Knowledge, attitudes, and behaviors of parents towards varicella and its vaccination.

BACKGROUND: The aims of this cross-sectional survey were to examine the knowledge, the attitudes, and the behavior regarding the varicella infection and its vaccination and to get insight into their determinants among parents of children in Italy. METHODS: From May to June 2015 in the geographic area of Naples (Italy) a random sample of 675 parents of children aged 4-7 years received a self-administered anonymous questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards varicella and its vaccination. RESULTS: A total of 414 parents responded to the questionnaire, for a response rate of 61.3%. A history of varicella was reported in 163 children (39.6%). Only 26.6% parents knew that the vaccine was available and the number of doses and this knowledge was significantly higher in those who had a university degree, in those who had received information on the vaccination from a health care provider, and in those who had vaccinated their child. The perceived utility towards vaccination had a mean value of 5.7. The positive attitude towards the utility of the vaccination was higher in parents with a level of education not higher than middle school, in those who had vaccinated their child, in those who considered the varicella a dangerous disease, and in those who had received information from a health care provider. More than one-third had vaccinated their child. Immunization was more frequent in parents who had knowledge about the vaccination, who beliefs that the immunization was useful, who believed that the disease was not dangerous, and who had not a history of varicella among their children. CONCLUSIONS: Educational programs are needed among parents as support to improve knowledge about vaccination and immunization coverage.

Knowledge and attitudes towards the use of antibiotics in the paediatric age group: a multicenter survey in Italy.

Background: : The misuse of antibiotics is one of the leading causes of antibiotic resistance. Paediatric patients are highly involved in this issue, as they are those who receive the largest amount of prescriptions of these drugs. Therefore, this study aimed to investigate the general knowledge regarding the use of antibiotics, as well as the attitudes related to the administration of these drugs to children, amongst parents of children in the paediatric age-group. : In 2014, a multicentre cross-sectional study was conducted amongst parents of children aged 0-14. A questionnaire made up of 33 items was administered in waiting rooms of outpatient departments. Multivariable logistic regression models were performed, in order to assess the potential predictors of a better knowledge about antibiotics. : A total of 1247 parents took part to the survey. Around 33% of the samples declared that antibiotics are useful for viral infections, 20.6% that antibiotics are useful for every kind of pain and inflammation, while 14% of the parents stated that they stop giving antibiotics to their children when they start feeling better. Multivariable models showed that males, unemployed and those with lower levels of education are less prone to answer correctly to the questions about antibiotics. : The present study demonstrates that parents have a lack of knowledge regarding the use of antibiotics, which results in bad habits and inappropriate attitudes when it comes to giving antibiotics to their children. Attention should be particularly focused on disadvantaged parents.

Unintentional Injuries in Children Up to Six Years of Age and Related Parental Knowledge, Attitudes, and Behaviors in Italy.

OBJECTIVES: To describe risk factors associated with unintentional injuries among children aged <6 years and to examine parents' level of knowledge, attitudes, and behaviors about pediatric injuries and related preventive measures. STUDY DESIGN: A cross-sectional survey was conducted between May and July 2015 on a random sample of 794 parents of 3- to 6-year-old children through a self-administered anonymous questionnaire. RESULTS: A total of 409 parents participated. Two-thirds of the children had experienced at least 1 unintentional injury in the previous 12 months. More than one-half of these children were boys. The leading cause was falls; the injuries occurred mainly at home, and only 9.2% were brought for attention to an emergency department. Parents who did not believe that it is possible to prevent unintentional injuries were more likely to have had a child injured. Approximately 70% of respondents were aware of security measures to prevent pediatric injuries, and this knowledge was more prevalent in older parents and in those with at least a college level of education compared with those with a middle school education. The perceived utility of education about preventive measures of pediatric injuries had a mean value of 8.9 on a Likert scale of 1-10 (1, not useful, to 10, very useful) and was significantly higher in mothers. CONCLUSIONS: This study highlights a clear need for public health educational programs for parents regarding prevention of unintentional injuries in children as a valuable tool to increase safety and injury prevention and to reduce risks, because the majority of such injuries occur at home.

Knowledge, attitudes, and behaviors regarding HIV among first time attenders of voluntary counseling and testing services in Italy.

BACKGROUND: This study assess knowledge, attitudes, and practices regarding Human Immunodeficiency Virus (HIV) testing and counseling services and the predictor characteristics of these outcomes among individuals who presented for the first time to Voluntary Counseling and Testing (VCT) public services. METHODS: A sample of 244 subjects in the geographic area of Naples (Italy) received a self-administered anonymous questionnaire about socio-demographic characteristics, knowledge, attitudes relating to HIV infection, and practices relating to access to VCT service. RESULTS: Only 25% correctly identified the main modes of transmission and the main preventative measures of HIV and this knowledge was significantly higher in who had had more than one sexual partner and have not always used a condom during the intercourse in the last year, in those who have received information about HIV/AIDS through physician, and in those who have received middle school or lower educational level. The perceived risk of contracting HIV/AIDS was significantly higher in respondents of lower age, in those who perceived a better personal health status, and in those unmarried. Only 20.9% reported that they had received the HIV test and males and those who visited a physician or participated in preventive activities about HIV/AIDS were significantly more likely to have had an HIV test. CONCLUSIONS: This study supports the need to disseminate information and interventions to this population.

Efficacy of Pegylated interferon α-2a and α-2b in patients with genotype 1 chronic hepatitis C: a meta-analysis.

BACKGROUND: Two formulations of Pegylated interferon (Peg-IFN) are on the market for treatment of chronic hepatitis C virus (HCV) infection. The purpose of this meta-analysis was to assess the efficacy of Peg-IFN α-2a versus Peg-IFN α-2b in combination with ribavirin in anti-human immunodeficiency virus (HIV)-negative patients with genotype 1 chronic HCV infection. METHODS: The following criteria were to be met for inclusion in the meta-analysis: (a) original data from randomized and non-randomized clinical trials; (b) study on the efficacy of conventional doses of Peg-IFN α-2a (180 µg/week) versus Peg-IFN α-2b (1.5 µg/kg of body weight/week), both in combination with ribavirin, in antiviral therapy-naïve HCV-genotype 1 subjects; (c) at least one of these primary outcomes: Rapid Virological Response (RVR); Early Complete Virological Response (EVR); End of Treatment Response (ETR); Sustained Virological Response (SVR); (d) odds ratio estimates of relative risk (RR) and associated 95% confidence intervals (CIs) or at least data enabling them to be computed; (e) English language; and (f) published as a full paper up to December 2011. RESULTS: Seven published studies met the inclusion criteria, allowing a meta-analysis on 3,026 patients. Peg-IFN α-2a and Peg-IFN α-2b showed similar rate of RVR (RR = 1.05; 95% CI = 0.87-1.27, p = 0.62) and SVR (RR = 1.08; 95% CI = 0.99-1.18, p = 0.098). Peg-IFN α-2a more frequently than Peg-IFN α-2b achieved EVR (RR = 1.11; 95% CI = 1.02-1.21, p = 0.013) and ETR (RR = 1.22; 95% CI = 1.14-1.31, p < 0.0001). CONCLUSION: The standard schedules of Peg-IFN α-2a and Peg-IFN α-2b, both in combination with ribavirin, can be used indifferently for patients with chronic HCV genotype 1 who are anti- to eliminate HIV-negative and antiviral treatment-naïve.

Parental knowledge, attitudes and behaviours towards influenza A/H1N1 in Italy.

BACKGROUND: This study assesses the level of knowledge, the attitudes and the behaviours relating to influenza A/H1N1 among parents in Italy. METHODS: A random sample of 1299 parents aged 26-65 years received a self-reported questionnaire including questions about socio-demographic characteristics, knowledge on modes of transmission and preventative measures, attitudes and behaviours relating to influenza A/H1N1. RESULTS: A total of 781 subjects participated with a response rate of 60.1%. Only 32.3% of the respondents correctly identified the main modes of transmission and the main preventative measures, and the results of the multivariate logistic regression analysis showed that this knowledge was significantly higher in those with a higher level of education and working as health-care personnel. The average level of perceived risk of contracting influenza A/H1N1 was 4.6 and the multivariate linear regression model showed that a greater perceived risk was significantly associated with being unmarried, having more than one son, not working in the health-care setting and needing additional information about influenza A/H1N1. Less than one-third (28.8%) of the respondents had visited a physician at least once in 2 months preceding the survey for any reason related to the influenza A/H1N1 and the multivariate logistic regression model indicated that females and those with more than one son were more likely to have a visit. CONCLUSION: Knowledge about influenza A/H1N1 is poor and the results could have significant implications for information provision and the targeting of future education programmes to this population.

Intention to Receive the COVID-19 Vaccine Booster Dose in a University Community in Italy.

This cross-sectional study, conducted in Naples (Italy) between 16 November and 6 December 2021, explored the willingness to receive the booster dose of the COVID-19 vaccine among a random sample selected from the list of those who had completed a primary vaccination series at the immunization center of a teaching hospital in Naples and the associated factors. Females had a significantly higher perceived risk of getting the SARS-CoV-2 infection, whereas those not-having a cohabitant were less worried. 85.7% were willing to receive the booster dose. Those older respondents who perceived a better health status after the primary vaccination series, who have friends/family members who were diagnosed with COVID-19, who had received information from official government organizations, and those who did not need information would be willing to get the booster dose. 24.7% was hesitant with a Vaccine Hesitancy Scale (VHS) score ≥ 25. Respondents who self-rated a lower health status after the primary vaccination series, who did not have friends/family members who were diagnosed with COVID-19, who had not received information from official government organizations, and who needed information were hesitant. Information and communication regarding the benefits and efficacy of the booster dose are needed in order to control the pandemic.

Parental COVID-19 vaccine hesitancy: a cross-sectional survey in Italy.

BACKGROUND: Understanding parents' hesitancy against COVID-19 vaccination for their children is useful. METHODS: A self-administered online survey was conducted among 394 parents with at least one child aged 12-18 years in Italy. RESULTS: The mean perceived risk that their child can be infected by the SARS-CoV-2, measured on a 10-point Likert-type scale, was 7.7 and it was higher if at least one parent/partner cohabitant have had COVID-19, in those who believed that COVID-19 is a serious illness, and in those who had not vaccinated their child. 82.1% respondents were willing to vaccinate their child and this was more likely among those who believed that this vaccine is useful and who did not need additional information. 12.4% were, according to the 5-item Parent Attitudes About Childhood Vaccines Survey (PACV-5) score, high-hesitant toward anti-COVID-19 vaccination. Respondents not graduated, those who did not believe that this vaccination was useful, those who did not get this vaccine, those who did not obtain information from physicians, and those who needed additional information were more likely to be high-hesitant. CONCLUSIONS: Communication and public health interventions must be intensified to enhance the attitude and to help parents in deciding on COVID-19 vaccination of their children.

An investigation of nurses' knowledge, attitudes, and practices regarding disinfection procedures in Italy.

BACKGROUND: This study assessed the level of knowledge, attitudes, and practice regarding disinfection procedures among nurses in Italian hospitals. METHODS: A face-to-face interview gathered the following information: demographic and practice characteristics; knowledge about the healthcare-associated infections (HAIs) and the disinfection practices; attitudes towards the utility of guidelines/protocols and perception of the risks of acquiring/transmitting HAIs; compliance with antisepsis/disinfection procedures; and sources of information. RESULTS: Only 29% acknowledged that urinary and respiratory tract infections were the two most common HAIs and this knowledge was significantly higher in those with a higher level of education. Attitudes towards the utility of guidelines/protocols for disinfection procedures showed a mean score of 9.1. The results of the linear regression model indicated a more positive attitude in female nurses, in those with a lower number of years of activity, and in those needing additional information about disinfection procedures. Nurses with higher educational level and with a higher perception of risk of transmitting an infectious disease while working were more likely to perform appropriate antisepsis of the surgical wound and handwashing before and after medication. CONCLUSIONS: Plan of successful prevention activities about HAIs and provide pointers to help optimize disinfection procedures and infection prophylaxis and management are needed.

Self-reported health status and access to health services in a sample of prisoners in Italy.

BACKGROUND: Self-reported health status in underserved population of prisoners has not been extensively explored. The purposes of this cross-sectional study were to assess self-reported health, quality of life, and access to health services in a sample of male prisoners of Italy. METHODS: A total of 908 prisoners received a self-administered anonymous questionnaire pertaining on demographic and detention characteristics, self-reported health status and quality of life, access to health services, lifestyles, and participation to preventive, social, and rehabilitation programs. A total of 650 prisoners agreed to participate in the study and returned the questionnaire. RESULTS: Respectively, 31.6% and 43.5% of prisoners reported a poor perceived health status and a poor quality of life, and 60% admitted that their health was worsened or greatly worsened during the prison stay. Older age, lower education, psychiatric disorders, self-reported health problems on prison entry, and suicide attempts within prison were significantly associated with a perceived worse health status. At the time of the questionnaire delivery, 30% of the prisoners self-reported a health problem present on prison entry and 82% present at the time of the survey. Most frequently reported health problems included dental health problems, arthritis or joint pain, eye problems, gastrointestinal diseases, emotional problems, and high blood pressure. On average, prisoners encountered general practitioners six times during the previous year, and the frequency of medical encounters was significantly associated with older age, sentenced prisoners, psychiatric disorders, and self-reported health problems on prison entry. CONCLUSIONS: The findings suggest that prisoners have a perceived poor health status, specific care needs and health promotion programs are seldom offered. Programs for correction of risk behaviour and prevention of long-term effects of incarceration on prisoners' health are strongly needed.

Surveying willingness toward SARS-CoV-2 vaccination of healthcare workers in Italy.

BACKGROUND: Understanding healthcare workers (HCWs) willingness to receive a future vaccination against coronavirus disease 2019 (COVID-19) may be useful. METHODS: Cross-sectional study, conducted in Italy from September 14th to November 30th, 2020, among 811 HCWs who undergo a voluntary antibody-testing for anti-SARS-CoV-2. RESULTS: The perceived risk level of developing COVID-19, measured on a Likert-type scale ranging from 1 to 10, was 6.6 and it was higher among females, older HCWs, and in those who agreed that COVID-19 is a severe disease. Married/cohabitant, not physicians, and those who needed additional information regarding the vaccination against COVID-19 were more likely to be concerned that COVID-19 vaccination might not be safe. Males, physicians, those who did not have had any symptom compatible with COVID-19, those who agreed that COVID-19 is a severe disease, those who perceived to be at higher risk of developing COVID-19, those who were not concerned about the vaccine's safety, and those who had received information regarding the COVID-19 vaccination from scientific journals expressed willingness to receive vaccination against COVID-19. CONCLUSIONS: Communication and education targeted to groups with lowest willingness are needed to raise awareness regarding the safety and benefits of the vaccination and to improve vaccine uptake.

Asbestos Exposure and Malignant Mesothelioma in Construction Workers-Epidemiological Remarks by the Italian National Mesothelioma Registry (ReNaM).

Notwithstanding the ban in 1992, asbestos exposure for workers in the construction sector in Italy remains a concern. The purpose of this study is to describe the characteristics of malignant mesothelioma (MM) cases recorded by the Italian registry (ReNaM) among construction workers. Incident mesothelioma cases with a definite asbestos exposure have been analyzed. Characteristics of cases and territorial clusters of crude rates of MM in construction workers have been described, as well as the relation between asbestos use before the ban and the historical trend of workforce in the construction sector in Italy. ReNaM has collected 31,572 incident MM cases in the period from 1993 to 2018 and asbestos exposure has been assessed for 24,864 (78.2%) cases. An occupational exposure has been reported for 17,191 MM cases (69.1% of subjects with a definite asbestos exposure). Among them, 3574 had worked in the construction sector, with an increasing trend from 15.8% in the 1993-98 period to 23.9% in 2014-2018 and a ubiquitous territorial distribution. The large use of asbestos in construction sector before the ban makes probability of exposure for workers a real concern still today, particularly for those working in maintenance and removal of old buildings. There is a clear need to assess, inform, and prevent asbestos exposure in this sector.

Microbiological quality of drinking water from dispensers in Italy.

BACKGROUND: Water coolers are popular in office buildings and commercial stores and the quality of this source of drinking water has the potential to cause waterborne outbreaks, especially in sensitive and immunocompromised subjects. The aim of this study was to determine the quality of water plumbed in coolers from commercial stores in comparison with tap water in Italy. METHODS: For each sample, microbial parameters and chemical indicators of contamination were evaluated and information about the date of installation, time since last ordinary and extraordinary maintenance of water coolers was collected. RESULTS: In all samples the chemical parameters (nitrite, ammonium, free active chlorine residual) did not exceed the reference values of the drinking water regulation; the pH value in 86.8% samples of the carbonated waters was lower than the reference limit. The microbiological results indicated that the bacteria count at 22 degrees C and 37 degrees C was higher than the required values in 71% and 81% for the non-carbonated water and in 86% and 88% for the carbonated one, respectively. Enterococcus spp. and Escherichia coli were not detected in any of the water samples. Pseudomonas aeruginosa was found in only one sample of the tap water and in 28.9% and 23.7% of the non-carbonated and carbonated water samples, respectively. No statistically significant differences in bacterial counts at 22 degrees C and 37 degrees C have been found between the non-carbonated and carbonated water from the sampled coolers in relation with the time since the last filter was substituted. The bacteriological quality of tap water was superior to that of non-carbonated and carbonated water from coolers. CONCLUSION: The results emphasize the importance of adopting appropriate routinely monitoring system in order to prevent or to diminish the chances of contamination of this water source.

Healthcare workers and health care-associated infections: knowledge, attitudes, and behavior in emergency departments in Italy.

BACKGROUND: This survey assessed knowledge, attitudes, and compliance regarding standard precautions about health care-associated infections (HAIs) and the associated determinants among healthcare workers (HCWs) in emergency departments in Italy. METHODS: An anonymous questionnaire, self-administered by all HCWs in eight randomly selected non-academic acute general public hospitals, comprised questions on demographic and occupational characteristics; knowledge about the risks of acquiring and/or transmitting HAIs from/to a patient and standard precautions; attitudes toward guidelines and risk perceived of acquiring a HAI; practice of standard precautions; and sources of information. RESULTS: HCWs who know the risk of acquiring Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) from a patient were in practice from less years, worked fewer hours per week, knew that a HCW can transmit HCV and HIV to a patient, knew that HCV and HIV infections can be serious, and have received information from educational courses and scientific journals. Those who know that gloves, mask, protective eyewear, and hands hygiene after removing gloves are control measures were nurses, provided care to fewer patients, knew that HCWs' hands are vehicle for transmission of nosocomial pathogens, did not know that a HCW can transmit HCV and HIV to a patient, and have received information from educational courses and scientific journals. Being a nurse, knowing that HCWs' hands are vehicle for transmission of nosocomial pathogens, obtaining information from educational courses and scientific journals, and needing information were associated with a higher perceived risk of acquiring a HAI. HCWs who often or always used gloves and performed hands hygiene measures after removing gloves were nurses, provided care to fewer patients, and knew that hands hygiene after removing gloves was a control measure. CONCLUSIONS: HCWs have high knowledge, positive attitudes, but low compliance concerning standard precautions. Nurses had higher knowledge, perceived risk, and appropriate HAIs' control measures than physicians and HCWs answered correctly and used appropriately control measures if have received information from educational courses and scientific journals.

Public concerns and behaviours towards solid waste management in Italy.

A self-administered questionnaire investigated knowledge, perceptions of the risks to health associated with solid waste management, and practices about waste management in a random sample of 1181 adults in Italy. Perceived risk of developing cancer due to solid waste burning was significantly higher in females, younger, with an educational level lower than university and who believed that improper waste management is linked to cancer. Respondents who had visited a physician at least once in the last year for fear of contracting a disease due to the non-correct waste management had an educational level lower than university, have modified dietary habits for fear of contracting disease due to improper waste management, believe that improper waste management is linked to allergies, perceive a higher risk of contracting infectious disease due to improper waste management and have participated in education/information activities on waste management. Those who more frequently perform with regularity differentiate household waste collection had a university educational level, perceived a higher risk of developing cancer due to solid waste burning, had received information about waste collection and did not need information about waste management. Educational programmes are needed to modify public concern about adverse health effects of domestic waste.

Healthcare Workers' Knowledge, Attitudes, and Practices about Vaccinations: A Cross-Sectional Study in Italy.

The cross-sectional study assessed the knowledge, attitudes, and practices regarding the recommended vaccinations and factors affecting such outcomes among a sample of healthcare workers (HCWs) in public hospitals in Italy. Only 14.1% knew all the recommended vaccinations for HCWs. Physicians and those who had received information about vaccinations from scientific journals, educational activities, or professional associations were more likely to have this knowledge, while those aged 36-45 were more likely to have less knowledge than those in the age group below 36 years. Only 57.3% agreed that the information received about vaccinations was reliable. Respondents who had children, who worked in pediatric/neonatal wards, who were more knowledgeable, or who did not need further information about vaccinations considered the available information to be reliable. Only 17.7% of respondents always recommended vaccinations to their patients. This behavior was more likely to occur in physicians, in HCWs, in pediatric/neonatal wards, in those who considered the information received about vaccinations reliable, and in those who considered themselves to be at high risk of transmitting an infectious disease to their patients. Health promotion programs and efforts are needed to improve the level of knowledge about vaccinations and immunization coverage among HCWs.

Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population-based nationwide study.

BACKGROUND: Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. Centralization of rare cancer in dedicated centers is recommended to ensure expertise, multidisciplinarity and access to innovation. In Italy, expert centers for MPM have not been identified in all regions. We aimed to describe the treatment patterns among MPM patients across different Italian regions and to identify factors associated with the treatment patterns across the regions. METHODS: We performed an observational study on a random sample of 2026 MPM patients diagnosed in 2003-2008. We included 26 population-based registries covering 70% of the Italian population. To identify factors associated with treatment patterns, across the different regions, we fitted a multinomial logistic regression model adjusted by age, sex, stage, histology and hospital with thoracic surgical department. RESULTS: MPM patients mostly received chemotherapy alone (41%) or no cancer-directed therapy (36%) especially the older patients. The first course of treatment for MPM patients differed across regions. Patients from Piedmont, Liguria and Campania were more likely to receive no cancer-directed therapy; those living in Tuscany and Sicily were more likely to get surgery; patients from Marche and Lazio were more likely to receive chemotherapy. These differences were not explained by age, sex, stage, histology and availability of a thoracic surgery department. CONCLUSIONS: There is limited expertise available and lack of a network able to maximize the expertise available may contribute to explaining the results of our study. Our findings support the need to ensure the appropriate care of all MPM patients in reorganizing the health care services. KEY POINTS: Significant findings of the study: MPM patients mostly received chemotherapy alone or no cancer-directed therapy especially the older patients. The first course of treatment for MPM patients differed across Italian regions. WHAT THIS STUDY ADDS: Differences in MPM clinical management are not explained by the age, stage, histology nor by the availability of a thoracic surgery department. Limited expertise for MPM contribute to explaining the unequal access to appropriate care for MPM patients in Italy.

Paediatricians knowledge, attitudes, and practices regarding immunizations for infants in Italy.

BACKGROUND: The purpose of this study was to investigate whether paediatricians have appropriate knowledge, attitudes, and behaviours regarding vaccinations for infants in Italy. METHODS: A random sample of 500 paediatricians received a self-administered anonymous questionnaire covering demographic and professional characteristics; knowledge about the mandatory, recommended, and not indicated vaccinations for infants; attitudes about vaccinations for infants; behaviour regarding current administration or willingness to administer mandatory or recommended vaccinations for infants and immunization education programs of the parents. RESULTS: Only 42.3% paediatricians knew all recommended vaccinations for infants and this knowledge was significantly higher in females, in those who worked a higher number of hours for week, and in those who use guidelines for immunization practice. Only 10.3% had a very favourable attitude towards the utility of the recommended vaccinations for infants and this was significantly higher in those who administered recommended vaccinations for infants. A large proportion (82.7%) of paediatricians routinely informed the parents about the recommended vaccinations for infants and this appropriate behaviour was significantly higher among younger, in those with a higher number of years in practice, and in those who administered the recommended vaccinations for infants. CONCLUSION: Training and educational interventions are needed in order to improve knowledge, attitudes, and behaviours regarding vaccinations for infants among paediatricians.

Use of television, videogames, and computer among children and adolescents in Italy.

BACKGROUND: This survey determined the practices about television (video inclusive), videogames, and computer use in children and adolescents in Italy. METHODS: A self-administered anonymous questionnaire covered socio-demographics; behaviour about television, videogames, computer, and sports; parental control over television, videogames, and computer. RESULTS: Overall, 54.1% and 61% always ate lunch or dinner in front of the television, 89.5% had a television in the bedroom while 52.5% of them always watched television there, and 49% indicated that parents controlled the content of what was watched on television. The overall mean length of time daily spent on television viewing (2.8 hours) and the frequency of watching for at least two hours per day (74.9%) were significantly associated with older age, always ate lunch or dinner while watching television, spent more time playing videogames and using computer. Those with parents from a lower socio-economic level were also more likely to spend more minutes viewing television. Two-thirds played videogames for 1.6 daily hours and more time was spent by those younger, males, with parents that do not control them, who watched more television, and who spent more time at the computer. The computer was used by 85% of the sample for 1.6 daily hours and those older, with a computer in the bedroom, with a higher number of computers in home, who view more television and play videogames were more likely to use the computer. CONCLUSION: Immediate and comprehensive actions are needed in order to diminish time spent at the television, videogames, and computer.

Physicians' knowledge, attitudes and professional use of RCTs and meta-analyses: a cross-sectional survey.

BACKGROUND: Familiarity with Randomized Control Trials (RCTs) and meta-analyses is essential to practice Evidence Based Medicine (EBM). The aims of this study were to describe knowledge, attitudes and professional behavior of physicians towards methods to evaluate the efficacy of health interventions, particularly meta-analysis and to find out their possible associated factors. METHODS: A cross-sectional survey was carried out on a random sample of Italian physicians through a self-administered questionnaire. RESULTS: A response rate of 70.1% was achieved (654 questionnaires). Despite satisfactory knowledge and substantial positive attitudes, Italian physicians have not integrated the use of RCTs and meta-analyses into their practice to a large extent, because they infrequently read and use RCTs and meta-analyses to make decisions in clinical practice. There is a high correlation between knowledge, attitudes and professional use of RCTs and meta-analyses. Moreover, the results of our multivariate analysis show that the probability of an appropriate professional use, that is higher for doctors who know the English language, have internet access and dedicate a proper amount of time to continuing medical education, increases significantly with a previous exposure to meta-analysis during graduate/post-graduate training (OR 2.25, 95% CI 1.44-3.52), and with the attendance of post-graduate courses about EBM (OR 1.75, 95% CI 1.09-2.82). Finally, Italian physicians demonstrate a high level of interest in further training. CONCLUSIONS: The association between the EBM educational background of doctors and the appropriate professional use of RCTs and meta-analyses suggest that EBM training may promote a more evidence-based practice among physicians.