Concetta Paola Pelullo

Human Papillomavirus Infection: Knowledge, Attitudes, and Behaviors among Lesbian, Gay Men, and Bisexual in Italy

Background This cross-sectional study assess knowledge, attitudes, and behavior towards the human papillomavirus (HPV) and the vaccination among a random sample of 1000 lesbian, gay men, and bisexual women and men. Methods A face-to-face interview sought information about: socio-demographic characteristics, knowledge about HPV infection, perception of risk towards HPV infection and/or cervical, anal, and oropharyngeal cancers, perception of the benefits of a vaccination to prevent cervical, anal, and oropharyngeal cancers, sexual behaviors, health-promoting behaviors, and willingness to receive the HPV vaccine. Results Only 60.6% had heard about the HPV infection and this knowledge was significantly higher in female, in those being a member of a homosexual association, in those having had the first sexual experience at a younger age, in those having received information about the HPV infection from physicians, and in those having no need of information about HPV infection. A higher perceived risk of contracting HPV infection has been observed in those younger, lesbian and gay men, who have heard of HPV infection and knew the risk factors and its related diseases, who have received information about HPV infection from physicians, and who need information about HPV infection. Only 1.7% have undergone HPV immunization and 73.3% professed intent to obtain it in the future. The significant predictors of the willingness to receive this vaccine were belief that the vaccination is useful, perception to be at higher risk of contracting HPV infection, and perception to be at higher risk of developing cervical, anal, and oropharyngeal cancers. Conclusions Information and interventions are strongly needed in order to overcome the lack of knowledge about HPV infection and its vaccination. Inclusion of boys in the national vaccination program and initiate a catch-up program for men who have sex with men up to 26 years may reduce their burden of HPV-related disease.

Frequency of discrimination, harassment, and violence in lesbian, gay men, and bisexual in Italy.

Background This cross-sectional study assessed the frequency of discrimination, harassment, and violence and the associated factors among a random sample of 1000 lesbian, gay men, and bisexual women and men recruited from randomly selected public venues in Italy. Methods A face-to-face interview sought information about: socio-demographics, frequency of discrimination, verbal harassment, and physical and sexual violence because of their sexual orientation, and their fear of suffering each types of victimization. Results In the whole sample, 28.3% and 11.9% self-reported at least one episode of victimization because of the sexual orientation in their lifetime and in the last year. Those unmarried, compared to the others, and with a college degree or higher, compared to less educated respondents, were more likely to have experienced an episode of victimization in their lifetime. Lesbians, compared to bisexual, had almost twice the odds of experiencing an episode of victimization. The most commonly reported experiences across the lifetime were verbal harassment, discrimination, and physical or sexual violence. Among those who had experienced one episode of victimization in their lifetime, 42.1% self-reported one episode in the last year. Perceived fear of suffering violence because of their sexual orientation, measured on a 10-point Likert scale with a higher score indicative of greater fear, ranges from 5.7 for verbal harassment to 6.4 for discrimination. Participants were more likely to have fear of suffering victimization because of their sexual orientation if they were female (compared to male), lesbian and gay men (compared to bisexual women and men), unmarried (compared to the others), and if they have already suffered an episode of victimization (compared to those who have not suffered an episode). Conclusions The study provides important insights into the violence experiences of lesbian, gay men, and bisexual women and men and the results may serve for improving policy initiatives to reduce such episodes.

Self-reported Changes in Health Status in a Traditional Chinese Medicine Centre: An Observational Study

Background: Traditional Chinese Medicine (TCM) is a complex medical system that includes acupuncture, pharmacology, massage, gymnastics, moxibustion and cupping among its treatments. Methods: The aim of this study was to investigate self-reported changes in health after TCM treatment that primarily involved acupuncture. An observational study of 428 patients was undertaken in a TCM centre in the city of Naples during the period 2013–2014. Six months after the first examination, we conducted telephone interviews to obtain information about the socio-demographic characteristics of patients, their clinical diagnosis and the therapy administered. The self-reported change in health status was obtained from question two of the short form-36 (SF-36) health survey questionnaire. Results: Of the 428 interviewees, 42.5% declared that they felt “much better”, and 31.8% felt “somewhat better” compared with the period before the treatment. The main reason for consultation was osteoarticular disorders (77.1%), divided into neck pain/dysfunctional limitations (41.6%), lower back pain/dysfunctional limitations (20.1%) and other reasons (15.4%). There were no statistical differences in the change in health status among the different diagnostic categories (p>0.05). Marked improvement was higher in women. Conclusions: Despite the well-known limitations of observational design, our study shows a satisfactory level of effectiveness of TCM and contributes to the assessment of TCM in actual clinical practice.

Can antenatal classes reduce the rate of cesarean section in southern Italy

BACKGROUND Among European Countries, Italy has the highest rate of cesarean section (36.8%), and in the Campania region this rate reaches 60.0%. QUESTION We conducted a retrospective cohort study to evaluate whether participation in antenatal classes during pregnancy reduces the rate of cesarean delivery in southern Italy. METHODS We selected three local health authorities, with the lowest, the highest, and an intermediate rate of cesarean delivery. The study included 1893 mothers who brought their children for vaccination and were interviewed about their participation in antenatal classes and their obstetric history. FINDINGS The main causes of cesarean section given in the interview were clinical indications (61.0%), previous cesarean section (31.0%) and womans request (8.0%). When we excluded emergency cesarean delivery, we found a moderate association between participation in antenatal classes and cesarean section reduction (relative risk=1.27; 95% CI=1.08-1.49; in percentage values from 49.3% to 38.8%). Private hospitals and the two local health authorities with higher baseline rates of cesarean section showed an enhanced reduction of these rates. CONCLUSION Our paper shows moderate efficacy of antenatal classes, which reduced the occurrence of cesarean section by about 10%. However, the cesarean section rate remained high. As it is possible that different classes have a different level of efficacy, a further study on a standardized model of an antenatal classes is in progress, to assess its efficacy in term of cesarean section reduction, with the purpose of its widespread implementation to the whole region.

Is it reasonable to abandon obligatory vaccinations in Italy? a 2013 survey.

In Italy, infant vaccinations are mandatory for four infectious diseases: diphtheria, polio, tetanus and hepatitis B. In the past, there was widespread apprehension in Italy that doing away with obligatory vaccinations would reduce the coverage rate, but the possibility of making vaccinations optional has recently become more popular. The objectives of this study were to investigate parental willingness to vaccinate their children if those vaccinations were no longer mandatory and to evaluate the variables influencing this intention. We conducted face-to-face structured interviews with 1,039 parents at public health vaccination centres in four cities of the Campania region of southern Italy. Most respondents (91.9%) said that they would certainly (69.4%) or probably (22.5%) vaccinate their children if vaccinations were not mandatory. The belief that vaccinations are effective and safe was positively associated with willingness to vaccinate their children, whereas having heard that autism is a possible adverse reaction to vaccination was inversely associated with willingness to vaccinate. Nevertheless, in the context of the relatively low 2012* [corrected] vaccination coverage rates in Campania (under the national standard of 95%), our results suggest that eliminating mandatory vaccinations is likely to lead to current coverage rates decreasing to unacceptably low levels, significantly below 90%.

Prostate cancer screening: Knowledge, attitudes and practices in a sample of men in Italy. A survey

Background The aim of this study was to evaluate the knowledge, attitudes and behaviors towards prostate cancer and its prevention. Methods A cross-sectional survey was conducted on a random sample of 625 fathers of students attending eight public schools. The self-administered questionnaire included questions on: socio-demographic characteristics, personal and familiar medical history of prostate cancer, knowledge about prostate cancer and the prostate-specific antigen (PSA) test, perception of risk towards prostate cancer, perception of the benefits of having a PSA-test, willingness to receive the PSA-test and sources of and needs of information regarding prostate cancer and the PSA-test. Results 72.7% of respondents had heard about the PSA-test and 51.1% of those had heard about it through their physicians. This knowledge was higher: in men with older age, in those that had a higher level of education, in those who had a relative with prostrate problems or prostate cancer and in those with prostate problems. Perceived personal risk of contracting prostate cancer was associated with a higher level of education, in those who had received information about prostate cancer from a physician and in those with prostate problems. Only 29.6% of men had undergone a PSA-test and 59.4% were willing to do so in the future. The significant predictors of the willingness to receive a PSA-test were the belief that the PSA-test was useful, the perception of not very good personal health status, and need of additional information about the PSA-test. Conclusion Respondents have a moderate knowledge about prostate cancer and a good propensity to undergo the PSA-test. Therefore, it would be necessary to increase information on the risks of prostate cancer and the benefits of prostate cancer prevention.

Lying to patients with dementia: Attitudes versus behaviours in nurses:

Background: Using lies, in dementia care, reveals a common practice far beyond the diagnosis and prognosis, extending to the entire care process. Objectives: In this article, we report results about the attitude and the behaviour of nurses towards the use of lies to patients with dementia. Research design: An epidemiological cross-sectional study was conducted between September 2016 and February 2017 in 12 elderly residential facilities and in the geriatric, psychiatric and neurological wards of six specialised hospitals of Italy’s Campania Region. Participants: In all, 106 nurses compiled an attitude questionnaire (A) where the main question was ‘Do you think it is ethically acceptable to use lies to patients with dementia?’, instead 106 nurses compiled a behaviour questionnaire (B), where the main question was ‘Have you ever used lies to patients with dementia?’ Ethical considerations: Using lies in dementia care, although topic ethically still controversial, reveals a common practice far beyond the diagnosis and prognosis, extending to the entire care process. Findings: Only a small percentage of the interviewed nurses stated that they never used lies/that it is never acceptable to use lies (behaviour 10.4% and attitude 12.3%; p = 0.66). The situation in which nurses were more oriented to use lies was ‘to prevent or reduce aggressive behaviors’. Indeed, only the 6.7% in the attitude group and 3.8% in the behaviour group were against using lies. On the contrary, the case in which the nurses were less oriented to use lies was ‘to avoid wasting time giving explanations’, in this situation were against using lies the 51.0% of the behaviour group and the 44.6% of the attitude group. Conclusion: Our results, according to other studies, support the hypothesis of a low propensity of nurses to ethical reflection about use of lies. In our country, the implementation of guidelines about a correct use of lie in the relationship between health operators and patients would be desirable.

Scarce information about breast cancer screening: An Italian websites analysis

AbstractAlthough the public should have complete and correct information about risk/benefit ratio of breast cancer screening, public knowledge appears generally scarce and oriented to overestimate benefits, with little awareness of possible disadvantages of the screening.We evaluated any document specifically addressed to the general female public and posted on internet by Italian public health services. The presence of false positive, false positive after biopsy, false negative, interval cancer, overdiagnosis, lead-time bias, exposure to irradiation, and mortality reduction was analyzed.Of the 255 websites consulted, 136 (53.3%) had sites addressed to the female public. The most commonly reported information points were the false-positive (30.8% of sites) and radiation exposure (29.4%) rates. Only 11 documents mentioned overdiagnosis, 2 mentioned risk of false positive with biopsy, and only 1 mentioned lead-time bias. Moreover, only 15 sites (11.0%) reported quantitative data for any risk variables.Most documents about breast cancer screening published on the web for the female public contained little or no information about risk/benefit ratio and were biased in favor of screening.