Epidemiologia E Prevenzione[JOURNAL]
Sun
200 papers
[Sexually transmitted infections: a new hub&spoke model to control the increasing trend of STIs in Italy and prevent their spread].
Suligoi B, Aiello A, Atzori L … +16 more , Bordonaro P, Capra G, Caraglia A, Cellini A, Chessa M, Comar M, Cusini M, Dal Conte I, Fasciana T, Galano A, Giammanco A, Lucchini A, Rossolini GM, Salfa MC, Vaggelli G, Palamara AT
Epidemiol Prev · 2024 · PMID 39679486 · Publisher ↗
The project "Experimentation of new integrated hospital-territory organizational models for the prevention and control of sexually transmitted infections: facilitated diagnostic-care pathways and offer of free targeted s...
The project "Experimentation of new integrated hospital-territory organizational models for the prevention and control of sexually transmitted infections: facilitated diagnostic-care pathways and offer of free targeted screening" was developed as part of the CCM 2019 programme, funded by the Italian Ministry of Health, being coordinated by the Italian National Health Institute (ISS), in collaboration with Sapienza University of Rome. Three clinical units located in Turin, Milan, and Cagliari, specialized in sexually transmitted infection (STI) diagnosis and treatment, and three highly specialized microbiology laboratories located in Trieste, Florence, and Palermo were involved.The objectives were to develop an innovative network model for the treatment of STIs based on multidisciplinary centres with high quality of care for STIs (hub-IST) and territorial structures (spoke-IST), to plan and test integrated facilitated care pathways for STIs, to evaluate the priorities, feasibility, and sustainability of prevention interventions.A focus group of 12 experts, together with other members from the participating units, defined the characteristics of hub-IST and spoke-IST centres and outlined the integrated care pathway (PIC) for STIs based on the hub&spoke model.A 4-month field trial was subsequently started, applying the proposed PIC in 3 participating units. Improvements were immediately observed in care (increased access to the centre, reduced waiting times, increased number of visits), in the direct connection with intrastructure specialists, in prevention interventions, and in the information provision.The hub&spoke model applied to STIs proved to be innovative, transferable, and adaptable to different Italian regional situations, establishing itself as the currently most functional model for modern care for this type of infections. By reducing barriers to healthcare access, expanding the number of attendees, reducing costs for the community, and implementing targeted and effective prevention interventions, the epidemic chain can be interrupted and the spread of STIs reduced. Based on these results, in Italy, it is urgent to develop an STI strategic prevention plan at a national level.
[The CCM Project "Guidelines for the Social Reporting of Screening Programmes"].
Betti E, Nappo V, Anghinoni E … +8 more , Ballotari P, Battisti F, Campari C, Caroli S, Codeluppi C, Marri S, Mantellini P, Gruppo di lavoro sul bilancio sociale
Epidemiol Prev · 2024 · PMID 39679485 · Publisher ↗
The Social Report (SR) is a form of measurement and reporting, transparency, and communication, essential for sharing decisions, activities, and the value an institution generates with stakeholders from a social responsi...
The Social Report (SR) is a form of measurement and reporting, transparency, and communication, essential for sharing decisions, activities, and the value an institution generates with stakeholders from a social responsibility perspective. It is a useful tool for screening programmes to understand their objectives and structure, assess their effectiveness, and promote informed participation by citizens and stakeholders.This contribution explores the implementation of the SR in oncological screening programmes - a project conducted in the CCM 2019 Programme 'Guidelines for Social Reporting of Screening Programmes', coordinated by the Institute for Cancer Research, Prevention and Clinical Network (ISPRO) in Tuscany Region in collaboration with the Centre for Oncological Screenings of Reggio Emilia (Emilia-Romagna Region) and the Population Screening Programmes Service of ATS Valpadana (Lombardy Region) - conducted between 2020 and 2022.The project general objective was to review the Guidelines for Social Reporting of Oncological Screening Programmes developed in 2012. This was achieved through a training and knowledge-deepening phase and an experimental phase in a co-creation logic with all stakeholders involved, particularly with Corporate Management, Regional Screening coordinators, and Associations of citizens and patients.The project had three specific objectives: to spread the culture and practice of social reporting through training courses for professionals working in screening programmes; to experiment with drafting SR in three pilot projects and subsequently update the guidelines; to disseminate the updated guidelines to regional screening coordination and promote informed and conscious involvement of stakeholders.At the end of the project, three SRs were produced for mammography, cervical, and colorectal screening programmes, structured into homogeneous sections and enriched with specific local content. This experience demonstrated the importance of the SR as an accountability tool, but also highlighted difficulties due to the pandemic and the need for earlier and more integrated stakeholder involvement. The updated Guidelines reflect the commitment towards more comprehensive, comparable, and inclusive reporting, to be systematically adopted within screening programmes.
[Analysis of the long-term effects of COVID-19 infection (long-COVID) in Italy during and after the pandemic emergency and response strategy].
Grassi T, Tiple D, Villa M … +14 more , Grisetti T, Pricci F, Floridia M, Giuliano M, Castriotta L, Rosolen V, Beorchia Y, Fanizza C, Bisceglia L, Francesconi P, Profili F, Bonaccorsi G, Bruschi M, Onder G
Epidemiol Prev · 2024 · PMID 39679484 · Publisher ↗
BACKGROUND: the long-COVID condition is gaining increasing relevance in terms of public health, but few studies have evaluated its impact on use of healthcare resources and the organizational responses of healthcare syst...
BACKGROUND: the long-COVID condition is gaining increasing relevance in terms of public health, but few studies have evaluated its impact on use of healthcare resources and the organizational responses of healthcare systems. Although many studies have evaluated case studies of individuals with long-COVID, the clinical spectrum of symptoms is still poorly defined due to the heterogeneity of the populations studied, the variability of the definitions used, and the absence of disease markers. In this context, in 2022, a project was designed and implemented in cooperation between the National Centre for Prevention and Control of the Italian Ministry of Health and the Italian National Health Institute (Istituto Superiore di Sanità, ISS). OBJECTIVES AND METHODS: this project was articulated into five main objectives: 1. definition of the health care dimensions of the long-COVID phenomenon. This objective included an analysis of regional data flows to measure use of hospitalization services (acute, rehabilitation, long-term care), resource consumption (specialist visits and drug consumption), and the rate of institutionalization in patients with a history of COVID-19; 2. definition of number, characteristics, and distribution of long-COVID centres across the national territory. This objective has been implemented through a national survey of long-COVID diagnosis and assistance centres; 3. definition of clinical good practices about the management of long-COVID condition by a multidisciplinary group of experts; 4. definition of a long-COVID surveillance system; including the definition of a specific data set of information and the identification of a sample of clinical centres that deal with the care of subjects with long-term effects of COVID-19 and the setup of a dedicated online platform; a phone survey based on more than 1,000 interviews assessed the spectrum of symptoms reported; 5. structuring a national network and providing information, which included networking of the centres participating in the study with the dissemination of periodic information and update workshops or webinars; the creation of a website dedicated to the long-COVID condition, with general information for citizens and a section dedicated to the project; training activities. RESULTS: Objective 1: a cohort study of over 600,000 individuals showed that people exposed to SARS-CoV-2 infection, particularly those who were hospitalized, appear to use more healthcare resources in the 6 months following infection than those who were not exposed. Individuals hospitalized in intensive care showed rates of outpatient visits 3 times higher than those who were not exposed and over 4 times higher rates for diagnostic imaging tests and hospitalizations. The case-control study found an increased risk of initiating antidepressant therapy among individuals exposed to SARS-CoV-2 infection compared to those who were not exposed, particularly among those who were hospitalized during acute infection. Furthermore, COVID-19 vaccination may play a protective role in this context. Objective 2: 124 clinical centres completed the questionnaire developed to define the patterns of clinical care for patients with long-COVID. Most centres provided care through outpatient visits or day hospital services with scheduled visits or referral to primary care and had specialist skills that allowed a multidisciplinary approach to the subject with suspected long-COVID condition. Objective 3: a multidisciplinary team, representative of the multi-systemic nature of long-COVID, with the participation of 16 experts, developed recommendations for the management of patients with long-COVID, based on current knowledge on the topic, with the aim of contributing to standardizing the activities of clinical centres throughout Italy. Objective 4: the clinical surveillance system has allowed the collection of data from over 1,200 patients from 30 clinical centres for the definition of symptom, their aggregation in clusters, and associated factors. Information on symptom profile was also assessed through a phone survey of more than 1,000 participants. Objective 5: the ISS website on long COVID provided information on the long-COVID condition and illustrated the CCM project, with links to webinars and workshops. In addition, a FAD course - entitled 'long-COVID: a new clinical scenario' - was implemented on the EDU-ISS platform, with over 14,000 participants. CONCLUSIONS: the results of this study show that long-COVID is a frequent condition in our country, which, due to the amplitude of numbers and the spectrum of symptoms, has a substantial impact on resource consumption. This demonstrates that it will be necessary to implement, guarantee and monitor well-defined care standards for this condition.
[Mortality due to mesothelioma and asbestosis in Campania Region (Southern Italy): perspectives for reducing asbestos exposure].
Taiano L, Porzio A, Massari S … +7 more , Iavicoli I, Palladino R, Menegozzo S, Mensi C, Binazzi A, Menegozzo M, Marinaccio A
Epidemiol Prev · 2024 · PMID 39679483 · Publisher ↗
OBJECTIVES: to provide an overview of the geographical distribution of mesothelioma and asbestosis deaths in the Campania Region (Southern Italy) occurred from 2005 to 2018 and to identify areas at higher risk. DESIGN: f...
OBJECTIVES: to provide an overview of the geographical distribution of mesothelioma and asbestosis deaths in the Campania Region (Southern Italy) occurred from 2005 to 2018 and to identify areas at higher risk. DESIGN: for each municipality, Standardized Mortality Ratios (SMRs) for mesothelioma and asbestosis have been estimated from the mortality data provided by the Italian National Institute of Statistics (Istat). Deaths for which mesothelioma and asbestosis were identified as the underlying causes, according to the classification system ICD-10 codes (C45 and J61, respectively), were included. Expected cases were estimated applying age- and gender-specific mortality rates in Campania on resident populations of each municipality. Furthermore, the association between the municipal SMR and the local socioeconomic deprivation index based on the 2011 General Census of Population and Housing was also analysed. SETTING AND PARTICIPANTS: Campania Region. MAIN OUTCOMES MEASURES: the study outcomes were standardized mortality ratios for mesothelioma and asbestosis and the identification of territorial subareas. RESULTS: a total of 998 deaths attributed to mesothelioma and 62 to asbestosis were identified. No cases of death due to mesothelioma or asbestosis were reported in the province of Benevento. A significant increase in mortality due to mesothelioma was observed across 34 municipalities. These findings show that several municipalities within the province of Naples display a high increase in mortality due to mesothelioma and asbestosis, with 506 deaths in total and 246 cases recorded in the municipality of Naples against 178,37 expected (SMR 1,38; 90%CI 1.24-1.53). In 15 municipalities, a notable increase in mortality for asbestosis was recorded; in Naples, 28 cases occurred (SMR 2,51; 90%CI 1.84-3.42). The overlap between mortality maps for mesothelioma and asbestosis confirms the existence of areas subjected to definite and prolonged asbestos exposure. Additionally, a correlation with the deprivation index was noted: the pooled SMR by quintiles increases with higher quintiles of the deprivation index, for both mesothelioma and asbestosis. CONCLUSIONS: results highlight the crucial need for epidemiological surveillance of asbestos-related diseases in Campania. Actively searching out for new cases of mesothelioma in the entire region is a crucial task in primary prevention of occupational, environmental, and domestic exposures to asbestos.
[Climate and Health: conceptual constructs and the role of the IPCC].
Forgione F
Epidemiol Prev · 2024 · PMID 39679482 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Farewell to the Italian National Health System? We claim for a new system].
Cislaghi C
Epidemiol Prev · 2024 · PMID 39679481 · Publisher ↗
Abstract loading — click title to view on PubMed.
Development and user-oriented visualization of health care composite indicators at district level: territorial health profiles.
Testa D, Andreano A, Zanfino A … +5 more , Salvatori A, Milanese A, Mazzali C, Magnoni P, Russo AG
Epidemiol Prev · 2024 · PMID 39633606 · Publisher ↗
BACKGROUND: after the recent reform of territorial healthcare, districts have been designated within the Lombardy Regional Health System to coordinate and deliver territorial care. This entails the need of readily availa...
BACKGROUND: after the recent reform of territorial healthcare, districts have been designated within the Lombardy Regional Health System to coordinate and deliver territorial care. This entails the need of readily available information to measure the quality of provided healthcare, identify critical areas for improvement, monitor the balance between demand and supply of healthcare services. OBJECTIVES: to present the development of a dynamic evaluation system of processes and outcomes resulting from the integration of territorial and hospital care, based on a set of composite indicators, called 'health profiles', and their visualization and release through a dedicated web platform. These summary measures aim to capture the complexity of a specific clinical area or population and easily convey it to health managers. METHODS: the definition of a reproducible process for the construction of composite indicators, having defined a theoretical framework, maps the potential indicators of the profile of interest in a matrix made up of health needs and healthcare quality dimensions, and selects them on the basis of desirable properties and statistical metrics. Single indicators are normalized in the range [0,1], weighted according to the value of their quality dimension and to their reliability (measured as intraclass correlation coefficient), and aggregated via a geometric mean. The result is the value of the health profile, a percentage ranging from 0 to 100. RESULTS: the 'cancer profile', related to the domain of cancer prevention and treatment, was developed as a case study to illustrate the methods and potential application of these composite indicators at the district level. The initial set of 37 candidate indicators investigated: adherence to organized screening; timeliness of first visits; efficacy and safety of treatment; and end-of-life care. Applying the methods described, 28 indicators were selected and used to compute the cancer profile for different territorial units. Four main user-oriented infographics were developed to convey the health profile, its individual indicators, and their variation over time and across territorial units. The cancer profile was calculated and graphically visualized for the years 2015-2022. CONCLUSIONS: a method has been defined and implemented to build synthetic territorial indicators, called health profiles, that can be applied to other clinical areas, such as chronic conditions. The release of a dedicated web platform for the effective communication of the profiles is an important tool to support evidence-based public health decisions.
[Update. Inventory of occupational exposure to asbestos with particular reference to Tuscan worker].
Angelini A, Martini A, Masala G
Epidemiol Prev · 2024 · PMID 39569577 · Publisher ↗
This Catalogue is a collection of information on the use of raw asbestos and asbestos-containing materials used in several industries and occupational activities, with particular attention to the situation of Tuscany, a...
This Catalogue is a collection of information on the use of raw asbestos and asbestos-containing materials used in several industries and occupational activities, with particular attention to the situation of Tuscany, a region of Central Italy. The work was developed at the Institute for Cancer Research, Prevention and Clinical Network (ISPRO) of Florence, where epidemiologic research and surveillance activities have been developing since 1988 and where the coordination and evaluation of the regional health surveillance programme provided to past asbestos workers started in 2016 and is still ongoing. The Catalogue aims at being a working tool for all health professionals engaged in examining and classifying the occupational asbestos exposures of subjects both affected by diseases that could be associated to this carcinogen and examined within the regional health surveillance programme. It is necessary for the health personnel engaged in the above-mentioned activities to know or to have the possibility to find exact and detailed data on asbestos exposure by occupational sector. These data are briefly described in the 29 factsheets this Catalogue consists of. In each factsheet, the presence and every use of asbestos are described, with reference to a precise occupational sector. Several occupational sectors can be considered together because of analogies on asbestos exposure. Occupations are considered on the basis of existing evidence on the use of raw asbestos or asbestos-containing materials (as semi-finished or finished products or as auxiliary materials in production processes). Besides the presence and use of asbestos, a description of the possible exposures of workers is reported. Sources of information were scientific and grey literature as well as the 8,097 occupational histories of mesothelioma registered by the specific Tuscan registry. Some factsheets have been revised and enhanced by Italian experts on the asbestos exposure with a specific competence in the examined sectors. Each factsheet includes also questions to be addressed to workers in order to examine in depth their possible asbestos exposure. For those who would like to expand their knowledge on this topic, references are reported both at the end of each factsheet and at the end of the volume. In all industrialized countries, also in those which have not already banned asbestos use, a decrease in the use of this material and in the relative exposure have been observing since the end of the Seventies, few years after the general consensus within the scientific community on asbestos carcinogenicity. This decreasing trend has been becoming greater and greater since the end of the Eighties, when more restrictive regulations have been approved and applied, especially in occupational settings. Nevertheless, nowadays asbestos-related diseases are still diagnosed due to past exposures, although during next decade a decreasing incidence of malignant mesothelioma - the cancer most specifically related to this carcinogen and characterized by a very bad prognosis and the longest latency - could be observed. Particular attention will be paid to jobs regarding renovation of old buildings containing asbestos and to decontamination activities. In conclusion, this Catalogue is a working tool - although it is not exhaustive and could be upgraded with new information - for all professionals engaged in asbestos risk prevention activities as health personnel, personnel of insurance companies, employers, and employee representatives.
[The network of the EASY-NET programme: a contribution to knowledge on the effectiveness of audit&feedback].
Acampora A, Angelici L, Deroma L … +16 more , Tullio A, Ciccone G, Pagano E, Marchesini G, Marenzi G, Bonomi A, Venturella R, Zambri F, Preziosi J, Giusti A, Maraschini A, Mignuoli AD, Bramanti P, Ciurleo R, Davoli M, Agabiti N
Epidemiol Prev · 2024 · PMID 39569495 · Publisher ↗
This work is the third in a series of articles dedicated to the EASY-NET network programme. The first article described the rationale, structure, and methodologies; while the second evaluated the adherence of individual...
This work is the third in a series of articles dedicated to the EASY-NET network programme. The first article described the rationale, structure, and methodologies; while the second evaluated the adherence of individual audit&feedback A&F interventions tested in EASY-NET to literature recommendations. This contribution provides a concise summary of the effectiveness results of A&ented by clinical and organizational areas: chronic disease management, emergency territorial and hospital care for acute conditions, post-acute rehabilitation, hospital oncology care, childbirth, and caesarean sections. In alignment with existing literature, the results on the effectiveness of A&F, in terms of measurable improvement, were observed across all settings, although to varying degrees and more significantly in processes than in outcomes. Key elements that proved to be fundamental to the implementation of A&F interventions include the importance of institutions in making A&F systematic, continuous, and a priority for healthcare professionals; the central role of the required and available data for preparing feedback; the involvement of A&F recipients in the whole path, from the design of the interventions to the discussion of results and improvement actions. A final consideration, in light of the activities conducted and the results achieved, suggests that integrating research into practice and practice into research is essential to ensure, on one hand, the transferability of evidence into operations and, on the other hand, the design of studies that are feasible and integrable into daily activities - a necessary aspect to optimize resources.
[Personal protection strategies for mitigating the effects of air pollution: A narrative literature review].
Murtas R, Tunesi S, Russo AG
Epidemiol Prev · 2024 · PMID 39530346 · Publisher ↗
BACKGROUND: reducing air emissions is the fundamental action necessary to mitigate the negative health effects caused by air pollution. However, increased public awareness has highlighted the need to identify protective...
BACKGROUND: reducing air emissions is the fundamental action necessary to mitigate the negative health effects caused by air pollution. However, increased public awareness has highlighted the need to identify protective measures that can mitigate the personal health risks associated with air pollution. OBJECTIVES: examine the evidence regarding personal protection strategies capable of mitigating the health effects caused by air pollution, with a focus on healthy individuals and at-risk categories. Design: narrative review. SETTING AND PARTICIPANTS: this study examines the most effective personal protection strategies for healthy and at-risk individuals, considering children, the elderly, and individuals with cardiovascular and respiratory diseases; the examined strategies include the use of air purifiers, respiratory masks, exposure limitation, physical activity, alternative means of transportation, and environmental monitoring systems. MAIN OUTCOMES MEASURES: reduction of individual exposure to air pollution, respiratory and cardiovascular outcomes, total and all-cause mortality. RESULTS: the evidence indicates that these measures can reduce exposure and promote well-being. For at-risk individuals, it is crucial to limit exposure during periods and in locations with high pollution levels, with an emphasis on physical activity. The use of high-efficiency air purifiers can reduce the negative effect of air pollution on individuals with respiratory and cardiovascular conditions, especially those with asthma. In healthy individuals, multiple mitigation actions have been identified, with evidence suggesting that the benefits of physical activity persist even in environments with high levels of air pollution. CONCLUSIONS: this narrative review provides an overview of personal strategies capable of reducing air pollution exposure and consequently mitigating its negative impact on health. These findings can support the development of recommendations and communication and prevention interventions, promoting risk reduction policies and increased awareness and engagement from both healthcare and non-healthcare networks at the local level. Although more robust systematic approaches are needed, this review serves as a useful tool for stakeholders and citizens, while also providing a simple instrument with significant communicative potential, applicable on a large scale.
[Errata corrige Epidemiol Prev 2024; 48 (1):12-23].
Epidemiol Prev · 2024 · PMID 39435464 · Publisher ↗
Gli autori hanno aggiornato la tabella 1 (p. 14) e la tabella 2 (p. 15) attribuendo le stime di NO2 all'Health Effects Institute (HEI) anziché alla World Health Organization (WHO). Di conseguenza, è stato modificato il p...
Gli autori hanno aggiornato la tabella 1 (p. 14) e la tabella 2 (p. 15) attribuendo le stime di NO2 all'Health Effects Institute (HEI) anziché alla World Health Organization (WHO). Di conseguenza, è stato modificato il paragrafo "Health impact estimation" a p. 14. I PDF nei quali sono segnalate le modifiche sono disponibili alla pagina dell'articolo.
[Italian Association of Epidemiology: How has the demographic, educational, and occupational profile of members changed in recent years].
Marra M, Farina E, Mataloni F … +7 more , Canova C, Carugno M, Petri D, Richiardi L, Venturelli F, Zambri F, Ancona C
Epidemiol Prev · 2024 · PMID 39434644 · Publisher ↗
In recent years, the number of members of the Italian Association of Epidemiology (AIE) has increased considerably, and their profile has undergone many changes. The aim of this work is to describe the characteristics of...
In recent years, the number of members of the Italian Association of Epidemiology (AIE) has increased considerably, and their profile has undergone many changes. The aim of this work is to describe the characteristics of the members, with particular attention to those who have been continuously enrolled. To evaluate these characteristics, the data from membership forms submitted to the Association and information available on the new website in the personal profile area (period 2016-2024) were used. The characteristics considered were: gender, age, education, and job position of the member, Region, and type of affiliated institution. Members with at least three registrations during the period considered, including at least one in the last three years (2022-2024), are considered continuous members.In 2024, AIE counts 557 members, of whom 340 (61.0%) are female and 182 (32.7%) are under 35 years old. This data confirms the growing trend observed since 2015, when the number of members was just above 300, considering that each year there is a quota of new members amounting to about 30%. A total of 382 members can be considered continuous. Over 90% of these members work in 8 Regions (Lazio, Piedmont, Emilia-Romagna, Lombardy, Tuscany, Veneto, Puglia, and Sicily), while the other regions are scarcely or not represented at all. Over time, and with the arrival of new members, the Association is shifting towards the academic world, while the proportion of professionals working in public health institutions has decreased. Members are overall highly educated; however, while older cohorts have predominantly a medical and biological education, younger cohorts increasingly have statistical/mathematical education. Seventy percent of the members have a permanent contract, 5% have a fixed-term contract, and 13% have an atypical contract. Precarious contracts tend to be lower among medical graduates and remain higher in other health professions and non-health-related degrees.AIE is dealing with a period of dynamism and openness, marked by the increase in the number of the members and the transformation of their occupational and educational profile. It is crucial to support and promote the ongoing positive changes, such as the wider geographic representativeness and the entry of new recruits, also facilitated by multiple activities carried out by AIE, including congresses, working groups, webinars, training courses, and collaborations with other scientific societies. At the same time, it might be useful to open a discussion on the meaning and consequences of the increase of academic members and the reduction, at least in relative terms, of individuals coming from public health. Finally, it will be necessary to approach some critical issues, such as the still poor multidisciplinarity and the persistence of job insecurity, especially among graduates in educational pathways that still do not fit into the professional profiles recognized by the NHS.
[Micro data on the demand for care of dependent older people in Italy: A review of available sources].
Lallo C, Del Balso C, Tomassini C
Epidemiol Prev · 2024 · PMID 39434643 · Publisher ↗
OBJECTIVES: to provide researchers and stakeholders with an overview of the statistical sources of micro data available for estimating and studying the demand for care for dependent older people in Italy. DESIGN: analysi...
OBJECTIVES: to provide researchers and stakeholders with an overview of the statistical sources of micro data available for estimating and studying the demand for care for dependent older people in Italy. DESIGN: analysis of questionnaires and variable displays from statistical surveys conducted on the resident population in Italy, selecting datasets that: 1. include at least one question on non-self-sufficiency and the related demand for care; 2. allow to distinguish the population by age groups; 3. are conducted uniformly at the national level and are representative of the population residing in Italy at least at NUTS-1 (nomenclature of statistical territorial units) level of geographic detail; 4. have periodicity character at least for the last ten years (2014-2024); 5. are immediately available for micro-analysis. SETTING AND PARTICIPANTS: all statistical surveys carried out on the Italian population between 2014 and 2024 that meet the requirements of the survey design. The most recent questionnaire is taken into account. MAIN OUTCOMES MEASURES: selected surveys and number of questions identified in the selected surveys related to 9 sets of variables useful for studying the demand for care among dependent older people, including analyses of associations and correlations. RESULTS: the review identified 8 statistical surveys that can provide useful information for estimating and studying the demand for care for dependent older people, consistent with the objectives and design of the study. Six of these surveys are conducted by the Italian National Institute of Statistics (Istat) (EHIS, EU-SILC, IMF-AVQ, IMF-FSS, IMF-TUS, and ISF); two surveys are carried out by private consortia (ESS and SHARE). Not all groups of variables are simultaneously available in the datasets of the surveys considered, with the exception of the EHIS and SHARE surveys, but with severe limitations. In addition, some surveys allow regional statistics (NUTS-2), but none of them allow analyses at a more detailed territorial level. CONCLUSIONS: no survey provides all the information useful for studying the demand for care of dependent older people, but sources have been identified which already allow demand to be estimated at sub-national level (NUTS-1 or NUTS-2) and correlations and associations with certain sets of variables to be investigated.
Impact of local food consumption on exposure to perfluorooctanoic acid and perfluorooctane sulfonate in a contaminated community in North-Eastern Italy.
Olivieri A, Shin HM, Saugo M
Epidemiol Prev · 2024 · PMID 39434642 · Publisher ↗
OBJECTIVES: to estimate the contribution of locally-grown food consumption to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) human exposure. DESIGN: residents of a PFAS-contaminated community of the V...
OBJECTIVES: to estimate the contribution of locally-grown food consumption to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) human exposure. DESIGN: residents of a PFAS-contaminated community of the Veneto Region (North-Eastern Italy) were categorized into two exposure groups, which refer to the period after the determination of serum levels of PFOA and PFOS conducted at baseline: 1. people drinking water filtered with double granular activated carbon (GAC) and not consuming locally-grown foods at all (reference group); 2. people drinking the same filtered water and which continue to consume only locally-grown foods. For each group, PFOA and PFOS daily intake rates (IR, ng/kg-day) were derived from measured PFOA and PFOS concentrations in treated water and local vegetable and animal food matrices. Then a one-compartment pharmacokinetic model was applied to predict PFOA and PFOS serum concentrations over time and the time needed to fall below a clinically significant threshold level of PFOA and PFOS (e.g., 20 ng/mL). SETTING AND PARTICIPANTS: the study area included 21 municipalities and 3 provinces (Vicenza, Verona, and Padua) located in the Veneto plain. Approximately 127,000 people lived in the most PFAS-contaminated areas on 31.12.2016; those aged 9 to 65 years were invited to participate in the Health Surveillance Plan (HPS), including laboratory tests and medical examination. MAIN OUTCOMES MEASURES: predicted PFOA and PFOS serum levels (ng/mL) among residents in the contaminated area. RESULTS: compared to the reference group, residents who continued to consume locally-grown foods had an approximately 24% higher IR of PFOA and PFOS and this resulted in 3 more years for their PFOA and PFOS concentrations to fall below the threshold level of 20 ng/mL. CONCLUSIONS: this study showed that the contribution of locally-grown food consumption cannot be ignored for people living in PFAS-contaminated areas.
Accuracy of the Lombardy Mesothelioma Registry: comparison with the autopsy database of Pavia University (Lombardy Region, Northern Italy).
Visonà SD, Pace MC, Consonni D … +1 more , Mensi C
Epidemiol Prev · 2024 · PMID 39434641 · Publisher ↗
OBJECTIVES: to evaluate the accuracy (completeness of case recording and diagnostic quality) of the Lombardy Mesothelioma Registry (Registro Mesoteliomi Lombardia, RML) through a comparison with the autopsy database of P...
OBJECTIVES: to evaluate the accuracy (completeness of case recording and diagnostic quality) of the Lombardy Mesothelioma Registry (Registro Mesoteliomi Lombardia, RML) through a comparison with the autopsy database of Pavia University (years 2000-2016). DESIGN: validation study. SETTING AND PARTICIPANTS: all mesothelioma records with incidence date between 01.01.2000 and 16.09.2016 were extracted from the RML. They were cross-referenced with deaths from any asbestos-related disease subjected to a forensic autopsy extracted from the archive of the Department of Public Health, Experimental and Forensic Medicine of Pavia University. MAIN OUTCOMES MEASURES: using the postmortem diagnosis by Pavia University as the gold standard, RML sensitivity and specificity and their 95% confidence intervals (95%CI) were calculated using the Agresti-Coull formula. RESULTS: based on 141 deaths, the RML showed very good accuracy: specificity was 100% (95%CI 87%-100%; 32/32 deaths) and sensitivity 94% (95%CI 87%-97%; 102/109 deaths). The 7 false negative cases either were missed by the RML (N. 4) or had been wrongly classified as non-mesotheliomas (N. 3) because the diagnosis was made or confirmed only postmortem after a forensic autopsy. CONCLUSIONS: RML accuracy (completeness and diagnostic quality) was very high. No false positive was found and the few false negatives were due to lack of notification of mesotheliomas diagnosed postmortem to the registry. Forensic pathologists should be made aware that mesothelioma notification to the regional mesothelioma registry is important and compulsory.
Pregnancy assistance for foreign women in Trentino Region (Northern Italy): retrospective cohort epidemiological study.
Pertile R, Poggianella S, Taddei F … +1 more , Mantovani W
Epidemiol Prev · 2024 · PMID 39434640 · Publisher ↗
OBJECTIVES: to identify any differences between Italian and foreign women in the access to prenatal care, including the number and appropriate scheduling of visits, the execution of diagnostic, blood, and microbiological...
OBJECTIVES: to identify any differences between Italian and foreign women in the access to prenatal care, including the number and appropriate scheduling of visits, the execution of diagnostic, blood, and microbiological tests and the use of specific healthcare services. DESIGN: retrospective cohort epidemiological study, based on the monitoring of current information flows. SETTING AND PARTICIPANTS: data extrapolated from the Birth Attendance Certificate information flow of the Autonomous Province of Trento (Northern Italy) between 2012 and 2016. A total of 23,165 women with data regarding citizenship were included in the analysis. MAIN OUTCOMES MEASURES: outcome variables used to assess appropriateness of antenatal care were medically assisted procreation techniques, use of invasive prenatal diagnosis, gestational age at the first appointment, total number of appointments and ultrasounds during pregnancy, blood and microbiological tests taken, and participation in antenatal classes. RESULTS: data indicates a significant difference in the use of chorionic villus sampling, testing for Cytomegalovirus, and vaginal-rectal swab for the detection of group B streptococcus, which are lower in the foreign population. Furthermore, there is a statistically significant difference in the gestational age at which the first appointment is attended, in the total number of visits, and in the number of ultrasounds performed during pregnancy as well as in participation in antenatal classes. CONCLUSIONS: this study reveals significant differences in access and use of pregnancy assistance between foreign and Italian women. There are also differences in terms of social determinants of health, with a concentration of unemployment and low education in the foreign population. It is therefore necessary to identify the factors that can potentially create health inequalities, considering the socioeconomic determinants and the specific needs of migrant women.
[Drugs, sex and gender].
Trabace L, Banzi R, Ruggieri A … +6 more , Addis A, Belleudi V, Barone-Adesi F, Kirchmayer U, Mangia C, Ferroni E
Epidemiol Prev · 2024 · PMID 39434639 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Nature Restoration Law and the right to health].
Dallagiacoma E
Epidemiol Prev · 2024 · PMID 39434638 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Are we willing to change our diet for the climate?].
Michelozzi P, Parrinello E, Vecchi S
Epidemiol Prev · 2024 · PMID 39434637 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Health impact assessment: strengthening epidemiology training and skills].
Forastiere F, Bisceglia L
Epidemiol Prev · 2024 · PMID 39434636 · Publisher ↗
Abstract loading — click title to view on PubMed.
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