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Since 2007 universal vaccination against Human Papilloma Virus (HPV) was included in the Italian ... more Since 2007 universal vaccination against Human Papilloma Virus (HPV) was included in the Italian national immunization programme. The vaccine is offered free of charge to 12-year-old girls who represent the primary target group. Additionally, a catch-up campaign has been promoted in some regions to extend the active offer to older female age groups (secondary target group). In Tuscany, the vaccine is offered free of charge to girls aged 12-18 yr. Currently, 11 years after the initiation of the programme, HPV vaccination coverage in the two target populations is substantially lower than WHO targets (95%). This work aims to assess attitudes, knowledge and intentions towards Human Papillomavirus and cervical cancer prevention among female university students in Tuscany

Background . Since 2007-2008 universal vaccination against Human Papilloma Virus (HPV) was includ... more Background . Since 2007-2008 universal vaccination against Human Papilloma Virus (HPV) was included in the Italian national immunization programme. The vaccine is offered free of charge to 11-year-old girls who represent the primary target group. Currently, HPV vaccination coverage in the two target populations is substantially lower than WHO targets (95%). Objectives. This work aims to assess attitudes, knowledge and intentions towards Human Papillomavirus and HPV vaccination among female university students in Tuscany. Methods. The study design is based on a convenience sample (n=462) of female students attending the first and the second undergraduate year in the universities of Pisa and Florence. A mixed-mode approach was considered in order to reach the largest possible number of respondents. Results . The majority of the respondents (69%) are in the age range of 19-22 years old and reside in Tuscany (72%). 71% (262) of the students were vaccinated against HPV, 23%(85) were u...

PharmacoEconomics

Background Antibiotics have led to considerable increases in life expectancy. However, over time,... more Background Antibiotics have led to considerable increases in life expectancy. However, over time, antimicrobial resistance has accelerated and is now a significant global public health concern. Understanding societal preferences for the use of antibiotics as well as eliciting the willingness to pay for future research is crucial. Objective To investigate preferences for different strategies to optimize antibiotic use and to understand the willingness to pay for future research in antimicrobial resistance and antimicrobial drug development. Methods A discrete-choice experiment was administered to a sample of the UK general population. Respondents were asked to make nine choices, each offering three options-two hypothetical "doctor and antibiotics" and one "no doctor-no antibiotics"-defined by five attributes: treatment, days needed to recover, risk of bacterial infection that needs antibiotics, risk of common side effects, and risk of antimicrobial resistance by 2050. Data were analyzed using random parameters logit models. A double-bounded contingent valuation was also included in the survey to explore the willingness to pay for policies to contain antimicrobial resistance. Results Among the 2579 respondents who completed the survey, 1151 always selected "no doctor-no antibiotics" and 57 never varied their choices; therefore, 1371 responses were used in the analysis. Risk of antimicrobial resistance by 2050 was the most important attribute and the "treatment" was the least important attribute, although this was sensitive to a higher risk of bacterial infection. The aggregate annual willingness to pay for containing antimicrobial resistance was approximately £8.35 billion (~£5-£10 billion). Conclusions The antimicrobial resistance risk is relevant and important to the general public. The high willingness to pay suggests that large investments in policies or interventions to combat antimicrobial resistance are justified.

PLOS ONE

Background In Italy, in recent years, vaccination coverage for key immunizations as MMR has been ... more Background In Italy, in recent years, vaccination coverage for key immunizations as MMR has been declining to worryingly low levels, with large measles outbreaks. As a response in 2017, the Italian government expanded the number of mandatory immunizations introducing penalties to unvaccinated children’s families. During the 2018 general elections campaign, immunization policy entered the political debate with the government in-charge blaming oppositions for fuelling vaccine scepticism. A new government (formerly in the opposition) established in 2018 temporarily relaxed penalties and announced the introduction of forms of flexibility. Objectives and methods First, we supplied a definition of disorientation, as the “lack of well-established and resilient opinions among individuals, therefore causing them to change their positions as a consequence of sufficient external perturbations”. Second, procedures for testing for the presence of both short and longer-term collective disorientat...

Social Science Medicine, 2013

Vaccination programs increasingly have to comply with standards of evidence-based decision making... more Vaccination programs increasingly have to comply with standards of evidence-based decision making. However, such a framework tends to ignore social and ethical sensitivities, risking policy choices that lack crucial public support. Research is needed under which circumstances and to which extent equity and autonomy should prevail over effectiveness and cost-effectiveness in matters of infectious disease prevention. We report on a study investigating public preferences over various vaccination policy options, based on a population survey held in Flanders, Belgium (N = 1049) between March and July 2011. We found (1) that public support varied considerably between policies that were equally efficient in preventing disease but differed according to target group or incentives to improve uptake and (2) that preferences over the use of legal compulsion, financial accountability or the offering of rewards appear to be driven by individuals' social orientation.

Over the last few years, the debate on measuring progress has become a relevant topic for the EU ... more Over the last few years, the debate on measuring progress has become a relevant topic for the EU political agenda (Commission of the European communities, 2009; Stiglitz Commission, 2009). In order to address such issue, official statistical offices have been developing new statistical systems aimed at better measuring collective well-being (Eurostat, 2011). It is uncontroversial that well-being depends on several factors like being in good health, living in a safe environment or accessing good quality public services. It is also agreed that household disposable income (especially if adjusted for transfers in kind) represents the main determinant of households material well-being (Istat , 2013). It is worth noting that well-being and territory are strictly connected dimensions. The determinants of well-being may deeply change across territories.Unfortunately official statistics do not provide reliable direct estimates at a detailed geographical area.This paper addresses the use of d...

Background: In any country, part of the population is sceptical about the utility of vaccination.... more Background: In any country, part of the population is sceptical about the utility of vaccination. To develop successful vaccination programmes, it is important to study and understand the defining characteristics of vaccine sceptics. Research till now mainly focused either on the underlying motives of vaccine refusal, or on socio-demographic differences between vaccine sceptics and non-sceptics. It remained till now unexplored whether both groups differ in terms of basic psychological dispositions. Methods: We held a population survey in a representative sample of the population in Flanders, Belgium (N = 1050), in which we investigated whether respondents' attitude to vaccination was associated with their basic disposition toward other community members or society in general, as measured by the Triandis and Gelfand social orientation scale. Results: We found that sceptics and non-sceptics have a different social orientation, even when several variables are controlled for. More specifically, vaccine sceptics scored significantly lower on both horizontal individualism and horizontal collectivism, indicating a lower disposition to see others as equals. Conclusion: These findings need confirmation in the context of different countries. Such insights can be valuable to optimize the design of effective communication strategies on vaccination programmes.

Since 2007 universal vaccination against Human Papilloma Virus (HPV) was included in the Italian ... more Since 2007 universal vaccination against Human Papilloma Virus (HPV) was included in the Italian national immunization programme. The vaccine is offered free of charge to 12-year-old girls who represent the primary target group. Additionally, a catch-up campaign has been promoted in some regions to extend the active offer to older female age groups (secondary target group). In Tuscany, the vaccine is offered free of charge to girls aged 12-18 yr. Currently, 11 years after the initiation of the programme, HPV vaccination coverage in the two target populations is substantially lower than WHO targets (95%). This work aims to assess attitudes, knowledge and intentions towards Human Papillomavirus and cervical cancer prevention among female university students in Tuscany

Background . Since 2007-2008 universal vaccination against Human Papilloma Virus (HPV) was includ... more Background . Since 2007-2008 universal vaccination against Human Papilloma Virus (HPV) was included in the Italian national immunization programme. The vaccine is offered free of charge to 11-year-old girls who represent the primary target group. Currently, HPV vaccination coverage in the two target populations is substantially lower than WHO targets (95%). Objectives. This work aims to assess attitudes, knowledge and intentions towards Human Papillomavirus and HPV vaccination among female university students in Tuscany. Methods. The study design is based on a convenience sample (n=462) of female students attending the first and the second undergraduate year in the universities of Pisa and Florence. A mixed-mode approach was considered in order to reach the largest possible number of respondents. Results . The majority of the respondents (69%) are in the age range of 19-22 years old and reside in Tuscany (72%). 71% (262) of the students were vaccinated against HPV, 23%(85) were u...

PharmacoEconomics

Background Antibiotics have led to considerable increases in life expectancy. However, over time,... more Background Antibiotics have led to considerable increases in life expectancy. However, over time, antimicrobial resistance has accelerated and is now a significant global public health concern. Understanding societal preferences for the use of antibiotics as well as eliciting the willingness to pay for future research is crucial. Objective To investigate preferences for different strategies to optimize antibiotic use and to understand the willingness to pay for future research in antimicrobial resistance and antimicrobial drug development. Methods A discrete-choice experiment was administered to a sample of the UK general population. Respondents were asked to make nine choices, each offering three options-two hypothetical "doctor and antibiotics" and one "no doctor-no antibiotics"-defined by five attributes: treatment, days needed to recover, risk of bacterial infection that needs antibiotics, risk of common side effects, and risk of antimicrobial resistance by 2050. Data were analyzed using random parameters logit models. A double-bounded contingent valuation was also included in the survey to explore the willingness to pay for policies to contain antimicrobial resistance. Results Among the 2579 respondents who completed the survey, 1151 always selected "no doctor-no antibiotics" and 57 never varied their choices; therefore, 1371 responses were used in the analysis. Risk of antimicrobial resistance by 2050 was the most important attribute and the "treatment" was the least important attribute, although this was sensitive to a higher risk of bacterial infection. The aggregate annual willingness to pay for containing antimicrobial resistance was approximately £8.35 billion (~£5-£10 billion). Conclusions The antimicrobial resistance risk is relevant and important to the general public. The high willingness to pay suggests that large investments in policies or interventions to combat antimicrobial resistance are justified.

PLOS ONE

Background In Italy, in recent years, vaccination coverage for key immunizations as MMR has been ... more Background In Italy, in recent years, vaccination coverage for key immunizations as MMR has been declining to worryingly low levels, with large measles outbreaks. As a response in 2017, the Italian government expanded the number of mandatory immunizations introducing penalties to unvaccinated children’s families. During the 2018 general elections campaign, immunization policy entered the political debate with the government in-charge blaming oppositions for fuelling vaccine scepticism. A new government (formerly in the opposition) established in 2018 temporarily relaxed penalties and announced the introduction of forms of flexibility. Objectives and methods First, we supplied a definition of disorientation, as the “lack of well-established and resilient opinions among individuals, therefore causing them to change their positions as a consequence of sufficient external perturbations”. Second, procedures for testing for the presence of both short and longer-term collective disorientat...

Social Science Medicine, 2013

Vaccination programs increasingly have to comply with standards of evidence-based decision making... more Vaccination programs increasingly have to comply with standards of evidence-based decision making. However, such a framework tends to ignore social and ethical sensitivities, risking policy choices that lack crucial public support. Research is needed under which circumstances and to which extent equity and autonomy should prevail over effectiveness and cost-effectiveness in matters of infectious disease prevention. We report on a study investigating public preferences over various vaccination policy options, based on a population survey held in Flanders, Belgium (N = 1049) between March and July 2011. We found (1) that public support varied considerably between policies that were equally efficient in preventing disease but differed according to target group or incentives to improve uptake and (2) that preferences over the use of legal compulsion, financial accountability or the offering of rewards appear to be driven by individuals' social orientation.

Over the last few years, the debate on measuring progress has become a relevant topic for the EU ... more Over the last few years, the debate on measuring progress has become a relevant topic for the EU political agenda (Commission of the European communities, 2009; Stiglitz Commission, 2009). In order to address such issue, official statistical offices have been developing new statistical systems aimed at better measuring collective well-being (Eurostat, 2011). It is uncontroversial that well-being depends on several factors like being in good health, living in a safe environment or accessing good quality public services. It is also agreed that household disposable income (especially if adjusted for transfers in kind) represents the main determinant of households material well-being (Istat , 2013). It is worth noting that well-being and territory are strictly connected dimensions. The determinants of well-being may deeply change across territories.Unfortunately official statistics do not provide reliable direct estimates at a detailed geographical area.This paper addresses the use of d...

Background: In any country, part of the population is sceptical about the utility of vaccination.... more Background: In any country, part of the population is sceptical about the utility of vaccination. To develop successful vaccination programmes, it is important to study and understand the defining characteristics of vaccine sceptics. Research till now mainly focused either on the underlying motives of vaccine refusal, or on socio-demographic differences between vaccine sceptics and non-sceptics. It remained till now unexplored whether both groups differ in terms of basic psychological dispositions. Methods: We held a population survey in a representative sample of the population in Flanders, Belgium (N = 1050), in which we investigated whether respondents' attitude to vaccination was associated with their basic disposition toward other community members or society in general, as measured by the Triandis and Gelfand social orientation scale. Results: We found that sceptics and non-sceptics have a different social orientation, even when several variables are controlled for. More specifically, vaccine sceptics scored significantly lower on both horizontal individualism and horizontal collectivism, indicating a lower disposition to see others as equals. Conclusion: These findings need confirmation in the context of different countries. Such insights can be valuable to optimize the design of effective communication strategies on vaccination programmes.