Federica Vigna-taglianti - Academia.edu (original) (raw)

Papers by Federica Vigna-taglianti

Research paper thumbnail of Effects of the "Unplugged" school-based substance use prevention program in Nigeria: A cluster randomized controlled trial

Drug and Alcohol Dependence

Research paper thumbnail of Socio-economic differences in factors associated with alcohol use among adolescents in Slovenia: a cross-sectional study

International Journal of Public Health

Research paper thumbnail of Do the socioeconomic context and the European geographical area modify parental influences on smoking experimentation among adolescents?

European Child & Adolescent Psychiatry

Research paper thumbnail of Correlates of cannabis and other illicit drugs use among secondary school adolescents in Nigeria

Drug and Alcohol Dependence

Research paper thumbnail of Knowledge, attitudes and behaviours on tobacco, alcohol and other drugs among Nigerian secondary school students: Differences by geopolitical zones

Research paper thumbnail of Psychopathology of addiction: May a SCL-90-based five dimensions structure be applied irrespectively of the involved drug?

Annals of General Psychiatry, 2016

Background: We previously found a five cluster of psychological symptoms in heroin use disorder (... more Background: We previously found a five cluster of psychological symptoms in heroin use disorder (HUD) patients: 'worthlessness-being trapped' , 'somatic-symptoms' , 'sensitivity-psychoticism' , 'panic-anxiety' , and 'violence-suicide'. We demonstrated that this aggregation is independent of the chosen treatment, of intoxication status and of the presence of psychiatric problems. Methods: 2314 Subjects, with alcohol, heroin or cocaine dependence were assigned to one of the five clusters. Differences between patients dependent on alcohol, heroin and cocaine in the frequency of the five clusters and in their severity were analysed. The association between the secondary abuse of alcohol and cocaine and the five clusters was also considered in the subsample of HUD patients. Results: We confirmed a positive association of the 'somatic symptoms' dimension with the condition of heroin versus cocaine dependence and of the 'sensitivity-psychoticism' dimension with the condition of alcohol versus heroin dependence. 'Somatic symptoms' and 'panic anxiety' successfully discriminated between patients as being alcohol, heroin or cocaine dependents. Looking at the subsample of heroin dependents, no significant differences were observed. Conclusions: The available evidence coming from our results, taken as a whole, seems to support the extension of the psychopathological structure previously observed in opioid addicts to the population of alcohol and cocaine dependents.

Research paper thumbnail of Gender Differences in Heroin Addiction and Treatment: Results from the VEdeTTE Cohort

Substance Use & Misuse, 2016

Gender differences strongly affect heroin addiction, from risk factors to patterns of consumption... more Gender differences strongly affect heroin addiction, from risk factors to patterns of consumption, access to treatments, and outcomes. To investigate gender differences in the VEdeTTE cohort of heroin addicts. VEdeTTE is a cohort of 10,454 heroin users enrolled between 1998 and 2001 in 115 public drug treatment centres in Italy. Clinical and personal information were collected at intake through a structured interview. Treatments were recorded using a standardized form. Gender differences were explored with regard to characteristics at intake, treatments, and retention in methadone maintenance and therapeutic community. Cox Proportional models were carried out to identify risk factors for treatment abandon. Compared with men, at their first access to treatment women with drug addiction were younger, more frequently married, legally separated, divorced or widow, unemployed though better educated, HIV+; more frequently they lived with their partner and sons. They reported a higher use of sedatives, but a lower use of alcohol; more frequently they had psychiatric comorbidity, including depression, self-injuries, and suicide attempts. Psychotherapy was more frequently prescribed to women, pharmacological treatments to men. Methadone maintenance was less frequently abandoned by women. Drug abuse severity factors predicted abandon of methadone among women. High methadone doses and the combination with psychotherapy improved treatment retention in both genders. Low education level and severity factors among women and young age among men predicted abandon of therapeutic community. Gender differences in the VEdeTTE cohort suggest the need of a gender sensitive approach to improve treatment outcomes among heroin addicts.

Research paper thumbnail of 18F-FDG Pet/CT in the Post-Operative Monitoring of Patients with Adrenocortical Carcinoma

European Journal of Endocrinology, 2015

ContextThe role of 18F-labeled 2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET... more ContextThe role of 18F-labeled 2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the post-operative monitoring of patients with adrenocortical carcinoma (ACC) is still unclear.ObjectiveTo assess the accuracy of FDG PET/CT to diagnose ACC recurrence in a real world setting.Design and methodsRetrospective evaluation of data of 57 patients with presumed ACC recurrence at CT scan who underwent FDG PET/CT within a median time of 20 days. We compared the results of either FDG PET/CT or CT with a gold standard confirmation of recurrence (positive histopathology report of removed/biopsied lesions or radiological progression of target lesions at follow-up) to assess their diagnostic performance at different body sites to correctly categorize target lesions. We also assessed whether FDG PET/CT findings may be useful to inform the management strategy.ResultsIn 48 patients with confirmed ACC recurrence, we found that FDG PET/CT had lower sensitivity...

Research paper thumbnail of Gli interventi educativi in ambito scolastico nella prevenzione dell’uso di sostanze illecite: una revisione Cochrane per valutarne l’efficacia

Research paper thumbnail of Psychic Structure of Opioid Addiction

Addictive Disorders & Their Treatment, 2015

ABSTRACT Background: By applying a Principal Component Analysis (PCA) to the items of the SCL-90 ... more ABSTRACT Background: By applying a Principal Component Analysis (PCA) to the items of the SCL-90 checklist, we previously investigated the psychopathologic structure of individuals with heroin addiction, finding a 5-factor aggregation of psychological/psychiatric symptoms: "Worthlessness and Being trapped," "Somatic Symptoms," "Sensitivity-Psychoticism," "Panic-Anxiety," and "Violence-Suicide." Our studies on this subject did not, however, explore the possible impact of comorbid psychiatric conditions on 5 psychopathologic dimensions listed above. The aim of the present study is to verify whether there is any difference in these 5 dimensions between heroin-addicted patients with (PC-HA) or without (NPC-HA) known lifetime psychiatric problems. Methods: A total of 1195 patients with heroin dependence entering a residential therapeutic community treatment were assigned to one of the 5-factor solutions yielded by Principal Component Analysis on the basis of the highest z score obtained. Differences between NPC-HA and PC-HA patients in the frequency of the 5 psychopathologic dimensions and in their severity were then analyzed by means of univariate and multivariate analyses. Results: All the SCL-90 factor scores were, from a statistical viewpoint, significantly higher in PC-HA than in NPC-HA patients, but the only statistically significant differences in the frequency of the 5 psychopathological dimensions were those observed in the case of "Panic-Anxiety," which turned out to be higher in the PC-HA group. Stepwise discriminant analysis showed that the severity of "Somatic Symptoms" and "Panic-Anxiety" made these 2 factors the only ones that successfully discriminated between NPC-HA and PC-HA patients. The other SCL-90-based psychopathologic dimensions were unable to improve the value of the discrimination. Conclusions: On the basis of our results, the SCL-90-defined structure of opioid addiction may be considered to be only partly dependent on the presence of a "psychiatric" condition. This observation adds to the previous ones that go to show the stability of the above aggregations of symptoms, irrespectively of other demographic and clinical characteristics, as well as active involvement with heroin abuse or the kind of treatment chosen. When the available evidence is considered as a whole, it seems to support the trait-dependent, rather than state-dependent, nature of the proposed factorial dimensions of the psychopathology of opioid addiction.

Research paper thumbnail of Lung cancers attributable to environmental tobacco smoke and air pollution in non-smokers in different European countries: a prospective study

Environmental Health, 2007

BACKGROUND: Several countries are discussing new legislation on the ban of smoking in public plac... more BACKGROUND: Several countries are discussing new legislation on the ban of smoking in public places, and on the acceptable levels of traffic-related air pollutants. It is therefore useful to estimate the burden of disease associated with indoor and outdoor air pollution. METHODS: We have estimated exposure to Environmental Tobacco Smoke (ETS) and to air pollution in never smokers and ex-smokers

Research paper thumbnail of School-based prevention for illicit drugs use: A systematic review

Preventive Medicine, 2008

Research paper thumbnail of Is universal prevention against youths' substance misuse really universal? Gender-specific effects in the EU-Dap school-based prevention trial

Journal of Epidemiology & Community Health, 2009

Keywords school-based prevention, comprehensive social influence model, effectiveness, substance ... more Keywords school-based prevention, comprehensive social influence model, effectiveness, substance use, gender differences.

Research paper thumbnail of Methadone Treatment in Clinical Practice in Italy: Need for Improvement

European Addiction Research, 2006

Methadone at appropriate doses has been demonstrated to be the most effective means for retaining... more Methadone at appropriate doses has been demonstrated to be the most effective means for retaining patients in treatment and suppressing heroin use. To describe the modalities of day-to-day provision of methadone maintenance treatments (MMT) in Italian public health centres and to analyze the duration of MMTs by dose and by association with psychosocial treatments. We analyzed 8,378 subjects, 18 years of age or over, enrolled between September 1998 and March 2001 in one of 115 public treatment centres for heroin dependence in Italy. Treatment data were collected for each subject from enrolment to the end of the study period (maximum of 18 months). Of the total of 29,495 treatments delivered, 21.0% were methadone maintenance, and 34.4% were methadone detoxification. Fifty percent of MMTs offered had a mean dose less than or equal to 40 mg/day, and only 19% had doses higher than or equal to 60 mg/day; treatments with doses higher than 60 mg/day lasted longer than treatments with lower doses. Differences in treatment length were observed between MMTs associated with a psychosocial treatment and those offered alone, only for doses <60 mg/day. In Italy, MMTs are delivered at inappropriate doses in more than 80% of the cases. The increase of methadone doses to adequate levels as indicated by the literature is necessary to ensure proper and effective use of MMTs in public treatment centres for heroin users.

Research paper thumbnail of Air Pollution and Cancer: The Genair Study

Research paper thumbnail of Aircraft Noise Exposure and Use of Medication

Epidemiology, 2009

ABSTRACT Long-term exposure to noise from aircraft and road traffic is associated with effects on... more ABSTRACT Long-term exposure to noise from aircraft and road traffic is associated with effects on well-being such as sleep disturbance and annoyance and with pathophysiological outcomes such as hypertension. Within the framework of the HYENA (Hypertension and Exposure to Noise near Airports) project, we investigated the effect of long-term exposure to aircraft and road noise on the usage of selected prescribed medication. Use of prescribed medication for hypertension, stomach ulcer, cancer, sleep disorders, psychiatric disorders and respiratory diseases was measured by a cross-sectional survey of 4,861 persons 45-70 years of age, who had lived at least 5 years (3 years for Greece) near any of six major European airports. Exposure was assessed using detailed models with a resolution of 1dB (5dB for UK road traffic noise) and spatial resolution of 250×250 m2 for aircraft noise and 10×10 m2 for road traffic noise. An increased risk of taking anti-hypertensive and anxiolytic medication was found for those exposed to aircraft noise at night, after adjustment for major confounders, but not for the other drugs under investigation. A 10dB increase in night-time aircraft noise exposure was associated with an odds ratio (OR) of 1.10 (95% CI, 1.02-1.20) in taking anti-hypertensives and OR of 1.29 (95% CI, 1.03-1.62) for taking anxiolytics. A higher risk of taking anxiolytics was observed for women vs men (OR = 2.52; 95%CI: 1.68-3.79) and differences were observed between countries. Results indicate excess risks of using anti-hypertensive and anxiolytic medication related to long-term exposure to aircraft noise. The association found between aircraft noise and anxiolytic use is consistent with the hypothesis suggesting that health effects of noise are stress-mediated.

Research paper thumbnail of The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial

Drug and Alcohol Dependence, 2010

Aim: To evaluate the effectiveness of a school-based substance abuse prevention program developed... more Aim: To evaluate the effectiveness of a school-based substance abuse prevention program developed in the EU-Dap study (EUropean Drug Addiction Prevention trial). Materials and methods: Cluster Randomized Controlled Trial. Seven European countries participated in the study; 170 schools (7079 pupils 12-14 years of age) were randomly assigned to one of three experimental conditions or to a control condition during the school year 2004/2005. The program consisted of a 12-h curriculum based on a comprehensive social influence approach. A pre-test survey assessing past and current substance use was conducted before the implementation of the program, while a post-test survey was carried out about 18 months after the pre-test. The association between program condition and change in substance use at post-test was expressed as adjusted prevalence odds ratio (POR), estimated by multilevel regression models. Results: Persisting beneficial program effects were found for episodes of drunkenness (any, POR = 0.80; 0.67-0.97; frequent, POR = 0.62; 0.47-0.81) and for frequent cannabis use in the past 30 days (POR = 0.74; 0.53-1.00), whereas daily cigarette smoking was not affected by the program as it was at the short-term follow-up. Baseline non-smokers that participated in the program progressed in tobacco consumption to a lower extent than those in the control condition, but no difference was detected in the proportion of quitters or reducers among baseline daily smokers. Conclusion: The experimental evaluation of an innovative school curriculum based on a comprehensive social influence approach, indicated persistent positive effects over 18 months for alcohol abuse and for cannabis use, but not for cigarette smoking.

Research paper thumbnail of Quale valutazione per il sistema dei servizi per le tossicodipendenze? What type of evaluation for the drug addiction system of care in Italy?

This paper aims to verify the process for quality assessment in health care, by comparing the rad... more This paper aims to verify the process for quality assessment in health care, by comparing the radiotherapy for the treatment of breast cancer and the methadone maintenance therapy for the treatment of heroin addiction. The comparison aims to underline problematic areas and to suggest priorities of intervention. In the case of the drug addiction system of care in Italy, we

Research paper thumbnail of “Unplugged,” a European school-based program for substance use prevention among adolescents: Overview of results from the EU-Dap trial

New Directions for Youth Development, 2014

The EU-Dap study aimed to develop and evaluate a school-based curriculum for the prevention of su... more The EU-Dap study aimed to develop and evaluate a school-based curriculum for the prevention of substance use among young people. The school curriculum, "Unplugged," is based on social influence approach and addresses social and personal skills, knowledge, and normative beliefs. It consists of 12 one-hour interactive sessions delivered by teachers. Its effectiveness was evaluated through a randomized trial involving 7,079 pupils of seven European countries. Unplugged was effective in reducing cigarette smoking, episodes of drunkenness, and the use of cannabis at short term. This association, however, was confined to boys, with age and self-esteem as possible explanations of this difference. Beneficial effects associated with the program persisted at fifteen-month follow-up for drunkenness, alcohol-related problems, and cannabis use, and were stronger among adolescents in schools of average low socioeconomic level. These results are of scientific importance and may inform the adoption of effective public health interventions at population level.

Research paper thumbnail of Medication use in relation to noise from aircraft and road traffic in six European countries: Results of the HYENA study

Occupational and Environmental Medicine, 2011

Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of... more Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of hypertension, cardiovascular disease and the use of sedatives and hypnotics. Our aim was to assess the use of medication in relation to noise from aircraft and road traffic. This cross-sectional study measured the use of prescribed antihypertensives, antacids, anxiolytics, hypnotics, antidepressants and antasthmatics in 4,861 persons living near seven airports in six European countries (UK, Germany, the Netherlands, Sweden, Italy, and Greece). Exposure was assessed using models with 1 dB resolution (5 dB for UK road traffic noise) and spatial resolution of 250×250 m for aircraft and 10×10 m for road traffic noise. Data were analysed using multilevel logistic regression, adjusting for potential confounders. We found marked differences between countries in the effect of aircraft noise on antihypertensive use; for night-time aircraft noise, a 10 dB increase in exposure was associated with ORs of 1.34 (95% CI 1.14 to 1.57) for the UK and 1.19 (1.02 to 1.38) for the Netherlands but no significant associations were found for other countries. For day-time aircraft noise, excess risks were found for the UK (OR 1.35; CI: 1.13 to 1.60) but a risk deficit for Italy (OR 0.82; CI: 0.71 to 0.96). There was an excess risk of taking anxiolytic medication in relation to aircraft noise (OR 1.28; CI: 1.04 to 1.57 for daytime and OR 1.27; CI: 1.01 to 1.59 for night-time) which held across countries. We also found an association between exposure to 24hr road traffic noise and the use of antacids by men (OR 1.39; CI 1.11 to 1.74). Our results suggest an effect of aircraft noise on the use of antihypertensive medication, but this effect did not hold for all countries. Results were more consistent across countries for the increased use of anxiolytics in relation to aircraft noise.

Research paper thumbnail of Effects of the "Unplugged" school-based substance use prevention program in Nigeria: A cluster randomized controlled trial

Drug and Alcohol Dependence

Research paper thumbnail of Socio-economic differences in factors associated with alcohol use among adolescents in Slovenia: a cross-sectional study

International Journal of Public Health

Research paper thumbnail of Do the socioeconomic context and the European geographical area modify parental influences on smoking experimentation among adolescents?

European Child & Adolescent Psychiatry

Research paper thumbnail of Correlates of cannabis and other illicit drugs use among secondary school adolescents in Nigeria

Drug and Alcohol Dependence

Research paper thumbnail of Knowledge, attitudes and behaviours on tobacco, alcohol and other drugs among Nigerian secondary school students: Differences by geopolitical zones

Research paper thumbnail of Psychopathology of addiction: May a SCL-90-based five dimensions structure be applied irrespectively of the involved drug?

Annals of General Psychiatry, 2016

Background: We previously found a five cluster of psychological symptoms in heroin use disorder (... more Background: We previously found a five cluster of psychological symptoms in heroin use disorder (HUD) patients: 'worthlessness-being trapped' , 'somatic-symptoms' , 'sensitivity-psychoticism' , 'panic-anxiety' , and 'violence-suicide'. We demonstrated that this aggregation is independent of the chosen treatment, of intoxication status and of the presence of psychiatric problems. Methods: 2314 Subjects, with alcohol, heroin or cocaine dependence were assigned to one of the five clusters. Differences between patients dependent on alcohol, heroin and cocaine in the frequency of the five clusters and in their severity were analysed. The association between the secondary abuse of alcohol and cocaine and the five clusters was also considered in the subsample of HUD patients. Results: We confirmed a positive association of the 'somatic symptoms' dimension with the condition of heroin versus cocaine dependence and of the 'sensitivity-psychoticism' dimension with the condition of alcohol versus heroin dependence. 'Somatic symptoms' and 'panic anxiety' successfully discriminated between patients as being alcohol, heroin or cocaine dependents. Looking at the subsample of heroin dependents, no significant differences were observed. Conclusions: The available evidence coming from our results, taken as a whole, seems to support the extension of the psychopathological structure previously observed in opioid addicts to the population of alcohol and cocaine dependents.

Research paper thumbnail of Gender Differences in Heroin Addiction and Treatment: Results from the VEdeTTE Cohort

Substance Use & Misuse, 2016

Gender differences strongly affect heroin addiction, from risk factors to patterns of consumption... more Gender differences strongly affect heroin addiction, from risk factors to patterns of consumption, access to treatments, and outcomes. To investigate gender differences in the VEdeTTE cohort of heroin addicts. VEdeTTE is a cohort of 10,454 heroin users enrolled between 1998 and 2001 in 115 public drug treatment centres in Italy. Clinical and personal information were collected at intake through a structured interview. Treatments were recorded using a standardized form. Gender differences were explored with regard to characteristics at intake, treatments, and retention in methadone maintenance and therapeutic community. Cox Proportional models were carried out to identify risk factors for treatment abandon. Compared with men, at their first access to treatment women with drug addiction were younger, more frequently married, legally separated, divorced or widow, unemployed though better educated, HIV+; more frequently they lived with their partner and sons. They reported a higher use of sedatives, but a lower use of alcohol; more frequently they had psychiatric comorbidity, including depression, self-injuries, and suicide attempts. Psychotherapy was more frequently prescribed to women, pharmacological treatments to men. Methadone maintenance was less frequently abandoned by women. Drug abuse severity factors predicted abandon of methadone among women. High methadone doses and the combination with psychotherapy improved treatment retention in both genders. Low education level and severity factors among women and young age among men predicted abandon of therapeutic community. Gender differences in the VEdeTTE cohort suggest the need of a gender sensitive approach to improve treatment outcomes among heroin addicts.

Research paper thumbnail of 18F-FDG Pet/CT in the Post-Operative Monitoring of Patients with Adrenocortical Carcinoma

European Journal of Endocrinology, 2015

ContextThe role of 18F-labeled 2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET... more ContextThe role of 18F-labeled 2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the post-operative monitoring of patients with adrenocortical carcinoma (ACC) is still unclear.ObjectiveTo assess the accuracy of FDG PET/CT to diagnose ACC recurrence in a real world setting.Design and methodsRetrospective evaluation of data of 57 patients with presumed ACC recurrence at CT scan who underwent FDG PET/CT within a median time of 20 days. We compared the results of either FDG PET/CT or CT with a gold standard confirmation of recurrence (positive histopathology report of removed/biopsied lesions or radiological progression of target lesions at follow-up) to assess their diagnostic performance at different body sites to correctly categorize target lesions. We also assessed whether FDG PET/CT findings may be useful to inform the management strategy.ResultsIn 48 patients with confirmed ACC recurrence, we found that FDG PET/CT had lower sensitivity...

Research paper thumbnail of Gli interventi educativi in ambito scolastico nella prevenzione dell’uso di sostanze illecite: una revisione Cochrane per valutarne l’efficacia

Research paper thumbnail of Psychic Structure of Opioid Addiction

Addictive Disorders & Their Treatment, 2015

ABSTRACT Background: By applying a Principal Component Analysis (PCA) to the items of the SCL-90 ... more ABSTRACT Background: By applying a Principal Component Analysis (PCA) to the items of the SCL-90 checklist, we previously investigated the psychopathologic structure of individuals with heroin addiction, finding a 5-factor aggregation of psychological/psychiatric symptoms: "Worthlessness and Being trapped," "Somatic Symptoms," "Sensitivity-Psychoticism," "Panic-Anxiety," and "Violence-Suicide." Our studies on this subject did not, however, explore the possible impact of comorbid psychiatric conditions on 5 psychopathologic dimensions listed above. The aim of the present study is to verify whether there is any difference in these 5 dimensions between heroin-addicted patients with (PC-HA) or without (NPC-HA) known lifetime psychiatric problems. Methods: A total of 1195 patients with heroin dependence entering a residential therapeutic community treatment were assigned to one of the 5-factor solutions yielded by Principal Component Analysis on the basis of the highest z score obtained. Differences between NPC-HA and PC-HA patients in the frequency of the 5 psychopathologic dimensions and in their severity were then analyzed by means of univariate and multivariate analyses. Results: All the SCL-90 factor scores were, from a statistical viewpoint, significantly higher in PC-HA than in NPC-HA patients, but the only statistically significant differences in the frequency of the 5 psychopathological dimensions were those observed in the case of "Panic-Anxiety," which turned out to be higher in the PC-HA group. Stepwise discriminant analysis showed that the severity of "Somatic Symptoms" and "Panic-Anxiety" made these 2 factors the only ones that successfully discriminated between NPC-HA and PC-HA patients. The other SCL-90-based psychopathologic dimensions were unable to improve the value of the discrimination. Conclusions: On the basis of our results, the SCL-90-defined structure of opioid addiction may be considered to be only partly dependent on the presence of a "psychiatric" condition. This observation adds to the previous ones that go to show the stability of the above aggregations of symptoms, irrespectively of other demographic and clinical characteristics, as well as active involvement with heroin abuse or the kind of treatment chosen. When the available evidence is considered as a whole, it seems to support the trait-dependent, rather than state-dependent, nature of the proposed factorial dimensions of the psychopathology of opioid addiction.

Research paper thumbnail of Lung cancers attributable to environmental tobacco smoke and air pollution in non-smokers in different European countries: a prospective study

Environmental Health, 2007

BACKGROUND: Several countries are discussing new legislation on the ban of smoking in public plac... more BACKGROUND: Several countries are discussing new legislation on the ban of smoking in public places, and on the acceptable levels of traffic-related air pollutants. It is therefore useful to estimate the burden of disease associated with indoor and outdoor air pollution. METHODS: We have estimated exposure to Environmental Tobacco Smoke (ETS) and to air pollution in never smokers and ex-smokers

Research paper thumbnail of School-based prevention for illicit drugs use: A systematic review

Preventive Medicine, 2008

Research paper thumbnail of Is universal prevention against youths' substance misuse really universal? Gender-specific effects in the EU-Dap school-based prevention trial

Journal of Epidemiology & Community Health, 2009

Keywords school-based prevention, comprehensive social influence model, effectiveness, substance ... more Keywords school-based prevention, comprehensive social influence model, effectiveness, substance use, gender differences.

Research paper thumbnail of Methadone Treatment in Clinical Practice in Italy: Need for Improvement

European Addiction Research, 2006

Methadone at appropriate doses has been demonstrated to be the most effective means for retaining... more Methadone at appropriate doses has been demonstrated to be the most effective means for retaining patients in treatment and suppressing heroin use. To describe the modalities of day-to-day provision of methadone maintenance treatments (MMT) in Italian public health centres and to analyze the duration of MMTs by dose and by association with psychosocial treatments. We analyzed 8,378 subjects, 18 years of age or over, enrolled between September 1998 and March 2001 in one of 115 public treatment centres for heroin dependence in Italy. Treatment data were collected for each subject from enrolment to the end of the study period (maximum of 18 months). Of the total of 29,495 treatments delivered, 21.0% were methadone maintenance, and 34.4% were methadone detoxification. Fifty percent of MMTs offered had a mean dose less than or equal to 40 mg/day, and only 19% had doses higher than or equal to 60 mg/day; treatments with doses higher than 60 mg/day lasted longer than treatments with lower doses. Differences in treatment length were observed between MMTs associated with a psychosocial treatment and those offered alone, only for doses <60 mg/day. In Italy, MMTs are delivered at inappropriate doses in more than 80% of the cases. The increase of methadone doses to adequate levels as indicated by the literature is necessary to ensure proper and effective use of MMTs in public treatment centres for heroin users.

Research paper thumbnail of Air Pollution and Cancer: The Genair Study

Research paper thumbnail of Aircraft Noise Exposure and Use of Medication

Epidemiology, 2009

ABSTRACT Long-term exposure to noise from aircraft and road traffic is associated with effects on... more ABSTRACT Long-term exposure to noise from aircraft and road traffic is associated with effects on well-being such as sleep disturbance and annoyance and with pathophysiological outcomes such as hypertension. Within the framework of the HYENA (Hypertension and Exposure to Noise near Airports) project, we investigated the effect of long-term exposure to aircraft and road noise on the usage of selected prescribed medication. Use of prescribed medication for hypertension, stomach ulcer, cancer, sleep disorders, psychiatric disorders and respiratory diseases was measured by a cross-sectional survey of 4,861 persons 45-70 years of age, who had lived at least 5 years (3 years for Greece) near any of six major European airports. Exposure was assessed using detailed models with a resolution of 1dB (5dB for UK road traffic noise) and spatial resolution of 250×250 m2 for aircraft noise and 10×10 m2 for road traffic noise. An increased risk of taking anti-hypertensive and anxiolytic medication was found for those exposed to aircraft noise at night, after adjustment for major confounders, but not for the other drugs under investigation. A 10dB increase in night-time aircraft noise exposure was associated with an odds ratio (OR) of 1.10 (95% CI, 1.02-1.20) in taking anti-hypertensives and OR of 1.29 (95% CI, 1.03-1.62) for taking anxiolytics. A higher risk of taking anxiolytics was observed for women vs men (OR = 2.52; 95%CI: 1.68-3.79) and differences were observed between countries. Results indicate excess risks of using anti-hypertensive and anxiolytic medication related to long-term exposure to aircraft noise. The association found between aircraft noise and anxiolytic use is consistent with the hypothesis suggesting that health effects of noise are stress-mediated.

Research paper thumbnail of The effectiveness of a school-based substance abuse prevention program: 18-Month follow-up of the EU-Dap cluster randomized controlled trial

Drug and Alcohol Dependence, 2010

Aim: To evaluate the effectiveness of a school-based substance abuse prevention program developed... more Aim: To evaluate the effectiveness of a school-based substance abuse prevention program developed in the EU-Dap study (EUropean Drug Addiction Prevention trial). Materials and methods: Cluster Randomized Controlled Trial. Seven European countries participated in the study; 170 schools (7079 pupils 12-14 years of age) were randomly assigned to one of three experimental conditions or to a control condition during the school year 2004/2005. The program consisted of a 12-h curriculum based on a comprehensive social influence approach. A pre-test survey assessing past and current substance use was conducted before the implementation of the program, while a post-test survey was carried out about 18 months after the pre-test. The association between program condition and change in substance use at post-test was expressed as adjusted prevalence odds ratio (POR), estimated by multilevel regression models. Results: Persisting beneficial program effects were found for episodes of drunkenness (any, POR = 0.80; 0.67-0.97; frequent, POR = 0.62; 0.47-0.81) and for frequent cannabis use in the past 30 days (POR = 0.74; 0.53-1.00), whereas daily cigarette smoking was not affected by the program as it was at the short-term follow-up. Baseline non-smokers that participated in the program progressed in tobacco consumption to a lower extent than those in the control condition, but no difference was detected in the proportion of quitters or reducers among baseline daily smokers. Conclusion: The experimental evaluation of an innovative school curriculum based on a comprehensive social influence approach, indicated persistent positive effects over 18 months for alcohol abuse and for cannabis use, but not for cigarette smoking.

Research paper thumbnail of Quale valutazione per il sistema dei servizi per le tossicodipendenze? What type of evaluation for the drug addiction system of care in Italy?

This paper aims to verify the process for quality assessment in health care, by comparing the rad... more This paper aims to verify the process for quality assessment in health care, by comparing the radiotherapy for the treatment of breast cancer and the methadone maintenance therapy for the treatment of heroin addiction. The comparison aims to underline problematic areas and to suggest priorities of intervention. In the case of the drug addiction system of care in Italy, we

Research paper thumbnail of “Unplugged,” a European school-based program for substance use prevention among adolescents: Overview of results from the EU-Dap trial

New Directions for Youth Development, 2014

The EU-Dap study aimed to develop and evaluate a school-based curriculum for the prevention of su... more The EU-Dap study aimed to develop and evaluate a school-based curriculum for the prevention of substance use among young people. The school curriculum, "Unplugged," is based on social influence approach and addresses social and personal skills, knowledge, and normative beliefs. It consists of 12 one-hour interactive sessions delivered by teachers. Its effectiveness was evaluated through a randomized trial involving 7,079 pupils of seven European countries. Unplugged was effective in reducing cigarette smoking, episodes of drunkenness, and the use of cannabis at short term. This association, however, was confined to boys, with age and self-esteem as possible explanations of this difference. Beneficial effects associated with the program persisted at fifteen-month follow-up for drunkenness, alcohol-related problems, and cannabis use, and were stronger among adolescents in schools of average low socioeconomic level. These results are of scientific importance and may inform the adoption of effective public health interventions at population level.

Research paper thumbnail of Medication use in relation to noise from aircraft and road traffic in six European countries: Results of the HYENA study

Occupational and Environmental Medicine, 2011

Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of... more Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of hypertension, cardiovascular disease and the use of sedatives and hypnotics. Our aim was to assess the use of medication in relation to noise from aircraft and road traffic. This cross-sectional study measured the use of prescribed antihypertensives, antacids, anxiolytics, hypnotics, antidepressants and antasthmatics in 4,861 persons living near seven airports in six European countries (UK, Germany, the Netherlands, Sweden, Italy, and Greece). Exposure was assessed using models with 1 dB resolution (5 dB for UK road traffic noise) and spatial resolution of 250×250 m for aircraft and 10×10 m for road traffic noise. Data were analysed using multilevel logistic regression, adjusting for potential confounders. We found marked differences between countries in the effect of aircraft noise on antihypertensive use; for night-time aircraft noise, a 10 dB increase in exposure was associated with ORs of 1.34 (95% CI 1.14 to 1.57) for the UK and 1.19 (1.02 to 1.38) for the Netherlands but no significant associations were found for other countries. For day-time aircraft noise, excess risks were found for the UK (OR 1.35; CI: 1.13 to 1.60) but a risk deficit for Italy (OR 0.82; CI: 0.71 to 0.96). There was an excess risk of taking anxiolytic medication in relation to aircraft noise (OR 1.28; CI: 1.04 to 1.57 for daytime and OR 1.27; CI: 1.01 to 1.59 for night-time) which held across countries. We also found an association between exposure to 24hr road traffic noise and the use of antacids by men (OR 1.39; CI 1.11 to 1.74). Our results suggest an effect of aircraft noise on the use of antihypertensive medication, but this effect did not hold for all countries. Results were more consistent across countries for the increased use of anxiolytics in relation to aircraft noise.