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COVID-19 infection causes respiratory pathology with severe interstitial pneumonia and extra-pulmonary complications; in particular, it may predispose to thromboembolic disease. The current guidelines recommend the use of thromboprophylaxis in patients with COVID-19, however, the optimal heparin dosage treatment is not well-established. We conducted a multicentre, Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe clinical characteristic of patients at admission, bleeding and thrombotic events occurring during hospital stay. The strategies used for thromboprophylaxis and its role on patient outcome were, also, described. 1091 patients hospitalized were included in the START-COVID-19 Register. During hospital stay, 769 (70.7%) patients were treated with antithrombotic drugs: low molecular weight heparin (the great majority enoxaparin), fondaparinux, or unfractioned heparin. These patients were more frequently affected by comorbidities, such as hypertension, atrial fibrillation, previous thromboembolism, neurological disease, and cancer with respect to patients who did not receive thromboprophylaxis. During hospital stay, 1.2% patients had a major bleeding event. All patients were treated with antithrombotic drugs; 5.4%, had venous thromboembolism [30.5% deep vein thrombosis (DVT), 66.1% pulmonary embolism (PE), and 3.4% patients had DVT + PE]. In our cohort the mortality rate was 18.3%. Heparin use was independently associated with survival in patients aged ≥ 59 years at multivariable analysis. We confirmed the high mortality rate of COVID-19 in hospitalized patients in ordinary wards. Treatment with antithrombotic drugs is significantly associated with a reduction of mortality rates especially in patients older than 59 years.

Sexually transmitted diseases (STDs)—or sexually transmitted infections (STIs)—are generally acquired through sexual contact [...]

Italian “Gelli–Bianco” law (law n. 24 enacted by the Italian Government on 8 March 2017) introduced innovative changes and regulations regarding patient safety and healthcare workers’ (HCWs) liability. We promoted a national survey to evaluate the effect of the law on HCWs. The questionnaire was edited and distributed using the free online tool “Google Forms” (Google LLC). The mode of administration chosen for the questionnaire was telematic self-completion. In particular, the questionnaire was sent to several portals of information, websites, in the scientific and medical sectors. Four hundred forty-five subjects participated in the survey. The differences in categorical variables for Gelli–Bianco Law reading with professional variables were analyzed in a univariate analysis using the Chi-square test and Fisher’s exact test. Reading the law is significantly and positively related to knowledge and communication of adverse events and sentinel events, checklist adoption, and participation in educational activities on risk management. The law’s implementation and promotion is a reliable educational tool for increasing patient safety culture and involving HCWs in risk management activities. Knowledge of the law, related education, and understanding of its application are still inadequate; therefore, educational programs regarding patient safety, risk management, and the contents of the law itself must be vigorously promoted to achieve clinical governance goals.

Objective: In this study, we explored the relationship between migraine and sport in a physically active population of students, analyzing the risk of migraine among sporty students. Background: The relationship between sport and migraine is controversial; moreover, several studies report on sport as a migraine trigger, but there is evidence that physical activity could have a relevant role in migraine prevention. Methods: A cross-sectional survey was conducted using the validated ID-migraine questionnaire including specific demo-anthropometric (gender, age, weight, height) and sports variables on a potentially active student population of the University of Palermo. Evaluation in putative migraine subjects of clinical features and disability was explored through the administration of the Italian version of the Migraine Disability Assessment Scale. Statistical analyses were performed using univariate and logistic regression analyses. Results: Three hundred and ninety-three out of 520 students (210 F, mean age: 23.5 ± 0.7 years; 183 M; mean age: 20.5 ± 0.7 years) participated in this study. Migraine screened positive in 102 subjects (26.0%) and its prevalence was significantly higher among females (P < .001). An increased risk of migraine was found in females, and a protective effect of sport on the risk of migraine among females, but not among males. Conclusions: The role of exercise in migraine is still unclear. This study supports a protective role of sport in migraine reporting a protective effect in females. Further studies are needed to deepen the association between sport and migraine.

Background The decline of health among university students represents an important and growing public health concern. Health problems and unhealthy lifestyle habits are common among many students, but factors influencing students’ health are not fully understood. Methods Italian university students from different study programs and curriculum years were asked to fill out a self-administered questionnaire, collecting data about age, gender, curriculum year, study program and health-related quality of life (QOL). Two latent factors were extracted: physical component summary score and mental component summary score. T-test, one-way ANOVA, multivariate and age and sex-stratified analyses were performed. Results Students scored relatively poor on health-related QOL, with an overall mental component summary score of 41,3% (± 10,0) and physical component summary score of 52,9% (±6,0), with significantly higher mental component summary score for male students (P = < 0,005). Studying economics, law (b = −2,513, P = 0,007) or engineering (b = −2,762; P = 0,001) was associated to negatively influence students’ health. Conclusions Factors such as study program are associated with health-related QOL. Further longitudinal studies assessing additional socio-demographic factors are needed to fully assess what influences students’ health. Students’ health should be at the top of the agenda of public health researchers, academic supervisors and policy-makers.

There is evidence of an association between cancer and certain types of altered eating behaviors, including orthorexia, food cravings, and food addiction. Given the growing interest in the topic throughout the scientific community we conducted a systematic review to summarize current evidence on the development of altered food behavior, including food addiction and cancer. The Cochrane Collaboration and the Meta-analysis Of Observational Studies in Epidemiology guidelines were followed to perform this systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to report the process and results. The structured literature search was conducted on 19 April 2022, on PubMed/Medline and Scopus, combining free-text terms and medical subject headings. A total of seven articles were included once the selection process was completed. Food craving has been associated with different types of cancer in adults and young patients, as well as with orthorexia; conversely, compulsive eating has only been explored in patients with prolactinoma treated with dopamine agonists. This systematic review explored a new area of research that warrants further investigation. More research is required to better understand the relationship between cancer and food behavior.

Introduction: Best care of esophagogastric junction and gastric cancer (EGC) requires a complex, timely interaction between members of a multi-disciplinary team (MDT). An integrated clinical pathway (ICP) is necessary to achieve this goal as well as the implementation of its use in daily practice. The objective of this study was to elaborate on an integrated clinical pathway for the multi-disciplinary management of ECG. Authors also put in act an implementation program to improve adherence to guidelines thought an ICP. Method: This prospective work carried out by a multi-institutional MDT in Italy identified expert panel extracted relevant recommendations and/or statements from published papers and guidelines obtaining a set of crucial interventions employed the Estimate-Talk-Estimate method. A flow-chart diagram was elaborated to elicit the process at a glance. The primary outcome measure was the elaboration of an ICP with a high consensus rate also reported as a snapshot diagram and its implementation in daily clinical practice. An accredited certification body agency validated results, and an implementation process was started in several hospitals known to treat ECG. Results: A methodologist aggregated a multi-disciplinary panel of experts from different institutions. The panel elaborated a flow-chart diagram with crucial intervention highlight and connecting lines, as well as outcome measures. An accredited certification body agency validated the entire process, representing the basis for empowerment and implementation among patients and oncological professionals in various hospitals. Conclusion: The multi-disciplinary and multi-institutional expert panel successfully elaborated on a validated ICP for all stages ECG. An in-hospital implementation program has been programmed.

Objectives: The purpose of this study is to assess the prevalence and determinants of workplace violence and the sociodemographic risk factors associated. Study design: This was a multicenter cross-sectional study. Methods: The study was performed using self-compiled Italian version of the World Health Organization's questionnaire on workplace violence online by filling in a Google form. The survey was opened from May 2018 to March 2020 and lasted 5-10 min. Results: The sample consists of 3659 healthcare workers, of which 2525 (69%) are females, 1446 (39.5%) are nurses, and 2029 (55.5%) are health workers from northern Italy. The most frequent age group of the sample is 50-54 years (16.7%). A total of 366 (10%) healthcare workers are victims of physical aggression at work in the last 12 months, of which 6.3% with a weapon. The risk of being a victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (odds ratio [OR] 1.72, 95% confidence interval [CI]: 1.36-2.17), work in southern Italy (OR 1.59, 95% CI: 1.10-2.28), and being a nurse (OR 2.56, 95% CI: 2.01-3.25). The risk of being a victim of physical aggression at work with a weapon in the last 12 months is significantly associated with work in southern Italy (OR 9.33, 95% CI: 3.83-22.73). A total of 1723 (47.1%) of healthcare workers declare to be a victim of verbal aggression at work in the last 12 months. The risk of being a victim of verbal aggression at work in the last 12 months is significantly associated with the following independent variables: work in northern Italy (adjusted OR [aOR] 1.54, 95% CI: 1.32-1.81), work in southern Italy (aOR 3.68, 95% CI: 2.90-4.68), and be more than 55 years old (aOR 0.73, 95% CI: 0.63-0.85). Conclusions: The study underlines that the problem of verbal and physical aggression against healthcare workers is still central and is a further starting point for research. The prevalence of violence is difficult to assess because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is needed to develop effective control strategies at the individual, hospital, and national levels to prevent aggression and improve the conditions of victims. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Obesity, type 2 diabetes (T2DM), hypertension (HTN), and Cardiovascular Disease (CVD) often cluster together as "Cardiometabolic Disease" (CMD). Just under 50% of patients with CMD increased the risk of morbidity and mortality right from the beginning of the COVID-19 pandemic as it has been reported in most countries affected by the SARS-CoV2 virus. One of the pathophysiological hallmarks of COVID-19 is the overactivation of the immune system with a prominent IL-6 response, resulting in severe and systemic damage involving also cytokines such as IL2, IL4, IL8, IL10, and interferon-gamma were considered strong predictors of COVID-19 severity. Thus, in this mini-review, we try to describe the inflammatory state, the alteration of the adipokine profile, and cytokine production in the obese state of infected and not infected patients by SARS-CoV2 with the final aim to find possible influences of COVID-19 on CMD and CVD. The immunological-based discussion of the molecular processes could inspire the study of promising targets for managing CMD patients and its complications during COVID-19.

Introduction: The aim of the study was to evaluate the knowledge, attitude and practices towards Sars-CoV-2 among nursing students of University of Palermo during the rapid rise period of the COVID-19 pandemic. Materials and Methods: This is cross-sectional study. A survey was provided to all nursing students and consisted of two parts: demographics and Knowledge, Attitude and Practices (KAP) survey. A multivariate linear regression model was used and adjusted Odds Ratios (aOR) are presented. Results: 575 students were interviewed and their mean age was 22.3. The overall score indicates good knowledge (p=0.046) and good practices among the four courses of study (p=0.038). Multivariate linear regression showed that Attitude score (ẞ=-0.29; p=0.024) and Knowledge score (ẞ=0.10; p=0.026) adjusted for age, gender, year of study, perceived economic status, perceived health status were significantly associated with Practice score. Conclusion: Our results suggest that proper health education is useful for encouraging optimistic attitudes and maintaining safe practices among future category of nurses., Journal of Preventive Medicine and Hygiene, Vol. 62 No. 2 (2021): 2021622

Aims. Evaluation of (hc knowledge and behavioral risks relatcd lo sexually transmiltcd infections (STIs) among the student population of the degree course in nursing at the University of Palermo. Materials and Methods. An anonymous online a survey was provided to students that investigate to socio-demographic information. sexual habits and the level of knowledge of the STIs. Multivariable logistic regression was performed. considering it as a dependent variable "Do you permanently have unprotected sex (without a condom)? Yes", in order to evaluate the role of the variables of the questionnaire. Results are expressed as adjusted Odds Ratio (aOR). Results. The sample size consists of 405. The average age of the sample is 21.65 years (standard deviation±3.24). The analysis shows that the risk of having permanently unprotected sex (without condom) is significantly associatcd with the following variables: "Are you engaged or single? Engagcd" (aOR 3.24,95% CI 1.66 - 6.33); "Sexual orientation. Homosexual or Bisexual (aOR4.45, 95% CI 1.30-15.29); "Have you occasionally had unprotected sex (without a condom)? Yes" (aOR 5.09, 95% CI 2.69 - 9.62); "How would you define your knowledge of sexually transmitted discases? Good" (aOR 2.07, 95% CI 1.05 -4.08); "How would you define your knowledge about contraceptive methods? Good" (aOR 2.51, 95% CI 1.23 - 5.15); "Have you or have you ever had a sexually transmitted discase? Yes (aOR 4.43,95% CI 1.71 - 11.53); "Do you know that men can also undergo HPV vaccination? Yes" (aOR 2.57,95% CI 1.03 -6.40); "Age. As the unit inercase" (aOR 1.14,95% CI 1.02- 1.26). Conclusions. These results highlight the importance of involving university students in programs aimed at improving the knowledge in terms of STIs and inercase of Sexual and reproductive health. Further. because STIs prevention is based mainly on human behavior. tailored intervention is needed especially because behavior change remains a complex challenge.

To compare microvascular flow imaging (MVFI) to conventional Color-Doppler (CDI) and Power-Doppler (PDI) imaging in the detection of vascularity of Focal Breast Lesions (FBLs). A total of 180 solid FBLs (size: 3.5–45.2 mm) detected in 180 women (age: 21–87 years) were evaluated by means of CDI, PDI, and MVFI. Two blinded reviewers categorized lesion vascularity in absent or present, and vascularity pattern as (a) internal; (b) vessels in rim; (c) combined. The presence of a “penetrating vessel” was assessed separately. Differences in vascularization patterns (chi2 test) and intra- and inter-observer agreement (Fleiss method) were calculated. ROC analysis was performed to assess performance of each technique in differentiating benign from malignant lesions. About 103/180 (57.2%) FBLs were benign and 77/180 (42.8%) were malignant. A statistically significant ( p

Background: COVID-19 and the policies to contain it have been a social problem and public health emer-gency for people in Italy in 2020. The aim of the study is assessing the prevalence of depression symptoms among nursing students from the University of Palermo during the COVID-19 pandemic. Materials and methods: The study employed a cross-sectional study design. On April 2020, a survey was performed including all the nursing students of the University of Palermo. The survey was structured into two parts. The first part consisted in the collection of socio-demographic information, the second in the administration of the QIDS-SR16 questionnaire. A multivariable logistic regression model was used to elaborate the results and adjusted Odds Ratios are presented. Results: The sample consisted of 525 students (70.3% female). The probability to have a moderate/severe/very severe depressive symptomatology is significantly associated with the following variables: "Female gender" (aOR 1.96), "Low perceived economic status" (aOR 2.32), "Low perceived health status" (aOR 2.30) and "To be a smoker" (aOR 2.24). Conclusions: The global pandemic and the efforts to contain it represent a unique event and offer the oppor-tunity to advance our understanding of how to provide mental health care focused on online psychoeducation and psychotherapy programs for young students.

Background: The restrictions taken to control the rapid spread of COVID-19 resulted in a sudden, unprecedented change in people’s lifestyle, leading to negative consequences on general health. This study aimed to estimate the impact of such changes on migraine severity during 2020 March–May lockdown. Methods: Patients affected by migraine with or without aura, diagnosed by expert physicians, completed a detailed interview comprehensive of: assessment of migraine characteristics, measure of physical activity (PA) levels, measure of the intake frequency of main Italian foods, the Insomnia Severity Index (ISI) questionnaire investigating sleep disorders. Results: We included 261 patients with a mean age of 44.5 ± 12.3 years. During social distancing, 72 patients (28%) reported a headache worsening, 86 (33%) an improvement, and 103 (39%) a stable headache frequency. A significant decrease of the PA levels during COVID-19 quarantine in the whole study sample was observed (median total metabolic equivalent task (METs) decreased from 1170 to 510, p &lt, 0.001). Additionally, a significant difference was reported on median ISI scores (from 7 to 8, 0.001), which were increased in patients who presented a stable or worsening headache. Conclusions: Our study confirmed that the restrictions taken during the pandemic have affected the practice of PA levels and sleep quality in migraine. Hence, PA and sleep quality should be assessed to find strategies for an improvement in quality of life.

Introduction. Vaccines are one of the most successful and cost-effective public health interventions of modern times. This cross-sectional study investigated the perception of vaccinations and potential risks of adverse events following immunization among nursing students. Materials and Methods. An anonymous, self-administered questionnaire was distributed to students undertaking a nursing degree course at the University of Palermo. This questionnaire consisted of three sections: the first part focused on socio-demographic information; the second part contained one question regarding the terms associated with vaccination; and the third part posed a question regarding adverse reactions after immunization. A multivariable logistic regression model was used and adjusted Odds Ratios will be presented in this paper. Results. The sample consisted of 403 students and the mean age was 22.0 years (±3.0). Having considered the dependent variable “Have you ever had adverse reactions after being vaccinated? Moderate-severe”, the statistically-significant independent variables were: the second (adjusted Odds Ratios 0.32) and third (adjusted Odds Ratios 0.18) years of study, the nursing students perceiving their economic and health status to be low (adjusted Odds Ratios 3.52 and 15.92 respectively). The following items from questionnaire were found to be associated with the term vaccination: “I associate the term vaccination with fear” (adjusted Odds Ratios 4.98) and “I do not associate the term vaccination with fighting illnesses” (adjusted Odds Ratios 10.02). Conclusions. Although vaccines are generally safe if used correctly, no vaccination is completely risk-free. There was a general awareness of adverse events following immunization among nursing students in this study. The future healthcare workers have been identified as the most important information source regarding potential solutions in a rapidly evolving health scenario in fighting vaccine hesitancy.

Background: This cross-sectional study aims to evaluate the prevalence and socio-demographic factors associated with workplace bullying, sexual harassment and racial harassment among Italian health workers. Methods: We recruited 3129 participants using an online Italian translation of the ‘Workplace Violence in the Health Sector Country Case Studies Research Instruments Survey’ (WVHS) questionnaire. Data were analyzed with univariate (chi-square) and multivariate (multiple logistic regression) analysis. Results: Univariate analysis shows that females are significantly more affected by bullying (16.4% vs. 12.3%) and sexual harassment (2.4% vs. 1.3%). On the other hand, males are significantly more affected by racial harassment (3.1% vs. 2.0%). Multivariate analysis shows higher odds of being affected by bullying (OR = 1.30; 95% CI (1.03, 1.64)) and sexual harassment (OR = 2.08; 95% CI (1.04, 4.00)) for females, and higher odds of undergoing racial harassment (OR = 1.55; 95% CI (0.95, 2.53)) for males. Conclusion: This analysis of work situations looks to identify those risk factors, existing or potential, that increase the probability of episodes of violence. A group of work or other subjects identified by direction will have to evaluate the vulnerability of workplaces and establish more effective preventive actions to be adopted.

Background: Violence in the workplace is now universally recognized as a significant global public health issue and is one of the most serious issues affecting the healthcare sector. Objectives: To assess the prevalence of workplace violence. Methods: We performed a multicenter cross-sectional study using an anonymous questionnaire submitted to doctors from Northern Italy. The survey investigates socio-demographic information, the number of years of work in the health sector and the physical and verbal aggressions that occurred in the workplace in the last 12 months. Results: The sample consists of 4545 healthcare workers, of whom 2603 (57.27%) are females. The mean age of the sample is 49.79 years (SD ± 12.63). The risk of being victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (aOR 2.09, 95% CI 1.51-2.88), work in the public sector (aOR 2.57, 95% CI 1.72-3.85), being victim of verbal aggression at work in the last 12 months (aOR 22.52, 95% CI 10.97-46.20), work in the operational units of the Medical area (aOR 2.36, 95% CI 1.33-4.21) and the Territorial area (aOR 1.97, 95% CI 1.04-3.74). Discussion: The prevalence of violent behaviour is difficult to assess, because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is necessary to develop effective control strategies at individual, hospital and national levels.

© 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design: Instrument development and cross-sectional study for psychometric testing. Methods: A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results: Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50–1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third-year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second-year students.

Human papilloma virus infection (HPV) is the most common sexually transmitted disease. Little is known about male infection. Nonavalent vaccine against types 6/11/16/18/31/33/45/52/58 was approved and neutral gender immunization programs have been proposed. This study evaluates the potential impact of nonavalent vaccine compared to quadrivalent in male living in Sicily (Italy). 58.7% of samples were HPV positive and forty-four types of HPV were identified. A significant higher estimated coverage of nonavalent vaccine than quadrivalent was observed (64.3% vs. 45.8%), with absolute and relative additional impact of 20.1% and 47.2%, respectively. Low impact of the vaccine were calculated as the empirical probability of HPV genotypes 6/11/16/18/31/33/45/52/58 alone or in combination; the high impact as empirical probability of HPV6/11/16/18/31/33/45/52/58 genotypes alone or in association with other genotypes. The potential impact of the nonavalent vaccine vs quadrivalent was significant for low and high impact (29.7% > 18:8%; 34:6% > 26.6%, respectively). Particularly, in men with lesions and risky sexual contact was significant only for low impact (35.5% > 29.7%; 31.4% > 19.7%, respectively). In partners with positive females was significant for low impact (26.3% > 15.1%) and high impact (33.7% > 23.2%). Nonavalent vaccine offers broader protection in men with HPV positive partners, who would have a potential role in the transmission of the infection.

Objective Eribulin mesylate (EM) is a fully synthetic macrocyclic ketone analogue of the marine natural product halichondrin. EM has been reported to be active in metastatic breast cancer. In this paper, we report efficacy and safety of data of EM in a retrospective, real-world series of patients with poor prognosis, hormone-refractory, or triple-negative metastatic breast cancer. Materials and methods The analysis was carried out at 4 interrelated oncology centers. EM was delivered at the dose of 1.4 mg/m2 in 100 mL of normal saline over 2 to 5 minutes on days 1 and 8 every 21 days. EM was continued until disease progression or unacceptable toxicity. Side effects were reported every cycle as per standard clinical practice and graded according to NCI-CTCAE, version 4.0. Time-to-progression and overall survival were reported. Results In this series of 90 patients the overall response rate was 22%, and 21% and 23% in the hormonal-resistant group and the triple-negative one, respectively. Stable disease was recorded in 24%, 21%, and 27%, respectively, in the whole series, the hormonal-resistant group, and the triple-negative one, respectively. Time-to-progression was 3.5 months (range, 1 to 22 mo) in the whole series and 3.0 months (range, 1 to 14.7 mo) and 3.4 months (range, 2.2 to 16.2 mo) in the hormonal-resistant group and the triple-negative one, respectively. Overall survival reached a median of 11.4 months. Conclusions This multicenter study, albeit retrospective, demonstrates the activity of this combination as third-line chemotherapy option in a challenging clinical setting such as triple-negative or hormone-resistant patients with breast cancer progressing after several lines of hormonal manipulations.

Background. Well-planned mass-media campaigns can increase health literacy and raise awareness about the consequences of tobacco use. This study aims to evaluate the emotions and opinions of adolescents about several anti-tobacco spots delivered by the mass media over the world. Study design. Cross-sectional study. Methods. The study was conducted in Italy in 2016–2017 among students aged 13–17 years. Students expressed their emotions and opinions about seven anti-tobacco spots from all over the world on different topics and styles. Results. 499 students attended. The video “Sponge” was found to be the most impressive (30.2%) and what they would have chosen if they had been responsible for campaign launched by the Minister of Health (40.5%). The “Icons” spot ranged second, with 19.2% and 17.4%, respectively. Conclusions. In summary, this study showed that the communication strategies most effective, according to the students interviewed, are those that give clear messages with a scientific profile or that discover the false stereotypes, as in the video “Icons”. However, further research is needed to investigate the effectiveness of TV campaigns against smoking, in terms of habits and knowledge in young people.

To date, four vaccines have been authorised for emergency use and under conditional approval by the European Medicines Agency to prevent COVID-19: Comirnaty, COVID-19 Vaccine Janssen, Spikevax (previously COVID-19 Vaccine Moderna) and Vaxzevria (previously COVID-19 Vaccine AstraZeneca). Although the benefit–risk profile of these vaccines was proven to be largely favourable in the general population, evidence in special cohorts initially excluded from the pivotal trials, such as pregnant and breastfeeding women, children/adolescents, immunocompromised people and persons with a history of allergy or previous SARS-CoV-2 infection, is still limited. In this narrative review, we critically overview pre- and post-marketing evidence on the potential benefits and risks of marketed COVID-19 vaccines in the above-mentioned special cohorts. In addition, we summarise the recommendations of the scientific societies and regulatory agencies about COVID-19 primary prevention in the same vaccinee categories. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-021-01131-6.

Introduction. The purpose of this study was to ascertain the determinants of nursing students’ compliance with flu vaccination. Methods. In this cross-sectional study, an anonymous paper ques- tionnaire was administered to students attending the 3-year nurs- ing course at the University of Palermo. Adjusted Odds Ratios (aOR) are presented. Results. 403 nursing students (65% female) completed the ques- tionnaire (response rate 98.5%). The average age of the respond- ents was 22.0 years (SD ± 3.04). The dependent variable: “In the next season, do you intend to be vaccinated against flu? Yes”, displayed a statistically significant association with the follow- ing independent variables: “year of study: second” (aOR 2.66), “year of study: third” (aOR 1.72), “Perceived health status: medium-high” (aOR 6.61), “Did you get vaccinated against sea- sonal flu last year? Yes” (aOR 22.47). Conclusions. Although nursing students are not yet health pro- fessionals, they spend part of their time in health facilities for their clinical training and will be the health workers of the future. Involving nursing students in influenza vaccination campaigns can also help them take better care of themselves and their patients., Journal of Preventive Medicine and Hygiene, Vol. 61 No. 4 (2020): 2020614

he number of people travelling internationally increases year after year, mainly due to the more and more affordable cost of travelling and to the evergreater ease of transportation. Nowadays, any destination can be reached within 24 hours by plane, and the improvement of economic conditions facilitates both business and leisure travelling, as a matter of fact, according to data from the World Tourism Organization, the number of international trips is expected to increase by 3% to 4% per year.1 However, international travelling poses various health risks depending on travelers’ health conditions and the type of trip undertaken. Indeed, travelers may experience sudden changes in altitude, humidity, and temperature that can cause illness. Furthermore, serious health risks can result from poorquality housing, poor sanitary conditions, inadequate medical services, and the unavailability of drinking water. Potential risks strictly depend on the destination and the characteristics of the travel, and for this reason, anybody planning a trip should seek advice on the potential risks related to their destination and understand the protective measures needed to minimize the risk of contracting a disease. The risk of infection is linked to the epidemiology of the single country and to the different climatic conditions, which could expose travelers to etiological agents and vectors which are different from those which can be found in their countries of origin, but also to lower sanitary levels. Although doctors and tour operators can provide great help and good advice, it is crucial that travelers seek further information, understand the risks associated with travelling, and take the necessary precautions during their journey in order to travel safely. New technologies and application for smartphone (also known as app) might help more and more in promoting healthy behaviors.2 The greatest strength of health-related apps is that information is provided through channels already used by the citizen and perceived as “friendly.” Moreover, apps are a great way to communicate in “one-to-many” mode, in contrast to the standard “one-to-one” healthcare approach; this exponentially increases the quantity of educational content sent. Furthermore, by using the app, users produce new electronic data and make it available to researchers and policy makers, thus creating a new field of big-data-based research.3, 4 The aim of this study was to develop an applications for smartphones (“iViaggio: the travel app, traveling in safety”) (Figure 1), designed to provide information about the main risks associated with travelling, also taking into consideration the kind of trip (health risks related to environment, accidents, traumas, and violence, potential risks of infectious diseases).

Background: SARS-CoV-2 infection is a global health problem that is primarily detected in Italy with progressive increase in cases and deaths. To facilitate the management of the pandemic in Italy, it is essential to understand the level of attention on COVID-19. The aim of the study was to evaluate the knowledge, attitude and practices towards SARS-CoV-2 among the nursing students of University of Palermo during the rapid rise period of the COVID-19 pandemic. Methods: The current study was a cross-sectional study. On-line questionnaires were used for the collection of the data by providing a survey in all nursing students. The questionnaire consisted of two parts: demographics and Knowledge, Attitude and Practices (KAP) survey. A multivariate linear regression model was used and adjusted Odds Ratios (aOR) are presented. Results: 525 students were interviewed and their mean age was 21.8. The overall score indicates good practices among the three courses of study (p=0.025). The Multivariable logistic regression showed that the dependent variable “Practice poor score” is statistically significant associated with these independent variables: “Other country of birth” (aOR 17.7, 95% CI 2.31-136.03), “second” (aOR 2.65, 95% CI 1.21-7.80) and “third” (aOR 2.96, 95% CI 1.31-6.72) year of study, “low perceived health status”(aOR 2.35, 95% CI 1.04-5.30) and “Knowledge poor score (aOR 3.05, 95% CI 1.06-8.77). Conclusion: Our results suggest that health education programs aimed at improving COVID-19 knowledge are helpful for nursing students to hold optimistic attitudes and maintain appropriate practices. (www.actabiomedica.it)

INTRODUCTION: Gambling disorder is recognized as a psychiatric disorder. It is shown that the prevalence of pathological gambling is on the rise among university students, especially involving students attending the nursing degree course. The aim of the study was to estimate the prevalence of gambling's problem and to analyze the associated factors in the population of nursing students at the University of Palermo. MATERIAL AND METHODS: It's a cross-sectional study. In April 2019, a self-administered, anonymous and voluntary questionnaire was provided to students who attend daily lessons of the 3-years nursing degree course of University of Palermo, after they gave informed consent. The questionnaire investigates on socio-demographic information, year of study, the perception of the economic and health status, alcohol use disorders and gambling problems. RESULTS: The average age of the sample is 22.0 years (standard deviation ±4.3), 67.6% of the interviewees are women. The analysis shows that the risk to be "Player at risk/Moderate gambling problems/Serious game problems" is significantly associated with the following independent variables: male gender (aOR 5.15); "Do you live with your family? No" (aOR 2.98); "perceived health status: low" (aOR 2.51); "Risky consumption of alcohol: At Risk" (aOR 3.40). CONCLUSIONS: It is important to develop an effective gambling prevention program that will reduce the risk that youths will develop gambling problems. Participation in the prevention program significantly improves youths' attitudes and knowledge regarding gambling activities.

Background Visceral leishmaniasis is a vector-borne parasitic disease caused by protozoa belonging to the genus Leishmania. The clinical presentation of visceral leishmaniasis strictly depends on the host immunocompetency, whereas depressive conditions of the immune system impair the capability to resolve the infection and allow reactivation from sites of latency of the parasite. Case presentation We describe a case of visceral leishmaniasis (VL) that occurred in a patient with chronic hepatitis C treated with direct-acting antiviral drugs (DAA). The hypothesized mechanism is the alteration of protective inflammation mechanisms secondary to DAA therapy. Downregulation of type II and III IFNs, their receptors, which accompany HCV clearance achieved during treatment with sofosbuvir and ribavirin might have a negative impact on a risk for reactivation of a previous Leishmania infection. We know indeed that IFN-γ is important to enhance killing mechanisms in macrophages, which are the primary target cells of Leishmania. Conclusion Since VL is endemic in Sicily as well as in other countries of the Mediterranean basin, physicians should be aware of the possible unmasking of cryptic Leishmania infection by DAAs.

Introduzione. Un tempo "barboni", oggi senzatetto, il loro numero sta aumentando considerevolmente negli ultimi anni. Molti di loro soffrono di malattie croniche, problemi di salute mentale, dipendenze e necessitano di cure mediche complesse. Il loro stato di salute è spesso esacerbato per maggiori difficoltà nell'accesso alle cure primarie rispetto alla popolazione generale. Materiali e Metodi. È stato distribuito un questionario autosomministrato al fine di valutare le condizioni di salute dei senzatetto che vivono a Palermo. È stato utilizzato un modello di regressione logistica multivariata calcolando gli Odds Ratios aggiustati (aOR). Risultati. Il campione è costituito da 52 senzatetto, di cui 35 (67,3%) maschi. La classe di età più rappresentativa (55,8%) ha un'età inferiore a 50 anni e l'88,5% è italiano. L'analisi ha mostrato che il sesso femminile è significativamente associato a: "non svolgere attività fisica regolare" (aOR 4.14, IC 95% 1,20 - 14,32, p=0,025), ad "avere malattie croniche" (aOR 3,52, IC 95% 1,02 - 12,11, p=0,046) e "ad assumere farmaci" (aOR 3,95, IC 95% 1,14 - 13,64, p=0,030). Conclusioni. La rilevanza e la complessità della situazione sociale dei senzatetto attira l'attenzione su questo fenomeno destinato ad avere un forte impatto sulle politiche e sui servizi sanitari. Questa fragile popolazione è esposta a malattie che sono in gran parte prevenibili o curabili attraverso un ampio e precoce accesso alle cure con conseguente riduzione del peggioramento degli esiti clinici e dei relativi costi sociali. Introduction. In Italy, as in the rest of the world, the number of homeless people is increasing considerably. Many of them suffer from chronic conditions, mental health problems and addiction to alcohol, drugs or smoking, and need complex medical care. Their health status is often exacerbated by greater difficulty in accessing primary care. The aim of the present study was to assess health conditions of homeless people living in Palermo, Southern Italy, and to find ways to limit the spread of common infectious diseases that can be prevented by vaccination. Materials and Methods. A self-administered questionnaire was distributed. The questionnaire was structured into two parts including an introduction with socio-demographic information, and a second part investigating health status, chronic diseases and vaccinations. A multivariable logistic regression model was used and adjusted Odds Ratios (aOR) are presented. Results. The sample consisted of 52 homeless, 35 (67.3%) of whom were male and the most represented age class (55.8%) was < 50 years of age. The average age of the sample was 49.6 years (SD ± 15.2) and 88.5% were born in Italy. A multivariable logistic regression model based on 52 observations was used. The analysis showed that the female gender was significantly associated with: not performing regular physical activity (aOR 4.14, 95% C.I. 1.20 - 14.32, p = 0.025), suffering from chronic diseases (aOR 3.52, 95% C.I. 1.02 - 12.11, p = 0.046) and taking medicines (aOR 3.95, 95% C.I. 1.14 - 13.64, p = 0.030). Conclusions. This particularly fragile population is exposed to diseases that are largely preventable or curable through a wider and more early access to care by local health facilities with a subsequent reduction in the worsening of clinical outcomes and related social costs.

Aim This retrospective observational study evaluated the role of hypo-fractionated stereotactic radiotherapy (SRT) in patients with oligo-progressive metastatic renal cell carcinoma (mRCC) treated with first-line oral tyrosine kinase inhibitors (TKI). Data on local control, delay of further progression, and safety are reported. Patients and methods Between January 2010 and December 2016, 28 patients with mRCC who showed oligo-progressive disease while receiving first-line pazopanib were treated with hypofractionated SRT to progressive metastatic sites to delay the change of systemic therapy. First and second progression-free survival (PFS-1 and PFS-2) were recorded, as well as objective response and toxicity. Results After pazopanib therapy, nine partial remissions (32%), 12 stable disease (43%) and seven progressions (25%) were recorded. The median time to progression from first-line pazopanib until oligo-progression was 9.45 months (PFS-1 range=2-30 months). Seventeen patients (61%) showed progression at pre-existing tumor sites, and 11 patients (39%) showed the appearance of new metastases. Progression-free survival after radiation therapy was 4.55 months (PFS-2 range=1-11 months). PFS-1 plus PFS-2 was 14.0 months (range=3-41 months). Severe grade 3-4 toxicities were seen only occasionally. Conclusion Patients with oligo-progressive mRCC treated with first-line pazopanib may benefit from hypo-fractionated high-dose SRT at progressing sites achieving a further increase in median progression-free survival. Further studies and prospective validation are required to establish if this minimally invasive approach may have a positive impact on overall survival and reported outcomes.

Introduction: Sexually transmitted diseases are an emerging problem especially among young people, increasing the burden of disease in this population. The aim of the study was to evaluate sexual habits, sexual relations and knowledge of STIs among the students in the nursing science course of the University of Palermo. Materials and Methods: In April 2019, a survey was provided to students that investigate on: personal information and habits, knowledge of sexually transmitted diseases, anti-HPV vaccination. Multivariable logistic regression was performed, considering it as a dependent variable “Have you occasionally had unprotected sex (without a condom)? Yes”, in order to evaluate the role of the variables of the questionnaire. Results are expressed as adjusted Odds Ratio (aOR). Results: 405 students completed the questionnaire. The mean age of the sample is 21.65 years, 69.63% of the interviewees are women. The multivariable logistic regression shows that the risk of having occasional unprotected sex (without condom) is significantly associated with “Do you permanently have unprotected sex (without a condom)? Yes” (aOR 4.46); “Have you ever received information on sex education and/or sexually transmitted diseases? No” (aOR 6.02); “Age Class

Introduction: The discovery and the clinical availability of novel cyclin-dependent kinases 4 and 6 inhibitors have profoundly changed the therapeutic scenario of metastatic hormone receptor-positive breast carcinoma. Among these inhibitors, abemaciclib can induce potent and sustained cell cycle arrest and immune system stimulation. Areas covered: This review summarizes the safety profile and clinical efficacy data on abemaciclib alone or in combination with aromatase inhibitors or fulvestrant in metastatic hormone receptor-positive breast carcinoma. The management of patients treated with abemaciclib is the object of this paper. Expert opinion: As shown in phase 2 and 3 clinical trials on efficacy and tolerability, abemaciclib is a potentially convenient, safe, and effective agent for the treatment of patients with advanced hormone receptor-positive patients. Orally administered abemaciclib in combination with aromatase inhibitors or fulvestrant has the potential to allow significant improvement in survival outcomes, quality of life, response rate, and duration of response even in poor prognosis subgroups. Adequate patients’ information, clinical selection, and prompt, proactive management of side effects are mandatory.

Aim This paper aims to analyze the usefulness of the G8 geriatric oncology questionnaire in patients with advanced/metastatic pancreatic adenocarcinoma (aPAC) and its possible association with different clinical outcomes. Methods Patients age > 70 years were screened with the G8 tool and treated with intravenous nab-paclitaxel 125 mg/m2 and gemcitabine 1000 mg/m2 for 3 consecutive weeks followed by one-week rest as prescribed after clinical evaluation by treating oncologists. Patient’s charts were evaluated for type and severity of toxicity, 2 cycle rate of completion, discontinuation rate, delays, dose reductions, and other outcomes response rates, progression-free, and overall survival. Sensitivity, specificity, and possible correlations were analyzed. Results Sensitivity and specificity of the G8 score for severe toxicity were respectively 55.9% and 50%. No association between all types of severe grade 3-4 toxicity, delays, or dose reductions, and the G8 score was present (p=0.622). ORR was 32.5% with no complete responses. Median PFS and OS were 4.5 months and 8.1 months, respectively. Correlation between G8 score and PFS was not statistically significant (p=0.0652). Correlation between G8 score and OS was statistically significant (p=0.0251). Although median survival of G8 fit patients was superior to that of G8 vulnerable patients (6.5 versus 4 months), the difference was not statistically different (p=0.1975). Conclusion Clinical results in terms of response rate, survival outcomes, and side-effects were in the range reported by others. However, the G8 questionnaire is not a reliable diagnostic tool to predict the risk of severe toxicity, and clinical outcomes in older patients with aPAC.

PURPOSE This descriptive investigation was undertaken at three oncology units to report queries, needs, and fears related to severe acute respiratory syndrome coronavirus 2 (COVID-19) of patients with cancer and to avoid uncontrolled treatment delays or withdrawal, behavioral mistakes, and panic. PATIENTS AND METHODS All queries spontaneously delivered through the WhatsApp instant messaging system commonly used by patients to communicate with oncology units were collected and grouped by homology in five categories. Responses to the queries were given according to recommendations by the Italian Association of Medical Oncology through WhatsApp and by subsequent phone calls. Patients were also classified according to the site of the primary tumor, stage of disease, and current treatments. Analysis of the association between these data and queries was carried out. RESULTS The social scenario in Italy is a nationwide lockdown except for hospitals, pharmacies, and food supplies. Overall, 446 different patients’ WhatsApp conversations were analyzed between March 1 and March 13 and comprised the following: requirement of visit delay by patients undergoing oral therapies or in follow-up, delays in chemotherapy or immunotherapy administration, queries about possible immunosuppression, and changes in lifestyle or daily activities. Delay requirements were statistically more frequent among patients with prostate or breast cancer compared with those with lung or pancreatic cancer. Actions taken by oncologists are also reported. CONCLUSION To our knowledge, the WhatsApp instant messaging system has been occasionally used in other medical settings with controversial results. In our experience, WhatsApp turned out to be adequate to give a rapid answer to most queries from patients with cancer in the COVID-19 pandemic scenario.

Introduction: Cases of measles in some European countries are increasing. The aim of this study is to find the correlation between Google Trends and Wikipedia searches and the real number of cases notified. Materials and Methods: The data on Internet searches have been obtained from Google Trends and Wikipedia. The reported cases of measles were selected from January 2013 until December 2018 for Google Trends and July 2015 until December 2018 from for Wikipedia. We have selected data from four European Countries: Italy, France, Germany and Romania. The data extracted from Wikipedia and Google Trends have been moved over time (Lag), one month in the future and one month in the past. Cross-correlation results are obtained as product-moment correlations between the two time series. The statistical analyses have been performed by using the Spearman’s rank correlation coefficient or Pearson correlation coefficient. Results: A temporal correlation was observed between the bulletin of ECDC and Wikipedia search trends. For Wikipedia the strongest correlation is at a lag of +1 for rougeole (r=0.9006) and masern (r=0.7023) and at lag 0 for morbillo (r=0.8892) and rujeola (r=0.5462); for Google Trends the strongest correlation at a lag 0 for rougeole (rho=0.7398), symptômes rougeole (rho=0.3399), masern (rho=0.6484), sintomi morbillo (rho=0.6029), rujeola (rho=0.7209), simptome rujeola (rho=0.5297) and at lag -1 for masern symptom (rho=0.4536) and morbillo (rho=0.5804). Conclusions: Google and Wikipedia could play an important role in surveillance, although these tools need to be combined with traditional surveillance systems. (www.actabiomedica.it)

The primary aim of this study was to evaluate the temporal correlation between Wikitrends and conventional surveillance data generated for measles infection reported by bulletin of Istituto Superiore di Sanità (ISS). The reported cases of measles were selected from July 2015 to October 2018. Wikipedia Trends was used to assess how many times a specific page was read by users, data were extracted as daily data and aggregated on a weekly and monthly basis. The following data were extracted: number of views by users from 1 July 2015 to 31 October 2018 of the Morbillo, Vaccinazione del Morbillo, Vaccinazione MPR and Macchie di Koplik pages (Measles, Measles Vaccination, MPR Vaccination and Koplik’s spots in English). Cross-correlation results were obtained as product-moment correlations between the two time series. Regarding the database with monthly data, temporal correlation was observed between the bulletin of ISS and Wikipedia search trends: the strongest correlation was at a lag of 0 for Measles (r=0.9164), Measles Vaccination (r=0.8622), MPR Vaccination (r=0.7852) and Koplik’s spots (r=0.8217). Regarding the database with weekly data, both moderate and strong correlation was observed. A possible future application for programming and management interventions of Public Health is proposed.

Introduction. The primary aim of this study is to evaluate the temporal correlation between Google Trends and the data on measles infection arising from the conventional surveillance system, reported by the Istituto Superiore di Sanità's (ISS) bulletin. Moreover, this study is also aimed at forecasting the trends of the reported infectious diseases cases over time. Materials and Methods. The reported cases of measles were selected from January 2013 until October 2018. The data on Internet searches have been obtained from Google Trends; the research data referred to the first 48 weeks of year 2017 have been aggregated on a weekly basis. The search volume provided by Google Trends has a relative nature and is calculated as a percentage of query related to a specific term in connection with a determined place and time-frame. The statistical analyses have been performed by using the Spearman's rank correlation coefficient (rho). The statistical significance level for such analyses has been fixed in 0.05. Outcomes. We have observed a strong correlation at a lag of 0 to -4 weeks (rho > 0.70) with the cases reported by ISS with the strongest correlation at a lag of -3 weeks (rho > 0.80 both for measles than for the symptoms of the measles). The database containing monthly data has shown a moderate correlation at a lag of -1 to +1 months and a strongest correlation at a lag of -1 (rho = 0.6152 for measles and rho = 0.5039 for symptoms of the measles). Conclusion. The surveillance systems based on Google Trends have a potential role in public health in order to provide near real-time indicators of the spread of infectious diseases. Therefore the huge potential of this approach could be used in the immediate future as a support of the traditional surveillance systems.

Introduction. We aimed at carrying out a quantitative and qualitative analysis of claims for adverse events addressed to Palermo University Hospital Policlinico “Paolo Giaccone” in order to promote evidence-based interventions and increase patient safety. Methods. A retrospective study of 296 claims collected between 1st of January, 2014 and 31st of December, 2017 by Quality and Clinical Risk Management staff unit was performed along with descriptive analysis of any associated determinant factors. Results. The most frequent causes of claims consisted of wrong surgical procedures (33.8%), mistaken diagnoses (18.6%), falls (17.6%), infections (6.4%), postoperative complications (5.4%) and wrong therapies (3.1%). At the end of the survey, the judicial process was not concluded in the majority of cases (82.8%). Claims were closed by receipt payment in 12.2% of cases, without any payment in 5.1%. Conclusions. Clinical risk management plays a pivotal role in providing information and tools to prevent medical adverse events, avoid claims addressed to hospitals and improve the quality of health care. Evoluzione della gestione dei rischio clinico nel siste-ma sanitario: indagine sugli eventi avversi verificatasi nell'Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone” di Palermo.

Background. The aim of the study was to evaluate in the Italian smokers, the effects of implementation of the law about Pictorial Health Warnings (PHWs) on tobacco products.Methods. A quasi-experimental longitudinal design was conducted between 2016 and 2017. The data were collected before (pre-PHW/Wave 1) and after (post-PHW/Wave 2) the implementation of the law. The adopted questionnaire included impact of advertisement (Label Impact Index, LII), quitting behavior and knowledge of tobacco related diseases.Results. 455 respondents completed both the Waves. 7.7% of smokers declared to have stopped smoking in Wave 2 and 29% of these declared the PHWs as one of the reasons to quit. The knowledge of tobacco related diseases was significantly (p < 0.001) increased from Wave 1 to Wave 2 (58% versus 72%), similarly the LII (mean = 26.9, SD = 16.7 and mean = 40.4, SD = 16.2).Conclusion. Tobacco addiction is a problem that needs to be addressed from different angles. PHWs confirm their complementary role as a support for smokers along with other strategies such as text warnings and the tobacco quit line of the Istituto Superiore di Sanita (Italian National Institute of Health) reported on the packages. Nonetheless, over the years these measures have been not enough and policy makers should consider more strategies synergistically acting in the fight against tabagism.

Aim. Evaluation of the knowledge and behavioral risks related to sexually transmitted infections (STIs) among the students at the University of Palermo. Materials and Methods. Cross-sectional study. An anonymous online questionnaire has been submitted to the students of Palermo University. Survey investigates to socio-demographic information, sexual habits and the level of knowledge of the STIs. Results. The sample consists of 539 students; average age 22.65 (± 2.95). The risk to have unprotected occasional sexual intercourse is related to the following circumstances: the homosexual or bisexual status, the male gender, the age of the occurrence of the first sexual intercourse, that is at 17 year or earlier and the circumstance to have contracted a sexually transmitted infection during life. Conclusions. It is necessary to implement sexual education programs aimed at improving the knowledge in terms of STIs and increase of sexual and reproductive health. The findings presented should be interpreted with a degree of caution. Future studies are needed to as-sess the effectiveness and cost of education programs.

Introduction: The purpose of the study was to assess tobacco smoking habits among nursing students and how these are influenced by family members and cohabitants. Methods: Cross-sectional study. An anonymous papery questionnaire was administered to nursing students of the three-year course of the University of Palermo. Adjusted Odds Ratio (aOR) are presented. Results: 301 nursing students (63.12 % female) completed the questionnaire (response rate 61.17%). The average age of the sample is 21.88 years (SD ± 2.80). Considering as a dependent variable: “I currently smoke”, the statistically significant independent variables associated are: “Male gender” (aOR 2.09), “Single” (aOR 2.06), “Second year of study of the degree course in nursing” (aOR 0.46), “Third year of study of the degree course in nursing” (aOR 0.43), “Don’t think that warnings and pictures on cigarette packs can help stop smoking” (aOR 6.38), “Mother smoked in the past” (aOR 2.25) and “Brother or sister smoked in the past” (aOR 5.50). Conclusions: Students and graduate nurses need to be aware of current knowledge in the smoking cessation field and they have an influential role in modifying patient behavior in order to assist them to smoking cessation., Journal of Preventive Medicine and Hygiene, Vol 60 No 3 (2019): 2019603

Introduction. On the day of a workshop (named "Vaccino Day") on vaccinations, organized for the students of the University of Palermo by the ERSU (Regional Office for the Right to University Study), the sample of students were given a questionnaire to fill out. The aim of the survey was to investigate the perception of vaccinations on a sample population made up of university students. Materials and Methods. A self-administered paper questionnaire was given to participants of the workshop. The questionnaire is divided into 3 parts: demographic, economic and habits informations have been asked in the first part in the second part, they had to answer the question: "What term do you associate with vaccination?" in the third part, they were posed the question: "Have you ever had any adverse reactions after being vaccinated?". Therefore, the percentage response frequencies and the statistically significant Odds-Ratio (aOR) are presented with a corresponding 95% confidence interval (CI). Statistical analysis was performed using the STATA® 14 software. Results. A total of 350 students were asked to participate and the response rate was 100%, the 61.43% of the interviewed population was made up of females. Taking into account the dependent variable: "at least a moderate-severe adverse reaction after a vaccination" the statistically significant independent variables associated are "Have fear of side effects" (aOR 7.06, 95% CI 1.73-28.57, p=0.006), "I associate the term "vaccination" to Needles/syringes" (aOR 3.82, 95% CI 1.08-13.48, p=0.037), "I associate the term "vaccination" to Protection" (aOR 3.50, 95% CI 1.02-11.98, p=0.046). Discussions and Conclusions. Vaccination is still influenced by emotional factors and lack of campaigns providing adequate information, therefore negative judgement tend to outweigh the real risks and benefits. Considering that the sample was composed of university students, being highly educated and capable of becoming opinion leaders in the future, there is a need to create a more efficient communication protocol that make the student, and then the citizen, better aware of the actual risks associated with vaccinations and their real benefits.

The university student is vulnerable to the adverse effects of many stress factors that can lead to depressive symptoms, anxiety and alcohol abuse, causing an increase in the burden of illness in young people. The aim of the study was to measure depressive symptoms, anxiety levels, and harmful alcohol consumption within the student population of the University of Palermo.An online questionnaire was sent by e-mail to the 8500 students enrolled in the (ERSU) Regional Office for the Right to University Study's mailing list in Palermo. It was evaluated the severity of depressive symptoms through the Quick Inventory of Depressive Symptomatology-Self Report, anxiety symptoms using the Beck Anxiety Inventory and risky consumption of alcohol by using the Alcohol Use Disorders Identification Test-Consumption test. From the test it was possible to get individual scores that allow you to evaluate the risk by associating each individual with a category. The obtained variables were analyzed by Pearson square test (χ 2).The questionnaire answered 1102 individuals, 756 females (68.60%), with an average age of 22 years (± 3.28). 13.52% of the sample have a risky consumption of alcohol. 22.14% showed moderate depressive symptoms and 12.16% had serious and very serious symptoms. Respectively, 19.69% and 7.53% have moderate and high levels of anxiety. As for depressive symptoms (χ2 (4)=31.58, p0.001) and anxiety (χ2 (2)=20.71; p0.001), the female gender is assigned to more relevant reference categories than males.There are no statistically significant differences of risky consumption of alcohol in terms of gender or type or length of course. An analysis of the data shows that anxiety, depression and alcoholism risk have a similar distribution in all degree courses. Female students are more vulnerable to anxiety and depression. Active public health planning and implementation of structural and organizational measures would be very effective in reducing alcohol consumption and promoting health.

Aim. The aim of the study was to evaluate the knowledge and behavioral risks associated with sexually transmitted infections (STIs) among the students of health professions at the University of Palermo divided into two age groups (18-22 years and 23-27 years). Materials and methods. A self-administered questionnaire was distributed. The questionnaire is structured in three parts in addition to an introduction to socio-demographic information. The first part investigates the quality of information provided by public institutions on the subject, the second part the knowledge of contraceptive methods used to reduce the risk of contagion and the third part the knowledge of STIs and HPV vaccination. A multivariable logistic regression model was used and adjusted Odds Ratios (aOR) are presented. Results. The sample was represented by 1022 respondents (70.8% females, 61.5% aged 18-22 years). In multivariate analyses males have a greater risk of not knowing HPV vaccine (aOR 3.52, 95% CI 2.26-5.49). The 18-22 age group has a higher risk than the 23-27 age group to think of being not sufficiently informed to avoid contagion (aOR 3.92, 95% CI 2.18-7.06), never having STIs specific tests (aOR 2.90, 95% CI 2.21-3.80), not knowing HPV vaccine (aOR 1.86, 95% CI 1.13-3.07) and not knowing that it can be administered to males (aOR 2.63, 95% CI 1.96-3.53). Conclusions. Based on our findings, it is necessary to implement sexual education programs for the improvement of knowledge in terms of STIs and the promotion of health. Future studies are needed to assess the effectiveness and cost of education programs that should also be addressed to young adults who do not attend university.

Violence in the workplace is now universally recognized as a significant global public health issue and is one of the most serious issues affecting the healthcare sector.To assess the prevalence of workplace violence.We performed a multicenter cross-sectional study using an anonymous questionnaire submitted to doctors from Northern Italy. The survey investigates socio-demographic information, the number of years of work in the health sector and the physical and verbal aggressions that occurred in the workplace in the last 12 months.The sample consists of 4545 healthcare workers, of whom 2603 (57.27%) are females. The mean age of the sample is 49.79 years (SD ± 12.63). The risk of being victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (aOR 2.09, 95% CI 1.51-2.88), work in the public sector (aOR 2.57, 95% CI 1.72-3.85), being victim of verbal aggression at work in the last 12 months (aOR 22.52, 95% CI 10.97-46.20), work in the operational units of the Medical area (aOR 2.36, 95% CI 1.33-4.21) and the Territorial area (aOR 1.97, 95% CI 1.04-3.74).The prevalence of violent behaviour is difficult to assess, because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is necessary to develop effective control strategies at individual, hospital and national levels.

Introduction. The internationally adopted child is a fragile subject who often shows an incomplete health documentation, which hinders the complete assessment of health status. Materials and Methods. Between January 2010 and June 2016, at the University Hospital "AOUP P. Giaccone" of Palermo, we reviewed the health documentations of 111 children recently arrived in Italy following the conclusion of the international adoption procedure. 62.2% of the children were male, of various nationalities and with an average age of 7 years (± 3.4). This study aims to detect, in the observed sample, the reliability of the vaccinal documentation and the real acquired immunization. We intend to estimate the presence of IgG against Measles, Mumps, Rubella and Hepatitis B viruses. Results. Percentages of subjects with a complete correspondence between documentation attesting the successful vaccination and the effective immunization were: 78% for measles, 66% for mumps, 84% for rubella, 71% for hepatitis B. Percentages of subjects without vaccinal documentation but with positive evidence of IgG were: 50% for measles, 38% for mumps, 71% for rubella, 50% for hepatitis B. Conclusion. The partial correspondence found between vaccinations performed and real immune status can be attributed to several reasons: poor reliability of the received health documentation, the complex economic situation of the health services in the countries of origin, the incorrect vaccines storage or the administration beyond the expiration date, the poor immunological response due to concomitant diseases or severe malnutrition, the probable non-administration of the expected booster dose. Particular attention needs to be paid to this population, which may represent a risk group susceptible to vaccine-preventable diseases.

During the university period, student wellbeing is exposed to the negative effects of many stressful factors, including the use and abuse of alcoholic beverages. The aim of this study is to estimate the risky alcohol consumption within the student population of the University of Palermo.An anonymous online questionnaire was provided to students enrolled in the mailing list of the Regional Agency for the Right to University Study (ERSU) of the University of Palermo. the first section investigated demographic and social data, while in the second section the A.U.D.I.T. C (Alcohol Use Disorders Identification Test-Consumption) test was administered.539 subjects agreed to the informed consent and completed the questionnaire. The average age of the sample is 22.65 years (SD ± 2.95). Considering as dependent variable "students with risky consumption of alcohol", the statistically significant independent variables associated were: "age class ≤22 years old" (aOR 2.02, 95% CI 1.18-3.44, p=0.019), "don't live with own family" (aOR 3.21, 95% CI 1.81-5.69, p0.001) and "I currently smoke" (aOR 6.44, 95% CI 3.85-10.79, p0.001).The results of the study show that about 19% of students experience risky alcohol consumption. This percentage seems not to be gender related. Information and training campaigns focused on alcoholism and related risks are of great importance in order to educate students on the socio-economic costs of alcohol related diseases to public health; parents can play a crucial role in minimising the use of alcohol in their sons/children through dialogue if properly trained to address these issues. In fact, our study seems to show that those who no longer live in the household have a higher risk of alcohol consumption.

In the light of diagnostic and therapeutic advances, patients with a previous myocardial infarction or with a diagnosis of chronic obstructive pulmonary disease are vulnerable and need continuous monitoring over time. These pathological frameworks have a strong impact on the economy and on the status of the population and require effective and low-cost solutions.The objective of this clinical trial is to evaluate the efficacy in the short term of a telephone counseling intervention to modify the lifestyles of these two patient populations.In May 2015, all the patients included in the study underwent a questionnaire to evaluate their eating and smoking habits and their quality of life. After randomization in two groups, the intervention group received telephone counseling related to the correct lifestyles. The control group did not undergo any intervention. In September-October 2015, the same initial questionnaire was administered to evaluate changes in patients' behavior.64 patients were included in the study: 34 were assigned to the intervention group and 30 to the control group. The outcomes evaluated were: quality of life, assessment of eating habits and smoking status. After the telephone counseling, the intervention group (34 persons) showed a significant improvement in the score of adherence to the Mediterranean diet (p = 0.01) and a significant reduction in the percentage of smokers (p = 0.01) compared to the population that did not receive any intervention (30 persons). On the other hand, the changes related to the quality of life questionnaire were not significant.A single telephone counseling intervention is effective in modifying the lifestyles of patients with a previous myocardial infarction or diagnosed with chronic obstructive pulmonary disease in the short term, reducing their risk profile.

Understanding perceptions and characteristics of human papillomavirus (HPV) vaccinated and non-vaccinated girls can inform communication activities and vaccine delivery strategies. The purpose of this study was to evaluate knowledge and factors associated with HPV unvaccinated girls after five years of vaccination program implementation in Sicily, an Italian region with low vaccination coverage (

The cross-sectional study has been based on the implementation of the Obstetric Appropriateness Evaluation Protocol (OAEP) in seven hospitals to determine inappropriate hospital admissions and days of stay. The outcomes were: inappropriateness of admission and "percentage of inappropriateness" for one hospitalization. A total number of 2196 clinical records were reviewed. The mean percentage of inappropriateness for hospitalization was 22%. The percentage of inappropriateness for the first 10 d of hospitalization peaked in correspondence of the fourth (42%). The logistic regression model on inappropriated admission reported that emergency admission was a protective factor (OR = 0.4) and to be hospitalized in wards with ≥30 beds risk factor (OR = 5.12). The second linear model on "percentage of inappropriateness" showed that inappropriated admission and wards with ≥30 beds increased the percentage (p < 0.001); whereas the admission in Teaching Hospitals was inversely associated (p < 0.001). The present study suggests that the percentage of inappropriate admission depends especially on the inappropriate admission and the large number of beds in obstetric wards. This probably indicates that management of big hospitals, which is very complex, needs improving the processes of support and coordination of health professionals. The OAEP tool seems to be an useful instrument for the decision-makers to monitor and manage the obstetric wards. © 2014 Informa UK Ltd. All rights reserved.