Electronic Package Leaflets for Vaccines: What Are People's Perceptions in Italy?

In Italy, the paper package leaflet (PPL) is the official document that is approved by the Italian Medicines Agency (AIFA) for each medicine. PPLs of all medicines, including vaccines, are freely available online by accessing the AIFA website. To investigate people's attitudes toward possible access to the PPLs of vaccines and the acceptability of switching to an electronic package leaflet (e-leaflet) in the future, we surveyed three target groups (pregnant women, young parents, and older people) in Italy, via an online survey. We collected 321 questionnaires from the cohorts, which comprised 104 pregnant women, 105 young parents, and 112 older people. The results indicate in all target groups that health care professionals (HCPs) do not usually offer the vaccine PPL during the vaccination session: only about 10.7% of respondents receive the PPL without asking for it, with pregnant women receiving it the most frequently. The acceptance rate for switching from a PPL to an e-leaflet is fairly high in all target groups (76.9% in pregnant women, 81.9% in young parents, and 66.1% in the elderly), especially if the option exists to request a paper print, to make sure that people with a low level of digital skills can access the PPL information as well. HCPs have an important role in ensuring access to the PPLs of vaccines. HCPs should be trained to inform their patients about the different options for accessing the PPLs (as well as online access) to increase their patients' knowledge and satisfaction.

Waist-to-height ratio and its associations with body mass index in a sample of Tuscan children in primary school.

BACKGROUND: Visceral obesity in children increases the risk of developing cardiovascular diseases. To evaluate overweight children, in addition to Body Mass Index (BMI), waist-to-height ratio (WHtR) can be used to predict cardiometabolic risk. The goal of this study is to describe WHtR in a sample of Tuscan children. METHODS: A sample of children living in the province of Pistoia, Tuscany, was measured for the following anthropometric parameters: weight, height, and waist circumference. BMI and WHtR were calculated. For the latter indicator, a threshold of 0.5 was considered as a cardiovascular risk predictor. The subjects were classified into underweight, normal weight, overweight, and obese using Cole's cut-offs. RESULTS: The number of children enrolled were 1575 (821 males; 754 females), aged 6-11 years. Of them, 64.3% were normal weight, 4.9% underweight, 22.3% overweight, and 8.5% obese. Moreover, 12.8% had a WHtR ≥0.5 (85.7% males; 88.7% females). The average WHtR value was 0.45 ± 0.045, and was significantly different as per gender (F = 0.45 vs. M = 0.46). WHtR was significantly correlated with BMI (r = 0.766). CONCLUSION: The average WHtR value was in line with previous studies conducted among children of similar age groups. Large-scale perspective studies are needed to validate the Italian WHtR cut-offs for children.

Nutritional status of 8-year-old rural and urban Italian children: a study in Pistoia, Tuscany.

In this study, performed in the province of Pistoia (Italy), we tested whether 8-year-old children living in rural areas differed from their urban peers as far as nutritional status, dietary habits and physical activity are concerned. The study sample was randomly selected to include 50% of the children attending the third elementary class in the province of Pistoia during 2002. A total of 1006 children underwent an anthropometric evaluation and an assessment of dietary habits and physical activity by means of specific questionnaires. Of these children, 927 were born in Italy and are described in this report. The relationship between body mass index (BMI<5th percentile versus 5thor=95th percentile) and the environment (urban versus rural) was of borderline significance (P=0.051). However, the percentage of children with BMI>or=85th percentile was greater in rural (24%) than in urban (18%) areas (P=0.012). The choice of foods and the physical activity of rural children mirrored those of urban children. These data sound as an alarm in view of the current epidemics of obesity that are invading Italy and other Mediterranean countries.