Parents' Perspective of Antibiotic Usage in Children: A Nationwide Survey in Italy.

BACKGROUND: Antibiotics represent the most widely prescribed drugs in children worldwide, both in hospital and community settings. A comprehensive approach to understanding the reasons and determinants of antibiotic prescription in the pediatric age is needed. This study aimed to assess parents' attitudes and perspectives about antibiotic use. METHODS: Prospective observational study was conducted in all Italian Regions between February 1 and April 30, 2020, using a standardized questionnaire. RESULTS: Six thousand six hundred twenty-five parents from all Italian regions completed the survey. Seventy-six percent of parents were aware that only bacteria are the target of antibiotics, but 92.9% knew that the antibiotic has no direct effect on fever. Antibiotic self-prescription (10.4%) or by remote consultation by phone call (19.9%) or message (9.6%) were relatively common. Ninety-three percent of parents were aware that excessive use of antibiotics could select resistant bacteria and 84.7% of them knew that they could actively fight antibiotic resistance. About two thirds of participants (66.1%) received information on antibiotic resistance from their family pediatrician. Parents born of Italy or those with lower income had a higher probability of having less information from pediatricians or knowledge of proper antibiotic use. DISCUSSION: Our study suggests that parents' knowledge and attitudes toward antibiotic use and prescription are improving compared with previous studies, while there is still a gap regarding antibiotic resistance, particularly on practices that can reduce its burden. Our study's negative finding is that families from low-income settings or those born abroad have significantly more misconceptions about important antibiotic practices.

Validity of Social Cognition Measures in the Clinical Services for Autism Spectrum Disorder.

The current study evaluated three social cognition (SC) tests for their clinical utility in aiding autism diagnosis. To do so, we compared the performance of 86 children with autism spectrum disorder (ASD) and 68 typically developing (TD) children, all aged from 4 to 10 years old, on three SC tasks [the Social Information Processing Interview (SIPI), the Comic Strip Task (CST), and the children's version of the Eyes Task] and calculated threshold scores that best differentiated the two groups. While difficulties in these abilities appear to represent the "central core" of ASD, services have largely ignored SC tests when supporting autism diagnoses. Therefore, this study attempted to validate and evaluate the diagnostic potential of these three tasks for children with ASD. To investigate the accuracy of these SC tests, we used the receiver operating characteristic (ROC) curve. As expected, the ASD group performed worse than the TD group on the SIPI and CST, but contrary to our prediction, the groups did not significantly differ on the Eyes Task. Specifically, the overall area under the curve (AUC) for the SIPI was 0.87, with a sensitivity of 73.5% and a specificity of 83.9% at the best cutoff point (score range 0-36; best cutoff = 31). The overall AUC for the CST was 0.75, with a sensitivity of 71.1% and a specificity of 77.0% at the best cutoff point (score range 0-15; best cutoff = 11). The overall AUC for the Eyes Task was 0.51, with a sensitivity of 50.3% and a specificity of 40.2% at the best cutoff point (score range 0-54; best cutoff = 45). In conclusion, the results showed that the SIPI test has good predictive power for classifying children with ASD. It should provide substantial supplementary clinical information and help to consolidate diagnostic procedures based on standard tools. Moreover, the results of the study have substantial implications for clinical practice: the better the knowledge of SC functioning in children with ASD, the more effective the intervention program for rehabilitation.

[Autism after an earthquake: the experience of L'Aquila (Central Italy) as a basis for an operative guideline]. / L'autismo nel post-terremoto: l'esperienza dell'Aquila come base per una linea guida operativa.

People with autism, their families, and their specialised caregivers are a social group at high health risk after a disruptive earthquake. They need emergency assistance and immediate structured support according to definite protocols and quality standards. We recommend to establish national guidelines for taking-in-charge people with autism after an earthquake. The adaptive behaviour of participants with autism declined dramatically in the first months after the earthquake in all the dimensions examined (i.e., communication, daily living, socialisation, and motor skills). After relatively stable conditions returned and with immediate and intensive post-disaster intervention, children and adolescents with autism showed a trend towards partial recovery of adaptive functioning. As to the impact on services, this study indicates the need for supporting exposed caregivers at high risk of burnout over the first two years after the disaster and for an immediate reorganisation of person-tailored services.

Facebook, quality of life, and mental health outcomes in post-disaster urban environments: the l'aquila earthquake experience.

BACKGROUND: An understudied area of interest in post-disaster public health is individuals' use of social networks as a potential determinant of quality of life (QOL) and mental health outcomes. A population-based cross-sectional study was carried out to examine whether continual use of online social networking (Facebook) in an adult population following a massive earthquake was correlated with prevalence of depression and post-traumatic stress disorders (PTSD) and QOL outcomes. METHODS: Participants were a sample of 890 adults aged 25-54 who had been exposed to the L'Aquila earthquake of 2009. Definition of "user" required a daily connection to the Facebook online social network for more than 1 h per day from at least 2 years. Depression and PTSD were assessed using the Screening Questionnaire for Disaster Mental Health. QOL outcomes were measured using the World Health Organisation Quality of Life BREF (WHOQOL-BREF) instrument. Logistic regression was carried out to calculate the prevalence odds ratios (POR) for social network use and other covariates. RESULTS: Two hundred and twenty one of 423 (52.2%) men, and 195 of 383 (50.9%) women, had been using Facebook as social network for at least 2 years prior to our assessment. Social network use correlated with both depression and PTSD, after adjusting for gender. A halved risk of depression was found in users vs. non-users (POR 0.50 ± 0.16). Similarly, a halved risk of PTSD in users vs. non-users (POR 0.47 ± 0.14) was found. Both men and women using online social networks had significantly higher QOL scores in the psychological and social domains of the WHOQOL-BREF. CONCLUSION: Social network use among adults 25-54 years old has a positive impact on mental health and QOL outcomes in the years following a disaster. The use of social networks may be an important tool for coping with the mental health outcomes of disruptive natural disasters, helping to maintain, if not improve, QOL in terms of social relationships and psychological distress.

A longitudinal study of quality of life of earthquake survivors in L'Aquila, Italy.

BACKGROUND: People's well-being after loss resulting from an earthquake is a concern in countries prone to natural disasters. Most studies on post-earthquake subjective quality of life (QOL) have focused on the effects of psychological impairment and post-traumatic stress disorder (PTSD) on the psychological dimension of QOL. However, there is a need for studies focusing on QOL in populations not affected by PTSD or psychological impairment. The aim of this study was to estimate QOL changes over an 18-month period in an adult population sample after the L'Aquila 2009 earthquake. METHODS: The study was designed as a longitudinal survey with four repeated measurements performed at six monthly intervals. The setting was the general population of an urban environment after a disruptive earthquake. Participants included 397 healthy adult subjects. Exclusion criteria were comorbidities such as physical, psychological, psychiatric or neurodegenerative diseases at the beginning of the study. The primary outcome measure was QOL, as assessed by the WHOQOL-BREF instrument. A generalised estimating equation model was run for each WHOQOL-BREF domain. RESULTS: Overall, QOL scores were observed to be significantly higher 18 months after the earthquake in all WHOQOL-BREF domains. The model detected an average increase in the physical QOL scores (from 66.6 ± 5.2 to 69.3 ± 4.7), indicating a better overall physical QOL for men. Psychological domain scores (from 64.9 ± 5.1 to 71.5 ± 6.5) were observed to be worse in men than in women. Levels at the WHOQOL domain for psychological health increased from the second assessment onwards in women, indicating higher resiliency. Men averaged higher scores than women in terms of social relationships and the environmental domain. Regarding the physical, psychological and social domains of QOL, scores in the elderly group (age > 60) were observed to be similar to each other regardless of the significant covariates used. CONCLUSIONS: WHOQOL-BREF scores of the psychological domain displayed trends conditioned by age and education: older subjects experienced less satisfaction with psychological health on average. Less-educated subjects always demonstrated the worst QOL scores. Gender, age and education impacted the variability of QOL in the environmental dimension in the elderly.