A longitudinal evaluation of two-year outcome in a community-based mental health service using graphical chain models. The South-Verona Outcome Project 9.

The 2-year outcome of 178 patients attending a community-based mental health service was assessed from a multidimensional perspective. The study investigated: (1) the effect of disease-related characteristics (such as diagnosis and illness duration) and of a series of outcome variables measured at baseline (global functioning, psychopathology, social disability, quality of life and satisfaction with services) on total costs of care over 2 years; and (2) the effect of costs of care and outcome variables measured at baseline on the corresponding outcome variables at 2 years. To gain insight into the multivariate longitudinal dependencies among variables, we used graphical Gaussian chain models, a new multivariate method that analyses the relationship between continuous variables taking into account the effect of antecedent and intervening variables, to reveal not only direct but also indirect correlations.

[Quality assessment of air pollutants concentration in epidemiologic time series on short-term effects of pollution on health].

Meta-analyses of short-term effect of air pollution use environmental exposure measurements defined as the concentration average between selected monitors. A simple quality index, Pearson's correlation coefficient between each pair of monitors, has been used in sensitivity analyses and meta-regression. To better characterize the degree of homogeneity in population exposure we propose to use Lin's concordance coefficient and the correlation coefficient between the difference and the average of each pair of values.

Analyzing a randomized trial on breast self-examination with noncompliance and missing outcomes.

Recently, instrumental variables methods have been used to address non-compliance in randomized experiments. Complicating such analyses is often the presence of missing data. The standard model for missing data, missing at random (MAR), has some unattractive features in this context.

Prevalence of HCV infection among health care workers in a hospital in central Italy.

Health care workers are at risk of acquiring transmissible diseases. Controversial results have been reported about HCV. The aims of the present study are to assess the prevalence of HCV in health care workers in Pistoia General Hospital (central Italy) and to compare prevalence with other groups, particularly with a sample of the general population.

The role of individual and contextual socioeconomic circumstances on mortality: analysis of time variations in a city of north west Italy.

Study Objective: To evaluate the independent and mutual effects of neighbourhood deprivation and of individual socioeconomic conditions on mortality and to assess the trends over the past 30 years and the residual neighbourhood heterogeneity.

Design: General and cause specific mortality was analysed as a function of time period, highest educational level achieved, housing conditions, and neighbourhood deprivation, using multilevel Poisson models stratified by gender and age class.

Setting: The study was conducted in Turin, a city in north west Italy with nearly one million inhabitants and consisting of 23 neighbourhoods.

A comparison of non-iterative and iterative estimators of heterogeneity variance for the standardized mortality ratio.

This paper continues work presented in Böhning et al. (2002b, Annals of the Institute of Statistical Mathematics 54, 827-839, henceforth BMSRB) where a class of non-iterative estimators of the variance of the heterogeneity distribution for the standardized mortality ratio was discussed. Here, these estimators are further investigated by means of a simulation study.

[Epidemiologic study of workers exposed to vinyl chloride in Porto Marghera: mortality update].

The investigation describes mortality of vinyl chloride exposed workers in the Montedison-Enichem plant located in Porto Marghera, near Venice, Italy. A total of 1658 workers employed from start of production (1950), present in 1956 or successively hired until 1985, were followed up between 01.01.

Some general points in estimating heterogeneity variance with the DerSimonian-Laird estimator.

In this paper we consider estimating heterogeneity variance with the DerSimonian-Laird (DSL) estimator as typically used in meta-analysis. In its general form the DSL estimator requires inverse population-averaged study-specific variances as weights, in which case the estimator is unbiased. It has become common practice, however, to use estimates of the study-specific variances instead of their population-averaged versions.

Low incidence of end-stage renal disease and chronic renal failure in type 2 diabetes: a 10-year prospective study.

Objective: Data on the incidence of end-stage renal disease (ESRD) and chronic renal failure from population-based studies in Caucasian type 2 diabetic patients are lacking. To provide such data, a population-based cohort of type 2 diabetic patients was identified in Casale Monferrato, Italy, and prospectively examined from 1991 to 2001.

Research Design And Methods: During the follow-up period, patients were regularly examined with centralized measurements of plasma creatinine and HbA(1c).

Progression to overt nephropathy in type 2 diabetes: the Casale Monferrato Study.

Objective: The first sign of diabetic nephropathy is microalbuminuria, but its predictive role of progression to overt nephropathy in type 2 diabetes has not yet been clarified. The aims of this study were to assess during 7 years of follow-up the incidence rate of overt nephropathy and the predictive role of microalbuminuria and other baseline variables (blood pressure, lipids, fibrinogen, uric acid, smoking, and HbA(1c) cumulative average during follow-up).

Research Design And Methods: A prospective population-based study was performed in Casale Monferrato, Italy, including 1,253 type 2 diabetic patients recruited at baseline (1991-1992), 765 with normoalbuminuria (albumin excretion rate [AER] <20 microg/min) and 488 with microalbuminuria (AER 20-200 microg/min).

Occupational exposure to n-hexane in Italy--analysis of a registry of biological monitoring.

Objective: This study assesses 2,5-hexanedione (2,5-HD) in the urine of subjects exposed to n-hexane solvent between 1991 and 1998, from details obtained from the Registry of Biological Monitoring (BM) at the Florence Local Health Unit, and its development over time.

Methods: The Registry contains 15,925 samples from 6,650 subjects occupationally exposed to n-hexane, especially in leather (9,099 samples; 3,607 subjects) and shoe (3,865 samples; 1,938 subjects) production.

Results: Over the time span studied there was a total reduction of 31.

Risk of respiratory cancer around a sewage plant in Prato, Italy.

In this study, the authors evaluated the risk of respiratory cancer related to environmental pollutants among a population that resided near a sewage plant in Prato, Italy. Subjects included lung cancer deaths (1987-1996) and incident cases of lung and laryngeal cancers (1987-1994) among residents of Prato. The authors used the mortality or incidence rates for the entire population of Prato (by gender and by 5-yr age group) to calculate the expected cases in each census unit.

[Environment and health status of the population in areas with high risk of environmental crisis in Italy].

The Italian Ministry of Environment identified 15 areas throughout the country as at "high risk of environmental crisis". The areas host industrial activities that may entail noxious exposures, through occupation and the environment. An epidemiological descriptive study on the residents was carried out using routinely collected mortality data.

Microsatellite instability in a population of sporadic colorectal cancers: correlation between genetic and pathological profiles.

Background: Tumours with high-frequency microsatellite instability exhibit unique genotype and phenotype features, whereas the difference between low-frequency microsatellite instability and apparently stable tumours is far from being clear.

Aims: To identify distinctive genetic and pathological characteristics of low-frequency microsatellite instability tumours.

Methods: Microsatellite instability status of 57 sporadic colorectal cancers and its correlation with genetic, pathological and clinical features was analysed.

Antitumorigenic activity of the prebiotic inulin enriched with oligofructose in combination with the probiotics Lactobacillus rhamnosus and Bifidobacterium lactis on azoxymethane-induced colon carcinogenesis in rats.

Prebiotics such as fructans, and probiotics such as Lactobacilli or Bifidobacteria, or a combination of prebiotics and probiotics (synbiotics) are thought to be protective against colon cancer. Therefore, we studied whether the prebiotic inulin enriched with oligofructose (Raftilose-Synergy1, briefly, Synergy1, 10% of the diet), probiotics [Bifidobacterium lactis (Bb12) and Lactobacillus rhamnosus (LGG), each at 5x10(8) c.f.

Mutations of the APC gene in human sporadic colorectal cancers.

Background: Mutations of the APC gene are reported to occur frequently in sporadic colorectal adenomas and adenocarcinomas. We studied APC gene mutations in cases of human sporadic colorectal cancer in order to evaluate their correlation with pathologic characteristics and clinical prognosis.

Methods: Most of the mutations of the APC gene (95%) are nonsense or frame shift mutations, encoding for truncated APC proteins.

Adult and childhood leukemia near a high-power radio station in Rome, Italy.

Some recent epidemiologic studies suggest an association between lymphatic and hematopoietic cancers and residential exposure to high-frequency electromagnetic fields (100 kHz to 300 GHz) generated by radio and television transmitters. Vatican Radio is a very powerful station located in a northern suburb of Rome, Italy. In the 10-km area around the station, with 49,656 residents (in 1991), leukemia mortality among adults (aged >14 years; 40 cases) in 1987-1998 and childhood leukemia incidence (eight cases) in 1987-1999 were evaluated.

[Leukemia mortality and incidence of infantile leukemia near the Vatican Radio Station of Rome].

Some recent epidemiological studies suggest an association between lymphatic and haematopoietic cancers and residential exposure to high frequency electromagnetic fields (100 kHz-300 GHz) generated by radio and television transmitters. Vatican Radio, a very powerful radio station transmitting all over the world (up to 600 kW) is located in Santa Maria di Galeria, in the northern suburbs of the city of Rome. Electric field measurements in the proximity of the radio station ranged between 1.