Small Italian Island Research Articles

Lampedusa Island hotspot is a crucial migrant health checkpoint. Is enough attention being paid?

Abstract Background The migrant reception system in Italy operates on two levels: first and second reception centers. The first reception is carried out in collective centers -called hotspots- where newly arrived migrants are identified. Approximately, ¾ of the landings take place on Lampedusa, a small Italian island 113 km away from the Tunisian coast, that has its own hotspot. Here migrants should receive the first medical care and the first health screening and identification. The aim of this study is to understand the quality of healthcare provided at the Lampedusa hotspot. Methods A survey was conducted in April 2023 on all the 80 doctors and nurses who worked in the Lampedusa hotspot clinic between 2020 and 2022. In the first part, questions concerning their work in hotspot, experience, training before starting the task, and the actual needs of the migrant population were asked. In the second part, the focus was on available medical tools and screening for infectious diseases. Results Thirty-nine (46%) of the healthcare professionals responded to the survey, with half of them in their first work experience. Less than 40% had previously worked in a migrant assistance context. 93% of them started the job without a training course. 80% of respondents have never had access to protocols or guidelines and 80% believe that the structure is unsuitable for screening infectious diseases. Four out of 10 migrants seek treatment and ⅔ of the respondents state that there was no health screening. Conclusions These results highlight the need for health screening and treatment implementation, to prevent the spreading of infectious diseases, the development of antibiotic resistance, and the good management of economic resources. The migrant reception system in Lampedusa is highly present in the political and journalistic debate, but not as much in the scientific, as the latest publication dates back to 2015. Key messages • Lampedusa hotspot is an essential checkpoint for infectious disease and migrants’ health screening. • Migrants’ health at arrival is a public health issue that must be better tackled by the scientific community.

Assessing optimal energy mix and stability in the island of Favignana

The transition from fossil fuels to renewable energy sources is a challenge that can no longer be postponed. However, the massive adoption of unprogrammable energy sources could downgrade the stability of the electrical grid, especially in small islands. For this reason, the paper analyses the issue of the energy transition in Favignana, a small Italian island in the Mediterranean Sea. The study proposes a suitable renewable energy mix after having sized it, minimizing the Levelized Cost of Energy. Consequently, the stability of the grid is assessed, comparing the as-is condition and the proposed energy mix. Results prove that even though the economic and environmental optimum can be reached, the realistic scenario shows some vulnerabilities during the winter period with a very high ROCOF.

What’s in a Name? The Impact of Disasters on Islands’ Reputations: The cases of Giglio and Ustica

Disasters and their aftermath can leave an enduring, negative impact on the image of tourism destinations. This paper presents research conducted in relation to Giglio (site of the January 2011 Costa Concordia shipwreck) and Ustica (associated with the June 1980 crash of Itavia Flight 870) in order to study the impact of these two disasters on the tourism industry of these two small Italian islands. Methods employed include content analysis of articles published online and interviews with tourism stakeholders including operators, government officials and park managers. Findings suggest that disaster news coverage may initially have helped to increase the international visibility of both islands, however, even after several years, references made to the islands in the press continue to be related to such disasters. Little acknowledgement is made to the islands as tourism destinations or to the nature-based attractions that they offer. In this regard, a counter-engagement with the media and marketing efforts, including the use of social media platforms, is key to ensure that the enduring image of the islands is corrected and better reflects the characteristics of the islands.

The western European hedgehog Erinaceus europaeus L. 1758 on San Pietro Island (southern Sardinia, Italy) and an updated review of its presence on the Italian small islands

The current presence and local distribution of the western European hedgehog Erinaceus europaeus L. 1758, on San Pietro Island (Southern Sardinia, Italy) are here discussed for the period 2013-2021 with a short review of the species’ occurrence on the small Italian islands. The species was found in the central-eastern sector of the island, which is characterised by a high urban and infrastructural density and an agricultural mosaic, both suitable ecological conditions favouring its presence. Most of the direct data were obtained from roadkills. Despite the elusive behaviour of the species and the consequent possible underestimation, it can be assumed that the species shows a low density. In this respect, it might be interesting to investigate whether local limiting factors, either anthropogenic or natural might act on the hedgehog population. At a larger scale, the updated review of the small Italian islands shows the presence of the species on 13 islands, of which probably only Elba, Asinara and San Pietro (all >50 km2) support established populations. Further research is needed to study anthropogenic origin, history of introduction, genetics, density and medium-long-term viability of these small populations in each insular context.

Impact of Lightning Data Assimilation on the Short-Term Precipitation Forecast over the Central Mediterranean Sea

Lightning data assimilation (LDA) is a powerful tool to improve the weather forecast of convective events and has been widely applied with this purpose in the past two decades. Most of these applications refer to events hitting coastal and land areas, where people live. However, a weather forecast over the sea has many important practical applications, and this paper focuses on the impact of LDA on the precipitation forecast over the central Mediterranean Sea around Italy. The 3 h rapid update cycle (RUC) configuration of the weather research and forecasting (WRF) model) has been used to simulate the whole month of November 2019. Two sets of forecasts have been considered: CTRL, without lightning data assimilation, and LIGHT, which assimilates data from the LIghtning detection NETwork (LINET). The 3 h precipitation forecast has been compared with observations of the Integrated Multi-satellitE Retrievals for Global Precipitation Mission (GPM) (IMERG) dataset and with rain gauge observations recorded in six small Italian islands. The comparison of CTRL and LIGHT precipitation forecasts with the IMERG dataset shows a positive impact of LDA. The correlation between predicted and observed precipitation improves over wide areas of the Ionian and Adriatic Seas when LDA is applied. Specifically, the correlation coefficient for the whole domain increases from 0.59 to 0.67, and the anomaly correlation (AC) improves by 5% over land and by 8% over the sea when lightning is assimilated. The impact of LDA on the 3 h precipitation forecast over six small islands is also positive. LDA improves the forecast by both decreasing the false alarms and increasing the hits of the precipitation forecast, although with variability among the islands. The case study of 12 November 2019 (time interval 00–03 UTC) has been used to show how important the impact of LDA can be in practice. In particular, the shifting of the main precipitation pattern from land to the sea caused by LDA gives a much better representation of the precipitation field observed by the IMERG precipitation product.

A Methodological Framework for Fostering Renewable Investments on Photovoltaic in Small Italian Islands

In Italy, 19 small off-grid islands with a total resident population of about 50,000 inhabitants almost exclusively rely on carbon intensive diesel generators to produce electricity. As a consequence, high costs and greenhouse gas emissions, as well as low security of electricity supply make these islands economically and environmentally unsustainable. This paper proposes an integrated and comprehensive methodological framework for improving the sustainability of the small Italian islands through the introduction of renewable energy sources. The framework is composed of a prescriptive phase, where the renewable capacity targets to be ideally achieved and the most effective incentives for actually promoting renewable investments on photovoltaic are identified, and an assessment phase, where the effect of the incentives introduction is evaluated, providing policy recommendations for further promoting renewable investments. Results show that a relatively high renewable share can be ideally reached with low efforts in almost all the islands considered, and differentiated incentives for promoting investments are needed to account for the different geographical characteristics of each island. However, the analysis performed in the assessment phase shows that the decarbonization process is evolving very slowly and almost all the islands are far from reaching 2020 and, even more, 2030 capacity targets. The main reasons include the short time elapsed after the incentives introduction and a generalized lack of suitable sites for the deployment of photovoltaic plants, also due to the strict environmental constraints of these areas. Further actions to promote renewable development should go in the direction of fostering investments from private subjects and better harmonizing the energy and environmental objectives through a shared strategy for the enhancement of the sustainability of the island electricity systems.

Evaluation of the optimal renewable electricity mix for Lampedusa island: The adoption of a technical and economical methodology

Worldwide, the majority of small islands not connected to the main grid is still dependent on fossil fuels. From an economic and environmental point of view, this condition is no more sustainable given the high costs for electricity generation and the high level of pollutant emissions. Furthermore, the dependence on fossil fuel represents a risk for the security of the supply of several small developing Countries since they are obliged to import those resources from foreign Countries. The introduction of renewable energy sources in small islands represents a valid solution to solve these problems. In this context, the paper investigates the case of Lampedusa, a small Italian island whose electrical power system is currently totally supplied by diesel power plants. In the paper, the authors investigate the transition toward an economically and technically feasible generating system based on solar, wind and sea wave plants, to achieve specific targets of decarbonization. Commercial technologies are adopted for the exploitation of solar and wind sources, while sea wave plants are based on an innovative device, currently under development at the University of Palermo. A mathematical model is proposed to find the optimal energy mix that can satisfy a fixed share of annual electricity production from renewables, considering the Levelized Cost of Electricity. Finally, the proposed solution is analyzed in order to check the dynamic stability of the power system. The paper shows that, for replacing the 40% of the current electricity demand of Lampedusa, an optimal energy mix comprising 1509 kW from photovoltaic plants, 2100 kW from wind turbines and 640 kW from wave energy converters is needed. In this way, the actualized cost for the electricity production could be reduced to 0.260 €/kWh from the current value of 0.282 €/kWh.

Disaster victim identification by kinship analysis: the Lampedusa October 3rd, 2013 shipwreck

On October 3rd, 2013 a boat carrying more than 500 migrants coming mostly from the Horn of Africa (Eritrea, Somalia, Ethiopia) sank near Lampedusa, a small Italian Island in the middle of the Mediterranean Sea. The recovered bodies were examined by a forensic team, and post mortem data (anthropological and odontological records, and DNA) were collected for identification. Genetic profiles based on 16 autosomal STRs were acquired from both victims and putative relatives recruited following an international call. The final genetic database included 363 victims and 43 reference persons from 36 independent families recruited until mid-2017, who were missing 35 first-degree and 6 second-degree relatives. A pairwise blind search approach was used to identify familial relationships within the victims and between victims and putative relatives. Two statistics were calculated, the Identity by State (IBS) and the Identity by Descent (IBD), the latter by using the DVI module of the FAMILIAS3 software to compute LRs and posterior probabilities. The putative identifications were confirmed in pedigree analysis using the information provided by the relatives. In selected cases, additional autosomal and lineage (Y-chromosome and mtDNA) markers were typed. Some critical points were highlighted: the lack for accurate allele and haplotype frequencies in African populations, especially for the lineage markers, and the need for a shared approach to the biostatistical interpretation of the results in DVI. In the end, 29 first-degree (parent-child and full sibs) out of 35 missing (83%), and 3 out of 6 of second-degree relatives (50%) showed a high statistical confidence for a positive identification. This study represents the first attempt to systematically deal with the genetic identification of African migrants who died in the Mediterranean Sea. The methodological and statistical approach used in this study was proved to be reliable and appropriate for future genetic identifications in other similar mass disasters.

The Mediterranean Incarnate: Region Formation Between Sicily and Tunisia Since World War II by Naor Ben-Yehoyada

Reviewed by: The Mediterranean Incarnate: Region Formation Between Sicily and Tunisia Since World War II by Naor Ben-Yehoyada David Loher Naor Ben-Yehoyada, The Mediterranean Incarnate: Region Formation Between Sicily and Tunisia Since World War II. Chicago: University of Chicago Press, 2017. 288 pp. How can anthropology study region formation? In his ethnography The Mediterranean Incarnate, Naor Ben-Yehoyada takes the reader aboard the fish trawler Naumachos. He explores the small encounters and dramas that unfold on deck during a six-week journey while the ship ploughs through the waves in the strait of Sicily between the Sicilian port town of Mazara del Vallo, the small Italian islands of Lampedusa and Pantelleria, and the Tunisian coast. With great detail the book describes how the multinational crew of Italian and Tunisian fishermen work and live together in this restricted space lost somewhere in the middle of the Mediterranean. The carefully crafted descriptions and interpretations of this everyday life aboard the Naumachos serve as starting points for the book’s broader aim: to study region formation between Tunisia and Sicily since World War II—an ambitious project indeed. “If we turn such moving sites like the Naumachos into stages, we can make the dramas that unfold on their decks summon the spaces and histories in which these floating stages meander” (237), suggests the author. In doing so, each chapter of the book is structured around a theme that represents an aspect of life onboard. After the Introduction sketches out the argument for studying region formation, Chapter 2, “Whose Strike?”, acts as the prelude to the ethnography of life onboard the trawler. While the ethnographer is roaming around between the quay and bars in search of a contact that will facilitate access to a trawler of the fleet, the book introduces the main political forces in town: fishermen (both Tunisians and Italians), boat owners, and local politicians. The following chapters structure the ethnographic material along different [End Page 1445] types of relationships. Chapter 3, “The Craft of Expansive Navigation,” explores the themes of labor and class, focusing on the hierarchies on board. In Chapter 4, “Fish and Bait,” the author discusses how seafood is used to forge alliances and establish relationships of patronage, both in the micro-cosmos of the Naumachos, and between boat-owners and local, as well as national politicians. A related but different type of relationship—family and kinship—is explored in Chapter 5, “One Big Family,” while Chapter 6, “Pissing Rage,” focuses on honor as a means to delineate group alliances and mark boundaries. “Terms of Transcultural Affinity” (Chapter 7) finally adopts a wider perspective with the theme of cosmopolitanism. In the Conclusion, Ben-Yehoyada comes back to the main argument of region formation, emphasizing the conceptual shift from connections to relationships structured through segmentation. Each chapter’s leitmotif draws on classical themes of Mediterranean anthropology. Starting with the description of these themes through life on board the ship, the book traces “scaling devices,” as Ben-Yehoyada terms them, that link the decks of the Naumachos to the political scene in Mazara del Vallo, all the way up to the national politics in Rome, and reaching across the Mediterranean to Tunisia. These scaling devices serve two purposes. On the one hand, they allow the author to connect the micro-perspective onboard the fish trawler with the macro-perspective of the changing relationship between Italy and Tunisia in the Mediterranean. On the other, they allow a reconsideration of the above-mentioned themes in classical Mediterranean anthropology. The most elaborate example of such a scaling device is seafood, as interpreted through the conceptual lens of patronage. Chapter 4, “Fish and Bait,” explores how the catch is divided between the boat owner, the fishing cooperative, and the crew members according to a complex set of explicit and implicit rules combined with mutual cheating that are linked to social status, affiliations, and hierarchies among the crew members. While particularly exquisite seafood is reserved for the boat owner’s gift-giving, sardines and other seafood that do not have any market-value can be collected and sold later in town by other crew members. The chapter then continues to explore how the...

Assessing the feasibility of cogeneration retrofit and district heating/cooling networks in small Italian islands

Sustainability of energy supply in small islands has been emerging as a severe issue, due to the large margins for improvement of the most frequently adopted solutions. In many European islands large amounts of heat are wasted by the operation of engines-based power plants; conversely, heat is produced by boilers or by electric equipment for different uses, like domestic hot water or space heating. In this paper a techno-economic analysis is proposed to assess the feasibility of CHP-retrofit of existing power plants and the possible utilization of the recovered heat to supply, via a district heating and/or cooling network, the energy requests of civil users in the tertiary and residential sectors. The analysis is performed for six islands in Italy characterized by different demographic and climatic conditions, so as to get a comprehensive understanding of the factors that favour/obstruct the viability of the examined technical solution. As expected, due to the low “linear heat density” observed in small islands, the investments resulted “far from being attractive”; only in the case where public support mechanisms are adopted, the integration of the existing power plants with heat recovery devices and a district heating network resulted moderately attractive, especially in the largest islands.

Infrastructure Aesthetics and the Crisis of Migrancy

Research Article| March 01 2017 Infrastructure Aesthetics and the Crisis of Migrancy Nicholas Gamso Nicholas Gamso NICHOLAS GAMSO teaches cultural studies and environmental history at the Pratt Institute in Brooklyn. Search for other works by this author on: This Site PubMed Google Scholar Afterimage (2017) 44 (5): 10–14. https://doi.org/10.1525/aft.2017.44.5.10 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Nicholas Gamso; Infrastructure Aesthetics and the Crisis of Migrancy. Afterimage 1 March 2017; 44 (5): 10–14. doi: https://doi.org/10.1525/aft.2017.44.5.10 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAfterimage Search This content is only available via PDF. © 2017 Afterimage/Visual Studies Workshop, unless otherwise noted. Reprints require written permission and acknowledgement of previous publication in Afterimage.2017 Article PDF first page preview Close Modal You do not currently have access to this content.

Human population density and tenebrionid richness covary in Mediterranean islands

Abstract. Human population growth is expected to drive several species to local extinction. Yet, an unexpected high biodiversity can be found even in densely populated areas. Although a positive correlation between human density and biodiversity can be explained by the intermediate disturbance hypothesis, an alternative possible explanation may come from the tendency of human settlements to be located in sites whose environmental conditions are particularly favourable also for many other animal species. To investigate this hypothesis, we studied the relationships between human population density and species richness of native tenebrionid beetles in small Italian islands. We used partial regression analysis to assess the individual contribution of island area (to account for the species–area relationship), elevation (used as a proxy of environmental diversity), and human density to species richness. We found that tenebrionid diversity increased with human population density even after controlling for area and elevation. This may suggest that islands that were (and are) more hospitable to humans are also those which can be more favourable for tenebrionids.

Irregular Migration

In December 2012, a comparative workshop was held at Flinders University, Adelaide to discuss emerging regimes of power in response to irregular migration. The workshop was conceptually organised around similar challenges being experienced by Australia and the southern European states of Italy and Greece. In both zones, the construction of the migration problem as a question of numbers and peoples plays a large role in developing border-control policies. Reactive policies are developed around highly visible cases, rather than a systemic review of the broader problem and its real causes. Instances of highly visible irregular migration in Australia and the European Union include the post-Tampa crisis and the ‘boat people’ debate in Australia, and the critical situation on the small Italian island of Lampedusa, near Tunisia. These instances elicit strong and equally visible responses, such as the revived ‘Pacific Solution’ (offshore processing) and the transformation of Lampedusa into an offshore detention ‘container’ that closely resembles the Christmas Island detention facility. This symposium arose from these themes and aims to offer a more comprehensive approach to the issue of irregular migration.

Influence of past land use and current human disturbance on non-native plant species on small Italian islands

Biological invasions are regarded as one of the main drivers of habitat degradation in island ecosystems. Mediterranean islands have been subjected to a high degree of land conversion over the past 60 years, resulting in a massive reduction in the amount of rural land and the sprawl of tourist activities. The aims of this paper are to evaluate the current level of invasion of alien plant species in semi-natural vegetation types that have developed after the abandonment of agriculture and to analyze the relationships between non-native species, native flora, and environmental characteristics. Two Italian islands (Ponza and Ventotene) were surveyed using a random-stratified sampling. The occurrence and relative cover of alien plant species were compared and separate analyses were performed for the native flora. Abundance patterns of both native and alien species were then studied in the light of the environmental and anthropogenic features. Although we found that some non-native species are extremely widespread, their relative cover at the plot level is low. Permutational Multivariate Analysis of Variance and Indicator Species Analysis revealed dissimilarities in the native species composition, while Mann–Whitney and Kruskal–Wallis tests showed differences in the ecological requirements (moisture, soil reaction, and nitrogen) of the native species pool. Canonical Correspondence Analysis pointed to the importance of the proximity to agricultural areas, human disturbance, and past land management, particularly residual terraces, in determining the difference between plant communities on the two islands. The results of our study suggest that traditional forms of agriculture may represent a key element for countering the establishment and spread of non-native plants in Mediterranean areas.

A CHECKLIST OF THE MAMMALS OF SMALL ITALIAN ISLANDS

Present knowledge on mammals of small Italian islands consists mainly of episodic records. In this paper we collect all available information about the distribution of wild mammals on 47 small Italian islands. A total of 37-38 species was found, including: 1 Erinaceomorpha, 4 Soricomorpha, 16-17 Chiroptera, 3 Lagomorpha, 7 Rodentia, 2 Carni- vora and 4 Artiodactyla. The subspecific level has been identified whenever possible. The mammal fauna of the Isle of Elba (Tuscan Archipelago) is the richest, with 24 species, while the most common species are Rattus rattus present on 47 islands Oryctolagus cunicu- lus (34), and Mus musculus (33). With the exception of Crocidura sicula, the current mammal fauna on small Italian islands originated from introductions.

Lampedusa in Focus: Migrants Caught between the Libyan Desert and the Deep Sea

It is the last day of August and at the airport of Lampedusa, a small Italian island situated south of Sicily, yet another deportation of ‘undocumented’ migrants is taking place. The incident appears as wrapped in the mantel of ordinariness that exacerbates even more the violence of the event. Two planes parked approximately 20m away from each other are waiting for passengers. A group of tourists pours out of the airport building and strolls towards the airplane of AirOne, an Italian tourist carrier. The adjacent plane of AirAdriatic, a private Croatian air company, is boarded by a group of passengers walking in a fixed formation behind each other. Four police officers (one officer in the back, one in front and two on the side of the row) wearing civilian clothes and large black protection gloves lead the group of 10 migrants from the detention camp to the airplane. The distance between the AirAdriatic plane and the detention camp is rather short. In fact, the plane is parked only 15m or so away from the barbed wire that separates the runway from the camp. Migrants boarding the plane are dressed the same: they wear dark blue sports trousers with a matching jacket and carry a white plastic shopping bag. Seven groups of 10 men are lead to the plane. Behind the barbed wire there are several hundreds of migrants seated in small groups on the soil. When the plane takes off most of them are on their feet, waving.

Assessment of Renewable Energy Solutions in an Italian Small Island Energy System Using a Transient Simulation Model

This paper presents a transient model of the energy system of the small Italian island of Ventotene. The model has been developed as a tool to validate the performance related to the integration of renewable energy technologies and energy efficiency measures into the island stand-alone power system, in presence of seasonal-dependent electric load equilibrium conditions. A hydrogen-based energy system has been proposed as an effective option for the seasonal buffering of the stochastic power contribution from renewable energy sources. The time-dependent behavior of the hybrid, diesel, and hydrogen-renewable, power generation system has been investigated by matching it with the electric load data with an hourly distribution over the period of one reference year. The technical feasibility and the behavior of the systems have been evaluated in terms of its electric and environmental performance.

Effects of desert dust and ozone on the ultraviolet irradiance at the Mediterranean island of Lampedusa during PAUR II

Observations of the ultraviolet spectral irradiance, tropospheric aerosols, and ozone were carried out at Lampedusa (35.5°N, 12.6°E), during May and June 1999, in conjunction with the Photochemical Activity and Ultraviolet Radiation modulating factors II experiment. Lampedusa is a small Italian island in the Mediterranean, about 100 km off the west coast of Tunisia, North Africa. During the campaign, aerosol transport from Sahara, mainly controlled by the development of high‐pressure systems over North Africa, strongly affected the troposphere at Lampedusa. Aerosol optical depths at 415 nm ranged between 0.14 and 0.91. Dust aerosols with an optical depth of 0.5 at 415 nm produced a reduction of the measured irradiance at 350 nm by about 20%, at a solar zenith angle of 30°, and by about 25% at 60°. The occurrence of large aerosol optical depths was associated with low total ozone values, mainly due to the influence of surface pressure on the stratospheric vertical structure and transport. Thus the aerosol attenuation of the UV irradiance was large when low absorption by ozone occurred, and a large ozone absorption occurred when aerosol attenuation was small. Mostly because of their large variability, aerosols produce larger attenuation effects than ozone on the UV irradiance for wavelengths longer than 315 nm. By neglecting the influence of aerosols on the radiation amplification factors, calculation of the dependence of the UV irradiance on ozone can be significantly underestimated. For the erythemally weighted irradiance a value for the radiation amplification factor between −0.1 and 0.7, depending on the solar zenith angle, has been derived. A simple model to take into account the aerosol effect in the determination of the radiation amplification factor has been developed. By applying this model an erythemal radiation amplification factor between 0.8 and 1.25 is obtained. It is estimated that an aerosol layer of optical depth 0.5 at 415 nm produces a reduction of the erythemal irradiance as large as 25 and 27% at solar zenith angles of 30° and 60°, respectively. When conditions similar to those of Lampedusa occur, i.e., when large aerosol loads may be present, and for certain meteorological conditions, the effects of the aerosol on the surface ultraviolet irradiance cannot be neglected.

Telemedicine for airline passengers, seafarers and islanders.

Airline passengers, seafarers and islanders are three different examples of people who can benefit from telemedicine. However, the peculiar characteristics of each group require different applications. In 60 years of activity, the CIRM has assisted more than 37,000 patients. In the 10 years from 1986 to 1996 the Centre provided radio medical assistance to 7647 patients, of whom 6981 (91.3%) were sailors, 642 (8.4%) were people living in isolated areas (small italian islands) with few medical facilities, while only 24 patients (0.3%) were airline passengers. In the same period, the telecommunication service received or transmitted almost 80,000 medical messages.