Giuseppe Furia

Knowledge, experiences, and attitudes of medical students in Rome about tuberculosis

Background Tuberculosis is the second leading cause of death from infectious disease. Insufficient knowledge among doctors about tuberculosis is one of the reasons for the increased tuberculosis rates in several low-endemic countries. The purpose of this study was to assess knowledge, experience, and attitude about tuberculosis among medical students. Material/Methods After a pilot study, a cross-sectional survey was performed on fifth-year medical students at the Catholic University of Rome (Italy), using a self-administered questionnaire on attitude, experience and knowledge about epidemiology, diagnosis, and treatment of tuberculosis. The t test and multivariable linear regression analysis were performed to estimate the association between TB knowledge and investigated variables. Results Among 220 fifth-year medical students, the response rate was 83.1%. The mean percentage of correct answers was 56.6% (63.5% for epidemiology and prevention, 54.1% for diagnosis, and 45.7% for treatment). Associations between internships in wards and greater knowledge of tuberculosis diagnosis (55.9% vs. 51.6%, p=0.02), treatment (48.4% vs. 41.8%, p=0.03) and total score (58.1% vs. 54.5%, p=0.04) were found. Students who reported receiving the Mantoux test had higher knowledge of tuberculosis epidemiology and prevention (65.4% vs. 53.3%, p=0.001), diagnosis (55.2% vs. 48.3%, p=0.005), and total score (58.0% vs. 49.1%, p=0.001). Students who had observed at least 1 active pulmonary tuberculosis case had a higher percentage of correct answers about diagnosis (55.5% vs. 51.4%, p=0.03) and total score (57.9% vs. 54.0%, p=0.03). The multivariable linear regression confirmed the association between higher knowledge and receiving the Mantoux test (β coefficient=7.2; 95% CI 2.6–11.7), as well as having observed at least 1 X-ray of a TB patient (β coefficient=5.3; 95% CI 1.0–9.7). Conclusions A moderate level of general knowledge about tuberculosis was found, which suggests the need to modify current programs of infectious diseases in the curriculum of medical schools.

Health inequalities: an analysis of hospitalizations with respect to migrant status, gender and geographical area

BackgroundThe quality of care includes several aspects which may be influenced by social-economic status.This study analyzes hospitalizations for several conditions, such as chronic diseases, cancer and appendectomy, in Italians and immigrant people living in Italy with the aim to evaluate possible inequalities in the quality of health care services due to migrant status, gender and geographical macro-areas (Northern, Central, Southern Italy).MethodsThe data source of hospital discharges for stroke, myocardial infarction, chronic liver disease, cervical cancer, mastectomy and appendectomy was the Ministry of Health. ICD 9 codes were used for data collection. Crude and standardized hospitalization rates per 100.000 were calculated. Italian resident population and an estimate of immigrants living in Italy were used as denominators while standardization was done with respect to the European population. The data we used covers the 2006–2008 period.ResultsImmigrants showed significantly higher hospitalization rates for stroke, cervical cancer and appendectomy and significantly lower hospitalization rates for chronic liver diseases and mastectomy. Males showed significantly higher hospitalization rates than females for myocardial infarction, chronic liver diseases and appendectomy. Notwithstanding, differences related to migrant status and gender varied according to geographical macro-area. With respect to that, Southern Italy showed significantly higher hospitalization rates for stroke, myocardial infarction and chronic liver diseases and significantly lower hospitalization rates for mastectomy and appendectomy.ConclusionsThe results of this study may reflect inequalities in the quality of health care, in particular in primary and secondary prevention, access to specialized care and inappropriateness, due to migrant status and gender. Also, differences between macro-areas suggest heterogeneities in the integration policies and the promotion of immigrants’ health. Research should be endorsed in this field in order to further describe inequalities and their reasons and in the light of supporting policies development.

Factors Influencing Quality of Life for Disabled and Nondisabled Elderly Population: The Results of a Multiple Correspondence Analysis

Objectives. The aim of our study is to examine the role of some factors (sociodemographic patterns, social relationship support, and trust in healthcare actors) on structure of quality of life among the Italian elderly population, by stratifying according to presence or absence of disability. Methods. Using data of the Italian National Institute of Statistics (ISTAT) survey, we obtained a sample of 25,183 Italian people aged 65+ years. Multiple Correspondence Analysis (MCA) was used to test such a relationship. Results. By applying the MCA between disabled and nondisabled elderly population, we identified three dimensions: “demographic structure and social contacts,” “social relationships,” “trust in the Italian National Health Services (INHS).” Furthermore, the difference in trust on the INHS and its actors was seen among disabled and non-disabled elderly population. Conclusions. Knowledge on the concept of quality of life and its application to the elderly population either with or without disability should make a difference in both peoples life and policies and practices affecting life. New domains, such as information and trusting relationships both within and towards the care networks nodes, are likely to play an important role in this relationship.

The role of the Student’s involvement in GlobalHealth Medical Education: the results of a surveyconducted in four Medical Schools in Rome

2010 as reached universal salt iodization (USI). After this time, researches on iodine deficiency at the national level were not held in Kazakhstan. Objectives: The evaluation of the situation on iodine intake at the national level by urine iodine excretion, revelation of salt iodization quality and the awareness level of the population on iodine deficiency, comparison of indicators overtime in RK. Methods A cross-sectional survey of 2011 included 64 clusters on 22 women in each cluster. The women of reproductive age (15-49 years) were interviewed and 1145 salt samples were collected from their households for quantitative determination of iodine, and 1296 their urine samples were analyzed on content of iodine by ammonium persulfate digestion method, based on the Sandell-Kolthoff reaction. It was conducted a comparative analysis of the results with data from national studies before adopting USI strategy (1999) and MICS (2006). Results The urinary iodine median at women in 2011 was 181.1 mg/l, in 2006 235.9 mg/l, in 1999 93.9 mg/l. The prevalence of iodine deficiency of women was 22.8% in 2011, it was 15.9% in 2006, and 54.2% in 1999. In 2011 the percentages of salt samples with adequately iodized salt (?15 ppm) were 95.9%, in 2006 91.4 %, in 1999 29%. In 2011 among interviewed women 92.7%, n = 1303 knew that salt is iodized, in 2004 these were 93,3%, n = 1 500, and only 58.6% were aware of the need to use iodized salt, n = 4800 in 1999. Conclusions Since the adoption of the Law on mandatory salt iodization consumption percentage of adequately iodized salt has increased, which in turn affected the rising of urinary iodine levels at the population. After 8 years of USI median of urinary iodine excretion decreased slightly comparing with 2006, but remained in the normal range on the Background of adequately iodized salt coverage more than 90%. It indicates the necessity of periodic biological monitoring and continuing communication activity among population on long-term and constantly basis. Key message After 8 years of USI median of urinary iodine excretion decreased slightly comparing with 2006, but remained in the normal range.