Le migrazioni ambientali e al femminile in prospettiva sociologica. Istanze di sostenibilità, diritti e vulnerabilità delle donne migranti

Le migrazioni ambientali rivestono un grande interesse negli studi sociologici nell’inquadramento delle cause e dei fattori di spinta (push factors) che le determinano, di tipo climatico e ambientale, insieme alle diverse spiegazioni teoriche di tipo macro, micro e mesosociologico che la disciplina applica allo studio delle migrazioni. Allo stesso tempo, negli ultimi anni, le migrazioni al femminile hanno ricevuto un’ampia attenzione a seguito dell’incremento sostanziale della componente femminile, anche primo-migrante, che intraprende un progetto migratorio in prospettiva individuale e/ o familiare. Interessante è, da questo punto di vista, l’articolazione delle questioni di genere e dei diritti di genere a esse legati intorno agli obiettivi dell’Agenda 2030 dell’ONU, che ben intersecano la condizione femminile alle istanze di sviluppo sostenibile, collegando i diritti fondamentali (istruzione, nutrizione, accesso alle risorse primarie, lavoro) al miglioramento delle condizioni di vita nei paesi svantaggiati e nei percorsi migranti. Il contributo propone una rassegna delle principali teorie che spiegano le migrazioni al femminile, nello specifico, nel novero delle migrazioni ambientali al fine di integrare in prospettiva sociologica lo studio di un fenomeno contemporaneo complesso e di grande rilievo sul piano analitico. A ciò si coniuga una discussione di matrice socio-giuridica introno alle dimensioni normative che possono incidere sulle pratiche dell’inclusione o dell’esclusione di una categoria sociale particolarmente esposta alla vulnerabilità.Environmental migrations are of great interest in sociological studies in the framing of their climatic and environmental causes and push factors, of climatic and environmental kind, along with the various macro, micro, and meso-sociological theoretical explanations that the discipline applies to the study of migrations. At the same time, in recent years female migrations have received wide attention following the significant increase in the female component, even the early migrant who undertakes a migration project from an individual and/or family perspective. Interesting, from this point of view, is the articulation of gender issues and related gender rights around the UN Agenda 2030 goals, which well intersect the status of women with instances of sustainable development, linking fundamental rights (education, nutrition, access to primary resources, employment) to improving living conditions in disadvantaged countries and migrant pathways. The essay proposes a review of the main theories that explain female migrations, specifically environmental migrations, in order to integrate the study of a complex contemporary phenomenon of great analytical importance in a sociological perspective. This is coupled with a socio-legal discussion about the normative dimensions that may affect the practices of inclusion or exclusion of a social category particularly exposed to vulnerability

Datafication of Care: Security and Privacy Issues with Health Technology for People with Diabetes

Through the conceptual framework of datafication, dataism and dataveillance, this study investigates beliefs and attitudes regarding datafication and the related privacy and security concerns among individuals with Type 1 diabetes. Qualitative research was conducted through interviews among fifty-two individuals with Type 1 diabetes in Poland and Italy. The findings reveal a dynamic interplay between self-discipline and empowerment. The majority of interviewees emphasized the benefits of technologies for gaining a better understanding of their health condition and for more effective disease management. However, a minority of interviewees perceived the negative effects of datafication, including dataveillance, which leads to hyper-control of the disease, and dataism, characterized by excessive reliance on and dependency on technology. Critical beliefs about technologies fuelled rejection attitudes, leading some interviewees to suspend or abandon their use. Lastly, reflexivity on privacy and security issues appears to be low, particularly among older individuals with lower levels of education and socioeconomic status. This results in a poor understanding and underestimation of the potential risks associated with security and privacy. The findings increase the understanding of the factors that can facilitate or hinder the adoption of technology among people with diabetes

Increased cancer risk in patients undergoing dialysis: a population-based cohort study in North-Eastern Italy

open116noBACKGROUND: In southern Europe, the risk of cancer in patients with end-stage kidney disease receiving dialysis has not been well quantified. The aim of this study was to assess the overall pattern of risk for de novo malignancies (DNMs) among dialysis patients in the Friuli Venezia Giulia region, north-eastern Italy. METHODS: A population-based cohort study among 3407 dialysis patients was conducted through a record linkage between local healthcare databases and the cancer registry (1998-2013). Person-years (PYs) were calculated from 30 days after the date of first dialysis to the date of DNM diagnosis, kidney transplant, death, last follow-up or December 31, 2013, whichever came first. The risk of DNM, as compared to the general population, was estimated using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). RESULTS: During 10,798 PYs, 357 DNMs were diagnosed in 330 dialysis patients. A higher than expected risk of 1.3-fold was found for all DNMs combined (95% CI: 1.15-1.43). The risk was particularly high in younger dialysis patients (SIR = 1.88, 95% CI: 1.42-2.45 for age 40-59 years), and it decreased with age. Moreover, significantly increased DNM risks emerged during the first 3 years since dialysis initiation, especially within the first year (SIR = 8.52, 95% CI: 6.89-10.41). Elevated excess risks were observed for kidney (SIR = 3.18; 95% CI: 2.06-4.69), skin non-melanoma (SIR = 1.81, 95% CI: 1.46-2.22), oral cavity (SIR = 2.42, 95% CI: 1.36-4.00), and Kaposi's sarcoma (SIR = 10.29, 95% CI: 1.25-37.16). CONCLUSIONS: The elevated risk for DNM herein documented suggest the need to implement a targeted approach to cancer prevention and control in dialysis patients.openTaborelli, Martina; Toffolutti, Federica; Del Zotto, Stefania; Clagnan, Elena; Furian, Lucrezia; Piselli, Pierluca; Citterio, Franco; Zanier, Loris; Boscutti, Giuliano; Serraino, Diego for the Italian Transplant & Cancer Cohort Study; Sarah Shalaby, Raffaella Petrara, Patrizia Burra, Giacomo Zanus, Stefano Zanini,Paolo Rigotti; Maria Rendina, AlfredoDi Leo, Francesco Paolo Schena, Giuseppe Grandaliano, Marco Fiorentino, Augusto Lauro, Antonio Daniele Pinna, PaoloDi Gioia, Sara Pellegrini, Chiara Zanfi, Maria Piera Scolari, Sergio Stefoni, PaolaTodeschini, Laura Panicali, Chiara Valentini, Umberto Baccarani, Andrea Risaliti, Gian Luigi Adani, Dario Lorenzin, Giuseppe Maria Ettorre, Giovanni Vennarecci,Marco Colasanti, Manuela Coco, Fabrizio Ettorre, Roberto Santoro, LuciaMiglioresi, Francesco Nudo, Massimo Rossi,Gianluca Mennini, Luca Toti, GiuseppeTisone, Annachiara Casella, Laura Fazzolari, Daniele Sforza, Giuseppe Iaria,Carlo Gazia, Chiara Belardi, ClaudiaCimaglia, Alessandro Agresta, Gianpiero D’Offizi, Ubaldo Visco Comandini,Raffaella Lionetti, Marzia Montalbano, Chiara Taibi, Giovanni Fantola, Fausto Zamboni, Gian Benedetto Piredda,Maria Benigna Michittu, Maria Gavina Murgia, Bruno Onano, Lucia Fratino, Luigino Dal Maso, Paolo De Paoli, Diana Verdirosi,Emanuela Vaccher, Francesco Pisani, Antonio Famulari, Federica Delreno, Samuele Iesari, LindaDe Luca, Maurizio Iaria, Enzo Capocasale,Elena Cremaschi, Silvio Sandrini, Francesca Valerio,Valentina Mazzucotelli, Nicola Bossini, Gisella Setti, Massimiliano Veroux, Pierfrancesco Veroux, Giuseppe Giuffrida,Alessia Giaquinta, Domenico Zerbo, GhilBusnach, Laura Di Leo, Maria Luisa Perrino, Marialuisa Querques, ValerianaColombo, Maria Chiara Sghirlanzoni , Piergiorgio Messa, Antonio Leoni , Laura Galatioto, Salvatore Gruttadauria, Vito Sparacino, FlaviaCaputo, Barbara Buscemi ,Franco Cit-terio, Gionata Spagnoletti, Maria Paola Salerno, Evaldo Favi Giuseppe Paolo Segoloni, Luigi Biancone, AntonioLavacca, Maria Cristina Maresca, CarmeloCascone, Bice Virgilio, Donato Donati, Fiorella Dossi, Andrea Fontanella, Andrea Ambrosini, Marco Di CiccoTaborelli, Martina; Toffolutti, Federica; Del Zotto, Stefania; Clagnan, Elena; Furian, Lucrezia; Piselli, Pierluca; Citterio, Franco; Zanier, Loris; Boscutti, Giuliano; Serraino, Diego for the Italian Transplant & Cancer Cohort Study; Shalaby, Sarah; Petrara, MARIA RAFFAELLA; Burra, Patrizia; Zanus, Giacomo; Zanini, Stefano; Rigotti, Paolo; Maria, Rendina; Alfredodi, Leo; Francesco Paolo Schena, ; Giuseppe, Grandaliano; Marco, Fiorentino; Augusto, Lauro; Antonio Daniele Pinna, ; Paolodi, Gioia; Sara, Pellegrini; Chiara, Zanfi; Maria Piera Scolari, ; Sergio, Stefoni; Paolatodeschini, ; Laura, Panicali; Chiara, Valentini; Umberto, Baccarani; Andrea, Risaliti; Gian Luigi Adani, ; Dario, Lorenzin; Giuseppe Maria Ettorre, ; Giovanni, Vennarecci; Marco, Colasanti; Manuela, Coco; Fabrizio, Ettorre; Roberto, Santoro; Luciamiglioresi, ; Francesco, Nudo; Massimo, Rossi; Gianluca, Mennini; Luca, Toti; Giuseppetisone, ; Annachiara, Casella; Laura, Fazzolari; Daniele, Sforza; Giuseppe, Iaria; Carlo, Gazia; Chiara, Belardi; Claudiacimaglia, ; Alessandro, Agresta; Gianpiero, D’Offizi; Ubaldo Visco Comandini, ; Raffaella, Lionetti; Marzia, Montalbano; Chiara, Taibi; Giovanni, Fantola; Fausto, Zamboni; Gian Benedetto Piredda, ; Maria Benigna Michittu, ; Maria Gavina Murgia, ; Bruno, Onano; Lucia, Fratino; Luigino Dal Maso, ; Paolo De Paoli, ; Diana, Verdirosi; Emanuela, Vaccher; Francesco, Pisani; Antonio, Famulari; Federica, Delreno; Samuele, Iesari; Lindade, Luca; Maurizio, Iaria; Enzo, Capocasale; Elena, Cremaschi; Silvio, Sandrini; Francesca, Valerio; Valentina, Mazzucotelli; Nicola, Bossini; Gisella, Setti; Massimiliano, Veroux; Pierfrancesco, Veroux; Giuseppe, Giuffrida; Alessia, Giaquinta; Domenico, Zerbo; Ghilbusnach, ; Laura Di Leo, ; Maria Luisa Perrino, ; Marialuisa, Querques; Valerianacolombo, ; Maria Chiara Sghirlanzoni, ; Piergiorgio, Messa; Antonio, Leoni; Laura, Galatioto; Salvatore, Gruttadauria; Vito, Sparacino; Flaviacaputo, ; Barbara, Buscemi; Franco, Cit-terio; Gionata, Spagnoletti; Maria Paola Salerno, ; Evaldo Favi Giuseppe Paolo Segoloni, ; Luigi, Biancone; Antoniolavacca, ; Maria Cristina Maresca, ; Carmelocascone, ; Bice, Virgilio; Donato, Donati; Fiorella, Dossi; Andrea, Fontanella; Andrea, Ambrosini; Marco Di Cicco

Brain oxygen tension, oxygen supply, and oxygen consumption during arterial hyperoxia in a model of progressive cerebral ischemia

We investigated the changes in brain oxygen tension (ptiO(2)) after ventilation with pure O-2 in order to (1) clarify the pathophysiology of O-2 exchange in the cerebral microcirculation; and (2) investigate the relationship between brain O-2 tension, O-2 delivery, and consumption in steady-state conditions during stepwise cerebral blood flow (CBF) reductions. A swine model was developed to reduce CBF in three stable steps: (1) baseline (CBF 100%), (2) CBF of 50-60% of baseline, and (3) CBF of (30% of baseline. CBF was reduced by infusing saline into the left lateral ventricle through a catheter connected with an infusion pump. At each step, hyperoxia was tested by increasing the inspired oxygen fraction up to 100%, PtiO(2) reflected the CBF reductions, since it was respectively 27.95 ( +/-10.15), 14.77 (+/-3.58), and 3.45 (+/-2.89) mm Hg during the three CBF steps. Hyperoxia was followed by an increase in ptiO(2), although the increase was significantly lower when hyperoxia was applied during progressive ischemia. O-2 supply to the brain did not change during hyperoxia. Arteriovenous oxygen difference (AVDO(2)) decreased during the phases of intact CBF and moderate impairment, but not during the phase of severe CBF reduction. In conclusion, ptiO(2) reductions closely reflect the imbalance between oxygen delivery and demand; this implies a link between low ptiO(2) and defective O-2 supply due to impaired CBF. However, this relation is not necessarily reciprocal, since manipulating brain oxygen tension does not always influence brain oxygen delivery, as in the case of ventilation with pure oxygen

Mineralogical evolution of cement pastes at early ages based on thermogravimetric analysis (TGA)

[EN] Ordinary thermogravimetric analysis (TG) and high-resolution TG tests were carried out on three different Portland cement pastes to study the phases present during the first day of hydration. Tests were run at 1, 6, 12 and 24 h of hydration, in order to determine the phases at these ages. High-resolution TG tests were used to separate decompositions presented in the 100¿200 C interval. The non-evaporable water determined by TG was used to determine hydration degree for the different ages. The effect of particle size distribution (PSD) on mineralogical evolution was established, as well as the addition of calcite as mineralogical filler. Finer PSD and calcite addition accelerate the hydration process, increasing the hydration degree on the first day of eaction between water and cement. According to high-resolution TG results, it was demonstrated that ettringite was the only decomposed phase in the 100¿200 C interval during the first 6 h of hydration for all studied cements. C-S-H phase starts to appear in all cements after 12 h of hydration.Funding was provided by Colciencias (Grant No. Convocatoria 567-2012).Gaviria, X.; Borrachero Rosado, MV.; Paya Bernabeu, JJ.; Monzó Balbuena, JM.; Tobón, J. (2018). Mineralogical evolution of cement pastes at early ages based on thermogravimetric analysis (TGA). Journal of Thermal Analysis and Calorimetry. 132(1):39-46. https://doi.org/10.1007/s10973-017-6905-0S39461321Benboudjema F, Meftah JM, Torernti F. Interaction between drying, shrinkage, creep and cracking phenomena in concrete. Eng Struct. 2005;27:239–50.Holt E. Contribution of mixture design to chemical and autogenous shrinkage of concrete at early ages. Cem Concr Res. 2005;35:464–72.Darquennes A, Staquet S, Delplancke-Ogletree MP, Espion B. Effect of autogenous deformation on the cracking risk of slag cement concretes. Cem Concr Compos. 2011;33:368–79.Slowik V, Schmidt M, Fritzsch R. Capillary pressure in fresh cement-based materials and identification of the air entry value. Cem Concr Compos. 2008;30(7):557–65.Evju C, Hansen S. Expansive properties of ettringite in a mixture of calcium aluminate cement, Portland cement and ß-calcium sulfate hemihydrates. Cem Concr Res. 2001;31:257–61.Bentz DP, Jensen OM, Hansen KK. Olesen, Stang, H. Haecker, C.J. Influence of cement particle-size distribution on early age autogenous strain and stresses in cement-based materials. J Am Ceram Soc. 2001;84(1):129–35.Barcelo L, Moranville M, Clavaud B. Autogenous shrinkage of concrete: a balance between autogenous swelling and self-desiccation. Cem Concr Res. 2005;35(1):177–83.Bouasker M, Mounanga P, Turcry P, Loukili A, Khelidj A. Chemical shrinkage of cement pastes and mortars at very early age: effect of limestone filler and granular inclusions. Cem Concr Compos. 2008;30(1):13–22.Bentz DP. A review of early-age properties of cement-based materials. Cem Concr Res. 2008;38(2):196–204.Ozawa T. Controlled rate thermogravimetry. New usefulness of controlled rate thermogravimetry revealed by decomposition of polyimide. J Therm Anal Calorim. 2000;59:375–84.Ramachandran VS, Paroli RM, Beaudoin JJ, Delgado AH. Thermal analysis of construction materials. Building materials series. New York: Noyes Publications; 2003.Zanier A. High-resolution TG for the characterization of diesel fuel additives. J Therm Anal Calorim. 2001;64:377–84.Tobón JI, Payá J, Borrachero MV, Restrepo OJ. Mineralogical evolution of Portland cement blended with silica nanoparticles and its effect on mechanical strength. Constr Build Mater. 2012;36:736–42.Singh M, Waghmare S, Kumar V. Characterization of lime plasters used in 16th century Mughal Monument. J Archeol Sci. 2014;42:430–4.Majchrzak-Kuçeba I. Thermogravimetry applied to characterization of fly ash-based MCM-41 mesoporous materials. J Therm Anal Calorim. 2012;107:911–21.Silva ACM, Gálico DA, Guerra RB, Legendre AO, Rinaldo D, Galhiane MS, Bannach G. Study of some volatile compounds evolved from the thermal decomposition of atenolol. J Therm Anal Calorim. 2014;115:2517–20.Rios-Fachal M, Gracia-Fernández C, López-Beceiro J, Gómez-Barreiro S, Tarrío-Saavedra J, Ponton A, Artiaga R. Effect of nanotubes on the thermal stability of polystyrene. J Therm Anal Calorim. 2013;113:481–7.Yamarte L, Paxman D, Begum S, Sarkar P, Chambers A. TG measurement of reactivity of candidate oxygen carrier materials. J Therm Anal Calorim. 2014;116:1301–7.Borrachero MV, Payá J, Bonilla M, Monzó J. The use of thermogravimetric analysis technique for the characterization of construction materials. The gypsum case. J Therm Anal Calorim. 2008;91(2):503–9.Tobón JI, Payá J, Borrachero MV, Soriano L, Restrepo OJ. Determination of the optimum parameters in the high resolution thermogravimetric analysis (HRTG) for cementitious materials. J Therm Anal Calorim. 2012;107:233–9.Kuzielova E, Žemlička M, Másilko, J, Palou, M.T. Effect of additives on the performance of Dyckerhoff cement, Class G, submitted to simulated hydrothermal curing. J Therm Anal Calorim. Accepted 29 Oct 2017Genc M, Genc ZK. Microencapsulated myristic acid–fly ash with TiO2 shell as a novel phase change material for building application. J Therm Anal Calorim. Accepted 24 Oct 2017.Singh M, Kumar SV, Waghmare SA. The composition and technology of the 3–4th century CE decorative earthen plaster of Pithalkhora caves, India. J Archeol Sci. 2016;7:224–37.Liu L, Liu Q, Cao Y, Pan WP. The isothermal studies of char-CO2 gasification using the high-pressure thermo-gravimetric method. J Therm Anal Calorim. 2015;120:1877–82.Majchrzak-Kuce I, Bukalak-Gaik D. Regeneration performance of metal–organic frameworks TG-vacuum tests. J Therm Anal Calorim. 2016;125:1461–6.Ion RM, Radovici C, Fierascu RC, Fierascu I. Thermal and mineralogical investigations of iron archaeological Materials. J Therm Anal Calorim. 2015;121:1247–53.Rupasinghe M, San Nicolas R, Mendis P, Sofi M, Ngo T. Investigation of strength and hydration characteristics in nano-silica incorporated cement paste. Cem Concr Compos. 2017;80:17–30.Esteves PL. On the hydration of water-entrained cement–silica systems: combined SEM, XRD and thermal analysis in cement pastes. Thermochim Acta. 2011;518:27–35.Riesen R. Adjustment of heating rate for maximum resolution in TG and TMA (MaxRes). J Therm Anal. 1998;53:365–74.Lim S, Mondal P. Micro- and nano-scale characterization to study the thermal degradation of cement-based materials. Mater Charact. 2014;92:15–25.Gill PS, Sauerbrunn SR, Crowe BS. High resolution thermogravimetry. J Therm Anal. 1992;38:255–66.Mounanga P, Khelidj A, Loukili A, Baroghel-Bouny V. Predicting Ca(OH)2 content and chemical shrinkage of hydrating cement pastes using analytical approach. Cem Concr Res. 2004;34:255–65.Zeng Q, Li K, Fen-chong T, Dangla P. Determination of cement hydration and pozzolanic reaction extents for fly-ash cement pastes. Constr Build Mater. 2012;27:560–9.Parrott LP, Geiker M, Gutteridge WA, Killoh D. Monitoring Portland cement hydration: Comparison of methods. Cem Concr Res. 1990;20:919–26.Hewlett PC. Lea’s chemistry of cement and concrete. 4th ed. Oxford: Elsevier Science & Technology Books; 2004.ASTM C305 Standard practice for mechanical mixing of hydraulic cement pastes and mortars of plastic consistency. ASTM International, West Conshohocken, PA; 2012.Taylor HF. Cement chemistry. 2nd ed. Westminster: Thomas Telford; 1997.Nadelman EI, Freas DJ, Kurtis KE. Nano- and microstructural characterization of Portland limestone cement paste. In: Nanotechnology in construction. Proceedings of NICOM 5. 2015. p. 87–92

Diagnóstico e alternativas para a recuperação ambiental da Bacia Hidrográfica do Rio Guandu (BHRG) - RJ.

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Do women ⩾50 years of age need as much screening as women <50 years after they have had negative screening results?

To assess the adequacy of a routine screening to identify cervical intraepithelial neoplasia 2 or worse (CIN2+) in women over 50 years of age, a retrospective cohort was set in six Italian organised population-based screening programmes. In all, 287 330 women (1 714 550 person-years of observation, 1110 cases) screened at age 25–64, with at least two cytological screening tests, the first negative, were followed from their first negative smear until a biopsy proven CIN2+ lesion or their last negative smear. For women aged 25–49 and 50–64 years, crude and age-standardised detection rate (DR), cumulative risk (CR), adjusted hazard risk for number of previous negative screens, probability of false-positive CIN2+ after two or more smear tests were calculated. Detection rate is significantly lower over 50 years of age. Multivariable analysis shows a significant protective effect from four screening episodes (DR=0.70, 95% CI: 0.51–0.97); the effect of age ⩾50 is 0.29 (95% CI: 0.24–0.35). The CR of CIN2+ is at least eightfold higher in women <50 (CR=2.06, 95% CI: 1.88–2.23) after one previous negative test than in women ⩾50 years with four screens (CR=0.23, 95% CI: 0.00–0.46). Over 50 years of age, after four tests at least three false-positive cases are diagnosed for every true positive. Benefits arising from cytological screening is uncertain in well-screened older women

ITALIAN CANCER FIGURES - REPORT 2015: The burden of rare cancers in Italy = I TUMORI IN ITALIA - RAPPORTO 2015: I tumori rari in Italia

OBJECTIVES: This collaborative study, based on data collected by the network of Italian Cancer Registries (AIRTUM), describes the burden of rare cancers in Italy. Estimated number of new rare cancer cases yearly diagnosed (incidence), proportion of patients alive after diagnosis (survival), and estimated number of people still alive after a new cancer diagnosis (prevalence) are provided for about 200 different cancer entities. MATERIALS AND METHODS: Data herein presented were provided by AIRTUM population- based cancer registries (CRs), covering nowadays 52% of the Italian population. This monograph uses the AIRTUM database (January 2015), which includes all malignant cancer cases diagnosed between 1976 and 2010. All cases are coded according to the International Classification of Diseases for Oncology (ICD-O-3). Data underwent standard quality checks (described in the AIRTUM data management protocol) and were checked against rare-cancer specific quality indicators proposed and published by RARECARE and HAEMACARE (www.rarecarenet.eu; www.haemacare.eu). The definition and list of rare cancers proposed by the RARECAREnet "Information Network on Rare Cancers" project were adopted: rare cancers are entities (defined as a combination of topographical and morphological codes of the ICD-O-3) having an incidence rate of less than 6 per 100,000 per year in the European population. This monograph presents 198 rare cancers grouped in 14 major groups. Crude incidence rates were estimated as the number of all new cancers occurring in 2000-2010 divided by the overall population at risk, for males and females (also for gender-specific tumours).The proportion of rare cancers out of the total cancers (rare and common) by site was also calculated. Incidence rates by sex and age are reported. The expected number of new cases in 2015 in Italy was estimated assuming the incidence in Italy to be the same as in the AIRTUM area. One- and 5-year relative survival estimates of cases aged 0-99 years diagnosed between 2000 and 2008 in the AIRTUM database, and followed up to 31 December 2009, were calculated using complete cohort survival analysis. To estimate the observed prevalence in Italy, incidence and follow-up data from 11 CRs for the period 1992-2006 were used, with a prevalence index date of 1 January 2007. Observed prevalence in the general population was disentangled by time prior to the reference date (≤2 years, 2-5 years, ≤15 years). To calculate the complete prevalence proportion at 1 January 2007 in Italy, the 15-year observed prevalence was corrected by the completeness index, in order to account for those cancer survivors diagnosed before the cancer registry activity started. The completeness index by cancer and age was obtained by means of statistical regression models, using incidence and survival data available in the European RARECAREnet data. RESULTS: In total, 339,403 tumours were included in the incidence analysis. The annual incidence rate (IR) of all 198 rare cancers in the period 2000-2010 was 147 per 100,000 per year, corresponding to about 89,000 new diagnoses in Italy each year, accounting for 25% of all cancer. Five cancers, rare at European level, were not rare in Italy because their IR was higher than 6 per 100,000; these tumours were: diffuse large B-cell lymphoma and squamous cell carcinoma of larynx (whose IRs in Italy were 7 per 100,000), multiple myeloma (IR: 8 per 100,000), hepatocellular carcinoma (IR: 9 per 100,000) and carcinoma of thyroid gland (IR: 14 per 100,000). Among the remaining 193 rare cancers, more than two thirds (No. 139) had an annual IR &lt;0.5 per 100,000, accounting for about 7,100 new cancers cases; for 25 cancer types, the IR ranged between 0.5 and 1 per 100,000, accounting for about 10,000 new diagnoses; while for 29 cancer types the IR was between 1 and 6 per 100,000, accounting for about 41,000 new cancer cases. Among all rare cancers diagnosed in Italy, 7% were rare haematological diseases (IR: 41 per 100,000), 18% were solid rare cancers. Among the latter, the rare epithelial tumours of the digestive system were the most common (23%, IR: 26 per 100,000), followed by epithelial tumours of head and neck (17%, IR: 19) and rare cancers of the female genital system (17%, IR: 17), endocrine tumours (13% including thyroid carcinomas and less than 1% with an IR of 0.4 excluding thyroid carcinomas), sarcomas (8%, IR: 9 per 100,000), central nervous system tumours and rare epithelial tumours of the thoracic cavity (5%with an IR equal to 6 and 5 per 100,000, respectively). The remaining (rare male genital tumours, IR: 4 per 100,000; tumours of eye, IR: 0.7 per 100,000; neuroendocrine tumours, IR: 4 per 100,000; embryonal tumours, IR: 0.4 per 100,000; rare skin tumours and malignant melanoma of mucosae, IR: 0.8 per 100,000) each constituted &lt;4% of all solid rare cancers. Patients with rare cancers were on average younger than those with common cancers. Essentially, all childhood cancers were rare, while after age 40 years, the common cancers (breast, prostate, colon, rectum, and lung) became increasingly more frequent. For 254,821 rare cancers diagnosed in 2000-2008, 5-year RS was on average 55%, lower than the corresponding figures for patients with common cancers (68%). RS was lower for rare cancers than for common cancers at 1 year and continued to diverge up to 3 years, while the gap remained constant from 3 to 5 years after diagnosis. For rare and common cancers, survival decreased with increasing age. Five-year RS was similar and high for both rare and common cancers up to 54 years; it decreased with age, especially after 54 years, with the elderly (75+ years) having a 37% and 20% lower survival than those aged 55-64 years for rare and common cancers, respectively. We estimated that about 900,000 people were alive in Italy with a previous diagnosis of a rare cancer in 2010 (prevalence). The highest prevalence was observed for rare haematological diseases (278 per 100,000) and rare tumours of the female genital system (265 per 100,000). Very low prevalence (&lt;10 prt 100,000) was observed for rare epithelial skin cancers, for rare epithelial tumours of the digestive system and rare epithelial tumours of the thoracic cavity. COMMENTS: One in four cancers cases diagnosed in Italy is a rare cancer, in agreement with estimates of 24% calculated in Europe overall. In Italy, the group of all rare cancers combined, include 5 cancer types with an IR&gt;6 per 100,000 in Italy, in particular thyroid cancer (IR: 14 per 100,000).The exclusion of thyroid carcinoma from rare cancers reduces the proportion of them in Italy in 2010 to 22%. Differences in incidence across population can be due to the different distribution of risk factors (whether environmental, lifestyle, occupational, or genetic), heterogeneous diagnostic intensity activity, as well as different diagnostic capacity; moreover heterogeneity in accuracy of registration may determine some minor differences in the account of rare cancers. Rare cancers had worse prognosis than common cancers at 1, 3, and 5 years from diagnosis. Differences between rare and common cancers were small 1 year after diagnosis, but survival for rare cancers declined more markedly thereafter, consistent with the idea that treatments for rare cancers are less effective than those for common cancers. However, differences in stage at diagnosis could not be excluded, as 1- and 3-year RS for rare cancers was lower than the corresponding figures for common cancers. Moreover, rare cancers include many cancer entities with a bad prognosis (5-year RS &lt;50%): cancer of head and neck, oesophagus, small intestine, ovary, brain, biliary tract, liver, pleura, multiple myeloma, acute myeloid and lymphatic leukaemia; in contrast, most common cancer cases are breast, prostate, and colorectal cancers, which have a good prognosis. The high prevalence observed for rare haematological diseases and rare tumours of the female genital system is due to their high incidence (the majority of haematological diseases are rare and gynaecological cancers added up to fairly high incidence rates) and relatively good prognosis. The low prevalence of rare epithelial tumours of the digestive system was due to the low survival rates of the majority of tumours included in this group (oesophagus, stomach, small intestine, pancreas, and liver), regardless of the high incidence rate of rare epithelial cancers of these sites. This AIRTUM study confirms that rare cancers are a major public health problem in Italy and provides quantitative estimations, for the first time in Italy, to a problem long known to exist. This monograph provides detailed epidemiologic indicators for almost 200 rare cancers, the majority of which (72%) are very rare (IR&lt;0.5 per 100,000). These data are of major interest for different stakeholders. Health care planners can find useful information herein to properly plan and think of how to reorganise health care services. Researchers now have numbers to design clinical trials considering alternative study designs and statistical approaches. Population-based cancer registries with good quality data are the best source of information to describe the rare cancer burden in a population

Analisi dei tempi d\u2019attesa tra le varie fasi di gestione dei carcinomi mammari screening-detected a Trieste nel biennio 2013-2014: come si pu\uf2 migliorare?

Gli indicatori relativi ai tempi di attesa sono difficili da rispettare, come recentemente evidenziato al XIII Convegno ONS 2015 . Per questo motivo \ue8 fondamentale identificare in quale momento della gestione dei carcinomi screening-detected si concentrino i ritardi e stabilirne le cause (se attribuibili alla paziente o all\u2019organizzazione del programma o intrinseci al tipo di lesione) cos\uec da proporre mirate modifiche migliorative. Metodi: L\u2019analisi riguarda 146 carcinomi screening-detected consecutivi (biennio 2013-2014). Sono stati misurati i tempi tra le varie fasi diagnostiche (Mammografia di I\ub0 livello, Richiamo II\ub0 livello, I\ub0 approfondimento cito/microistologico, Comunicazione diagnosi) e i tempi chirurgici (Visita chirurgica, Intervento chirurgico, Referto istologico con marcatori biologici, Visita oncologica). Per ogni fase sono stati calcolati i tempi medi/mediani rappresentati tramite box plot e giustificati gli outliers.Risultati: La latenza nella presa in carico chirurgica \ue8 legato alla complessit\ue0 degli esami preoperatori (3) (tempo mediano tra richiamo al II\ub0 livello ed intervento: 53 giorni (se unico esame pre-operatorio) vs 73 (se pi\uf9 di un esame pre-operatorio, p<0.0001), mentre rispetto ad un recente studio (4) il tempo mediano tra visita chirurgica e intervento non \ue8 aumentato per i casi con necessit\ue0 di RM (28 vs 26 giorni, p=0.13), perch\ue9 gi\ue0 programmata in fase preoperatoria. Per i casi con mastectomia sempre con ricostruzione, si registra un tempo medio dalla visita chirurgica all\u2019intervento di 7 giorni superiore rispetto alle quadrantectomie. Ulteriore criticit\ue0 \ue8 il tempo mediano tra intervento e visita oncologica (44 giorni), attribuibile in parte ad un \u201critardo\u201d nella disponibilit\ue0 dei marcatori biomolecolari (soprattutto HER2/FISH) ed in parte a rinvii dell\u2019appuntamento da parte della paziente stessa Conclusioni: Soltanto un attento monitoraggio del turnaround time dell\u2019intero percorso delle pazienti con carcinoma screening detected consente l\u2019identificazione dei punti di debolezza su cui intervenire efficacemente per garantire il rispetto degli indicatori