash, 2.10). Poor quality, different eating habits and the feeling of satiety were the main reasons patients gave for food waste. Our study suggests that the most promising way to reduce food waste in hospitals is to improve the quality of meals and to establish an individual, simplified and flexible meal reservation process based on specific needs and preferences.

This cross-sectional survey was designed to evaluate hospital healthcare workers’ (HCWs) willingness to receive the influenza vaccination during the COVID-19 pandemic and to identify the related determinants, since it is plausible that the two epidemics will coexist in future winters. Overall, 68% out of 490 participants expressed their willingness to receive influenza vaccination in the 2020/21 season, with 95% of those ever and 45.8% of those never vaccinated in the previous six influenza seasons. Belief that influenza vaccine is useful in distinguishing influenza symptoms from those of COVID-19 and that the influenza vaccine is useful to prevent influenza in hospital settings, willingness to receive COVID-19 vaccination, having no concern about influenza vaccine side effects, concern about the possibility to transmit influenza to hospitalized patients, and influenza vaccination in previous years were all predictors of willingness to receive influenza vaccination. In the context of the COVID-19 pandemic, a relevant increase in the willingness to undergo influenza vaccination was reported. Therefore, interventions focused primarily on enabling factors are needed to promote the adherence to influenza vaccination in future seasons among HCWs.

Understanding whether members of the university population are willing to receive a future vaccination against COVID-19 and identifying barriers may help public health authorities to develop effective strategies and interventions to contain COVID-19. This cross-sectional study explored the willingness to accept a future SARS-CoV-2 vaccine in a university population in Southern Italy. The perceived risk level of developing COVID-19 was 6.5 and it was significantly higher among females, younger subjects, and those who agreed/strongly agreed that COVID-19 is a severe disease. Only 21.4% of respondents were not worried at all regarding the safety of the vaccine. Males, not being married/cohabitant, being a faculty member, those who perceived a lower risk of developing COVID-19, and those who did not need information regarding the vaccination against COVID-19 were significantly more likely to have no concern at all regarding the safety of the vaccine. The vast majority (84.1%) were willing to receive a future vaccine against COVID-19. Almost coherently with predictors of concern on the safety of the vaccine, being male, not being married/cohabitant, being a faculty member, not being concerned at all that COVID-19 vaccination might not be safe, and agreeing that COVID-19 can have serious health consequences were significant predictors of the willingness to receive the vaccine against COVID-19. A considerable proportion of the population had a positive willingness to receive the future COVID-19 vaccine, although some concerns have been expressed regarding the effectiveness and safety and public health activities seem necessary to achieve the rate that can lead to the protection of the community.

Pharmacists should be educated about travel medicine, since they could influence their own choices and those of the individuals they encounter. This study aims to investigate the knowledge, attitudes, and behaviors towards infectious diseases related to travel among community pharmacists in Italy. The data was collected from September 2018 to September 2019 using semi-structured telephone interviews. Only 1.8% answered correctly to all seven questions regarding the infectious diseases related to travel. Community pharmacists who had heard about travel medicine and those who had received information were more likely to have good knowledge. More than two-thirds of the respondents believed that it is important to provide information to the public about travel medicine. Pharmacists who worked a higher number of hours per week, were more knowledgeable about the more frequent infectious diseases related to travel, believed that travel medicine was a pharmacist competency, believed that they could give advice to the public, and had received information from scientific journals and educational activities were more likely to have this positive attitude. More than two-thirds often/always informed the public about the importance of having travel health center counseling. Pharmacists who had heard about travel medicine and those who believed that they could give advice to the public were more likely to inform. Interventions are needed to improve knowledge in order that community pharmacists can play an active role in counseling the public.