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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.

Objectives: to compare three injuries indicators to establish which are less affected by underreporting and therefore best suited for the monitoring of the occupational injuries time trend during economic crisis., Design: open cohort., Setting and Participants: a national sample of employees in the private sector, blue collars, males aged 15-64 years, extracted from the Work History Italian Panel-Healt archive, which combines data about firms and employee from the National Social Security Institute (Inps) and occupational injuries data from the Italian National Institute for Insurance against Accidents at Work (Inail)., Main Outcome Measures: annual injuries rates for the period 2001-2012 classified according to three severity definitions: • serious injuries according to the prognosis (IGP); • serious Injuries according to the type of lesion (IGL); • minor injuries. Time trends and their changes during the economic crisis (2008-2013) were analysed through negative binomial regression models, stratified by country of origin, macroarea of work, firm size, and economic activity., Results: IGP rates decreased more than IGL and minor injuries rates during the economic crisis, highlighting their greater association with the economic cycle. Negatives and significant trend changes were observed in some subgroups: in manufacturing, among workers from high developed countries and Moroccans, in the Northern and Central macroareas of Italy, and in larger firms., Conclusions: variations in injuries rates were not so much influenced by the underreporting of injuries as by the changes in the working conditions following the economic crisis. To accurately monitor the injuries time trends, it is recommended to report at the same time at least one indicator based on minor injuries and one based on serious injuries.

Objectives: to describe a pilot study to evaluate the impact on injury rates of Occupational health and safety (OHS) inspections conducted in the construction sites of the Novara Health Unit territory during 2005-2007., Design: study design is "treated/non treated" where: "treated" are construction companies inspected during 2005-2007 and not inspected in the periods before and after; "non treated" are construction companies never inspected during 2002-2010., Setting and Participants: two information sources have been used: Italian Workers' Compensation Authority databases and Novara Health Unit inspection database. The period of analysis is 2002-2010 divided into sub-periods: pre-inspection (2002-2004); inspection (2005-2007); post-inspection (2008-2010)., Main Outcome Measures: two injury rates, total and serious, have been calculated and the difference-in-differences (DID) method was used to assess the effectiveness., Results: passing from pre-inspection to post-inspection period, the rate of total injuries in the companies inspected decreased more than the rate of the companies not inspected (DID: -1,95; 95%CI -15,30; 11,39). No effect was shown on severe injuries (DID: -0,27; 95%CI -7,84;7,31)., Conclusion: the inspections conducted during 2005-2007 on the construction sites operating in the Novara Health Unit territory seem to have had a slight positive impact on reducing the injury rates. The procedures developed in this pilot study can be used in other Italian Health Units. Further research is needed to confirm the results and to clarify the mechanism by which the inspections were effective.

Si intende qui descrivere il sistema di sorveglianza sugli effetti sulla salute (SpoTT) dell'inquinamento ambientale nelle aree circostanti l'inceneritore di Torino. SPoTT ha 3 linee di attività: 1. monitoraggio epidemiologico degli effetti a breve termine attraverso analisi temporali e misura della correlazione tra livelli giornalieri di emissioni dell'impianto e andamento degli eventi individuati dagli archivi dei dimessi (SDO), di pronto soccorso e di mortalità; sono coinvolti coloro che nel 2013-2018 risiedevano nell'area di ricaduta delle emissioni; 2. sorveglianza epidemiologica degli effetti a lungo termine, stimando tassi standardizzati di mortalità e morbosità; a ogni soggetto è attribuito il valore stimato di esposizione cumulato nel tempo caratteristico della residenza anagrafica; le informazioni sulla salute sono reperite dagli archivi SDO, di mortalità e dai certificati di assistenza al parto; sono studiati due decenni pre-post l'avvio dell'impianto: 2003-2012 e 2013-2022; 3. monitoraggio biologico con misurazione pre-post di metalli, PCDD/F, PCB, OH-IPA; sono coinvolti 196 residenti esposti e 196 di controllo di 35-69 anni, campionati a caso dalle anagrafi comunali; sono effettuate misure di funzionalità endocrina e respiratoria, pressione arteriosa, rischio cardiovascolare; l'esposizione cumulativa sarà stimata per ciascuna persona campionata integrando l'indirizzo di residenza, il tempo di permanenza in ciascun indirizzo e i dati ricavati dai modelli di ricaduta; sarà costituita una biobanca per future indagini di laboratorio; sono coinvolti anche 20 allevatori e i lavoratori dell'impianto. Una quarta linea di attività, non descritta in questo articolo, riguarda il monitoraggio della salute dei lavoratori addetti all'impianto. SPoTT è il primo studio in Italia su inceneritori e salute che adotta un disegno di studio longitudinale di adeguata potenza sia per i residenti sia per i lavoratori. I primi risultati sono attesi nel corso del 2016.

Introduction: The knee is the most frequent location for osteosarcoma (60%). Until 30 years ago patients with osteosarcoma were treated with an amputation of the affected limb; today 85% of these cases are treated with a "Limb Salvage" procedure, through replacement of the affected bone with a mega prosthesis implant., Aim: To measure functional recovery of patients with a knee mega-prosthesis and how rehabilitation impacts on quality of life (QOL); another aim is to define rehabilitation guidelines to manage these patients in the rehabilitation pathway., Methods: A sample of outpatients with knee mega-prosthesis were selected in the follow-up orthopedic oncology surgery between march and may 2013. We measured the functional outcome using the multidimensional standardized Musculoskeletal Tumor Society scale (MSTS) that gives a score (0-5) for each of 7 items: pain, range of motion, stability, deformity, strength, functional activity, emotional acceptance., Results: The sample included 28 outpatients. The median MSTS score was 29 (min 19, max 33) equal to 83%. Only 14 patients (50%) followed a correct rehabilitation path after surgery., Discussion: 21 cases got "excellent" outcomes and 3 "good" (based on MSTS classification). In few cases (n 4) the outcome was "fairly good", related to necessity of a prosthesis surgical revision based on instability of implant (because of usage). Quadricep strength is the item that most affects the final score. There is a statistically significant correlation between high scores and patients who have recently undergone surgery. We found higher scores in patients that followed a physiotherapy program after surgery: the difference was statistically significant., Conclusions: Mega-prosthesis implants give satisfactory functional outcomes. These outcomes keep high score in time. It is recommended to follow the guidelines described in the purposed rehabilitation program.

Background: The aim of this study was to evaluate the prevalence of chronic cardiovascular diseases in the territory of a health district in Turin (Italy) to achieve better management of healthcare services according to healthcare needs., Methods: In order to assess healthcare needs, we surveyed the prevalence of five cardiovascular chronic diseases in the general population, using data from the general practitioners of one health district., Results: Eighty-six general practitioners participated in the study, collecting data regarding 87 885 attendees, for the year 2010. Among men, the following prevalence rates were estimated: 2% prior myocardial infarction, 2.4% other forms of chronic ischemic heart disease, 2% cardiac arrhythmias, 0.4% heart failure, 0.9% late effects of cerebrovascular disease. Prevalence rates were lower among women, except for dysrhythmias and heart failure, and were increasing with age. Prevalence rates were higher than those previously reported by the Italian Cardiovascular Epidemiological Observatory for northwestern regions. In addition, differences in disease distribution were observed among patients when comparing male doctors and female doctors., Conclusions: Our findings show several critical issues in primary care, suggesting the need for improving the healthcare delivery system within the health district according to local care needs.

Objective: To examine the usefulness for prevention of the National Surveillance System on occupational fatalities, which is based on the narrative description of the work accident collected by OSH inspectors and on the subsequent classification of the injury dynamics by means of a standardized model of analysis., Materials and Methods: The system ability of providing useful recommendations for prevention was evaluated on one hand by analyzing the effectiveness of inspections in preventing fatalities, on the other hand by identifying the most frequent accident mechanisms. Data analyzed consisted of investigation reports of construction fatalities occurred during 2002-2008 in the Piedmont Region, collected by surveillance system. The injury narrative description was used to assess whether the fatality would have been preventable by an inspection hypothetically conducted the day before the event; injuries were classified as probably preventable, probably not preventable, and uncertain. A standardized model of classification of injury dynamics was employed to identify mechanisms and circumstances related to the construction fatalities, and particularly those caused by falls from height., Results: Among 122 construction fatalities occurred, 25%were considered probably preventable and 60%probably not preventable. Half of the construction fatalities was caused by fall from height, most of which were caused by sudden breaking of a surface walkway, and almost 20% by fall of objects, including burial., Conclusion: The analysis of the preventability of construction fatalities in Piedmont seems partly to rebut the assumption that more inspections are necessarily associated with a reduction in fatalities. The interpretation of the injury narrative descriptions, which are implemented by OHS inspectors as part of their usual activity, through a standardized model of analysis allows to identify the breaking of surface walkways as the most important mechanism of fatality among falls from height.

Objective: To develop a method for adapting the best available cancer practice guidelines (CPGs) to the regional oncology network in Piedmont (NW of Italy, with about 4.3 million residents)., Methods: Four CPG were developed by multidisciplinary working groups, involving local opinion leaders, coordinated by the same team (including epidemiologists and health economists). The major features of these guidelines were: (a) to cover all the phases ofthe disease (from diagnosis to palliative care); (b) to satisfy common standards for evidence based guidelines; (c) to be coherent with the local health organization and resource availability. In the first three CPGs, regarding common cancers (colon-rectum, breast, lung), recommendations were graded according to the underlying level of evidence, from A to C, and treatment was organized by specialty. In the last guideline, regarding a rare condition (soft tissue sarcomas, STS), a grading system reflecting also the clinical importance of the decision was adopted and treatment recommendations were organized by clinical scenarios. In each guideline, some implementation tools, including a set of process and outcome indicators for audit monitoring, were provided., Results: The four CPGs have been published between 2001 and 2004. The number ofrecommendations ranged between 38 (STS) and 103 (colon-rectum), with some differences in the distribution by specialty and grading. The CPGs have been disseminated through the oncology network and local health coordinators have been involved in the implementation. The impact of the CPGs is being evaluated by different approaches (analyses of administrative data, sample surveys and user's interviews)., Conclusions: To adapt evidence based guidelines to a specific regional health organization is feasible and may be usefil for diseases requiring a multidisciplinary approach and continuity of care.

The authors have studied the ultrastructural modifications after one year of a homologous bone grafting stored for 8 days in nitrogen liquid at -196 degrees C. It was observed that the osteocytes showed nuclear and cytoplasmic degenerations; the empty lacunae showed precipitates of mineralized matrix. In comparison with a bone autografting a homologous bone grafting lost the ability of bone synthesis.