Publications by authors named "Gianluigi Ferrante"

60 Publications

The perception of Italian pregnant women and new mothers about their psychological wellbeing, lifestyle, delivery, and neonatal management experience during the COVID-19 pandemic lockdown: a web-based survey.

BMC Pregnancy Childbirth 2021 Jul 1;21(1):473. Epub 2021 Jul 1.

Obstetrics and Gynecology Unit, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.

Background: In response to the COVID-19 pandemic, drastic measures for social distancing have been introduced also in Italy, likely with a substantial impact in delicate conditions like pregnancy and puerperium. The study aimed to investigate the changes in lifestyle, access to health services, and mental wellbeing during the first Italian lockdown in a sample of Italian pregnant women and new mothers.

Methods: We carried out a web-based survey to evaluate how pregnant women and new mothers were coping with the lockdown. We collected data about healthy habits (physical exercise and dietary habits), access to health services (care access, delivery and obstetric care, neonatal care, and breastfeeding), and mental wellbeing (psychological well-being and emotive support). Descriptive analysis was performed for both groups of participants, whereas a Poisson analysis was used to measure the association between some structural variables (age, education, socio-economic data, partner support, contact, free time, previous children, and pregnancy trimester) and anxiety or depression, difficulties in healthy eating and reduction in physical activity after lockdown started. Chi2 and Adjusted Prevalence Ratios were estimated only for pregnant women.

Results: We included 739 respondents (response rate 85.8 %), 600 were pregnant (81.2 %), and 139 (18.8 %) had delivered during lockdown (new mothers). We found a high score for anxiety and depression in 62.8 % of pregnant women and 61.9 % of new mothers. During the lockdown, 61.8 % of pregnant women reduced their physical exercise, and 44.3 % reported eating in a healthier way. 94.0 % of new mothers reported to have breastfed their babies during the hospital stay. Regarding the perceived impact of restrictive measures on breastfeeding, no impact was reported by 56.1 % of new mothers, whereas a negative one by 36.7 %.

Conclusions: The high prevalence of anxiety and depressive symptoms in pregnant women and new mothers should be a public health issue. Clinicians might also recommend and encourage "home" physical exercise. On the other hand, about half of the sample improved their approach towards healthy eating and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.
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http://dx.doi.org/10.1186/s12884-021-03904-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246432PMC
July 2021

Impact of Prior Antibiotic Use in Primary Care on Resistance to Third Generation Cephalosporins: A Case-Control Study.

Antibiotics (Basel) 2021 Apr 16;10(4). Epub 2021 Apr 16.

Department of Medical Sciences and Public Health, Faculty of Medicine and Surgery, University of Cagliari, 09124 Cagliari, Italy.

Research is lacking on the reversibility of antimicrobial resistance (AMR). Thus, we aimed to determine the influence of previous antibiotic use on the development and decay over time of third generation cephalosporin (3GC)-resistance of . Using the database of hospital laboratories of the Autonomous Province of Bolzano/Bozen (Italy), anonymously linked to the database of outpatient pharmaceutical prescriptions and the hospital discharge record database, this matched case-control study was conducted including as cases all those who have had a positive culture from any site for 3GC resistant (3GCREC) during a 2016 hospital stay. Data were analyzed by conditional logistic regression. 244 cases were matched to 1553 controls by the date of the first isolate. Male sex (OR 1.49, 95% CI 1.10-2.01), older age (OR 1.11, 95% CI 1.02-1.21), the number of different antibiotics taken in the previous five years (OR 1.20, 95% CI 1.08-1.33), at least one antibiotic prescription in the previous year (OR 1.92, 95% CI 1.36-2.71), and the diagnosis of diabetes (OR 1.57, 95% CI 1.08-2.30) were independent risk factors for 3GCREC colonization/infection. Patients who last received an antibiotic prescription two years or three to five years before hospitalization showed non-significant differences with controls (OR 0.97, 95% CI 0.68-1.38 and OR 0.85, 95% CI 0.59-1.24), compared to an OR of 1.92 (95% CI 1.36-2.71) in those receiving antibiotics in the year preceding hospitalization. The effect of previous antibiotic use on 3GC-resistance of is highest after greater cumulative exposure to any antibiotic as well as to 3GCs and in the first 12 months after antibiotics are taken and then decreases progressively.
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http://dx.doi.org/10.3390/antibiotics10040451DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073604PMC
April 2021

A comparison of diagnostic indicators of cervical cancer screening among women accessing through volunteer organisations and those via the organised programme in Turin (Piedmont Region, Northern Italy).

Epidemiol Prev 2020 Sep-Dec;44(5-6 Suppl 1):115-123

SSD epidemiologia screening, CPO AOU Città della salute e della scienza di Torino (Italy).

Objectives: to compare cervical cancer screening diagnostic indicators in women accessing screening through volunteer non-governmental organisations (NGOs) and in those who access via the National Health Service (NHS) programme.

Design: cohort study on archive data.

Setting And Participants: the study cohort consists of 93,086 women aged 30-64 years who underwent an HPV test via NHS screening programme or through premises implemented within volunteers NGOs in Turin between 2015 and 2019. The screening history and Census data recorded into the Piedmont screening archive were used.

Main Outcome Measures: positive baseline HPV test, positive triage cytology (low-grade lesions, ASC-US, L-SIL and high-grade lesions, H-SIL, ASC-H, AGC, Cancer), attendance at one-year HPV test repeat, referral and attendance to colposcopy at first and test repeat, and detection rate at first and test repeat, for cervical intraepithelial neoplasia grade >=2 (CIN2+) and >=3 (CIN3+), overall detection rates.

Results: women performing cervical screening through volunteer NGOs (WASVO) are disadvantaged in terms of diagnostic indicators compared to women accessing via the NHS. WASVO are 60% more likely to be positive at the first HPV-test (adjusted prevalence ratio 1.6; 95%CI 1.2-2.0); their likelihood of being referred to colposcopy is double (adj PR 2.1; 95%CI 1.3-3.4); attendance rate to one year HPV test repeat is lower (adj PR 0.2; 95%CI 0.1-0.5); detection rates at first HPV screening test both for CIN2+ (adj PR 2.1; 95%CI 0.9-4.6) and CIN3+ (adj PR 2.1; 95%CI 0.9-5.1) is higher, even if statistical significance is borderline for the latter results.

Conclusions: those responsible for screening programmes should establish and maintain collaborative relationships with local volunteer NGOs and migrant organisations for promoting strategies to raise awareness on cancer prevention among subgroups that are not captured in the main screening programs.
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http://dx.doi.org/10.19191/EP20.5-6.S1.P115.081DOI Listing
June 2021

[Did social isolation during the SARS-CoV-2 epidemic have an impact on the lifestyles of citizens?]

Epidemiol Prev 2020 Sep-Dec;44(5-6 Suppl 2):353-362

SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy).

Objectives: to study the impact of social isolation, related to the SARS-CoV-2 epidemic, on lifestyles in Italy, with particular reference to physical activity, alcohol consumption, smoking, and eating habits. Moreover, to investigate the association between lifestyle changes during the pandemic and sociodemographic characteristics.

Design: epidemiological investigation based on a cross-sectional study.

Setting And Participants: between April 21st and June 7th 2020, an electronic questionnaire to collect information on physical activity, alcohol consumption, smoking, and eating habits during the period of home containment was made available on the web. Respondents were recruited through non-probabilistic snowball sampling. The link to the electronic questionnaire was disseminated through institutional websites, social networks (Facebook, Twitter), and messaging systems such as WhatsApp, Telegram, and SMS. A total of 10,758 interviews were collected, of which 7,847 (73%) were complete for a minimum set of indicators (age, gender, and area of residence).

Main Outcome Measures: reduction of physical activity, increase in alcohol consumption, increase in cigarette smoking, increase in consumption of unhealthy foods (processed meat, red meat or desserts) without increasing healthy foods (vegetables, legumes or whole grains) and, vice versa, increase in consumption of healthy foods without increasing unhealthy foods.

Results: the population under study consists of 7,847 people with a mean age of 48.6 years (standard deviation: 13.9). Most of respondents are women (71.3%), 92.5% have a high school or university degree and 91% live in Northern Italy. During home containment, 56% of interviewees reported they had reduced the time devoted to physical activity. In particular, this happened among older people and those living in large cities. More than 17% of respondents increased their alcohol consumption, especially men, those highly educated and those living in large urban centres. Older age and residence in the Southern Italy represent, instead, protective factors for this outcome. Among smokers, 30% increased cigarette consumption during the period of home containment, on average of 5.6 cigarettes per day. A small proportion of former smokers (0.6%) resumed smoking. With regard to eating habits, 3 out of 10 respondents (29.9%) reported an inappropriate eating behaviour (increasing unhealthy food without increasing healthy ones). This behaviour was less frequent among men (adjusted Prevalence Ratio 0.80, p=0.005). A lower percentage of respondents (24.5%) increased the consumption of healthy foods without increasing the consumption of unhealthy ones.

Conclusions: the results of this survey show that social isolation during the SARS-CoV-2 pandemic has had an impact on citizens' behaviours. In particular, it was found a noteworthy increase in sedentariness, alcohol consumption, and tobacco smoking. A meaningful proportion of respondents reported a worsening of eating habits, especially among women. However, for each of the behavioural risk factors investigated, small proportions of respondents with resilient attitudes were also found, namely, capable of taking advantage of social isolation for improving their daily habits. Studying changes in lifestyles during a pandemic, identifying population groups most at risk of adopting unfavourable behaviours, is a useful tool for policy makers to plan targeted and effective public health interventions.
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http://dx.doi.org/10.19191/EP20.5-6.S2.137DOI Listing
January 2021

[Deaths from noncommunicable diseases attributable to behavioral risk factors in Italy and Italian regions, 2016].

Epidemiol Prev 2019 Sep-Dec;43(5-6):338-346

SS Epidemiologia dell'ambiente e del lavoro, SC Epidemiologia dei fattori di rischio e degli stili di vita, Istituto per lo studio, la prevenzione e la rete oncologica (ISPRO), Firenze.

Objectives: to estimate the number of deaths from noncommunicable chronic diseases (NCD) attributable to behavioural risk factors (tobacco smoking, unhealthy nutrition, physical inactivity, overweight, and excessive alcohol use) in 2016 for Italy and for the Italian regions.

Design: descriptive study.

Setting And Participants: mortality data were obtained by the Italian National Institute of Statistics. Causes of deaths from NCD associated with the five RFs were selected. Italian attributable fractions were obtained by the 2016 estimates of the Global Burden of Disease Study and applied to the mortality data. Regional prevalence of risk factors was obtained by the national surveillance system PASSI for the years 2013-2016.

Main Outcome Measures: absolute number of attributable deaths, joint attributable fraction, proportion of total deaths attributable to RFs (MAprop).

Results: about 191,000 out of 614,307 deaths occurred in Italy in 2016 were attributable to combined RFs (about 37% in males; 26% in women). Joint MAprop was between 33% in men (24% in women) from Val d'Aosta and 40% in men (31% in women) from Campania. In Italy, 17% and 6% of the total amount of deaths were attributable to smoking in men and women, respectively; 6% and 3% to alcohol abuse; 7% and 8% to overweight; 13% and 12% to dietary RFs, and 2% and 3% to low physical activity. The higher proportion of attributable deaths by age-group was recorded in people aged 40-59 years (43% in men; 28% in women). Regional differences in attributable deaths are confirmed by regional RF prevalence recorded by the PASSI surveillance system for the years 2013-2016.

Conclusions: these are the first estimates of the number of deaths due to NCDs attributable to behavioural RFs estimated for each region and for Italy as a whole. Effective primary prevention policies should be reinforced, since these RFs are potentially modifiable.
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http://dx.doi.org/10.19191/EP19.5-6.P338.103DOI Listing
April 2020

[Socioeconomic and regional inequalities in smoking cessation in Italy, 2014-2017].

Epidemiol Prev 2019 Jul-Aug;43(4):275-285

Ministero della salute, Roma.

Objectives: to study regional differences in Italy of quit smoking attempts and of successful abstinence, in relation to socioeconomic status, cigarettes per day (cig/die), and smoking cessation method in a representative sample of the population resident in Italy.

Design: cross-sectional survey.

Setting And Participants: in 2014-2017, PASSI survey (the ongoing Italian behavioural risk factor surveillancesystem) gathered data on smoking and sociodemographic characteristics of 35,157 smokers; 13,130 aged 18-69 years made >1 quit attempt in the previous year, 1,176 of them were successful quitters for >6 months.

Main Outcome Measures: proportion of smokers who tried to quit; proportion of smokers who successfully quitted.

Results: about 35% of smokers made >1 quit attempt in the last year. Northern Italians and smokers with many economic difficulties were more likely to make a quit attempt, whereas heavy smokers were less likely. About 10% of attempters were abstinent for >6 months: from 6% in Campania and Abruzzo to 17% in the Bolzano province. Attempters who smoked <20 cig/die had higher likelihood to be abstinent, compared to those smoking <20 cig/die. Attempters with many economic difficulties had the lowest likelihood to be abstinent (7%), with no differences by region, educational level, quitting method. Attempters with no economic difficulties recorded the highest cessation rates (12%). Among them, those from Northern Italy, Tuscany, Marche, and Lazio (Central Italy), and Apulia (Southern Italy) compared to attempters from most Southern regions, and those with high education level or using traditional quitting methods compared to those using electronic cigarettes or unaided were more likely to be abstinent for >6 months.

Conclusions: smokers with many economic difficulties in all Italy, and those with no economic difficulties residing in Umbria and in most Southern Italian regions, except for Basilicata and Puglia, recorded lower chances to quit. Regional differences may have two possible explanations integrating each other: Northern-Central regions are in a slightly more advanced stage in the tobacco epidemic; regions which developed specific tobacco control interventions in their Prevention Plans recorded higher quitting rates. Not-yet-implemented interventions could promote smoking cessation in smokers from Southern Italy and in those with lower socioeconomic status: reimbursement of smoking cessation treatments, a well-developed national Quitline linked to a webplatform and to mobile phone application or text-messaging, an opt-out smoking cessation service offered systematically to all smokers at every encounter in hospitals or health services.
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http://dx.doi.org/10.19191/EP19.4.P275.078DOI Listing
April 2020

Is the association between precarious employment and mental health mediated by economic difficulties in males? Results from two Italian studies.

BMC Public Health 2019 Jul 3;19(1):869. Epub 2019 Jul 3.

Epidemiologia&Precariato, Group for the study of precarious work of the Italian Association of Epidemiology (AIE), Rome, Italy.

Background: Flexible employment is increasing across Europe and recent studies show an association with poor mental health. The goal of the current study is to examine this association in the Italian population to assess the possible mediating role of financial strain.

Methods: Data were obtained by two Italian cross-sectional studies (PASSI and HIS) aimed at monitoring the general population health status, health behaviours and determinants. Mental health status was assessed using alternatively two validated questionnaires (the PHQ-2 and the MCS-12 score) and Poisson regression models were performed to assess if precarious work was associated with poor mental health. A formal mediation analysis was conducted to evaluate if the association between precarious work and mental health was mediated by financial strain.

Results: The analyses were performed on 31,948 subjects in PASSI and on 21,894 subjects in HIS. A nearly two-fold risk of depression and poor mental health was found among precarious workers, compared to workers with a permanent contract, which was strongly mediated by financial strain.

Conclusions: Even with the limitations of a cross-sectional design, this research supports that precarious employment contributes through financial strain to reduce the mental health related quality of life and to increase mental disorders such as symptoms of depression or dysthymia. This suggests that when stability in work cannot be guaranteed, it would be appropriate to intervene on the wages of precarious jobs and to provide social safety nets for ensuring adequate income.
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http://dx.doi.org/10.1186/s12889-019-7243-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609380PMC
July 2019

[Precarious employment in public Health research: an initiative to improve working and contractual conditions of precarious workers.]

Recenti Prog Med 2019 Feb;110(2):63-64

Gruppo di lavoro Epidemiologia e Precariato dell'Associazione Italiana di Epidemiologia - Dipartimento di Scienze Cliniche e Biologiche, Università di Torino.

The problem of precarious employment is particularly rooted in epidemiological and public health research. Through a shared path, within the Italian Association of Epidemiology, a commitment document on precariousness in the epidemiological field has been produced with the aim of improving the working and contractual conditions of the precarious personnel involved in the initiative. If this experience were repeated in other scientific associations, the number of precarious workers with more protection would increase.
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http://dx.doi.org/10.1701/3112.30999DOI Listing
February 2019

Roll-your-own cigarette use in Italy: sales and consumer profile-data from PASSI surveillance, 2015-2016.

Int J Public Health 2019 Apr 25;64(3):423-430. Epub 2019 Jan 25.

Department of Environmental Health Sciences, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.

Objectives: The use of roll-your-own (RYO) cigarette has substantially increased in most high-income countries recently. This work aims to update Italian trends on loose tobacco sales and to describe the consumer profile of predominant RYO users.

Methods: Data from the Italian Agency of Customs and State Monopolies and from PASSI (Italian behavioral risk factor surveillance system) were used. Information on 16,858 interviews to current smokers aged 18-69 was analyzed.

Results: Sales of loose tobacco increased more than sevenfold between 2004 and 2017. In 2015-2016, 11.6% of smokers reported smoking predominantly RYO cigarettes, with higher percentages among the youngest where a significant association between use of RYO and education was observed, unlike what happened in older adults. The association between economic difficulties and use of RYO was observed only in older adults.

Conclusions: A growing trend in RYO cigarette sales was registered between 2004 and 2017. In young smokers, the greater use of RYO was observed among the most educated regardless of financial strain, while in older ones among those with economic difficulties.
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http://dx.doi.org/10.1007/s00038-019-01204-5DOI Listing
April 2019

[France defeats Italy 1 million-zero].

Epidemiol Prev 2018 Sep-Dec;42(5-6):384-385

Osservatorio epidemiologico, ASL Vercelli.

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http://dx.doi.org/10.19191/EP18.5-6.P384.113DOI Listing
September 2019

[The war on sugar].

Epidemiol Prev 2018 Mar-Apr;42(2):178-179

Osservatorio epidemiologico, ASL Vercelli.

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http://dx.doi.org/10.19191/EP18.2.P178.048DOI Listing
March 2019

An Estimate of Attributable Cases of Alzheimer Disease and Vascular Dementia due to Modifiable Risk Factors: The Impact of Primary Prevention in Europe and in Italy.

Dement Geriatr Cogn Dis Extra 2018 Jan-Apr;8(1):60-71. Epub 2018 Feb 21.

National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy.

Background: Up to 53.7% of all cases of dementia are assumed to be due to Alzheimer disease (AD), while 15.8% are considered to be due to vascular dementia (VaD). In Europe, about 3 million cases of AD could be due to 7 potentially modifiable risk factors: diabetes, midlife hypertension and/or obesity, physical inactivity, depression, smoking, and low educational level.

Aims: To estimate the number of VaD cases in Europe and the number of AD and VaD cases in Italy attributable to these 7 potentially modifiable risk factors.

Methods: Assuming the nonindependence of the 7 risk factors, the adjusted combined population attributable risk (PAR) was estimated for AD and VaD.

Results: In Europe, adjusted combined PAR was 31.4% for AD and 37.8% for VaD. The total number of attributable cases was 3,033,000 for AD and 873,000 for VaD. In Italy, assuming a 20% reduction of the prevalence of each risk factor, adjusted combined PAR decreased from 45.2 to 38.9% for AD and from 53.1 to 46.6% for VaD, implying a 6.4 and 6.5% reduction in the prevalence of AD and VaD, respectively.

Conclusion: A relevant reduction of AD and VaD cases in Europe and Italy could be obtained through primary prevention.
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http://dx.doi.org/10.1159/000487079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869579PMC
February 2018

[The place of prevention].

Epidemiol Prev 2018 Jan-Feb;42(1):100-101

Centro nazionale di ricerca e valutazione preclinica e clinica dei farmaci, Istituto superiore di sanità, Roma.

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http://dx.doi.org/10.19191/EP18.1.P100.029DOI Listing
March 2019

The Use of TIGR Matrix in Breast Aesthetic and Reconstructive Surgery: Is a Resorbable Synthetic Mesh a Viable Alternative to Acellular Dermal Matrices?

Clin Plast Surg 2018 Jan 18;45(1):65-73. Epub 2017 Sep 18.

National Center of Disease Prevention and Health Promotion, Italian National Institute of Health, Viale Regina Elena, Rome 299 00161, Italy.

The authors document their experience in the use of synthetic 100% bioresorbable surgical mesh (TIGR Matrix, Novus Scientific, Uppsala, Sweden) in breast reconstruction as well as in breast aesthetic surgery. They performed a retrospective review on patients who underwent implant-based breast reconstruction as well as patients who underwent breast reduction mammoplasty procedures with the use of TIGR Matrix Surgical Mesh. When compared with other synthetic but nonresorbable meshes, it appears to show a potentially lower seroma and infection rates, but most importantly, a lower rate of revisional and mesh explantation surgeries.
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http://dx.doi.org/10.1016/j.cps.2017.08.005DOI Listing
January 2018

The Regulatory Environment and Cost of Electronic Cigarettes in Italy, 2014-2015, Influenced their Use for Quitting.

Nicotine Tob Res 2018 07;20(8):1029-1030

National Institute of Health (ISS), Rome, Italy.

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http://dx.doi.org/10.1093/ntr/ntx172DOI Listing
July 2018

Epidemiology of chronic respiratory diseases and associated factors in the adult Italian population.

Eur J Public Health 2017 12;27(6):1110-1116

Ca'Foscari University, Department of Statistics, Dorsoduro 3246, 30123,Venice, Italy.

Background: Detailed epidemiology of Chronic Respiratory Diseases (CRDs) and of their risk and protective factors is needed to plan preventive interventions to reduce the burden of CRDs on population health. This study determines the prevalence of doctor-diagnosed CRDs and its associated factors in the adult Italian population.

Methods: Data was collected from adults participating in the ongoing cross-sectional Italian Behavioural Risk Factor Surveillance System (PASSI) between 2013 and 2015.

Results: Among 108 705 respondents, 7.0% reported a CRD (3.4% asthma, 2.6% COPD, 1.0% Asthma-COPD Overlap Syndrome). Current smoking was more frequent in the group with CRD compared to those without (30.8% vs. 25.2%, P < 0.001), as was physical inactivity (41.9% vs. 36.4%, P 0.009) and overweight/obesity (52.4% vs. 41.4%, P 0.009). Adults with CRDs also reported appropriate perception of insufficient physical activity and excessive body weight, adopted protective behaviours and received preventive interventions more often than those without CRDs.

Conclusions: Italian adults with CRDs are more likely to be exposed to aggravating factors but are also knowledgeable of their condition and amenable to behaviour change. Since effective interventions for modifying these factors are available, there is an opportunity to reduce the significant disease burden of CRDs through specifically targeted health promotion interventions.
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http://dx.doi.org/10.1093/eurpub/ckx109DOI Listing
December 2017

Comparison of rubella immunization rates in immigrant and Italian women of childbearing age: Results from the Italian behavioral surveillance system PASSI (2011-2015).

PLoS One 2017 2;12(10):e0178122. Epub 2017 Oct 2.

National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Italian National Institute of Health (ISS), Rome, Italy.

Background: International migration rapidly increased in the last decade, raising a renewed attention to its impact on public health. We evaluated differences in rubella immunization rate (RIR) between immigrant and Italian women of childbearing age and tried to identify the driving factors causing them.

Methods: We analyzed data from the Italian behavioral surveillance system PASSI collected in 2011-2015 in a nationally representative sample of residents in Italy. The analysis was performed using log-binomial models to compare RIR between 41,094 Italian women and 3140 regular immigrant women of childbearing age (18-49 years), stratifying the latter by area of origin and length-of-stay in Italy (recent: ≤ 5-years; mid-term: 6-10-years; long-term: > 10-years).

Results: Immigrant women showed a RIR of 36.0% compared to 60.2% among Italian women (RIR-ratio = 0.60, 95% confidence interval (CI): 0.57-0.63). Adjusting for demographic characteristics (i.e., sex, age and area of residence), socio-economic factors (i.e., education, occupation, family composition and economic status) and an indicator of the presence of at least one health-risk behavior (i.e., physical inactivity, current cigarette smoking, excessive alcohol consumption and excess weight) did not significantly change this difference (RIR-ratio = 0.56, 95% CI: 0.53-0.59). Recent immigrants (RIR-ratio = 0.47, 95% CI: 0.42-0.53) and immigrants from high migratory pressure countries (HMPC) in sub-Saharan Africa (RIR-ratio = 0.41, 95% CI: 0.31-0.56) and Asia (RIR-ratio = 0.42, 95% CI: 0.33-0.53) showed the greatest differences in RIR compared with Italian women.

Conclusions: Differences in RIR between immigrant and Italian women were not explained by different demographic, socioeconomic and health-risk behaviors characteristics. As entitlement to free-of-charge immunization in Italy is universal, regardless of migration status, other informal barriers (e.g., cultural and barriers to information access) might explain lower RIRs in immigrant women, especially recent immigrants and those from HMPC in sub-Saharan Africa and Asia. Further investigations are needed to identify obstacles and appropriate promotion and access-enabling strategies for rubella immunization.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178122PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624576PMC
October 2017

Electronic cigarette use as an aid to quit smoking in the representative Italian population PASSI survey.

Prev Med 2017 Sep 23;102:1-5. Epub 2017 Jun 23.

Italian Ministry of Health, Center for Disease Prevention and Control, Rome, Italy.

This study explored electronic cigarette (e-cigarette) use as an aid to quit smoking and compared abstinence rates for different quitting methods in a representative sample of the Italian population. In the 2014-2015 PASSI survey, the ongoing Italian behavioural risk factor surveillance system, 6112 adults who smoked and made at least one quit attempt in the previous 12months, were categorized into three groups according to the method used in their most recent quit attempt: e-cigarette only, no aid, other quitting methods (medications; programmes delivered in smoking cessation services; other unspecified methods). The primary outcome was self-reported abstinence for a period ≥6months, adjusted for potential confounders. Eleven percent used e-cigarettes only, 86% no aid, 3% other quitting methods. Smoking abstinence was reported among 9% of those using no aid; 8% of e-cigarette users; 15% of those using other methods. No significant differences in abstinence were observed for e-cigarette users compared with those reporting no aid (adjusted Prevalence Ratio [aPR]=0.81; 95%Confidence Interval (CI)=0.58-1.14). Changing the reference group to e-cigarette users, those using other quitting methods were significantly more likely to report abstinence than e-cigarette users (aPR=1.76; 95%CI=1.07-2.88). One out of ten smokers who attempted to quit in 2014-2015 in Italy used e-cigarettes. E-cigarettes users were as likely to report abstinence as those using no aid, but were less likely to report abstinence than users of established quitting methods. Further studies are needed to understand the relationship between e-cigarette types used to quit and abstinence rates.
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http://dx.doi.org/10.1016/j.ypmed.2017.06.029DOI Listing
September 2017

[Non-tenured researchers: a successful story].

Epidemiol Prev 2017 Mar-Apr;41(2):74

Ricercatori precari, Istituto superiore di sanità.

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http://dx.doi.org/10.19191/EP17.2.P74.019DOI Listing
July 2019

Quit attempts and smoking cessation in Italian adults (25-64 years): factors associated with attempts and successes.

Eur J Public Health 2017 08;27(4):717-722

Department of Translational Medicine, Avogadro University, Novara, Italy.

Background: Over the past 50 years there was a substantial decrease in the prevalence of smoking in Italy. The objective of this work is to describe attempts to quit and cessation success in Italian smokers.

Methods: A surveillance on health-related behaviors (PASSI) was conducted in 2007-13 on a sample of 203 610 Italian adults 25-64 years of age. An analysis of smokers' characteristics and behaviors was performed, focusing on attempts to quit and quit success. Data from national surveys (ISTAT) from 1983 to 2013 (Italian adults, 25-64 years of age, 1983: 46 634; 1987: 40 915; 1990: 36 622; 2000: 77 531; 2005: 71 032; 2013: 64 205) were used to explore if a cessation trend in Italy exists.

Results: Smokers who quit in the previous year and were still abstinent when interviewed increased from 1990 to 2013. In the years 2011-13, 38% of people who had smoked in the last 12 months reported at least a quit attempt during the same period and 7% were still abstinent when interviewed. An association of successful recent quit attempts with higher educational level, absence of economic difficulties and younger age was found. In the years 2007-13, the great majority tried to stop unaided. Having received assistance from a cessation program did not increase the probability of enduring abstinence.

Conclusions: In Italy interventions to drive more smokers to quit should be focused in particular on disadvantaged groups. Initiatives have to be studied not only to incentive more smokers to try to quit, but also to maintain abstinence over time.
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http://dx.doi.org/10.1093/eurpub/ckw262DOI Listing
August 2017

Polyurethane Implants in 2-Stage Breast Reconstruction: 9-Year Clinical Experience.

Aesthet Surg J 2017 Feb 9;37(2):171-176. Epub 2016 Dec 9.

Dr Pompei is Head of the Plastic and Reconstructive Surgery Unit, and Drs Arelli, Labardi, and Marcasciano are Consultant Plastic Surgeons, San Camillo Hospital, Rome, Italy. Dr Evangelidou is a Plastic Surgeon, Emirates Hospital Group Plastic and Reconstructive Surgery Department, Dubai, United Arab Emirates. Dr Ferrante is a Researcher, National Institute of Health, Rome, Italy.

Background: Capsular contracture (CC) is a major complication of breast surgery with smooth and textured implants. Polyurethane (PU) foam-coated breast implants were developed to decrease the incidence of CC.

Objectives: The authors determined the incidence of CC following 2-stage breast reconstruction using PU foam-covered implants, with and without radiation therapy.

Methods: The records of 92 patients who received 115 PU implants were retrospectively reviewed. The rates of CC over time were compared for irradiated and nonirradiated groups with a Kaplan-Meier analysis and log-rank test. CC rates also were analyzed with respect to age.

Results: The median follow-up time for patients was 103.3 months. Nine patients experienced unilateral Baker grade III or IV fibrous CC, including 6 patients from the irradiated group and 3 patients from the nonirradiated group. The overall cumulative incidence of CC at 9 years was 8.1%. In the irradiated and nonirradiated groups, the 9-year cumulative incidence was 10.7% and 5.5%, respectively. CC occurred within 3 years in the irradiated group and within 7 years in the nonirradiated group. The incidence of CC appeared to be higher among younger patients.

Conclusions: Radiation therapy increases the risk of high-grade CC with textured or smooth implants. PU implants are associated with a much lower cumulative incidence of CC following 2-stage breast reconstruction, even when radiotherapy is performed. LEVEL OF EVIDENCE 3.
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http://dx.doi.org/10.1093/asj/sjw183DOI Listing
February 2017

The Modern Polyurethane-Coated Implant in Breast Augmentation: Long-Term Clinical Experience.

Aesthet Surg J 2016 Nov 27;36(10):1124-1129. Epub 2016 Sep 27.

Dr Pompei is Unit Head and Dr Arelli is a Plastic Surgeon, San Camillo Plastic and Reconstructive Surgery Unit, Rome, Italy. Dr Evangelidou is a Plastic Surgeon, Emirates Hospital Group Plastic and Reconstructive Surgery Department, Dubai, United Arab Emirates. Dr Ferrante is a Researcher, National Center of Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy.

Background: First-generation polyurethane foam-coated breast implants were associated with a low risk of capsular contracture (CC), but the risk of CC with modern polyurethane-coated silicone implants has not been established.

Objectives: The authors sought to determine the long-term rates of CC after primary breast augmentation with Microthane, a polyurethane-coated silicone gel implant.

Methods: A total of 131 patients (255 breasts) were evaluated in a retrospective study. Data were compiled from postoperative follow-up sessions at 2 weeks; 1, 3, 6, and 12 months; and annually thereafter. Rates of various complications, including CC, were determined.

Results: CC developed in 3 of the 255 implanted breasts (1.2%; Baker grade III or IV), and postoperative hematoma occurred in 2 implanted breasts (0.8%). Spontaneous CC that was not associated with other complications was observed in 1 implanted breast (0.4%). All instances of CC occurred before the 31st postoperative month.

Conclusions: For patients who undergo primary breast augmentation with modern polyurethane-coated implants, the long-term risk of CC is low.

Level Of Evidence: 3 Therapeutic.
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http://dx.doi.org/10.1093/asj/sjw171DOI Listing
November 2016

[Active mobility: thanks to bicycles, in Italy in 2014 saved 1,867 deaths and 1,5 million tonnes of CO2].

Epidemiol Prev 2016 Mar-Apr;40(2):146

Centro nazionale per l'epidemiologia, sorveglianza e promozione della salute (CNESPS), Istituto superiore di sanità, Roma.

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http://dx.doi.org/10.19191/EP16.2.P146.072DOI Listing
January 2018

[Tobacco smoking and alcohol intake in pregnant and breastfeeding women: preliminary data of the survey PASSI 2014].

Epidemiol Prev 2016 Jan-Feb;40(1):76

Centro nazionale per l'epidemiologia, la sorveglianza e la promozione della salute (CNESPS), Istituto superiore di sanità, Roma.

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http://dx.doi.org/10.19191/EP16.1.P076.019DOI Listing
September 2017
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