Search

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.

INTRODUZIONE Circa il 20% degli Operatori Sanitari (OS) contrae annualmente una patologia da virus influenzale e la vaccinazione stagionale è fortemente raccomandata quale migliore strategia di prevenzione tra gli OS. Diverse iniziative sono state messe in atto a livello nazionale per incrementare le scarse coperture vaccinali antinfluenzali evidenziate tra gli OS. In questo studio viene analizzato il trend di adesione vaccinale degli OS operanti presso l’Azienda Ospedaliera Universitaria (AOU) Policlinico di Palermo nelle ultime otto stagioni vaccinali, valutando l’impatto di differenti strategie comunicative ed informative messe in atto nel corso delle ultime tre stagioni vaccinali (2015/2016 - 2016/2017 - 2017/2018) MATERIALI E METODI Gli OS aderenti alla vaccinazione antinfluenzale hanno compilato un questionario validato ed autosomministrato al termine della seduta vaccinale. Contestualmente, è stato predisposto un modulo di dissenso informato per tutti gli OS che non hanno aderito alla vaccinazione antinfluenzale, compilabile sulla pagina personale (intranet) del portale Web Aziendale. Nelle ultime tre stagioni vaccinali sono state messe in atto diverse iniziative atte a promuovere l’adesione alla vaccinazione antinfluenzale degli OS tra cui: creazione di pagine web (internet e social media) dedicate alla campagna vaccinale, creazione di locandine, slogan e hashtag anche in formato cartaceo da utilizzare per promuovere la vaccinazione, settimana di vaccinazione “on site” nei reparti, formazione preliminare degli OS operanti nei reparti a maggiore rischio (UTI, UTIN, Oncologia, Ginecologia, etc...) RISULTATI La copertura vaccinale è salita progressivamente da un valore medio del 5 (dalla stagione 2010/2011 alla 2014/2015) al 27% nell’ultima stagione 2017/2018 (chi-square for trend: 857, p

Background: Although influenza vaccination has been demonstrated to be safe and effective, vaccination coverage rates among health care workers and among medical residents appear generally low. Several investigations have been performed worldwide to analyze the healthcare workers' educational deficiencies. This multicentre survey aimed to investigate at a nationwide level training quality and work environment associated with seasonal influenza vaccination uptake among Italian medical residents. Methods: A retrospective cohort study was carried out from April 2012 to June 2012 on medical residents regularly attending the post-graduate medical schools of 18 Italian Universities via an anonymous, self administered, web-based questionnaire. Data have been analyzed by using the R statistical software package. Results: A total of 2506 out of 10,854 medical residents (23.1 %) have been recruited. The quality of training on influenza and influenza vaccination was reported as "fair" or "poor" during both pre-graduate (40.7 % of respondents) and post-graduate medical school (59.6 % of respondents). Vaccination uptake was associated with adherence to seasonal 2011/2012 influenza vaccination of medical school tutors (adjusted OR = 4.4; 95 % CI = 1.35-14.26) and other medical residents (adjusted OR = 2.2; 95 % CI = 1.14-4.23). Moreover, influenza vaccination uptake was also associated with correct knowledge about the virus composition of 2011/2012 influenza vaccine (adjusted OR = 2.43; 95 % CI = 1.64-2.58) and consultation of scientific sources or Institutional recommendations on influenza vaccination (adjusted OR = 6.96; 95 % CI = 3.38-214.36). Conclusions: Medical residency represents an opportunity to implement educational and training interventions aiming to promote appropriate professional behaviors and skills. Our study suggest that appropriate training, adequate education and proactive coworkers feelings can improve influenza vaccination attitudes towards young doctor.

Background: General practitioners (GPs) have to be considered as key figures of health promotion among health care workers since they are strongly asked to recommend influenza vaccination to their patients and perform on them. Despite this consideration, GPs have influenza vaccination rates that are significantly below the 75% coverage proposed by International Public Health guidelines. In order to increase future coverage of influenza vaccination within GPs, and through them within the population, the aim of this study was to assess determinants associated with influenza vaccine uptake among GP trainees. Methods: A survey was carried out on GP trainees attending the training course in Community Medicine of Western Sicily (Italy). Each participant was interviewed via an anonymous self-administered questionnaire which included questions on attitudes, behaviours and perceptions regarding influenza and influenza vaccination. Results: Vaccination coverage was 26.2% for seasonal 2008-2009 influenza, 20.0% for pandemic A (H1N1) influenza and 18.7% for seasonal 2009-2010 influenza. Considering themselves as a high risk group for developing influenza was significantly associated with seasonal 2009-2010 influenza vaccine (adj-OR 2.35). Vaccination for seasonal 2009-2010 influenza (adj-OR 1 063), pandemic A (H1N1) influenza (adj-OR 16.77) and seasonal 2010-2011 influenza (adj-OR 38.08) were significantly more frequent in GP trainees who had been vaccinated more than three times in the previous five influenza seasons. Conclusion: Influenza vaccine uptake among GP trainees is more a habit than a professional responsibility, and influenza vaccination is still administrated to patients on the basis of GP trainees’ clinical evaluation or patient willingness. Multidisciplinary learning pathways may implement vaccination coverage in the attempt to modify the current GP trainees’ attitude towards recommended influenza vaccination.

Background: In the last decades, there has been increased worldwide interest in the management of health risks from indoor radon.Methods: From 2006 to 2008, a survey on air radon levels was carried out in a total of 57 indoor gymnasia respectively located in the urban area of Palermo (Sicily) and Sassari (Sardinia).Results: The indoor radon levels were generally low with different geometric means in the two geographic areas (14.3 Bq/m3 in Palermo and 36 Bq/m3 in Sassari, respectively). Overall, in both groups increasing values of radon were found during the night and the early morning, with radon concentrations significantly lower during working time than at other times. The analysis of structural parameters showed that direct contact with the soil significantly correlated with increased levels of radon in gymnasia located in Palermo’s area (pConclusions: Radon tends to accumulate in indoor sites and it’s monitoring, especially in buildings with potentially overcrowded conditions, could be of public health interest. Mitigation measures and minimization of the number of structural and functional risk parameters should be strongly encouraged in order to limit radon accumulation especially in countries with higher radium concentration in the soil.

Introduction. The aim of this paper is to improve the feasibility perception of policymakers, health care workers and target population about the cost-effectiveness of the implementation of colorectal screening as Public Health strategy. Methods. Retrospective study by application of a three-step model designed for a local setting in Sicily (Palermo and its Province) in order to distribute Fecal Occult Blood Tests (FOBTs), offer colonoscopy and surgery, by district allocation of pharmacies, public digestive endoscopic centres and oncologic and general surgery units. Mean adherence to consolidated colorectal screening programs in Italy was applied in order to evaluate the feasibility of an operative model in our area. Results. Applying the model to the target population (269,368 individuals of both sexes), it can be expected a mean percentage of 79% delivered invitation and a mean participation rate of 46.3% accounting for a total of 213,070 invited individuals and 98,651 participating in the first round of the program. Furthermore, considering the national mean of 6% positive FOBT, 82% of colonscopy adhesion and 7% CRC detection rate, it can be scheduled a burden for health care structures involved in the program accounting for 49,325 FOBTs, 2,338 colonscopies and 141 surgeries for each year. Discussion. This work demonstrates the feasibility of a colorectal screening project in our area, showing a sustainable impact for local health care involved structures. Furthermore, this program may be spread as an applicative model to other areas, adapting the project to the needs of the local setting in which the colorectal screening will be organized., Journal of Preventive Medicine and Hygiene, Vol 52, No 4 (2011)

© 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.

Background: Leishmania is a vector-borne parasite responsible for significant morbidity and mortality worldwide. The aim of this study was to assess the prevalence of and risk factors for Leishmania infantum seropositivity in a sample of Sicilian population.Methods: A total of 260 subjects were interviewed using a standardized questionnaire and requested for an venous blood sample.Results: Overall, 36 subjects (13.8%) were seropositive against L. infantum with a statistically significant higher prevalence of positivity in older subjects (p=0.04). After adjustment for age, a higher risk for Leishmania seropositivity was found in subjects who had pets living outdoors and untreated with anti-pests, and in those who were current smokers (adj-OR = 2.95 and adj-OR = 3.11, respectively; p < 0.05).Conclusions: Our data confirm that Leishmania infections among Sicilian citizens can be considered relatively frequent, suggesting that a percentage of Leishmania seropositivity can be probably attributed to exposure to both old and new risk factors.

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Background: Up to 7% of hospitalised patients acquire at least one healthcare-associated infection (HAI). The aim of the present study was to quantify the burden of HAIs in an Italian hospital, identifying involved risk factors. Methods: Prevalence point study carried out from 2011 to 2018. For each recruited patient, a data entry form was compiled including information on demographics, hospital admission, risk factors, antimicrobial treatment, and infection if present. Results: A total of 2844 patients were included and 218 (7.03%) reported an infection. HAI prevalence rates showed a significant increase (average annual per cent change (AAPC) +33.9%; p=0.018) from 2011 to 2014 whereas from 2014 to 2018 a gradual decline was observed (AAPC –6.15%; p=0.35). Urinary tract infection was the most common HAI (25.2%) and a total of 166 (76.1%) pathogens were isolated from 218 infections. Enterococcus and Klebsiella species were the most prevalent pathogens, causing 15.1% and 14.5% of HAIs, respectively. A significant higher risk of HAIs was found in patients exposed to central catheter (adjusted odds ratio (adj-OR)=5.40), peripheral catheter (adj-OR=1.89), urinary catheter (adj-OR=1.46), National Healthcare Safety Network surgical intervention (adj-OR=1.48), ultimately fatal disease (adj-OR=2.19) or rapidly fatal disease (adj-OR=2.09) and in patients with longer hospital stay (adj-OR=1.01). Conclusion: Intervention programmes based on guidelines dissemination and personnel training can contribute to reduce the impact of HAI. Moreover, McCabe score can be a very powerful and efficient predictor of risk for HAI. Finally, an unexpected very high burden of disease due to Enterobacteriaceae and Gram positive cocci that could be related to the frequent use of carbapenems and third generation cephalosporins in this hospital was found.

Influenza A and B viruses are responsible for respiratory infections, representing globally seasonal threats to human health. The 2 viral types often co-circulate and influenza B plays an important role in the spread of infection. A 6-year retrospective surveillance study was conducted between 2010 and 2016 in 2 large administrative regions of Italy, located in the north (Liguria) and in the south (Sicily) of the country, to describe the burden and epidemiology of both B/Victoria and B/Yamagata lineages in different healthcare settings. Influenza B viruses were detected in 5 of 6 seasonal outbreaks, exceeding influenza A during the season 2012–2013. Most of influenza B infections were found in children aged ≤ 14 y and significant differences were observed in the age-groups infected by the different lineages. B/Victoria strains prevailed in younger population than B/Yamagata, but also were more frequently found in the community setting. Conversely, B/Yamagata viruses were prevalent among hospitalized cases suggesting their potential role in the development of more severe disease. The relative proportions of viral lineages varied from year to year, resulting in different lineage-level mismatch for the B component of trivalent influenza vaccine. Our findings confirmed the need for continuous virological surveillance of seasonal epidemics and bring attention to the adoption of universal influenza immunization program in the childhood. The use of tetravalent vaccine formulations may be useful to improve the prevention and control of the influenza burden in general population.

Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of several initiatives in order to increase HCWs&rsquo, awareness about influenza vaccination. Vaccines administration within hospital units, dedicated web pages on social media and on the UH of Palermo institutional web site, and mandatory compilation of a dissent form for those HCWs who refused vaccination were carried out during the last four influenza seasons. After the introduction of these strategies, influenza vaccination coverage went up from 5.2% (2014/2015 season) to 37.2% (2018/2019 season) (p&lt, 0.001), and mean age of vaccinated HCWs significantly decreased from 48.1 years (95% CI: 45.7&ndash, 50.5) to 35.9 years (95% CI: 35.0&ndash, 36.8). A reduction of working days lost due to acute sickness among HCWs of the UH of Palermo was observed. Fear of adverse reactions and not considering themselves as a high-risk group for contracting influenza were the main reasons reported by HCWs that refused vaccination. Strategies undertaken at the UH of Palermo allowed a significant increase in vaccination adherence and a significant reduction of absenteeism from work.

During March 2011 an outbreak of gastroenteritis occurred in Santo Stefano di Quisquina, Agrigento, Sicily, Italy. Within two weeks 156 cases were identified among the 4,965 people living in the municipality. An epidemiological investigation was conducted to characterize the outbreak and target the control measures. A case was defined as a person developing diarrhea or vomiting during February 27–March 13, 2011. Stool specimens were collected from 12 cases. Norovirus (NoV) genotype GII.4 variant New Orleans 2009 was identified in stool samples from 11 of 12 cases tested (91.7%). Epidemiological investigations suggested a possible association with municipal drinking water consumption. Water samples from the public water system were tested for NoV and a variety of genotypes were detected during the first 3 months of surveillance, including GII.4 strains belonging to different variants from that involved in the gastroenteritis outbreak. Contamination of the well and springs supplying the public water network was eventually thought to be the source of the NoV contamination.

Objective: To evaluate the characteristics of hospital discharge diagnoses of influenza measured by using specific International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) codes. Subjects and Methods: The study was conducted for the 3 years 2007, 2008 and 2011. The database included (1) administrative and clinical data on Sicilian patients admitted to acute care hospitals and (2) data from the influenza virological surveillance of 10 European countries (FluNet database). All Sicilian patients diagnosed with at least 1 ICD-9 CM code for influenza (487.0, 487.1 and 487.9) were considered influenza cases. Results: Overall, 2,880 patients with an ICD-9 CM code attributable to influenza were hospitalized in Sicily: 2,119 (73.6%) were admitted from November to April, whereas 761 (26.4%) were admitted from May to October. In the 3 years studied, the analyzed European influenza surveillance systems recorded a peak of laboratory-confirmed influenza activity from November to April with 36,753 (99.7%) influenza cases, whereas only 124 cases (0.3%) were observed from May to October. Conclusions: In Sicily, more than one quarter of all hospital admissions with an ICD-9 CM code for influenza were observed in the months with a negligible circulation of influenza viruses. Our findings show that several hospital discharge records included ICD-9 CM codes for influenza with low levels of sensitivity, specificity and/or appropriateness for clinical information and support the need for improving medical education on the epidemiology and hospital management of influenza cases.

The spread of Streptococcus pneumoniae within families has been scarcely investigated so far. This feasibility study aimed to estimate the prevalence of pneumococcal carriage in school-aged children and co-habiting relatives and to explore the potential link between the family environment and the sharing of pneumococcal serotypes covered by the vaccine. Oropharyngeal samples of 146 subjects belonging to 36 different family groups were molecularly tested for pneumococcal detection and serotyping. The overall prevalence of pneumococcal carriage was 65.8% (n = 96/146), whereas it was higher among schoolchildren (77.8%, n = 28/36); subjects of seven years of age had the highest odds of being colonized (odds ratio, OR = 5.176; p = 0.145). Pneumococcal serotypes included in the 13-valent conjugate vaccine formulation were largely detected in the study population and multiple serotypes colonization was considerable. Factors relating to a close proximity among people at the family level were statistically associated with pneumococcal carriage (OR = 2.121; p = 0.049), as well as active smoking habit with a clear dose-response effect (ORs = 1.017-3.326). About half of family clusters evidenced similar patterns of carried pneumococcal serotypes and the odds of sustaining a high level of intrafamilial sharing increased with household size (ORs = 1.083-5.000). This study highlighted the potential role played by the family environment in sustaining both the circulation and horizontal transmission of pneumococcus.

Nasal turbinate hypertrophy is a major cause of nasal airway obstruction that affects up to 20% of the European general population. This study aims to determine the efficacy of radiofrequency treatment as perceived by patients during a 2-years period. From 2007 to 2009, an observational study was conducted on 36 patients who consecutively underwent temperature-controlled radiofrequency tissue volume reduction. A questionnaire was administered to each patient in order to collect demographic data, lifestyle habits, health status and visual analogue scale (VAS) score of perceived symptoms. Mean VAS scores of nasal obstruction, headache, rhinorrhoea and anosmia after treatment were significantly lower than that at baseline. Urban residence and allergic rhinitis were significantly associated with lower mean improvement (2.9 vs. 5.6; P = 0.04 and 2.3 vs. 5.3; P = 0.01, respectively). A non significant association with scarce nasal obstruction improvement was present in older aged patients, in patients other than students and in active and passive smokers. Our data enrich the general knowledge on radiofrequency treatment of turbinate hypertrophy identifying the rate of long-term efficacy of radiofrequency treatment as perceived by patients and focusing on several risk factors involved in patient prognosis after treatment.

INTRODUZIONE La colonizzazione orofaringea da pneumococco interessa il 90% dei bambini nel primo anno di vita ed i contatti familiari possono giocare un ruolo cruciale nella stessa. Per analizzare i fattori associati alla colonizzazione da pneumococco e alla possibile trasmissione intra-familiare, è stato realizzato il progetto BINOCOLO: "Bambini Insieme ai NOnni COntro LO Pneumococco" su una popolazione studentesca e relativi familiari co- residenti. METODI Per l'arruolamento dei partecipanti allo studio, sono state identificate due scuole primarie del Comune di Palermo. Per ogni soggetto reclutato, un questionario e un tampone orofaringeo sono stati raccolti attraverso un team opportunamente formato di operatori sanitari. La ricerca e la sierotipizzazione di Streptococcus pneumoniae sono state condotte mediante analisi molecolari in real-time PCR. RISULTATI Nello studio sono stati arruolati 36 nuclei familiari di studenti, per un totale di 110 individui co-residenti. L'86% degli studenti aveva ricevuto almeno una dose di vaccino anti- pneumococcico (contro il 2% dei familiari >12 anni di età). Tra i principali fattori associati alla colonizzazione da pneumococco sono stati individuati: la presenza di un meno di 4 stanze per abitazione (p=0.05), il fumare più di 15 sigarette/die (p=0.078), l'aver effettuato o meno la vaccinazione antipneumococcica (p=0.77). La distribuzione dei sierotipi identificati è riportata in Figura 1. CONCLUSIONI Il presente lavoro identifica alcuni potenziali determinanti socio-demografici e comportamentali correlabili alla diffusione della colonizzazione da pneumococco in ambito familiare. I RISULTATI ottenuti, per quanto statisticamente non significativi per la limitata dimensione campionaria, confermano quanto emerso in altre esperienze condotte in contesti differenti. Lo studio ha permesso di standardizzare i METODI da applicare in futuro su una casistica più ampia in grado di consolidare i RISULTATI preliminari fin qui ottenuti.

to assess the trends of foodborne diseases in respect of the abolition of food handler certification by Italian Regions.

Contaminated hospital surfaces have been demonstrated to be an important environmental reservoir of microorganisms that can increase the risk of nosocomial infection in exposed patients. As a consequence, cleaning and disinfecting hospital environments play an important role among strategies for preventing healthcare-associated colonization and infections. The aim of the present study was to evaluate whether adenosine triphosphate (ATP) presence, measured by bioluminescence methods, can predict microbiological contamination of hospital surfaces. The study was carried out between September and December 2012 at the University Hospital "P. Giaccone" of Palermo. A total of 193 randomly selected surfaces (tables, lockers, furnishings) were sampled and analyzed in order to assess ATP levels (expressed as relative light units or RLU) and aerobic colony count (ACC) or presence of S. aureus. ACC had median values of 1.85 cfu/cm2(interquartile range = 4.16) whereas ATP median was 44.6 RLU/cm2(interquartile range = 92.3). Overall, 85 (44.0%) surfaces exceeded the established microbial benchmark: 73 (37.8%) exceeded the 2.5 cfu/cm2ACC standard, 5 (2.6%) surfaces were positive for S. aureus and 7 (3.6%) showed both the presence of S. aureus and an ACC of more than 2.5 cfu/cm2. ACC and bioluminescence showed significant differences in the different surface sites (p < 0.001). A significant correlation was found between ACC and RLU values (p-value < 0.001; R 2= 0.29) and increasing RLU values were significantly associated with a higher risk of failing the benchmark (p < 0.001). Our data suggest that bioluminescence could help in measuring hygienic quality of hospital surfaces using a quick and sensitive test that can be an useful proxy of microbial contamination; however, further analysis will be necessary to assess the cost-efficacy of this methodology before requiring incorporation in hospital procedures.

Introduzione: Nel corso della stagione influenzale, gli Operatori Sanitari (OS) rappresentano una delle categorie lavorative maggiormente investite dalla responsabilità di limitare la diffusione della patologia influenzale tra i pazienti ospedalizzati e contemporaneamente di proteggere se stessi garantendo la continuità dell'assistenza sanitaria nei periodi di maggiore assenteismo lavorativo e sovraccarico delle attività assistenziali (picco influenzale stagionale). La vaccinazione antinfluenzale, ormai riconosciuta sicura ed efficace, rappresenta ancora oggi una argomento di dibattito tra gli OS, nonostante le raccomandazioni dei Center for Disease Control and Prevention Statunitense ed Europeo a mantenere le coperture tra gli OS sopra il 75%. Numerosi studi confermano come i tassi di vaccinazione antinfluenzale rimangano generalmente bassi sia tra gli OS che in particolare tra i medici in formazione specialistica (MFS). I risultati del presente studio multicentrico cercano di indagare le attitudini e i determinanti associati con la scelta vaccinale antinfluenzale tra i MFS italiani per comprendere le cause e proporre delle soluzioni. Materiali e Metodi: Nel 2012 è stata condotta una survey tra i MFS iscritti a 18 Università Italiane (Bari, Bologna, Brescia, Catania, Catanzaro, Chieti, L'Aquila, Messina, Modena, Napoli Federico II, Palermo, Pavia, Parma, Roma Cattolica, Roma Tor Vergata, Siena, Torino, Verona). Ciascun partecipante è stato contattato tramite una mail in cui erano illustrate le motivazioni dello studio e veniva chiesto di rispondere ad un breve questionario online, anonimo ed autosomministrato che includeva domande sulle attitudini riguardanti la vaccinazione antinfluenzale. Il questionario è stato precedentemente elaborato in collaborazione con il gruppo di lavoro nazionale e successivamente testato in uno studio pilota condotto nell'Università capofila dello studio (Palermo). Results: 2.506 MFS su un totale di 10.854 hanno aderito allo studio (23.1%). L'adesione alla vaccinazione antinfluenzale per la stagione 2011/2012 è stata pari al 11,9%, dato in chiara diminuzione rispetto al 2010/2011 (21.,7%) ed al 2009/2010 (15.5%). I MFS vaccinati nella stagione 2011/2012 sono significativamente più anziani (p=0.006), afferenti all'area clinica (p=0.048), e vaccinati nelle precedenti stagioni influenzali (p

To assess knowledge, risk perception and behaviours of a sample of swimming pool users in Palermo. A total of 498 subjects were interviewed by self-administered anonymous questionnaire including socio-demographic questions, knowledge/risk perception and behaviours. Overall, 289 subjects (58%) had a mean of 1.9±1.2 healthy behaviours. Age older than 30 years (OR=0.46; 95% CI=0.26–0.81), female sex (OR=0.52; 95% CI=0.35–0.76) and a high knowledge score (OR=0.15; 95% CI=0.03–0.69) were significantly associated with having healthy behaviours in both univariate and multivariate analysis. Unhealthy behaviours can be frequently found in swimming pool bathers and, particularly, in some target groups. Public health prevention strategies should be implemented to improve public awareness and information on a safe use of recreational water environments.

L’utilizzo di fitofarmaci costituisce a tutt’oggi un rischio non trascurabile per tutto il settore primario, coinvol- gendo sia coloro che sono addetti alle coltivazioni di prodotti destinati all’uso alimentare (agricoltori), sia di piante ornamentali e fiori (giardinieri e vivaisti). L’obiettivo dello studio è la verifica delle conoscenze specifiche dei lavora- tori addetti al settore florovivaistico, riguardo il corretto utilizzo di prodotti fitosanitari, in particolare nell’attività di stoccaggio, preparazione delle miscele e conservazione delle stesse presso la sede di lavoro. Inoltre è stata approfondita la tematica della corretta formazione, informazione ed addestramento delle maestranze nell’utilizzo dei dispositivi di protezione individuale (DPI). Lo studio

Introduzione La procedura della certificazione del LISA prevista da una legge del lontano 1962, è stata messa in discussione, quale strumento efficace e costo-efficace di prevenzione primaria, fin dalla fine degli anni ’80. La sua abolizione ha modificato il programma di Sanità pubblica in cui era inserito, facendo maggiore spazio a strumenti di autocontrollo, formazione sanitaria e responsabilizzazione del personale della filiera alimentare. Lo scopo del presente lavoro è di effettuare, per tutto il territorio italiano, un confronto fra i dati delle notifiche delle principali MTA relativi al periodo antecedente con quelli del periodo successivo all’abolizione del LISA. Materiali e Metodi Il numero annuale di notifiche delle singole malattie, per Regione, nel periodo 1996-2009, è stato ricavato dalla consultazione del “Bollettino Epidemiologico” on-line del sito del Ministero della Salute. I flussi considerati sono stati: Diarrea infettiva, Salmonellosi non tifoidee e numero dei casi di MTA in focolai epidemici. Sono state analizzate le Regioni italiane in cui è stata pubblicata, almeno due anni prima del 2009, una disposizione legislativa di abrogazione/sospensione del LISA (tutte le Regioni tranne il Molise). Per ogni MTA considerata e per ogni Regione, si è proceduto al calcolo della variazione percentuale tra l’incidenza media degli anni precedenti la pubblicazione della disposizione legislativa e l’incidenza media degli anni che l’hanno seguita. L’anno di pubblicazione della delibera menzionata non ha contribuito al calcolo delle incidenze. E’stata verificata, infine, la significatività (test t Student a 2 code, livello di fiducia 0,05) dell’eventuale differenza tre le medie. Risultati In molte Regioni si dimostra una riduzione del numero di casi notificati di MTA. In particolare, il numero di casi di focolai epidemici si riduce in tutte le Regioni e in nove di esse in maniera statisticamente significativa. Cospicua anche la riduzione della salmonellosi in tutte le Regioni. Un aumento significativo delle notifiche dei casi di Diarrea infettiva, invece, è da segnalare in Toscana, Piemonte, Lombardia e PP.AA. di Trento e Bolzano. Discussione e Conclusioni I risultati di questa indagine, pur nei limiti caratteristici della fonte utilizzata, confermano - complessivamente - ciò che è stato rilevato in altri studi precedenti condotti su aggregati regionali, dimostrando che in Italia non vi è evidenza di aumento dell’incidenza di MTA da addebitare alla modifica del programma di Sanità pubblica sulla sicurezza alimentare con l’abolizione del LISA. I dati derivanti da alcune realtà regionali del Centro e Nord del Paese, costituiscono, sotto un profilo nosologico (Diarrea infettiva), una controtendenza giustificabile, anche se in maniera non completamente esaustiva, con l'accrescimento dell'efficienza dei sistemi di sorveglianza locali, come ipotizzato da alcuni autori.

Background: Annual flu vaccination of healthcare workers (HCWs) is recommended worldwide as the best way to prevent influenza and to avoid its transmission. However, in several European Countries, vaccination rate among HCWs is still less than 25%. The aim of this study was to determine the HCW vaccination coverage during a three year period in a large University Hospital, identifying socio demographic and occupational variables involved in the decision to accept influenza vaccination. Moreover, for the 2007-2008 season, we also assessed the effectiveness of influenza vaccination in reducing influenza-related absenteeism.Methods: During three consecutive influenza seasons (from 2005-2006 to 2007-2008), a cross-sectional study was carried out on all HCWs employed in the “Azienda Ospedaliera Universitaria Policlinico” (AOUP) of Palermo (Italy). Socio-demographic and occupational data of HCWs were collected from administrative hospital personnel records and included gender, age, birthplace, residence, profession and the workplace unit. In addition, during the 2007-2008 season, a retrospective study was conducted to evaluate absence from work due to influenza–like illness (ILI) in vaccinated versus unvaccinated personnel.Results: A total of 7,848 HCW-years were observed and 881 vaccines were administered during the study period. Vaccination rate declined from 14.7% in 2005-2006 to 8.2% in 2007-2008 (Chi-square for trend=53.6, pConclusions: Our experience encourages flu vaccination of HCWs and accentuates the importance of annual influenza vaccination programs for healthcare personnel.

Summary Objectives High Toscana virus (TOSV) antibody seropositivity rates have been documented in the last decade, especially in the Mediterranean area. It is unclear if these rates are associated with a recent or past exposure to the virus. This is of importance, as primary infection can cause neurologic complications, especially in adults. The aim of the present study was to assess the current active TOSV circulation in western Sicily. Methods A cross-sectional seroprevalence study was conducted on 271 individuals aged 4–92 years, sampled from the general population of a small city. Each participant completed a self-administered questionnaire and provided serum, which was analyzed for the presence of specific anti-TOSV IgM and IgG. Results Anti-TOSV IgM was detected in eight (3.0%) participants, of whom only three had anti-TOSV IgG. The prevalence of anti-TOSV IgM was highest in subjects aged 25–34 and 35–44 years (7.1% and 4.8%, respectively). All subjects positive for anti-TOSV IgM were resident in the suburban area. Conclusions The detection of IgM documented the circulation of TOSV, a Phlebovirus, in a random population sample of Sicilian adults. The highest risk of TOSV seroconversion in subjects living in the suburbs appears to suggest a high density of TOSV vectors in peri-urban areas.

Background: although the epidemiological features of overweight and obesity have been well described, especially for very populous urban areas, less evidences are available for small urban areas. The aim of the present work was to assess BMI and factors associated with overweight and obesity in a representative sample of general population of a small city of Western Sicily (Italy). Methods: four hundred and eleven randomly selected adult subjects from general population living in a small Sicilian city with 7 144 inhabitants were interviewed by a standardized questionnaire investigating life-styles, eating habits, anthropometric measurements (weight, height and BMI) and socio-economic deprivation. Results: the standardized prevalence of overweight and obesity were 43.8% and 18.3%, respectively. The multivariate analysis has indicated an increased risk of BMI≥25 in subjects 40-59 years old (OR=2.3; 95% CI=1.2-4.4) in comparison with 18-39 years old, in males (OR=2.8; 95% CI=1.6-4.7) in comparison with females, and in participants who had a higher socio-economic deprivation (OR=1.3; 95% CI=1.1-1.7). ConclusionS: in small urban areas some demographic factors and socio-economic deprivation can be considered important risk factors for increased BMI also after controlling for the most common confounding factors.