Antibiotic Use: A Cross-Sectional Survey Assessing the Knowledge, Attitudes and Practices amongst Students of a School of Medicine in Italy

<div><p>Background</p><p>Since antibiotic resistance has become a worldwide public health concern and is in part related to physicians’ lack of knowledge, it is essential to focus our attention on healthcare profession students. The present study aims at evaluating the knowledge and attitudes of the School of Medicine’s students towards antibiotic usage and antibiotic resistance.</p><p>Methods</p><p>In December 2013, a cross sectional study was conducted amongst medical, dental, nursing and other health care profession students of the School of Medicine at the University of Torino. Students of all the academic years took part in this study. Questionnaires were submitted during regular lectures (only students who attended courses on one specific day were surveyed) and the data collected was analyzed using StataMP11 statistical software.</p><p>Results</p><p>Overall, 1,050 students were interviewed. The response rate was 100%. Around 20% of the sample stated that antibiotics are appropriate for viral infections and 15% of the students that they stop taking those drugs when symptoms decrease. Results of the multivariate analyses showed that females were more likely than males to take antibiotics only when prescribed (OR 1.43, 95% CI 1.04–1.98). Interestingly, students with a relative working in a health-related field, as well as those who took at least one course of antibiotics in the last year, had a lower probability of taking those drugs only under prescription (OR = 0.69 95% CI: 0.49–0.97 and OR = 0.38 95% CI: 0.27–0.53, respectively).</p><p>Conclusion</p><p>The present paper shows how healthcare profession students do not practice what they know. Since those students will be a behavioral model for citizens and patients, it is important to generate more awareness around this issue throughout their studies. It would be advisable to introduce a specific course and training on antibiotics in the core curriculum of the School of Medicine.</p></div

Supplemental Material - The Impact of COVID-19 on Mental Health in Medical Students: A Cross-Sectional Survey Study in Italy

Supplementary Material for The Impact of COVID-19 on Mental Health in Medical Students: A Cross-Sectional Survey Study in Italy by Sara Carletto, Giuseppina Lo Moro, Vittoria Zuccaroli Lavista, Giovanna Soro, Roberta Siliquini, Fabrizio Bert, and Paolo Leombruni in Psychological Reports.</p

The switch between cataract surgical settings: Evidence from a time series analysis across 20 EU countries

<div><p>Objectives</p><p>To analyze trajectories of cataract surgery rates and to confirm the switch between inpatient cases and day surgery or outpatient cases.</p><p>Design</p><p>Pooled, cross-sectional, time series analysis.</p><p>Methods</p><p>Data on 20 European countries from 2004 to 2014 retrieved from the OECD.</p><p>Results</p><p>The number of cataract surgery cases per 100,000 population has increased since 2004 (<i>b</i> = 31.1, <i>p</i> < 0.001, 95% CI = 26.7, 35.6). A reversal of the inpatient cases and same-day cases was found: the first ones decreased (<i>b</i> = –14.7, <i>p</i> < 0.001, 95% CI = –17.7, –11.8) while day surgery and outpatient cases increased (<i>b</i> = 37.5, <i>p</i> < 0.001, 95% CI = 31.6, 43.4, and <i>b</i> = 8.3, <i>p</i> = 0.001, 95% CI = 3.6, 13.1, respectively). Since 2004, the ratio of day surgery and outpatient cases to inpatient cases has grown significantly (<i>b</i> = 3.3, <i>p</i> < 0.001, 95% CI = 2.5, 4.0), reaching a share of 31.7 in 2014. However, this slope of 3.3 was not constant and slowed over the years: from 4.5 per year during the first five years to 1.9 in the second five. No association was found between cataract surgery rate and two regressors: elderly people, and health care expenditure per capita.</p><p>Conclusion</p><p>EU countries have preserved cataract surgery, and this preservation is probably affected by the switch from inpatient to same-day surgery, thanks to the decrease in the cost and equivalent clinical outcomes. However, the slope of the switch slowed over time. Consequently, health care systems must support this process of change especially through reforms in financial and organizational fields.</p></div

Individuals over 64 years of age (%) in 20 EU countries, year 2004 to 2014.

<p><i>Abbreviations</i>: AUT, Austria; BEL, Belgium; CZE, Czech Republic; DEU, Germany; DNK, Denmark; ESP, Spain; EST, Estonia; FIN, Finland; FRA, France; GBR, United Kingdom; HUN, Hungary; IRL, Ireland; ITA, Italy; LUX, Luxembourg; NOR, Norway; POL, Poland; PRT, Portugal; SVK, Slovakia; SVN, Slovenia; SWE, Sweden.</p

Results of regression analysis.

<p>Results of regression analysis.</p

Ratio of day and outpatient cases to inpatient cases of cataract surgery in 20 EU countries, years 2004 to 2014.

<p>Ratio of day and outpatient cases to inpatient cases of cataract surgery in 20 EU countries, years 2004 to 2014.</p

Data_Sheet_1_Gut microbiota, behavior, and nutrition after type 1 diabetes diagnosis: A longitudinal study for supporting data in the metabolic control.pdf

IntroductionType 1 diabetes (T1D) risk involves genetic susceptibility but also epigenetics, environment, and behaviors. Appropriate metabolic control, especially quickly after the diagnosis, is crucial for the patient quality of life.MethodsThis study aimed to produce a quantitative comparison of the behavior, nutrition habits, and gut microbiota composition between the onset and the 1-year follow-up in 35 children with T1D.Results and discussionAt follow-up, with the metabolic control, many parameters improved significantly, with respect to the onset, such as glycated hemoglobin (−19%), body mass index (BMI), and also nutritional behaviors, such as normal calorie intake (+6%), carbohydrate intake (−12%), extra portion request (−4%), and meals distribution during the day. Moreover, glycated hemoglobin decrement correlated with both total and rapid absorption carbohydrate intake (Spearman's rho = 0.288, 95% CI 0.066–0.510, p = 0.013), showing as the nutritional behavior supported the insulin therapy efficiency. The next-generation sequencing (NGS) analysis of microbiota revealed abundance differences for Ruminococcus bromii and Prevotella copri (higher at onset, p < 0.001) and the genera Succinivibrio and Faecalibacterium (lower at onset, p < 0.001), as a consequence of nutritional behavior, but it was not the only changing driver. The qRT-PCR analysis showed significant variations, in particular for Bacteroidetes and Bifidobacterium spp. (+1.56 log gene copies/g stool at follow-up, p < 0.001). During the year, in 11% of the patients, severe clinical episodes occurred (hypoglycemic or ketoacidosis). The likelihood of a severe hypoglycemic episode was modulated when the Methanobrevibacter smithii amount increased (odds ratio 3.7, 95% CI 1.2–11.4, p = 0.026). Integrated evaluation, including nutritional behavior and microbiota composition, could be considered predictive of the metabolic control management for children cohort with a recent diagnosis of T1D.</p

The receiver operating characteristic curve of the Mediterranean diet score.

<p>The receiver operating characteristic curve of the Mediterranean diet score.</p

Results of multivariate analysis (outcome variable = case of AMI).

<p>Results of multivariate analysis (outcome variable = case of AMI).</p

Characteristics of cases and controls.

<p>Characteristics of cases and controls.</p