Le attitudini relazionali e psicosociali del medico di famiglia in Italia: indagine conoscitiva mediante un nuovo questionario A new questionnaire survey on relational and psychosocial attitudes of family physicians in Italy

Questionnaires capable of measuring the psychosocial orientation of physicians, in the sense not only of relating adequately with the patient, but also of a consideration of the patient as a person and of psychosocial aspects as possible determinants of health and disease, appear to be scarce in the literature. Materials and Methods: On the basis of the literature examined and of contents emerging from some interviews administered to family physicians, a self-report Questionnaire for the measure of psychosocial orientation of physicians was constructed. This was administered to 174 family physicians. Results: Exploratory actor analysis showed the presence of three factors, which were named: "Good Relationship with the patient", including items indicating the physician's capacity to feel at ease in the relationship; Confusive and Destabilizing Closeness", including items indicating on one hand the possibility of considering the patient as a whole person and of acknowledging the influence of psychosocial factors on health and disease, on the other a feeling of confusion around clinical judgement; "Technical Efficacy", including items referring to professional, technical efficacy. "Good Relationship with the patient" and "Technical Efficacy" appear significantly correlated. Conclusions: Resuts show the possibility for the Questionnaire to assess the quality of the doctor's h man relationship with the patient and of his/her sense of efficacy in clinical work; these two aspects appear correlated. Results show, on the other hand, a difficulty for the physician to envisage a psychosocial dimension in health and disease construction, since this view may eventually cause insecurity in respect to his/her capacities of clinical judgement

A Quick Test of Cognitive Speed: norm-referenced criteria for 121 Italian adults aged 45 to 90 years.

ABSTRACT Background: A Quick Test of Cognitive Speed (AQT) is a brief test that can identify cognitive impairment. AQT has been validated in Arabic, English, Greek, Japanese, Norwegian, Spanish, and Swedish. The aim of this study was to develop Italian criterion-referenced norms for AQT. Methods: AQT consists of three test plates where the patient shall rapidly name (1) the color of 40 blue, red, yellow, or black squares (AQT color), (2) the form of 40 black figures (circles, squares, triangles, or rectangles; AQT form), (3) the color and form of 40 figures (consisting of previous colors and forms; AQT color-form). The AQT test was administered to 121 Italian cognitively healthy primary care patients (age range: 45-90 years). Their mean Mini-Mental State Examination (MMSE) score was 28.8 ± 0.9 points (range 26-30 points). AQT naming times in seconds were used for developing preliminary criterion cut-off times for different age groups. Results: Age was found to have a significant moderate positive correlation with AQT naming times color (r = 0.65, p < 0.001), form (r = 0.53, p < 0.001), color-form (r = 0.63, p < 0.001) and a moderate negative correlation with MMSE score (r = -0.44, p < 0.001) and AQT naming times differed significantly between younger (45-55 years old), older (56-70 years old), and the oldest (71-90 years old) participants. Years of education correlated positively but weakly with MMSE score (r = 0.27, p = 0.003) and negatively but weakly with AQT color (r = -0.16, p = ns), form (r = -0.24, p = 0.007), and color-form (r = -0.19, p = 0.005). We established preliminary cut-off times for the AQT test based on +1 and +2 standard deviations according to the approach in other languages and settings. Conclusions: This is the first Italian normative AQT study. Future studies of AQT - a test useful for dementia screening in primary care - will eventually refine cut-off times for normality balancing sensitivity and specificity in cognitive diagnostics

Association between coeliac disease and psoriasis: Italian primary care multicentre study

25noBACKGROUND: Studies assessing the association between coeliac disease (CD) and psoriasis show conflicting results. OBJECTIVE: To assess in the primary care setting the prevalence of CD in patients with psoriasis and the response to a gluten-free diet (GFD) in subjects with psoriasis and CD. METHODS: We enrolled 218 patients with psoriasis and 264 controls. Coeliac screening was carried out in all subjects (Eurospital, Trieste, Italy). In subjects with a positive serology, the diagnosis of CD was confirmed histologically. RESULTS: Nine (4.1%) psoriatic patients had positive anti-tissue transglutaminase antibodies compared to only 1 among controls (0.4%, p < 0.05; OR 2.03, 95% CI 1.42-90.11). The diagnosis of CD was confirmed histologically in all 10 subjects. At 6 months GFD was associated with a great improvement of skin lesions in 7 out of 8 patients with psoriasis. CONCLUSION: Our multicentre primary care study showed an high prevalence of CD in psoriasis and an improvement of skin lesions in CD under GFD.nonenoneDe Bastiani, Rudi; Gabrielli, Maurizio; Lora, Liliana; Napoli, Luigi; Tosetti, Cesare; Pirrotta, Enzo; Ubaldi, Enzo; Bertolusso, Luciano; Zamparella, Maria; De Polo, Manuela; Nebiacolombo, Cristina; Bortot, Mario; Mancuso, Maurizio; Bacchin, Paolo; Marsala, Valerio; Pinna, Roberto; Tursi, Antonio; Benedetto, Edoardo; Cuffari, Alfredo; Pati, Antonino; Di Caro, Simona; Perenzin, Gastone; Sala, Raffaella; Calzavara Pinton, P; Gasbarrini, AntonioDe Bastiani, Rudi; Gabrielli, Maurizio; Lora, Liliana; Napoli, Luigi; Tosetti, Cesare; Pirrotta, Enzo; Ubaldi, Enzo; Bertolusso, Luciano; Zamparella, Maria; De Polo, Manuela; Nebiacolombo, Cristina; Bortot, Mario; Mancuso, Maurizio; Bacchin, Paolo; Marsala, Valerio; Pinna, Roberto; Tursi, Antonio; Benedetto, Edoardo; Cuffari, Alfredo; Pati, Antonino; Di Caro, Simona; Perenzin, Gastone; Sala, Raffaella; CALZAVARA PINTON, Piergiacomo; Gasbarrini, Antoni

Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey-The COCO Study.

Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design. We describe the study protocol for a cross-sectional survey in 27 primary care centers from 14 European countries. At all sites, 120 consecutive adult patients, who visit their general practitioner for any reason, filled in a self-administered 27-item questionnaire. This addresses patients' self-care practices for common colds. Separately, the subjective level of discomfort when having a common cold, knowing about the diseases' self-limited nature, and medical and sociodemographic data are requested. Additionally, physicians are surveyed on their use of and recommendations for self-care practices. We are interested in investigating which self-care practices for common colds are used, whether the number of self-care practices used is influenced by knowledge about the self-limited nature of the disease, and the subjective level of discomfort when having a cold and to identify potential adverse interactions with chronic physician-prescribed medications. Further factors that will be considered are, for example, demographic characteristics, chronic conditions, and sources of information for self-care practices. All descriptive and analytical statistics will be performed on the pooled dataset and stratified by country and site. Discussion. To our knowledge, COCO is the first European survey on the use of self-care practices for common colds. The study will provide new insight into patients' and general practitioners' self-care measures for common colds across Europe