Anna Rita Giuliani

Influenza vaccination coverage among medical residents: an Italian multicenter survey

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011–2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P < 0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011–2012 season (P < 0.001). “To avoid spreading influenza among patients” was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future.

Survey of nursing knowledge on bioterrorism

With the aim of identifying intervention programmes within the framework of basic and permanent nursing training, we evaluated the knowledge of 187 nurses and nursing students concerning biological emergencies. A questionnaire was used to identify their knowledge of the pathogens that may be used in a terrorist attack and measures for containing them, and their perception of the danger to public health. Analysis of the responses showed that the undergraduates studying for the Triennial Degree were the best informed, and those studying for the specialist degree were the least informed. The question relating to the precautions adopted against transmission of Bacillus anthracis was the most predictive of the total score because it was the only one with a substantial number of correct answers (79/187). It seems that the information derived more from the generalist media than from academic training. We conclude that there is a need to train qualified personnel capable of responding to a possible emergency in terms of both preventive and interventional medicine.

Attitudes towards compulsory vaccination in Italy: Results from the NAVIDAD multicentre study

BACKGROUND Vaccine hesitancy is a considerable issue in European countries and leads to low coverage rates. After a long debate, Italy has made vaccination mandatory for admission to its schools. METHODS In the NAVIDAD study (a cross-sectional multicentre study), a 63-item questionnaire was administered to 1820 pregnant women from 15 Italian cities. The questionnaire assessed the interviewees opinion on mandatory vaccines, as well as their socioeconomic status, sources of information about vaccines, confidence in the Italian National Healthcare Service (NHS), and intention to vaccinate their newborn. RESULTS Information sources play a key role in determining the opinion on restoration of mandatory vaccines; in particular, women who obtained information from anti-vaccination movements are less likely to accept the vaccines (OR: 0.35, 95% CI: 0.21-0.58, p < 0.001). Women who had confidence in healthcare professional information agreed more on mandatory vaccination than did the other women (OR: 2.66, 95% CI: 1.62-4.36, p < 0.001); those who perceived that healthcare professionals have economic interest in child immunization and who declared that healthcare providers inform only on vaccinations benefits not on risks were less likely to agree on compulsory vaccination (OR: 0.66, CI 95%: 0.46-0.96, p = 0.03; OR: 0.66, CI 95%: 0.46-0.95, p = 0.03, respectively). CONCLUSION Information sources and confidence towards health professionals are the main determinants of acceptance of mandatory vaccine restoration. To increase the acceptability of the restoration and reduce vaccine hesitancy, these aspects need to be strengthened.

Cardiovascular Risk and Physical Activity: Simulated Analysis in GeneralPractice Patients Based on a Risk Score System

Abstract Aim: This cross-sectional study was aimed at evaluating the association between physical activity (PA), overweight and CV risk in a large sample of Italian general practice patients and forecast the impact of increasing PA in a general population. Methods: Regression analysis on single CV risk factors and stratification of global risk score have been carried out on 45,862 records with normal/overweight and active/inactive conditions as primary explanatory variables. Moreover a hypothetical attributable risk was calculated on the basis of expected cases. Results: HDL cholesterol resulted the risk factor most correlated with PA. Systolic blood pressure and fasting plasma glucose levels seemed to be more correlated to overweight than to PA. Active women and men would respectively have a 15% and 17% lower probability of experiencing a major cardiovascular event in the subsequent ten years than their inactive counterparts, adjusting for overweight. If inactive subjects became active at the lowest level, 818.8 cases/100,000 men and 201.5 cases/100,000 women aged 35-69 years would be protected during the same period. Conclusion: As counsellors for active lifestyle, general practitioners could contribute in reducing the absolute number of CV major events in the ‘healthy’ general population.