Stakeholder perceptions of policy tools in support of sustainable food consumption in Europe: Policy implications

Transitioning agri-food systems towards increased sustainability and resilience requires that attention be paid to sustainable food consumption policies. Policy-making processes often require the engagement and acceptance of key stakeholders. This study analyses stakeholders' solutions for creating sustainable agri-food systems, through interviews with a broad range of stakeholders including food value chain actors, non-governmental organizations, governmental institutions, research institutions and academic experts. The study draws on 38 in-depth, semi-structured interviews conducted in four European countries: France, Iceland, Italy and the UK, as well as three interviews with high-level EU experts. The interviewees' solutions were analysed according to a five-category typology of policy tools, encompassing direct activity regulations, and market-based, knowledge-based, governance and strategic policy tools. Most of the identified solutions were located in the strategic tools category, reflecting shared recognition of the need to integrate food policy to achieve long-term goals. Emerging solutions-those which were most commonly identified among the different national contexts-were then used to derive empirically-grounded and more universally applicable recommendations for the advancement of sustainable food consumption policies

Donne immigrate e screening cervicale nel Veneto

According to the literature, women coming from countries with strong migratory pressure are at a greater risk of cancer of the cervix with respect to Italian women. This is connected with the fact that women born outside Italy are less likely to undergo a cervical smear. In the Veneto Region the official immigrant population is equivalent to approximately 10% of the total population. This article analyzes the utilization of cervical smear from immigrant women in the Veneto Region, taking into account the smears performed both inside and outside organized screening programmes. Data have been gathered both from the archives of the screening programmes of the Local Health Authorities and from PASSI, a national surveillance system based on a standardized questionnaire administered through telephone interviews. The screening crude participation rate among foreign women was 45.3%, only slightly lower than the one of Italian women. The participation is lower in women from Asia and in women above 50 years. The percentage of positive smear tests was 2.7% among Italian women and 4.0% among foreign women. Compliance to colposcopy has been 89.9% for Italian women and 88.1% for foreign women. The detection rate of cervical intraepithelial neoplasia grade II or worse (CIN II+ diagnoses) in foreign women has been twofold the one detected in Italian women. If we consider the number of smear tests carried out in the last three years and outside the context of screening programmes, the number of women who have undergone a pap smear is much higher among Italian women, women 39-45 years old and women with a high level of education and without particular economic difficulties. The opposite is true for the organized screening programmes, where the differences according to age, level of education, economic difficulties and citizenship are reduced. These data confirm that women coming from countries with strong migratory pressure are at a greater risk of cancer of the cervix with respect to Italian women. A decrease in inequalities (in terms of education level, socio-economical status and nationality) is shown when considering the access to the screening programs

Scenario analysis report with policy recommendations: An assessment of sustainability, resilience, efficiency and fairness and effective chain relationships in VALUMICS case studies : Deliverable 8.4

This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/. The final version of this report is available at https://doi.org/10.5281/zenodo.6534011The functioning of food value chains entails a complex organisation from farm to fork which is characterised by various governance forms and externalities which have shaped the overall food system. VALUMICS food value chain case studies: wheat to bread, dairy cows to milk, beef cattle to steak, farmed salmon to fillets and tomato to processed tomato were selected to enable explorative and empirical analysis to better understand the functioning of the food system and, to identify the main challenges that need to be addressed to improve sustainability, integrity, resilience, and fairness of European food chains. The VALUMICS system analysis was executed through four operational phases starting with Groundwork & analysis including mapping specific attributes and impacts of food value chains and their externalities. This was followed by Case study baseline analysis, which provided input to the third phase on Modelling and exploration of future scenarios and finally Policy and synthesis of the overall work. This report is an overall synthesis of the VALUMICS results as follows: • Key findings from the VALUMICS project on the functioning of European food value chains and their impacts on more sustainable, resilient, fairer, and transparent food system are summarised through a compilation of 25 Research Findings and Policy Briefs. • By highlighting the major contributions from the research activities throughout the four phases of the VALUMICS project, this report delivers an assessment of various factors influencing sustainability, resilience, efficiency and fairness and effective chain relationships of different food value chains, and their determinants. • The synthesis of the outcome allows the identification of opportunities and challenges characterising the functioning of food supply chains, and thus, the prospects and potentials for strengthening the EU food sector

Characteristics of the colorectal cancers diagnosed in the early 2000s in Italy. Figures from the IMPATTO study on colorectal cancer screening

The impact of organized screening programmes on colorectal cancer (CRC) can be observed at a population level only several years after the implementation of screening. We compared CRC characteristics by diagnostic modality (screen-detected, non-screen-detected) as an early outcome to monitor screening programme effectiveness. Data on CRCs diagnosed in Italy from 2000 to 2008 were collected by several cancer registries. Linkage with screening datasets made it possible to divide the cases by geographic area, implementation of screening, and modality of diagnosis (screen-detected, non-screen-detected).We compared the main characteristics of the different subgroups of CRCs through multivariate logistic regression models. The study included 23,668 CRCs diagnosed in subjects aged 50-69 years, of which 11.9%were screendetected (N=2,806), all from the North-Centre of Italy. Among screen-detected CRCs, we observed a higher proportion of males, of cases in the distal colon, and a higher mean age of the patients. Compared with pre-screening cases, screen-detected CRCs showed a better distribution by stage at diagnosis (OR for stage III or IV: 0.40, 95%CI: 0.36-0.44) and grading (OR for poorly differentiated CRCs was 0.86, 95%CI: 0.75-1.00). Screen-detected CRCs have more favourable prognostic characteristics than non-screen-detected cases. A renewed effort to implement screening programmes throughout the entire country is recommended

Syntetic 2D + tomosynthesis for population breast cancer screening: first year of a pilot study

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A 3-year interval is too short for re-screening HPV negative women: a population-based cohort study

none11To compare the results of the first round and of re-screening 3 years after a negative human papillomavirus (HPV) test in women attending two HPV-based screening programs.noneZorzi, Manuel; Frayle, Helena; Rizzi, Martina; Fedato, Chiara; Rugge, Massimo; Penon, Maria Gabriella; Bertazzo, Alessandra; Callegaro, Susanna; Campagnolo, Marisa; Ortu, Fausta; Del Mistro, AnnarosaZorzi, Manuel; Frayle, Helena; Rizzi, Martina; Fedato, Chiara; Rugge, Massimo; Penon, Maria Gabriella; Bertazzo, Alessandra; Callegaro, Susanna; Campagnolo, Marisa; Ortu, Fausta; DEL MISTRO, Annaros

Cervical cancer screening by high risk HPV testing in routine practice: results at one year recall of high risk HPV-positive and cytology-negative women

Abstract OBJECTIVE: Cervical cancer screening by human papillomavirus (HPV) testing requires the use of additional triage and follow-up analyses. We evaluated women's compliance with and the performance of this strategy in a routine setting. SETTING: Five cervical service screening programmes in North-East Italy. METHODS: Eligible women aged 25-64 invited for a new screening episode underwent HPV testing for high risk types (hrHPV by Hybrid Capture 2) and cytology triage. Women with positive HPV and cytology results were referred for colposcopy; women with positive HPV but negative cytology results were referred to 1-year repeat hrHPV testing. RESULTS: Of 46,694 women screened by HPV testing up to December 2011, 3,211 (6.9%) tested hrHPV positive; 45% of these had a positive triage cytology. Those with negative cytology were invited for 1-yr repeat testing. Compliance with invitation was 61.6% at baseline and 85.3% at 1-yr repeat. Rate of persistent hrHPV positivity was 58% (830/1,435). Colposcopy performed in women with a positive hrHPV test at 1-yr repeat accounted for 36% of all colposcopies performed within the screening programmes. Cumulatively, a histological high-grade lesion was detected in 276 women (5.9‰ detection rate), 234 at baseline (85%), and 42 (15%) at 1-yr repeat. CONCLUSIONS: Compliance with hrHPV-based screening programmes was high both at baseline and at 1-yr repeat. Compared with the randomized trials, a higher proportion of triage cytology was read as positive, and only a small number of high-grade lesions were detected among the group of hrHPV positive cytology negative women who repeated testing 1-yr after baseline

Cervical cancer screening by high risk HPV testing in routine practice: results at one year recall of high risk HPV-positive and cytology-negative women

Abstract OBJECTIVE: Cervical cancer screening by human papillomavirus (HPV) testing requires the use of additional triage and follow-up analyses. We evaluated women's compliance with and the performance of this strategy in a routine setting. SETTING: Five cervical service screening programmes in North-East Italy. METHODS: Eligible women aged 25-64 invited for a new screening episode underwent HPV testing for high risk types (hrHPV by Hybrid Capture 2) and cytology triage. Women with positive HPV and cytology results were referred for colposcopy; women with positive HPV but negative cytology results were referred to 1-year repeat hrHPV testing. RESULTS: Of 46,694 women screened by HPV testing up to December 2011, 3,211 (6.9%) tested hrHPV positive; 45% of these had a positive triage cytology. Those with negative cytology were invited for 1-yr repeat testing. Compliance with invitation was 61.6% at baseline and 85.3% at 1-yr repeat. Rate of persistent hrHPV positivity was 58% (830/1,435). Colposcopy performed in women with a positive hrHPV test at 1-yr repeat accounted for 36% of all colposcopies performed within the screening programmes. Cumulatively, a histological high-grade lesion was detected in 276 women (5.9‰ detection rate), 234 at baseline (85%), and 42 (15%) at 1-yr repeat. CONCLUSIONS: Compliance with hrHPV-based screening programmes was high both at baseline and at 1-yr repeat. Compared with the randomized trials, a higher proportion of triage cytology was read as positive, and only a small number of high-grade lesions were detected among the group of hrHPV positive cytology negative women who repeated testing 1-yr after baseline

Factors associated with breast screening radiologists\u2019 annual mammogram reading volume in Italy

Purpose: Screening mammogram reading volume (SMRV) and total (screening and clinical) mammogram reading volume (TMRV) per year are strongly associated with the radiologist\u2019s diagnostic performance in breast cancer screening. The current article reports the prevalence and correlates of a SMRV and a TMRV 655000 among Italian breast screening radiologists. Materials and methods: A questionnaire survey was carried out in 2013\u20132014 by the Italian Group for Mammography Screening (GISMa). The questionnaire included items of information for radiologist\u2019s experience-related characteristics and for facility-level factors supposedly associated with SMRV and TMRV. Multivariate analysis was performed using backward stepwise multiple logistic regression models. Results: Data for 235 radiologists from 51 local screening programmes were received. Of the 222 radiologists who were eligible, 133 (59.9 %) reported a SMRV 655000 and 163 (73.4 %) a TMRV 655000. Multivariate factors positively associated with both characteristics included: the number of years of experience reading mammograms; the percentage of total working time dedicated to breast imaging and breast care; the participation in diagnostic assessment; and the availability of digital tomosynthesis at facility. Full-time dedication to breast imaging and breast care was associated with the highest odds ratio for a SMRV and a TMRV 655000, i.e. 11.80 and 46.74, respectively, versus a percentage of time 6450 %. An early (<2000) year of implementation of the screening programme and the availability of vacuum-assisted biopsy at facility were associated with a SMRV and, respectively, a TMRV 655000. Conclusions: Increasing the proportion of radiologists with full-time dedication to breast imaging and breast care qualified as the most effective approach to improve SMRV and TMRV

The professional quality criteria of Italian breast screening radiologists: Results from a national survey comparing the programmes started in 2000-2012 versus the ones started in 1990-1999

Introduction. In Italy, due to increasing healthcare budget and staff shortages, the recently created regional mammography screening programmes were established under worse radiology practice quality criteria than the previously created programmes. Methods. Using available data from a national questionnaire survey conducted at the end of 2013 and involving 222 responder radiologists, we compared the main professional quality standards of radiologists working in the screening programmes established during the period 2000-2012 with those working in the screening programmes created from 1990 to 1999. Results. The former reported more years of clinical experience in breast imaging and a greater clinical mammogram reading volume than the latter. Conversely, they dedicated less working time to breast imaging, were less likely to participate in the diagnostic assessment of screen-detected lesions, to work in large-staffed screening centres, and to have a screening and a total mammogram reading volume (SMRV and TMRV) 65 5000 per year. Conclusions. The level of most professional quality criteria of Italian mammography screening radiologists has decreased over time. As SMRV and TMRV are important predictors of diagnostic accuracy, we can expect a lower interpretation performance of radiologists working in the recently created screening programmes