Elisa Langiano

Prevalence of stress, anxiety and depression in with Alzheimer caregivers

BackgroundAlzheimers disease presents a social and public health problem affecting millions of Italians. Those affected receive home care from caregivers, subjected to risk of stress.The present investigation focuses on stress, anxiety and depression in caregivers.MethodsData on 200 caregivers and their patients were collected using a specific form to assess cognitive, behavioural, functional patient (MMSE, and ADL-IAD) and caregiver stress (CBI). The relationship between stress, depression and disease has been assessed by means of a linear regression, logistic analysis which reveals the relationship between anxiety, stress and depression and cognitive problems, age, the patients income.ResultsThe caregivers are usually female (64%), mean age of 56.1 years, daughters (70.5%), pensioners and housewives (30%), who care for the sick at home (79%). Of these, 53% had little time for themselves, 55% observed worsening of health, 56% are tired, 51% are not getting enough sleep. Overall, 55% have problems with the patients family and/or their own family, 57% at work. Furthermore, 29% feel they are failing to cope with the situation as they wish to move away from home. The increase in the degree of anxiety and depression is directly proportional to the severity of the illness, affecting the patient (r = 0.3 stress and depression r = 0.4 related to CBI score). The memory disorders (OR = 8.4), engine problems (OR = 2.6), perception disorders (OR = 1.9) sick of the patient with Alzheimers disease are predictive of caregiver stress, depression is associated with the presence of other disorders, mainly behavioural (OR = 5.2), low income (OR = 3.4), patients < 65 years of age (OR = 2.9).ConclusionThe quality of life of caregivers is correlated with the severity of behavioural disorders and duration of the Alzheimers disease. The severity of the disease plays an important role in reorganization of the family environment in families caring for patients not institutionalised. It is important to promote measures to soften the impact that the patient has on the caregiver, and that, at the same time, improves the quality of life of the patient.

Food safety at home: knowledge and practices of consumers

AimTo define food safety and risk perception of foodborne diseases in the private home setting and identify specific behaviours during food purchase, storage and preparation in a large survey study.Subject and methodsA large sample of individuals (n = 1,000) living in the area of Cassino, Italy, volunteered to participate in the study. All participants were randomly recruited and underwent a questionnaire-based interview at their home regarding food-safety measures. Logistic regression analyses were used to test for correlations between demographic characteristics and knowledge/behaviours of food diseases. Risks of hazardous practices in the home were calculated according to educational, physical, occupational and marital status. All analyses were performed using the EPIINFO 3.5 statistical program.ResultsOur data showed that there was an insufficient amount of knowledge regarding foodborne diseases and pathogens. In most families, we found that there was a lack of correct adherence to food hygiene, mainly due to errors during both food preparation and storage. There was a higher risk for food safety errors in families with children, older persons and pregnant women.ConclusionOur findings confirm that the home environment represents an important site for the spread of pathogens responsible for foodborne diseases. In order to adopt good hygiene practices in the home setting, consumers need to be informed about safety procedures of domestic food handling, storage and preparation.

Epidemiology of hepatitis C virus antibodies in blood donors from the province of Latina, Italy

In order to calculate the incidence of hepatitis C virus (HCV) antibodies in blood donors and to verify the efficacy of the pre-donation method (testing blood samples of potential donors at least 3 months in advance of their first donation), we performed a retrospective cohort study in 1995 and in the period 1996–2000 at the blood transfusion unit in Latina (Italy). Third generation ELISA method as well as RIBA-3 were used. 5,978 donors in 1995 and 20,741 in the 1996–2000 period were analysed. The age of donors (prevalently male, 78.5%) was between 18 and 65 (median 38). A total of 110 borderline and 62 positives were found with ELISA, of which 75 borderlines and 42 positives in 1995, and the remaining in the 1996–2000 period (p > 0.5). Percentage of HCV antibodies dropped from 8.5% in 1995 to 5.45% in the 1996–2000 period. The non reactivity and undetermined status were found in 82.1 and 9.4% respectively in 1995, and 69.1 and 25.45% respectively in the 1996–2000 period. The incidence of HCV antibodies was 167.28 cases per 100,000 person-years in 1995 and 4.13 per 100,000 person-years in the 1996–2000 period, 2.5 times lower than the national one. There was a statistically significant association between dental care and RIBA positivity (RR: 2.63; p = 0.045). This study, moreover, evidences how pre-donation practices, if extended to a national basis, may be able to nullify the dangers associated with post-transfusional hepatitis and to reduce the number of false positives and of blood packs donated but either unused or destroyed.

Breast and cervical cancer screening : Knowledge, attitudes and behavior among schoolteachers in Italy

The study explores knowledge, attitudes and behavior regarding screening for breast and cervical cancers. All female teachers in primary and secondary schools in Crotone and in Cassino (Italy) received a questionnaire on demographic and socioeconomic characteristics, clinical history, knowledge, behavior and attitudes about breast and cervical cancer and related screening procedures. A response rate of 65% was achieved. Knowledge on effectiveness of mammography and pap test in finding related cancers was widely spread in the sample. Only about 30% and 50% had respectively undergone their last mammogram and pap test according to the recommended time interval. Having been examined by a physician in the previous year and having had a screening CBE or a screening pap smear in the past three years were significantly more likely in women who underwent mammography for screening purposes in the past two years. Pap smear in the previous three years was significantly more likely in women in their forties, with a higher family income and in those who had been examined by a physician in the previous year. The results strongly recommend continued emphasis of physicians on education of women regarding mammography and pap smear.

Rubella seroprevalence in childbearing age women: a cross sectional study in the province of Frosinone, Central Southern Italy

Background: Congenital rubella infection can be prevented by protecting women of reproductive age through vaccination. The aims of this study were to estimate the seroprevalence of rubella virus antibodies among females aged between 15 and 45 years in the province of Frosinone and to assess knowledge about Rubella and Congenital Rubella Syndrome (CRS) and the association between rubella immunization status and various risk factors. Methods: A cross sectional study was carried out involving 1242 females recruited by random selection. Enzyme immunoassay method was used to detect and quantify human anti IgG antibodies for rubella virus in 1242 anonymously females aged between 15 and 45 years. A questionnaire was used to collect demographic data including age, sex, previous history, previous vaccination and knowledge about rubella. Statistical analysis was carried out using the program EpiInfo 3.3. Results: The majority of the females recruited to the study were 15-24 years old (66%), unmarried (71.2%), students (61%) who had not previously given birth (87.9%). Rubella Seroprevalence was 90.3% in women aged 40-45 years old and 68.8% in those aged 15-19 (p=0.0001). Only 137 participants reported having received rubella vaccination. Generally knowledge about rubella and congenital rubella syndrome was lacking. Conclusions: In the province of Frosinone, women in each age group were in need of active immunization. Furthermore, the susceptibility rates for rubella are far from the value of national serosurveys for similar age groups (8%) and even further from the target set by the National Plan for Measles and Congenital Rubella Elimination launched in 2003. For females of reproductive age, immunization is an effective but underutilized method of CRS prevention and although rubella vaccine is free charge for these women and pre-conception screening is available, these opportunities remain substantially underutilised.

From directive to practice: are pictorial warnings and plain packaging effective to reduce the tobacco addiction?

OBJECTIVES Tobacco packaging represents an important form of promotion of tobacco products and for this reason plain packaging (PP) can be considered an additional tobacco control measure. In Italy the current tobacco packaging is branded with textual warnings. The study investigated the perception of PP with textual warnings (PPTWs) and pictorial warnings (PPPWs) in Italy. STUDY DESIGN Cross-sectional. METHODS The study was conducted on adults who were current, never and former smokers. The participants watched out three types of packages (current packaging, PPTWs and PPPWs) and eight pictorial warnings, and indicated which they considered the most effective ones to motivate smoking cessation or reduction and to prevent the onset. RESULTS 1065 subjects were recruited. The PPPWs were considered the most effective in motivating to quit, reduce and prevent the smoking habits (ranged 83.4%-96.1%) in all tobacco users and age groups (≤40/>40 years) (P < 0.005). In general PP does not seem to be very effective in quitting for three-quarters of the smokers and 60% declared that they would have still started smoking with PP. The younger group believed less than the older one that PP gives a motivation to quit (29.4% vs 39.1%, P = 0.002). The pictures perceived as most effective in communicating the smoking effects were lung cancer and gangrene (about one-third of the sample). CONCLUSIONS The textual warnings on tobacco products are a measure of control now outdated. Countries still using them should consider the idea of replace them with pictorial warnings that seem to be more effective. It is also desirable in the near future that these countries introduce the PPPWs.

The project “D.E.A.Th. by Eros to Thanatos AIDS and Sexually Transmitted Diseases”. A multimedia exhibition as a means of prevention of sexually transmitted infections

Background : An educational intervention on Sexually Transmitted Diseases (STDs) accompanied by a multimedia exhibition was proposed in order to verify the effectiveness of an exhibition as a tool for prevention, to increase awareness in youth and to evaluate whether it yielded changes in the sexual behaviour of its’ visitors. The Target population were high schools and university students. Methods : The Exhibition consisted of a historical overview and four other sections: biological and clinical aspects, epidemiology, prevention and a section called the Red Zone with clear and explicit images relating to STDs. The exhibition was supported by three observational studies carried out on about2000 students of two High Schools and the university in the city of Cassino, Italy. Data collection took place through three different types of “ad hoc” questionnaires. The Statistical analysis carried out was that typical of cross-sectional surveys. We utilized the statistical program Epi-Info 3.5. Results : Regarding survey 1, 48% of 529 students taking part said that the exhibition had contributed “enough” for them to acquire new knowledge, 75.2% had already had sexual intercourse and 37.7% of them did not change their sexual habits. Relative to survey 2, 583 responded to the pre test and 403 posttests returned. Regarding knowledge, data obtained from processing of pre-tests showed how 63.9% of the sample did not know how many STDs existed, whilst this value dropped in post test answers to 49.2% . AIDS was the best known disease (96%) whilst other STDs were little known. The educational intervention partly increased these percentages. With regard to sexual practices although 43% of the sample claimed to have already had sexual intercourse (66% male and 34% female). The family doctor is seen by a high percentage of young people (70% - 68.6%) as the first figure which should address an individual affected by a sexually contracted disease. Only 46% (pre and post tests) recognized at risk groups such as “drug addicts”, homosexuals and heterosexuals. Eight hundred university students participated in Survey 3. The sample had good knowledge about HIV transmission and the AIDS disease and 93% of respondents knew how to avoid infection. They identified drug users and homosexuals as the most prone to infection to HIV, while awareness of infection risk among heterosexuals was less marked. Despite its importance, awareness of condom use was worrying as only 44.2% reported to always one. Conclusions : The exhibition can be considered as an effective prevention tool for new knowledge acquisition but not for the modification of behaviours already present. Even in this study, it looks like the long-term effects, in populations who have had health education interventions with the models of behavioural change, are not sufficiently protective . Therefore, it is necessary to intensify efforts to broadly apply the most effective models of self empowerment in order to change risk behaviours.

Is there a lack of information on HPV vaccination given by health professionals to young women

OBJECTIVE The aim of this survey is to compare the main sources of information about vaccination against Human papillomavirus (HPV) of young women aged over-18 and under-18 years. METHODS A multicenter study was carried out in Italy through the administration of a questionnaire. Univariate analyses were conducted to evaluate possible differences between age groups and different locations (chi-square test and Fisher test where possible). RESULTS The sample consisted of 987 young women. The main sources of information about HPV vaccination are represented by magazines/books (23.1%) and TV (20.5%) for the over-18s, while for the under-18s the sources are general practitioners (22.6%) and pediatricians (15.4%). The over-18s with health professionals as parents consult mostly gynecologists (27.7%) and general practitioners (20.5%). DISCUSSION This study highlights lack of information on HPV vaccination given by health professionals to young women and underlines the need to improve education about cervical cancer, prevention and HPV vaccination.

A school based community randomized trial of the effect of peer health education on primary prevention knowledge, attitude and behaviours towards HPV among adolescents

Abstract : Background: this study in the prospect of promoting adherence to the primary and secondary preven- tion programmes will research knowledge, attitudes and behaviors of the student population attending high schools regarding HPV infections and will also promote health education sessions based on peer education. Methods : we carried out a cross-sectional kaP survey regarding HPV infection, HPV vaccination, and sexual health, of students and a peer educational intervention. To verify the effectiveness of peer educators in changing opinions and beliefs about HPV a self-com- pletion questionnaire was made and distributed pre (T1) and post (T2) peer educator intervention. The same questionnaires were assigned to the control group. Results : the sample consisted of 900 students, mean age was 16.6±1.4, having relationship 34.4%. at T1, 64.6% of students in experimental group said that they knew HPV, 83.4% how it is transmitted and 71.1% HPV vaccination, 54.7% perceived dangerousness with significant gender-related difference. at T2 the percentages increased. at T1, 14.1% of females were vaccinated at T2 they were 17.5%. The main factors associated with the students’ propensity to vaccination were: having at least one sister; being in favour of vaccinations in general; knowing that the vaccine is aimed at preventing cervical cancer; and being aware that they could be infected by HPV. Conclusion : both the HPV test and HPV vaccine need effective communication and monitoring of the spread of knowledge, especially among women identified as most in need of information and included in the age group at risk, in wich it is crucial to encourage informed choices. This underlines the need to plan adequate educational programmes....

Knowledge, attitudes and behaviour about Sexually Transmitted Infections: a survey among Italian university female students

Aims: Improvements have been made in terms of STIs mortality, but young women still have a lack of attention to the STIs prevention. We investigated the knowledge and attitudes about STIs and their prevention among a sample of Italian university female students. Methods: We designed a questionnaire about knowledge and attitudes toward STIs, Papanicolau test (Pap test) and Human Papilloma Virus (HPV) and had it filled out by 285 young women. Chi-square test, Mann-Whitney test and a multivariable analysis were performed in order to identify associated factors. Results: Knowledge about STIs seems weak, oppositely to knowledge about preventive measures. In line with the results of the univariate analyses, the multivariable one confirmed a higher probability to answer rightly for women who knew the effective behaviours for preventing STIs, women who took information about STIs from Internet, books and TV and those using natural methods (OR 2.77 - 95%CI 1.47-5.23, OR 2.99 - 95%CI 1.62-5.53 and OR 2.55 - 95%CI 1.05-6.18, respectively) and a lower one for students from Cassino and those who knew is possible to recover from STIs (OR 0.38, 95%CI 0.17-0.87 and 0.42, 95%CI 0.20-0.88, respectively). Furthermore, about Pap test it also confirmed the role of a medium-high STIs level of knowledge (OR 2.11, 95%CI 1.02-4.37) and a lower probability to know about it for women from Cassino (OR 0.25, 95%CI 0.09-0.73). Conclusions: Young women are not completely aware of STIs risks and preventive measures. Informational and educational campaigns should be implemented to reach this target group and lighten the current and future burden of STIs.