The success of large-scale COVID-19 vaccination campaigns is contingent upon people being willing to receive the vaccine. Our study explored COVID-19 vaccine hesitancy and its correlates in eight different countries around the globe. We analyzed convenience sample data collected between March 2020 and January 2021 as part of the iCARE cross-sectional study. Univariate and multivariate statistical analyses were conducted to explore the correlates of vaccine hesitancy. We included 32,028 participants from eight countries, and observed that 27% of the participants exhibited vaccine hesitancy, with increases over time. France reported the highest level of hesitancy (47.3%) and Brazil reported the lowest (9.6%). Women, younger individuals (≤29 years), people living in rural areas, and those with a lower perceived income were more likely to be hesitant. People who previously received an influenza vaccine were 70% less likely to report COVID-19 vaccine hesitancy. We observed that people reporting greater COVID-19 health concerns were less likely to be hesitant, whereas people with higher personal financial concerns were more likely to be hesitant. Our findings indicate that there is substantial vaccine hesitancy in several countries, with cross-national differences in the magnitude and direction of the trend. Vaccination communication initiatives should target hesitant individuals (women, younger adults, people with lower incomes and those living in rural areas), and should highlight the immediate health, social and economic benefits of vaccination across these settings. Country-level analyses are warranted to understand the complex psychological, socio-environmental, and cultural factors associated with vaccine hesitancy.

Children obesity is a serious public health issue. This study aimed to investigate physical/sedentary activities of first-year primary schools children in Modena, and their association with overweight/obesity and dietary habits of children and family characteristics to identify the risk factors for unhealthy lifestyles. Child physical/sedentary activities were gathered through an anonymous questionnaire administered to parents, as well as family characteristics and weight/height of child and parents. Logistic regression models, eventually adjusted for parents’ sociodemographic characteristics, were used to analyze data. Questionnaires were delivered by 660 families (74.2%), of which 72 without anthropometric data were excluded. Three out of four children spent in physical activities less than 7 h/week, while 63.9% dedicated to sedentary activities two or more hours/day. From multivariate analysis, the habit significantly affecting children’s overweight/obesity was spending time on tablets/Personal Computers/mobile phones/videogames. Higher parental education level resulted in a protective factor for implementing unhealthy lifestyles in terms of time dedicated to physical/sedentary activities. Our results suggest the need of interventions to increase time for physical activity and to promote a responsible use of digital media involving the entire families to reach all parents regardless of their education and nationality with a possible relapse on other family members.

The formation of potentially carcinogenic N-nitrosamines, associated with monochloramine, requires further research due to the growing interest in using this biocide for the secondary disinfection of water in public and private buildings. The aim of our study was to evaluate the possible formation of N-nitrosamines and other toxic disinfection by-products (DBPs) in hospital hot water networks treated with monochloramine. The effectiveness of this biocide in controlling Legionella spp. contamination was also verified. For this purpose, four different monochloramine-treated networks, in terms of the duration of treatment and method of biocide injection, were investigated. Untreated hot water, municipal cold water and, limited to N-nitrosamines analysis, hot water treated with chlorine dioxide were analyzed for comparison. Legionella spp. contamination was successfully controlled without any formation of N-nitrosamines. No nitrification or formation of the regulated DBPs, such as chlorites and trihalomethanes, occurred in monochloramine-treated water networks. However, a stable formulation of hypochlorite, its frequent replacement with a fresh product, and the routine monitoring of free ammonia are recommended to ensure a proper disinfection. Our study confirms that monochloramine may be proposed as an effective and safe strategy for the continuous disinfection of building plumbing systems, preventing vulnerable individuals from being exposed to legionellae and dangerous DBPs.

Background: The immunization of healthcare workers (HCWs) plays a recognized key role in prevention in the COVID-19 pandemic: in Italy, the vaccination campaign began at the end of December 2020. A better knowledge of the on-field immune response in HCWs, of adverse effects and of the main factors involved is fundamental. Methods: We performed a study on workers at a nursing home in Northern Italy, vaccinated in January–February 2021 with two doses of the BNT162b2 vaccine four weeks apart, instead of the three weeks provided for in the original manufacturer protocol. One month after the second dose, the serological titer of IgG-neutralizing anti-RBD antibodies of the subunit S1 of the spike protein of SARS-CoV-2 was determined. The socio-demographic and clinical characteristics of the subjects and adverse effects of vaccination were collected by questionnaire. Results: In all of the workers, high antibody titer, ranging between 20 and 760 times the minimum protective level were observed. Titers were significantly higher in subjects with a previous COVID-19 diagnosis. Adverse effects after the vaccine were more frequent after the second dose, but no severe adverse effects were observed. Conclusions: The two doses of the BNT162b2 vaccine, even if administered four weeks apart, induced high titers of anti-SARS-CoV-2 neutralizing IgG in all the operators included in the study.

Antenatal care (ANC) is considered a cornerstone of reproductive health programmes, but many women face difficulties in accessing these services, particularly in some sub-Saharan African countries, such as Tanzania. This study aimed to test ANC visit acceptability using mHealth system PANDA (Pregnancy And Newborn Diagnostic Assessment) in the Mufindi district (Tanzania). We investigated the ANC visit acceptability of pregnant women and healthcare workers (HCWs) in an intervention area using the PANDA system compared with a control area. An ad hoc questionnaire was administered to pregnant women in an implementation area (n = 52) and in a control area (n = 46). In the implementation area, group interviews with 50 pregnant women were conducted and five HCWs evaluated ANC visits through a questionnaire. The implementation group was significantly more satisfied with the ANC visit compared with the control group. All the 52 women and the HCWs declared that PANDA icons were useful in understanding and remembering the provided information and the PANDA app was able to improve the ANC quality and to positively influence the relationship of HCWs and pregnant women. HCWs reported that the PANDA app was “easy-to-use” and “able to improve the adherence to ANC WHO recommendations”. In underserved areas, many pregnant women could benefit from the PANDA system increasing their access to high-quality ANC and overcoming language and/or literacy barriers.

In literature, the microbial diversity of hot spring waters has been the focus of extensive research, while there is a paucity of studies on thermal water distribution network of spa centres and as yet no studies have been carried out on the bacterial population of thermal muds. In this context, the aim of our study is to characterize the microbial community of sulphurous-bromine-iodine thermal water and mud within an Italian spa complex using Next Generation Sequencing (NGS) technologies. This is the first report of microbiome characterization along a water supply network from the spring to points of use within a spa. According to the 16S rRNA gene sequences analysis, our data highlight the presence of a typical microbial community, mainly composed of sulphur-cycling bacteria belonging to Desulfomonile, Thermodesulfovibrio, Geothermobacterium, Thermus, Thiofaba and Syntrophomonas genera. In addition, the characterization and evolution of the bacterial community in thermal muds during the maturation process is investigated for the first time. Interestingly, the microbiome of mature mud resulted dominated by bacteria capable of lipid biosynthesis, suggesting that these bacteria may play a role in the anti-rheumatic properties of thermal mud.