Maria Ferrara

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.

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.

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....

Un progetto di educazione alla salute sul fumo di tabacco in un campione di donne in ambiente di lavoro. Un cross sectional study

The aim of the study is to analyze the smoking attitudes of women in their working envi-ronment before and after a prevention campaign on the damage of smoking. 831 question-naires were administered, before and after the educational intervention, with special attention to smoking habits and to the behaviours typical of the working circle. 26% of the interviewees is an active smoker, 14% is a former smoker, 56% started smoking around the age of 15-20, 42% of the women smokes at the presence of their children. 81% is conscious of the damage caused by smoke on the foetus, only 9% declared smoking during the pregnancy. Only 7% of the interviewees smoked during lactation. 44% of smokers do not consider preventing from smoking in the presence of non-smoking colleagues, 36% usually smokes in working hours, 21% do not ask for permission when smoking in the presence of colleagues. 48% claims that passive smoking can reason minor effects and 21% of smokers claims never tried to stop smoking. 96% of the women declared the necessity of prevention with public campaigns.

Social awareness on Voluntary Termination of Pregnancy: A cross-section study

The objective of this research is to assess the social awareness of Voluntary Termination of Pregnancy (VTP) in order to develop adequate information and training programmes. An observational study was carried out on a sample of individuals aged between 14 and 68. In social-aggregation areas 800 questionnaires were distributed, prior to the assurance of anonymity. 90.5% of the individuals asked to participate, answered the questionnaire. 21.2% of the sample was not aware of the existence of guidance centre in the Local Health Authorities and 25.7% of the Law that regulates VTP. Less than half of the interviewees (42.3%) considered VTP as an admissible choice in special circumstances, 11% consider it as a means of prevention of unwanted pregnancy and 55.35% do not know that a minor can have an abortion without the consent of her parents. 41.7% of the women interviewed would resort to VTP, while 12.2% have already resorted to it. The inclination to perform VTP has been drastically associated mainly with not being in a stable relationship, age, or being an atheist.

Gli incidenti domestici infantili: percezione dei rischi ecomportamenti [The childhood home accidents: risk perception and behavior]

OBJECTIVE The aim of the study was to assess the frequency and the kind of home injuries among the children and to have information on the sources of risk and hazardous behaviors in the home setting. METHODS An anonymous questionnaire was administered to parents. In order to evaluate the risk perception in relation to the home environment, drawings to color were administered to children in kindergarten and to those of the first cycle of elementary school. A questionnaire was administered to older pupils. Statistical analyses were performed using the statistical program EPIINFO. RESULTS The most risky behaviors showed by about half of parents were to cook lunch and doing other works in the house, cook with children in the kitchen. 28.0% said that sometimes left unattended appliances. Discordant opinions were found on the possibility of having injuries at home, in fact, 39.7% of parents affirmed that their son was victim of a home injury, compared with 64.0% of children. The number of children victims of home injuries was significantly higher among those aged between 6 and 10 years. DISCUSSION Our search was in according with the national trend of the types and outcomes of home injuries, and confirms the existence of relationship between low educational level and higher frequency of injuries in childhood. Although prevention was considered an invaluable tool by parents to ensure the childs safety from the earliest years of life in this way, this study highlights the urgent need to take preventive action to develop an adequate safety culture.

Knowledge, opinions and attitudes of Italian mothers towards HPV vaccination and Pap test.

Aim This study evaluated the knowledge and attitudes of Italian mothers – whose daughters had been vaccinated in 2012 – towards primary (anti-HPV vaccination) and secondary (Pap test screening) cervical cancer prevention, as well as sources of information and mother-daughter communication on health issues. Methods The survey – part of a multicenter study carried out in 4 Italian cities (Ferrara, Rome, Cassino and Palermo) – was conducted through self-administered questionnaires. The first univariate analysis evaluated differences between mothers of under-18s and over-18s relative to knowledge and attitudes on HPV vaccination and Pap test. The second univariate analysis evaluated differences between the 2 groups of mothers and possible geographical variations regarding the sources of information on HPV and Pap test. Results The sample proved knowledgeable about the correlation between HPV and cervical cancer (>85%) but less aware of other HPV-related diseases. HPV vaccination should be administered before first sexual intercourse according to mothers of over-18s, and to 14- to 17-year-olds according to mothers of under-18s. Up to 88% of mothers of under-18s and 80% of mothers of over-18s declared that the vaccine should be given free of charge. More mothers of under-18s consulted a general practitioner (GP) or gynecologist before deciding to vaccinate their daughters. Mothers of under-18s received information on HPV vaccination mainly from GPs and gynecologists, while mothers of over-18s were informed through TV and books/journals. Over 80% of the sample declared satisfaction with the information received from their gynecologist during the Pap test. Conclusions The findings provide useful information for the development of effective public health interventions that may help improve acceptance of HPV vaccination among mothers.