Epidemiologia & Prevenzione最新文献

{"title":"[Construction of district-level denominators for monitoring assistance: Methods, data, comparisons, and implications for health monitoring].","authors":"Sara Tunesi, Luca Cavaliero d'Oro, Simona Dalle Carbonare, Anna Clara Fanetti, Maria Letizia Gambino, Giovanni Maifredi, Marco Villa, Alberto Zucchi, Olivia Leoni, Danilo Cereda, Antonio Giampiero Russo","doi":"10.19191/EP25.2-3.A867.032","DOIUrl":"10.19191/EP25.2-3.A867.032","url":null,"abstract":"<p><strong>Background: </strong>Lombardy Region (RL) is organized into 8 Health Protection Agencies (ATS) and 86 Districts, which are responsible for organizing and coordinating territorial health care for reference population ranging between 80,000 and 120,000 inhabitants. RL has implemented the Health Profiles Portal, an advanced system that integrates health care, socio-health, and social data to provide a clear and comparable view of the population's needs at different territorial levels. To develop the portal, it was necessary to construct denominators that would ensure the accuracy and comparability of the healthcare indicators.</p><p><strong>Objectives: </strong>to compare three different methods for constructing population denominators: two based on Regional Registries (NAR) and one on the Italian National Institute of Statistics (Istat) data.</p><p><strong>Methods: </strong>the first denominator (NAR_portale) used for the portal was constructed from all monthly extractions of NAR in 2023 collected by the ATSs; the second denominator (NAR_202401) was based on the assisted population as of January 2024, including those who died in 2023; the third denominator (ISTAT_202401) was based on Istat population data as of 01.01.2024. Comparisons, expressed as percentage variations (VP) relative to NAR_portale, were carried out at both the ATS and District levels, with separate analyses by gender, age, nationality, and residence in nursing homes (RSA).  Results: overall, NAR_portale identified a population of 10,111,769 residents, NAR_202401 recorded 10,106,191 subjects (VP 0.05%), and ISTAT_202401 recoded 10,012,054 (VP 0.99%). Greater variability was observed at the ATS level, whereas districts within the same ATS exhibited more homogeneous trends. The largest VPs were observed in the extreme age groups (0-1 and 85+ years), among foreign citizens, and among RSA residents.</p><p><strong>Conclusions: </strong>the differences between denominators highlight the complexity of constructing reference populations for health monitoring. NAR_portale provides greater dynamism and completeness, but efforts are needed to standardise and ensure comparability with other sources. In the future, the integration of different data sources and the use of advanced methodologies could improve monitoring quality and support more effective healthcare planning.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"158-167"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276511","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":"[Social vulnerability in climate change effect of a large city in Northern Italy: case study of Turin (Piedmont Region) within the Climactions project].","authors":"Giulia Melis, Marta Ellena, Nicolás Zengarini, Eduardo Di Gangi, Guglielmo Ricciardi, Giuseppe Costa","doi":"10.19191/EP25.2-3.S1.060","DOIUrl":"https://doi.org/10.19191/EP25.2-3.S1.060","url":null,"abstract":"<p><strong>Background: </strong>urban areas face growing challenges from climate change, especially in the form of extreme heat events that disproportionately affect vulnerable populations. Turin, a large city in Northern Italy, in past years has developed a policy framework integrating health equity into urban planning through the \"Health in All Policies\" approach.</p><p><strong>Objectives: </strong>to assess climate-related health risks in Turin by identifying spatial patterns of social vulnerability associated with Urban Heat Islands (UHIs), with the goal of guiding targeted adaptation and mitigation strategies.</p><p><strong>Design: </strong>cross-sectional ecological risk assessment using the IPCC framework, integrating data on hazard, exposure, and vulnerability.</p><p><strong>Setting and participants: </strong>the analysis focused on the municipality of Turin (847,237 residents), with a specific emphasis on individuals aged over 65 years. The spatial unit of analysis was the census tract (N. 3,852).</p><p><strong>Main outcome measures: </strong>an index of climate risk was developed for each census tract by aggregating normalized indicators for climatic hazard (UHI intensity), exposure (elderly population), and vulnerability (socioeconomic, demographic, health, and environmental indicators).</p><p><strong>Results: </strong>the analysis revealed significant spatial disparities in climate risk across the city. Northern and peripheral neighbourhoods showed the highest levels of social vulnerability and climate risk, while green and less densely populated areas displayed lower risk. The approach enabled the identification of high-priority areas for urban health interventions.</p><p><strong>Conclusions: </strong>the study demonstrates the feasibility and policy relevance of applying a structured climate health risk assessment framework at the urban level. The methodology supports evidence-based planning for climate adaptation, helping local authorities target actions to protect vulnerable populations and reduce health inequalities. The results contribute to ongoing efforts in Turin to integrate climate resilience into citywide health and social policy agendas.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"86-96"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790553","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":"[If healthcare gets sick, does health get sick too?]","authors":"Giuseppe Costa","doi":"10.19191/EP25.2-3.038","DOIUrl":"https://doi.org/10.19191/EP25.2-3.038","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"114-115"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555504","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":"[Impact of heat on health: intervention scenarios to reduce heat in urban areas and health co-benefits in 6 Italian cities involved in the Climactions project].","authors":"Francesca de'Donato, Manuela De Sario, Paola Michelozzi","doi":"10.19191/EP25.2-3.S1.056","DOIUrl":"https://doi.org/10.19191/EP25.2-3.S1.056","url":null,"abstract":"<p><strong>Objectives: </strong>to quantify the impact of heat on mortality, in terms of heat attributable deaths in 6 Italian cities included in the CCM Climactions project (Turin, Genoa, Bologna, Rome, Bari, Palermo) and to estimate the potential health co-benefits by considering temperature reduction scenarios in urban areas proposed in the project case studies in terms of urban nature-based solutions measures and albedo variation of impervious surfaces.</p><p><strong>Design: </strong>city-specific time series models and impact assessment.</p><p><strong>Setting and participants: </strong>daily mortality counts and average temperature data in six Italian cities (Turin, Genoa, Bologna, Rome, Bari, Palermo) included in the CCM CLIMACTIONS project Main outcome measures: overall mortality. Non-linear distributed lag models were used to estimate risk and attributable deaths for increments between the 75th and the 99th percentiles of the mean temperature distribution (lag 0-3) over the period 2006-2015. To estimate the benefits of the intervention scenarios proposed in Climactions to reduce temperatures in urban areas, the deaths attributable to heat with and without this reduction were calculated and the difference between the two estimates corresponds to the potential change in the impact due to scenario measures introduced.</p><p><strong>Results: </strong>the study reports a reduction in heat attributable deaths between 25% and 35% and between 40% and 60% in all cities, respectively, for the two scenarios of average temperature mitigation equal to 1.3°C and 2°C.</p><p><strong>Conclusions: </strong>although only referring to simulation scenarios, the study provides further evidence of how urban nature-based solutions and the variation in the albedo of surfaces can be beneficial at an urban level both for the environment and populations health, supporting the implementation of climate change adaptation measures.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"56-61"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790551","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":"[A data-driven approach to optimizing the management of chronic patients within the framework of DM77].","authors":"Maria Teresa Greco, Pietro Magnoni, Walter Bergamaschi, Antonio Giampiero Russo","doi":"10.19191/EP25.2-3.A864.034","DOIUrl":"10.19191/EP25.2-3.A864.034","url":null,"abstract":"<p><strong>Objectives: </strong>to develop tools to identify the most appropriate and/or prioritized sets of patients with stable chronic conditions who are eligible for management by territorial services, to be included in a dedicated care pathway within Community Health Centers (CdC), as outlined in Italian Ministerial Decree 77/2022.</p><p><strong>Design: </strong>retrospective observational study.</p><p><strong>Setting and participants: </strong>subjects residing in the territory of the Health Protection Agency of Milan (ATS Milano) in the year 2023.</p><p><strong>Main outcome measures: </strong>prevalence of hospitalizations, visits to the Emergency Room (ER) and patients receiving polytherapy, defined by specific criteria, to select chronic condition and cohort with potential territorial management. Duration of the disease and visits to the general practitioner (GP) clinic for the chronic population eligible for care in Community Houses provided for by the Italian Ministerial Decree No. 77 (DM77).</p><p><strong>Results: </strong>starting from a population of 3.5 million inhabitants in the ATS Milano, 35% suffer from at least one chronic condition. The most represented pathologies are arterial hypertension (254,232 cases) and hypercholesterolemia (156,314 cases). Applying selection criteria on hospital discharge, access in emergency room, and therapy, 16 chronic pathologies of interest for territorial assistance were identified. The 15% of patients had the disease for less than 1 year while the 36,2% for over 10 years. Over 60,000 patients (10,2%) included in the cohort with potential territorial management did not even make one visit to the GP clinic during 2023.</p><p><strong>Conclusions: </strong>through this model, approximately 600,000 subjects were identified as eligible for territorial care, based on the integration between the GP and the Community House, to be managed preferably within a Territorial Operations Center. This work represents a proposal for the application of a model to the information system available in a structure of the Italian National Health System for the planning of the care of the population affected by chronic diseases, as indicated by the DM77. The possibility of validating and developing similar approaches at a national level could represent a significant step towards better management of chronic conditions.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"168-180"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276510","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":"[One hundred days of the Trump presidency: the risks for science].","authors":"Francesco Barone-Adesi","doi":"10.19191/EP25.2-3.031","DOIUrl":"https://doi.org/10.19191/EP25.2-3.031","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"116-119"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555507","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":"[The effects of the European Pact on Migration and Asylum on the health of migrant populations].","authors":"","doi":"10.19191/EP25.2-3.032","DOIUrl":"https://doi.org/10.19191/EP25.2-3.032","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 2-3","pages":"125-128"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555619","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":"Regardless of the true number of deaths, the suffering of Gazans has been immense. And it is not yet over.","authors":"Sandro Colombo","doi":"10.19191/EP25.1.A853.007","DOIUrl":"https://doi.org/10.19191/EP25.1.A853.007","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 1","pages":"9-11"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598335","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":"[The European Court requires Italy to guarantee independent monitoring procedures].","authors":"Annibale Biggeri","doi":"10.19191/EP25.1.013","DOIUrl":"https://doi.org/10.19191/EP25.1.013","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 1","pages":"12-13"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598280","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":"[\"I don't go out anymore\": an analysis of voluntary social withdrawal among Italian 15-19-year-old students].","authors":"Sonia Cerrai, Silvia Biagioni, Ivan Severi, Leopoldo Grosso, Sabrina Molinaro","doi":"10.19191/EP25.1.A788.011","DOIUrl":"10.19191/EP25.1.A788.011","url":null,"abstract":"<p><strong>Objectives: </strong>to analyse the prevalence and characteristics of the hikikomori phenomenon in Italy within a representative sample of students aged 15 to 19 years, assessing the factors associated with this behaviour to guide preventive interventions.</p><p><strong>Design: </strong>cross-sectional study based on anonymous data collected through the ESPAD®Italia (European School Survey Project on Alcohol and other Drugs) survey using a self-administered questionnaire.</p><p><strong>Setting and participants: </strong>a representative sample of Italian high-school students is selected annually to ensure the comparability of ESPAD®Italia estimates. In this study, the pooled 2021-2023 sample consists of 36,868 students (50.8% male), with an average age of 17.0 years (standard deviation: 1.4).</p><p><strong>Main outcomes measures: </strong>the outcomes analysed are having experienced voluntary social withdrawal for at least six months over a lifetime (Lifetime Hikikomori) and the current behaviour of never leaving the house during the week (Current Withdrawal).</p><p><strong>Results: </strong>in 2023, 2.0% of students reported having voluntarily isolated themselves for at least six months in their lifetime, with a slightly higher prevalence among girls. Current withdrawal involved 11.3% of students, a significant increase compared to the previous two years. In the pooled 2021-2023 sample, the analysis of independent variables showed that the hikikomori phenomenon is associated with the use of psychotropic drugs, cigarette smoking, having been a victim of cyberbullying, feelings of exclusion, dissatisfaction in friendships, risky behaviours related to internet and video game use, and belonging to non-traditional families. The current withdrawal is directly associated with cigarette smoking, lack of enjoyment in social interactions, overweight/obesity, and belonging to non-traditional families.</p><p><strong>Conclusions: </strong>the study provided the first quantitative estimate of voluntary social withdrawal among Italian students aged 15-19 years, confirming that the phenomenon is widespread and concerning, especially among girls. Factors such as the perception of social exclusion, problematic online behaviours and the use of psychotropic drugs are strongly associated with the phenomenon. Future longitudinal research could further explore these relationships and support the development of integrated educational strategies in schools to identify and support at-risk students.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"49 1","pages":"35-43"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598275","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}