In the United States, from 1999 to 2019, opioid overdose, either regularly prescribed or illegally acquired, was the cause of death for nearly 500,000 people. In addition to this pronounced mortality burden that has increased gradually over time, opioid overdose has significant morbidity with severe risks and side effects. As a result, opioid misuse is a cause for concern and is considered an epidemic. This article examines the trends and consequences of the opioid epidemic presented in recent international literature, reflecting on the causes of this phenomenon and the possible strategies to address it. The detailed analysis of 33 international articles highlights numerous impacts in the social, public health, economic, and political spheres. The prescription opioid epidemic is an almost exclusively North American problem. This phenomenon should be carefully evaluated from a healthcare systems perspective, for consequential risks and harms of aggressive opioid prescription practices for pain management. Appropriate policies are required to manage opioid use and prevent abuse efficiently. Examples of proper policies vary, such as the use of validated questionnaires for the early identification of patients at risk of addiction, the effective use of regional and national prescription monitoring programs, and the proper dissemination and translation of knowledge to highlight the risks of prescription opioid abuse.

The phenomenon of bacterial antimicrobial resistance (AMR) is a rapidly growing global problem. Overuse and misuse of antibiotics as well as self-prescription are among the most important causes contributing to the growth of antibiotic resistance in humans. This systematic review describes the phenomenon of antibiotics self-medication (ASM) in children. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist by searching PubMed, Scopus, and Web of Science until July 2022. Published English language studies containing information regarding parents knowledge, attitudes, and behaviors in self-administration of antibiotics in children were included. A total of 702 articles were identified, and 57 were selected. A higher prevalence of ASM among children was found in the Middle-East (34%), Africa (22%), Asia (20%) and South America (17%), while the lowest prevalence was found in Europe (8%). High distance from hospital, and low income, such as having more than one child, are related with an increased risk of ASM in children. Fever and cough can also promote the misuse of antibiotics by parents. A greater attention to the regulation of the sale of antimicrobial drugs can certainly limit the risk of self-medicating behavior.

Type 1 diabetes (T1D) is a common autoimmune disease that is characterized by insufficient insulin production. The onset of T1D is the result of gene-environment interactions. Sociodemographic and behavioural factors may contribute to T1D, and the gut microbiota is proposed to be a driving factor of T1D. An integrated preventive strategy for T1D is not available at present. This case–control study attempted to estimate the exposure linked to T1D to identify significant risk factors for healthy children. Forty children with T1D and 56 healthy controls were included in this study. Anthropometric, socio-economic, nutritional, behavioural, and clinical data were collected. Faecal bacteria were investigated by molecular methods. The findings showed, in multivariable model, that the risk factors for T1D include higher Firmicutes levels (OR 7.30; IC 2.26–23.54) and higher carbohydrate intake (OR 1.03; IC 1.01–1.05), whereas having a greater amount of Bifidobacterium in the gut (OR 0.13; IC 0.05 – 0.34) was a protective factor for T1D. These findings may facilitate the development of preventive strategies for T1D, such as performing genetic screening, characterizing the gut microbiota, and managing nutritional and social factors.

Background: The misuse of antibiotics is one of the leading causes of antibiotic resistance. Paediatric patients are highly involved in this issue, as they are those who receive the largest amount of prescriptions of these drugs. Therefore, this study aimed to investigate the general knowledge regarding the use of antibiotics, as well as the attitudes related to the administration of these drugs to children, amongst parents of children in the paediatric age-group. Methods: In 2014, a multicentre cross-sectional study was conducted amongst parents of children aged 0–14. A questionnaire made up of 33 items was administered in waiting rooms of outpatient departments. Multivariable logistic regression models were performed, in order to assess the potential predictors of a better knowledge about antibiotics. Results: A total of 1247 parents took part to the survey. Around 33% of the samples declared that antibiotics are useful for viral infections, 20.6% that antibiotics are useful for every kind of pain and inflammation, while 14% of the parents stated that they stop giving antibiotics to their children when they start feeling better. Multivariable models showed that males, unemployed and those with lower levels of education are less prone to answer correctly to the questions about antibiotics. Conclusion: The present study demonstrates that parents have a lack of knowledge regarding the use of antibiotics, which results in bad habits and inappropriate attitudes when it comes to giving antibiotics to their children. Attention should be particularly focused on disadvantaged parents.

School-based sex education is essential to improve the knowledge and behavior of young people. Unlike most European countries, sex education in Italy is not compulsory in the school curriculum. Therefore, to assess potential gaps, the main aim of this study was to explore Italian regional initiatives about sex education. A review of gray literature from 2006 to 2021 was conducted in December 2021 on national databases and institutional websites of each Italian region, during which official documents on regional sex education programs were selected. Moreover, a rapid systematic review was carried out in scientific databases to find more information. For both reviews, the sex education topics recommended by UNESCO were used for extracting and analyzing data. A total of 12 Italian regions out of 20 had at least one sex education program, for a total of 39 projects. Overall, all the topics identified by UNESCO have been covered, with considerable differences between northern, central, and southern Italy. Contraception, love, marriage, partnerships, and family were the main topics discussed (hosted in 92% of the regions). Only 25% of the regions discussed pregnancy and birth. Disability was the least debated topic (17%). The rapid systematic review showed that relevant improvements were achieved after sex education interventions. In conclusion, this study underlined important limitations to the implementation of school-based sex education in Italy. Hence, it is necessary to increase sex education interventions to reach adequate standards and flatten the differences not only between Italian regions but also between Italy and other European countries.

Objective. The aim of the present work is to describe the state of the art of tobacco habits in Italy, eight years after the law was introduced.Methods. Time series analyses, based on estimates of smoking prevalence/consumption derived from the openly available data of national surveys performed during the 2001–2013 period, were performed. Data have been expressed in percentage of smokers and daily cigarettes consumption. Time changes are expressed as expected annual percentage change (EAPC).Results. Over time, the percentage of Italian smokers shows a constant and statistically significant decrease (from 28.9% in 2001 to 20.6% in 2013, EAPC = −2.6%, andP<0.001). Regarding data stratified by gender, we found a stronger reduction among men (EAPC = −2.9%,P<0.001) than in women (EAPC = −2.5%,P<0.001). Similarly, the consumption of tobacco smoking, measured as the number of daily cigarettes smoked, registered a downward trend (P<0.001). No join point (time point when a significant trend change is detected) resulted from the trend analysis.Conclusions. Data show a constant decrease of tobacco consumption in Italy, with no join point related to the introduction of the banning law. These findings require to reflect on the priorities of the smoking banning policies that may be focused on other intervention activities such as to increase the price of cigarettes.