Cancer screening uptake: association with individual characteristics, geographic distribution, and time trends in Italy

In Italy, organized screening programmes invite the vast majority of the population for cervical and breast cancer, and about one half of the population for colorectal cancer. Programme activity and quality are closely monitored. Nevertheless, there is a vast spontaneous activity, both public and private, for which information on service and coverage is missing. To estimate actual population coverage for the three types of screening the extent of spontaneous screening needs to be known

MANUAL WORKERS ARE MORE LIKELY TO ADOPT UNHEALTHY HABITS

Background. In Italy, organized screening programmes invite the vast majority of the population for cervical and breast cancer, and about one half of the population for colorectal cancer. Programme activity and quality are closely monitored. Nevertheless, there is a vast spontaneous activity, both public and private, for which information on service and coverage is missing. To estimate actual population coverage for the three types of screening the extent of spontaneous screening needs to be known. Methods. PASSI is a national telephone-interview surveillance system that continuously collects information about behavioural health risk factors and the diffusion of preventive health interventions. From 2010 to 2013, more than 151,000 18- to 69-year-olds were interviewed. During 2013, 136 out of 147 Italian local health authorities participated in the survey. Information about screening includes: test uptake (Pap smear, HPV, mammography, faecal occult blood test, colonoscopy), date of the last test, provider of the last test (whether paid or for free, proxy of the organized screening programme), reason for not participating in screening, and screening promotion/recommendation received. Individual information on socio-economic characteristics is available. Results. Seventy-seven percent of the 25-64 year-old women interviewed said they had undergone a Pap smear or HPV test in the three years before the interview, 40% within the screening programme, 37% spontaneously and paying. Seventy percent of the 50-69 year-old women interviewed reported having had a mammography in the two years before the interview, 51% within the screening programme, 19% spontaneously and paying. Thirty-eight percent of the 50-69 year olds interviewed reported having undergone colorectal screening in the two years before the interview, 31% within the screening programme, 7% spontaneously and paying. All three screening programmes showed a decreasing North-South trend in coverage. From 2010 to 2013, coverage increased for all types of screening; the trend was stronger in the South; the increase was mostly due to the tests performed within the organized programmes. People with low education, economic problems, and immigrants from high migration pressure countries had lower coverage levels. In regions with well-implemented organized screening programmes, test coverage was higher and differences for socio-economic factors were smaller than in regions with incomplete programme activation

Self-reported influenza vaccination uptake in people with chronic diseases: data from Progressi delle Aziende Sanitarie per la Salute in Italia (PASSI)

Background Influenza is an important public health problem, with potential severe consequences among people with chronic diseases. The aim of this study was to obtain reliable measures of seasonal influenza vaccine uptake in this population, otherwise not available in Italy. Methods Progressi delle Aziende Sanitarie per la Salute in Italia (PASSI) is a nationwide surveillance system of health-related behaviours and acceptance of preventive interventions (including influenza immunisation) offered by the Italian National Health Service. Data are collected with telephone interviews at local health unit level for supporting local activities. The survey sample is randomly selected from local health unit lists of adult residents. The trend of annual vaccine coverage since 2008 was estimated for people aged 18–64 years who reported having at least one chronic disease. To obtain a sufficient sample size in subgroups, we analysed the characteristics of vaccinated people in the 2010–13 cumulative dataset. Univariate, multivariate, and logistic regression analyses were undertaken. Findings In 2008–13, 13 659 individuals with at least one chronic disease were interviewed. Vaccination coverage fell significantly from 29·7% (95% CI 27·2–32·4) in 2007–08 to 19·9% (18·0–22·1) in 2012–13. During 2010–13, the overall proportion of vaccinated people with a chronic disease was 25·6% (24·5–26·7). Vaccine coverage of people with diabetes (34·3%, 31·7–36·9) or cardiovascular diseases (31·8%, 29·6–34·2) was greater than that of people affected by renal failure, respiratory diseases, tumours, or chronic liver diseases (26·5% [22·5–30·7], 24·9% [23·2–26·7], 22·2% [20·0–24·6], and 20·6% [17·5–24·6], respectively). Vaccination coverage increased with age (from 13·1% [11·0–15·5] in the 18–34 year age group to 33·4% [31·9–35·1] in people aged 50–64 years); it was higher among people with a low educational level than among those with a high educational level, higher in those having economic difficulties than in those with no economic difficulties, and higher among Italian citizens than among non-citizens. Interpretation In the past few years, prevalence of influenza vaccination in Italian adults with at least one chronic disease was well below the Ministry of Health's goal (75% minimum) and showed a downward trend. A major reason of this evolution is probably the changing public perception of the benefits and risks of vaccines. PASSI is a source of useful data not otherwise available for public health intervention. Funding Italian Ministry of Health

Self-reported influenza vaccination uptake in people with chronic diseases: data from Progressi delle Aziende Sanitarie per la Salute in Italia (PASSI)

Background Influenza is an important public health problem, with potential severe consequences among people with chronic diseases. The aim of this study was to obtain reliable measures of seasonal influenza vaccine uptake in this population, otherwise not available in Italy. Methods Progressi delle Aziende Sanitarie per la Salute in Italia (PASSI) is a nationwide surveillance system of health-related behaviours and acceptance of preventive interventions (including influenza immunisation) offered by the Italian National Health Service. Data are collected with telephone interviews at local health unit level for supporting local activities. The survey sample is randomly selected from local health unit lists of adult residents. The trend of annual vaccine coverage since 2008 was estimated for people aged 18\u201364 years who reported having at least one chronic disease. To obtain a sufficient sample size in subgroups, we analysed the characteristics of vaccinated people in the 2010\u201313 cumulative dataset. Univariate, multivariate, and logistic regression analyses were undertaken. Findings In 2008\u201313, 13\u2008659 individuals with at least one chronic disease were interviewed. Vaccination coverage fell significantly from 29\ub77% (95% CI 27\ub72\u201332\ub74) in 2007\u201308 to 19\ub79% (18\ub70\u201322\ub71) in 2012\u201313. During 2010\u201313, the overall proportion of vaccinated people with a chronic disease was 25\ub76% (24\ub75\u201326\ub77). Vaccine coverage of people with diabetes (34\ub73%, 31\ub77\u201336\ub79) or cardiovascular diseases (31\ub78%, 29\ub76\u201334\ub72) was greater than that of people affected by renal failure, respiratory diseases, tumours, or chronic liver diseases (26\ub75% [22\ub75\u201330\ub77], 24\ub79% [23\ub72\u201326\ub77], 22\ub72% [20\ub70\u201324\ub76], and 20\ub76% [17\ub75\u201324\ub76], respectively). Vaccination coverage increased with age (from 13\ub71% [11\ub70\u201315\ub75] in the 18\u201334 year age group to 33\ub74% [31\ub79\u201335\ub71] in people aged 50\u201364 years); it was higher among people with a low educational level than among those with a high educational level, higher in those having economic difficulties than in those with no economic difficulties, and higher among Italian citizens than among non-citizens. Interpretation In the past few years, prevalence of influenza vaccination in Italian adults with at least one chronic disease was well below the Ministry of Health's goal (75% minimum) and showed a downward trend. A major reason of this evolution is probably the changing public perception of the benefits and risks of vaccines. PASSI is a source of useful data not otherwise available for public health intervention. Funding Italian Ministry of Health

Shaping the Interpreters of the Future and of Today: Preliminary results of the SHIFT Project

As a result of globalization and of the continuous developments of ICTs, spoken language travels through new devices and media. Similar trends can be observed in the field of spoken-language interpreting where, alongside traditional onsite interpreting, remote interpreting is spreading through the use of telephone and videoconferencing. Therefore, the need arises for updating existing theoretical models of oral discourse, interpreter-mediated communication and approaches to interpreter education. Against this backdrop, the SHIFT in Orality - Shaping the Interpreters of the Future and of Today Project was launched by a Consortium including four Higher Education Institutions providing interpreter training and two remote-interpreting service providers with the aim to develop a comprehensive pedagogical solution for the training of remote dialogue interpreters at HEI level and for Lifelong Learning. This paper presents the main features of the SHIFT Project, a Spanish-English-Italian 3-year Erasmus+ project, and some preliminary results, focusing on turn management in telephone interpreting between Spanish-Italian in service/tourism and English-Spanish in legal/police settings

Epidemiologia e conflitti armati. Riflessioni dopo due anni di attivit\ue0 del gruppo di lavoro AIE-Guerra

I conflitti armati continuano a rappresentare una seria mi- naccia alla salute pubblica e all\u2019integrit\ue0 ambientale nel no- stro pianeta; si stima che nel secolo appena trascorso circa 191 milioni di persone siano morte per gli effetti diretti di guer- re. Durante il periodo 1990-2001 si sono verificati 57 con- flitti armati di maggiori dimensioni in 45 luoghi diversi, nel- la maggior parte conflitti interni (frequentemente con parte- cipazione di eserciti regolari), ma anche conflitti internazio- nali come la guerra Iraq-Kuwait, la prima guerra del Golfo, i conflitti tra India-Pakistan e tra Etiopia-Eritrea, la guerra del- la Nato contro la ex-Jugoslavia. Nel solo 2002 si sono conta- ti 21 conflitti, in maggioranza guerre civili;1 nello stesso an- no \ue8 iniziata la guerra in Afghanistan e nel 2003 la seconda guerra del Golfo. Molti conflitti, in particolare quelli civili, sono poco rappresentati dal punto di vita mass-mediatico no- nostante i loro effetti devastanti. In questo contesto si \ue8 for- mato nel 2004 un gruppo di lavoro AIE coordinato da Giu- seppe Gorini del CSPO di Firenze. Gli obiettivi iniziali del gruppo sono stati quelli di approfondire il tema delle conse- guenze sanitarie di guerra e terrorismo e di esplorare quale ruolo specifico e quali possibili attivit\ue0 di prevenzione po- trebbero essere svolti in questo campo da chi si occupa di epi- demiologia e di sanit\ue0 pubblica in Italia