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Low measles, mumps and rubella (MMR) immunization levels in European children highlight the importance of identifying determinants of parental vaccine uptake to implement policies for increasing vaccine compliance. The aim of this paper is to identify the main factors associated with partial and full MMR vaccination uptake in European parents, and combine the different studies to obtain overall quantitative measures. This activity is included within the ESCULAPIO project, funded by the Italian Ministry of Health. ORs and CIs were extracted, sources of heterogeneity explored and publication bias assessed. Forty-five papers were retrieved for the qualitative study, 26 of which were included in the meta-analysis. The following factors were associated with lower MMR vaccine uptake: misleading knowledge, beliefs and perceptions on vaccines (OR 0.57, CI 0.37-0.87); negative attitudes and behaviors toward vaccination (OR 0.71, CI 0.52-0.98); demographic characteristics, such as different ethnicity in Southern populations (OR 0.44, CI 0.31-0.61), higher child's age (OR 0.80, CI 0.76-0.85); low socio-economic status (OR 0.64, CI 0.51-0.80), especially low income (OR 0.39, CI 0.25-0.60) and education (OR 0.64, CI 0.48-0.84), high number of children (OR 0.54, CI 0.42-0.69), irregular marital status (OR 0.80, CI 0.66-0.96). The factors explaining heterogeneity were country location, administration modality, collection setting and responses reported on MMR alone or in combination. Findings from this study suggest policy makers to focus communication strategies on providing better knowledge, correct beliefs and perceptions on vaccines, and improving attitudes and behaviors in parents; and to target policies to people of ethnic minority from Southern Europe, low educated and deprived, with higher number of children and non-married marital status.

Eight Italian Regions have begun offering vaccination against varicella to children aged 13-15 months, with a second dose at 5-6 years of age. A serosurvey was conducted to evaluate the impact of extensive vaccination in these "pilot" Regions.Samples were collected in compliance with current legislation and after the approval of the Ethics Committee. The qualitative and quantitative determination of antibodies (IgG) against varicella was performed using an ELISA assay with high sensitivity and specificity.1,470 samples were analyzed. After the decrease of seropositivity associated with the decay of passively acquired antibody titer, there was a progressive increase of seroprevalence in the other age groups. The comparison with what was recorded in two studies conducted with similar assays in the periods 1996/97 and 2003/04, showed a significant increase in seroprevalence following extensive immunization, particularly in the age classes 1 year, 2-4 years and 5-9 years. The proportion of seropositivity in the age classes 1 year and 2-4 years has more than doubled.Seroepidemiological studies are a useful tool to evaluate the distribution of susceptible individuals in the population. This study highlighted the impact of extensive vaccination against varicella in eight "pilot" Regions.

La gastroenterite da rotavirus (GARV) rappresenta uno dei principali bisogni assistenziali durante l’età pediatrica. Purtroppo, in Italia, in assenza di notifica obbligatoria e di specifici sistemi di sorveglianza, le uniche valutazioni epidemiologiche disponibili sulle GARV sono rese possibili dall’analisi delle ospedalizzazioni. Il presente lavoro ha avuto l’obiettivo di valutare le ospedalizzazioni per GARV e per intussuscezione, avvenute in Sicilia in soggetti di età compresa tra 0 e 60 mesi, negli anni 2003-2012 (periodo prevaccinale) e 2013 (anno di introduzione della vaccinazione antirotavirus). Nel periodo in esame si sono osservate 9.886 ospedalizzazioni per GARV con una media annua di 899 casi. La maggior parte dei ricoveri (62,3%) è stata registrata nella fascia di età compresa tra 0 e 2 anni con una progressiva riduzione negli anni di vita successivi. Durante il 2013 si è osservata una copertura vaccinale regionale attestatasi tra il 30 ed il 40% per la prima dose ed il 25-35% per la seconda dose. Nello stesso anno si è assistito ad una riduzione dei casi di GARV di circa il 38,9% nei soggetti di età 0-5 anni (931 casi/anno nel 2003-2012 vs. 569 nel 2013) e superiore al 50% nella fascia di età 0-11 mesi (277 casi/anno nel 2003-2012 vs. 137 nel 2013). Diversamente, nel 2013 il numero di ospedalizzazioni per intussuscezione in soggetti di età compresa tra 0 ed 11 mesi si è mantenuta in linea con quanto osservato in epoca prevaccinale (15 casi nel 2013 vs. 15,4 casi/anno osservati in media tra 2003 e 2012). I dati presentati evidenziano l’importante peso assistenziale che le GARV hanno annualmente in Sicilia e supportano l’efficacia della vaccinazione nella riduzione significativa dei casi di ospedalizzazione per GARV in assenza di incrementi di rischio di intussuscezione.

The purpose of this study was to evaluate knowledge, attitudes, and practices concerning energy drink consumption and the prevalence of side effects among medical students. Twenty-two percent of respondents were regular users, particularly men (p < .0005). Users were younger (p = .027) and drank alcohol more frequently (p = .008) than "non-users." Forty-nine percent consumed alcohol associated with energy drinks. Forty-five percent of medical students declared side effects after energy drink consumption, such as palpitations (35%), insomnia (21%), and irritability (20%). The study confirms a large use of energy drinks among students and the occurrence of side effects. The use of energy drinks may influence the ingestion of large amounts of alcohol.

Introduction Universal varicella vaccination in Sicily was introduced in infant population since 2003, with a rapidly increasing coverage. Aim of the present study was to analyze changes in the epidemiology of varicella since the introduction of universal vaccination. Methods The study was performed by analyzing Sicilian administrative/clinical data on varicella case notifications and hospitalizations from 2003 to 2012 (ICD-9-CM discharge diagnosis codes 052 and 052.×). MMR+V and V coverage were also calculated for each birth cohort. Moreover, blood samples drawn in 2013/2014 from general population stratified by age were tested for varicella antibodies. Results From 2003 to 2012, 15 433 varicella cases were notified with a decreasing temporal trend (1.1/1000 population in 2003 to 0.1/1000 in 2012) (P