Epidemiologia & Prevenzione最新文献

Juvenile prisons represent a jumble of dilemmas and choices for those concerned about the health and future of young detained people. While often presented as an opportunity for "rescue" and even social redemption, juvenile justice facilities offer a variety of approaches, ranging from the more advanced ones that allow effective interactions with the "outside" (family, school, and the world of work) to the more closed ones where the lack of support and activities exposes the most serious aspects of any incarceration: violence, isolation, and various forms of addiction. Italy's main and largest juvenile prison, named after Cesare Beccaria (an Italian philosopher universally renowned for laying the conceptual foundations against the death penalty and torture), has been experiencing a period of great difficulty for years, characterized by widespread violence, inadequate care for the needs of young people in prison, staff frustration, and social criminalization of inmates, accompanied by the stigmatization of those who work there. The author analyses the risks for young people detained in such places and invites to reflect about what general conclusions can be drawn about juvenile prisons in today's Italian society.

Objectives: to estimate CO2 emissions for different commuting modes before, during, and after the COVID-19 lockdown, and define scenarios to assess their impact on the environment and health.

Design: cross-sectional study using data retrieved from a survey.

Setting and participants: the study included anonymous participation from both researchers involved in the Climactions project and the general population; the questionnaire was made available through social media. Information was gathered on the transportation modes used to commute, the distance travelled and travel times before, during, and after the COVID-19 emergency, and proposals for actions/solutions to enhance sustainable commuting in urban areas.

Main outcome measures: the amount of CO2 emissions due to different commuting modes during various stages of the pandemic was estimated based on vehicle-specific emission coefficients provided by the European Environmental Agency, taking into account the average number of passengers per vehicle. Sustainable commuting scenarios were also proposed, including active transportation (walking, cycling, etcetera).

Results: the online questionnaire was filled-in by 2,904 persons, predominantly women (62.3%) and residents in Northern Italy (44.6%). Over 80% of the respondents were aged over 40 (0.7% <25 years). On average, the distance travelled on a daily commute was 23.6 km (median: 13 km), with longer distances in the Southern Regions (average: 38.2 km, median: 20 km). The average per-capita CO2 emissions were 2 kg per day in the pre-pandemic situation. The reduction in commuting during lockdown periods led to a significant decrease in estimated CO2 emissions, with an average per capita reduction of about 100 grams per day. From September 2020, the increase in smart working among respondents still allowed for a reduction in estimated CO2 levels, despite an increase in emissions from private vehicle use (1.5 kg per capita per day). Considering sustainable scenarios, a 15-minute walk during the daily commute would lead to a reduction in estimated CO2 levels of up to 0.7 kg per capita per day. Regarding the statement that "improving air quality in cities and reducing greenhouse gas emissions are useful actions to combat climate change", 94% of respondents strongly agreed.

Conclusions: in Italy, road transport accounts for approximately 25% of the total CO2 emissions. The lockdown provided a natural scenario for reducing emissions in urban areas, and the implementation of smart working was associated with a decrease in CO2 emissions due to reduced commuting. However, it is crucial to promote sustainable and active transportation modes for daily commuting such as walking and cycling, also considering the significant health co-benefits.

Background: public health aims to promote a health-centred approach in all policies, even in adaptation and mitigation policies for climate change.

Objectives: to provide a critical summary on legislations, policies and case studies at international, national and local level and to assess the implementation of the "health lens", in support of researchers and workers on environment and health.

Design: document review on legislations, policies and case studies, focusing on mitigation of urban health island and sustainable mobility.

Methods: a policy and legislation review was carried out from institutional websites at European and local level. Sustainable urban mobility plans (SUMP) and energy and climate action plans (SECAP) were retrieved for the cities included in the Climactions project (Genoa, Turin, Bologna, Rome, Bari, Palermo) from local authorities' websites. Best practices of urban heat island mitigation and sustainable mobility were searched from European platforms (Climate adapt, Urban mobility observatory -- ELTIS, EIT Urban Mobility) to obtain a critical picture of adaptation and mitigation options in cities.

Results: the review shows a large number of legislations, plans, and programmes on adaptation and mitigation both at European and Italian level with a gap between planned and actually implemented actions also due to the lack of dedicated economic resources. There is also an inequal level of implementation among Italian regions, with some criticalities, for example, in the citizen participatory process within the strategic environmental assessment of SUMPs, SECAPs, and adaptation plans. At the local level, in the last decade, several best practices of urban heat island mitigation and sustainable mobility were experienced in different sectors including new urban green space infrastructures, albedo enhancement measures, car-pooling apps, incentives to active mobility, temporary streets liberation, and a combination of measures within adaptation plans such as London Climate Action Plan and Barcelona Superblock programme. Only few measures were health centred embedding public health into urban planning (e.g., the London plan based on the 'healthy streets' approach) suggesting health benefits for the population.

Conclusions: the recent increase in regulations and policies at European and national level is not paralleled by real progresses in climate actions, despite the constant growth of annual emissions. Therefore, there is the need to accelerate the fossil fuel emission mitigation while promoting adaptation to be ready to counteract actual and future climate related risks. Health workers such as paediatricians, family doctors, epidemiologists can advocate the transition and support the citizens and youth engagement in climate-related decision making.

Background: twenty years after the last review of the European Union (EU) pharmaceutical legislation, the pharmaceutical sector has significantly changed and become more globalised. Unmet medical needs and unequal access to innovative treatments persist. In addition, there is a growing awareness of the need for developing new antibiotics and a rational use of existing ones. In this context, in 2020 the European Commission proposed a new pharmaceutical strategy for Europe aiming to ensure equitable access to effective and safe medicines while strengthening the competitiveness of the sector globally. In line with this strategy, the Commission itself proposed a comprehensive reform of the pharmaceutical legislation in 2023, which was later amended by the European Parliament.

Objectives: to analyse some of the main proposals for changes to the current regulatory framework and discuss their impact on European pharmaceutical policies and public health.

Design: analysis of the current regulatory context on medicines and comparison with the main proposals of the European Commission and Parliament.

Results: among the most significant reform proposals are: 1. the changes to data and market protection with the creation of a system of incentives to support innovation, promoting the development of safe and effective medicines and their access to patients, and making the EU attractive to the pharmaceutical companies; 2. the set of measures to incentivise the development of new antimicrobials and control antimicrobial resistance; 3. the measures aimed at increasing the transparency of the European Medicines Agency.

Conclusions: this critical and independent analysis of the current draft reform of the pharmaceutical legislation shows important novelties that could deeply transform the current European regulatory framework of the pharmaceutical sector, highlighting some critical issues regarding the significance and effectiveness of some proposals. Once the entire legislative process has been completed, it will be possible to witness the implementation of the reform in its final version, which will require an assessment of its real impact.