Epidemiologia & Prevenzione最新文献

{"title":"[A Charter to ensure paediatric palliative care].","authors":"Mariachiara Tallacchini","doi":"10.19191/EP26.3.071","DOIUrl":"https://doi.org/10.19191/EP26.3.071","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 3","pages":"228-230"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438703","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":"[Seveso (Italy), 1976-2026. A crime of peace].","authors":"Luigi Bisanti, Dario Consonni","doi":"10.19191/EP26.3.069","DOIUrl":"https://doi.org/10.19191/EP26.3.069","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 3","pages":"232-240"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438898","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":"Mortality in agriculture workers: a case-control study in Italy.","authors":"Claudio Gariazzo, Alessandro Marinaccio, Dario Consonni, Lucia Miligi, Stefania Massari","doi":"10.19191/EP26.3.A1016.060","DOIUrl":"10.19191/EP26.3.A1016.060","url":null,"abstract":"<p><strong>Background: </strong>population working or living in agriculture settings may experience important exposure to pesticides and other agents. Although some health effects associated with them are well known, for others (e.g., neurological diseases and lymphoid, hematopoietic and related tissue cancers) additional epidemiological evidence is needed.</p><p><strong>Objectives: </strong>to investigate mortality for neurological diseases and cancer in workers employed in agriculture in Italy.</p><p><strong>Design: </strong>case-control study using mortality data linked with working histories retrieved from the Italian National Social Insurance archive.</p><p><strong>Setting and participants: </strong>countrywide mortality data from 2005 to 2018 were used. Cases were blue-collar workers with primary/middle school education who died from selected causes; controls were individuals with the same characteristics, but died from all other causes. Each participant was assigned to the economic sector in which he/she worked for the longest period. Cause-specific mortality odds ratios (MORs) adjusted for age class, educational level, year of death, and region of residence were estimated using logistic regression models in which exposure of interest was \"ever/never\" (or length of employment) in agriculture using the service sectors as (unexposed) reference category. Analyses were adjusted for or stratified by gender.</p><p><strong>Main outcomes measures: </strong>MORs for causes of death within the groups of mental, behavioural and neurodevelopmental disorders (F01-F99), diseases of the nervous system (G00-G99), and malignant neoplasms (C00-C96)Results: about 64,000 workers employed in agriculture were included and compared with a control group of 107,000 workers in the service sector. Elevated mortality risk in agriculture workers was found for spinal muscular atrophy (MOR 1.26; 95%CI 1.03-1.56; 261 deaths) and Parkinson's disease (PD) (MOR 1.16; 95%CI 1.00-1.34; 742 deaths). As for cancer mortality, positive associations were found for non-follicular lymphoma (NFL) (MOR 1.59; 95%CI 1.03-2.46; 82 deaths), multiple myeloma (MM) (MOR 1.42; 95%CI 1.22-1.65; 546 deaths), and myeloid leukaemia (ML) (MOR 1.36; 95%CI 1.16-1.60; 474 deaths), as well as for stomach (MOR 1.30; 95%CI 1.20-1.41; 1,732 deaths), prostate (MOR 2.03; 95%CI 1.85-2.24, 1,582 deaths), and brain and central nervous system cancer (MOR 1.30; 95%CI 1.13-1.50; 601 deaths). PD, NFL, ML, cancers of skin, of connective and soft tissue, of prostate and of brain were found to involve mainly men.</p><p><strong>Conclusions: </strong>employment in agriculture has been associated with various health risks, some of which may be attributed to pesticides exposure. Although the use of the different agronomic categories of pesticides changed over time and some active ingredients were prohibited or limited, their health effects remain of concern for their large use, demanding further focused investigations a","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 3","pages":"290-300"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438877","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":"[Prostate cancer screening: moving forward, but with judgment].","authors":"Marco Zappa","doi":"10.19191/EP26.3.068","DOIUrl":"https://doi.org/10.19191/EP26.3.068","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 3","pages":"217-219"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438835","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":"[Prostate cancer: the phoenix of population screening. Evidence, controversies and organisational perspectives in the experience of the Lombardy Region].","authors":"Danilo Cereda, Silvia Deandrea, Margherita Zeduri, Sara Piccinelli, Michela Viscardi, Elena Tettamanzi, Antonio Giampiero Russo, Anna Odone, Bernardo Rocco, Andrea Salonia, Antonio Galfano, Claudio Talmelli, Elena Azzolini, Richard Naspro, Cristina Renzi, Piergiuseppe Colombo, Mario Melazzini","doi":"10.19191/EP26.2.A1024.031","DOIUrl":"https://doi.org/10.19191/EP26.2.A1024.031","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 2","pages":"In press"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787997","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 gravity model approach to the network of Centres for Assistance and Urgency and Emergency Department in Emilia-Romagna (Northern Italy): a tool to support equitable access planning].","authors":"Davide Iannuzzi, Raffaele Catananti, Antonio Fortino, Maria Pia Randazzo, Lorenzo Spinardi, Alessandro Valente, Danilo Catania","doi":"10.19191/EP26.2.A919.036","DOIUrl":"10.19191/EP26.2.A919.036","url":null,"abstract":"<p><strong>Background: </strong>in Emilia-Romagna Region (Northern Italy), over 60% of emergency room (ER) visits involve low-complexity cases, with a hospitalization rate of less than 5%, in line with the national trend. In 2023-2024, to improve system efficiency and ensure more appropriate use of hospital resources, the Region established 42 Centres for Assistance and Urgency (CAU) to handle minor emergencies.</p><p><strong>Objectives: </strong>to estimate the impact of this reorganization on healthcare service accessibility developing a gravitational model based on an adapted version of the Modified Huff Three-Step Floating Catchment Area (MH3SFCA).</p><p><strong>Design: </strong>an observational and modelling study was implemented and adapted to the healthcare context, focusing on emergency department (ED) and Centres for Asisstance and Urgency (CAU) access flows in the Emilia-Romagna Region in 2024. The study was structured into three phases: 1. calculation of access probability (using the Huff probability model); 2. estimation of the regional network's service capacity; 3. computation of the accessibility index to the network. To implement the gravitational model, distance matrices were employed - constructed on road networks - to accurately estimate travel times and distances between municipalities and healthcare facilities.</p><p><strong>Setting and participants: </strong>admission to ERs CAUs in Emilia-Romagna in 2023-2024.</p><p><strong>Main outcome measures: </strong>theoretical accessibility to network facilities, expressed as a composite municipal-level index; model performance assessed through R² and Weighted Mean Absolute Error (WMAE).</p><p><strong>Results: </strong>the model integrates variables such as travel times, mobility propensity, and inter-municipal attractiveness. The results show good predictive performance and an accessibility distribution with higher values in peripheral municipalities.</p><p><strong>Conclusions: </strong>the proposed model serves as an operational tool to support healthcare planning by assessing territorial equity in access to services and simulating alternative scenarios in the planning process.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 2","pages":"185-195"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152124","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":"Natural Language Clinical Pathways for Automated Coding of Topography and Morphology in Cancer Registries: Leveraging Healthcare Dataflows through the LN-PDTA Algorithm.","authors":"Adele Zanfino, Carlotta Buzzoni, Antonio Giampiero Russo","doi":"10.19191/EP26.2.A955.030","DOIUrl":"10.19191/EP26.2.A955.030","url":null,"abstract":"<p><strong>Background: </strong>cancer registries (CRs) are essential tools for oncological surveillance. The accurate coding of topography and morphology (through ICD-O-3 coding), traditionally performed manually, is complex and time-consuming. Artificial Intelligence (AI) offers new opportunities to automate this process, overcoming the limitations of existing algorithms, which often focus only on topography.</p><p><strong>Objectives: </strong>to develop an AI-based algorithm capable of automatically assigning the combined topography-morphology (topo-morpho) code from a synthetic clinical pathway expressed in natural language (LN-PDTA).</p><p><strong>Design: </strong>retrospective observational study based on integrated registry and healthcare administrative data. Deterministic record linkage was performed among the CR, administrative databases, and pathology reports (AP), considering clinical events within ±180 days from incidence date. Clinical information (diagnoses, pharmacological therapies, surgical procedures, causes of death, pathology codes) was transformed into chronological clinical tokens concatenated into a single string. The target variable was the combined topo-morpho code assigned by registry coders. An LSTM neural network (embedding=64, hidden=128) was trained to learn token sequences.</p><p><strong>Setting and participants: </strong>incident cancer cases recorded by the Cancer Registry of the Agency for Health Protection of the Metropolitan Area of Milan in 2017-2018; multiple, benign, and uncertain tumors were excluded.  Main outcome measures: accuracy in the prediction of topography, morphology, and combined topo-morpho. Precision, recall, and F1 score at different confidence thresholds. Secondary analysis for high-incidence cancer sites and identification of the most predictive tokens and information sources.</p><p><strong>Results: </strong>the dataset included 34,168 cases, split 80:20 into training and test sets. On the test set, the model achieved 89% accuracy for topography prediction, 59% for morphology, and 56% for the combined topo-morpho classification. Performances were better for highly frequent sites (breast 73%; colorectal 61%). For lung and prostate cancers, accuracy for topography reached 94% and 98%, respectively. The most predictive tokens and information sources were identified: pathology reports, mortality data, and surgical procedures for topography; pathology reports, hospital discharge diagnoses, and mortality for morphology.</p><p><strong>Conclusions: </strong>the LN-PDTA-based neural network approach shows promising results for the most frequent topographies and morphologies, thus enabling automatic coding of a fair number of cases, reducing manual coding time and supporting more efficient cancer registry operations.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 2","pages":"173-187"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788082","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":"[Wars, oil, climate, and health: renewable energy to end the era of fossil fuels and conflicts].","authors":"Francesco Forastiere","doi":"10.19191/EP26.2.035","DOIUrl":"https://doi.org/10.19191/EP26.2.035","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 2","pages":"124-127"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152097","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":"Diabetes, disease management, and risk of mortality by immigrant status: a population-based cohort study in Reggio Emilia Province (Northern Italy).","authors":"Francesca Leoni, Francesca Bononi, Francesco Venturelli, Laura Bonvicini, Massimo Vicentini, Alessio Petrelli, Silvia Pierconti, Pietro Amedei Modesti, Alessio Pellegrino, Maria Perticone, Elisa Manicardi","doi":"10.19191/EP26.2.A1018.033","DOIUrl":"10.19191/EP26.2.A1018.033","url":null,"abstract":"<p><strong>Background: </strong>migration is reshaping the epidemiology of chronic diseases in Europe. Although ethnicity is a known determinant of diabetes burden, evidence on diabetes prevalence, care pathways, and mortality across different migrant groups remains limited.</p><p><strong>Objectives: </strong>to compare diabetes prevalence, clinical management, and mortality between Italians and migrants from High Migration Pressure Countries (HMPC) in Reggio Emilia (Northern Italy).</p><p><strong>Design: </strong>population-based study with a cross-sectional analysis and a cohort analysis.</p><p><strong>Setting and participants: </strong>the data used in this study have been extracted from the Reggio Emilia Diabetes Registry and stratified by geographic area of citizenship: Italy, High Developed Countries (HDC), and HMPC (further divided by geographic area). Principal outcome measures: a cross-sectional analysis (31.12.2024) was performed to estimate age-standardized prevalence of Type 1 (T1DM) and Type 2 diabetes (T2DM) and to assess care management indicators (shared care vs exclusive specialist care) among residents. Additionally, a cohort analysis (2019-2024) evaluated all-cause mortality. Hazard ratios (HRs) were estimated by Cox proportional hazards models.</p><p><strong>Results: </strong>T2DM age-standardized prevalence was significantly higher in HMPC citizens compared to Italians (females: 9.7% vs 5.0%; males: 11.4% vs 7.7%), peaking in South Asians (F: 18.3%; M: 15.7%). By contrast, T1DM prevalence was lower in HMPC. Regarding management, immigrants were less likely to be under formal diabetes care compared to Italians; when treated, HMPC patients were more frequently managed exclusively by specialist clinics rather than through shared care with General Practitioners. T2DM was associated with increased all-cause mortality in all groups. Compared to their non-diabetic counterparts, the excess mortality risk was higher in specific migrant groups than in Italians (HR 2.25): East Asians (HR 5.69), and South Asians (HR 3.15) showed the largest survival disadvantage. Among non-diabetic individuals, the survival advantage typically associated with the 'healthy migrant effect' was not observed in people aged under 50.</p><p><strong>Conclusions: </strong>substantial heterogeneity exists in diabetes burden, care organization, and mortality across migrant groups. Differences likely reflect both biological susceptibility and structural barriers to primary care access. Tailored public health strategies are needed to reduce inequalities in diabetes outcomes.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 2","pages":"162-172"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788099","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":"[Distress during adolescence: a gender-based approach].","authors":"Michela Bersia, Carla Bietta, Chiara Primieri, Ilaria Domenicano, Franca Emanuelli, Roberta Narducci, Maria Ferrara, Daniela Fortuna, Lucia Miligi, Eva Papa, Eliana Ferroni","doi":"10.19191/EP26.2.A926.034","DOIUrl":"https://doi.org/10.19191/EP26.2.A926.034","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"50 2","pages":"151-155"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152155","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}