Three foundations

Europe faces a historic opportunity. We need to reimagine European unity as a collective endeavour, as the only way in which we can turn threats to our way of life into the possibility to create a better life for all. This report focuses on three core areas where EU-wide political ambition and investment are truly necessary: Rapid technological change amid increasing global competition, with digital technologies set to have dramatic impacts across all sectors of the economy. Europe needs to become more competitive through innovation and the fast absorption of new technologies if it is to reap the benefits of this wave of change. Increasing breakdown of the global climate and other ecosystems due to our economic system, with action on mitigation – and to adapt to already inevitable changes – now incredibly urgent. In part, this is because of the time lags built into natural systems. In part, it is because of the unavoidable path-dependency and pace of our own response. Growing threats to social cohesion and social sustainability from multiple trends, including how we manage technological change and automation, the climate transition, and societal ageing. This is happening against a background of stalling convergence across Europe, rising income inequality over several decades, rising burdens on households and persistent inequalities of opportunity that are also a drag on economic performance. Competitiveness, sustainability and inclusion have to be addressed together, holistically. This is why this report addresses all three with a focus on the complex interlinkages between them. The vital role of far-sighted investment is a key theme that emerges from this investigation. The critical role of European-level collaboration is another. Instead of merely adapting to change, we need to be proactive through timely reform and investment that sets us on a pathway towards a society that is productive, sustainable and inclusive, by design

A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities

Background. The peak of sexually transmitted infections (STI) among adolescents/young adults suggests a low level of prevention. In order to assess whether the level of sexual health education (SHE), received by several channels, was effective at improving sexual behaviors, we conducted a survey among freshmen from four Italian universities. Methods. This observational cross-sectional study was carried out with an anonymous self-reported paper questionnaire, administered during teaching lectures to university freshmen of the northern (Padua, Bergamo, and Milan campuses) and southern (Palermo campus) parts of the country. Knowledge of STI (a linear numerical score), knowledge of STI prevention (dichotomous variable: yes vs. no) and previous STI occurrence (polytomous variable: "no"; "don't know"; "yes") were the outcomes in the statistical analysis. Results. The final number of freshmen surveyed was 4552 (97.9% response rate). The mean age of respondents was 21.4 ± 2.2 years and most of them (70.3%) were females. A total of 60% of students were in a stable romantic relationship. Only 28% respondents knew the most effective methods to prevent STI (i.e., condom and sexual abstinence), with a slightly higher prevalence of correct answers among females (31.3%) than males (25.8%). Students with history of STIs were 5.1%; they reported referring mostly to their general practitioner (GP) (38.1%) rather than discussing the problem with their partner (13.1%). At multivariable analysis, a significantly higher level of STI knowledge was observed in older students (25+ years of age), biomedical students, and those from a non-nuclear family; lower levels were found among students of the University of Palermo, and those who completed a vocational secondary school education. Those who had less knowledge about the most effective tools to prevent STIs included males, students from the University of Palermo, students registered with educational sciences, economics/political sciences, those of foreign nationality, and those whose fathers had lower educational levels. The risk of contracting a STI was significantly lower only in students not in a stable relationship (relative risk ratio, RRR = 0.67; 95% confidence interval, 95%CI = 0.48; 0.94), whereas such risk was significantly higher in students with higher STI knowledge (RRR = 1.15; 95%CI = 1.08; 1.22). Discussion and Conclusions. University freshmen investigated in this study had poor knowledge of STIs and their prevention. Unexpectedly, those with higher levels of knowledge had an increased risk of STIs. There have been no educational interventions-with good quality and long-term follow-ups-that increased the confidence that such SHE programs could have population level effects. A new high-quality study is therefore recommended to assess the effectiveness of an intervention generating behavioral changes; increasing only STI knowledge may not be sufficient

Universal newborn hearing screening in the italian region of sicily in 2018

Objectives. We have clarified the role of Universal Neonatal Hearing Screening (UNHS) for both early diagnosis and rapid treatment in order to improve the prognosis of the deaf child and reduce patient management costs. Although in Sicily UNHS has been progres-sively implemented, there is scarce data in the literature on this matter. Therefore, the main objective was to collect in the year 2018 the following data: number of newborns screened for hearing loss, number of infants “referred” to transiently evoked otoacoustic emissions (TEOAE), number of infants with pathologic auditory brainstem response (ABR) and number of infants affected by permanent hearing loss. Methods. UNHS monitoring was conducted through the collection of data through a ques-tionnaire, which was analysed evaluating the effectiveness and adherence to the screening program prepared by the Department for Health Activities and the Epidemiological Obser-vatory (DASOE). Results. In 2018, there were 40,243 newborns in Sicily. A total of 37,562 newborns were screened (93.3%). There were 1,328 “referred” infants with TEOAE (3.5%). On the 2nd lev-el, “referred” newborns examined were 1,080 of 1,328 expected (missing 248 “refer” new-borns, equal to 18.6%). The number of “referred” infants confirmed with TEOAE was 113 of 1,080, while “referred” infants confirmed with ABR were 71. On the 3rd level, 67 of 71 were infants examined: 28 infants were suffering from monolateral hearing loss (13 slight/ mild, 13 moderate, 1 severe and 1 profound) and 39 from bilateral hearing loss (1slight/ mild, 19 moderate, 13 severe and 7 profound). Excluding 7 infants from the NICU, 60 of 37,562 infants had hearing loss (1.5%). Conclusions. The monitoring of the UNHS in Sicily has allowed obtaining the data of individual centres, absent in the literature to date, to verify the effectiveness of the screening, according to JCIH criteria, to highlight some criticalities and, finally, to propose possible solutions

The role of social medicine in the COVID-19 pandemic era

OVID-19 has proved to be a social disease due to its widespread diffusion in the general population, the serious harm it causes on affected patients and its impact on the economy and social life of burdened countries. While socialization is a risk factor for the spread of the SARS-C0V-2, health protection measures such as isolation and lockdown further aggravated the “social” burden of COVID-19. Diseases with social impact require a management approach based on social medicine, integrating health, social and economic responses

Proposal for an integrated safety and security management system for Seveso plants

After the critical facts of the 11th of September 2001 and some more recent which occurred both in some facilities and pipelines determined by terrorist attacks, industrial vision of safety for industrial plants, and Risk Analysis has changed and has new duties to consider. Aspects and problems concerning security must be included in the overall safety analysis path, and evaluation of the threats and new parameters as attractiveness, vulnerability and reachability of a target – assumed as centre of danger: storages, process unit, transport and convey units – must be included in the definition of the risk for the plant unit. For some plant, both for those of large multinational company, security is now a key priority. This paper proposes an approach for implementing a Safety and Security Management System (SSMS) taking into account all the characteristics required for Safety Management Systems as indicated in the 82/501/CE Directive also known as Seveso III.Anew overall parameter is introduced to estimate the criticality of a target considering different parameters as its vulnerability, attractiveness, reachability and worst-case scenario approach (intentional attacks are considered to produce catastrophic scenarios involving all the confined substance of a unit or storage). The procedure presents an easy implementation by knowing the main results of risk analysis. It is also possible to give gross evaluations even without knowing the results of risk analysis contained in the Safety Report, a mandatory requirement for dangerous plants. This short-cut evaluation provides useful information for ranking interventions and countermeasures, and to focus on security items within the plant. The SSMS is conceived with a PDCA approach (including the ISO 14001:2004, ISO 16017 and OHSAS 18001:1999 schemes), it includes the organizational structure and all the process and resources for determining and implementing the major accident prevention policy considering both the safety and the security issues. This paper is intended to analyze and give methods to build a SSMS including methods for the identification and evaluation of major hazards, to improve the operation control and the active monitoring of the attractive targets. A test case will be presented and an application of the method will show the importance of the results achieved and the real possibilities of application and integration with SMS of Seveso plant

Three foundations

Europe faces a historic opportunity. We need to reimagine European unity as a collective endeavour, as the only way in which we can turn threats to our way of life into the possibility to create a better life for all. This report focuses on three core areas where EU-wide political ambition and investment are truly necessary: Rapid technological change amid increasing global competition, with digital technologies set to have dramatic impacts across all sectors of the economy. Europe needs to become more competitive through innovation and the fast absorption of new technologies if it is to reap the benefits of this wave of change. Increasing breakdown of the global climate and other ecosystems due to our economic system, with action on mitigation – and to adapt to already inevitable changes – now incredibly urgent. In part, this is because of the time lags built into natural systems. In part, it is because of the unavoidable path-dependency and pace of our own response. Growing threats to social cohesion and social sustainability from multiple trends, including how we manage technological change and automation, the climate transition, and societal ageing. This is happening against a background of stalling convergence across Europe, rising income inequality over several decades, rising burdens on households and persistent inequalities of opportunity that are also a drag on economic performance. Competitiveness, sustainability and inclusion have to be addressed together, holistically. This is why this report addresses all three with a focus on the complex interlinkages between them. The vital role of far-sighted investment is a key theme that emerges from this investigation. The critical role of European-level collaboration is another. Instead of merely adapting to change, we need to be proactive through timely reform and investment that sets us on a pathway towards a society that is productive, sustainable and inclusive, by design