This work is the third in a series of articles dedicated to the EASY-NET network programme. The first article described the rationale, structure, and methodologies; while the second evaluated the adherence of individual audit&feedback A&F interventions tested in EASY-NET to literature recommendations. This contribution provides a concise summary of the effectiveness results of A&ented by clinical and organizational areas: chronic disease management, emergency territorial and hospital care for acute conditions, post-acute rehabilitation, hospital oncology care, childbirth, and caesarean sections. In alignment with existing literature, the results on the effectiveness of A&F, in terms of measurable improvement, were observed across all settings, although to varying degrees and more significantly in processes than in outcomes. Key elements that proved to be fundamental to the implementation of A&F interventions include the importance of institutions in making A&F systematic, continuous, and a priority for healthcare professionals; the central role of the required and available data for preparing feedback; the involvement of A&F recipients in the whole path, from the design of the interventions to the discussion of results and improvement actions. A final consideration, in light of the activities conducted and the results achieved, suggests that integrating research into practice and practice into research is essential to ensure, on one hand, the transferability of evidence into operations and, on the other hand, the design of studies that are feasible and integrable into daily activities - a necessary aspect to optimize resources.

reducing air emissions is the fundamental action necessary to mitigate the negative health effects caused by air pollution. However, increased public awareness has highlighted the need to identify protective measures that can mitigate the personal health risks associated with air pollution.

after the recent reform of territorial healthcare, districts have been designated within the Lombardy Regional Health System to coordinate and deliver territorial care. This entails the need of readily available information to measure the quality of provided healthcare, identify critical areas for improvement, monitor the balance between demand and supply of healthcare services.

This Catalogue is a collection of information on the use of raw asbestos and asbestos-containing materials used in several industries and occupational activities, with particular attention to the situation of Tuscany, a region of Central Italy. The work was developed at the Institute for Cancer Research, Prevention and Clinical Network (ISPRO) of Florence, where epidemiologic research and surveillance activities have been developing since 1988 and where the coordination and evaluation of the regional health surveillance programme provided to past asbestos workers started in 2016 and is still ongoing. The Catalogue aims at being a working tool for all health professionals engaged in examining and classifying the occupational asbestos exposures of subjects both affected by diseases that could be associated to this carcinogen and examined within the regional health surveillance programme. It is necessary for the health personnel engaged in the above-mentioned activities to know or to have the possibility to find exact and detailed data on asbestos exposure by occupational sector. These data are briefly described in the 29 factsheets this Catalogue consists of.  In each factsheet, the presence and every use of asbestos are described, with reference to a precise occupational sector. Several occupational sectors can be considered together because of analogies on asbestos exposure. Occupations are considered on the basis of existing evidence on the use of raw asbestos or asbestos-containing materials (as semi-finished or finished products or as auxiliary materials in production processes). Besides the presence and use of asbestos, a description of the possible exposures of workers is reported. Sources of information were scientific and grey literature as well as the 8,097 occupational histories of mesothelioma registered by the specific Tuscan registry. Some factsheets have been revised and enhanced by Italian experts on the asbestos exposure with a specific competence in the examined sectors. Each factsheet includes also questions to be addressed to workers in order to examine in depth their possible asbestos exposure. For those who would like to expand their knowledge on this topic, references are reported both at the end of each factsheet and at the end of the volume. In all industrialized countries, also in those which have not already banned asbestos use, a decrease in the use of this material and in the relative exposure have been observing since the end of the Seventies, few years after the general consensus within the scientific community on asbestos carcinogenicity. This decreasing trend has been becoming greater and greater since the end of the Eighties, when more restrictive regulations have been approved and applied, especially in occupational settings. Nevertheless, nowadays asbestos-related diseases are still diagnosed due to past exposures, although during next decade a decreasing incidence of malignant mesothelioma - the cancer most specifically related to this carcinogen and characterized by a very bad prognosis and the longest latency - could be observed. Particular attention will be paid to jobs regarding renovation of old buildings containing asbestos and to decontamination activities. In conclusion, this Catalogue is a working tool - although it is not exhaustive and could be upgraded with new information - for all professionals engaged in asbestos risk prevention activities as health personnel, personnel of insurance companies, employers, and employee representatives.

to evaluate the accuracy (completeness of case recording and diagnostic quality) of the Lombardy Mesothelioma Registry (Registro Mesoteliomi Lombardia, RML) through a comparison with the autopsy database of Pavia University (years 2000-2016).

The area known as Piana di Venafro is situated between the Mainarde and Matese massifs in the extreme western Region of Molise (Southern Italy). This valley was formerly designated as Campania felix, a moniker derived from the global esteem in which its crops were held. Nowadays, the valley is traversed by numerous high-volume thoroughfares, rendering it challenging to maintain the designation of felix. The presence of significant industrial facilities along its periphery has resulted in the valley becoming a heavily polluted area. This contribution provides an overview of the significant activities undertaken by the non-profit organisation 'Mamme per la Salute e l'Ambiente ODV ETS' (Mums for Health and Environment) in their efforts to safeguard the Venafro Plain region and address the environmental concerns they have identified.

the long-COVID condition is gaining increasing relevance in terms of public health, but few studies have evaluated its impact on use of healthcare resources and the organizational responses of healthcare systems. Although many studies have evaluated case studies of individuals with long-COVID, the clinical spectrum of symptoms is still poorly defined due to the heterogeneity of the populations studied, the variability of the definitions used, and the absence of disease markers. In this context, in 2022, a project was designed and implemented in cooperation between the National Centre for Prevention and Control of the Italian Ministry of Health and the Italian National Health Institute (Istituto Superiore di Sanità, ISS).

to provide researchers and stakeholders with an overview of the statistical sources of micro data available for estimating and studying the demand for care for dependent older people in Italy.

The project "Experimentation of new integrated hospital-territory organizational models for the prevention and control of sexually transmitted infections: facilitated diagnostic-care pathways and offer of free targeted screening" was developed as part of the CCM 2019 programme, funded by the Italian Ministry of Health, being coordinated by the Italian National Health Institute (ISS), in collaboration with Sapienza University of Rome. Three clinical units located in Turin, Milan, and Cagliari, specialized in sexually transmitted infection (STI) diagnosis and treatment, and three highly specialized microbiology laboratories located in Trieste, Florence, and Palermo were involved.The objectives were to develop an innovative network model for the treatment of STIs based on multidisciplinary centres with high quality of care for STIs (hub-IST) and territorial structures (spoke-IST), to plan and test integrated facilitated care pathways for STIs, to evaluate the priorities, feasibility, and sustainability of prevention interventions.A focus group of 12 experts, together with other members from the participating units, defined the characteristics of hub-IST and spoke-IST centres and outlined the integrated care pathway (PIC) for STIs based on the hub&spoke model.A 4-month field trial was subsequently started, applying the proposed PIC in 3 participating units. Improvements were immediately observed in care (increased access to the centre, reduced waiting times, increased number of visits), in the direct connection with intrastructure specialists, in prevention interventions, and in the information provision.The hub&spoke model applied to STIs proved to be innovative, transferable, and adaptable to different Italian regional situations, establishing itself as the currently most functional model for modern care for this type of infections. By reducing barriers to healthcare access, expanding the number of attendees, reducing costs for the community, and implementing targeted and effective prevention interventions, the epidemic chain can be interrupted and the spread of STIs reduced. Based on these results, in Italy, it is urgent to develop an STI strategic prevention plan at a national level.

The Social Report (SR) is a form of measurement and reporting, transparency, and communication, essential for sharing decisions, activities, and the value an institution generates with stakeholders from a social responsibility perspective. It is a useful tool for screening programmes to understand their objectives and structure, assess their effectiveness, and promote informed participation by citizens and stakeholders.This contribution explores the implementation of the SR in oncological screening programmes - a project conducted in the CCM 2019 Programme 'Guidelines for Social Reporting of Screening Programmes', coordinated by the Institute for Cancer Research, Prevention and Clinical Network (ISPRO) in Tuscany Region in collaboration with the Centre for Oncological Screenings of Reggio Emilia (Emilia-Romagna Region) and the Population Screening Programmes Service of ATS Valpadana (Lombardy Region) - conducted between 2020 and 2022.The project general objective was to review the Guidelines for Social Reporting of Oncological Screening Programmes developed in 2012. This was achieved through a training and knowledge-deepening phase and an experimental phase in a co-creation logic with all stakeholders involved, particularly with Corporate Management, Regional Screening coordinators, and Associations of citizens and patients.The project had three specific objectives: to spread the culture and practice of social reporting through training courses for professionals working in screening programmes; to experiment with drafting SR in three pilot projects and subsequently update the guidelines; to disseminate the updated guidelines to regional screening coordination and promote informed and conscious involvement of stakeholders.At the end of the project, three SRs were produced for mammography, cervical, and colorectal screening programmes, structured into homogeneous sections and enriched with specific local content. This experience demonstrated the importance of the SR as an accountability tool, but also highlighted difficulties due to the pandemic and the need for earlier and more integrated stakeholder involvement. The updated Guidelines reflect the commitment towards more comprehensive, comparable, and inclusive reporting, to be systematically adopted within screening programmes.

Hearing and vision disorders in newborns are a serious social and public health problem. To improve the effectiveness and efficiency of screening protocols, it is necessary to use standardized procedures and ensure their implementation at a national level. This is the first set of Italian national practice recommendations for professionals involved in the diagnosis, treatment, and management of hearing and eye screening that will guide the development of multidisciplinary services and public health policies to prevent and/or treat hearing and vision impairment in newborns. This document refers to art. 38 of the Italian Prime Ministerial Decree of 12th January 2017 defining the essential levels of assistance. It also provides an overview - albeit not exhaustive - of the current organization of the screening system as a whole and the potential areas of implementation.

Carbapenem-resistant Enterobacterales (CREs) are globally considered to be a major threat to public health. National and international guidelines emphasize the importance of routine active surveillance policies to prevent their transmission. Consequently, screening for the evaluation of the status of colonization by CREs in hospitalized patients in Italy is considered essential to contain and control the spread of these microorganisms and their evolution towards infection. The Italian Ministry of Health funding the CCM Project "Phenotypic and molecular screening methodologies for the detection of colonizations due to carbapenem-resistant enterobacterales (CRE)", carried out between February 2018 and January 2021 with the aim of evaluating phenotypic and molecular tests as methods able to detect patients colonized by CRE in Italian hospital setting. To assess the impact of the SARS-CoV-2 pandemic on CRE colonization, the observation period was divided into two periods: September 2018-September 2019 (first period) and October 2019-September 2020 (second period).As general objective of the project, the evaluation of the effectiveness of the methods has been appropriately foreseen. In addition, four specific objectives have been envisaged: 1. to standardize and to compare phenotypic and molecular methods, in terms of Turnaround Time (TAT); 2. to quantify the frequency of colonization at the admission and during hospitalization in Intensive Care Unit (ICU) and non-ICU wards; 3. to evaluate the effectiveness of screening interventions; 4. to provide activities that attest to the importance of screening.In order to evaluate the role of hospitalization in CRE-colonization, 11,063 patients were enrolled to perform rectal swabs on admission, and, if negative, weekly for three weeks during hospitalization. The data were collected in a dedicated IT platform.The molecular test demonstrated to be able to detect colonized patients and presence of resistance markers within 60 minutes from the sample arriving.The prevalence of CRE has increased during SARS-CoV-2 pandemic, especially in hospitals in South Italy. K. pneumoniae was the species most frequently associated with patients colonized by CRE.Training activities have been started for hospital staff, in order to reduce the frequency of colonization of patients. All the participating centres have defined the procedures to be applied locally for the screening of CRE colonized patients and have started screening activities.

The Italian Association of Epidemiology's experience during the COVID-19 pandemic and its collaboration on a national project focused on contact tracing have prompted significant insights essential for the management of future pandemics in Italy and the development of new pandemic plans. In particular, the Italian Association of Epidemiology highlighted the need to collect, analyse and interpret data, and produce indicators of effectiveness and efficiency in a consistent manner across the country to support the governance of the pandemic response. During the COVID-19 pandemic in Italy, this capacity was severely hampered by structural and regulatory factors and the limited availability of specific expertise. The lack of applications developed for contact tracing purposes and the absence of interoperability between existing information systems highlighted the need to invest in integration among ICT, Epidemiology, and Public Health Services. The absence of predefined indicators made it impossible to compare different organisational solutions for contact tracing. From the regulatory point of view, there is an urgent need for clarification of the legitimacy and legal basis of the use of data already available to the National Health System collected for different purposes to be used for the performance of proactive medicine and prevention activities. Finally, investment in training for health workers and decision-makers at all levels and community awareness raising are essential to building a resilient community. The Italian National Pandemic Plan 2024-2028 is an opportunity to prepare an effective and efficient response to future health emergencies, through coordinated plans and the valorisation of the pandemic experience.

Gli autori hanno aggiornato la tabella 1 (p. 14) e la tabella 2 (p. 15) attribuendo le stime di NO2 all'Health Effects Institute (HEI) anziché alla World Health Organization (WHO). Di conseguenza, è stato modificato il paragrafo "Health impact estimation" a p. 14. I PDF nei quali sono segnalate le modifiche sono disponibili alla pagina dell'articolo.

to provide an overview of the geographical distribution of mesothelioma and asbestosis deaths in the Campania Region (Southern Italy) occurred from 2005 to 2018 and to identify areas at higher risk.

In recent years, the number of members of the Italian Association of Epidemiology (AIE) has increased considerably, and their profile has undergone many changes. The aim of this work is to describe the characteristics of the members, with particular attention to those who have been continuously enrolled. To evaluate these characteristics, the data from membership forms submitted to the Association and information available on the new website in the personal profile area (period 2016-2024) were used. The characteristics considered were: gender, age, education, and job position of the member, Region, and type of affiliated institution. Members with at least three registrations during the period considered, including at least one in the last three years (2022-2024), are considered continuous members.In 2024, AIE counts 557 members, of whom 340 (61.0%) are female and 182 (32.7%) are under 35 years old. This data confirms the growing trend observed since 2015, when the number of members was just above 300, considering that each year there is a quota of new members amounting to about 30%. A total of 382 members can be considered continuous. Over 90% of these members work in 8 Regions (Lazio, Piedmont, Emilia-Romagna, Lombardy, Tuscany, Veneto, Puglia, and Sicily), while the other regions are scarcely or not represented at all. Over time, and with the arrival of new members, the Association is shifting towards the academic world, while the proportion of professionals working in public health institutions has decreased. Members are overall highly educated; however, while older cohorts have predominantly a medical and biological education, younger cohorts increasingly have statistical/mathematical education. Seventy percent of the members have a permanent contract, 5% have a fixed-term contract, and 13% have an atypical contract. Precarious contracts tend to be lower among medical graduates and remain higher in other health professions and non-health-related degrees.AIE is dealing with a period of dynamism and openness, marked by the increase in the number of the members and the transformation of their occupational and educational profile. It is crucial to support and promote the ongoing positive changes, such as the wider geographic representativeness and the entry of new recruits, also facilitated by multiple activities carried out by AIE, including congresses, working groups, webinars, training courses, and collaborations with other scientific societies. At the same time, it might be useful to open a discussion on the meaning and consequences of the increase of academic members and the reduction, at least in relative terms, of individuals coming from public health. Finally, it will be necessary to approach some critical issues, such as the still poor multidisciplinarity and the persistence of job insecurity, especially among graduates in educational pathways that still do not fit into the professional profiles recognized by the NHS.

to estimate the contribution of locally-grown food consumption to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) human exposure.

to identify any differences between Italian and foreign women in the access to prenatal care, including the number and appropriate scheduling of visits, the execution of diagnostic, blood, and microbiological tests and the use of specific healthcare services.

The "One Health and Citizen Science" (OHCS) project aims to provide an integrated intervention model useful for characterising the state of environmental quality, assessing population exposure to pollutants, investigating the association between environmental risk factors and health outcomes, and measuring the impacts associated with contamination and remediation scenarios. In pursuing this objective, the activation of participatory pathways and the use of risk communication strategies are envisaged.Within the OHCS project, training and discussion meetings were planned on a number of issues deemed central. The first of these meetings focused on the theme of environmental justice. By embracing this theme, researchers explicitly acknowledged several essential elements: the value of a transdisciplinary approach in enriching our understanding, the non-neutrality of knowledge, and the prioritization of public health. Environmental justice, through this perspective, can represent the trait d'union of different disciplines and, in this circumstance, it was a fertile ground for exchanges between epidemiology, history, and social sciences allowing the historical and narrative reconstruction of the events affecting a place and its community as a result of personal and collective reflections.This contribution, therefore, explores the perspectives that can be developed around the topic of environmental justice. These perspectives are investigated by adopting a transdisciplinary approach, which on the one hand integrates the contributions of these different disciplines, on the other includes knowledge of other natures, with a view to peer collaboration in the production of knowledge. The theoretical reflections are complemented by the description of the training workshop experience, presented as a practical example for the construction of a useful dialogue space for local communities and technicians.