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Background: the Covid-19 pandemic has provoked a huge of clinical and epidemiological research initiatives, especially in the most involved countries. However, this very large effort was characterized by several methodological weaknesses, both in the field of discovering effective treatments (with too many small and uncontrolled trials) and in the field of identifying preventable risks and prognostic factors (with too few large, representative and well-designed cohorts or case-control studies)., Objectives: in response to the fragmented and uncoordinated research production on Covid-19, the   italian Association of Epidemiology (AIE) stimulated the formation of a working group (WG) with the aims of identifying the most important gaps in knowledge and to propose a structured research agenda of clinical and epidemiological studies considered at high priority on Covid-19, including recommendations on the preferable methodology., Methods: the WG was composed by 25 subjects, mainly epidemiologists, statisticians, and other experts in specific fields, who have voluntarily agreed to the proposal. The agreement on a list of main research questions and on the structure of the specific documents to be produced were defined through few meetings and cycles of document exchanges., Results: twelve main research questions on Covid-19 were identified, covering aetiology, prognosis, interventions, follow-up and impact on general and specific populations (children, pregnant women). For each of them, a two-page form was developed, structured in: background, main topics, methods (with recommendations on preferred study design and warnings for bias prevention) and an essential bibliography., Conclusions: this research agenda represents an initial contribution to direct clinical and epidemiological research efforts on high priority topics with a focus on methodological aspects. Further development and refinements of this agenda by Public Health Authorities are encouraged.

Objectives: to evaluate the prevalence of acid burns among asylum seekers hosted in an initial reception centre and to evaluate if the prevalence is reduced after the introduction of the European Union (EU) regulation No. 29 (14th September 2016) that indirectly reduced the permanence time of the subjects on board of boats., Design: cross-sectional study., Setting and Participants: 10,627 asylum seekers hosted in the centre for initial reception of Piedmont and Valle d'Aosta Regions (Northern Italy) between June 2016 and May 2017., Main Outcome Measures: frequencies of health problems and prevalence of second and third grade acid burns identified on arrival., Results: among the asylum seekers coming to the centre, about 25% suffered at least from a mild disease, mainly cutaneous, respiratory, or digestive; 69 acid burns were identified (prevalence: 6.7‰, 95%CI 5.2-8.3), mainly located in the lower limbs and in the glutes. Median time between disembarkation and treatment is 2 days. Prevalence is significantly higher in women compared to men and a not-significant 20% reduction was observed comparing the situation before and after the introduction of the EU regulation No. 29., Conclusion: an assessment of the health status of asylum seekers that takes into account more than the identification of the rare life-threatening or infective diseases allows to take prompt action and to invest economical resources in the fields where they are more useful. This would facilitate a good health care for asylum seekers, that is the basis of an efficient functioning of services for integration.

Objectives: to investigate hypothesised relationships between diet and cancer by assessing diet as a whole, in the Italian cohort EPIC., Design: multicentric prospective study., Setting and Participants: 47,749 volunteers were recruited between 1993 and 1998 in the centres of Varese and Turin (Northern Italy), Florence (Central Italy), Naples and Ragusa (Southern Italy). Information on diet and lifestyle were collected through validated questionnaires. Anthropometric measurements were taken and biological samples collected using standardised protocols., Main Outcome Measures: follow-up was carried out by accessing regional cancer and mortality registries, hospital discharge records, and by telephone inquiries (only for Naples). After a median follow-up of 11 years, 879 incident cases of breast cancer, 421 cases of colorectal cancer, and 152 deaths were identified. Multivariate Cox regression models were used to estimate risks in relation to dietary characteristics., Results: the "Olive oil & Salad" dietary pattern, characterised by high consumption of raw vegetables and olive oil, was associated with a lower risk of overall mortality in the elderly. Adherence to a Mediterranean diet rich in vegetables and fruit was associated with reduced risk of colon cancer. Consumption of high-glycemic carbohydrates was associated with higher incidence of breast cancer and colorectal cancer. Reduced risk of colon cancer was also found in regular consumers of yoghurt., Conclusions: the accuracy and comprehensiveness of EPIC-Italy data made it possible to investigate both individual dietary components and dietary habits as a whole, to thereby provide Italians with dietary and lifestyle advice that will help them to remain healthy.

Objectives: to investigate the impact of socioeconomic status on dietary habits in Italy., Design: large Italian multicentric prospective cohort study., Setting and Participants: more than 45,000 subjects recruited between 1993 and 1998 in five Italian centres (Turin, Varese, Florence, Naples, and Ragusa). Dietary habits, educational level, and other characteristics were collected at baseline using standardised questionnaires., Main Outcome Measures: dietary habits collected for the EPIC study, grouped by food type and summarised by a Mediterranean dietary index., Results: we observed differences in dietary habits and in lifestyle habits by tertile of educational level. Principally, we noticed a positive association between higher education and healthy dietary habits (reduction in intake of processed meat, bread and rice, sweet drinks; increase in intake of fruit and vegetables, yoghurt, fish, olive oil, and tea)., Conclusion: a relationship between educational level and dietary habits is confirmed also in Italy, even if differences due to gender and residence area are present. This study shows an important role of dietary habits in health inequalities of the population with lower socioeconomic status.

Objective: To determine whether the guidelines (LGR) prepared in Piedmont for the treatment of colorectal and breast cancer reached the targetphysician population and how they were been perceived by physicians., Design: We invited all Piedmont hospital units that had treated at least 5 cases of colon-rectal or breast cancer in 2002 to participate to the survey. Physicians had to fill a short mail questionnaire. The questionnaire had three sections: distribution and implementation, quality of the instrument, utility and applicability., Results: Replies were 65% (53/82) and 73% (105/143) respectively for the for colon rectal cancer guidelines (LGR-CR) and for breast cancer guidelines (LGR-M)). Among responders, 6% and 9% units ignored the existence of the LGR-CR and LGR-M respectively. More than 50% responders participated in the LGR presentation meetings and/or working groups for the local implementation of LGR. Overall the units judged the LGR quality positively. The LGR utility was judged positively for LGR-CR but opinions were heterogeneous for LGR-M. The LGR-M were judged unable to improve the doctor-patient relationship--or the continuity of care., Conclusion: The physicians who replied to the questionnaires had received the LGRs and are familiar with them. Furthermore they had a positive attitude towards the instrument. The LGR-CR seems to be better accepted than LGR-M, for which some resistance was found among gynaecologists and radiotherapists. However, very few responders described how they formally implemented the instrument in their clinical practice. Absence of LGR promotion activities (such as working groups) and low patient volume were relevant factors in limiting local implementation.

Background: Essential Thrombocythemia (ET) is a chronic myeloproliferative disorder characterized by a long median survival, even though serious complications such as acute hemorrhagic or thrombotic events are not infrequent. Very few information are available about risk factors for ET because of lack of epidemiological studies focused on this topic., Methods: We conducted a case-control study in order to analyze the possible association between ET and some occupational and environmental risk factors. A total of 93 patients enrolled in two hospitals in Turin (Italy) and 280 subjects randomly selected from the general population as controls, were included in the analysis., Results: We found an association between ET and selected occupations. OR estimates suggest a significant association between ET cooks/waiters (OR 4.96, CI 1.59-16.9) and clerks (OR 2.63, CI 1.53-4.51) and a non significant association between ET and hairdressers (OR 5.10, CI 0.82-31.4), nurses (OR 3.75, CI 0.80-19.4), farmers (OR 1.74, CI 0.84-3.56), electricians (OR 1.42, CI 0.48-3.78), and photographers (OR infinity). Data did not suggest any strong association between environmental risk factors and ET., Conclusions: Selected occupations seem to be associated to ET. The association of ET with occupations as hairdressers, farmers and electricians could be attributable to known risk factors for other hematolymphopoietic malignancies such as hair dye, pesticides and magnetic fields. The association with other occupations is more difficult to explain, but all the results we presented are consistent with data from previous studies on onco-hematological diseases.