Slow progress in measles and rubella elimination in Italy

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Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal

Although most countries in the WHO European Region were verified in 2017 as having interrupted endemic measles transmission, nine countries were still endemic. Among these, Italy accounted for the second highest number of measles cases reported in Europe in 2017. The elimination of measles is verified at national level by each country's National Verification Committee (NVC) through the production of an Annual Status Update (ASU). Since in Italy decentralization has led to an inhomogeneous implementation of immunization strategies among the 21 administrative Regions, the Italian NVC proposed that measles elimination should also be documented at the subnational level through regional ASUs and Synthetic Regional Reports (SRRs). The regional ASUs and the SRRs for 2014, 2015 and 2016 were produced and appraised by the NVC to evaluate the Regions' performances in each individual year as well as over the whole period. A specific analysis of vaccination coverage, including official immunization data for 2017, was performed. Moreover, the measles epidemic of 2017 was examined. Firstly, in the period 2014±2016, low immunization rates were registered in most Regions. Sixty-three per cent of southern Regions reported rates below the national mean and an overall low-quality performance. The approval of Italy's mandatory vaccination law in 2017 resulted in a marked increase in vaccination coverage; however, this increase was not homogeneous among Regions. Secondly, more than 50% of Regions did not report any supplemental immunization activity (SIA) for the period 2014-2016. Thirdly, from 2014 to 2016, fewer than one-third of Regions improved their reporting of outbreaks. Finally, over the study period, only two Regions reached the target required by the WHO for measles laboratory investigations. In countries with decentralized health policies, subnational monitoring can help identify local barriers to measles elimination. In Italy it has highlighted the need for further SIAs and a stronger surveillance system

Childhood vaccinations: A pilot study on knowledge, attitudes and vaccine hesitancy in pregnant women

Background. The objective of this pilot study was to test a questionnaire aimed at assessing knowledge of and attitudes towards vaccination, as well as intention to vaccinate, among pregnant women. Methods. The questionnaire was self-administered by 49 pregnant women attending antenatal classes at three Family Centers in Rome. Results. Poor knowledge of vaccinations, inadequate attention from healthcare professionals, recurrent consultation of unreliable sources of information, and misconceptions about the side effects of vaccines, all contribute to vaccine hesitancy. Where appropriate, questionnaire sections were shown to be internally consistent. Conclusion. The questionnaire proved reliable and is suitable for further studies

Identification of delivery models for the provision of predictive genetic testing in Europe: protocol for a multicentre qualitative study and a systematic review of the literature

Introduction: The appropriate application of genomic technologies in healthcare is surrounded by many concerns. In particular, there is a lack of evidence on what constitutes an optimal genetic service delivery model, which depends on the type of genetic test and healthcare context considered. The present project aims to identify, classify, and evaluate delivery models for the provision of predictive genetic testing in Europe and in selected Anglophone extra-European countries (the USA, Canada, Australia, and New Zealand). It also sets out to survey the European public health community’s readiness to incorporate public health genomics into their practice. Materials and equipment: The project consists of (i) a systematic review of published literature and selected country websites, (ii) structured interviews with health experts on the genetic service delivery models in their respective countries, and (iii) a survey of European Public Health Association (EUPHA) members’ knowledge and attitudes toward genomics applications in clinical practice. The inclusion criteria for the systematic review are that articles be published in the period 2000–2015; be in English or Italian; and be from European countries or from Canada, the USA, Australia, or New Zealand. Additional policy documents will be retrieved from represented countries’ government-affiliated websites. The results of the research will be disseminated through the EUPHA network, the Italian Network for Genomics in Public Health (GENISAP), and seminars and workshops. Expected impact of the study on public health: The transfer of genomic technologies from research to clinical application is influenced not only by several factors inherent to research goals and delivery of healthcare but also by external and commercial interests that may cause the premature introduction of genetic tests in the public and private sectors. Furthermore, current genetic services are delivered without a standardized set of process and outcome measures, which makes the evaluation of healthcare services difficult. The present study will identify and classify delivery models and, subsequently, establish which are appropriate for the provision of predictive genetic testing in Europe by comparing sets of process and outcome measures. In this way, the study will provide a basis for future recommendations to decision makers involved in the financing, delivery, and consumption of genetic services

Clinical, pathological and PAM50 gene expression features of HER2-low breast cancer

Novel antibody-drug conjugates against HER2 are showing high activity in HER2-negative breast cancer (BC) with low HER2 expression (i.e., 1+ or 2+ and lack of ERBB2 amplification). However, the clinical and molecular features of HER2-low BC are yet to be elucidated. Here, we collected retrospective clinicopathological and PAM50 data from 3,689 patients with HER2-negative disease and made the following observations. First, the proportion of HER2-low was higher in HR-positive disease (65.4%) than triple-negative BC (TNBC, 36.6%). Second, within HR-positive disease, ERBB2 and luminal-related genes were more expressed in HER2-low than HER2 0. In contrast, no gene was found differentially expressed in TNBC according to HER2 expression. Third, within HER2-low, ERBB2 levels were higher in HR-positive disease than TNBC. Fourth, HER2-low was not associated with overall survival in HR-positive disease and TNBC. Finally, the reproducibility of HER2-low among pathologists was suboptimal. This study emphasizes the large biological heterogeneity of HER2-low BC, and the need to implement reproducible and sensitive assays to measure low HER2 expression

“Beaks and berries”: zoological laboratory (II) of the formative proposal of inclusive scientific divulgation

Searching a topic that help us about the implementation of an inclusive divulgation, aimed also at sensory disabilitiesusers, we have chosen birds as a key to connect different scientific issues (pollution, environmental changes, exploitation of resources) and create new knowledge in a heterogeneous auditorium, through the suggestions that the workshop lessons can infuse on the users, whether they are disabled or not. All this to bring them closer to thescientific contents to which they do not have easy access. In particular, the project aims to develop, deepen and consolidate, through communication and information, issues concerning the concept of biodiversity, in order to sensitize users to safeguard the species and habitats of our territory and make them as the main actors of scientific dissemination.Indeed, weestabilisheda convention between the “Istituto dei Ciechi Opere riunite I. Florio – F. ed A. Salamone” of Palermo and the “Consiglio Nazionale delle Ricerche - Istituto per lo studio degli impatti Antropici e Sostenibilità in ambiente marino” of Capo Granitola (TP). The main role of this convention is to bring disable people closer to these scientific subjects and make the contents of our laboratories as inclusive as possible.The project "The world of birds", developed from January to April 2019 is divided into three main themes, the second of which is the focus of this report: The bird alimentation

“How a good video can remove ‘barriers’ for a more inclusive science communication”

There is a burgeoning body of evidence suggesting that technology can enhance learning, and multiple studies have shown that videos represent a very effective tool in science engagement and education. In fact, video media can transform the complexities of science and nature into something more tangible and tractable (Dabylchuk et al., 2018). Documentaries can hence be powerful tools for learning, to raise awareness for important topics, and adding a scientific approach makes it possible to deepen knowledge about the world. According to Dale’s cone of experience (Fig. 1), people memorize 10% of what they read, 20% of what they hear, 30% of what they see and 50% of what they hear and see (Wiman and Mierhenry, 1969). These statistics seems to convey a very clear message: blind or visually impaired people are penalised in the learning compared to sighted ones. However, our experience in the area of inclusive science communication has led us to wonder: are we sure that sight is a fundamental means for learning? Or is it possible that sight is a predominant sense over others, and therefore it can even mislead or limit learning? To answer this question, we held an ad-hoc educational laboratory with the users of the “IstitutodeiCiechiOpereRiunite I. Florio – F. ed A. Salamone” of Palermo, with which we have established a convention on 29/01/2019. Specifically, we involved 20 users with different degrees of visual impairment, in the projection of three science videos, selected from those realised by the EDUlab divulgation group over the years. At the end of the video projection, users were asked to express their opinions and their personal interpretations of scientific issues, allowing us to understand what e how many information have been received and, above all, if sighted usersare really advantaged compared to the visually impaired ones

“For whom the Calandra tolls?”: zoological laboratory (III) of the formative proposal of inclusive scientific divulgation

Blind people, though not seeing the world, is nevertheless able to imagine it, activating mental processes different from those of the sighted. They can come in contact with the reality of the world and know it with appreciable effectiveness (Angeli F., 2012). It has been imagined that only the view was the capable sense of allowing the conception of space and its forms. Of course, it was the facts that showed, with increasing clarity, that the lack of sight does not prevent the mental construction of space. Although touch is generally regarded as the sight of the blind, it is important to understand how sight cannot be validly replaced by a single sense. To organize a good relationship with the surrounding reality, the person who does not see needs to activate the whole of their residual senses. In particular, the complementarity between touch and hearing makes us understand like the blind. The touch sense has a very small perceptive field and therefore proceeds bysuccession of spatial fragments, but also presents a very analytical capacity,refined and punctual. Hearing has a greatly extended perceptual field, whichallows the blind to have a broad overall spatial reference but offers insufficient information on the objects and on the particular characteristics of the surrounding space (Coppa M.M., 1997).We have therefore devised a playful-practical laboratory to allow a sensory disabilitypublic,with various degrees of blindness, to reach zoological and scientific contents and then re-connect to more general problems such as the numerous environmental emergencies of this decade. Thanks to a convention between the “IstitutodeiCiechiOpereriunite I. Florio – F. ed A. Salamone” of Palermo and the “Consiglio Nazionale delleRicerche - Istituto per lo studio degliimpattiAntropici e Sostenibilità in ambientemarino” of Capo Granitola (TP), we start with the project "The world of birds", developed from January to April 2019 and divided into three main themes. The third of which is the focus of this report: Nest and songs

“On the science’s wing”: zoological laboratory (I) of the formative proposal of inclusive scientific divulgation

The scientific divulgation work is increasingly like a facilitator task. In fact, in this work it is primary to transform the results and the notions of scientific research so that they became accessible to the public, understood as the largest possible number of people. However, this information flow turns out to be purely verbal, moreover with a language rich of visual references, that are inaccessible and incomprehensible for the user with sensory disabilities. Wehavethusestablished a convention between the “Istituto dei Ciechi Opere riunite I. Florio – F. ed A. Salamone” of Palermo and the “Consiglio Nazionale delle Ricerche - Istituto per lo studio degli impatti Antropici e Sostenibilità in ambiente marino” of Capo Granitola (TP). Wedeveloped a formative proposal that links the science world with sensory disabilities, proposing Birds as principal argument and the whole world connected to it. The birds appear as the key to connect to different scientific issues (pollution, environmental changes, exploitation of resources) to create new knowledge in the public, through the suggestions that the workshop lessons can give people, both disabled or not. All this in order to bring them closer to these subjects and make the contents of our laboratories as inclusive as possible. The project "The world of birds", developed from January to April 2019 is divided into three main themes, the first of which is the focus of this report: The bird plumage