Knowledge, attitudes and practices towards patients with HIV/AIDS in staff nurses in one university hospital in Sicily

Background: nurses’ knowledge, attitudes and practices towards patients with HIV/AIDS are of ongoing interest, especially in developing countries. Nothing or very little is known about Italian nurses. Methods: HIV/AIDS knowledge, attitudes and behaviours of the nurses (n=107) from one university hospital inCatania,Sicily, were documented. Comparisons among nurses belonging to different Operative Units (O.U.) were conducted by the chi-square test (P<0.05). Results: although HIV was nurses’ main concern in regard to contracting infections in the workplace (54%), the vast majority of them (98%) had never refused an HIV/AIDS patient care assignment. Moreover, despite their concern of being more at risk of contracting HIV than the general population (41%), a not negligible percentage of nurses did not use gloves routinely (21%) and only a few treated all patients as potentially HIV-positive (9%). The vast majority of the respondents knew the meaning of AIDS (87%) and of a positive serological test (78%). On the contrary, a relatively low percentage of them knew what is the ‘window period’ (62%) and were acquainted with HIV pathophysiology (65%). No statistically significant differences in terms of risk perception were found between nurses who had previously attended an HIV/AIDS workshop, lecture or specific course (43%) and nurses who did not (57%). Level of knowledge was positively associated to age (P=0.000) and to education (P=0.016), and it was found higher in nurses working in a O.U. of Infectious Diseases. Conclusions: data from our study show that also in developed countries, such as Italy, nurses could have some misconceptions and concerns about HIV/AIDS. The importance of examining the impact of continuing education on nurses’ preparedness to care for patients with HIV/AIDS and to prevent the risks of occupational HIV transmission is discussed.&nbsp

Persistent oral and urinary Candida spp. carriagein Italian HIV-seropositive asymptomatic subjects

The aim of the present study was to ascertain frequency and persistence of Candida spp. oral and urinary carriage in asymptomatic, HAART-naive HIV-seropositive subjects who had not undergone therapy with antimycotic drugs, and whose CD4+ lymphocyte count was greater than 200/?l. Oral carriage was the most common Candida spp. carriage (63.0% of the subjects), while candiduria was more rarely observed (6.5%). C. albicans was recovered from the majority of the subjects examined (56.5%), followed by C. krusey (4.3%), C. tropicalis (2.2%) and C. dubliniensis (2.2%). C. albicans was also isolated from two urinary carriers (4.3%) and C. glabrata from another one (2.2%). The same C. albicans clone was repeatedly isolated from 14 out of 15 oral carriers while the same clone of C. dubliniensis was repeatedly isolated from one carrier, as shown by the persistence of RAPD fingerprint of serial isolates during one year of follow-up. Since persistence of Candida spp. carriage may influence the development of clinical candidiasis in immunocompromised hosts, monitoring of the carrier status could be useful for preventing clinical thrush in HIV-seropositive subjects

Healthcare-associated Clostridium difficile infection: role of correct hand hygiene in cross-infection control

Introduction - Clostridium difficile (CD) is the most common cause of health-care-associated infectious diarrhea and incidence and severity have increased in recent years. The main cause of hospital’s acquired cross infections can be attributed to incorrect hand hygiene. We described the epidemiology of CD infection (CDI) in a teaching hospital in Southern Italy during a two years surveillance period and evaluated the health-care workers compliance to hand hygiene.Methods - CDI Incidence rates were calculated as the number of patients with positive C. difficile toxin assay per 10,000 patient-days. Compliance with hand hygiene was the ratio of the number of performed actions to the number of opportunities observed. Approximately 400 Hand Hygiene (HH) opportunities/year /ward were observed.We finally checked out if any correlation could be found.Results - From January 2015 to December 2016 a total number of 854 CD determinations were performed in patients with clinical symptoms of diarrhea. The search for toxins A and B was positive in 175 cases (21,2 %), confirming the diagnosis of CDI.Compliance to hand hygiene was significantly inversely associated with the number of CDIs: the lower the compliance of  health-care workers with hand hygiene the higher was the number of cases of CDIs (p=0.003).Conclusion - According to our results proper handwashing of health-care workers appears to be a key intervention in interrupting CD cross infections regardless of age and type of department in which the patient is admitted. 

Mediterranean diet and metabolic status in post-menopausal women living in a mediterranean area

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Antimicrobial potential of Sicilian honeys against commensal Escherichia coli and pathogenic Salmonella serovar Infantis

Introduction. The purpose of this study was to investigate the antibacterial effect of 71 locally produced honeys from different botanical sources collected from apiarist?s open markets in Sicily. Methods. Antimicrobial activity was determined against Escherichia coli (ATCC 25922) and Salmonella serovar Infantis (ATCC 1523) by an agar-diffusion assay from the estimation of the diameter of the inhibition zone produced by the honeys. Statisti- cally significant differences (P inf. .000) regarding inhibition were observed for the honeys tested. Results. The chestnut and polyfloral honey samples exhibited the largest and highest inhibition (diameter of the inhibition zone > 25 mm) against both E. coli and S. Infantis. The honey of oregano origin showed intermediate or low activity against E. coli and S. Infantis, respectively. Prickly pear and erica honeys showed no antimicrobial activity against the two reference strains. Discussion. The results may partially suggest the usefulness of the Sicilian honeys on treating multi-resistant enterobacteria. In light of the enormous potential for application of honey in the clinical practice, it is important that research continues not only into those honeys well recognized as antimicrobial, but also into other locally produced and yet untested honeys

Pregnancy-induced hypertension is an independent risk factor for meconium aspiration syndrome: A retrospective population based cohort study

Objective: Meconium aspiration syndrome (MAS), possibly resulting from fetal hypoxia, is a respiratory distress disorder in the infant. Pregnancy-induced hypertension (PIH) can cause placental dysfunction and lead to fetal hypoxia, which may induce the development of MAS. Therefore, the aim of this study was to determine the association between PIH and MAS and to identify the predictive risk factors. Materials and methods: This was a retrospective cohort study. We selected patients with newly diagnosed PIH and a matched cohort group from the Taiwan National Health Insurance Research Database (NHIRD), from January 1, 2000 till December 31, 2013. For each patient in the PIH cohort, 4 subjects without PIH, matched for age and year of delivery, were randomly selected as the comparison cohort. The incidence of meconium aspiration syndrome was assessed in both groups. Results: Among the 23.3 million individuals registered in the NHIRD, 29,013 patients with PIH and 116,052 matched controls were identified. Patients who experienced PIH had a higher incidence of MAS than did those without PIH. According to a multivariate analysis, PIH (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.49–1.93, p < 0.0001) was independently associated with increased risk of MAS. Additionally, age ≥30 years (OR = 1.26, 95% CI = 1.12–1.42, p = 0.0001), nulliparity (OR = 1.13, 95% CI = 1.01–1.27, p = 0.0367) and patients with diabetes mellitus (OR = 3.09, 95% CI = 1.35–7.09, p = 0.0078) were also independent risk factors of MAS. Conclusion: Patients with PIH obtained higher subsequent risk for the development of MAS than those without PIH. Besides, age ≥30 years, nulliparity and patients with diabetes mellitus are the independent risk factors of developing MAS. Keywords: Pregnancy-induced hypertension, Hypertension in pregnancy, Gestational hypertension, Preeclampsia, Meconium aspiration syndrom

Knowledge and beliefs on vaccines among a sample of Italian pregnant women: results from the NAVIDAD study

BACKGROUND: Vaccine hesitancy is an emerging phenomenon in European countries and leads to decreasing trends in infant vaccine coverage. The aim of this study was to analyze the level of confidence and correct awareness about immunizations, which are crucial for the success of vaccination programmes. METHODS: As part of the NAVIDAD multicentre study, we examined vaccination confidence and complacency among a sample of 1820 pregnant women from 14 Italian cities. The questionnaire assessed the interviewee's knowledge, beliefs and misconceptions, as well as their socioeconomic status, information sources about vaccines and confidence in the Italian National Healthcare Service. RESULTS: Only 9% of women completely believed to the efficacy, necessity and safety of vaccinations. Almost 20% of them had misconceptions on most of the themes. There was a significant difference in the level of knowledge considering educational level: women with a high educational level have less probability of obtaining a low knowledge score (odds ratio (OR) 0.43 [95% confidence interval (CI) 0.34-0.54]). The level of knowledge was also influenced by the sources of information: women who received information from their general practitioner (GP) and from institutional websites had a significantly lower chance of having misconceptions (OR 0.74 [95% CI 0.58-0.96]; OR 0.59 [95% CI 0.46-0.74]). Finally, the results underlined the influence of trust in healthcare professional information on the likelihood of having misconceptions (OR 0.49 [95% CI 0.27-0.89]). CONCLUSIONS: The data suggest the efficacy of GPs and institutional websites as a source of information to contrast misconceptions and underline the importance of confidence in the healthcare system to increase complacency and confidence in vaccines

Vaccination coverage in healthcare workers: a multicenter cross-sectional study in Italy

IntroductionIn recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among health workers, determining a reduction in vaccination coverage (VC). A study aimed at evaluating VC among healthcare workers (HCWs) in 10 Italian cities (L'Aquila, Genoa, Milan, Palermo, Sassari, Catanzaro, Ferrara, Catania, Naples, Messina) was performed.Materials and methodsAnnex 3 of the Presidential Decree n. 445 of 28 December 2000 was used to collect information on the vaccination status of HCWs. The mean and standard deviation (SD) were calculated with regard to the quantitative variable (age), while absolute and relative frequencies were obtained for categorical data (sex, professional profile, working sector, vaccination status). The connection between VC and the categorical variables was evaluated by chi-square method (statistical significance at p&lt;0.05). The statistical analyses were performed by SPSS and Stata software.ResultsA total of 3,454 HCWs participated in the project: 1,236 males and 2,218 females. The sample comprised: physicians (26.9%), trainee physicians (16.1%), nurses (17.2%) and other professional categories (9.8%). Low VC was generally recorded. Higher VC was found with regard to polio, hepatitis B, tetanus and diphtheria, while coverage was very low for measles, mumps, rubella, pertussis, chickenpox and influenza (20-30%). ConclusionsThis study revealed low VC rates among HCWs for all the vaccinations. Measures to increase VC are therefore necessary in order to prevent HCWs from becoming a source of transmission of infections with high morbidity and/or mortality both within hospitals and outside

A Knowledge, Attitude, and Perception Study on Flu and COVID-19 Vaccination during the COVID-19 Pandemic: Multicentric Italian Survey Insights

In January 2020, Chinese health authorities identified a novel coronavirus strain never before isolated in humans. It quickly spread across the world, and was eventually declared a pandemic, leading to about 310 million confirmed cases and to 5,497,113 deaths (data as of 11 January 2022). Influenza viruses affect millions of people during cold seasons, with high impacts, in terms of mortality and morbidity. Patients with comorbidities are at a higher risk of acquiring severe problems due to COVID-19 and the flu-infections that could impact their underlying clinical conditions. In the present study, knowledge, attitudes, and opinions of the general population regarding COVID-19 and influenza immunization were evaluated. A multicenter, web-based, cross-sectional study was conducted between 10 February and 12 July 2020, during the first wave of SARS-CoV-2 infections among the general population in Italy. A sample of 4116 questionnaires was collected at the end of the study period. Overall, 17.5% of respondents stated that it was unlikely that they would accept a future COVID-19 vaccine (n = 720). Reasons behind vaccine refusal/indecision were mainly a lack of trust in the vaccine (41.1%), the fear of side effects (23.4%), or a lack of perception of susceptibility to the disease (17.1%). More than 50% (53.8%; n = 2214) of the sample participants were willing to receive flu vaccinations in the forthcoming vaccination campaign, but only 28.2% of cases had received it at least once in the previous five seasons. A higher knowledge score about SARS-CoV-2/COVID-19 and at least one flu vaccination during previous influenza seasons were significantly associated with the intention to be vaccinated against COVID-19 and influenza. The continuous study of factors, determining vaccination acceptance and hesitancy, is fundamental in the current context, in regard to improve vaccination confidence and adherence rates against vaccine preventable diseases

Adherence to a Mediterranean Dietary Pattern Is Associated with Higher Quality of Life in a Cohort of Italian Adults

Background: The observed rise in non-communicable diseases may be attributed to the ongoing changes of urban environment and society, as well as greater awareness of health-related issues and subsequent higher rates of diagnosis, which all contribute to the overall quality of life. The aim of the study was to test the association between adherence to the Mediterranean dietary pattern and self-reported quality of life in a cohort of Italian adults. Methods: The demographic and dietary characteristics of 2044 adults living in southern Italy were analyzed. Food frequency questionnaires (FFQs) and a Mediterranean diet adherence score were used to assess dietary intake. The Manchester Short Appraisal (MANSA) was used to assess self-rated quality of life. Multivariate logistic regression analyses were used to test the associations. Results: A significant linear trend of association was found for the overall quality of life and adherence to Mediterranean diet score. All of the components of the MANSA, with the exception of self-rated mental health, were individually associated with higher adherence to this dietary pattern. Conclusions: Adherence to a healthy dietary pattern is associated with the measures of better overall perceived quality of life