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Where the italian journal of public health is going? a tale of the last two years
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Cost and cost-effectiveness of the mediterranean diet: Results of a systematic review
No full textThe growing impact of chronic degenerative pathologies (such as cardiovascular disease, type 2 diabetes and Alzheimer's disease) requires and pushes towards the development of new preventive strategies to reduce the incidence and prevalence of these diseases. Lifestyle changes, especially related to the Mediterranean diet, have the potential to modify disease outcomes and ultimately costs related to their management. The objective of the study was to perform a systematic review of the scientific literature, to gauge the economic performance and the cost-effectiveness of the adherence to the Mediterranean diet as a prevention strategy against degenerative pathologies. We investigated the monetary costs of adopting Mediterranean dietary patterns by determining cost differences between low and high adherence. Research was conducted using the PubMed and Scopus databases. Eight articles met the pre-determined inclusion criteria and were reviewed. Quality assessment and data extraction was performed. The adherence to the Mediterranean diet has been extensively reported to be associated with a favorable health outcome and a better quality of life. The implementation of a Mediterranean dietary pattern may lead to the prevention of degenerative pathologies and to an improvement in life expectancy, a net gain in health and a reduction in total lifetime costs
Socioeconomic Differences in Tobacco Smoking in Italy: Is There an Interaction between Variables?
Full text linkObjectives. To assess the influence of sociodemographic factors on smoking habits in Italy and if an interaction exists between these variables. Methods. Data from the national survey “Health Conditions and Healthcare Services Use” in 2005 were used. The independent association between tobacco smoking and sociodemographical variables was assessed using logistic regression analysis. Interactions between variables were investigated calculating the synergism index (SI). Results. Sample population consists of 109.829 subjects (over 15 years). 21.9% are current and 21.8% are former smokers. Current smokers are mostly 45–54-years old males, from Central Italy, unemployed, divorced or separated but having a good health status without chronic medical conditions. Ever smokers are mostly 45–54 years old males, from Northeast Italy, unemployed, with chronic conditions. People with a university degree and with a good household income have the lowest OR for both conditions. A synergistic effect was found between marital status and educational level (for ever smokers SI = 1.96; for current smokers SI = 1.67). Conclusions. Smoking is prevalent in lower socioeconomic groups and there is the strong need to increase social, economic and cultural capital in order to reduce it
Knowledge, attitude, and behaviour of public health doctors towards pandemic influenza compared to the general population in Italy
No full textAim: To study differences between public health physicians' and general population's knowledge, attitude, and behaviours towards an influenza pandemic. Methods: During winter 2009, an anonymous questionnaire online (www.ijph.it) of 34 questions was available for participants, structured into three parts: socio-demographic information, people's knowledge, and behaviours about influenza H1N1. Results: 836 persons were interviewed (335 physicians and 501 not physicians). Of these, 50.8% of physicians and 78.1% of not physicians were aged less than 50 years and 57.6% of physicians and 31.7% of not physicians were male. Physicians were more interested to be updated about the pandemic (90.6% versus 88.4% of not physicians; p = 0.003); not physicians were more inclined to avoid crowded places (29.7% versus 17.6% of physicians; p < 0.001); and physicians were more prone to get vaccinated (56.4% versus 23.6% of not physicians; p < 0.001). Broadly, physicians had a better ability to deal the pandemic, both for knowledge and behaviours. Particularly, a significant difference (p < 0.001) was found concerning the principle source of information on the pandemic, for physicians being the internet (41.5%), followed by the health facilities' internal communication (33.1%), while for not physicians being watching the national television news (34.1%) and surfing the internet (30.9%). Conclusions: During the spread of the pandemic flu, a lot of information was propagated chaotically. The information given were not always truthful and often they were interpreted incorrectly or sometimes only partially understood by the population, and this needs to be taken into account for future successful communication in cases of emergency
Role of pap-test in cervical cancer prevention: a systematic review and meta-analysis<subtitle>Brigid Unim</subtitle>
No full textBackground
Cervical cancer is third in incidence and fourth in mortality
among cancers of women worldwide. Screening-test, such as
conventional cytology, are used to identify pre-cancers, to
prevent the occurrence of invasive cancers or to diagnose an
early stage of disease, permitting a well-timed treatment. This
systematic review and meta-analysis investigates the effective-
ness of pap test in the prevention of cervical cancer.
Methods
A systematic review and meta-analysis were performed. The
literature review, from 1979 to 2013, was based on Pubmed,
Scopus, Google Scholar and ISI engines using the keywords
‘‘pap test AND study design (RCT, cohort, case-control, cross
sectional) AND cervical cancer’’. The selection of articles was
carried out independently by four authors. Predefined study
quality indicators were applied for evaluation of articles: Jadad
scale was used for randomized clinical trials (RCTs) and New
Castle-Ottawa Scale for other studies. Four different meta-
analyses were carried out, one for each study design, using the
RevMan software version 5 for Windows.
Results
From the 3372 screened citations, 360 met our inclusion
criteria (86 cohort, 119 RCT, 62 cross-sectional and 93 case-
control). All papers were selected for title, abstract and study
design pertinence. Up to 81 doublets, 871 cohort, 526 RCT,
1046 cross sectional and 669 case-control studies were
excluded. Meta-analysis shows that Pap test reduces mortality
from and incidence of advanced cervical cancer compared to
no screening [mortality risk ratio (RR) 0.65, 95% CI 0.47-0.90;
incidence RR 0.56, 95% CI 0.42-0.7]. In a cohort study pap test
reduced the risk of invasive cervical cancer diagnosis compared
to no screening (RR 0.38, 95% CI = 0.23-0.63. Furthermore, a history of two negative Pap test rather than one is associated
with a decreased risk of developing cancer of the cervix (OR
1.33, 95% CI 0.93-1.90 vs OR 1.55, 95% CI 1.15-2.10).
Conclusions
Pap test is an effective screening tool, it is protective and
associated with a reduced risk of incidence of and mortality for
advanced cervical cancer. Risk-relative should be stratified for
women’s age, ethnic group, number of previous pap smears,
and time of follow-up.
Key messages
- Cytological screening programs play a major role in
reducing both incidence and mortality of invasive cervical
cancers. - The importance of Pap-test in early diagnosis of cervical can-
cer remains unaltered despite the availability of new screen-
ing methods, different HPV-DNA tests and HPV vaccines
Association between smoking habits and acne vulgaris. A case-control study
No full textBackground: Acne vulgaris, is one of the most common skin disorder. Previous studies about the role of smoke in the pathogenesis of acne reported contradictory results. The aim of this study was to conduct a case-control study investigating the relationship between tobacco smoking and acne. Methods: A case-control study was performed during the period September 2009 - February 2010. A questionnaire was administrated to each participant, to assess the association acne - smoke. Cases were outpatients of the Dermatologic Ambulatory of the "Fiorini" Hospital, Sapienza University of Rome (Italy). Controls were age and gender-matched to the cases. The ratio cases-controls was 1:2. A univariate and a multiple logistic regression analysis were conducted; Odds Ratio (OR) and the relative 95% confidence interval (95%CI) were assessed. The statistical significance was set at p < 0.05. Results: Crude OR for the association acne - smoke was 7.26 (IC=2.27-23.18); adjusted OR for sex and age was 5.47 (IC=1.67-17.97). Of 93 cases, 6 had a severe grade of acne (6.5%), 19 had an intermediate grade of acne (20.4%), and 68 had a mild grade of acne (73.1%). No one of the smokers had a severe grade of acne, one had an intermediate grade of acne and 11 had mild acne; these differences are not statistically significant. ConclusionS: The association between acne and smoke shows an increased risk (OR=7.26) with a statistically significant CI. Moreover, people ≥ 18 years of age have twice the risk compared to persons < 18 years of age (OR=2.31)
Maternal smoking and socio-demographic characteristics in correlation with low birth weight: A Turin (piedmont) study
No full textAbstract
Introduction. 15 to 25% of women smoke during pregnancy. Scientific evidence suggests that exposure to smoking causes decreased birth weight. The aim of this study was to assess the correlation between smoking during pregnancy, maternal sociodemographic characteristics, and low birth weight. Methods. Data were derived from 1572 questionnaires administered to each woman that gave birth at the Gynecology Teaching Hospital "S. Anna" in Turin (Italy) during the period from 2008 to 2010. Multiple logistic analysis was used to evaluate the association between socio-demographic characteristics and birth weight; the stepwise approach with a "backward elimination" procedure was followed, and the goodness of fit of the model was estimated using the Hosmer-Lemeshow test. Results. The univariate analysis revealed that smoking cigarettes (17%), having a lower educational level (13%), and female sex of the infant (13%) seem to be risk factors, as they increase the risk of having a low birth weight child. Logistic regression analysis showed that gestational age and maternal smoking are the statistically associated variables. Conclusions. The results confirmed that birth weight increases proportionally with the length of the gestational age and that maternal smoking and the child's sex (female) increase the risk of having a lower birth weight. Logistic regression demonstrated that the association between maternal smoking and low birth weight shows an increased risk for the whole population (OR=2.85), for male (OR=3.45) and for female newborns (OR=2.44).Abstract
Introduction. 15 to 25% of women smoke during pregnancy. Scientific evidence suggests that exposure to smoking causes decreased birth weight. The aim of this study was to assess the correlation between smoking during pregnancy, maternal sociodemographic characteristics, and low birth weight. Methods. Data were derived from 1572 questionnaires administered to each woman that gave birth at the Gynecology Teaching Hospital "S. Anna" in Turin (Italy) during the period from 2008 to 2010. Multiple logistic analysis was used to evaluate the association between socio-demographic characteristics and birth weight; the stepwise approach with a "backward elimination" procedure was followed, and the goodness of fit of the model was estimated using the Hosmer-Lemeshow test. Results. The univariate analysis revealed that smoking cigarettes (17%), having a lower educational level (13%), and female sex of the infant (13%) seem to be risk factors, as they increase the risk of having a low birth weight child. Logistic regression analysis showed that gestational age and maternal smoking are the statistically associated variables. Conclusions. The results confirmed that birth weight increases proportionally with the length of the gestational age and that maternal smoking and the child's sex (female) increase the risk of having a lower birth weight. Logistic regression demonstrated that the association between maternal smoking and low birth weight shows an increased risk for the whole population (OR=2.85), for male (OR=3.45) and for female newborns (OR=2.44)
Human papillomavirus and cancerous diseases of the head and neck: a systematic review and meta-analysis
No full textOBJECTIVES:
The increasing incidence of head and neck cancer (HNSCC) highlights the need to better understand the role of Human papilloma virus (HPV) in the development of these cancers. The aim of this study is to conduct a systematic review and a meta-analysis concerning observational studies on the association between HPV infection and HNSCC and to quantify this association obtaining a reliable estimation of the risk infection in its development.
MATERIALS AND METHODS:
Literature searches was performed using PubMed and Scopus databases. StatsDirect 2.7.8 program was used for the analysis.
RESULTS:
We found 15 case-control studies and 63 prevalence studies, none cohort studies. The pooled Odds Ratio (OR) for all the included case-control studies resulted in a value of 1.63 (95% CI 1.27-2.09; P<0.0001). The highest pooled OR resulted from the analysis of all the studies that examined HPV 16 genotype in association oral cavity (OR 5.36; 95% IC 1.4-20).
CONCLUSION:
The strong evidenc
A cross-sectional study on dermatological diseases among male prisoners in southern Lazio, Italy.
No full textPrisoners have heightened health needs, and only recently has the importance of skin diseases in this group been recognized. The aim of this study was to estimate the prevalences of dermatological diseases among prisoners in the jails of southern Lazio and to investigate the determinants of these. A cross-sectional study was carried out in three jails in southern Lazio. Retrospective data collection for sociodemographic characteristics, lifestyle habits, and health status was realized using patients' charts. The study sample consisted of 2653 male prisoners detained during 1995-2000. A total of 7.9% of the sample were found to have dermatological disease. The most common diseases were nonspecific dermatitis (3.1%), acne (1.5%), mycosis (1.4%), and scabies (0.7%). Multiple regression analyses were conducted to establish the associations of skin diseases with substance addiction status and age. In addition, a highly significant association emerged between length of detention and rate of dermatological disease. This study shows that habitual offenders, foreign inmates, prisoners serving long sentences, and prisoners who are illiterate are the most affected by dermatological disease. The conditions of detention may be the main reason; preventative strategies such as limiting overcrowding and the provision of electronic case sheets and a centralized database to collect and maintain patient clinical data might be effective in improving public health in jails. © 2013 The International Society of Dermatology
Acne as a public health problem
Full text linkAlthough acne is the most common skin disorder, epidemiological data on this condition are scarce. The social and economic effects of acne are mostly related to the high prevalence of this pathology, so much so that we can consider acne as a public health problem. Our proposal is to realize a computerized case sheet for each acne sufferer based on a minimum data set. This should include: patient’s age, sex, clinical form of acne and grade of severity. This information should then be introduced into a database management system. Examining the data collected we hope to contribute to the efficient use of health care resources and to improve management of public health problems highlighted in prior epidemiological investigations
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