Effectiveness of pneumococcal vaccination on hospitalization and death in the adult and older adult diabetic population: a systematic review.

INTRODUCTION: Diabetic patients are at a higher risk of getting pneumococcal disease and are therefore recommended to get vaccinated. The aim of our systematic review is the retrieval and analysis of all available evidence on the effect of pneumococcal vaccination on the risk of hospitalization and death in adult patients with diabetes. RESEARCH DESIGN AND METHODS: MEDLINEand EMBASE were searched from inception until January 2023. We included all studies investigating whether pneumococcal vaccination reduces the risk of dying or being hospitalized in diabetic patients. The Newcastle-Ottawa scale was used to assess risk of bias. RESULTS: Only two studies, encompassing a total of 68,246 subjects, were considered eligible for inclusion and of high quality. In both studies polysaccharide pneumococcal vaccination was associated with a reduction of the risk of hospitalization or death in adult diabetic patients (aHR: 0.76 in one study, aOR: 0.97 in the other one). However, in neither of the two included studies the lower risk was statistically significant. CONCLUSIONS: Further research is needed due to the potentially major clinical implications for diabetic patients. The results of this systematic review can serve as a foundation for future studies, indicating the importance of continuing research in this area to improve patient outcomes.

Health literacy of informal caregivers of older adults with dementia: results from a cross-sectional study conducted in Florence (Italy).

AIM: The aim of this study was to measure the prevalence of inadequate health literacy (HL) in a sample of family caregivers of older adults with dementia, and to assess the relationship of HL with characteristics of caregiver and persons with dementia. METHODS: The study followed a cross-sectional design. Persons with dementia and their family caregivers were enrolled in an outpatients' geriatric memory clinic. For the caregivers, the following information was collected: socio-demographic data, level of HL, cognitive impairment (using the Mini-Cog). For persons with dementia, the following data were collected: socio-demographic data, functional status (using the Basic and Instrumental Activities of Daily Living), cognitive impairment (using the Mini Mental State Evaluation, and the Global Deterioration Scale) behavioral and psychological symptoms associated with dementia (assessed using the Neuropsychiatric Inventory). RESULTS: A total of 174 person with dementia/caregiver dyads were enrolled. About 45% of the caregivers presented a possibility or a high likelihood of inadequate HL. The percentage of caregivers with inadequate HL was higher among spousal caregivers than in offspring. Female gender, higher age and lower education were independent predictors of low HL. On multiple logistic regression analysis, persons with dementia assisted by caregivers with a high likelihood of limited HL presented higher risk of a more severe disease. CONCLUSION: The results of this study suggest that the HL of dementia caregivers has to be included in the comprehensive geriatric assessment, to develop an appropriate individualized care plan. Moreover, public health interventions are needed to increase the HL of dementia caregivers.

A Study of Hepatitis A Seroprevalence in a Paediatric and Adolescent Population of the Province of Florence (Italy) in the Period 2017-2018 Confirms Tuscany a Low Endemic Area.

Background: Italy is considered an area with very low HAV (hepatitis A virus) endemicity. Currently in Italy the anti-HAV vaccine is recommended only for specific risk groups and there is no universal vaccination program. The aim of this study was to assess the level of immunity against hepatitis A in a sample of children and adolescents from the province of Florence. Methods: A total of 165 sera were collected from subjects aged 1 to 18 years, proportionally selected according to the general population size and stratified by age and sex. A qualitative evaluation of anti-HAV antibodies was performed using the enzyme-linked immunosorbent assay (ELISA). Anamnestic and vaccination status data were also collected. Results: Our study showed a hepatitis A seroprevalence of 9.1% in the enrolled population. A statistically significant difference in the prevalence of anti-HAV was found between Italian and non-Italian subjects. About half of the population having anti-HAV antibodies was reported to be vaccinated, and no cases of hepatitis A were found. Conclusions: The data from our study confirmed Tuscany as an area with low HAV endemicity and showed that hepatitis A seroprevalence is significantly higher in foreign children and adolescents. The presence of more seropositive subjects than those vaccinated was probably due to a natural immunization achieved through a subclinical infection and/or to underreporting of the surveillance systems.

COVID-19 and schools: what is the risk of contagion? Results of a rapid-antigen-test-based screening campaign in Florence, Italy.

INTRODUCTION: In the coronavirus disease 2019 era, debate around the risk of contagion in school is intense in Italy. The Department of Welfare and Health of Florence promoted a screening campaign with rapid antigen tests for all students and school personnel. The aim of this study was to assess the circulation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the school setting by means of mass screening in every primary and middle school in Florence. METHODS: All students and school personnel at primary and middle schools in Florence were asked to take part. The campaign started on 16 November 2020 and was completed on 12 February 2021. If a subject had a positive result on rapid antigen testing, a molecular test was performed to confirm the result. RESULTS: In total, 18,414 subjects were tested: 15,233 students (82.7%) and 3181 school personnel (17.3%). The rapid antigen test gave a positive result in 27 cases (0.15%). Of these, only 14 tests were confirmed to be positive on molecular testing. These results show a very low number of cases of SARS-CoV-2 among the study subjects (0.08%). CONCLUSIONS: These results show that the spread of SARS-CoV-2 in the school setting was low in Florence during the screening period.

Factors Influencing SARS-CoV-2 Vaccine Acceptance and Hesitancy in a Population-Based Sample in Italy.

Vaccination against SARS-CoV-2 represents an effective and safe tool to protect the population against the disease; however, COVID-19 vaccine hesitancy could be a major barrier to achieving herd immunity. Despite the severity of the current pandemic, the population's intention to get vaccinated against COVID-19 is still not clear. The aim of this study was to evaluate the intention to get vaccinated against COVID-19 among a convenience sample of the general population resident in Italy and the factors associated with hesitancy and acceptance of the vaccine in the context of the current pandemic before the rolling out of COVID-19 vaccines. An anonymous online survey was diffused among a general adult population living in Italy. Participants aged 18 or older and living in Italy were considered eligible. Incomplete questionnaires were excluded. Overall, 7605 valid questionnaires were collected. Most of the participants (81.9%) were inclined to get vaccinated; male sex (OR 1.38, 95% CI 1.12-1.71), a high level of trust in institutions (OR 3.93, 95% CI 2.04-7.83), and personal beliefs about high safety of COVID-19 vaccines (OR 56.33, 95% CI 31.57-105.87) were found to be among the significant predictors of COVID-19 acceptance. These data could help design larger studies to address the problem of COVID-19 vaccine hesitancy in the current pandemic.

Insights into the Predictors of Attitude toward Entomophagy: The Potential Role of Health Literacy: A Cross-Sectional Study Conducted in a Sample of Students of the University of Florence.

In Western countries, one of the main barriers to entomophagy is repulsion toward insects. Few studies have investigated the factors that influence attitudes toward entomophagy. Therefore, we conducted a cross-sectional study involving a sample of 248 university students, focusing on disgust and other potential attributes that can influence insect consumption, including health literacy. We used a 17-item self-administered questionnaire. Consistent with the literature, two items were chosen as outcome variables to evaluate the predictors of the propensity to consume insects: "Have you ever eaten insects or insect-based products?" and "How disgusting do you find eating insects?" The data analysis shows that having already eaten insects is inversely associated with the level of disgust (OR: 0.1, p < 0.01); and it is positively associated with higher levels of health literacy (OR: 3.66, p > 0.01). Additionally, having some knowledge and information about entomophagy is inversely associated with a higher level of disgust (OR: 0.44, p = 0.03 and OR: 0.25, p = 0.03, respectively), while being female is positively associated with disgust (OR: 3.26, p < 0.01). Our results suggest the potential role of health literacy, in addition to other factors, in influencing the willingness to taste insects. However, further studies involving larger and non-convenience samples are needed to confirm our hypothesis.

Fake News and Covid-19 in Italy: Results of a Quantitative Observational Study.

During the Covid-19 pandemic, risk communication has often been ineffective, and from this perspective "fake news" has found fertile ground, both as a cause and a consequence of it. The aim of this study is to measure how much "fake news" and corresponding verified news have circulated in Italy in the period between 31 December 2019 and 30 April 2020, and to estimate the quality of informal and formal communication. We used the BuzzSumo application to gather the most shared links on the Internet related to the pandemic in Italy, using keywords chosen according to the most frequent "fake news" during that period. For each research we noted the numbers of "fake news" articles and science-based news articles, as well as the number of engagements. We reviewed 2102 articles. Links that contained fake news were shared 2,352,585 times, accounting for 23.1% of the total shares of all the articles reviewed. Our study throws light on the "fake news" phenomenon in the SARS-CoV-2 pandemic. A quantitative assessment is fundamental in order to understand the impact of false information and to define political and technical interventions in health communication. Starting from this evaluation, health literacy should be improved by means of specific interventions in order to improve informal and formal communication.