Measles vaccine in the school settings: a cross-sectional study about knowledge, personal beliefs, attitudes and practices of schoolteachers in northern Italy.

BACKGROUND: School teachers (STs) might have a crucial role in countering students' and parents' hesitancy towards immunization. Such role is associated with STs own knowledge, attitudes and practices (KAP) towards vaccines. In this cross-sectional study we assess measles vaccine KAP in a sample of Italian STs. METHODS: Between January 2012 and August 2015, 376 STs from the Lombardy region were enrolled in the study; data were retrieved on socio-demographic characteristics, KAP towards MeV, including immunization status. The association between knowledge, practices and a favorable attitude towards MeV was assessed calculating Odds Ratio (OR) and respective 95% confidence intervals (95% CIs) through multivariate regression analysis. RESULTS: 16.7% of STs in Italy know national recommendations on MeV and 16.0% were favorable to MeV and 12.8% of STs reported to have been vaccinated against MeV as adults and only 5.9% reported fears of MeV side effects (e.g. autisms). MeV propensity was associated with previous vaccination as adults (OR=5.222; 95% CI: 1.752-15.567), knowledge of national recommendations, and the understanding that MeV prevents natural infection and disease transmission (OR=2.274; 95% CI: 1.246-4.149, OR=14.061; 95% CI: 7.048-28.063, and OR=2.085; 95% CI: 1.125-3.864, respectively). CONCLUSIONS: The share of STs holding false beliefs and misconceptions towards MeV was lower than expected. STs might actively contribute to fight parents' vaccine hesitancy and such social role should be further acknowledged and promoted by policy makers and the wider public health community.

Maternal polyunsaturated fatty acid concentrations during pregnancy and childhood liver fat accumulation.

BACKGROUND & AIMS: Maternal polyunsaturated fatty acids (PUFA) concentrations in pregnancy are essential for fetal lipid metabolism and adipocyte differentiation. Whether suboptimal maternal gestational PUFA concentrations adversely affect offspring liver fat development is unknown. We aimed to examine the associations of maternal n-3 and n-6 PUFA concentrations in pregnancy with childhood liver fat accumulation. METHODS: In a population-based prospective cohort study among 2424 mother-child pairs, we measured maternal total and individual n-3 and n-6 PUFA plasma concentrations at mean gestational age of 20.6 ± 1.1 weeks. Childhood liver fat fraction was obtained by MRI at 10 years. Non-alcoholic fatty liver disease was a liver fat fraction ≥5.0%. RESULTS: We observed that 1-Standard deviation (SD) higher maternal n-3 PUFA concentrations, especially DHA, was associated with a lower childhood liver fat fraction [-0.07 SD-score (95% CI -0.11 to -0.02, p-value = 0.001) for both total n-3 PUFA and DHA concentrations]. Of n-6 PUFAs, 1-SD higher maternal dihomo-gamma-linolenic acid concentrations was associated with a higher childhood liver fat fraction [0.06 SD-score (95% CI 0.02-0.10, p-value = 0.004)]. Associations were not explained by maternal or childhood socio-demographic and lifestyle characteristics. Associations were stronger among boys and less consistent among girls. Among boys, higher maternal total n-3 PUFA concentrations were associated with a lower risk of childhood non-alcohol fatty liver disease [odds ratio 0.42 (95% CI 0.25-0.70, p-value = 0.001)]. CONCLUSIONS: Maternal lower n-3 PUFA and higher n-6 PUFA concentrations in pregnancy are associated with offspring liver fat accumulation in childhood. Optimizing maternal PUFA concentrations during pregnancy may be a target for preventing liver fat accumulation in their offspring.