Level In Italy Research Articles

Acid sphingomyelinase deficiency (ASMD): addressing knowledge gaps in unmet needs and patient journey in Italy-a Delphi consensus.

Acid sphingomyelinase deficiency (ASMD) is an ultra-rare disease, and several gaps of knowledge on various issues remain, particularly at a regional/national level. Expert opinions collected through well-defined consensus methodologies are increasingly used to make available reliable information in the context of rare/ultra-rare diseases. With the aim to provide indications on infantile neurovisceral ASMD (also formerly known as Niemann-Pick disease type A), chronic neurovisceral ASMD (formerly known as Niemann-Pick disease type A/B) and chronic visceral ASMD (formerly known as Niemann-Pick disease type B) in Italy, we conducted a Delphi consensus of experts focused on five main areas: (i) patients and disease characteristics; (ii) unmet needs and quality of life; (iii) diagnostic issues; (iv) treatment-related aspects; and (v) patient journey. Pre-specified, objective criteria were used to outline the multidisciplinary panel, based on 19 Italian experts in ASMD in paediatric and adult patients from different Italian Regions, including both clinicians (n = 16) and ASMD patients' advocacy or payors with expertise in rare diseases (n = 3). During two Delphi rounds, a high ratio of agreement was found on several topics related to ASMD characteristics, diagnosis, management and disease burden. Our findings may provide valuable indications for management of ASMD at a public health level in Italy.

The Pandemic Implications for Carsharing: An Italian Context

Carsharing, as an innovative mobility option, can potentially support the urban transition towards a more sustainable mobility system and achieving sustainable development goals. This short communication aims at providing the status of carsharing services in Italy, with a focus on Turin, before and after the COVID-19 pandemic. In this regard, an overview of the role of carsharing in urban traffic is provided. Then, carsharing services in Italy before and after the pandemic are mapped. Accordingly, the implications of the pandemic outbreak for carsharing services are discussed. The provided insights confirm that although carsharing services have been affected by the pandemic, even after returning to normal life, the usage of carsharing is still far below its pre-pandemic level in Italy. Finally, to support sustainable mobility and incentivize using shared mobility services, a research agenda for further research is proposed, targeting the research gaps regarding (i) the factors leading to lower usage of carsharing after the pandemic, (ii) potential solutions and policies to support carsharing services return to their pre-pandemic level and exceeding it, and (iii) examining the impact of provided supports by governments during the pandemic, such as bonuses for purchasing bikes and scooters, on the adoption of carsharing services for the post-pandemic era.

An overview of bioinformatics courses delivered at the academic level in Italy: Reflections and recommendations from BITS.

In Italian universities, bioinformatics courses are increasingly being incorporated into different study paths. However, the content of bioinformatics courses is usually selected by the professor teaching the course, in the absence of national guidelines that identify the minimum indispensable knowledge in bioinformatics that undergraduate students from different scientific fields should achieve. The Training&Teaching group of the Bioinformatics Italian Society (BITS) proposed to university professors a survey aimed at portraying the current situation of bioinformatics courses within undergraduate curricula in Italy (i.e., bioinformatics courses activated within both bachelor's and master's degrees). Furthermore, the Training&Teaching group took a cue from the survey outcomes to develop recommendations for the design and the inclusion of bioinformatics courses in academic curricula. Here, we present the outcomes of the survey, as well as the BITS recommendations, with the hope that they may support BITS members in identifying learning outcomes and selecting content for their bioinformatics courses. As we share our effort with the broader international community involved in teaching bioinformatics at academic level, we seek feedback and thoughts on our proposal and hope to start a fruitful debate on the topic, including how to better fulfill the real bioinformatics knowledge needs of the research and the labor market at both the national and international level.

An exploration of biosimilar TNF-alpha inhibitors uptake determinants in hospital environments in Italy, Portugal, and Spain.

The availability of biosimilar medicines in Southern European markets has allowed purchasing biologics at a lower cost for healthcare systems. However, the capacity to seize this cost-reduction opportunity in the long run depends on fostering a sustainable competitive environment for all the market players involved. Diverse policies and information campaigns have been launched in Italy, Portugal and Spain to support uptake of "best-value" biologics (BVB). Despite these measures, the utilization of lower-cost biologics in certain regions is low, especially when it comes to the treatment of chronic conditions. We aim to identify biosimilar uptake determinants in hospital environments in Italy, Portugal and Spain, using the class of TNF-alpha inhibitors as an example. This is a mixed-methods study based on (1) the quantitative analysis of regional uptake data for TNF-alpha inhibitor biosimilars and (2) the qualitative processing of semi-structured interviews capturing experts' views on uptake determinants for biosimilars. The organization of multi-stakeholder information campaigns supporting TNF-alpha inhibitor biosimilars use in Italy, Portugal and Spain has resulted in an increased familiarity of healthcare professionals and patients with the prescription/use of these products. However, barriers persist that impede high biosimilars uptake, especially in chronic patient populations eligible for a switch. These are: (1) the late publication of position statements on biosimilars interchangeability by regulatory health authorities; (2) the vague positioning of (national/regional) health authorities on best switching practices (including multiple biosimilar-to-biosimilar switches); (3) the existence of policy frameworks that do not necessarily support the initiation of switching protocols; (4) the establishment of sometimes inefficient purchasing procedures that limit biosimilars potential to compete for market shares. Diverse approaches taken regionally to address these barriers have contributed to heterogeneous TNF-alpha inhibitor biosimilars uptake across Southern Europe. Our research signaled the limited reach of biosimilar policies implemented locally, if not supported by a national policy framework. This study highlights the need for the coordinated implementation of policy measures fostering biosimilars use at the regional and national level in Italy, Portugal and Spain. These measures should account for the particularities of off-patent biologic and biosimilar markets and should jointly address supply- and demand-side challenges.

Mapping the Diffusion and Implementation of Breast Units: Lessons Learned from the Case of Italy

The paper examines the diffusion and implementation of breast units (BUs) in Italy as a paradigm of pathology units. Through a case study methodology, the article analyses both European and Italian requirements for the identification of BUs and conducts a comprehensive census of active BUs in Italy, by reconciling data from four distinct databases. The analysis reveals variations in requirements between the national and the European level, indicating a process of adaptation while adopting European guidelines and underscoring the complexity of harmonizing BUs identification criteria. Furthermore, the census of active BUs provides an estimate of the total number of BUs in Italy and assesses adherence to the recommended population coverage standard (one breast unit per approximately 250,000 inhabitants) at the regional level in Italy. Indeed, the analysis shows geographical disparities in the diffusion of BUs across Italian regions. Additionally, this study highlights the challenge deriving from the lack of a unified national database displaying the total number of active BUs in Italy, a limitation that extends to the European context. The paper ends by offering some insights for future research in this area, emphasizing the need for standardized data collection.

Digging into waste: an analysis of waste crime in the Italian provinces

ABSTRACT This article examines the drivers of waste crime using a panel dataset at the provincial level in Italy. The results demonstrate that while waste crime is characterized by some degree of inertia, it lacks significant spatial patterns and does not respond to general modes of deterrence. With respect to income, the human capital effect prevails over the scale effect. An inefficient public sector and inadequate waste management system result in higher waste crime rates. The hauling and storage facilities also provide several opportunities for illegal shipment and disposal, which organized crime groups can especially exploit.

Framing socioecological complexity: The long-term evolution of multiple dimensions of desertification risk in Italy.

Desertification risk depends on the interplay of biophysical and socioeconomic drivers, among which climate change, soil depletion, landscape modifications, and biodiversity decline are key factors of change in Southern Europe. The present study introduces a diachronic analysis of desertification risk in Italy adopting a multidimensional approach based on four dimensions (ecological, economic, demographic, and administrative) assessed at three dates (1961, 1991, and 2011). These risk components were evaluated separately in Southern Italy, a formerly affected region (sensu United Nations Convention to Combat Desertification), and Northern/Central Italy, a nonaffected region in the country. All risk measures document how the divide between affected and nonaffected regions in Italy has gradually reduced. Because of local warming and rising human pressure, Northern Italy has recently displayed a level of desertification risk close to those observed in Southern Italy over the last 30 years. These results suggest a thorough revision of the national classification of risky areas, that may inform more specific mitigation and adaptation policies responding effectively to recent socioenvironmental trends and local (economic) dynamics. The intrinsic system's evolution observed at both regional and national level in Italy may be generalized to a broader European context. Our work finally documents the appropriateness of a multidimensional definition of desertification risk grounded on the joint analysis of ecological, demographic, economic, and administrative indicators. A comprehensive knowledge of socioeconomic patterns and processes of change contributes to more precise scenario modeling and design of integrated strategies mitigating desertification risk.

Walk the path of cervical cancer elimination in Italy: current scenario and shared recommendations

Abstract Issue/problem In 2020, the World Health Organization (WHO) called for the elimination of cervical cancer. In order to get it, vaccination against Human Papillomavirus (HPV), screening of cervical cancer and treatment of high-grade cervical disease and cancer must be implemented at country level. Description of the problem Italy has implemented HPV vaccination and cervical cancer screening for many years. Nevertheless, nationwide data show that both vaccination coverage and adherence to screening programs are unsatisfactory as compared to the WHO 90 and 70 targets, namely 90% of girls fully vaccinated by the age of 15 years and 70% of women screened with a high-performance test (i.e., HPV-DNA test) by age 35 and again by 45. Results In order to address the progress of vaccination and screening at regional level in Italy, a project was conducted in 2021-2022 in order to collect data on relevant indicators and issues. In particular, information was collected on both coverage indicators (for both vaccination and screening) adherence (for screening) and history and characteristics of the vaccination offer (e.g., targets, gratuity) and of screening (e.g., presence of clinical pathways, type of tests used). Collected data were shared with a multidisciplinary panel of experts on HPV-related diseases to issue recommendations to foster the elimination of cervical cancer in Italy. For this purpose, a survey was also conducted to identify potential actions in respect to vaccination, screening and treatment. Lessons A great heterogeneity across Italian regions was observed. The following actions were identified to implement vaccination, screening and treatment: educational campaigns, reminders and active calls for both vaccination and screening and more interoperability of data and definition of clinical pathway involving a multidisciplinary medical team for the proper management of all HPV-related diseases. Key messages • Actions are requested at national level to achieve the goals set by the global strategy for cervical cancer elimination with respect to vaccination, screening and treatment. • Actions identified to foster cervical cancer elimination in Italy includes educational campaigns, reminders and active calls, better interoperability of data and integrated medical team.

Measuring Competitiveness: A Composite Indicator for Italian Municipalities

This study measures territorial competitiveness at the municipal level in Italy, by proposing a robust composite indicator based on variables not yet used in the literature. The underlying theoretical framework is identified based on the literature on regional competitiveness. The proposed indicator consists of the following seven dimensions of competitiveness: Education, Job, Economic Wellbeing, Territory and Environment, Entrepreneurship, Innovation, and Infrastructures and Mobility. Data are retrieved mainly from administrative sources, for 2014 and 2015. In the building process, three aggregation methods are compared: a compensatory method, the arithmetic mean, and two partially compensatory methods, the geometric mean and the Adjusted Mazziotta-Pareto Index (AMPI). The arithmetic mean turns out to be the most robust method among the three considered, but the AMPI is the most robust method among the two partially compensatory methods. All the methods considered agree in identifying Innovation and Entrepreneurship as the most influential pillars in 2014 and 2015, respectively. The detailed geographical focus provides specific insights into territorial competitiveness in Italy. It emerges a rather heterogeneous picture of municipal competitiveness within the Italian regions. Highly competitive municipalities are present in every region, though with different concentration levels.

Implementation of a dashboard for monitoring health data at regional level in Italy

Background and Aims : Collection of epidemiological data and information on related healthcare is crucial to monitoring healthcare appropriateness and the fulfillment of clinical needs. This project aimed to implement a dashboard for epidemiological data collection, with a focus on patients with hypercholesterolemia.

CO2 sequestration in the subsoil and groundwater

Statistics for year 2020 show CO2 emission levels in Italy of 5 tons/inhabitant/year. At a planetary level, 300 Mton/year have been produced in Italy. For comparison, 4500 Mton/year were produced by the USA, 650 Mton/year by Germany and 11500 Mton/year by China. Greenhouse gas increase is a matter of concern, bringing about temperature increase on a global scale, which will impact in turn the hydrological cycle, thus also involving groundwater [...].

Ten Actions to Counteract Vaccine Hesitancy Suggested by the Italian Society of Hygiene, Preventive Medicine, and Public Health.

Vaccine hesitancy (VH) is one of the main causes of the widespread decline in vaccination coverage and has become the subject of ongoing debate among public health professionals. The present commentary is a “decalogue” of strategic actions to counteract vaccine hesitancy for public health professionals that comes from the cognitive and formative path put in place by the “Communication in Public Health” working group (WG) of the Italian Society of Hygiene, Preventive Medicine, and Public Health. From the establishment of a national, multidisciplinary WG on VH to the activation of a national monitoring/surveillance system on vaccine hesitancy, several proposals are discussed. The identification and dissemination of good practices and tools to counteract and understand vaccine hesitancy, interdisciplinary training on vaccine hesitancy and on risk communication, community engagement and infodemiology, the inclusion of effective interventions to counteract vaccine hesitancy within the National Immunization Plan (NIP), the promotion and growth of a community of practice and research in the field of vaccine hesitancy, collaborations between scientific societies, and knowledge from the behavioral sciences represent other actions recommended in the present commentary. The present document suggests ten undeferrable strategies that could be implemented at the national and local levels in Italy, and that could be borrowed by other European countries in order to counteract vaccines hesitancy with a systematic and organic approach.

Cooperative movement and widespread prosperity across Italian regions

AbstractOur goal is to participate in the debate on regional well‐being. To this end, we explore the relationship between prosperity and the cooperative movement at the regional level in Italy between 2010 and 2019. We summarize prosperity through an index originally proposed by Amartya Sen and we apply it to classify Italian regions. We then perform panel analyses showing that there is a positive and significant association between such an index and the cooperative presence. We detect that, and explain why, the cooperative movement contributes to the regional prosperity more through its employment than in terms of the added value it generates.

ADSWIM and WATERCARE Projects Meet Kids and Youth: The Challenge of Bringing the World of Research to School to Merge Research, Education and Communication

The transfer of communication and knowledge from science and research to the general public is a paramount step to raise people’s awareness about environmental issues and their negative and positive impacts on each of us. Many projects and initiatives seek to raise awareness among citizens, with particular attention to young people, about the importance of maintaining clean and healthy oceans. With this paper, we aim to present the successful communication initiatives developed during two Interreg projects, AdSWiM and WATERCARE, with schools and educational organisations on the local and national levels in Italy and Croatia. Both projects make a special effort to realize dedicated communication strategies with the objective of raising the awareness of environmental topics and issues among young people (i.e., students of different school grades) and teachers. The promotion of ocean literacy among students is crucial, as children and young people represent the future citizens and consumers who will develop attitudes and make decisions that will inevitably affect the environment.

TBE in Italy

Italy is considered a low-incidence country for tick-borne encephalitis (TBE) in Europe. Areas at higher risk for TBE in Italy are geographically clustered in the forested and mountainous regions and provinces in the northeast part of the country, as suggested by TBE case series published over the last decade. A national enhanced surveillance system for TBE has been established since 2017. Before this, information on the occurrence of TBE cases at the national level in Italy was lacking. Both incidence rates and the geographical distribution of the disease were mostly inferred from endemic areas where surveillance was already in place, ad hoc studies and international literature.

Does money laundering inflate residential house prices? Evidence from the Italian provincial markets

AbstractIn this paper, we provide an estimate of the impact of money laundering on residential house market prices. The housing market is commonly exploited by criminal organizations to clean illegal profits. The increase in demand due to money laundering contrasts the negative externality of crime on house prices, which has been investigated by a large literature. We build a new dataset on residential house prices at the provincial level in Italy over the period 2005–2012, obtaining a sample of 672 observations. We then estimate a hedonic equilibrium price model, controlling for proxies both for illegal profits derived from “entrepreneurial” crimes (drug dealing, receiving stolen goods, prostitution) and for violent crimes (extortions), together with traditional market drivers. Adding to the evidence from the traditional literature, which remarks the negative impact of crime on house prices, our findings suggest that money laundering from “entrepreneurial” crimes creates an upward distortion in the housing market prices. The impact is stronger where retail markets for illicit trades are richer.

The Impact of the First 11 Months of the COVID-19 Pandemic on Vascular Patients’ Care and Hospitalisation Rate in the Vascular Surgery Divisions of Southern Italy

The Impact of the First 11 Months of the COVID-19 Pandemic on Vascular Patients’ Care and Hospitalisation Rate in the Vascular Surgery Divisions of Southern Italy

Disaggregation of poverty indicators by small area methods for assessing the targeting of the “Reddito di Cittadinanza” national policy in Italy

In Italy, a crucial anti-poverty policy “Reddito di Cittadinanza” (RdC), a measure of guaranteed minimum income, was introduced in April 2019. We aim to evaluate the targeting of the RdC policy at the local level, as aggregated analyses could mask important misalignments between the share of beneficiaries of the RdC and the share of poor households. To measure the poverty share in the local areas of interest, two main indicators to capture and monitor poverty are used in Europe: the At-Risk-of-Poverty Rate based on the EU Statistics on Income and Living Conditions survey and the Absolute Poverty Index based on consumption data collected through the Household and Budget Survey. To obtain reliable estimates of these indicators at the local level, it is necessary to introduce small area estimation models that allow the use of data from different sources. We apply a bivariate Fay and Herriot model to provide reliable estimates of absolute and relative poverty for the assessment of RdC policy targeting in the 59 areas represented by the region by degree of urbanisation level in Italy. The degree of urbanisation is indeed a key geographical variable in the study of the poverty phenomenon. Our results suggest that the RdC policy implemented at the national level shows heterogeneous targeting performance at the local level, excluding large shares of poor households from the program. These findings yield a set of policy implications for improving the targeting of the measure.

Is the epithelial barrier hypothesis the key to understanding the higher incidence and excess mortality during COVID-19 pandemic? The case of Northern Italy.

The high incidence and increased mortality of COVID‐19 make Italy among the most impacted countries by SARS‐CoV‐2 outbreak. In the beginning of the pandemic, Northern regions accounted for 40% of cases and 45% of deaths from COVID‐19 in Italy. Several factors have been suggested to explain the higher incidence and excess mortality from COVID‐19 in these regions. It is noticed that Northern Italian regions, and particularly the cities in Po Valley, are the areas with the highest air pollution due to commercial vehicle traffic, industry and a stagnant meteorological condition, with one of the highest levels in Italy and Europe of fine particulate matter 2.5 micron or smaller in size (PM2.5). PM2.5, the major environmental pollutant deriving mainly by factory and automobile exhaust emissions and coal combustion, increases the expression of angiotensin‐converting enzyme 2, the epithelial cell entry receptor for SARS‐CoV‐2, and thus increase the susceptibility to this virus. The epithelial barrier hypothesis proposes that many diverse diseases may rise from the disruption of epithelial barrier of skin, respiratory tract and gastrointestinal system, including allergic diseases, metabolic and autoimmune diseases, and chronic neuropsychiatric conditions. There is evidence of a close correlation between air pollution and airway epithelial barrier dysfunction. Air pollution, causing lung epithelial barrier dysfunction, may contribute to local chronic inflammation, microbiome dysbiosis and impaired antiviral immune response against SARS‐CoV‐2, all of which contribute to the high incidence and excess mortality from COVID‐19. In addition, air pollution and epithelial barrier dysfunction contribute also to the higher prevalence of several comorbidities of COVID‐19, such as diabetes, chronic obstructive pulmonary disease and obesity, which have been identified as risk factors for mortality of COVID‐19. In this article, on the basis of epidemiological and environmental monitoring data in Northern Italy, it is suggested that epithelial barrier hypothesis may help to understand the excess burden and mortality from COVID‐19.

The National Recovery & Resilience Plans According to Citizens’ Perspective: will the EU regain its Leadership in Health? From the Italian Case History to the XVI European Patients’ Rights Day

Healthcare, well-being, and a healthy lifestyle are vital for all of us. In this regard, the engagement of European citizens is key to improve the health system and it is necessary to provide a leading role to the people, the communities, intermediate bodies such as Patients' Advocacy Groups (PAGs), citizens organizations involved in healthcare issues and, more generally, to all actors that promote health as a common good. European institutions struggle to translate into concrete actions the many times highlighted principle relating to the involvement of actors of the civil society and PAGs in the management of health issues. The need to close the gap between the principles affirmed and the real involvement is even more serious when discussing about the management of serious cross-border threats to health. In line with its standing point, the civic organization Cittadinanzattiva [1], being deeply involved in health issues that promote civic participation in the policy-making activities both at the national level in Italy and, through its EU branch Active Citizenship Network (ACN) [2], also at the EU level, is working – of course not alone – to promote civic participation in the drafting and implementation process of National Recovery and Resilience Plans (NRRPs), with relevant political goals already achieved. As the Conference on the Future of Europe (CoFoE) [3] is approaching, emphasizing the great contribution of civil society to the success of the EU recovery plans is urgent and essential, now more than ever.