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Background and aim of the work: Even though vaccination is easy to access in Europe, it has been facing several outbreaks caused by vaccine preventable diseases. Trying to balance the right to health of the community with individual self-determination, in Italy was mandate vaccination for ten vaccine preventable diseases in 2017. The project “Sportello Vaccinale” provided a counseling service to parents in kindergarten of Palermo. The main objective of the study was to investigate knowledge and compliance on vaccination by children’s parents after the implementation of mandatory vaccination. Methods: A cross sectional study was conducted among parents accessing to the “Sportello Vaccinale” using a questionnaire. The questionnaire consisted of 34 items divided into three sections: socio-demographic data; knowledge and attitude on mandatory vaccination using Health Belief Model (HBM); Health Literacy (HL) level. Results: A total of 95 questionnaires were garnered in the kindergartens from respondents with a mean age of 36 (±SD=6) years. The respondents who delayed hexavalent or Measles, Mumps, Rubella and Varicella (MMRV) vaccinations were 8 (8%) and the more frequent cause was fear of adverse reaction (87%). The sample had more often high level of health literacy (37%), and 55% had higher HBM score. The factor significantly associated with higher HBM score was the age of respondents (OR= 1.14, p=0.006) after controlling for other variables. Conclusions: Consent to vaccination practice was widely represented, but the results of the study highlighted the need for parents to have more information and more time devoted to the practice of vaccination counseling. Implementing counseling activities at school or at the vaccination service, could support an aware decision process of the parents on vaccination topic.

Questo contributo focalizza l’attenzione sulle competenze dei docenti di sostegno in formazione iniziale cosi come vengono descritte nel framework del Technological Pedagogical Con- tent Knowledge (TPCK – Koehler & Mishra, 2006), a partire dagli studi di Shulman (1986) sul PCK e intende offrire alcune riflessioni metodologiche sulla formazione dell’insegnante di sostegno. I risultati ottenuti con un campione di 1591 docenti iscritti al corso di specializzazione per il sostegno dell’Università degli Studi di Palermo e le riflessioni provenienti dal modello TPACK potrebbero consentire di adeguare le attività formative relative alle TIC alle reali competenze iniziali dei corsisti, contribuendo alla formazione di un insegnante di sostegno in grado di utilizzare in modo inclusivo ed efficace le risorse digitali. This paper analyses training support teachers’ knowledge as described by the Technological Pedagogical Content Knowledge framework (TPCK – Koehler & Mishra, 2006) based on Shulman’s PCK (1986). Technological resources offer indisputable opportunities to teachers who want to renew the contents and strategies of their teaching and provide students with active learning processes; yet they offer some reflections about the methodologies used in support teacher training. The results obtained with a sample of 1591 teachers enrolled in the support teacher specialization course, run by the University of Palermo, as well as the reflections related the TPACK, could allow to adapt the ICT courses to the real initial skills of the students, contributing to the training of support teachers able to use digital resources in an inclusive and effective way.

In the last decades, the issues related to health risk communication to stakeholders and citizens involving health care practitioners and local political authorities have been increasingly debated. The study evaluated an alternative strategy to communicate cancer risk to local communities, involving an expert panel of public health operators in comparing two different graphic tools, Funnel Plot and Choropleth map.A Delphi method process was implemented to achieve a unified consensus on an expert panel of public health operators with regard to weaknesses and strengths of the Funnel Plot and the Choropleth map as tools for cancer risk communication to local communities and other stakeholders.Participants were asked to score the efficacy of the two tools using a scale. Six properties were explored through two consecutive consensus rounds. Scales were used to calculate frequencies and the content validity ratio for each domain within the consensus rounds.After the two consecutive rounds, participants expressed their preference in favour of the Choropleth map for its ability to define the spatial location of the risk and to locate any potential cluster, while reaching a consensus with regard to the Funnel Plot properties to identify hot spots, displaying the scope of the phenomenon under investigation, and to show the precision of estimates and communicating the significance of estimates.The Delphi process allowed us to conclude that Funnel Plot could be used as a complement to the current and commonly used graphical and visual formats to effectively communicate cancer epidemiological data to communities and local authorities, representing a useful tool for empowering the general population.

An increasing need for healthcare workers as been estimated worldwide. To provide a comprehensive framework of the medical workforce in Italy, we investigated the post-lauream medical workforce training supply and demand. Further, a comparison of the medical workforce between Italy and other European Countries with a similar epidemiological and/or demographic context was performed. The distribution of pre-and post-lauream medical educational providers and post-lauream resources in place in Italy was analyzed among Italian macro-areas in the academic years 2015-2016, 2016-2017 and 2017-2018.Italy and the European countries in study were compared in term of post-lauream funding and number of active physicians by specialization per 1,000 inhabitants. Open access data from official Italian and European institutional sources were used. The most of medical schools were distributed in the North, followed by South, islands and Central Italy, while the highest enrolment rate in the pre-lauream medical education was reported in Central Italy, followed by South & islands and North. The total number of active residency programs increased from 1092 to 1286 in the three considered academic years, while number of post-lauream training contracts decreased from 11.0 to 10.2 per 100,000 inhabitants. A misalignment between contracts assigned to residency programs and grants assigned to general practitioners specific courses was observed. Furthermore, when compared to the EU countries in study, Italy documented the lowest number of post-graduated training positions in 2015, with a rate of 12.1/100,000 inhabitants. Also, an excess of medical specialists (3.06 per 1,000 inhabitants) with a simultaneous shortage of general practitioners (0.89 per 1,000 inhabitants) was reported. On the contrary, Italy documented the highest number of paediatric practitioners. More efforts, including the implementation of adequate tools, are required both at national and regional level in order to provide a medical workforce planning in line with a continuously changing health context.

Introduction. Healthcare workers are continuously exposed to the risk of being infected by influenza viruses during their work, thus representing a threat especially for fragile patients. Although the Italian Ministry of Health strongly recommends influenza vaccination for all HCWs, coverage levels in Italy are still far from the expected. Several studies report that one of the preferred strategies to improve vaccination coverage among Healthcare Workers is improving vaccination knowledge through specific multidisciplinary courses. To assess the effectiveness of an educational intervention on influenza vaccination coverage among Healthcare Workers a study was conducted at "Paolo Giaccone" University Hospital of Palermo, in the occasion of the 2016/2017 seasonal influenza vaccination campaign. Material and methods. Educational interventions on influenza infection and vaccination were organized involving personnel of the hospital units in which patients were more fragile. The Healthcare Workers who volunteered attend the course were considered as the intervention group, while two controls for each case, composed by Healthcare Workers not attending it, were randomly selected from the same unit. For both groups, a questionnaire was used to investigate attitude and behaviors toward influenza vaccination, while vaccination coverage data were obtained throughout the Hospital informational data system. Results. Overall, out of the 125 participants, 38 (30.4%) followed the course (intervention group) and 87 (69.6%), not attending the course, represented the control group; later, only 43 Healthcare Workers out of 125 (34.4%) underwent vaccination during the season considered. In particular, after the educational intervention, 42% of the attending Healthcare Workers got vaccinated, while vaccination prevalence in the control group was 31%. The Healthcare Workers who underwent vaccination reported, before the intervention, a higher risk perception for contracting (transmitting) influenza compared to those not vaccinated (p < 0.05), while no significant difference in risk perception of transmitting influenza to their patients was reported between the two groups. Discussion. Despite the training provided, and an improvement in vaccination adherence by the Healthcare Workers involved, coverage obtained was lower than recommended to reduce influenza spread in hospital contexts. In conclusion, our data suggest that specific training alone may play a role in the improvement of influenza vaccination adherence, but it should be integrated by a wider range of public health measures, including mandatory vaccination.

Currently, surgical training of physicians in Italy has limited possibilities.Surgical training can be performed on dissection of human bodies as well as in animal laboratories, but experience is very poor. We conducted a survey through an anonymous questionnaire in order to evaluate the opinions of post-graduate physicians on their need for experience training on both human and animal bodies during their medical studies. A total of 165 young Sicilian physicians responded to the survey. Only 14 of them (8.5%) declared they had specific training on a live animal, while 46 (27.9%) reported they already attended cadaver labs. Over 70% assigned the maximum score to the utility of such courses as integration of medical academic offer. Our results showed that the majority of the subjects interviewed expressed a need for training using these practices and that it might be necessary to investigate patterns to promote the opportunity for direct practice on human and animal bodies.

INTRODUZIONE: La diffusione su larga scala del consumo di pesce crudo ha contribuito all’incremento di manifestazioni allergiche conseguenti al contatto col parassita del pesce Anisakis. Obiettivo dello studio è stato quello di stimare il rischio di contrarre allergie Anisakis-correlate in lavoratori del comparto ittico e della ristorazione. MATERIALI E METODI: È stato realizzato uno studio cross-sectional per stimare la prevalenza della sensibilizzazione ad Anisakis simplex (As) su un campione di 46 cuochi e/o addetti alla preparazione degli alimenti reclutati nella provincia di Palermo. A tutti i soggetti è stato somministrato un questionario clinico-anamnestico ed è stato effettuato un prelievo ematico per la rilevazione nel siero di IgE speci che anti-As. I livelli di IgE anti-As sono stati determinati tramite immuno uoroscenza (Unicap 100) con valori di siero-conversione pari a >0,35 kU/L. I dati ottenuti sono stati combinati coi dati di una precedente rilevazione similare condotta su un campione di 95 lavoratori del settore ittico nella Sicilia Occidentale. Sono state effettuate analisi descrittive ed è stato testato un modello di regressione logistica, utilizzando il software R, Version 3.3.1 – © 2009-2016 RStudio, Inc. RISULTATI: È stata documentata una siero-prevalenza ad As nel 9,2% (13/141) dei soggetti reclutati. La frequenza di siero- conversione ad As è risultata maggiore nella categoria dei pescatori/marinai (18,4%), seguita dai pescivendoli/addetti pulizia del pesce (13,6%), dai cuochi/addetti preparazione alimenti (6,2%) e dai lavoratori dell’industria del pesce (2,0%) (p-value= 0,05). Per la categoria dei pescatori/marinai è stato stimato un signi cativo eccesso di rischio di sieroconversione ad As (OR: 10,84; IC95%: 1,27 - 92,43) rispetto al riferimento dei lavoratori dell’industria del pesce, mentre per i Cuochi/addetti preparazione alimenti è stato stimato un OR di 3,20 con IC95%: 0,28-36,84. CONCLUSIONI: Un’elevata siero-prevalenza è stata documentata nel campione di soggetti professionalmente esposti ad As. Studi più estesi sono necessari per valutare se sia possibile annoverare le allergie Anisakis-correlate tra le malattie professionali per categorie e mansioni professionali ad elevata frequenza e persistenza di esposizione al parassita in ambito occupazionale.

Corruption affects healthcare effectiveness and efficiency and limits equity in access to health services. Aim of the survey was to document knowledge and viewpoints on the impact of corruption on healthcare system in a sample of students attending pre-lauream healthcare professional courses at Palermo University Medical school and to evaluate any improvement in their awareness on this topic after a dedicated multidisciplinary educational intervention. An anonymous questionnaire was administered to students before and after the intervention. Absolute and relative frequency of correct and incorrect answers was computed. Chi-squared test was used to compare answers given before and after the educational intervention. Approximately less than a quarter of the respondents were able to correctly estimate impact of corruption, inappropriateness and waste in healthcare on NHS. The study documented how improving students’ knowledge of the impact of corruption in the healthcare system could represent a possible strategy to prevent corruption in healthcare.

Trace volatile elements like He are key for understanding the mantle source signature of magmas and to better constrain the relative roles of subduction and crustal processes to the variability of along-arc chemical and isotopic signatures of magmatic fluids. Here we report on noble gas abundances and isotopic data of Fluid Inclusions (FIs) in eruptive products and/or fumarolic gases from the Colombia-Ecuador segment of Andean Northern Volcanic Zone (NVZ). FIs in olivine phenocrysts from Ecuador (El Reventador, Cotopaxi and Tungurahua) yield air-normalized corrected He-3/He-4 ratios of 7.0-7.4 R-A, within the MORB range (8 +/- 1 R-A). With exception of the Cotopaxi lavas (opx < < oliv.), these are indistinguishable of those obtained for their cogenetic orthopyroxene pairs and of gas emissions previously reported in literature. Olivine phenocrysts from Nevado del Ruiz fissure lavas also yield the highest He-3/He-4 (8.5 +/- 0.3 R-A) for this volcanic system, which is in the range of fumarolic gases for Galeras (previously reported as high as 8.8 R-A and here measured to a maximum of 8.3 +/- 0.1 R-A). Our dataset highlights disparities between isotope signatures of eruptive products from Ecuador (avg. similar to 7.2 R-A) and those reported for the Colombian portion of the NVZ (avg. similar to 8.5 R-A). Previous studies on the geochemistry of erupted products put in evidence significant along-arc variations ascribed either to the involvement of different slab components, or to variable depths of evolution of arc magmas within the continental crust. However, the same variation is not discernible in the signature of noble gases, especially helium, from FIs and gas emissions analyzed in this study, with little inter-variation between Cotopaxi, Reventador and Tungurahua (all within 0.2 R-A from the Ecuador average of 7.2) and Galeras and Nevado del Ruiz, whose maximum values differ by similar to 0.3 RA. We therefore suggest a homogenous MORB-like He-3/He-4 signature for the mantle wedge beneath this arc segment, whereby along-arc variations in crustal thickness (from = 50 km at the Ecuadorian arc segment) may factor largely into the variability recorded on our data set. The first CO2/He-3 ratios obtained in FIs from Andean rocks support the hypothesis of increasing crustal contamination from Colombia to Ecuador, concomitant with increasing crustal thicknesses under the respective arc regions.

In recent years, the considerable progress of miniaturization and the consequent increase of the efficiency of digital circuits has allowed a great diffusion of the wireless sensor network technology. This has led to the growth of applications and protocols for applying these networks to several scenarios, such as the military one, where it is essential to deploy security protocols in order to prevent opponents from accessing the information exchanged among sensor nodes. This paper analyzes security issues of data processed by the WSN and describes a system able to generate sequences of random numbers, which can be used by security algorithms and protocols. The proposed True Random Number Generator (TRNG) exploits measurements obtained from sensor nodes, in order to allow every node to produce random data upon request, without involving a trusted third party. The proposed TRNG behavior has been tested by carrying out the NIST tests, and the obtained experimental results indicate the high degree of randomness of the produced numbers.