Low measles, mumps and rubella (MMR) immunization levels in European children highlight the importance of identifying determinants of parental vaccine uptake to implement policies for increasing vaccine compliance. The aim of this paper is to identify the main factors associated with partial and full MMR vaccination uptake in European parents, and combine the different studies to obtain overall quantitative measures. This activity is included within the ESCULAPIO project, funded by the Italian Ministry of Health. ORs and CIs were extracted, sources of heterogeneity explored and publication bias assessed. Forty-five papers were retrieved for the qualitative study, 26 of which were included in the meta-analysis. The following factors were associated with lower MMR vaccine uptake: misleading knowledge, beliefs and perceptions on vaccines (OR 0.57, CI 0.37-0.87); negative attitudes and behaviors toward vaccination (OR 0.71, CI 0.52-0.98); demographic characteristics, such as different ethnicity in Southern populations (OR 0.44, CI 0.31-0.61), higher child's age (OR 0.80, CI 0.76-0.85); low socio-economic status (OR 0.64, CI 0.51-0.80), especially low income (OR 0.39, CI 0.25-0.60) and education (OR 0.64, CI 0.48-0.84), high number of children (OR 0.54, CI 0.42-0.69), irregular marital status (OR 0.80, CI 0.66-0.96). The factors explaining heterogeneity were country location, administration modality, collection setting and responses reported on MMR alone or in combination. Findings from this study suggest policy makers to focus communication strategies on providing better knowledge, correct beliefs and perceptions on vaccines, and improving attitudes and behaviors in parents; and to target policies to people of ethnic minority from Southern Europe, low educated and deprived, with higher number of children and non-married marital status.

Objective: The aim of the present work was to determine what dietary assessment method can provide a valid and accurate estimate of nutrient intake by comparison with the gold standard.Design: A MEDLINE, EMBASE, ISI Web of Science, Cochrane and related references literature review was conducted on dietary assessment methods for adolescents reporting the validity and/or reproducibility values. A study quality assessment on the retrieved FFQ was carried out according to two different scoring systems, judging respectively the quality of FFQ nutrition information and of FFQ validation and calibration.Setting: The present review considered adolescents attending high schools and recruited in hospitals or at home.Subjects: The target of the review was the healthy adolescent population in the age range 13–17 years.Results: Thirty-two eligible papers were included and analysed separately as ‘original articles’ (n20) and ‘reviews’ (n12). The majority (n17) assessed the validation and reproducibility of FFQ. Almost all studies found the questionnaires to be valid and reproducible (r> 0·4), except for some food groups and nutrients. Different design and validation issues were highlighted, such as portion-size estimation, number of food items and statistics used.Conclusions: The present review offers new insights in relation to the characteristics of assessment methods for dietary intake in adolescents. Further meta-analysis is required although the current review provides important indications on the development of a new FFQ, addressing the need for a valid, reproducible, user-friendly, cost-effective method of accurately assessing nutrient intakes in adolescents.

Objective: The present work is aimed at meta-analysing validity studies of FFQ for adolescents, to investigate their overall accuracy and variables that can affect it negatively.Design: A meta-analysis of sixteen original articles was performed within the ASSO Project (Adolescents and Surveillance System in the Obesity prevention).Setting: The articles assessed the validity of FFQ for adolescents, compared with food records or 24 h recalls, with regard to energy and nutrient intakes.Subjects: Pearson’s or Spearman’s correlation coefficients, means/standard deviations, kappa agreement, percentiles and mean differences/limits of agreement (Bland–Altman method) were extracted. Pooled estimates were calculated and heterogeneity tested for correlation coefficients and means/standard deviations. A subgroup analysis assessed variables influencing FFQ accuracy.Results: An overall fair/high correlation between FFQ and reference method was found; a good agreement, measured through the intake mean comparison for all nutrients except sugar, carotene and K, was observed. Kappa values showed fair/moderate agreement; an overall good ability to rank adolescents according to energy and nutrient intakes was evidenced by data of percentiles; absolute validity was not confirmed by mean differences/limits of agreement. Interviewer administration mode, consumption interval of the previous year/6 months and high number of food items are major contributors to heterogeneity and thus can reduce FFQ accuracy.Conclusions: The meta-analysis shows that FFQ are accurate tools for collecting data and could be used for ranking adolescents in terms of energy and nutrient intakes. It suggests how the design and the validation of a new FFQ should be addressed.

Vaccine knowledge of the general population is shaped by different information sources and strongly influences vaccination attitudes and uptake. The CCM-Italian Ministry of Health ESCULAPIO project attempted to identify the role of such information sources, in order to address adequate strategies to improve information on vaccines and vaccine preventable diseases. In the present study, data on 632 adults from Southern Italy regarding information sources were collected, and their perceived and actual knowledge on vaccinations were compared and analyzed in relation to socio-demographic characteristics and information sources. The main reported reference sources were general practitioners (GPs) (42.5%) and pediatricians (33.1%), followed by mass media (24.1%) and the Internet (17.6%). A total of 45.4% reported they believed to be informed (45.4%), while those estimated to be truly informed were 43.8%. However, as showed in the multivariate logistic regression, people having the perception to be correctly informed ascribed their good knowledge to their profession in the health sector (Adj OR 2.28, CI 1.09–4.77, p < 0.05) and to friends/relatives/colleagues (AdjOR 6.25, CI 2.38–16.44, p < 0.001), while the non-informed population thought the responsibility had to be attributed to mass media (AdjOR 0.45, CI 0.22–0.92, p < 0.05). Those showing the real correct information, instead, were younger (AdjOR 1.64, CI 1.04–2.59, p < 0.05), and their main reference sources were pediatricians (AdjOR 1.63, CI 1.11–2.39, p < 0.05) and scientific magazines (Adj OR 3.39, CI 1.51–7.59, p < 0.01). Only 6% knew the “VaccinarSì” portal, developed to counter the widespred antivaccine websites in Italy. The post-survey significant increase of connections to “VaccinarSi” could be ascribed to the counselling performed during questionnaire administration. Strategies to improve information about vaccination should be addressed to fortifying healthcare workers knowledge in order to make them public health opinion leaders. General population should be provided with correct indications on trustworthy websites on vaccines to contrast false information supplied by anti-vaccinists on their own websites or social networks pages and on the mass media.

High levels of physical fitness (PF) can positively affect both health and cognitive function, thus monitoring its levels in youth can help increase health and quality of life in adult populations later on. This systematic review aims to identify PF field-based tests used in young European populations practicing sport to find tools that are adequate for the considered target involving a new battery within the Enriched Sport Activities (ESA) project. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed. In the 83 identified articles, the main tests used were: vertical/horizontal jumps (for muscular strength/power); push-ups, running at maximum effort, sit-ups (for muscular strength/endurance); multistage non-intermittent and intermittent tests (for aerobic endurance); sit and reach (for flexibility); sprinting and agility T-tests (for speed and agility, respectively); 10 × 5 m shuttle run (SR) (for both speed and agility). Few studies assessed coordination, reaction time, power, and balance. Although the selected tests are widely used and validated, they do not determine all PF aspects and do not reflect sport-specific features. A final decision was made for the inclusion of the following tests: standing broad jump, seated medicine ball throw, 20 m SR test, 30 m sprint, Illinois test, and a new test, i.e., the crunning test, to assess different skill-related components at once. The use of this combination of tests allows for the assessment of all PF components and can help planning effective training programs and cultivate sporting talent.

The aim of the present investigation was to describe profiles of adolescents’ fitness level, identify latent classes of fitness-related risk behaviours, and describe their sociodemographic and environmental predictors. In total, 883 adolescents (16.4 ± 1.4 years; 167.3 ± 10.4 cm; 62.8 ± 13.5 kg; 62.2% males) were assessed for personal and lifestyle information and for physical fitness components. Eleven possible fitness determinants and seven predictors were included. Latent class analysis (LCA) was used to determine fitness-related risk behaviours. Logistic regressions predicted class membership and assessed associations with fitness levels and fitness components. Five latent classes were recognised: 1—virtuous, 30.7% of respondents; 2—low physical activity/sport, 18.8%; 3—incorrect alcohol/food habits, 25.8%; 4—health risk/overweight, 15.9%; 5—malaise/diseases, 8.8%. Sex, age, parents’ overweightness/obesity and education, and school type predicted most classes significantly. Compared to class 1, class 2 had higher odds of having all poor fitness components except upper body maximal strength; class 4 had higher risk of low muscular endurance; and class 5 was likely to have lower maximal strength, muscular endurance, and speed/agility. Educating adolescents to reach a sufficient practice of PA/sport could help decreasing the risk of low health-related fitness more than discouraging them from using alcohol, addressing proper food behaviours and habits, and helping them understand their psychophysical malaise symptoms.