Amitava Pal, Sujaya De, P. Sengupta, P. Maity, P. Dhara
Background: Anemia is now globally recognized major public health problem. The present study was undertaken to investigate the prevalence of anemia and interrelationship of anemia with BMI among adult rural population of West Bengal state, India. Method: Anthropometric measures, nutritional parameters, heart rate and hemoglobin were measured from 310 adult subjects by using standard technique. Results: The prevalence of anemia was high among both sexes and more than the global prevalence. The anemic individuals consumed nutritionally deficient diet than the non-anemic individuals. The prevalence of anemia was significantly high in underweight and normal groups. The Odds ratios became significantly higher in underweight group than normal and overweight/obese groups of both sexes. Conclusions: The prevalence of anemia in the adult rural population might be related to dietary deficiency and poor dietary patterns. The present study was hypothesized that the subjects with low BMI would have a higher risk of anemia compared to normal or overweight subjects.
{"title":"An investigation on prevalence of Anemia in relation to BMI and nutrient intake among adult rural population of West Bengal, India","authors":"Amitava Pal, Sujaya De, P. Sengupta, P. Maity, P. Dhara","doi":"10.2427/8915","DOIUrl":"https://doi.org/10.2427/8915","url":null,"abstract":"\u0000Background: Anemia is now globally recognized major public health problem. The present study was undertaken to investigate the prevalence of anemia and interrelationship of anemia with BMI among adult rural population of West Bengal state, India. \u0000Method: Anthropometric measures, nutritional parameters, heart rate and hemoglobin were measured from 310 adult subjects by using standard technique. \u0000Results: The prevalence of anemia was high among both sexes and more than the global prevalence. The anemic individuals consumed nutritionally deficient diet than the non-anemic individuals. The prevalence of anemia was significantly high in underweight and normal groups. The Odds ratios became significantly higher in underweight group than normal and overweight/obese groups of both sexes. \u0000Conclusions: The prevalence of anemia in the adult rural population might be related to dietary deficiency and poor dietary patterns. The present study was hypothesized that the subjects with low BMI would have a higher risk of anemia compared to normal or overweight subjects. \u0000","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83153759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Amodio, G. Calamusa, E. Sidoti, A. Migliazzo, F. Vitale, C. Costantino, F. Vitale
Background: Leishmania is a vector-borne parasite responsible for significant morbidity and mortality worldwide. The aim of this study was to assess the prevalence of and risk factors for Leishmania infantum seropositivity in a sample of Sicilian population.Methods: A total of 260 subjects were interviewed using a standardized questionnaire and requested for an venous blood sample.Results: Overall, 36 subjects (13.8%) were seropositive against L. infantum with a statistically significant higher prevalence of positivity in older subjects (p=0.04). After adjustment for age, a higher risk for Leishmania seropositivity was found in subjects who had pets living outdoors and untreated with anti-pests, and in those who were current smokers (adj-OR = 2.95 and adj-OR = 3.11, respectively; p < 0.05).Conclusions: Our data confirm that Leishmania infections among Sicilian citizens can be considered relatively frequent, suggesting that a percentage of Leishmania seropositivity can be probably attributed to exposure to both old and new risk factors.
{"title":"Seroprevalence of and risk factors for Leishmania seropositivity in a sample population of Western Sicily (Italy)","authors":"E. Amodio, G. Calamusa, E. Sidoti, A. Migliazzo, F. Vitale, C. Costantino, F. Vitale","doi":"10.2427/9024","DOIUrl":"https://doi.org/10.2427/9024","url":null,"abstract":"\u0000Background: Leishmania is a vector-borne parasite responsible for significant morbidity and mortality worldwide. The aim of this study was to assess the prevalence of and risk factors for Leishmania infantum seropositivity in a sample of Sicilian population.Methods: A total of 260 subjects were interviewed using a standardized questionnaire and requested for an venous blood sample.Results: Overall, 36 subjects (13.8%) were seropositive against L. infantum with a statistically significant higher prevalence of positivity in older subjects (p=0.04). After adjustment for age, a higher risk for Leishmania seropositivity was found in subjects who had pets living outdoors and untreated with anti-pests, and in those who were current smokers (adj-OR = 2.95 and adj-OR = 3.11, respectively; p < 0.05).Conclusions: Our data confirm that Leishmania infections among Sicilian citizens can be considered relatively frequent, suggesting that a percentage of Leishmania seropositivity can be probably attributed to exposure to both old and new risk factors. \u0000","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84054816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Galfo, L. D’Addezio, L. Censi, R. Roccaldo, Giordano Giostra
Background: screen-based sedentary behaviours likely have a negative impact on many aspects of youth health and development. The purpose of this study was to describe the screen-based sedentary behaviours and to examine factors associated in a sample of Italian school children. Methods: 2129 children, aged 8-9 years, from the three main geographical areas of Italy were involved. Body weight and height were measured. Screen-based sedentary behaviours were evaluated using a parent-reported questionnaire that included items about the time spent watching television (TV) and using computer/playstation and other electronic games. Pearson’s chi-square test and logistic regression analysis were conducted to study possible associated factors. Results: more time was spent in screen-based sedentary activities during non-school days rather than on school days. More males than females watched television more than the recommended 2 hours a day and spent the same time using computer (PC), playstation and other electronic games. The presence of a TV in the child’s bedroom was significantly associated with geographical area, and inversely associated with mother’s education. Moreover, children with a TV in the bedroom had higher odds of being overweight/obese and watching TV more than 2 hours a day than those without a TV. According to multiple logistic regression gender, mother’s age and mother’s education were predictors of the total screen time. Conclusions: Italian children spent a significant amount of time in screen-based sedentary behaviours, exceeding media recommendations. In addition gender, mother’s age and mother’s education were predictors of the total screen time.
{"title":"Screen-based sedentary behaviours in Italian school children: the ZOOM8 study","authors":"M. Galfo, L. D’Addezio, L. Censi, R. Roccaldo, Giordano Giostra","doi":"10.2427/9473","DOIUrl":"https://doi.org/10.2427/9473","url":null,"abstract":"Background: screen-based sedentary behaviours likely have a negative impact on many aspects of youth health and development. The purpose of this study was to describe the screen-based sedentary behaviours and to examine factors associated in a sample of Italian school children. \u0000Methods: 2129 children, aged 8-9 years, from the three main geographical areas of Italy were involved. Body weight and height were measured. Screen-based sedentary behaviours were evaluated using a parent-reported questionnaire that included items about the time spent watching television (TV) and using computer/playstation and other electronic games. Pearson’s chi-square test and logistic regression analysis were conducted to study possible associated factors. \u0000Results: more time was spent in screen-based sedentary activities during non-school days rather than on school days. More males than females watched television more than the recommended 2 hours a day and spent the same time using computer (PC), playstation and other electronic games. The presence of a TV in the child’s bedroom was significantly associated with geographical area, and inversely associated with mother’s education. Moreover, children with a TV in the bedroom had higher odds of being overweight/obese and watching TV more than 2 hours a day than those without a TV. According to multiple logistic regression gender, mother’s age and mother’s education were predictors of the total screen time. \u0000Conclusions: Italian children spent a significant amount of time in screen-based sedentary behaviours, exceeding media recommendations. In addition gender, mother’s age and mother’s education were predictors of the total screen time.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85533517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Clinical trials of phase II and III often fail due to poor experimental planning. Here, the problem of allocating available resources, in terms of sample size, to phase II and phase III is studied with the aim of increasing success rate. The overall success probability (OSP) is accounted for. Methods Focus is placed on the amount of resources that should be provided to phase II and III trials to attain a good level of OSP, and on how many of these resources should be allocated to phase II to optimize OSP. It is assumed that phase II data are not considered for confirmatory purposes and that are used for planning phase III through sample size estimation. Being $r$ the rate of resources allocated to phase II, $OSP(r)$ is a concave function and there exists an optimal allocation $r_{opt}$ giving $max{OSP}$. If $M_I$ is the sample size giving the desired power to phase III, and $kM_I$ is the whole sample size that can be allocated to the two phases, it is indicated how large $k$ and $r$ should be in order to achieve levels of OSP of practical interest. Results For example, when 5 doses are evaluated in phase II and 2 parallel phase III confirmatory trials (one-tail type I error $=2.5%$, power $=90%$) are considered with 2 groups each, $k=24$ is needed to obtain $OSPsimeq 75%$, with $r_{opt}simeq 50%$. The choice of $k$ depends mainly on how many phase II treatment groups are considered, not on the effect size of the selected dose. When $k$ is large enough, $r_{opt}$ is close to $50%$. An $rsimeq25%$, although not best, might give a good OSP and an invitingly small total sample size, provided that $k$ is large enough. Conclusions To improve the success rate of phase II and phase III trials, the drug development could be looked at in its entirety. Resources larger than those usually employed should be allocated to phase II to increase OSP. Phase II allocation rate may be increased to, at least, 25%, provided that a sufficient global amount of resources is available.
{"title":"Allocating the Sample Size in Phase II and III Trials to Optimize Success Probability","authors":"D. De Martini","doi":"10.2427/9958","DOIUrl":"https://doi.org/10.2427/9958","url":null,"abstract":"\u0000Background Clinical trials of phase II and III often fail due to poor experimental planning. Here, the problem of allocating available resources, in terms of sample size, to phase II and phase III is studied with the aim of increasing success rate. The overall success probability (OSP) is accounted for. \u0000Methods Focus is placed on the amount of resources that should be provided to phase II and III trials to attain a good level of OSP, and on how many of these resources should be allocated to phase II to optimize OSP. It is assumed that phase II data are not considered for confirmatory purposes and that are used for planning phase III through sample size estimation. Being $r$ the rate of resources allocated to phase II, $OSP(r)$ is a concave function and there exists an optimal allocation $r_{opt}$ giving $max{OSP}$. If $M_I$ is the sample size giving the desired power to phase III, and $kM_I$ is the whole sample size that can be allocated to the two phases, it is indicated how large $k$ and $r$ should be in order to achieve levels of OSP of practical interest. \u0000Results For example, when 5 doses are evaluated in phase II and 2 parallel phase III confirmatory trials (one-tail type I error $=2.5%$, power $=90%$) are considered with 2 groups each, $k=24$ is needed to obtain $OSPsimeq 75%$, with $r_{opt}simeq 50%$. The choice of $k$ depends mainly on how many phase II treatment groups are considered, not on the effect size of the selected dose. When $k$ is large enough, $r_{opt}$ is close to $50%$. An $rsimeq25%$, although not best, might give a good OSP and an invitingly small total sample size, provided that $k$ is large enough. \u0000Conclusions To improve the success rate of phase II and phase III trials, the drug development could be looked at in its entirety. Resources larger than those usually employed should be allocated to phase II to increase OSP. Phase II allocation rate may be increased to, at least, 25%, provided that a sufficient global amount of resources is available. \u0000","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"159 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80613011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Pezzotti, S. Pozzato, E. Ferroni, V. Mazzocato, A. Altieri, G. Gualano, M. Loffredo, P. Napoli, F. Perrelli, E. Girardi
OBJECTIVE: To estimate patient and health care delays in the diagnosis of PTB and to evaluate associated factors. METHODS: PTB incident cases ≥18 years diagnosed between September 2010 and September 2011 in the Lazio region; information on symptoms and date of onset, health professionals contacts, diagnostic exams performed, and drugs prescribed before diagnosis were collected through a standardized questionnaire. The total delay (TD) was divided into patient delay (PD: from symptoms onset to first contact with healthcare services) and health system delay (HSD: from first contact to diagnosis). RESULTS: 278 cases were evaluated. Median PD,HSD, and TD, were 31, 15, and 77.5 days, respectively. The median PD, HSD, and TD were significantly lower in foreign born patients (26, 10.5, 63.5, vs. 45, 36, 100 days, respectively). Other factors independently associated with longer delay were: absence of fever and presence of weight loss for PD; prior unspecific treatment, absence of cough, consult with a general practitioner, visit to an outpatient clinic, and a PD <30 days for HSD. CONCLUSIONS: In Italy, the delay in TB diagnosis is similar to that estimated in other European countries. Results indicate that actions aimed to reduce diagnostic delay should be primarily addressed to Italian patients.
{"title":"Delay in diagnosis of pulmonary tuberculosis: a survey in the Lazio region, Italy","authors":"P. Pezzotti, S. Pozzato, E. Ferroni, V. Mazzocato, A. Altieri, G. Gualano, M. Loffredo, P. Napoli, F. Perrelli, E. Girardi","doi":"10.2427/9494","DOIUrl":"https://doi.org/10.2427/9494","url":null,"abstract":"\u0000OBJECTIVE: To estimate patient and health care delays in the diagnosis of PTB and to evaluate associated factors. \u0000METHODS: PTB incident cases ≥18 years diagnosed between September 2010 and September 2011 in the Lazio region; information on symptoms and date of onset, health professionals contacts, diagnostic exams performed, and drugs prescribed before diagnosis were collected through a standardized questionnaire. The total delay (TD) was divided into patient delay (PD: from symptoms onset to first contact with healthcare services) and health system delay (HSD: from first contact to diagnosis). \u0000RESULTS: 278 cases were evaluated. Median PD,HSD, and TD, were 31, 15, and 77.5 days, respectively. The median PD, HSD, and TD were significantly lower in foreign born patients (26, 10.5, 63.5, vs. 45, 36, 100 days, respectively). Other factors independently associated with longer delay were: absence of fever and presence of weight loss for PD; prior unspecific treatment, absence of cough, consult with a general practitioner, visit to an outpatient clinic, and a PD <30 days for HSD. \u0000CONCLUSIONS: In Italy, the delay in TB diagnosis is similar to that estimated in other European countries. Results indicate that actions aimed to reduce diagnostic delay should be primarily addressed to Italian patients.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79813668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective. To determine mortality trends from breast cancer in Mexico nationwide, by state, by socioeconomic region, and to establish an association between education, state of residence, and socioeconomic region with mortality from breast cancer in 2002–2011. Methods. Records of mortality associated with breast cancer were obtained. Rates of mortality nationwide, by state, and by socioeconomic region were calculated. The strength of association between states where women resided, socioeconomic regions, and education with mortality from breast cancer was determined. Results. Women who completed elementary school had a higher risk of dying from breast cancer than people with more education [relative risk (RR) 2.58, 95% confidence interval (CI) 2.49–2.67]. Mexico City had the strongest association with dying from breast cancer as state and as socioeconomic region 7 [Mexico City: RR 3.47, CI95% 2.7-4.46 (2002) and RR 3.33, CI95% 2.66-4.15 (2011) and region 7: RR 3.72, CI 95%: 3.15-4.38 (2002) and RR 2.87, CI 95%: 2.51-3.28 (2011)]. Conclusions. In Mexico, the raw mortality rates per 100 000 women who died from breast cancer increased. Mortality was higher in women who had elementary school than in those with more education. The strongest association was in Mexico City as state and as region 7.
{"title":"Mortality trends and risk of dying from breast cancer in the 32 states and 7 socioeconomic regions of Mexico, 2002-2011","authors":"J. Sánchez-Barriga","doi":"10.2427/10236","DOIUrl":"https://doi.org/10.2427/10236","url":null,"abstract":"\u0000Objective. To determine mortality trends from breast cancer in Mexico nationwide, by state, by socioeconomic region, and to establish an association between education, state of residence, and socioeconomic region with mortality from breast cancer in 2002–2011. \u0000Methods. Records of mortality associated with breast cancer were obtained. Rates of mortality nationwide, by state, and by socioeconomic region were calculated. The strength of association between states where women resided, socioeconomic regions, and education with mortality from breast cancer was determined. \u0000Results. Women who completed elementary school had a higher risk of dying from breast cancer than people with more education [relative risk (RR) 2.58, 95% confidence interval (CI) 2.49–2.67]. Mexico City had the strongest association with dying from breast cancer as state and as socioeconomic region 7 [Mexico City: RR 3.47, CI95% 2.7-4.46 (2002) and RR 3.33, CI95% 2.66-4.15 (2011) and region 7: RR 3.72, CI 95%: 3.15-4.38 (2002) and RR 2.87, CI 95%: 2.51-3.28 (2011)]. \u0000Conclusions. In Mexico, the raw mortality rates per 100 000 women who died from breast cancer increased. Mortality was higher in women who had elementary school than in those with more education. The strongest association was in Mexico City as state and as region 7. \u0000","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76421963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Gehring, C. Jommi, R. Tarricone, M. Cirenei, G. Ambrosio
Background Italy is Europe’s third largest pharmaceutical market, yet it ranks only ninth in the number of NIH-registered clinical trials per capita. The aim of our study was to explore stakeholders’ perception of Italy as place to undertake clinical trials, and to estimate the potential economic impact of selected reforms in terms of incremental trial activity. Methods The Survey of Attitudes towards Trials in Europe (SAT-EU Study) was an anonymous, web-based survey which systematically assessed factors impacting clinical trial site selection in Europe. Estimates of Italian economic impact were developed in collaboration with AICRO (Association of Italian Contract Research Organisations). Results Responses were obtained from 485 professionals in 34 countries (15% residing in Italy) representing over 100 institutions, spanning BioPharma Clinical Research Organizations (CROs), and Academic Clinical Trial Units (CTUs). Italy ranked tenth of twelve in terms of accessibility and transparency of information required to run clinical trials, and last with respect to predictability and speed of Ethics Committees. Costs of running clinical trials were not considered critical, whereas, fragmented and slow approval process was. Streamlined centralized trial authorization would translate into an estimated 1.1 billion Euros of incremental trial investments over three years. Conclusions Clinical trial professionals consider Italy’s governance of clinical research suboptimal, among the worst in Europe, and indicate that much could be done to make Italy more attractive for clinical trial investments. The present study also provides evidence about stakeholders’ willingness to invest in trials and its economic consequences provided effective reforms are put in place.
{"title":"Towards a More Competitive Italy in Clinical Research: The Survey of Attitudes towards Trial sites in Europe (The SAT-EU Study TM)","authors":"M. Gehring, C. Jommi, R. Tarricone, M. Cirenei, G. Ambrosio","doi":"10.2427/10246","DOIUrl":"https://doi.org/10.2427/10246","url":null,"abstract":"Background \u0000Italy is Europe’s third largest pharmaceutical market, yet it ranks only ninth in the number of NIH-registered clinical trials per capita. The aim of our study was to explore stakeholders’ perception of Italy as place to undertake clinical trials, and to estimate the potential economic impact of selected reforms in terms of incremental trial activity. \u0000Methods \u0000The Survey of Attitudes towards Trials in Europe (SAT-EU Study) was an anonymous, web-based survey which systematically assessed factors impacting clinical trial site selection in Europe. Estimates of Italian economic impact were developed in collaboration with AICRO (Association of Italian Contract Research Organisations). \u0000Results \u0000Responses were obtained from 485 professionals in 34 countries (15% residing in Italy) representing over 100 institutions, spanning BioPharma Clinical Research Organizations (CROs), and Academic Clinical Trial Units (CTUs). Italy ranked tenth of twelve in terms of accessibility and transparency of information required to run clinical trials, and last with respect to predictability and speed of Ethics Committees. Costs of running clinical trials were not considered critical, whereas, fragmented and slow approval process was. Streamlined centralized trial authorization would translate into an estimated 1.1 billion Euros of incremental trial investments over three years. \u0000Conclusions \u0000Clinical trial professionals consider Italy’s governance of clinical research suboptimal, among the worst in Europe, and indicate that much could be done to make Italy more attractive for clinical trial investments. The present study also provides evidence about stakeholders’ willingness to invest in trials and its economic consequences provided effective reforms are put in place. \u0000 ","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87176137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background:The Kandovan region in Iran is physically and geologically similar to the Cappadocian region in Turkey where fibrous zeolites, including erionite, have been found in volcanic tuffs. In some Cappodocian villages there is strong evidence that erionite, and possibly related minerals, are responsible for the high level of mesothelioma found there. So, although mesothelioma clusters have not been reported in Kandovan, it is a plausible hypothesis that many cases of mesothelioma in Iran may be due to naturally occurring fibrous zeolites.Methods: A detailed study of Iranian geology was made to determine similarities between the Kandovan region and Cappadocia, ‘inter-mountain zones’ in the Western US and Mexico. Areas where mesothelioma cases probably attributable to erionite exposure have been found. Results:Although there is a long history of asbestos use in Iran many cases of mesothelioma do not present with positive asbestos exposure histories. Since fibrous zeolites are so widespread, why have not more mesotheliomas attributable to them been found throughout Iran? Various possible reasons were explored including misdiagnosis, poor surveillance, a general lack of awareness that this tumor may be linked to mineral fibre exposure. There is also the analytical problem of identifying fibrous erionite in lung tissue.Conclusions:There is every reason to believe mesotheliomas due to fibrous zeolite including erionite will be found in Iran. The most likely places to find them are the villages that look very similar to those found in Cappadocia since these are based upon similar geological formations.
{"title":"Kandovan the next ‘Capadoccia’? – A potential public health issue for erionite related mesothelioma risk","authors":"E. Ilgren, Hossein Kazemain, J. Hoskins","doi":"10.2427/10106","DOIUrl":"https://doi.org/10.2427/10106","url":null,"abstract":"Background:The Kandovan region in Iran is physically and geologically similar to the Cappadocian region in Turkey where fibrous zeolites, including erionite, have been found in volcanic tuffs. In some Cappodocian villages there is strong evidence that erionite, and possibly related minerals, are responsible for the high level of mesothelioma found there. So, although mesothelioma clusters have not been reported in Kandovan, it is a plausible hypothesis that many cases of mesothelioma in Iran may be due to naturally occurring fibrous zeolites.Methods: A detailed study of Iranian geology was made to determine similarities between the Kandovan region and Cappadocia, ‘inter-mountain zones’ in the Western US and Mexico. Areas where mesothelioma cases probably attributable to erionite exposure have been found. Results:Although there is a long history of asbestos use in Iran many cases of mesothelioma do not present with positive asbestos exposure histories. Since fibrous zeolites are so widespread, why have not more mesotheliomas attributable to them been found throughout Iran? Various possible reasons were explored including misdiagnosis, poor surveillance, a general lack of awareness that this tumor may be linked to mineral fibre exposure. There is also the analytical problem of identifying fibrous erionite in lung tissue.Conclusions:There is every reason to believe mesotheliomas due to fibrous zeolite including erionite will be found in Iran. The most likely places to find them are the villages that look very similar to those found in Cappadocia since these are based upon similar geological formations.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91040605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Fabbro, S. Crivellaro, C. D. Fratte, L. Vetrugno, G. Adani, B. Saule, Daniela Drigo, Giulia Zumerle, C. Favaretti, G. Guarrera
BACKGROUND: Robotic Assisted Radical Prostatectomy (RALP) is one of the most expensive urological innovations. Prices of the “Da Vinci System” range from € 761.105 to € 1.902.762 for each unit, without taking into account the cost of maintenance and the use of additional devices. We evaluated outcomes, and costs retrospectively, comparing RALP to open retro-pubic radical prostatectomy (RRP) performed in our hospital between December 2009 and December 2010. METHODS: We compared 53 RALP, and 50 RRP in terms of costs, and clinical outcomes. We also implemented a Break Even Analysis in order to evaluate if the public reimbursement covered the total cost of RALP. RESULTS: According to our analysis, RALP showed lower hospitalization (p < 0,0001), higher early continence rate (p < 0,0001), better potency rate in nerve sparing procedures (p < 0,0142), and required no transfusions. Excluding the cost of purchasing and maintenance, single case costs were € 6.046,08 for RALP and € 4.834,11 for RRP, respectively. Considering the affordability of the technology, the point where the total revenue is sufficient to cover the total costs is an average of 60 cases performed per year, only in presence of additional reimbursement. CONCLUSIONS: Although our clinical analysis shows better results in favour of RALP, the economical analysis shows that RALP's costs are consistently higher than RRP. Considering also the purchasing costs, we demonstrate that the health gain of the technology does not necessarily offset the higher costs, even in a large, university hospital (1.000 beds).
{"title":"Robot-assisted laparoscopic prostatectomy: a costs and break-even point analysis for decision-making in a university hospital and a regional healthcare system in Northern Italy","authors":"E. Fabbro, S. Crivellaro, C. D. Fratte, L. Vetrugno, G. Adani, B. Saule, Daniela Drigo, Giulia Zumerle, C. Favaretti, G. Guarrera","doi":"10.2427/10234","DOIUrl":"https://doi.org/10.2427/10234","url":null,"abstract":" \u0000 \u0000BACKGROUND: Robotic Assisted Radical Prostatectomy (RALP) is one of the most expensive urological innovations. Prices of the “Da Vinci System” range from € 761.105 to € 1.902.762 for each unit, without taking into account the cost of maintenance and the use of additional devices. We evaluated outcomes, and costs retrospectively, comparing RALP to open retro-pubic radical prostatectomy (RRP) performed in our hospital between December 2009 and December 2010. \u0000METHODS: We compared 53 RALP, and 50 RRP in terms of costs, and clinical outcomes. We also implemented a Break Even Analysis in order to evaluate if the public reimbursement covered the total cost of RALP. \u0000RESULTS: According to our analysis, RALP showed lower hospitalization (p < 0,0001), higher early continence rate (p < 0,0001), better potency rate in nerve sparing procedures (p < 0,0142), and required no transfusions. Excluding the cost of purchasing and maintenance, single case costs were € 6.046,08 for RALP and € 4.834,11 for RRP, respectively. Considering the affordability of the technology, the point where the total revenue is sufficient to cover the total costs is an average of 60 cases performed per year, only in presence of additional reimbursement. \u0000CONCLUSIONS: Although our clinical analysis shows better results in favour of RALP, the economical analysis shows that RALP's costs are consistently higher than RRP. Considering also the purchasing costs, we demonstrate that the health gain of the technology does not necessarily offset the higher costs, even in a large, university hospital (1.000 beds). \u0000","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88152753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Missing values are a common problem for data analyses in observational studies, which are frequently applied in health services research. This paper examines the usefulness of different approaches to tackle the problem of incomplete observational data, focusing whether the Multiple Imputation (MI) strategy yields adequate estimates when applied to a complex analysis framework. Methods: Based on observational study data originally comparing three forms of psychotherapy, a simulation study with different missing data scenarios was conducted. The considered analysis model comprised a propensity score-adjusted treatment effect estimation. Missing values were handled by complete case analysis, different MI approaches, as well as mean and regression imputation. Results: All point estimators of the applied methods lay within the 95% confidence interval of the treatment effect derived from the complete simulation data set. Highest deviation was observed for complete case analysis. A distinct superiority of MI methods could not be demonstrated. Conclusion: Since there was no clear benefit of one method to deal with missing values over another, health services researchers faced with incomplete observational data are well-advised to apply different imputation methods and compare the results in order to get an impression of their sensitivity.
{"title":"Propensity score adjustment of a treatment effect with missing data in psychiatric health services research","authors":"B. Mayer, B. Puschner","doi":"10.2427/10214","DOIUrl":"https://doi.org/10.2427/10214","url":null,"abstract":"\u0000Background: Missing values are a common problem for data analyses in observational studies, which are frequently applied in health services research. This paper examines the usefulness of different approaches to tackle the problem of incomplete observational data, focusing whether the Multiple Imputation (MI) strategy yields adequate estimates when applied to a complex analysis framework. \u0000Methods: Based on observational study data originally comparing three forms of psychotherapy, a simulation study with different missing data scenarios was conducted. The considered analysis model comprised a propensity score-adjusted treatment effect estimation. Missing values were handled by complete case analysis, different MI approaches, as well as mean and regression imputation. \u0000Results: All point estimators of the applied methods lay within the 95% confidence interval of the treatment effect derived from the complete simulation data set. Highest deviation was observed for complete case analysis. A distinct superiority of MI methods could not be demonstrated. \u0000Conclusion: Since there was no clear benefit of one method to deal with missing values over another, health services researchers faced with incomplete observational data are well-advised to apply different imputation methods and compare the results in order to get an impression of their sensitivity. \u0000","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89525650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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