Garlic consumption and colorectal cancer risk in man: a systematic review and meta-analysis.

OBJECTIVE: Colorectal cancer shows large incidence variations worldwide that have been attributed to different dietary factors. We conducted a meta-analysis on the relationship between garlic consumption and colorectal cancer risk. DESIGN: We systematically reviewed publications obtained by searching ISI Web of Knowledge, MEDLINE and EMBASE literature databases. We extracted the risk estimate of the highest and the lowest reported categories of intake from each study and conducted meta-analysis using a random-effects model. RESULTS: The pooled analysis of all fourteen studies, seven cohort and seven case-control, indicated that garlic consumption was not associated with colorectal cancer risk (OR=0·93; 95 % CI 0·82, 1·06, P=0·281; I 2=83·6 %, P≤0·001). Separate analyses on the basis of cancer sites and sex also revealed no statistically significant effects on cancer risk. However, when separately analysed on the basis of study type, we found that garlic was associated with an approximately 37 % reduction in colorectal cancer risk in the case-control studies (combined risk estimate=0·63, 95 % CI 0·48, 0·82, P=0·001; I 2=75·6 %, P≤0·001). CONCLUSIONS: Our results suggest that consumption of garlic is not associated with a reduced colorectal cancer risk. Further investigations are necessary to clarify the discrepancy between results obtained from different types of epidemiological studies.

The role and working conditions of Movement Science students employed in sport and recreational facilities: An Italian multicenter study.

BACKGROUND: In Italy, students from Movement Science (MS) Degree Courses often work in sport and recreational facilities before graduation. OBJECTIVE: The employment conditions of Movement Science students working in sport/recreational facilities were investigated, and the management and structural features of the facilities were evaluated, including safety policies. Regional differences were also considered. METHODS: Questionnaires were administered to undergraduate and graduate students (N = 4,217) in 17 Universities. Students' perceptions of the quality of the facilities where they had been employed was evaluated using multivariate analysis. A latent class model with covariates was used to evaluate how variables relating to participants, employment facilities or regions influence their opinions. RESULTS: A high proportion of MS students were employed in sporting facilities (undergraduate level: 33% ; graduate level: 55%), in most cases without any formal employment contracts. Both the structural and hygienic features, as well as the professional knowledge of the staff, were considered good to excellent by the majority of participants (about 70%). Communication of the basic behavioral rules was considered adequate by 61-63% of undergraduate students and 71-75% of graduate students, while nearly half of the participants were dissatisfied with the staff safety training. Correlations between the perceived good structural/hygienic conditions, the presence of regulations and training programs for the staff were investigated. Differences regarding occupational level and safety training among different regions of Italy were also observed. CONCLUSIONS: Italian students in Movement Science were easily employed in sport/recreational facilities, but frequently without a formal contract. This is a consequence of the lack of specific regulations in the field of recreational/leisure employment and could have negative implications, especially in terms of safety.

[Healthcare research and regional programming in Umbria (Italy)]. / Ricerca scientifica in campo sanitario e Programmazione regionale: l'esperienza dell'Umbria.

This paper discusses the relationship between regional programming and national health research policy, and in particular evaluates the role that intellectual capital plays in innovation processes of knowledge-based organizations. The concepts of intellectual capital and knowledge-based organization are defined in the paper, as these are especially useful when speaking of university, healthcare systems and research and development companies. The paper also examines the various types of healthcare research (basic research, clinical trial, epidemiological research, valutative research) and the role that each type of research plays in healthcare programming at the national and regional levels.

Epidemiology of prostate cancer in the Umbria region of Italy: evidence of opportunistic screening effects.

OBJECTIVES: To examine the impact of prostate-specific antigen-based screening on prostate cancer incidence, mortality, and survival in the Umbria region of Italy for the period 1978 to 1999. METHODS: Incidence rates were derived from an ad hoc survey and from cancer registry records for the period 1978 to 1982 and 1994 to 1999, respectively. The mortality trend was assessed by joinpoint analysis using data from the official publications. The observed, relative, and age-adjusted relative survival rates were also calculated. RESULTS: The number of newly diagnosed cases in 1997 to 1999 was almost four times greater than in 1978 to 1982, the crude incidence rate was more than three times, and the age-adjusted incidence rate increased by about 125%. No trend was apparent for mortality. The survival rates also showed a large increase. The 5-year relative survival rate was 37% and 74% for 1978 to 1982 and 1994 to 1998 incident cases, respectively. People older than 75 years showed the same striking increase in incidence and survival rates as the younger age groups. CONCLUSIONS: As in many other developed countries, prostate cancer screening activities are the likely cause of the increase in incidence and survival rates observed in the study area, but a decreasing mortality trend is not yet evident. Opportunistic screening is likely to be performed among all age groups, including the elderly, although the latter are unlikely to benefit from intervention. The evaluation of opportunistic screening is difficult and a lack of evaluation implies a high risk of ineffective interventions and inequality of care.