[New users of mental health services for adults in Tuscany (Italy). Characteristics of cases and pathways of care].

The aim of this cross-sectional study was to describe the characteristics and pathways of care for users ("first visits") of adult mental health services in Tuscany. A questionnaire was mailed to healthcare workers of mental health services in Tuscany. Overall 184 psychiatrists and psychologists replied (136 psychiatrists and 48 psychologists) Sixty three percent of new users of mental health services were female, 32.

Risk factors for disability in older persons over 3-year follow-up.

Background: the identification of modifiable risk factors for preventing disability in older individuals is essential for planning preventive strategies.

Purpose: to identify cross-sectional correlates of disability and risk factors for the development activities of daily living (ADL) and instrumental ADL (IADL) disability in community-dwelling older adults.

Methods: the study population consisted of 897 subjects aged 65-102 years from the InCHIANTI study, a population-based cohort in Tuscany (Italy).

Association between satisfaction and stress with aspects of job and practice management among primary care physicians.

Background: Reforms introduced in the last decade in Italian general practice, have contributed to the changing role of primary care physicians (PCPs) within the Italian National Health Service, with potential difficulties adapting that may lead to job stress and dissatisfaction. The present study aims to compare job satisfaction and stress levels of PCPs working in primary healthcare teams (PHCTs) with those for practitioners operating in single ambulatory offices, and to assess potential associations with aspects of job and practice management.

Method: A postal survey was conducted between January and March 2005 among PCPs working in Tuscany.

[Health effects of heat waves].

Climate change, characterized by increased mean temperatures and more frequent occurrence of extreme temperatures, may lead to adverse health effects through different and complex mechanisms due to substantial changes in the physical and social environment. The most easily measurable health effects of climate change in high-risk groups are the direct effects of excessively high temperatures. A literature review was performed to identify studies regarding heat waves, risk factors and prevention programmes.

Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status.

Background: Carpal tunnel syndrome (CTS) is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status.

Methods: Seven regions were considered (overall population, 14.

Physical exertion (lifting) and retinal detachment among people with myopia.

Background: People with myopia (near sightedness) are at increased risk for retinal detachment. We explored other factors that may be associated with retinal detachment within this high-risk group.

Methods: We conducted a case-control study comprising 61 cases with retinal detachment and myopia and 99 hospital controls who also had myopia.

Low total plasma carotenoids are independent predictors of mortality among older persons: the InCHIANTI study.

Background: Plasma carotenoids are considered a valid biological marker for fruit and vegetable dietary intake. Recent studies show that low carotenoid levels are associated with a high risk of inflammation, cancer, and cardiovascular disease.

Aim Of The Study: To determine whether low plasma carotenoids are associated with increased mortality among older adults.

Management of acute myocardial infarction in the real world: a summary report from The Ami-Florence Italian Registry.

The Florence Acute Myocardial Infarction registry was a population-based, prospective study aimed at identifying the determinants of coronary reperfusion therapy [CRT, by primary coronary intervention (PCI) in more than 95% of cases] utilization and of prognosis in patients with ST-segment elevation myocardial infarction (STEMI). The registry involved one teaching hospital with, and five district hospitals without PCI facilities. Overall, as many as 45.

Liver enzymes and risk of diabetes and cardiovascular disease: results of the Firenze Bagno a Ripoli (FIBAR) study.

The aim of the study was to assess gamma-glutamyl transpeptidase (gamma-GT), alanine aminotransferase, and aspartate aminotransferase (AST) in the prediction of diabetes and cardiovascular disease (CVD) in subjects free from hepatic diseases other than nonalcoholic fatty liver disease. The present analysis was performed on the cohort of subjects enrolled in the Firenze Bagno a Ripoli (FIBAR) study, a screening program for diabetes performed between 1 March 2001 and 31 December 2003 in the city of Florence on 3124 subjects who underwent an oral glucose tolerance test. Incident cases of diabetes in nondiabetic subjects (n = 2662) were obtained through databases of drug prescriptions, hospital admissions, and lists of subjects eligible for reimbursement.

[Femur fractures among elderly in Lazio and Tuscany regions from 1999 to 2003].

Objectives: to compare the assistance delivered to elderly persons (age 65 +) hospitalized in 1999-2003 after femur fracture between two Italian regions (Lazio and Tuscany). Indicators derived from current databases have been used.

Main Outcomes: 1) age-standardized proportion of patients treated surgically; 2) age-standardized proportion of patients with surgery within 2 days from admission among all the patients with surgery; 3) age-standardized proportion of deaths within 30 days from admission.

The Tuscany experimental registry for Alzheimer's disease and other dementias: how many demented people does it capture?

Background And Aims: A Regional Registry for Alzheimer's Disease and Other Dementias is being tested in Tuscany (Italy) to provide a basis for epidemiological studies. Current results are presented and critically evaluated.

Methods: The Registry extracts data on cases of dementia from Hospital Discharge Records, Outpatient Service Records, Regional Mortality Registry and Disease-Specific Co-payment Exemption Records, based on ICD-9 codes of dementias, and from Prescription Records based on registered anti-dementia drug codes.

Screening of older community-dwelling people at risk for death and hospitalization: the Assistenza Socio-Sanitaria in Italia project.

Objectives: To develop and validate mortality and hospitalization prognostic tools based upon information readily available to primary care physicians (PCPs).

Design: Population-based cohort study. Baseline predictors were patient demographics, a seven-item questionnaire on functional status and general health, use of five or more drugs, and previous hospitalization.

Health observation compared to health reporting: findings from a pilot study in Florence.

Purpose: Both health interview surveys (HISs) and health examination surveys (HESs) are used to describe the health status of populations. In Italy, to determine the feasibility of conducting a national-level HES, a pilot HES was conducted in the city of Florence among participants of a previous national-level HIS. The aim of the present analysis was to compare the results of the two surveys.

The impact of different rehabilitation strategies after major events in the elderly: the case of stroke and hip fracture in the Tuscany region.

Background: On a regional level, our aims were to describe rehabilitation patterns for elderly patients with stroke and hip fracture and to investigate mortality risk during the 6-month post acute period.

Methods: Data sources included administrative data relative to patients aged 65+ resident in Tuscany admitted in hospital for stroke or hip fracture between 2001 and 2003, traced up to 3 years before and 6 months following index admission. The study design involves computerized linkage of administrative data, and an exploratory analysis of the association between rehabilitation patterns and 6-month mortality, adjusting for clinical, demographic, and acute-related care characteristics using multivariate Cox regression.

General practitioners' knowledge and practice of complementary/alternative medicine and its relationship with life-styles: a population-based survey in Italy.

Background: The growing popularity of CAM among the public is coupled with an ongoing debate on its effectiveness, safety, and its implications on the reimbursement system. This issue is critically important for GPs, who have a "gatekeeping" role with respect to health care expenditure. GPs must be aware of medications' uses, limitations and possible adverse effects.

[Injury-related Emergency Department visits in Tuscany (Italy)].

The frequency of injuries underscores the need for planning and implementing efficient injury surveillance systems. Emergency Departments represent the preferred source of data on injuries but information regarding emergency department visits is not always available. We examined the feasibility of utilizing emergency department data to monitor the occurrence of injuries in Tuscany.

Chemoprevention of precancerous gastric lesions with antioxidant vitamin supplementation: a randomized trial in a high-risk population.

Background: Gastric cancer is one of the most common malignancies worldwide. Histopathologic studies have identified a sequence of changes in the gastric mucosa that mark the slow progression from normal tissue to carcinoma. Epidemiologic evidence suggests that a diet rich in fresh fruit and vegetables could be a protective factor against this disease.

[Prevalence of dementia in Tuscany: results from four population-based epidemiological studies].

Objective: to provide information on epidemiology of dementia in Tuscany needed to plan for dedicated health and social services.

Design: analysis of pooled baseline data from 4 population-based longitudinal studies.

Setting: 4 municipalities in Tuscany.

[Incidence of acute myocardial infarction in Tuscany, 1997-2002: data from the Acute Myocardial Infarction Registry of Tuscany (Tosc-AMI)].

Objective: The Acute Myocardial Infarction Regional Registry of Tuscany was aimed to assess incidence and prognosis of acute myocardial infarction (AMI) in Tuscany, and the spread of interventional cardiology (coronarography and coronary angioplasty) in AMI treatment.

Design: Record-linkage between current hospitalisation and mortality databases, aimed to identify total events (hospitalised AMI cases + out-of-hospital coronary deaths), also including recurrent events (rule of 28 days or more after any previous event in the same patient).

Setting: Population based registry (residents in Tuscany).

[Mortality in the area around Massa-Carrara 10 years after ANIC-Agricoltura and Farmoplant chemical plants were shut down].

Objective: To describe mortality of residents in the area of Massa-Carrara for the period 1995-2000 and to compare it with mortality for the years 1990-1994.

Design: Geographical descriptive study.

Setting: In the area of Massa-Carrara cause and gender specific standardized mortality ratios (SMR), adjusted for age and municipal deprivation index (reference: Tuscany Region), have been computed for the years 1995-2000 and compared with mortality in the period 1990-1994 calculating ratios between standardized rates by age classes with a direct method (CMF).

Early discharge after acute myocardial infarction in the current clinical practice. Community data from the AMI-Florence Registry, Italy.

Background: Clinical trials suggested feasibility and safety of early discharge after ST-segment elevation acute myocardial infarction (STEMI) for selected patients. Current United States and European guidelines recommend early discharge for uncomplicated AMI. The present study was aimed to assess early discharge in the current clinical practice for STEMI patients.

Classification of residents in nursing homes in Tuscany (Italy) using Resource Utilization Groups Version III (RUG-III).

Background And Aims: Samples of nursing homes in Tuscany (Italy) classify their residents and determine their case-mix according to the Resource Utilization Groups System, Version III (RUG-III).

Methods: A large sample of nursing homes was selected, based on willingness to participate, representation of both public and private institutions, and wide geographic representation. Two registered nurses assessed all residents using the RUG questionnaire.