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Mental health issues are common among university students. Nevertheless, few studies focused on Italian students. This study aimed to assess prevalence and associated factors of perceived stress (PS), depressive symptoms (DS) and suicidal ideation (SI) in an Italian sample. A cross-sectional study was conducted amongst a convenience sample of students in humanities field (2018). Questionnaires were self-administered. Outcomes were assessed through Beck Depression Inventory-II (DS, SI) and Perceived Stress Scale (PS). Multivariable regressions were performed (p-value < 0.05 significant; sample size = 203). DS and SI prevalence was 30.6% and 8.8%. PS median score was 20 (IQR = 11), 87.7% reported moderate/severe PS. DS likelihood was increased by psychiatric disorders family history and not attending first year of course and decreased by not thinking that university hinders personal activities. Chronic disease and higher stress score increased SI probability; good/excellent family cohesion reduced it. Being female, thinking that university hinders resting/relaxing, seeing a psychologist/psychiatrist were positively associated with PS; having no worries about future was negatively associated. A high prevalence of mental health issues was reported, with miscellaneous associated factors that were linked to both private and social aspects. Universities must be aware of this to provide efficient preventive measures. [ABSTRACT FROM AUTHOR]

This study aimed to assess depression, anxiety, posttraumatic stress disorder (PTSD) and discrimination in African migrants and investigate determinants. A cross‐sectional study was conducted in Italy (July 2019–February 2020). Inclusion criteria: being a citizen of an African country or having parents who are citizens of an African country. Questionnaires included tests for depression, anxiety, PTSD, discrimination. Multivariable regressions were performed. Participants were 293. The prevalence of depression, anxiety, and PTSD was: 12.1%, 12.1%, and 24.4%. Only 7.2% declared not to be discriminated. Among significantly associated factors, waiting for/being in possession of temporary permits and discrimination were associated with all mental outcomes. Being (or having parents from) Sub‐Saharan Africa increased the likelihood of discrimination. A relevant prevalence of mental illnesses was reported. Particularly, Sub‐Saharan Africans potentially offer a unique point of view. Migrants' mental health should be a priority for national and international programs of health monitoring. [ABSTRACT FROM AUTHOR]

An excessive control of quality of food can turn into Orthorexia Nervosa (ON). The organic store customers (OSCs) can be apopulation at risk for ON. The aims of this study were to assess ON symptoms prevalence among them, comparing them with non-OSCs and investigate potential predictors of ON. Across-sectional survey was carried among 121 OSCs and 119 non-OSCs. The questionnaire assessed socio-demographic characteristics and investigated current dietary habits. The main outcome measures used were ORTO-15 and Eating Habits Questionnaire (EHQ). Chi-squared analyses were performed to assess differences between groups (OSCs and non-OSCs). Logistic and linear regressions were performed to evaluate potential predictors of ON symptoms and to compare questionnaires. As main results, OSCs had ahigher probability to result positive at ORTO-15 compared to non-OSCs. The prevalence among OSCs was 69.4% and 23.1% (using ORTO-15 with 40 and 35 cut-offs). Higher EHQ scores were reported among OSCs (p < 0.001). Potential predictors were mainly being an OSC or following food restrictions. Predictors varied using different cut-offsof ORTO-15 and EHQ. These results suggest the association between OSCs and ON symptoms. Some differences were found between ORTO-15 and EHQ. Further studies need to be performed to improve diagnostic tools. [ABSTRACT FROM AUTHOR]

Introduction: The gastro‐oesophageal reflux disease (GERD) is a public health issue for its prevalence and association with low life quality and substantial costs. Since most of Italian data refer to over a decade ago, the aim was to provide an updated estimate of GERD symptoms prevalence. Knowledge about appropriate nutrition and behaviours in presence of GERD was assessed. Predictors for symptoms presence and knowledge were explored. Methods: This study was an online cross‐sectional survey that investigated socio‐demographics, knowledge about nutrition/behaviours in case of GERD (Knowledge Score KS: percentage of right answers), nutrition/lifestyle attitudes. The questionnaire included the GerdQ to assess symptoms (presence if score ≥8). Adults resident in Italy were enrolled between June and August 2019 through convenience sampling on the major social networks (sample size = 559). Descriptive analyses were run. Multivariable regressions were performed to explore predictors of symptoms presence and KS. Results: The 27.7% had GERD symptoms. Among them, 33.8% never received GERD information by their general practitioner (GP). Body mass index (P =.036), secondary education (P =.040) were associated with higher symptoms risk. Weekly exercise was associated with lower risk (P <.001). Median KS was 92% (IQR = 12). Sleeping on the left side, chocolate, citrus fruit, mint reported the lowest right answers percentages. None/basic education was negatively associated with KS (P <.001), being female (P =.004) and in a relationship (P =.012) positively. Conclusions: A high prevalence was reported, consistently with the worldwide increasing trend. Despite overall knowledge was high, specific gaps were found. GPs should improve communication and awareness campaigns targeted to less known aspects must be planned. [ABSTRACT FROM AUTHOR]

Improving health literacy is a public health goal. Our aim was to validate the Italian version of the Medical Data Interpretation Test (MDIT-I) and create a MDIT-I short version. This cross-sectional study assessed gender, age, education, biomedical employment, MDIT-I and its short version. Internal consistency was evaluated through Cronbach's a; construct validity by comparing MDIT-I score across education levels and employment fields. There were 141 participants, 50.4% were female and the median age was 37 (IQR 31). MDIT-I internal consistency was good (a=0.747) and construct validity was confirmed. The short version had a=0.66 and construct validity was confirmed like the long version. The short version score was tested in correlation: Spearman's 1=0.932 (p-value<0.001). The scores were dichotomized and Cohen's was estimated to be 0.786. Long and short MDIT-I showed good internal consistency and construct validity and could be used to increase knowledge about health literacy in the Italian population. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives: Seasonal flu represents a major public health issue, especially for health care workers (HCWs). WHO highlights the need of higher awareness and flu vaccine coverage among HCWs. In Europe the coverage is less than 30‐40%. Italy reports some of the lowest rates. The paper aims to illustrate the 2017/2018 flu vaccination campaign within Molinette, the third Italian hospital for dimensions, to provide inputs about strategies for increasing HCWs coverage. The campaign objective was to increase the administered doses at least of 30%. Methods: The intervention included informational material, direct educational sessions for workers, extension of the access time to Occupational Medicine Service, elimination of the reservation requirement, composition of "moving vaccination units" (MVUs), and organisation of vaccination sessions within departments. Results: In 2017/2018, 593 doses were administered. The doses percentage change between 2017/2018 and 2016/2017 vaccination seasons was +46.06%, while it was +84.74% compared with the previous 5‐year period mean. The majority was administered by Occupational Medicine Service, while 6.75% by MVUs. Among the total doses, 72.68% were administered to workers, 13.49% to residents, 6.75% to students, and 7.08% to "other". So, 7.68% of total workforce was vaccinated. Only 0.3% of vaccinated people presented mild adverse reactions. Conclusions: A combined campaign, that includes actions for education, increase of awareness, improved access to facilities and active offers to workers has potentiality but there is still work to do. The vaccination increase was determined mostly by the re‐organization of the occupational medicine, while the MVUs were useful to HCWs of detached offices. [ABSTRACT FROM AUTHOR]

Background: Four percent of the world's population suffers from depression, which is a major public health issue. Medical students are at risk, as their depressive symptoms (DS) prevalence is reported to be approximately 27% worldwide. Since few data on Italian medical students exist, this study aimed to estimate their DS prevalence and assess risk and protective factors. Methods: The PRIMES was a multicentre cross-sectional study performed in 12 Italian medical schools. Questionnaires were self-reported and included 30 sociodemographic items and the Beck Depression Inventory-II (BDI-II). The primary outcome was the presence of DS (BDI-II score≥14). The main analyses were chi-squared tests and multivariable logistic regressions with a p-value<0.05 considered significant. Results: The number of collected questionnaires was 2,513 (117 BDI-II incomplete). Females accounted for 61.3% of the respondents, and the median age was 22 years (IQR = 4). The prevalence of DS was 29.5%. Specifically, 14.0% had mild depression, 11.1% had moderate depression, and 4.5% had severe depression. The main risk factors for DS were age, being female, bisexual/asexual orientation, living with partner/housemates, poor economic status (worsened by living far from home), less than 90 min of weekly exercise, relatives with psychiatric disorders, personal chronic disease, judging medical school choice negatively, unsatisfying friendships with classmates, competitive and hostile climate among classmates, thinking that medical school hinders specific activities and being worried about not measuring up to the profession. Protective factors included family cohesion, hobbies, intellectual curiosity as a career motivation and no worries about the future. Conclusion: Italian medical students are at high risk of reporting DS, similar to the global population of medical students'. Medical schools must make efforts to implement preventive and treatment interventions by offering counselling and working on modifiable factors, such as lifestyle and learning climate. [ABSTRACT FROM AUTHOR]

Aim: The lack of health professionals and the physicians' migration trend represents a challenging issue for the health systems' sustainability worldwide. The current study aims to evaluate the intentions of Italian medical students to pursue their own careers abroad by investigating the push and pull factors of migration., Subject and Methods: A cross-sectional study was performed among Italian medical students through a self-administered questionnaire. Primary and secondary outcomes were established as the intention of moving abroad after graduation and knowledge about residency programmes, application, quality training and remuneration in the country of interest. Descriptive analysis for all variables and univariable and multivariable regression for primary and secondary outcomes were performed., Results: Overall, 307 medical students took part in the study. More than half of the sample considered moving abroad after graduation, mainly to find a higher quality training programme. Regression analysis highlighted a significant association between the primary outcome and general personal and professional reasons, as well as previous experiences abroad, whereas bureaucratic procedures were perceived as the main barrier. Perceived better knowledge about residency programmes and quality of training related to sources of information such as the Internet (blogs, forums, websites) and medical associations., Conclusion: Retention policies are necessary to meet the expectations and requests of future generations of doctors by allocating financial resources to offer high-quality training and broad career opportunities, together with appropriate wages, as crucial factors for discouraging the migration of healthcare professionals.

Background: Scientific evidence demonstrates that poor sleep quality can lead to various health problems. This study aimed to investigate sleep patterns among Italian university students and identify several factors that may contribute to its quality., Study Design: Cross-sectional study., Methods: An electronic questionnaire regarding sociodemographic characteristics, lifestyle, and sleep-related habits, including the Pittsburgh Sleep Quality Index (PSQI) questionnaire, was distributed between January 2022 and July 2023 among students belonging to 12 universities located in Northern, Central, and Southern Italy., Results: On a total of 1,674 questionnaires collected, the participants (mean age 24.06±4.56 years, 71.3% F) reported an average number of hours of nocturnal sleep equal to 6.89±1.28 hours. A total of 927 (54.6%) of respondents showed a poor sleep quality (PSQI >5). Regression analysis showed that better sleep quality is associated with lower age, attending universities in Northern Italy, less time spent on electronic devices during the day, not being used to study at night and not playing videogames before sleep., Conclusion: From a public health perspective, our findings suggest that public health operators should raise the awareness of young adults about the importance of sleep quality for maintaining good health, as well as the impact that certain behaviors can have on sleep.

Introduction: Negative trends of trust in governments have been described around the world. This study aimed to describe the distrust level in the National Health Service (NHS) and in governmental management of the pandemic, one year after the start of the COVID-19 vaccination campaign., Methods: A survey was distributed in February 2022 among a convenience sample. Outcomes were measured through validated tools: Revised Health Care System Distrust Scale, and the COVID-SCORE-10 questionnaire. Associations were assessed using multiple linear regression models., Results: A total of 2111 questionnaires were collected (54.8% female, median age 43 years [IQR = 34-50]). Distrust in the NHS had a median level of 12 [IQR = 10-14], while trust in the government had a level of 47 [IQR = 35-60]. COVID-19 vaccine hesitancy, high educational attainment, worse economic status, low conventional and digital health literacy, as well as the presence of conspiracy thoughts and distrust in the NHS were significantly associated with lower trust in government during the COVID-19 pandemic. Lack of trust in governmental actions, along with low education and health literacy, as well as the presence of conspiracy thoughts and worse perceptions of one's own health, were associated with greater distrust in the NHS., Conclusions: Overall, low levels of trust in both the government and the NHS have emerged. Since the determinants of reduced trust in institutions can be very diverse and that such levels of distrust after a pandemic can last for an entire generation, tailored interventions are needed to rebuild adequate levels of trust in institutions among the population., Competing Interests: The authors declare no conflict of interest., (©2024 Pacini Editore SRL, Pisa, Italy.)

The VAX-TRUST project addresses vaccine hesitancy in seven European countries with a systematic and evidence-based approach. Interventions, targeting healthcare professionals, draw from behavioural and social theories. A checklist, inspired by the TIDieR (Template for Intervention Description and Replication), ensures a detailed description of actions, transparency and replicability. The intervention development process begins with collaborative meetings and systematic revisions, concluding with external evaluations for replicability in diverse public health contexts. This study aims to provide valuable insights for future complex interventions in public health, based on lessons learnt to reduce the risk of vaccine-preventable diseases. The analysis of educational interventions within the VAX-TRUST project has led to the definition of precise guidelines to ensure their replicability and adaptation to various contexts, attempting to establish a universally applicable approach. Active participant engagement and consideration of local social dynamics, beyond information transmission, have emerged as key factors to improve intervention effectiveness. Various educational tools and collaboration with academic institutions have contributed to strengthening credibility., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Objective: The aim was to investigate the role of different forms of social support in early sexual intercourse and contraceptive use., Materials and Methods: The study sample included 18,918 15-year-olds who took part in the 2018 Italian Health Behaviour in School-aged Children study. Multivariable multilevel logistic regressions were performed taking into account geographical region and socioeconomic status., Results: 21.7% of adolescents reported early sexual intercourse. 71.9% used a condom at last sexual intercourse, 12.2% oral contraceptives 41.2% other contraceptive methods (multiple response question). High support from family and from teachers were associated with a lower likelihood of early sexual intercourse in both genders, while peer support was shown to increase this likelihood among boys. Adolescents with high social support were more likely to use condoms., Conclusions: Social support can have a positive influence on adolescents' sexual behaviour. Sexual education programmes should aim to engage peers and those significant adults who can influence adolescents' lives, in and out of school.

The general practitioner (GP) has a significant role in primary care, being more than a gatekeeper to health services access. In Italy, if a citizen moves for studies for at least 3 months, he/she can choose temporarily another GP in the new city (the so-called "Healthcare Domicile" (HD)). The aims were to estimate the university students' knowledge about the HD, evaluate the frequency of the transition to another GP, and assess the university students' attitudes towards the primary care services. In 2018, a cross-sectional pilot study was performed in study rooms among students attending the University of Turin Participation was voluntary, anonymous, and without compensation. A 25-item questionnaire collected information about the sociodemographic characteristics, health services use, health conditions and medications, HD knowledge, and HD use. The outcomes were having the GP far away, knowing HD, and not moving the GP even if aware of HD. Chi-square test, Mann-Whitney U -test, and logistic regression analyses were performed. The significance level was p ≤ 0.05. Participants were 388 and those who knew HD were 45.36%. Among those who moved to Turin (44.85%), 77.67% knew HD but did not move the GP anyway. The 72.68% used medications without prescription (the most taken: nonsteroidal anti-inflammatory drugs and antibiotics). Age, nationality, and degree course type could be predictors for outcomes considered. HD knowledge was associated with a different use of healthcare resources. The data of the present paper suggest that further studies are required to better understand the framework connected with the university students' access to primary healthcare. Our results highlighted the need to implement campaigns targeted to university students to spread information about the HD and a more appropriate use of the healthcare services and medications., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Gianluca Voglino et al.)

Background: The age around 50 years represents a crucial point for women: menopause leads to biological changes and it begins breast and colon-rectal cancer screening. This study aimed at assessing frequencies of cardiovascular risk factors and analyzing participation in screening and vaccination., Methods: In 2017, a cross-sectional study was performed in Northern Italy. Totally, 12 249 women, aged between 50 and 54 years, were enrolled by General Practitioners (GPs). It was used a 21-item form, with information about: socio-demographic, anamnestic and clinical data, execution of a booster shot of tetanus-diphtheria-acellular pertussis (Tdap) vaccine in the last decade and of PAP-test, mammography and faecal occult blood test in the last 2 years. Descriptive and crosstab χ2 analyses were performed with STATA MP13. The significance level was P ≤ 0.05., Results: Our findings showed the presence of cardiovascular risk factors, such as obesity (10.95%), hypertension (13.76%), hyperlipidaemia (11.57%), glycaemia ≥ 100 mg dl-1 (16.97%), poor physical activity (73.49%), smoking (18.28%), cardiovascular family history (FH) (51.70%). There were a lower participation in colo-rectal cancer screening (45.09%) compared with breast (85.06%) and cervical (77.16%) cancer screening and an insufficient Tdap booster dose compliance (17.56%). Chi-square analyses showed correlations between cardiovascular FH and body mass index, hypertension, hyperlipidaemia, glycaemia and smoking, and between cancer FH and participation in breast and colo-rectal cancer screening (P < 0.05)., Conclusions: Women with cardiovascular disease FH represent a priority target of educational interventions considering the prevalence of concomitant risk factors. Programmes aimed at increasing screening and vaccination participation should be implemented., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)