Epidemiologia & Prevenzione最新文献

{"title":"[Smart working and active mobility for reducing CO2 emissions from the home-to-work commute: the results of the Climactions project].","authors":"Lisa Bauleo, Francesca de'Donato, Manuela De Sario, Paola Michelozzi, Carla Ancona","doi":"10.19191/EP25.2-3.S1.053","DOIUrl":"https://doi.org/10.19191/EP25.2-3.S1.053","url":null,"abstract":"<p><strong>Objectives: </strong>to estimate CO2 emissions for different commuting modes before, during, and after the COVID-19 lockdown, and define scenarios to assess their impact on the environment and health.</p><p><strong>Design: </strong>cross-sectional study using data retrieved from a survey.</p><p><strong>Setting and participants: </strong>the study included anonymous participation from both researchers involved in the Climactions project and the general population; the questionnaire was made available through social media. Information was gathered on the transportation modes used to commute, the distance travelled and travel times before, during, and after the COVID-19 emergency, and proposals for actions/solutions to enhance sustainable commuting in urban areas.</p><p><strong>Main outcome measures: </strong>the amount of CO2 emissions due to different commuting modes during various stages of the pandemic was estimated based on vehicle-specific emission coefficients provided by the European Environmental Agency, taking into account the average number of passengers per vehicle. Sustainable commuting scenarios were also proposed, including active transportation (walking, cycling, etcetera).</p><p><strong>Results: </strong>the online questionnaire was filled-in by 2,904 persons, predominantly women (62.3%) and residents in Northern Italy (44.6%). Over 80% of the respondents were aged over 40 (0.7% <25 years). On average, the distance travelled on a daily commute was 23.6 km (median: 13 km), with longer distances in the Southern Regions (average: 38.2 km, median: 20 km). The average per-capita CO2 emissions were 2 kg per day in the pre-pandemic situation. The reduction in commuting during lockdown periods led to a significant decrease in estimated CO2 emissions, with an average per capita reduction of about 100 grams per day. From September 2020, the increase in smart working among respondents still allowed for a reduction in estimated CO2 levels, despite an increase in emissions from private vehicle use (1.5 kg per capita per day). Considering sustainable scenarios, a 15-minute walk during the daily commute would lead to a reduction in estimated CO2 levels of up to 0.7 kg per capita per day. Regarding the statement that \"improving air quality in cities and reducing greenhouse gas emissions are useful actions to combat climate change\", 94% of respondents strongly agreed.</p><p><strong>Conclusions: </strong>in Italy, road transport accounts for approximately 25% of the total CO2 emissions. The lockdown provided a natural scenario for reducing emissions in urban areas, and the implementation of smart working was associated with a decrease in CO2 emissions due to reduced commuting. However, it is crucial to promote sustainable and active transportation modes for daily commuting such as walking and cycling, also considering the significant health co-benefits.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"30-40"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Climactions project: document review of policies and measures of climate change adaptation and mitigation in urban areas].","authors":"Manuela De Sario, Francesca de'Donato, Paola Michelozzi","doi":"10.19191/EP25.2-3.S1.037","DOIUrl":"10.19191/EP25.2-3.S1.037","url":null,"abstract":"<p><strong>Background: </strong>public health aims to promote a health-centred approach in all policies, even in adaptation and mitigation policies for climate change.</p><p><strong>Objectives: </strong>to provide a critical summary on legislations, policies and case studies at international, national and local level and to assess the implementation of the \"health lens\", in support of researchers and workers on environment and health.</p><p><strong>Design: </strong>document review on legislations, policies and case studies, focusing on mitigation of urban health island and sustainable mobility.</p><p><strong>Methods: </strong>a policy and legislation review was carried out from institutional websites at European and local level. Sustainable urban mobility plans (SUMP) and energy and climate action plans (SECAP) were retrieved for the cities included in the Climactions project (Genoa, Turin, Bologna, Rome, Bari, Palermo) from local authorities' websites. Best practices of urban heat island mitigation and sustainable mobility were searched from European platforms (Climate adapt, Urban mobility observatory -- ELTIS, EIT Urban Mobility) to obtain a critical picture of adaptation and mitigation options in cities.</p><p><strong>Results: </strong>the review shows a large number of legislations, plans, and programmes on adaptation and mitigation both at European and Italian level with a gap between planned and actually implemented actions also due to the lack of dedicated economic resources. There is also an inequal level of implementation among Italian regions, with some criticalities, for example, in the citizen participatory process within the strategic environmental assessment of SUMPs, SECAPs, and adaptation plans. At the local level, in the last decade, several best practices of urban heat island mitigation and sustainable mobility were experienced in different sectors including new urban green space infrastructures, albedo enhancement measures, car-pooling apps, incentives to active mobility, temporary streets liberation, and a combination of measures within adaptation plans such as London Climate Action Plan and Barcelona Superblock programme. Only few measures were health centred embedding public health into urban planning (e.g., the London plan based on the 'healthy streets' approach) suggesting health benefits for the population.</p><p><strong>Conclusions: </strong>the recent increase in regulations and policies at European and national level is not paralleled by real progresses in climate actions, despite the constant growth of annual emissions. Therefore, there is the need to accelerate the fossil fuel emission mitigation while promoting adaptation to be ready to counteract actual and future climate related risks. Health workers such as paediatricians, family doctors, epidemiologists can advocate the transition and support the citizens and youth engagement in climate-related decision making.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"8-29"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New European Pharmaceutical Legislation: a challenge to reconcile public health protection and market competitiveness].","authors":"Emanuele Sbraga, Chiara Gerardi, Eleonora Allocati, Rita Banzi, Silvio Garattini","doi":"10.19191/EP25.2-3.A802.026","DOIUrl":"https://doi.org/10.19191/EP25.2-3.A802.026","url":null,"abstract":"<p><strong>Background: </strong>twenty years after the last review of the European Union (EU) pharmaceutical legislation, the pharmaceutical sector has significantly changed and become more globalised. Unmet medical needs and unequal access to innovative treatments persist. In addition, there is a growing awareness of the need for developing new antibiotics and a rational use of existing ones. In this context, in 2020 the European Commission proposed a new pharmaceutical strategy for Europe aiming to ensure equitable access to effective and safe medicines while strengthening the competitiveness of the sector globally. In line with this strategy, the Commission itself proposed a comprehensive reform of the pharmaceutical legislation in 2023, which was later amended by the European Parliament.</p><p><strong>Objectives: </strong>to analyse some of the main proposals for changes to the current regulatory framework and discuss their impact on European pharmaceutical policies and public health.</p><p><strong>Design: </strong>analysis of the current regulatory context on medicines and comparison with the main proposals of the European Commission and Parliament.</p><p><strong>Results: </strong>among the most significant reform proposals are: 1. the changes to data and market protection with the creation of a system of incentives to support innovation, promoting the development of safe and effective medicines and their access to patients, and making the EU attractive to the pharmaceutical companies; 2. the set of measures to incentivise the development of new antimicrobials and control antimicrobial resistance; 3. the measures aimed at increasing the transparency of the European Medicines Agency.</p><p><strong>Conclusions: </strong>this critical and independent analysis of the current draft reform of the pharmaceutical legislation shows important novelties that could deeply transform the current European regulatory framework of the pharmaceutical sector, highlighting some critical issues regarding the significance and effectiveness of some proposals. Once the entire legislative process has been completed, it will be possible to witness the implementation of the reform in its final version, which will require an assessment of its real impact.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"190-199"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Climactions project: good practices of climate change adaptation and mitigation in 6 Italian cities].","authors":"Paola Michelozzi","doi":"10.19191/EP25.2-3.S1.030","DOIUrl":"https://doi.org/10.19191/EP25.2-3.S1.030","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"5-7"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Epidemiology... what next? To breathe clean air we need more prevention and lots of advocacy].","authors":"Francesco Forastiere","doi":"10.19191/EP25.2-3.045","DOIUrl":"https://doi.org/10.19191/EP25.2-3.045","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"111-113"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New therapies for old viruses: when everyone gets something wrong].","authors":"Valeria Belleudi, Antonio Addis","doi":"10.19191/EP25.2-3.A839.027","DOIUrl":"https://doi.org/10.19191/EP25.2-3.A839.027","url":null,"abstract":"<p><p>The respiratory syncytial virus causes numerous respiratory infections in children, with particularly severe manifestations during the first months of life, especially in premature infants or those with pre-existing clinical conditions.In Italy, the introduction of nirsevimab, a monoclonal antibody that is more practical and potentially usable in a broader population compared to the previous palivizumab, has highlighted several critical issues in the management of the prevention system. Initially, the manufacturer proposed the drug under category C, making it fully paid by patients. Subsequently, the company began direct negotiations with regional authorities, which independently planned the administration of the drug at no cost to patients, adopting differing and inconsistent approaches to preventive immunoprophylaxis programmes.Difficulties worsened when a statement from the Italian Ministry of Health clarified that regions undergoing financial recovery plans could not guarantee the administration of nirsevimab, as the treatment was excluded from the essential levels of care. The public and media uproar surrounding this exclusion prompted institutions to find a rapid solution. A national agreement was reached, allocating funds for an immunization campaign covering approximately 75% of newborns, corresponding to the availability guaranteed by the manufacturer. Additionally, a solidarity distribution mechanism was introduced, allowing up to 20% of doses to be shared among regions to protect the most vulnerable individuals.Despite the campaign started with the onset of the epidemic season, challenges persist in organizing procurement processes and managing immunoprophylaxis operations, resulting in significant disparities in implementation across regions.The nirsevimab case underscores the urgency of a nationally coordinated and shared strategy among central institutions, regional authorities, and other stakeholders to ensure equity and effectiveness in prevention policies, especially in light of upcoming regional autonomies.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"220-223"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Alcohol Dependence: one or more nosological entities? Identifying geographical diversities among patients through DSM-4 and Artificial Intelligence].","authors":"Allaman Allamani, Fabio Voller, Stefano Bravi, Pasquale Pepe, Marco Biffino, Paolo Massimo Buscema, Giulia Massini, Shlomo Stan Einstein, Jakob Manthey, Jürgen Rehm","doi":"10.19191/EP25.2-3.A798.036","DOIUrl":"https://doi.org/10.19191/EP25.2-3.A798.036","url":null,"abstract":"<p><strong>Background: </strong>although there is an overabundance of terms that over time have connoted the phenomenon usually defined as Alcoholism, or Alcohol Dependence, this has been universally considered a unitary disease by experts, the media and lay people.</p><p><strong>Objectives: </strong>to investigate whether there is a variety of configurations of alcohol dependence and alcohol abuse corresponding to different countries.</p><p><strong>Design: </strong>secondary analysis of a dataset from a European project conducted in 2013-2014. The analysis was carried out mainly based on both artificial intelligence and statistical tools: Self Organizing Map (SOM) Neural Network, Multidimensional Scaling Population Algorithm (MSPA), and K-Means clustering algorithm.</p><p><strong>Setting and participants: </strong>1,767 participants in a European project treated in specialist alcohol dependence units in 9 countries/regions of Europe.</p><p><strong>Main outcome measures: </strong>patients were interviewed to ascertain their correspondence to the 11 DSM-4 symptoms used for the diagnosis of 'alcohol dependence' and 'alcohol abuse', following up on a previous study that used traditional statistical methodology.</p><p><strong>Results: </strong>results confirm that the symptoms of 'alcohol dependence' and 'alcohol abuse' identified by the DSM-4 are distributed according to distinct European geographical macroareas: Central-Northern and Southern, with an intermediate macroarea. These could partly correspond to different typologies of drinking cultures in the different macroareas.</p><p><strong>Conclusions: </strong>alcoholism does not appear to be a unitary disease, but varies according to different cultures and social contexts, and should be treated appropriately.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"208-219"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Playground marking for contrasting sedentary lifestyle: systematic literature review].","authors":"Fabio Cruciani, Zuzana Mitrova, Patrizia Brigoni, Thellenxa Kalemi, Alice Masini, Rosella Saulle","doi":"10.19191/EP25.2-3.A838.028","DOIUrl":"https://doi.org/10.19191/EP25.2-3.A838.028","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;promoting physical activity and reducing sedentary behaviour are public health priorities aimed at ensuring health and well-being at all stages of life. Physical activity should be encouraged from early childhood, with play being a key component, including interactive 'floor-based' activities in safe spaces. The introduction of colourful markings in playgrounds and public spaces (such as 'playground markings') may offer a cost-effective and feasible way to promote physical activity, also providing structured opportunities for teachers to support motor skill development.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;to provide evidence of the benefits of playground markings interventions in schools on increasing physical activity levels and enhancing the physical and psychological well-being in pre-school and school-aged children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;a systematic literature search was conducted in Cochrane Library, MedLine, Embase, PsycInfo, and Epistemonikos databases up to 13.02.2024. The primary focus was to identify systematic reviews (SRs) or, in their absence, randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs). Study quality was assessed using validated tools according to study design, and meta-analyses were conducted where feasible. The GRADE approach was used to evaluate the certainty of evidence and results were presented in Summary of Findings (SoF) tables. Studies not included in the meta-analyses due to data unavailability or heterogeneity in outcome measures or interventions were narratively reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and participants: &lt;/strong&gt;students aged 3 to 10 years attending preschool and primary school.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;increased physical activity (including light, moderate vigorous and reduction of sedentary lifestyle); reduced obesity, overweight, Body Mass Index; well-being (quality of life, psychological aspect); cognitive level; school performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;a total of 557 records were screened and 35 potentially eligible full-text assessed publications. The review included 14 publications corresponding to 11 studies: 6 RCTs and 5 NRCTs. No systematic reviews were included. Meta-analyses were conducted using data from 2 RCTs, examining outcomes related to reduced sedentary behaviour and increased light, moderate, and vigorous physical activity. No statistically significant differences between comparison groups. The certainty of evidence was very low for all outcomes. Four of the 9 studies that were not included in the meta-analysis were RCT studies and 5 non-randomized studies reported heterogeneous results with respect to the physical activity outcome with some outcomes showing an effect in favour of the intervention while others reported no effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;multi-coloured playground markings consist of a low-cost approach to promote physical activity in children. However, the r","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"200-207"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prepared for which emergencies? The parabola of preparedness from public health to war].","authors":"Mariachiara Tallacchini","doi":"10.19191/EP25.2-3.044","DOIUrl":"https://doi.org/10.19191/EP25.2-3.044","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"134-136"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[When ideology undermines science: the consequences of gender identity exclusion in transgender population health research].","authors":"Gianluigi Ferrante, Fulvio Ricceri, Eliana Ferroni, Cristina Mangia, Roberta Rosin","doi":"10.19191/EP25.2-3.A885.039","DOIUrl":"https://doi.org/10.19191/EP25.2-3.A885.039","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"122-124"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}