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Vincenti S, La Milia DI, Boninti F, Marchetti E, Wachocka M, Laurenti P. Effect of ClO2 on the distribution of Legionella pneumophila serogroups in a Teaching Hospital. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The prevention of Legionella colonization of water systems is one of the goals of hospital management. Among chemical disinfection methods, chlorine dioxide (ClO2) has been largely used to control Legionella in water systems. We analysed the distribution of Legionella pneumophila serogroups (sg) and Legionella other spp before (PRE) and after (POST) installation of chlorine dioxide (ClO2) continuous disinfection systems in a Teaching Hospital in Rome.
According to the Italian National Guidelines, our surveillance plan involved a systematic sampling of the water system. The sampling was performed from Jan. 2010 to Dec. 2019. From 2011 to 2019, ClO2 continuous disinfection systems were installed in all hot water system of the hospital, and maintained at a concentration of 0.25 mg/l at the end point. The isolated strains of Legionella were first serotyped using a kit that identifies sg1, other species and that discriminate sg from 2 to 15.
1505 hot water samples were collected from the Hospital and analysed. 363 samples are PRE and 1142 are POST activation of ClO2. Only the 16.74% of monitored sampling points were colonized by Legionella during the study period. This percentage decrease from 31.40% of PRE samples, to 12.08% of POST samples (p ≤ 0.000). The sg isolated were: sg3 (60.31%), sg8 (17.12%), sg1 (16.73%), sg6 (1.95%) and other species (3.89%). Comparing the distribution of sg between the PRE and POST samples, the sg8 showed a high increase (+136.84%) and the sg3 a slight decrease (-17.94%). These variations were statistically significative.
The results showed a predominance of Legionella pneumophila sg3, compared to what was observed in a multicenter study conducted between different hospitals of various regions of Italy, where sg6 was the major isolate. The ClO2 affect the distribution of sg, in particular for sg8. This interesting result will be further investigated.
Key messages
Our data deriving from an environmental monitoring plan, show that the ClO2 affects the distribution of Legionella’s serogroups. The ClO2 reduces the percentage of samples colonized by Legionella. The ClO2 reduces the percentage of samples colonized by Legionella.
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Affiliation(s)
- S Vincenti
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - D I La Milia
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - F Boninti
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - E Marchetti
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Wachocka
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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2
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Barbara A, Azzolini E, DiPumpo M, La Milia DI, Vallone D, Lagioia M, Cambieri A, Damiani G, Ricciardi W, Laurenti P. FLUChallenge: an innovative strategy to increase flu vaccination in two Italian Teaching Hospitals. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
In Europe flu vaccination among healthcare workers (HCWs) is strongly recommended even though not mandatory such as elsewhere (USA). Despite this, vaccination coverage in EU countries is usually low: 30.2% in 2016-17. In Italy, at the end of the same season it was 15.6%. Aim of this study is to describe and evaluate the new strategy adopted by Gemelli and Humanitas Research Hospitals, two Italian Teaching Hospitals (THs) part of the MIRO Public Health Center, to increase the vaccination coverage among their HCWs.
Before the 2019-20 campaign, experts of the two THs met up to identify a common strategy to promote flu vaccination among HCWs in addition to the ones already implemented. It was decided to launch a FLUChallenge: a platform of monitoring updated bi-weekly and available on the THs' internal websites with the vaccination coverage overall and stratified by job category and macro-areas of activity. Descriptive and inferential analysis were performed.
Preliminary Results
6673 HCWs included (4241 Gemelli, 2432 Humanitas). The overall flu vaccination coverage at the end of the 2019-20 campaign was 28.4% (1026 HCWs vaccinated Gemelli, equal to 24.2%; 869 HCWs vaccinated Humanitas, 35.7%). Both THs significantly increased the vaccination coverage compared to the previous year (+10% Gemelli, 22% in 2018-19, p = 0.01; +45.7% Humanitas, 24.5% in 2018-19, p < 0.001). Physicians had the highest coverage both in Gemelli (483/1320, 36.6%) and Humanitas (443/979, 45.2%), while the lowest was registered among nurses in Gemelli (357/2017, 17.7%) and other HCWs in Humanitas (134/605, 22.1%). Infectious disease was the macro-area with highest coverage in Gemelli (32.3%), while in Humanitas the emergency department (63.9%).
The FLUChallenge intervention was an effective strategy to increase flu vaccination coverage in the two TH. The website platform was useful for the purpose of accountability and able to create a positive challenge between the HCWs working in the two THs involved.
Key messages
Flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission. It is important to promote new engagement and innovative strategies to increase flu vaccination coverage among HCWs, when it is not mandatory.
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Affiliation(s)
- A Barbara
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Azzolini
- Humanitas Research Hospital, Rozzano (Milano), Italy
| | - M DiPumpo
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - D I La Milia
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - D Vallone
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Lagioia
- Humanitas Research Hospital, Rozzano (Milano), Italy
| | - A Cambieri
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - G Damiani
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - W Ricciardi
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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3
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Di Pumpo M, Lanza TE, Villani L, Aulino G, Barbara A, La Milia DI, Moscato U, Damiani G, Ricciardi W, Laurenti P. Flu vaccination coverage among healthcare workers: the example of younger generations. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Flu vaccination is highly recommended among Healthcare Workers (HCWs). The low coverage in Italy among HCWs (mean 15.6% for 2016/17 flu season, ECDC) calls for new approaches. The aim of this study was to evaluate in which measure the vaccination coverage among HCWs registered during the 2019-2020 flu vaccination campaign in a large Teaching Hospital in Rome was affected by age and education.
A retrospective observational quasi-experimental study was conducted. Descriptive and inferential statistical analysis (chi-square test, significance level of 0.05) were performed. The 2019-2020 flu vaccination campaign was aimed at more than 4000 employed HCWs (total coverage 24.2%). Vaccination was also extended to not-employed HCWs such as Medical Residents (MRs) and Medical Students (MSs) in clinical training. The coverage in this groups was higher (46.0% and 63.2% respectively) and the difference between them and the coverage among employed HCWs was statistically significant (p < 0.05); Further analysis was performed comparing MRs / MSs in clinical training with their respective professional group of employed HCWs, with a percentage of vaccinated Medical Doctors (MD) of 36.6%. MRs / MSs in clinical training coverage was higher than MDs coverage and the difference still proved to be statistically significant (p < 0.05).
The higher coverage among MRs / MSs in clinical training could be explained, in general, in light of the more open-mindedness to prevention and to healthy lifestyles that characterizes young people with an up-to-date education. It could also be explained considering the specific culture and sense of responsibility of Medical Students and Medical Residents towards their high-demanding educational path and clinical training as an incentive not to get ill.
Flu vaccination is highly recommended among HCWs. Younger generations, who represent the future of Healthcare, prove to be more open-minded and responsible towards good prevention practices such as this.
Key messages
Flu vaccination is highly recommended among HCWs. Younger generations, who represent the future of Healthcare, prove to be more open-minded and responsible towards good prevention practices.
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Affiliation(s)
- M Di Pumpo
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - T E Lanza
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Villani
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Aulino
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Barbara
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - D I La Milia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - U Moscato
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Damiani
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - W Ricciardi
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Pecere S, Gibiino G, La Milia DI, Bertè G, Burrelli Scotti G, Petruzziello C, Minordi LM, Manfredi R, Franceschi F, Ojetti V, Gasbarrini A. Acute uncomplicated diverticulitis: key points for early management. A single-centre retrospective study. Eur Rev Med Pharmacol Sci 2020; 24:2710-2718. [PMID: 32196622 DOI: 10.26355/eurrev_202003_20543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Acute uncomplicated diverticulitis is an important clinical condition usually managed in clinical practice with antibiotic therapies and hospitalization in ward. In this setting, recent papers and guidelines suggest to limit the use of antibiotics in selected cases and encourage an early discharge in low-risk patients. The purpose of this retrospective study is to identify serological inflammatory markers and CT findings of acute uncomplicated diverticulitis (AUD) at the onset of the disease and the correlation with the need for in-patient or out-patient management. PATIENTS AND METHODS It was used a database drawn from the collection of the patients admitted to our Emergency Room from January 2016 to 2019 and undergoing urgent abdominal CT-scan for suspicious of acute diverticulitis. For each patient we considered biochemical and radiological parameters at the onset of the disease and if patients were managed as in-patients (hospitalization in ward) or as out-patient (early discharged or after observation in Short Stay Unit). RESULTS Among patients with early diagnosis of AUD, 108 (65%) were hospitalized in ward with mean time of in-stay of 6.94 days, while only 58 (35%) patients with same diagnosis were managed as out-patient and early discharged from emergency room or after observation in short stay unit with a mean time of in-stay significantly shorter (3.39 days, p-value 0.0007). Higher levels of C reactive protein and the length of colon involved considered as percentage (%) in comparison with the entire colon were significantly related to the need for hospitalization (p-value 0.03). CONCLUSIONS Biochemical parameters and a more advanced radiological evaluation, as the length (%) of colon involved, could allow a stratification of patients with diagnosis of AUD at the admission and help physicians in the early management.
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Affiliation(s)
- S Pecere
- Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
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5
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Pumpo MD, Barbara A, La Milia DI, Tamburrano A, Vallone D, Gentili A, Cavalieri S, Viora C, Berloco F, Laurenti P. Flu vaccination coverage in a large Italian teaching hospital: the example of the leaders. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Annual flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission especially to frail patients. In our teaching hospital, flu vaccination rate among HCWs has been growing during last 3 years. The aim of this study was therefore to describe the flu vaccination coverage across the past 3 years and to analyze which factors lead to such increase. We performed a cross-sectional study on all HCWs of Fondazione Policlinico Universitario “A. Gemelli” (FPG) hospital of Rome (Italy) to determine the flu vaccination coverage. Socio-demographic and occupational data were collected from hospital personnel records and included age, gender, previous flu vaccination, profession and workplace unit. On site vaccination plus academic detailing involving leaders have been the main strategies adopted in this last 3 years that have already proved to be effective in increasing vaccination coverage among HCWs. During the 2018-2019 season, we analyzed how the flu vaccination coverage among leaders (nurse coordinators and head physicians) could affect all HCWs coverage rate. Flu vaccination rate increased from 9.57% in the 2016-17 to 14.24% in the 2017-18 and to 22.38% in 2018-2019. A total of 4035 HCWs employed in the FPG were included in 2018-19. Concerning the role played by vaccination of leaders in increasing general vaccination coverage during the 2018-2019, the group of HCWs with a vaccinated leader showed a higher coverage rate (28.65%) than the group with a non-vaccinated leader (16.22%) (p < 0.0001). The results are preliminary. Flu vaccination coverage of HCWs in our hospital during the last 3 years has been increasingly higher. Vaccination of the leaders, in addition to previously implemented effective strategies, resulted to be a key factor in increasing flu vaccination coverage among all HCWs. Socio-demographic and occupational variables can significantly influence the coverage rate as well.
Key messages
Annual flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission especially to frail patients. This study shows the growing flu vaccination coverage rate in our teaching hospital and the effectiveness of the example given by the vaccinated leaders in increasing the coverage among all HCWs.
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Affiliation(s)
- M Di Pumpo
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Barbara
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D I La Milia
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Tamburrano
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D Vallone
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Gentili
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Cavalieri
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Viora
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Berloco
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Sezione di Igiene – Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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6
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Gentili A, La Milia DI, Vallone D, Di Pumpo M, Vangi G, Berloco F, Cambieri A, Damiani G, Laurenti P, Ricciardi W. A six-years point prevalence survey of healthcare-associated infections in an Italian hospital. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Healthcare-Associated Infections (HAIs) are among the most serious public health problems in Europe representing the most frequent adverse event during care delivery. Despite their limitations, point prevalence surveys of HAIs are often preferred to prospective surveillance, since they provide a feasible estimate when resources are limited.
The aim of this study was to analyze the results of a six-years point prevalence survey of HAIs in a teaching acute care hospital in Italy and to investigate the main risk factors of HAIs in the acute-care hospital. A point prevalence survey to detect HAIs was carried out in Gemelli Hospital during the last 6 years, from 2013 to 2018. Inpatients of any age in Gemelli Hospital were eligible for inclusion. Patients in outpatient areas were excluded. HAIs were identified according to diagnosis guideline from ECDC in 2011. Statistically significant differences were tested through t-test and Chi-square test. Multi-variate analysis was performed to evaluate the impact of regressor factors for predict HAI’s prevalence. The statistical significance level was set at p < 0.05. The point prevalence ranged from 3,16% in 2017 to 6,64% in 2013. Pneumonia and surgical site infections (SSI) were the most frequent HAIs during the 6 years, with a rate of 27,31% and 26,20% respectively of all HAIs. The multiple logistic regression showed that length of stay at the moment of detection, urinary catheter, CVC and antibiotic therapy are useful to meaningfully predict HAI prevalence, with a regression coefficient (adjusted R2) of 0.2780.
Thanks to proper hospital policies, the point prevalence of HAIs does not seem to increase through the years, even though it is still too early to draw any conclusions. Pneumonia and SSI represented each one more than a quarter of all the HAIs, as reported also in literature. There is a strong association between length of stay at the moment of detection and HAIs but it is hard to understand which one is the cause of the other.
Key messages
Point prevalence from 2013 to 2018 seems to be stable. An accurate incidence survey is needed in order to identify the main risk factors of HAI and to realize more specific hospital programmes. Length of stay at the moment of detection is useful to meaningfully predict HAIs prevalence although the cause-and-effect relationship is still not clear.
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Affiliation(s)
- A Gentili
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D I La Milia
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - D Vallone
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Di Pumpo
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Vangi
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - F Berloco
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - A Cambieri
- Medical Management, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - G Damiani
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - P Laurenti
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
| | - W Ricciardi
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
- Radioprotection and Hospital Hygiene Unit, Fondazione Agostino Gemelli IRCCS, Rome, Italy
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7
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de Waure C, Quaranta G, Ianuale C, Panatto D, Amicizia D, Apprato L, Campanella P, Colotto M, De Meo C, Di Nardo F, Frisicale EM, La Milia DI, Rizzitelli E, Aquilani S, Briata MP, Frumento V, Marensi L, Spadea A, Turello V, Gasparini R, Ricciardi W. Knowledge, attitudes and behaviors of the Italian population towards Neisseria meningitidis, Streptococcus pneumoniae and HPV diseases and vaccinations: A cross-sectional multicentre study. Public Health 2016; 141:136-142. [PMID: 27931989 DOI: 10.1016/j.puhe.2016.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/11/2016] [Accepted: 09/06/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study addressed knowledge of Streptococcus pneumoniae, Neisseria meningitidis and human papillomavirus (HPV), and attitudes and behaviours towards vaccines against them. STUDY DESIGN This is a cross-sectional, multicentre study. METHODS Data were collected through a questionnaire administered to 530 adults who accessed four Departments of Prevention of the Italian National Health Service in 2013. RESULTS Less than 50% of people gave the right answer to all the questions concerning the three diseases, but 96.2%, 94% and 92.7% agreed with the importance of vaccination against N. meningitidis, S. pneumoniae and HPV, respectively, and 58.4% expressed own willingness to have their children vaccinated with N. meningitidis B vaccine. The attitude towards vaccination was more positive in women for N. meningitidis and in people having children for HPV. Furthermore, individuals giving correct answers to all knowledge items were more in favour of both HPV and S. pneumoniae vaccination. A total of 68.8%, 82.6% and 84.5% of respondents vaccinated their own children against N. meningitidis C, S. pneumoniae and HPV, respectively. About 50% of the respondents reported paediatricians' or other health professionals' recommendations as the main reason for vaccination. CONCLUSIONS Vaccinations may be promoted through actions aimed at increasing citizens' knowledge. Health professionals should be educated to actively provide information on vaccinations in a clear, comprehensive and effective way.
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Affiliation(s)
- C de Waure
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - G Quaranta
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - C Ianuale
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - D Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Italy
| | - D Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Italy
| | - L Apprato
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Italy
| | - P Campanella
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - M Colotto
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - C De Meo
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - F Di Nardo
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - E M Frisicale
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - D I La Milia
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - E Rizzitelli
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Italy
| | - S Aquilani
- Dipartimento di Prevenzione ASL Viterbo, Italy
| | - M P Briata
- Dipartimento di Prevenzione S.C. Igiene e Sanità Pubblica ASL2 savonese, Italy
| | - V Frumento
- Dipartimento di Prevenzione S.C. Igiene e Sanità Pubblica ASL2 savonese, Italy
| | - L Marensi
- Dipartimento di Prevenzione S.C. Igiene e Sanità Pubblica ASL3 genovese, Italy
| | - A Spadea
- UOS Medicina Preventiva Età Evolutiva IV Distretto, ASL RMA, Italy
| | - V Turello
- Dipartimento di Prevenzione S.C. Igiene e Sanità Pubblica ASL3 genovese, Italy
| | - R Gasparini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Italy
| | - W Ricciardi
- Istituto di Sanità Pubblica - Sezione di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
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8
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La Milia DI, Laurenti P, Damiani G, Moscato U, Bruno S, Boccia S, Quaranta G, Posteraro B, Ficarra MG, Vincenti S, Milovanovic M, Avolio M, Raponi M, Ricciardi W. A three-steps integrated program of hospital environmental surveillance: costs and potential savings. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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9
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Russo R, Sciacca S, La Milia DI, Poscia A, Moscato U. Vanadium in drinking water: toxic or therapeutic?! Systematic literature review and analysis of the population exposure in an Italian volcanic region. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku162.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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