Search

In many European countries requirements for retirement have been tightened, causing an increase in work participation of older workers, in spite their potentially poorer health may limit their work ability. This study aimed at assessing the diffusion of health problems and exposure to unfavorable working conditions among ageing workers in two Italian surveys, as well as comparing them with those observed in the same surveys conducted before the 2011 Italian pension reform tightening the normal retirement age. The 2013 National Health Survey (NHS) and Labour Force Survey (LFS) were employed to assess the prevalence of poor perceived health, health conditions and functional limitations, and of exposure to physical, psychosocial and organization factors at work, among 60–64 years workers. Poisson regression models were used to estimate Prevalence Ratios of health outcomes and unfavorable working conditions in the two surveys, compared to data from the 2005 (NHS) and 2007 (LFS) corresponding surveys, respectively. Among both men and women, approximately one quarter had at least one physical disorder or functional limitations and 15% poor mental health. Exposure to different ergonomic factors (15–30%) and working during unsocial hours (19%) were particularly diffused. A significant increase in the prevalence of functional limitations and of working at night or during unsocial hours was found in 2013, compared to corresponding data from 2005 and 2007, respectively. Our results indicate that exposure to ergonomic and organizational hazards should be reduced among ageing workers, to avoid decreased work ability, health damage or early exit from the labour market.

Aims. Evaluation of (hc knowledge and behavioral risks relatcd lo sexually transmiltcd infections (STIs) among the student population of the degree course in nursing at the University of Palermo. Materials and Methods. An anonymous online a survey was provided to students that investigate to socio-demographic information. sexual habits and the level of knowledge of the STIs. Multivariable logistic regression was performed. considering it as a dependent variable "Do you permanently have unprotected sex (without a condom)? Yes", in order to evaluate the role of the variables of the questionnaire. Results are expressed as adjusted Odds Ratio (aOR). Results. The sample size consists of 405. The average age of the sample is 21.65 years (standard deviation±3.24). The analysis shows that the risk of having permanently unprotected sex (without condom) is significantly associatcd with the following variables: "Are you engaged or single? Engagcd" (aOR 3.24,95% CI 1.66 - 6.33); "Sexual orientation. Homosexual or Bisexual (aOR4.45, 95% CI 1.30-15.29); "Have you occasionally had unprotected sex (without a condom)? Yes" (aOR 5.09, 95% CI 2.69 - 9.62); "How would you define your knowledge of sexually transmitted discases? Good" (aOR 2.07, 95% CI 1.05 -4.08); "How would you define your knowledge about contraceptive methods? Good" (aOR 2.51, 95% CI 1.23 - 5.15); "Have you or have you ever had a sexually transmitted discase? Yes (aOR 4.43,95% CI 1.71 - 11.53); "Do you know that men can also undergo HPV vaccination? Yes" (aOR 2.57,95% CI 1.03 -6.40); "Age. As the unit inercase" (aOR 1.14,95% CI 1.02- 1.26). Conclusions. These results highlight the importance of involving university students in programs aimed at improving the knowledge in terms of STIs and inercase of Sexual and reproductive health. Further. because STIs prevention is based mainly on human behavior. tailored intervention is needed especially because behavior change remains a complex challenge.

Background: Violence in the workplace is now universally recognized as a significant global public health issue and is one of the most serious issues affecting the healthcare sector. Objectives: To assess the prevalence of workplace violence. Methods: We performed a multicenter cross-sectional study using an anonymous questionnaire submitted to doctors from Northern Italy. The survey investigates socio-demographic information, the number of years of work in the health sector and the physical and verbal aggressions that occurred in the workplace in the last 12 months. Results: The sample consists of 4545 healthcare workers, of whom 2603 (57.27%) are females. The mean age of the sample is 49.79 years (SD ± 12.63). The risk of being victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (aOR 2.09, 95% CI 1.51-2.88), work in the public sector (aOR 2.57, 95% CI 1.72-3.85), being victim of verbal aggression at work in the last 12 months (aOR 22.52, 95% CI 10.97-46.20), work in the operational units of the Medical area (aOR 2.36, 95% CI 1.33-4.21) and the Territorial area (aOR 1.97, 95% CI 1.04-3.74). Discussion: The prevalence of violent behaviour is difficult to assess, because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is necessary to develop effective control strategies at individual, hospital and national levels.

Background and aim: The urgency of having rapidly safe and efficient COVID-19 vaccines called for the need to shorten trial phases, reduce sample sizes, and speed-up the approval process by the regulatory Agencies. In light of this, monitoring adverse effects (AEFI) (both immediate and at medium-long term) become of great importance. Aim of this cross-sectional study was to explore the associations between several factors and risk of immediate AEFI. Methods: Data come from the electronic dataset developed ad hoc to record demographic data, anamnesis and data related to immunization, set-up in the mass vaccination site in Novegro (Milan). Novegro mass vaccination site was one of the mass vaccinations sites with the highest flow in Lombardy Region, with a maximum capacity of 5,000 vaccinations/day. The center opened in April 2021 and closed the 1st of August 2021. A multivariable logistic regression model was used. Odds ratios adjusted (aOR) for age and sex are presented. Statistical significance was set at p

Background Retirement is a life-course transition likely to affect, through different mechanisms, behavioural risk factors’ patterns and, ultimately, health outcomes. We assessed the impact of transitioning to retirement on lifestyle habits and perceived health status in a nationwide cohort of Italian adults. Methods We analysed data from a large cohort of Italian adults aged 55–70, derived from linking six waves of the Participation, Labour, Unemployment Survey (PLUS), a national survey representative of the Italian workforce population, conducted between 2010 and 2018. We estimated relative-risk ratios (RRR) of transition to retirement and their corresponding 95% confidence intervals (CIs) for selected behavioural risk factors and health outcomes using multivariable logistic regression models. We used propensity score matching (PSM) to account for potential confounders. Results We included 5169 subjects in the study population, of which 1653 retired between 2010 and 2018 (exposed, 32%). Transition to retirement was associated with a 36% increased probability of practising sports (RRR 1.36, 95% CI 1.12–1.64). No statistically significant changes were reported for smoking habit (current smoker RRR: 1.18, 95% CI 0.94–1.46) and BMI (overweight/obese RRR: 0.96, 95% CI 0.81–1.15). Overall, retiring was associated with improved self-rated health status (RRR 1.26, 95% CI 1.02–1.58). Conclusion Individual data-linkage of multiple waves of the PLUS can offer great insight to inform healthy ageing policies in Italy and Europe. Transition to retirement has an independent effect on perceived health status, physical activity and selected behavioural risk factors. It should be identified as a target moment for preventive interventions, with particular reference to primary prevention so as to promote health and wellbeing in older ages.

During the COVID-19 pandemic, many countries adopted restrictive measures to mitigate infection spread, which might have influenced people's lifestyle and dietary habits. We conducted a systematic review to evaluate the impact of national lockdowns on adherence to the Mediterranean Diet (MD).Studies were identified searching Medline, Embase, Web of Science, and the Cochrane Library. Studies published until 4th May 2021 were included. We only considered studies reporting original data from quantitative analysis and assessing changes in adherence to the MD, using validated dietary scores, or in consumption of MD food items. Data extraction, pooling, and quality appraisal of included studies were conducted following the PRISMA guidelines.Forty-two studies were retrieved. After screening, 12 studies met inclusion criteria and were included in the review, of which 4 (33%) were longitudinal studies. Six (85.7%) of the seven studies that measured changes in MD adherence before-during lockdown reported an increase (rate of change of high-adherence to MD ranged between +3.3% and +21.9%). Evidence indicates that consumption of MD food items increased during lockdown but is heterogeneous in study design, quality, and findings.Our results suggest adherence to the MD during lockdown might have increased in some settings, while the determinants of such a trend are to be further explored. We raise awareness of the need to research further the impacts and long-term consequences of COVID-19 containment measures on dietary and lifestyle habits.

Introduction. The role of vaccinations is widely acknowledged. However, over the last decades, an alarming reduction in immunization coverage and a rising number of reported cases of vaccine-preventable diseases have been recorded. This multicentre cross-sectional study aimed at examining whether there is an association between self-reported vaccination knowledge and the immunization behaviour of Health Sciences students. Methods. A cross-sectional study was performed, using a validated questionnaire. A multivariate logistic regression with stepwise backward selection process with a univariate p-value

We analyzed the spread of the COVID-19 epidemic in 6 metropolitan regions with similar demographic characteristics, daytime commuting population and business activities: the New York metropolitan area, the Île-de-France region, the Greater London county, Bruxelles-Capital, the Community of Madrid and the Lombardy region. The highest mortality rates 30-days after the onset of the epidemic were recorded in New York (81.2 x 100,000) and Madrid (77.1 x 100,000). Lombardy mortality rate is below average (41.4 per 100,000), and it is the only situation in which the capital of the region (Milan) has not been heavily impacted by the epidemic wave. Our study analyzed the role played by containment measures and the positive contribution offered by the hospital care system. (www.actabiomedica.it).

Not required.

We analyzed the spread of the COVID-19 epidemic in 9 metropolitan regions of the world with similar socio-demographic characteristics, daytime commuting population and business activities: the New York State, Bruxelles-Capital, the Community of Madrid, Catalonia, the Île-de-France Region, the Greater London county, Stockholms län, Hovedstaden (Copenhagen) and the Lombardy Region. The Lombardy region reported the highest COVID-19 crude mortality rate (141.0 x 100,000) 70-days after the onset of the epidemic, followed by the Community of Madrid (132.8 x 100,000) New York State (120.7 x 100,000). The large variation in COVID-19 mortality and case-fatality rates for COVID-19 in different age strata suggested a more accurate analysis and interpretation of the epidemic dynamics after standardization of the rates by age. The share of elder populations (>70 years) over total population varies widely in the considered study settings, ranging from 6.9% in Catalonia to 17.0% in Lombardy. When taking age distribution into consideration the highest standardized mortality rate was observed in the State of New York (257.9 x 100,000); with figures in most of the European regions concentrated between 123.3 x 100,000 in Greater London and 177.7 x 100,000 in Bruxelles-Capital, lower in French and Danish regions. We also report and critical appraise, when available, COVID-19 mortality figures in capital cities, nursing homes, as well as excess mortality at country level. Our data raise awareness on the need for a more in-depth epidemiological analysis of the current COVID-19 public health emergency that further explores COVID-19 mortality determinants associated with health services delivery, community-level healthcare, testing approaches and characteristics of surveillance systems, including classification of COVID-19 deaths. (www.actabiomedica.it).

Introduction. Our study aim has been to investigate if the Umbrian population follows the healthy diet recommendations; mainly we focused on the daily intake of almost 5 portions of fruit and vegetables (five-a-day). Furthermore, we analyzed the relationship between fruits and vegetables consumption and other lifestyles in order to construct the relative health profile. Materials and methods. Data were extracted from three national population-based surveillance systems, including children (OKkio alla SALUTE), adults aged 18-69 years (PASSI) and elderly people (PASSI d'Argento). Among the 18-69 year-old people, multivariable analyses were used to compare the fruits/vegetables daily consumption with socio-demographic variables and healthy lifestyles patterns. Results. Fruits/vegetables average intake was less than 5 portions/ day in all age groups, and it was significantly lower when compared to the national average. The 5 fruits/vegetables daily portions consumption is more frequent with increasing age, higher education and among women. Moreover among the 18-69 year-old people, five-a-day was significantly associated with no economic difficulties, normal weight, not being sedentary, not being smoker, not alcohol drinking. Conclusions. In Umbria region the 5 portions/ day consumption was largely below the guidelines. Moreover, due to the associations, it could be used as a good trace of healthy lifestyles.

Background and aim: The low measles vaccination coverage contributes to the re-emerging of measles in Italy. This study aimed to estimate the measles burden, expressed in Disability Adjusted Life Years (DALYs), in Umbria, for the period 2013-2018. Methods: Data on measles cases in Umbria were obtained from the MoRoNet. While data related to the resident population, were obtained from the website of the National Institute of Statistics. The estimated DALYs was calculated using the Burden of Communicable Diseases in Europe toolkit. The results are expressed in DALYs per year, per case and per 100,000 subjects, for acute illness and for sequelae. Results: The estimated incidence in mean for the entire period was 52.50 cases per year. Resulting in an average loss of 3.10 DALYs per year. Conclusions: The data obtained from this analysis provide important information on the impact of measles in the Umbria region, and offer useful data to the Health Authorities that can be used to reduce measles incidence in the region.

Vaccination coverage rates in healthcare workers in Italy are among the lowest in Europe, and only 10-15% of hospital staff members are immunized against seasonal influenza. The goal of this study was to analyze the attitude and awareness factors of influenza vaccination compliance among Italian future healthcare professionals. A multi-center cross-sectional study was performed using an online, self-reported and anonymous questionnaire, given to students attending different Healthcare degree programs in 14 Italian Universities. A total of 3,123 questionnaires were collected. More than 90% of students >23 years old were not vaccinated against seasonal influenza during the past years. Students vaccinated over the previous seasons, those that were usually recommended influenza vaccination based on their clinical evaluation or in accordance with the ministerial guidelines, and those that were recommended vaccination by other healthcare workers in the past years, demonstrated a greater acceptance of influenza vaccination. Campaigns promoting influenza vaccination among healthcare workers should consider students attending healthcare courses as a priority group, not only for their training activities in healthcare facilities, but also for their future and potential active role in the healthcare system.

Introduzione. Un tempo "barboni", oggi senzatetto, il loro numero sta aumentando considerevolmente negli ultimi anni. Molti di loro soffrono di malattie croniche, problemi di salute mentale, dipendenze e necessitano di cure mediche complesse. Il loro stato di salute è spesso esacerbato per maggiori difficoltà nell'accesso alle cure primarie rispetto alla popolazione generale. Materiali e Metodi. È stato distribuito un questionario autosomministrato al fine di valutare le condizioni di salute dei senzatetto che vivono a Palermo. È stato utilizzato un modello di regressione logistica multivariata calcolando gli Odds Ratios aggiustati (aOR). Risultati. Il campione è costituito da 52 senzatetto, di cui 35 (67,3%) maschi. La classe di età più rappresentativa (55,8%) ha un'età inferiore a 50 anni e l'88,5% è italiano. L'analisi ha mostrato che il sesso femminile è significativamente associato a: "non svolgere attività fisica regolare" (aOR 4.14, IC 95% 1,20 - 14,32, p=0,025), ad "avere malattie croniche" (aOR 3,52, IC 95% 1,02 - 12,11, p=0,046) e "ad assumere farmaci" (aOR 3,95, IC 95% 1,14 - 13,64, p=0,030). Conclusioni. La rilevanza e la complessità della situazione sociale dei senzatetto attira l'attenzione su questo fenomeno destinato ad avere un forte impatto sulle politiche e sui servizi sanitari. Questa fragile popolazione è esposta a malattie che sono in gran parte prevenibili o curabili attraverso un ampio e precoce accesso alle cure con conseguente riduzione del peggioramento degli esiti clinici e dei relativi costi sociali. Introduction. In Italy, as in the rest of the world, the number of homeless people is increasing considerably. Many of them suffer from chronic conditions, mental health problems and addiction to alcohol, drugs or smoking, and need complex medical care. Their health status is often exacerbated by greater difficulty in accessing primary care. The aim of the present study was to assess health conditions of homeless people living in Palermo, Southern Italy, and to find ways to limit the spread of common infectious diseases that can be prevented by vaccination. Materials and Methods. A self-administered questionnaire was distributed. The questionnaire was structured into two parts including an introduction with socio-demographic information, and a second part investigating health status, chronic diseases and vaccinations. A multivariable logistic regression model was used and adjusted Odds Ratios (aOR) are presented. Results. The sample consisted of 52 homeless, 35 (67.3%) of whom were male and the most represented age class (55.8%) was < 50 years of age. The average age of the sample was 49.6 years (SD ± 15.2) and 88.5% were born in Italy. A multivariable logistic regression model based on 52 observations was used. The analysis showed that the female gender was significantly associated with: not performing regular physical activity (aOR 4.14, 95% C.I. 1.20 - 14.32, p = 0.025), suffering from chronic diseases (aOR 3.52, 95% C.I. 1.02 - 12.11, p = 0.046) and taking medicines (aOR 3.95, 95% C.I. 1.14 - 13.64, p = 0.030). Conclusions. This particularly fragile population is exposed to diseases that are largely preventable or curable through a wider and more early access to care by local health facilities with a subsequent reduction in the worsening of clinical outcomes and related social costs.

Introduction: Breast cancer is the most common cancer in women worldwide, for which the survival rate is increasing over time. Growing evidence is showing that the effect of lifestyle could have the same weight of the effect of the usual clinical-pathological risk factors on survival rate. The DianaWeb study responds to the pressing request of patients diagnosed with breast cancer to know the most advanced point of scientific research on the prevention of recurrences, to have a virtual space to meet, where to receive advice and practical information for the daily management the lifestyle change. DianaWeb is a community-based participatory research, dedicated to breast cancer patients, aimed to monitor lifestyle, provide them tips to encourage sustainable lifestyle changes, and to analyze clinical outcomes. In order to achieve these aims, DianaWeb uses a specific interactive website (http://www.dianaweb.org/). Methods: The web architecture has been designed essential and light, with a rigorous implantation that brings the figure of the woman to the center. In order to humanized the project the acronym used to identify the study was Diana (Diet and Androgens), a classical female name, who was illustrated as a female avatar, aimed to symbolize all women. The graphical interface was developed using seven pastel tones colors, which become a fundamental elements of the layout, such as frame, navigation menu, and separation interspaces. Results: The project started in 2015, and in 4 days the web site was visited by more than 1000 people. A total of 2823 persons enrolled in the study, but 2182 did not send the full documentations, 61 persons abandoned the study, 641 timely answered to the questionnaires. Conclusions: The high number of participants' interaction within the web page, confirmed the high usability of the web page and the great interest of patients. Prevention of breast cancer recurrences with low cost technologies, easily available to everybody, is a priority for both public health and public finances

Aims Retirement is a major life transition that may improve or worsen mental health, including depression. Existing studies provide contradictory results. We conducted a systematic review with meta-analysis to quantitatively pool available evidence on the association of retirement and depressive symptoms. Methods We applied PRISMA guidelines to conduct a systematic review and meta-analysis to retrieve, quantitatively pool and critically evaluate the association between retirement and both incident and prevalent depression and to understand better the potential role of individual and contextual-level determinants. Relevant original studies were identified by searching PubMed, Embase, PsycINFO and the Cochrane Library, through 4 March 2021. Subgroup and sensitivity meta-analyses were conducted by gender, study design (longitudinal v. cross-sectional studies), study quality score (QS) and considering studies using validated scales to diagnose depression. Heterogeneity between studies was evaluated with I2 statistics. Results Forty-one original studies met our a priori defined inclusion criteria. Meta-analysis on more than half a million subjects (n = 557 111) from 60 datasets suggested a protective effect of retirement on the risk of depression [effect size (ES) = 0.83, 95% confidence interval (CI) = 0.74–0.93], although with high statistical heterogeneity between risk estimates (χ2 = 895.19, df = 59, I2 = 93.41%, p-value < 0.0001). Funnel plot asymmetry and trim and fill method suggested a minor potential publication bias. Results were consistent, confirm their robustness and suggest stronger protective effects when progressively restricting the included studies based on quality criteria: (i) studies with the highest QS [55 datasets, 407 086 subjects, ES = 0.81, 95% CI = 0.71–0.91], (ii) studies with a high QS and using validated assessment tools to diagnose depression (44 datasets, 239 453 subjects, ES = 0.76, 95% CI = 0.65–0.88) and (iii) studies of high quality, using a validated tool and with a longitudinal design (24 datasets, 162 004 subjects, ES = 0.76, 95% CI = 0.64–0.90). We observed a progressive reduction in funnel plot asymmetry. About gender, no statistically significant difference was found (females ES = 0.79, 95% CI = 0.61–1.02 v. men ES = 0.87, 95% CI = 0.68–1.11). Conclusions Pooled data suggested that retirement reduces by nearly 20% the risk of depression; such estimates got stronger when limiting the analysis to longitudinal and high-quality studies, even if results are affected by high heterogeneity. As retirement seems to have an independent and protective effect on mental health and depressive symptoms, greater flexibility in retirement timing should be granted to older workers to reduce their mental burden and avoid the development of severe depression. Retirement may also be identified as a target moment for preventive interventions, particularly primary and secondary prevention, to promote health and wellbeing in older ages, boosting the observed impact.

Road tunnel construction workers revealed higher frequencies of cells with genotoxic damage (i.e., MN and NBUD). MN and NBUD resulted to be Poisson distributed and counts of these genotoxicity biomarkers were then analysed by Poisson regression. The frequency ratio (FR) for MN was 1.31 (95% CI: 0.84-2.04), with an increase in the exposed subjects; this finding, though indicating a higher genotoxic risk in the exposed subjects, did not reach statistical significance. On the other hand, the FR for NBUD was 3.49 (95% CI: 1.86-6.56), with a statistically significant increased risk of chromosomal damage. Even the frequencies of binucleated cells (a marker of cell proliferation) and pyknotic cells (a cell death biomarker) were significantly higher in tunnel workers.Tunnel construction workers are exposed to complex mixtures of toxic agents, some of which are known to be genotoxic. The aim of this study was to evaluate the genotoxic risk in this occupational setting by comparing tunnel workers with a control group for frequencies of nuclear aberrations in oral exfoliated cells.To evaluate the genotoxic effects of tunnel air pollutants, we conducted a cross-sectional, molecular epidemiological study (35 tunnel workers and 35 healthy controls) using the buccal micronucleus cytome assay. A questionnaire was administered to obtain information about demographic variables, lifestyle, dietary habits, anthropometric data, and occupational history. Buccal mucosa cells were collected by scraping the buccal mucosa with a small-headed toothbrush. Coded slides were examined blind by trained scorers for micronuclei (MN), nuclear buds (NBUD), and other nuclear abnormalities.Our observations provide further knowledge and understanding of the occupational hazards of tunnel workers and confirm the complexity of effects (cytotoxic and genotoxic) probably induced by fumes and dust produced in underground operations.

The aim of this work is to provide a picture about the problem of childhood obesity and its relationship with mass media and food advertising. Examining scientific literature, we described the epidemiology of obesity focusing on its increase in children and young people. In particular, it will be examined the effects of television advertising addressed to children, in order to explain how it operates and affects children's food choices. Finally, we will provide information about health promotion and prevention strategies to fight obesity both in European Union (EU) and in Italy. For the EU strategies, we considered the 'Action Plane on Childhood Obesity 2014-2020'. In the case of Italy we focused our attention primarily on SIAN (Servizio Igiene degli Alimenti e della Nutrizione) that operate through the local health authorities of the various Italian regions, to promote health. Moreover, we considered the actions that have taken place to reduce the influence of mass media and food advertising on the food habits of children.

Introduction. Influenza is an infectious disease with a high burden, for which a safe and efficacy vaccine is available. However, vaccination coverage is generally low, also among Health Care Workers (HCW). Health Professions students are comparable to HCW in terms of workplace exposure. Aim. The study aim was to identify predictive factors of flu vaccination acceptance among Italian students of Health Professions. Methods. A cross-sectional study was performed using a validated, on-line, anonymous questionnaire. Data were analyzed performing both univariable and multivariable logistic analysis. Results. The results showed a statistically significant association between intention to vaccinate next year and: geographical distribution, considering themselves at higher risk due to their profession, having been vaccinated last year, having recommended the vaccination last year, and being willing to recommend it next year and being favorable to mandatory vaccination. In conclusion, identifying an effective vaccination strategy and including students in flu vaccination campaigns might have positive effect on vaccination acceptance.

A travel medicine clinic is the proper medical centre aimed to provide updated recommendations before any journey. The study aim was to assess the number of accesses during 2016 at the Travel Medicine Clinic of the Local Health Unit in the Umbria Region. An electronic ad hoc database was developed. Paper-based data referring to 2016 were recorded in this electronic registry, developed on Microsoft Office Access ® . In 2016, 891 subjects came in our clinic in order to get information before travelling. In our sample, 53.3% were male and the mean age was 35.33 years ± 0.58. Almost half had a higher education, and 20% were foreign. Vaccines against food- and water-borne diseases were the most frequently administered. Approximately, 74% of the attenders were suggested to do an anti-malaria prophylaxis (Mefloquine in one-half, approximately). Every traveller received a pre-travel counselling. Performance activity of our clinic and the adherence to preventive protocols in case of international travels, have been assessed.

Background. Immunization Information Systems, or Immunisation registries (IRs), are essential to monitor and evaluate the accessibility, quality and outcomes of immunisation programmes both at local and national level. Study design. We conducted a cross-sectional survey in order to investigate and map the level of IRs implementation obtained by the 21 Italian Regional Health Authorities. On this basis we defined a roadmap towards implementing an Italian National IR. Methods. We designed an online questionnaire. Data were collected from July to September 2016 from all the 21 Regional Health Authorities in charge of infectious diseases control and immunization management. Results. 18/21 Italian Regions have fully implemented an IR, out of them, 11 use the same software for all Local Health Units. Two Regions have partially implemented their IRs and one Region is not yet computerised. Conclusions. The decentralization of the Italian Health System is reflected also on the IRs characteristics and functionalities in terms of fragmented implementation of IRs and diversity in the software systems and data flows in place. Future efforts should not only aim not only to clarify the functionalities of Regional IRs, but should also aim to define how aggregation of data at national level can be optimised.

Alcohol consumption has a substantial importance in the causation of cancer of the oral cavity, pharynx, liver, colon, rectum; and in women, breast. It is also recognized as an independent risk factor for esophageal squamous cell carcinoma (ESCC). Nevertheless, the association with esophagus adenocarcinoma (EAC) is still not completely defined; as well as the association between alcohol intake and Barrett's Esophagus (BE). The aim of this mini-review is to summarize recent findings from population studies focused on the association between alcohol consumption and risk of BE. The research was carried out in PubMed, filtering for studies conducted in the period 2009-2015. Our mini-review has shown no association between the consumption of alcohol and BE. Some type of alcoholic beverages has shown an inverse association. Direct public health applications of these findings are limited, considering the causal link between moderate-to-heavy alcohol consumption with increased risks of several cancers. Given the rising incidence of BE and EAC, it is important to understand the interplay of dietary and lifestyle factors that influence the development of these conditions.