Prevalence and factors associated with bullying phenomenon among pre-adolescents attending first-grade secondary schools of Palermo, Italy, and a comparative systematic literature review

Background: Bullying is recognized as one of the most significant social and health problems in the school environment for children and adolescents. In Italy, bullying involved 2 in 10 kids between 11–17 years that referred to have been bullied two or more times in a month. In Sicily, the estimated prevalence of children aged 11 to 15 that suffered at least one act of bullying in the last two months was 14% in 2011. Methods: A questionnaire consisting of 30 items investigating physical, verbal and indirect bullying, observers of bullying, resiliency, and prosociality was administered to preadolescents of ten first-grade secondary schools within the Palermo Province in order to analyze prevalence and factors associated with bullying phenomenon. Also, a systematic literature review (SLR) analyzing manuscripts that reported prevalence of the bullying phenomenon worldwide was conducted. Results: Survey: a total of 867 students, belonging to 35 s and 31 third classes of ten different schools in Palermo, Italy, were recruited in the survey. The values of physical bullying are included between the 4% of the single question method and the almost forty percent detected by the score of 7 method. Verbal bullying oscillates between 15.9% and 66.3%. Observers average values varies from 15.8% to 47.5%. SLR: the estimated prevalence showed a considerable fluctuation. The occurrence of the bullying phenomenon was low in some Northern European countries, while in Anglo-Saxon countries it affected over a quarter of the middle school student population (28% in Maryland, USA and 21% in the UK). Conclusions: The prevalence of the bullying phenomenon recorded by this survey with the three different methods used is similar to observations in international literature. In the Sicilian context, a higher prevalence of bullying phenomena was observed in pre-adolescents attending major classes and in schools with lower socio-economic index. Though it remains difficult to obtain univocal data that clarifies the prevalence of different type of bullying, the continuous investigation of prevalence and factors associated with the phenomenon is a necessary starting point to introduce interventions and preventive measures in Public Health programs

Determinants of vaccine hesitancy and effectiveness of vaccination counseling interventions among a sample of the general population in Palermo, Italy

Counteract vaccine hesitancy is a public health priority. Main objectives of the cross-sectional study conducted were to evaluate knowledge, attitudes, and behaviors regarding vaccination issues, to estimate the prevalence of vaccine hesitancy and to estimate the effectiveness of vaccination counseling on community advocacy in a sample of general population. An anonymous validated questionnaire was administered in April 2017 at the main shopping center of Palermo and was followed by tailored vaccination counseling interventions. To estimate the effectiveness of the interventions four main connection parameters to the vaccinarsi.org website were evaluated, in the two months before and after the intervention and in the two months before the intervention compared with the same period of previous and following years. Among the 299 subject enrolled 12.7% were hesitant about vaccinations, and 4.7% declared being against vaccinations. General practitioners (GPs) and pediatricians were the most affordable source of information about vaccinations. A higher probability of vaccination hesitancy/refusal was reported among subjects who considered “alternative strategies” the best way for the prevention of infectious diseases (adj-OR = 7.01, IC95% 2.88–17.09, p-value < 0.001). A considerable increase of all the vaccinarsi.org website indicators analyzed was observed, from the area in which survey participants lived. Prevalence of vaccine hesitancy among population surveyed is consistent with the literature data. HCWs, such as GPs and pediatricians, should play a key role in modifying personal convictions and choices about vaccinations. A proper vaccination counseling could improve attitudes regarding vaccination issues, such as quality of web-based research

Human papilloma virus infection and vaccination: Pre-post intervention analysis on knowledge, attitudes and willingness to vaccinate among preadolescents attending secondary schools of palermo, sicily

In recent years, vaccination coverage rates against Human Papilloma Virus (HPV) in Europe have shown a decreasing trend and remain below the required standard. The present study aims to assess knowledge and attitudes regarding HPV infection and vaccination among a representative sample of preadolescents of Palermo, Italy. A survey was carried out throughout two questionnaires, before and after carrying out an educational intervention scheduled during school hours. A total of 1702 students attending first-grade secondary schools of the province of Palermo were enrolled (response rate 68.9%). Students attending third classes (adj OR = 1.18; CI 95% 1.03\u20131.36), being of higher socioeconomic status (adj OR = 1.35; CI 95% 1.05\u20131.73), who had previously received information about sexually transmitted diseases (STDs) at home (adj OR = 1.62; CI 95% 1.27\u20132.07) or at school (adj OR = 2.15; CI 95% 1.70\u20132.71) and who had ever heard in the past about HPV (adj OR = 1.80; CI 95% 1.42\u20132.29) showed a significantly higher baseline level of knowledge regarding HPV. Willingness to receive HPV vaccination, in a 10-point Likert scale, significantly increased between the pre-(8.51; SD \ub1 1.79) and post-(9.01 SD \ub1 1.52) intervention questionnaires (p < 0.001). A total of 188 out of 272 (69.1%) preadolescents attending five out eighteen schools involved in the project, who had not previously received the HPV vaccine, were vaccinated. During past years, education campaigns on HPV were mainly dedicated to adult women, excluding teenagers and omitting young males. It should therefore be of primary importance that school-based education and vaccination programmes be standardized

Association between family environment and the bullying phenomenon among school-age children: A systematic review

There is a lack of evidence about the possible role of the family environment in the occurrence of the bullying phenomenon among school-age children. We carried out a systematic review of the literature to investigate the positive and negative family determinants associated with the bullying phenomenon. Potential classes of determinants-e.g. interparental conflict and/or parenting behaviours-were studied by searching peer-reviewed literature published between the January 2008 and December 2018 on PubMed/MEDLINE, SCOPUS and ISI Web of Science. At the end of the eligibility process, only 3 studies met all the inclusion criteria, and were then included in the narrative synthesis. Mother destructive profile and excessive infant crying resulted significantly associated with child emotional insecurity and conduct/mood problems at the age of 5-6 years, respectively. Moreover, a decrease of medically unexplained symptoms in adolescent was observed after a one-year family functioning therapy. This body of evidences should raise the interest of the researchers in order to invest in depth the family unit impact on the bullying phenomenon in school environment

Campagna social #proteggitixproteggermi: andamento delle coperture vaccinali antinfluenzali degli operatori sanitari dell’AOU Policlinico “P. Giaccone” di Palermo in seguito all’implementazione di strategie comunicative ed informative

Introduzione Ogni anno il 20% circa degli operatori sanitari (OS) contrae l’influenza, continuando a lavorare e favorendo la diffusione dei virus influenzali nei reparti. La copertura media della vaccinazione antinfluenzale tra gli OS italiani si attesta attorno al 22%. Alla base del rifiuto vaccinale degli OS vi sono principalmente le scarse conoscenze, attitudini e percezioni in merito all’efficacia e alla sicurezza della vaccinazione antinfluenzale. In questo studio è stato analizzato il trend della copertura vaccinale contro l’influenza durante le ultime 12 stagioni negli OS dell’Azienda Ospedaliera Universitaria Policlinico (AOUP) di Palermo, valutando l’impatto delle strategie comunicative e informative adottate nelle ultime quattro stagioni vaccinali, con lo scopo di implementare la fiducia nella vaccinazione e aumentare l’aderenza alla stessa. Metodi Prima e durante le ultime quattro campagne di vaccinazione antinfluenzale stagionale, diverse iniziative sono state organizzate e condotte dagli medici in formazione specialistica in Igiene e Sanità pubblica dell’Università di Palermo: pagine web e di social media dedicate, campagne social “ad hoc” (#proteggitixproteggermi) vaccinazioni “in situ” nei reparti, corsi multidisciplinari per i dipendenti delle unità operative di degenza in cui soggiornano i pazienti più critici. È stato, inoltre, predisposto sull’area riservata del portale aziendale un modulo, la cui mancata compilazione impediva la piena funzionalità dell’intranet, dove si doveva esprimere il dissenso informato e le motivazioni del rifiuto della vaccinazione antinfluenzale. Risultati La copertura vaccinale è passata da un valore medio del 5% (stagioni 2010/2011- 2014/2015), al 37% nella stagione influenzale 2018/2019 (chi-square for trend: 857, p < 0.001). Inoltre è significativamente diminuita l’età media dei vaccinati passando da 48,1 (DS ± 15,7) nella stagione 2013/2014, a 35,9 (± 14,6) nel 2018/2019. In particolare, è aumentata la prevalenza di OS vaccinati tra i medici in formazione specialistica operanti presso l’AOUP. La paura di eventuali reazioni avverse (33%) e una mancata percezione del rischio di diffondere la patologia ai pazienti (31%) sono i motivi principali del rifiuto vaccinale. Conclusioni Tra le diverse strategie per aumentare l’adesione alla pratica vaccinale tra gli OS (formazione, obbligo, premialità, ecc) la comunicazione attraverso metodi web-based o social-based si è dimostrata un valido ed efficace strumento integrativo per aumentare le coperture tra gli OS più giovani. Tuttavia, la copertura vaccinale totale rimane ben al di sotto del 75% raccomandato dalle autorità internazionali di sanità pubblica. In futuro, sarà necessario affiancare a tali strategie comunicative, politiche di vaccinazione obbligatoria, specialmente per gli OS dei reparti a rischio, per aumentare le coperture vaccinali negli stess

The role of the Community Pharmacist in promoting vaccinations among general population according to the National Vaccination Plan 2017-2019: Results from a survey in Sicily, Italy

Introduction. The 2017-2019 Italian National Vaccination Plan promotes the improvement of knowledge and attitudes of healthcare workers about vaccine prevention, in order to spread a vaccination culture among general population. Similarly to the General Practitioner, the Pharmacist represents a fundamental forefront for both patients and healthy people, also in promoting vaccine acceptance. This research aims to analyze knowledge and attitudes about vaccines of Community Pharmacists and to evaluate the burden of vaccination counselling during their work activities. Material and methods. A standardized, self-administered and previously validated questionnaire, including 5 sections and 28 items, was submitted to a sample of Community Pharmacists working in Western Sicily. The survey was carried out through an online questionnaire, that investigated socio-demographic data, knowledge and attitudes towards vaccination and the role of the Pharmacist as vaccination counselor during his work. Results. A total of 120 Pharmacists were surveyed. 99.2% of them were definitely agreed with the Regional Vaccination Schedule. A large majority (n = 114, or 95%) were fully vaccinated and have vaccinated, or would vaccinate in future, their children. According to Community Pharmacists interviewed, at least 90% of clients asked for further explanations about vaccination, and the citizens' trust towards vaccination increased (30%) or remained stable (54.2%) over time in the last 5 years. Finally, as reported by interviewed Pharmacists, a correct counselling provided by General Practitioners (GPs) and Family Pediatricians was the main boost in increasing vaccination confidence, instead of mass-media and web misinformation that has led to skepticisms among general population. Conclusions. The study demonstrated the key role of the Community Pharmacist for their consumers in vaccination counselling. In future, a strong collaboration between Community Pharmacists and all the actors promoting vaccination themes (GPs, family Pediatricians, public health workers) will be essential, as well as a uniform and standardized University training on vaccination themes for all these categories

Public health strategies adopted to manage the increase of accesses to vaccination services, as a result of the application of the law 119/2017

Background and aim of the work: In response to the alarming reduction of vaccination coverage rates, Italian Ministry of Health approved the law number 119/2017, which has extended the number of mandatory vaccinations, for school attendance, from four to ten. The present study aims to evaluate accesses to the vaccination services of the Palermo Local Health Unit (LHU) and the variation of the vaccination coverage rates for hexavalent and measles, mumps, rubella and varicella (MMRV) vaccines, after the implementation of the law 119/2017. Methods: An extent of opening hours and an involvement of other health-care professionals in the vaccination services of the Palermo LHU have been adopted to manage the excess of accesses after the introduction of 119/2017 law and to limit the discomfort of general population. Vaccination accesses and coverage rates were calculated from the electronic immunization registers. Results: An overall increase of about 15% of single vaccination accesses was observed in the three semester after the introduction of the law in the LHU of Palermo. A peak of 35,516 accesses was observed during the second semester of 2017 (+ 30% compared to the same semesters of 2016 and 2018). From 2016 to 2018, coverage rates for full hexavalent cycle and first dose of MMRV, at 24 and 36 months, and for full MMRV cycle and fourth dose of diphtheria, tetanus, pertussis, poliomyelitis (DTPa+IPV), among 6 years old children, showed considerable increases. Conclusions: Law 199/2017 demonstrated a high efficacy in increase vaccination coverage rates also in Sicily. The synergy established between the LHU and the University of Palermo allowed an excellent management of the accesses to vaccination services, making it possible to respond to the public health needs of the general population