Genital and Oral HPV Geno-Prevalence Measured through Urine and Saliva Samples in Young Adults in Italy.

BACKGROUND: The aims of the study were to determine, in the urine and oral samples of young adults, the genotype-specific prevalence of Human Papilloma Virus (HPV) infection, the HPV DNA type-specific prevalence in unvaccinated and vaccinated individuals, and the determinants of HPV infection. METHODS: Selected participants were asked to fill in a self-administered questionnaire and to self-collect urine and saliva samples. RESULTS: Among the 1002 participants, 81 (8.1%) resulted positive for HPV DNA. The most common low-risk genotype was HPV 42 (2.2%), followed by HPV 43 (0.8%), and 40 (0.5%). The HPV 51 was the most common high-risk genotype (1.5%) followed by HPV 66 (1%) and HPV 68 (1%), and no participants were infected with HPV genotypes 18, 33, 45. Females, those who have had one or more occasional sexual partner, those who never/rarely/sometimes used condoms during their sexual activity, those with a previous diagnosis of sexually transmitted infection, and those who were not vaccinated were more likely to be tested positive for HPV infection. CONCLUSIONS: The low prevalence of genital HPV infections has provided evidence of the effectiveness of HPV vaccination both in vaccinated and not yet vaccinated subjects through herd immunity and indicated its decisive role in the changing epidemiology of circulating HPV genotypes in the population.

Evaluating Knowledge, Attitudes, and Behaviors toward HPV Infection and Vaccination among University Students in Italy.

BACKGROUND: This survey investigated the knowledge, attitudes, and behaviors towards HPV preventive measures among university students in Italy and their associated factors. METHODS: The cross-sectional survey was conducted between November 2022 and April 2023. RESULTS: Only 41.7% knew about HPV infection and the main preventive measures. Multilevel mixed-effects logistic regression analysis showed that females, those aged 25-30 years, those who have had oral sex, those who had received information about HPV infection and preventive measures from physicians, and those who needed additional information about HPV infection and preventive measures were more knowledgeable. Only 39.1% have received at least one HPV vaccination dose, whereas 29.2% and 31.7% had not been vaccinated or did not remember. Multilevel mixed-effects logistic regression analysis identified that female students enrolled in the field of health sciences, those who did not report a prior history of a sexually transmitted infection, and those with a higher knowledge about HPV infection and preventive measures were more willing to receive the HPV vaccination. CONCLUSIONS: Despite some limitations, this was the first detailed survey on this topic conducted in the post-acute phase of COVID-19 among university students in Italy. The survey underlined the need to develop and to implement comprehensive educational programs and health interventions among students, to enhance their knowledge and modify their attitudes and improve the HPV vaccine uptake.

The quality of sleep: evaluation among university students.

Introduction: This study explored the quality of sleep among university students in the South of Italy during the Covid-19 pandemic. Methods: A cross-sectional study was conducted between March 2022 and January 2023 and involved students over the age of 18, who were invited to complete a self-administered questionnaire using an online application. Results: Overall, 88% of men and 94.5% of women had Pittsburgh Sleep Quality Index (PSQI) scores of ≥5 and a mean PSQI score of 9.2 ± 3. Students with severe or extremely depression score, with sever or extremely stress score, male and who did not had Covid-19 infection were more likely to have a PSQI global score. Moreover, 62.6% of the students declared a reduction in social relations and 72.3% an increase in the use of social media during the pandemic period. The majority of respondents reported an extremely severe level of depression (68.1%), anxiety (84.4%) and stress (71.9%). Conclusion: This finding indicate that a relevant percentage of students are poor sleepers with a higher overall PSQI score with depression and stress and underline the role the implementation of public health interventions to promote healthy life styles and in particular focus on the duration of long night sleep.

Vaccinations Status against Vaccine-Preventable Diseases and Willingness to Be Vaccinated in an Italian Sample of Frail Subjects.

BACKGROUND: Study aim was to investigate the vaccination status against vaccine-preventable diseases (VPD) of frail adults during the SARS-CoV-2 pandemic and, for those subjects eligible for at least one vaccine, with respect to the recommended vaccination in line with the Italian National Vaccination Prevention Plane (NPVP), to explore the willingness to be vaccinated. METHODS: A cross-sectional study was carried out among adults aged ≥ 60, immunocompromised or subjects affected by chronic conditions. RESULTS: Among the 427 participants, a vaccination coverage rate lower than the targets for all the vaccines considered was found. Of those, 72.6% of subjects stated their willingness to receive recommended vaccinations, and 75.2% of the respondents stated that the advice to undergo vaccinations was received by the General Practitioner (GP). In a multivariable logistic regression model, higher odds of recommended VPD vaccination uptake (defined as having two or more of the recommended vaccinations) were associated with the willingness towards recommended VPD vaccination (Odds Ratio = 3.55, 95% Confidence Interval: 1.39 to 9.07), university education (OR = 2.03, 95% CI: 1.03 to 3.97), but having another person in the household (OR = 0.52, 95% CI: 0.28 to 0.97), and history of oncological disease (OR = 0.39, 95% CI: 0.18 to 0.87) were predictive of lower odds of vaccination uptake. In another multivariable model, higher odds of willingness to receive vaccines were associated with kidney disease (OR = 3.3, 95% CI: 1.01 to 10.5), perceived risk of VPD (OR = 1.9, 95% CI: 1.02 to 3.3), previous influenza vaccination (OR = 3.4, 95% CI: 1.8 to 6.5), and previous pneumococcal vaccination (OR = 3.1, 95% CI: 1.3 to 7.7), but increasing age (OR = 0.93 per year, 95% CI: 0.91 to 0.97), working (OR = 0.40, 95% CI: 0.20 to 0.78), and fear of vaccine side effects (OR = 0.38, 95% CI: 0.21 to 0.68) were predictive of lower odds of willingness to receive vaccines. CONCLUSIONS: Despite specific recommendations, vaccination coverage rates are far below international targets for frail subjects. Reducing missed opportunities for vaccination could be a useful strategy to increase vaccination coverage in frail patients during the routine checks performed by GPs and specialists.

Understanding Individual Barriers to HIV Testing Among Undergraduate University Students: Results From a Cross-Sectional Study in Italy.

Background: In Europe during 2019, just over half of those with HIV were diagnosed at a late stage of infection. Even though HIV testing is crucial for all strategies related to care, prevention and treatment of HIV/AIDS, we hypothesized that it is less practiced among university students, and, therefore, this study aimed to assess the uptake and factors associated with HIV testing in southern part of Italy. Methods: A cross-sectional study was conducted from 1st to 31st July 2020 among undergraduate university students aged 18-29 years. Data were collected through an anonymous online questionnaire and included questions on socio-demographic and sexual history characteristics, knowledge and attitudes toward HIV infection, sexual and testing behaviors, and sources of information about HIV. Findings: Among 1007 students, 41.5 and 54.7% knew that in Italy the test for early detection of HIV infection has not to be prescribed by a physician and that it is provided to anyone free of charge, respectively. Only 16.2% of the eligible students reported having ever tested for HIV and a very similar proportion (17.8%) was displayed among those who reported risky sexual behaviors. The multiple logistic regression analysis results indicated that the strongest predictor of HIV testing was attending medical or life sciences majors. Interpretation: The uptake of HIV testing was low among Italian university students. Effective strategies to increase HIV testing and diagnoses have to aim at overarching individual barriers, such as lack of knowledge about information around the test itself. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Endodontic Infections and the Extent of Antibiotic Overprescription among Italian Dental Practitioners.

The objectives of this study were to evaluate the pattern of antibiotic prescription for endodontic infections (EIs) among Italian dental practitioners (DPs) and to explore the role of potential predictors of antibiotic overprescription. A nationwide cross-sectional survey was conducted between 1 April and 30 October 2019 using a structured questionnaire. Information was gathered on demographics, professional characteristics, and practices regarding antibiotic prescription for both therapeutic and prophylactic purposes. Of the 1,250 invited DPs, 563 answered the general questionnaire (response rate of 52.6%). The proportions of DPs who prescribed an antibiotic without indication for therapeutic and prophylactic purposes were 33.3% and 30.2%, respectively. Acute alveolar abscess without systemic involvement represents the clinical scenario at a high risk of overprescription for therapeutic purposes. Possible predictors of overprescribing included demographics and professional characteristics. Moreover, overprescribing was found to be higher for EIs without an indication than for the cases in which the prescription is indicated for therapeutic purposes. The odds of overprescription for prophylactic purposes were higher for cases of acute apical periodontitis and lower for cases of symptomatic irreversible pulpitis than for acute and chronic alveolar abscesses, for which prescription is indicated. The main findings of the present study provide up-to-date insight into the pattern of antibiotic prescriptions for EIs and evidence useful to identify opportunities to reduce overprescription among DPs through tailored interventions. The development of practical antibiotic prescribing guidelines with a clear description of indications and regimen ease of use is strongly needed.

Vaccination coverage among health-care workers: pre-post intervention study to assess impact of an on-site vaccination-dedicated clinic.

BACKGROUND: Several studies have revealed low vaccinations coverage among health-care workers (HCWs) for all vaccinations. The aim of our study was to evaluate the impact of the implementation of an on-site vaccination-dedicated clinic on the vaccination coverage rates of HCWs. RESEARCH DESIGN AND METHODS: A quasi-experimental pre-post intervention study was carried out among undergraduate and postgraduate students attending medical and health-care professions schools. RESULTS: We enrolled 804 students, 404 in the control and 400 in the experimental group. A significantly higher increase of vaccination coverage in the experimental group than in the control group for all the investigated vaccinations (p < 0.001) was found. The odds of adherence to vaccinations in the experimental group, compared to the control group, ranged from 6.9-fold (95% CI 3.51-13.44) to 18.9-fold (95% CI 10.85-32.96). The increase in the coverage rate in the control group was between 2.5% and 3.5%, whereas in the experimental group, higher increases were found, ranging from 34.8% to 71%. CONCLUSIONS: The extraordinary increase in the adherence to HCWs recommended vaccinations found in the study seems to indicate a significant role of enabling factors in the complex process of decision-making and implementation of health-related behaviors.

Obesity, Blood Pressure, and Intraocular Pressure: A Cross-Sectional Study in Italian Children.

INTRODUCTION: Several studies in the adult population have shown that obesity is an independent risk factor for elevated intraocular pressure (IOP), whereas data in the paediatric population are sparse and controversial. The purpose of the present study is to investigate the relationship between body mass index (BMI), blood pressure (BP), and IOP in healthy school children. METHODS: The survey was conducted among a random sample of 8-year-old Italian students. Data were collected on their health status and behaviours related to obesity (physical activity, food and drinking habits, etc.). Physical examinations, conducted at school, included measurements of height, weight, BP, and IOP. RESULTS: Five hundred and seventy-six subjects were recruited (92.8% response rate); 42.4% were overweight or obese, 58.9% consumed inadequate daily servings of fruit and vegetables, and 87.5% were involved in sedentary activities. Elevated BP/hypertension (HTN) affected 3.6% and high IOP was revealed in 12.5% of the children. In the multivariate analysis, elevated BP/HTN was the only significant determinant of ocular HTN (OR 5.36, 95% CI 1.95-14.73, p = 0.001). CONCLUSIONS: Our results show that high IOP affects 12.5% of 8-year-old school children and appears to be associated with high BP related to a high BMI.

Oral Health Status and the Impact on Oral Health-Related Quality of Life among the Institutionalized Elderly Population: A Cross-Sectional Study in an Area of Southern Italy.

Background: The objectives of this study were to describe the oral health status in the institutionalized geriatric population in an area of southern Italy and to identify the impact of oral health on the Oral Health Related Quality of Life (OHRQoL). Methods: Data were collected from individuals aged ≥60 years in randomly selected Calabrian long-term care facilities. The dental health status was assessed recording the decayed, missing, or filled dental elements due to the carious lesions (DMFT) index, the presence of visible dental plaque, and the gingival condition. The influence of the dental health status on the self-perceived value of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Results: Among the 344 elderly individuals included, 18.4% reported frequent tooth-brushing, and only 39.9% reported the need of dental care. The DMFT index was 26.4. Less than a third of the participants had a GOHAI score of ≤50 which is suggestive of highly compromised OHRQoL. The GOHAI score was significantly better for elderly individuals with no self-perceived need of dental care and with a lower DMFT index. Conclusions: The burden of oral conditions among residents in long-term care facilities was considerable, with a high prevalence of missing teeth and dentures. Strategies targeting care providers are needed.

Chemical risk and safety awareness, perception, and practices among research laboratories workers in Italy.

INTRODUCTION: Exposure to chemical compounds occurs in numerous occupational settings, among which the research and healthcare laboratories have not been adequately investigated. These settings are characterized by an extreme variability of the used compounds and by the frequent turnover of young researchers. The main objectives of the study were to explore the occupational exposure to hazardous chemical substances among research laboratory workers; to assess their awareness and perceptions regarding chemical hazards; to investigate adherence to guidelines on safe handling of chemical compounds; and to analyze the effects of several factors on these outcomes of interest. METHODS: The survey was conducted among research laboratories workers who were exposed to chemical substances during their activity. Subjects completed a questionnaire exploring knowledge, attitudes and behaviors related to chemical hazards involved in research activities. RESULTS: Enrolled subjects were 237, for an 81.7% response rate. More than 90 hazardous chemical substances were used in the surveyed laboratories. A correct knowledge on hazardous chemicals was significantly more likely in younger researchers, in those manipulating a higher number of hazardous chemicals, and in those with a higher number of years of training in the attended laboratory; 54.4% of the workers said they felt very exposed to chemical risk. Correct practices in the laboratories were significantly more likely in researchers who perceived to have a low exposure to chemicals, but a high exposure to biological risk, who agreed with the statement that colleagues handle chemicals following safety procedures and who perceived to have received an adequate training in the management of accidents and first aid. CONCLUSIONS: Our results showed significant gaps in knowledge and scarce preparedness in the adherence to safety processes to prevent and contain risks related to use of chemical compounds in research laboratories.

Preventable pediatric hospitalizations and access to primary health care in Italy.

The aim of this study was to quantify the burden of avoidable pediatric hospital admissions for Ambulatory care-sensitive conditions (ACSC) and to identify factors related to these preventable hospitalizations. The study was conducted by retrospectively reviewing all medical records of children admitted in a non-teaching 474-bed acute care hospital located in Catanzaro (Italy) for an avoidable hospitalization diagnosis. Two control clinical records involving children hospitalized for clinical conditions not classified as ACSC were randomly selected for each clinical record that included an ACSC. Among the 4293 pediatric hospitalizations, 451 (10.5%) were judged to be preventable. Of these, the most frequent discharge diagnoses were: dehydration (29.7%), pneumonia (17.7%), seizures (15.7%) and chronic obstructive pulmonary disease (12.9%).Children admitted for a preventable hospitalization were more likely to be females, to be younger, to be residents in the same province as the hospital and less likely to have had at least one Community-Based Pediatrician (CBP) access in the previous year and to have used the district health service. The burden of pediatric preventable hospitalizations found in this study is quite high, and the results show that there is still work that lies ahead on the way to improve interaction between hospital and community-based services.

Prevalence of Staphylococcus aureus carriage and pattern of antibiotic resistance, including methicillin resistance, among contact sport athletes in Italy.

Background and purpose: Athletes participating in contact or collision sports have a great chance of acquiring Staphylococcus aureus infections. The risk factors for colonization and infections include frequent antibiotic use, close contact situations, skin trauma, sharing of sports equipment, and poor hygiene. Therefore, our specific goals were to determine (1) prevalence of S. aureus among different types of contact sport athletes which were barely studied in the European region, (2) antimicrobial resistance of S. aureus isolates, and (3) association of carriage with particular risk factors of spor t practices. Patients and methods: A cross-sectional study was conducted among contact or collision sport athletes in Italy. A questionnaire was used to gather information about sociodemographic characteristics, specific sport activities, and participants' health conditions. Swabs were collected from the nares, oropharynx, and fingers and tested for S. aureus isolation and antimicrobial susceptibility. Results: S. aureus was carried by 42% of 238 enrolled athletes. Colonization was associated with number of weekly training days, sharing of sports equipment, not taking a shower immediately after training, and a previous history of pharyngitis or sinusitis and skin manifestations. Isolates were resistant to clindamycin (24.8%) and erythromycin (15.8%). Of all athletes, 1.3% carried methicillin-resistant S. aureus (MRSA); MRSA were 3% of all S. aureus isolates. No strains were resistant to sulfamethoxazole/trimethoprim. Conclusion: Our results have shown a high prevalence of S. aureus carriage and a relevant resistance to antimicrobials used for the treatment of S. aureus infections. Prevention efforts aimed at reducing S. aureus colonization, and thus potentially reducing infections, should be improved.

Prevalence of Livestock-Associated Methicillin-Resistant Staphylococcus Aureus (LA-MRSA) Among Farm and Slaughterhouse Workers in Italy.

OBJECTIVE: We measured the prevalence of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in swine livestock workers, examined LA-MRSA resistance profile, and associated carriage with the working activities. METHODS: Information was collected on demographics and occupational history. Swabs were collected and tested for the isolation of S. aureus, examined for antimicrobial susceptibility, and all MRSA underwent ST398qPCR assay. RESULTS: LA-MRSA was isolated in 7.3% of the 396 enrolled workers. LA-MRSA colonization was more likely in farmers than in slaughterhouse workers (Fisher exact P = 0.001). Carriage was associated with herd size, being less frequent in small/medium farms (odds ratio = 0.20; 95% confidence interval = 0.07 to 0.53), and with the number of working days per week (OR = 2.11; 95% confidence interval = 1.07 to 4.19). CONCLUSIONS: LA-MRSA carriage is strongly animal-exposure related, and educational intervention informing about the risks related to the activity with livestock is needed.

Prevalence and determinants of oral impacts on daily performance: results from a survey among school children in Italy.

BACKGROUND: The use of health status measures to assess health-related quality of life is not widespread. The objectives of this study were to assess the prevalence, characteristics and severity of oral impacts on health using the Child-Oral Impact on Daily Performance (Child-OIDP). METHODS: The survey was conducted on 11-16 years old randomly selected students in Catanzaro. Data were collected through a self-administered questionnaire, an interview for the calculation of Child-OIDP and the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and an oral examination. RESULTS: Only 5.5% out of 530 children did not report any dental problem in the previous 3 months and 66.8% had experienced dental impacts according to the Child-OIDP. Sex, fruit intake frequency, mouthwash habits and IOTN AC score assessed by dentist were significant risk factors for dental impacts. CONCLUSION: Our findings suggest that the measurement of Oral Health-Related Quality of Life (OHRQoL) should be an essential component of oral health surveys.

Guidelines for venous thromboembolism and clinical practice in Italy: a nationwide survey.

Venous thromboembolism (VTE) is a common health problem for today's society, and considering the role that it plays in surgical patients (general surgery, gynecology, and orthopedics), new advances in our understanding of the procedures and trauma characteristics are relevant and necessary. The most important and recently published guidelines concerning this problem have been taken into consideration, leading to articulate investigations and data evaluation. This project has proposed a data-survey framework available as a questionnaire in order to investigate application of the guidelines for VTE throughout the national territory. Of the total 714 Italian centers, a random sample of 214 were contacted and asked to take part in this study; of these, 146 replied (20.4% of total and 68.2% of the sample): 48 departments of general surgery, 46 departments of gynecology, and 52 departments of orthopedics. About 70% of the centers has appropriate information about surgery as a risk factor for VTE. The answers have provided evidence of an adequate knowledge of the instrumental and laboratory diagnostic pathways, useful to confirm the diagnosis of TE (80%). Data waiting compared with morbidity and mortality rates related to deep vein thrombosis and pulmonary embolism showed an increase of mortality associated with the diagnostic data timing of supply, with an exponential trend linked to the data acquisition delay. Both risk stratification and adequate application of prophylaxis together with treatment devices represent a real tool to control morbidity and mortality for VTE. Moreover, diagnostic data waiting significantly influences adequate prophylaxis. In Italy, only 40% of the centers are ready to provide diagnostic data within 12 hr.