Health education intervention to improve vaccination knowledge and attitudes in a cohort of Obstetrics students.

Introduction. To improve the vaccination coverage in pregnant women it is important to increase their knowledge of vaccines and related preventable diseases. Midwifes can play an important role because they are often the first contact for woman during her pregnancy. This study aimed to explore the vaccination knowledge and attitudes in a cohort of Obstetrics students in Italy and improve their knowledge through an informative health education intervention. Methods. The study consisted in the administration of a first questionnaire followed by a health education intervention concerning all aspects of vaccinations. Then, a second questionnaire to evaluate the efficacy of the educational program was administered. Results. From the pre-intervention questionnaire resulted that almost the whole sample (97.1%) were favorable to vaccines in general. Moreover, 65.7% of the participants declared a sufficient level of vaccination knowledge but 62.9% found herself unprepared to answer questions and provide information about vaccinations. Concerning the answers about vaccination in pregnancy, the correct answers went from 17.1%, to 68.6% respectively before and after educational intervention. The training intervention obtained a total consensus (100%). The most part of the students (85.7%) declared that the received information changed some of their beliefs and the entire sample (100%) stated that it improved their preparation. Conclusions. Our results revealed some critical issues in the preparation of midwifes about vaccinations and confirm the necessity to carry out health intervention campaigns to these health professionals that, for the role they play, they must necessarily be well prepared

CAMPYLOBACTER: FROM MICROBIOLOGY TO PREVENTION

In last years, Campylobacter spp has become one of the most important foodborne pathogens even in high-income countries. Particularly, in Europe, Campylobacteriosis is, since 2005, the foodborne disease most frequently notified and the second in USA, preceded by the infection due to Salmonella spp. Campylobacter spp is a commensal microorganism of the gastrointestinal tract of many wild animals (birds such as ducks and gulls), farm animals (cattle and pigs) and companion animals (such as dogs and cats) and it is responsible for zoonoses. The transmission occurs via the fecal-oral route through ingestion of contaminated food and water. The disease varied from a watery diarrhea to a severe inflammatory diarrhea with abdominal pain and fever and can be burdened by some complications. The main recognized sequelae are Guillain-Barré Syndrome (GBS), the Reactive Arthritis (REA) and irritable bowel syndrome (IBS). Recently, many cases of Campylobacter spp isolated from human infections, showed an important resistance to various antibiotics such as tetracyclines and fluoroquinolones. For these reasons, the prevention of this infection plays an essential role. Many preventive measures exist to limit the transmission of the pathogens and the subsequent disease such as the health surveillance, the vaccination of the poultry and the correct food hygiene throughout the entire production chain. A global surveillance of Campylobacteriosis is desirable and should include data from all countries, including notifications of cases and the microbiological data typing of strains isolated from both human and animal cases

Interleukin‑6 signalling as a valuable cornerstone for molecular medicine (Review)

The biological abilities of interleukin‐6 (IL‐6) have been under investigation for nearly 40 years. IL‐6 works through an interaction with the complex peptide IL‐6 receptor (IL‐6R). IL‐6 is built with four α‐chain nanostructures, while two different chains, IL‐6Rα (gp80) and gp130/IL6β (gp130), are included in IL‐6R. The three‐dimensional shapes of the six chains composing the IL‐6/IL‐6R complex are the basis for the nanomolecular roles of IL‐6 signalling. Genes, pseu‐ dogenes and competitive endogenous RNAs of IL‐6 have been identified. In the present review, the roles played by miRNA in the post‐transcriptional regulation of IL‐6 expression are evaluated. mRNAs are absorbed via the ‘sponge’ effect to dynamically balance mRNA levels and this has been assessed with regard to IL‐6 transcription efficiency. According to current knowledge on molecular and nanomolecular structures involved in active IL‐6 signalling, two different IL‐6 models have been proposed. IL‐6 mainly has functions in inflamma‐ tory processes, as well as in cognitive activities. Furthermore, the abnormal production of IL‐6 has been found in patients with severe acute respiratory syndrome coronavirus 2 (SARS‐coV‐2; also known as cOVId‐19). In the present review, both inflammatory and cognitive IL‐6 models were analysed by evaluating the cytological and histological loca‐ tions of IL‐6 signalling. The goal of this review was to illustrate the roles of the classic and trans‐signalling IL‐6 pathways in endocrine glands such as the thyroid and in the central nervous system. Specifically, autoimmune thyroid diseases, disorders of cognitive processes and SARS‐coV‐2 virus infection have been examined to determine the contribution of IL‐6 to these disease states

Prevention of cardiovascular diseases and diabetes: importance of a screening program for the early detection of risk conditions in a target population

Introduction. Cardiovascular diseases and diabetes are one of the main causes of morbidity and mortality worldwide. In their genesis, an important role is played by some behavioral risk factors that may act inducing the onset of “intermediate risks factors” represented by hypertension, prediabetes, overweight and obesity. This study aimed to show the importance of the screening methodology to early detect these risk conditions in order to reduce the burden of cardiovascular diseases and diabetes complications. Methods. We carried out a screening program involving a cohort of people aged 45-60 in which risk factors for cardiovascular diseases and diabetes were evaluated. The subjects were then classified in four groups according to the risk conditions. Results. A high percentage (27.0%) of the sample resulted with some alteration in the detected anthropometric and/or clinical-laboratory parameters but unaware of this condition and, consequently, not under therapeutic treatment. Conclusions. The screening program allowed the early detection of hypertension and prediabetes or full-blown diabetes conditions in subjects that unknown their pathological condition, and consequently to proceed with adequate investigations and start healthy lifestyles/pharmacological therapies. Overall, the results highlight the need to anticipate these screening campaigns, especially in men, to increase the effectiveness of the prevention programs

Role of the 1st booster dose of COVID-19 vaccine in the protection against the infection: A fundamental public health tool

Introduction. The COVID-19 pandemic is having a huge impact on human health with high morbidity and mortality rates worldwide. Healthcare Workers (HCWs) are one of the most at risk categories to contract the infection. Effective anti-COVID-19 vaccines were approved in a very short time. Making the 1st booster dose is essential to induce a good protection against the infection. Methods. We conducted a retrospective sero-epidemiological survey of already existing data concerning the antibody response of a HCWs sample vaccinated with the primary cycle and the 1st booster dose of the Pfizer-BioNTech COVID-19 mRNA vaccine and, specifically, after three weeks from the third dose of vaccination. Results. In our analysis, after the primary cycle, a 95.15% efficacy was detected. Among the non-responders, women were significantly more frequent (69.56%). Moreover, we found a significant reverse correlation between the immune response and the age of the sample, especially in women. However, the 1st booster dose completely cancelled these differences. Conclusions. Our data are perfectly in line with what has been declared by the conducted studies in terms of efficacy. However, it is important to highlight that people with only the primary cycle are at high risk to contract the COVID-19 infection. Therefore, it is necessary to not consider people vaccinated with the primary cycle completely risk-free and to stress the importance to perform the 1st booster dose

RISK FACTORS FOR VOLUNTARY INTERRUPTION OF PREGNANCY AND POSSIBLE PREVENTIVE PUBLIC HEALTH ACTIONS

Introduction. Voluntary interruption of pregnancy (VIP) is one of the most frequent healthcare procedures in the world and a Public Health concern in many countries, especially after liberalization of the abortion laws. The study has been carried out to identify the factors that still influence a fraction of female population towards abortion in the absence of fetal malformations.Methods. We conducted a cross-sectional study in the period 2012-2016. The survey was carried out on all VIPs performed at the Gynecology and Obstetrics Unit of the University Hospital "G. Martino" in Messina, Italy. Results. The analyzed sample consisted of 1131 women, aged between 16 and 50 years. Only 4% of VIPs was due to a diagnosis of fetal malformation. In relation to the presence or absence of fetal malformations as the possible reason for VIP, the sample was split up into two groups and the socio-demographic characteristics were considered. VIPs in the absence of malformations were significantly more frequent in younger women with a lower educational level, in unmarried and unemployed women and in women who already had children. Multivariate analysis, including as covariates education level, marital status, profession, number of children, number of previous abortions and nationality, indicated that the variables mainly related to using VIP in the absence of malformations were marital status, age and number of sons.Conclusions. Based on our results, it is crucial to further prevent requests for VIPs through information and sex education programs for adolescents in schools and consultants, and responsible procreation promotion programs

FIVE-YEAR MICROBIOLOGICAL MONITORING OF WARDS AND OPERATING THEATRES IN SOUTHERN ITALY

INTRODUCTION. Nosocomial infections are one of the greatest problems in public health. Several studies have highlighted the role played by the hospital environment as a possible source of transmission of nosocomial pathogens.METHODS. A five-year monitoring of bacterial contamination on healthcare workers hands, surfaces most closely in contact with inpatient wards, operating theatres and “at rest” and “in use” operating theatre air samples. For the samples, we used sterile swabs, contact slides, manual API, and automated VITEK systems for identification.RESULTS. In the five-year period, a total of 9396 samples were collected and analysed. In ward patients, 4398 samplings were carried out with 4.7%, 9.4%, 7%, 10.8% and 7.9% positive results respectively from 2010 to 2014. For hands, 648 samplings were carried out, with a positivity of 40.74%. In operating theatres, 4188 samples were taken, with a positivity of 11.9%. Regarding air in empty and full theatres, 1962 samplings were carried out with a positivity rate equal to 31.9%. The monitoring showed a low rate of contamination with a progressive decrease in the five-year period on operating theatres surfaces and hands, while there was an increase in the surgical site wards and in the air of operating rooms.CONCLUSIONS. Our investigation has revealed the presence of pathogens on the assessed surfaces and the need for environmental monitoring, which can be a valuable tool for reducing contamination

MEASLES OUTBREAK FROM FEBRUARY TO AUGUST 2017 IN MESSINA, ITALY

AbstractIntroduction. Measles continues to be a major public health issue worldwide, with high morbidity and mortality rates. The disease remains endemic in 14 European countries, including Italy where, from 2013 to 2016, over 5,000 cases have been reported. In 2017, many Italian regions, including Sicily, have reported many cases of measles. In this study, we described the latest measles outbreak in the city of Messina, from 1st February to 31st August 2017.Methods. We considered all reported measles cases that came to the “Public Health, Epidemiology and Preventive Medicine” Operative Unit of the Messina Provincial Health Agency Prevention Department, which receives all reported cases of measles in the Messina province.Results. From 1st February to 31st August 2017, a total of 59 measles cases were reported, of which 44 were confirmed, nine were classified as possible, four were probable and two cases were discarded. Of the 57 possible, probable and confirmed cases, 31 (54%) were males and 26 (46%) were females. Moreover, 54 (95%) had not been previously vaccinated while the remaining cases had documented evidence of one (two cases) or two doses (one case). Genotype B3 was identified in 39 cases (68%) by the regional reference laboratory in Palermo.Conclusion. Despite the development of an effective vaccination, unfortunately measles continues to threaten the lives of millions of children worldwide each year. The suboptimal immunisation level in Italy has led to an increase in the transmission of measles with detrimental effects on both public health and ongoing measles elimination efforts

Humidifiers for oxygen therapy: what risk for reusable and disposable devices?

INTRODUCTION. Nosocomial pneumonia accounts for the vast majority of hospital-acquired infections. Although numerous medical devices have been discussed to be potential vehicles of microorganisms, very little is known about the role played by oxygen humidifiers as potential sources of nosocomial pathogens. The purpose of this research was to analyze the rate of microbial contamination of reusable and disposable oxygen humidifiers used during therapy, and, thus, to speculate their potential role in the transmission of respiratory pathogens.METHODS. Water samples from reusable and disposable oxygen humidifiers were gathered from different wards where nosocomial pneumonia has a higher incidence rate due to “critical” clinical conditions of inpatients. The samples were collected always after a period of 5 days from initial use for both the types of humidifiers. Samples were processed using standard bacteriological techniques and microbial colonies were identified using manual and automated methods.RESULTS. High rates of microbial contamination were observed in samples from reusable oxygen humidifier employed in medical (83%), surgical (77%) and emergency (50%) areas. The most relevant pathogens were Pseudomonas aeruginosa, amongst Gram-negative bacteria, and Staphylococcus aureus, amongst Gram-positive bacteria. Other pathogens were detected in lower percentage. Disposable oxygen humidifier samples showed no contamination.CONCLUSIONS. This research presents evidence of the high rate and type of microbial contamination of reusable humidifiers employed for oxygen therapy. These devices might thus be involved in the transmission of potential pathogens. For the purpose of preventing nosocomial pneumonia, it is advisable to substitute reusable oxygen humidifiers with safer disposable ones

Vaccine hesitancy: An overview on parents' opinions about vaccination and possible reasons of vaccine refusal

Background. Vaccine hesitancy has increased worldwide with a subsequent decreasing of vaccination rates and outbreaks of vaccine-preventable diseases (i.e. measles, poliomyelitis and pertussis) in several developed countries, including Italy. Design and Methods. We conducted a survey to investigate the attitudes of a parents’ sample about vaccinations by the distribution of questionnaires in six lower secondary schools of the Italian city of Messina. Results. Regarding vaccinations carried out on children, the declared vaccination coverage rates ranged widely between good coverage percentages for some vaccinations (Measles-Mumps-Rubella, Diphtheria-Tetanus-Pertussis), and very low coverage rates for others, especially for “new” vaccinations (HPV, meningococcal, pneumococcal). The vaccinations carried out correlated negatively with both parents’ age and their level of education. Moreover, a favourable parents’ opinion was strongly influenced by a favourable opinion of the physician, while an unfavourable parents’ opinion seemed conditioned by a direct or indirect knowledge of people harmed by vaccines. In addition, our data show that parents do not often know or partially know the real composition of the vaccines and the diseases prevented by vaccinations. Conclusions. Data analysis shows that parents are, theoretically, favourable towards vaccinations but have little knowledge of such practices, sometimes not being unaware of the types of vaccines administrated to their children. Health education and communication of correct information are certainly the cornerstones to improve the situation and to fight the widespread and non-grounded fears about vaccines