A Familial Form of Epidermolysis Bullosa Simplex Associated with a Pathogenic Variant in KRT5.

Epidermolysis bullosa simplex is a disease that belongs to a group of genodermatoses characterised by the formation of superficial bullous lesions caused by minor mechanical trauma to the skin. The skin fragility observed in the EBS is mainly caused by pathogenic variants in the KRT5 and KRT14 genes that compromise the mechanical stability of epithelial cells. By performing DNA sequencing in a female patient with EBS, we found the pathogenic variant c.967G>A (p.Val323Met) in the KRT5 gene. This variant co-segregated with EBS in the family pedigree and was transmitted in an autosomal dominant inheritance manner. This is the first report showing a familial form of EBS due to this pathogenic variant.

Knowledge and practices regarding antibiotics use: Findings from a cross-sectional survey among Italian adults.

BACKGROUND AND OBJECTIVES: This study aimed to assess the knowledge on antibiotics and antimicrobial resistance (AMR) and the antibiotic use among the general public in Southern Italy and to analyze whether sociodemographic characteristics could be associated with poor knowledge and improper practices. METHODOLOGY: From March to November 2019, a face-to-face interview was conducted with adult subjects attending the waiting room of 27 randomly selected general practitioners (GPs) in Southern Italy. The questionnaire covered sociodemographic characteristics, knowledge on antibiotics and AMR and practices regarding the consumption of and self-medication with antibiotics. RESULTS: The response rate was 89.7%. In the sample, 29.2% thought that antibiotics are effective for viral infections, and 49.5% correctly recognized the definition of AMR. Predictors of good knowledge about antibiotics and AMR were female gender and a higher education level. Almost half of the respondents had used antibiotics in the previous year and 23.6% took antibiotics to treat a common cold and/or fever. Among participants, 25.5% reported to have bought antibiotics without a prescription, and 30.6% were classified as antibiotic self-medication users. Use of antibiotics in the previous 12 months and having taken an antibiotic after a phone consultation with the GP were positively associated with both antibiotic use for a common cold and/or fever and self-medication with antibiotics. CONCLUSIONS AND IMPLICATIONS: The findings of this study highlighted a considerable antibiotic consumption in the adult population of Southern Italy together with misconceptions regarding the correct indication for antibiotic use that could foster indiscriminate antibiotic use. LAY SUMMARY: The findings of this study highlighted a considerable antibiotic consumption in the adult Italian population together with misconceptions regarding the correct indication for antibiotic use that could foster indiscriminate antibiotic use. Almost a quarter of the respondents took antibiotics to treat a common cold and/or fever and reported to have bought antibiotics without a prescription.

Preventable pediatric hospitalizations and access to primary health care in Italy.

The aim of this study was to quantify the burden of avoidable pediatric hospital admissions for Ambulatory care-sensitive conditions (ACSC) and to identify factors related to these preventable hospitalizations. The study was conducted by retrospectively reviewing all medical records of children admitted in a non-teaching 474-bed acute care hospital located in Catanzaro (Italy) for an avoidable hospitalization diagnosis. Two control clinical records involving children hospitalized for clinical conditions not classified as ACSC were randomly selected for each clinical record that included an ACSC. Among the 4293 pediatric hospitalizations, 451 (10.5%) were judged to be preventable. Of these, the most frequent discharge diagnoses were: dehydration (29.7%), pneumonia (17.7%), seizures (15.7%) and chronic obstructive pulmonary disease (12.9%).Children admitted for a preventable hospitalization were more likely to be females, to be younger, to be residents in the same province as the hospital and less likely to have had at least one Community-Based Pediatrician (CBP) access in the previous year and to have used the district health service. The burden of pediatric preventable hospitalizations found in this study is quite high, and the results show that there is still work that lies ahead on the way to improve interaction between hospital and community-based services.

Adherence to evidence-based recommendations for surgical site infection prevention: Results among Italian surgical ward nurses.

BACKGROUND: The aims of the study were to assess the level of knowledge, the attitudes and the adherence to evidence-based recommendations for surgical site infection (SSI) prevention and to describe any influences that may motivate nurses to adopt evidence-based practices for SSI prevention. METHODS: The present study was a national cross-sectional survey conducted from June to November 2017. For each hospital that agreed to participate, 30 nurses were randomly selected. The questionnaire was aimed at exploring socio-demographic and practice characteristics, knowledge of, attitudes toward, and reported practices regarding evidence-based procedures for SSI prevention. RESULTS: Out of 55 hospitals that were contacted, 36 agreed to participate (a response rate of 65%). Of the original sample of 1313 nurses, a total of 1305 returned the questionnaire, a response rate of 99.4%. Regarding knowledge, only 53.8% knew that preoperative hair removal, if necessary, should take place shortly before surgery, and 28.9% of the sample did not know the right definition of "bundle". Over three quarters of participants stated that they always perform hand antisepsis before and after biological sample collection while 9.7% considered that wearing gloves during this practice is sufficient to prevent SSI. Furthermore, 91% of nurses reported that they always performed hand antisepsis before and after invasive procedures. CONCLUSION: The study findings highlight the areas that were most lacking in nurses' training and for which targeted activities are needed. These data could support healthcare managers to implement interventions focused at enabling adherence to effective prevention practices to reduce risk to all patients.

Parent perspectives on childhood vaccination: How to deal with vaccine hesitancy and refusal?

BACKGROUND: The aims of the study are to evaluate attitudes about childhood vaccines and vaccine refusal or delay among parents and to assess the role played by the variables mapped as potential determinants to suggest strategies that could improve childhood vaccination rates. METHODS: The cross-sectional study was intended for parents of kindergarteners. Parental attitudes were measured using the Parent Attitudes about Childhood Vaccines (PACV) survey, to screen for Vaccine Hesitancy (VH). In addition, selected factors have been grouped in three categories (contextual, individual and group and vaccine/vaccination-specific influences), and were explored as potential determinant of VH and vaccination refusal or delay. RESULTS: 7.7% of subjects were defined as VH parents (VHPs) through PACV score, while 24.6% reported having refused or delayed at least one dose of vaccine for their child. VH was more common in those parents that decided not to vaccinate their child after having received information from mass-media, in those who did not agree with mandatory vaccinations, and in those who agreed with political leaders who oppose to vaccination. Vaccine refusing/delaying parents were more frequently those who agreed that infant vaccinations are primarily an economic business of pharmaceutical companies, and who disagreed that access to the kindergarten should only be allowed to children who had been vaccinated. CONCLUSION: The findings of the present study emphasize the importance of PACV as a tool to screen VHPs. Furthermore, results highlight important potential determinants of VH, such as communication and media environment, and attitudes about prevention. Health care providers could act as key components to improve the public trust to scientific and epidemiological evidence.

To what extent do hospitalised patients receive appropriate CT and MRI scans? Results of a cross-sectional study in Southern Italy.

OBJECTIVES: The aim of this study was to assess the frequency of appropriateness of inpatient CT and MRI scans performed in Southern Italy. METHODS: The study was carried out by retrospectively reviewing medical records of adult patients admitted between 1 January and 31 December 2012 in two hospitals. The evaluation of appropriateness was performed according to the American College of Radiology Appropriateness Criteria, which assigns a score between 1 and 9. RESULTS: Eight hundred and fifty-three medical records were reviewed. Six hundred and thirty-nine patients received CT examinations and 256 received MRI examinations. Four hundred and ninety-six (77.6%) of the patient population had appropriate CT and 202 (78.9%) received appropriate MRI examinations. The appropriateness was associated with: a confirmation of the diagnostic hypothesis, only one examination performed during hospital stay, the anatomical scan region, with musculoskeletal system being the least appropriate anatomical scan region. Moreover, for CT examinations, appropriateness was also associated with no use of contrast agent. CONCLUSIONS: Our findings highlight the need to reduce inappropriate use of CT and MRI. The study showed that the tool used is reliable to measure the extent of appropriateness of diagnostic imaging for inpatient examinations.

Internet and social media use for antibiotic-related information seeking: Findings from a survey among adult population in Italy.

BACKGROUND: The Internet represents an increasingly common source of health-related information. Internet and Social Media can be used to promote a prudent use of antibiotics. OBJECTIVE: To establish the extent of Internet and Social Media use to search for antibiotic related information and the potential implications in health care among adult population in Italy. METHODS: This cross-sectional study was conducted from March to May 2017, among a sample of parents of public school students. A 2-stage cluster sample design was planned. An informed consent form and a questionnaire were given to selected students to deliver to their parents. The questionnaire included questions on knowledge, attitudes, and behavior toward antibiotic use, and questions about Internet use to gather information about antibiotics. RESULTS: A total of 913 parents completed the questionnaire, with a 67.4% response rate; 22.1% did not know when it was appropriate to use antibiotics. 32.3% of parents reported self-medication with antibiotics. 73.4% of respondents used the Internet to search for information about antibiotic use. Among social networks users, 46.5% reported the use of these media to get information about antibiotics and 45% of instant messaging app users share information about antibiotics. The results of the multiple logistic regression analysis showed that Internet use to search for antibiotic-related information was higher among females, younger subjects, with a higher level of education, in those who reported self-medication with antibiotics and in those who needed additional information on side effects of antibiotics from the GP compared with those who did not need any additional information. Internet use was significantly less likely in participants with cardiovascular diseases and cancer compared with those without chronic conditions, and in those who reported to strongly agree/agree, or were uncertain about antibiotic use without a GP prescription, compared with those who reported to be disagree/strongly disagree. CONCLUSIONS: Internet and social media are widely used for antibiotic-related information seeking in the Italian population. Health organizations must consider social media within their communication strategy to promote the appropriate Web use for antibiotic-related information seeking in the general population, although more evidence is needed regarding the optimal mix of communication interventions.

Alcohol use in early adolescence: findings from a survey among middle school students in Italy.

BackgroundThe aims of this study were to measure the extent of alcohol use among a sample of early adolescents and to provide information on the factors influencing the consumption.MethodsData were collected via self-administered anonymous questionnaires from 1,520 middle school students (mean age of 13.1 years (range 12-15 years)), who were recruited from a random sample of public schools in Calabria Region, Italy.ResultsA total of 1,032 participants completed the survey for a response rate of 68%. Nearly 70% of the respondents had drunk at least once during their lifetime, and 16.7% reported consuming alcohol during 30 days before the survey. Multivariate analysis showed that the factors associated with the consumption of alcohol were being male (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.41-0.80), being older (OR 1.88, 95% CI 1.37-2.56), living in an urban area (OR 0.29, 95% CI 0.21-0.40), reporting a sad self-perceived mood (OR 2.76, 95% CI 1.87-4.48), reporting parental drinking habits (OR 7.11, 95% CI 5.02-10.08), and not considering alcohol use as an unhealthy behavior (OR 2.43, 95% CI 1.11-5.31).ConclusionAlcohol use among early adolescents is widespread. Multicomponent interventions are required in order to reduce the average levels of alcohol drinking among early adolescents.

[Knowledge, attitudes, and training needs of residents in Preventive Medicine and Hygiene in Italy, in the context of Primary Health Care]. / Ricognizione dei bisogni formativi dei medici specializzandi di Igiene e Medicina Preventiva nell'ambito dell'Assistenza Primaria: risultati di una survey online.

In June 2015, the working group "Primary Health Care" of the Italian Society of Hygiene Representatives of Hygiene and Preventive Medicine Residents, performed an online questionnaire survey among residents of this specialty in Italy, to analyze their training needs regarding primary health care. In total, 730 residents in 32 schools were invited to participate by email, of whom 40.7% (297/730) completed the questionnaire. Most of the respondents were female (66.7%) and 40.1% were enrolled in a school in northern Italy. Almost half of participating residents were enrolled in the second or third year of the five-year program. Over 65% reported interest in deepening their knowledge in each of the proposed thematic areas of primary healthcare. For each area, less than one quarter of respondents (range 5-22%) considered satisfactory the skillsets acquired in that area. Eighty-seven percent reported that the option to do electives in primary health care during the residency was available to them.

Parents seeking health-related information on the Internet: cross-sectional study.

BACKGROUND: The Internet represents an increasingly common source of health-related information, and it has facilitated a wide range of interactions between people and the health care delivery system. OBJECTIVE: To establish the extent of Internet access and use to gather information about health topics and the potential implications to health care among the adult population in Calabria region, Italy. METHODS: This cross-sectional study was conducted from April to June 2012. The sample consisted of 1544 adults aged ≥18 years selected among parents of public school students in the geographic area of Catanzaro in southern Italy. A 2-stage sample design was planned. A letter summarizing the purpose of the study, an informed consent form, and a questionnaire were given to selected student to deliver to their parents. The final survey was formulated in 5 sections: (1) sociodemographic characteristics, (2) information about chronic diseases and main sources of health care information, (3) information about Internet use, (4) data about the effects of using the Internet to search for health information, and (5) knowledge and use of social networks. RESULTS: A total of 1039 parents completed the questionnaire, with a response rate equivalent to 67.29%. Regarding health-related information types, 84.7% of respondents used the Internet to search for their own medical conditions or those of family members or relatives, 40.7% of parents reported looking for diet, body weight, or physical activity information, 29.6% searched for vaccines, 28.5% for screening programs, and 16.5% for smoking cessation tools and products. The results of the multiple logistic regression analysis showed that parents who looked for health-related information on the Internet were more likely to be female (OR 1.53, 95% CI 1.05-2.25), with a high school diploma (OR 1.69, 95% CI 1.02-2.81) or college degree (OR 2.14, 95% CI 1.21-3.78), younger aged (OR 0.96, 95% CI 0.94-0.99), with chronic conditions (OR 1.94, 95% CI 1.17-3.19), not satisfied with their general practitioner's health-related information (OR 0.6, 95% CI 0.38-0.97), but satisfied with information from scientific journals (OR 1.99, 95% CI 1.33-2.98). CONCLUSIONS: Our analyses provide important insights into Internet use and health information-seeking behaviors of the Italian population and contribute to the evidence base for health communication planning. Health and public health professionals should educate the public about acquiring health information online and how to critically appraise it, and provide tools to navigate to the highest-quality information. The challenge to public health practice is to facilitate the health-promoting use of the Web among consumers in conjunction with their health care providers.