Epidemiology, Biostatistics, and Public Health
type: channel
description: EBPH aims to be a cross-discipline, international forum for scientific integration and evidence-based policymaking
publisher: Milano University Press
language: en
publication name: Epidemiology, Biostatistics, and Public Health
issn: 2282-0930
items: Examining Youth Protections against Gambling in Ireland: A Tiger Team (Red Team) Examination of the National Lottery
items: An Examination of Public Concerns Relating to Combined Text and Graphic Alcohol Warning Labels: An all-Ireland Cross-Sectional Study
items: Effectiveness and Safety of Control-IQ Technology in Preschool and School-Aged Children with Type 1 Diabetes: A Real-World Multicenter Study
items: Long-Term Mental Health Consequences Of Road Traffic Crashes: A Scoping Review
items: Prevention of cervical cancer in a rural primary care centre in Eswatini
items: Anthropometric Indicators Of Central Obesity In The Identification Of General And Cancer Related Risk Mortality: Findings From The Epic Italian Cohort
items: Dietary Patterns, Metabolomic Profiles, And Metabolic Outcomes By Menopausal Status
items: Health Literacy, Diet, and Lifestyles for the Promotion of Health and Empowerment of University Students and Staff: The “ALFADIET” Study
items: Validity Of Socioeconomic Inequality Indices over Time in Public Health Research: A Case Study on Ivsm and Maternal Data
items: Scrolling and Self: How Self-Esteem and Physical Activity Shape the Effects of Intagram Use on Eating Behavior in Universitary Students
items: Epidemiological Approaches to Healthy Ageing Research Using Data from the Share Project
items: Perioperative nutritional supplementation to reduce postoperative infections: a systematic review and meta-analysis
items: https://test-ojs-unimi-it.archicoop.it/index.php/ebph/article/view/29201
items: A Framework to Improve Data Quality and Manage Dropout in Web-Based Medical Surveys: Insights from an Ai Awareness Study among Italian Physicians
items: Impact of First and Further Decompensation in Metabolic-Dysfunction Associated Compensated Advanced Chronic Liver Disease
items: Blood Biomarkers of Aging and Multimorbidity Prognosis in Older Adults: Preliminary Results from the Bio-Sign Project
items: Protact-Us: A Study on the Long-Term Impact of Road Traffic Crashes in Europe
items: Psychiatric Disorders and Psychoactive Substance Use in Children and Adolescents: A Population-Based Study in Lombardy, 2016–2022
items: Cross-Country External Validation of a Multisource Comorbidity Score
items: Evaluation of an educational intervention program designed to increase vaccination attitude in prison setting: results from the RISE-Vac project
items: Data Harmonization of Psychosocial Questionnaires across Population Cohorts: A Differential Item Functioning Analysis
items: Anni di Vita Persi Aggiustati per Disabilita’ per Malattie Amianto Correlate in Italia nel Periodo 2010-2020
items: Adherence to Diabetes Care Pathways and Risk of Diabetes-Related Complications by Citizenship: A Population-Based Study from The Mighty Project (Cup P2022ASXKR)
items: Evaluation of Vaccination Status of Patients Diagnosis of Multiple Myeloma or Monoclonal Gammopathy of Uncertain Significance: Analysis of Coverage in the Province of Catania
items: Determinants of Carbon and Water Footprints of Food Consumption in an Italian Population
items: Sleep Disorders, Smartphone Use and Mental Health: A Cross-Sectional Study on a Sample of Students from the University of Palermo – MORPHEO
items: Evaluating the Use of Cluster Analysis to Detect and Correct Selection Bias in Single-Center Observational Research on Voluntary Terminations of Pregnancy
items: Trajectories of Adherence to Biologics in Patients with Rheumatoid Arthritis and Risk of a Secondary Immuno-Mediated Inflammatory Disease: A Large Multi-Database Italian Study
items: A Randomized Controlled Field Trial: A Gamified Training Course on Workplace Health and Safety Prevention for Middle School Students – "Let's Play 81!"
items: Validation Protocol of the Italian Version of the Internet Related Measures (IRM) Questionnaire and Assessment of Internet Use Among High School Students in Italy: A Multicenter Study

Examining Youth Protections against Gambling in Ireland: A Tiger Team (Red Team) Examination of the National Lottery
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description: Background: Youth gambling in Ireland is of growing concern. Objectives: Thus, this study evaluated youth gambling protections in the Irish National Lottery’s online age verification system. Methods: A Tiger Team (Red Team) methodology was used. This involved using falsified National Lottery accounts (n = 56). Results: Over half (55.4%) of attempts were successfully verified, with successful verification significantly varying by gender. Conclusions: These findings highlight vulnerabilities in the National Lottery’s online age-verification system and underscore the urgent need for more robust safeguards to prevent underage access.
subject: Original articles
  topic: section
subject: Vol. 21 No. 1 (2026): in progress
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creator: Mia Daly
creator: Anne Campbell
creator: Frank Houghton
rights: Copyright (c) 2025 Mia Daly, Anne Campbell, Frank Houghton https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-24
publication date: 2025-11-24
doi: 10.54103/2282-0930/30098

An Examination of Public Concerns Relating to Combined Text and Graphic Alcohol Warning Labels: An all-Ireland Cross-Sectional Study
type: item
description: Alcohol remains a serious threat to the health and wellbeing of people across the island of Ireland. Ireland introduced legislation to introduce mandatory alcohol warning labels (AWLs) in 2026, although implementation is deferred until 2028. The cross-sectional survey research sought to explore support for AWLs across the island. The remainder of the survey then explored concerns people had with more graphic AWLs, as well as exploring what additional warnings or information people would like to see displayed in AWLs. Responses were gathered from 475 staff members and students at two universities, one located in Ireland and the other in Northern Ireland. A high level of support for the proposed Irish AWLs was noted (77.9%), with support for more graphic cigarette-style AWLs lower at 60.2%. The potential development of graphic AWLs evoked a considerable range of concerns thematically arranged as 1) Children; 2) Desensitisation; 3) Risks Over-played; 4) No Impact; 5) Unpleasant Viewing; 6) Addiction; 7) Trauma Trigger; 8) Stigmatisation; 9) Diverse Warnings. Although overall there is support for AWLs amongst the convenience sample, there remains confusion about the need and intent of AWLs. Further research is therefore recommended.
subject: Original articles
  topic: section
subject: Vol. 21 No. 1 (2026): in progress
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creator: Frank Houghton
creator: Jennifer Moran Stritch
creator: Gillian Shorter
creator: Anne Campbell
rights: Copyright (c) 2025 Frank Houghton, Jennifer Moran Stritch, Gillian Shorter, Anne Campbell https://creativecommons.org/licenses/by-sa/4.0
date: 2025-12-09
publication date: 2025-12-09
doi: 10.54103/2282-0930/29971

Effectiveness and Safety of Control-IQ Technology in Preschool and School-Aged Children with Type 1 Diabetes: A Real-World Multicenter Study
type: item
description: Introduction Achieving and maintaining optimal glycemic control from the onset of type 1 diabetes (T1D) is crucial in pediatric care, especially in early childhood when the developing brain is highly vulnerable to both hypo- and hyperglycemia [1-3]. Hyperglycemia during early childhood increases the risk of long-term vascular complications, while severe hypoglycemia may impair neurocognitive development, causes family anxiety, and complicates social integration [4-5]. Although automated insulin delivery (AID) systems have demonstrated efficacy in controlled trials, real-world evidence in children under six years of age, particularly involving off-label use, remains limited. The Control-IQ (CIQ) algorithm, integrated into the Tandem t:slim X2 insulin pump, has shown benefits in adolescents and school-aged children [6-10]. However, few studies have evaluated its long-term use in children under six in routine clinical practice. Objective This study aimed to compare the real-world effectiveness and safety of the CIQ system in two pediatric age groups—children aged 0.5–5 years and children aged 6–10 years—over an 18-month follow-up period. We evaluated effectiveness in terms of glycemic control (% of time in glucose range 70–180 mg/dL [TIR], % of time in glucose range 70–140 mg/dL [TITR], and HbA1c) and safety in term of adverse events (diabetic ketoacidosis [DKA], hyperglycemia and severe hypoglycemia). Methods This prospective, multicenter observational study used retrospective data from 32 Italian pediatric diabetes centers. Eligible participants had T1D diagnosed ≥ 6 months, , were < 11 years old at CIQ initiation, and had continuous glucose monitoring (CGM) data available via Glooko® or Clarity® software at least every 6 months during the 18-month follow-up. Children with non-T1D or aged >10 years at CIQ start were excluded. Participants were stratified by age at CIQ initiation (0.5–5 and 6–10 years). At CIQ initiation (baseline) sex, presence of celiac disease or t…
subject: Congress Abstract - Section 2: Epidemiologia Clinica
  topic: section
creator: Andrea Faragalli
creator: Roberto Franceschi
creator: Marco Marigliano
creator: Valentino Cherubini
creator: Rosaria Gesuita
creator: Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetology
rights: Copyright (c) 2025 Andrea Faragalli, Roberto Franceschi, Marco Marigliano, Valentino Cherubini, Rosaria Gesuita, Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetology https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29451

Long-Term Mental Health Consequences Of Road Traffic Crashes: A Scoping Review
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description: Introduction The considerable number of road crashes resulting in death, injury and disability makes road safety a crucial issue worldwide [1], [2]. Preventing road deaths, addressing severe injuries in road traffic and their long-term effects, both mental and physical, remains a critical aspect of achieving a resilient and future-proof transportation system. Aims To summarize findings from longitudinal studies on mental health, psychological outcomes, and mental health-related quality of life (HRQoL) following road traffic crashes (RTCs) in order to suggest implications to improve recovery and rehabilitation. Methods Long-term consequences (LTCs), physical and mental health, quality of life, and road traffic crash were the keywords used to search the PubMed, Scopus, and Web of Science electronic databases. The initial search yielded 420 records, reduced to 390 after the removal of duplicates. Following the PRISMA 2020 guidelines, 50 observational studies published between 2010 and 2024 were identified as relevant, and one was found through citation searching. At the full-text reading 17 papers were excluded. As a result, 34 articles were included in the review. These studies investigated the long-term physical and psychological consequences of road crashes across all categories of adult road users. Seven papers showed a specific focus on mental health outcomes, including post-traumatic stress syndrome, pain-related psychological distress, depressive symptoms, mental HRQoL, and cognitive impairment. Results The reviewed studies consistently show that RTCs can lead to substantial long-term mental health consequences. A considerable number of individuals experience post-traumatic stress symptoms, with higher rates observed among those with more severe injuries. Persistent pain and residual physical or psychological symptoms are common even several months after the crash, often impairing daily functions and delaying return to work. Depression and anxiety symptoms are a…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Manuela Anelli
creator: Ottavia Eleonora Ferraro
creator: Mattia Celebrin
creator: Anna Morandi
creator: Cristina Montomoli
rights: Copyright (c) 2025 Manuela Anelli , Ottavia Eleonora Ferraro , Mattia Celebrin , Anna Morandi, Cristina Montomoli https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29176

Prevention of cervical cancer in a rural primary care centre in Eswatini
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description: Background: Cervical cancer is a priority public health concern in the Kingdom of Eswatini, primarily due to a high incidence rate of high-risk human papillomavirus (HR-HPV) infection [1,2]. Socio-cultural, economic, and policy-related barriers often limit women’s access to essential screening and preventive services, resulting in delayed diagnoses and high mortality rates [3]. Test invasiveness and sampling modalities may further reduce women's participation in existing screening programs implemented mainly through Visual Inspection with Acetic Acid (VIA), [4, 5, 6, 7]. Since May 2023, the 4-valent (4v, HPV-6, 11, 16, 18) HPV vaccine has been offered to girls aged 9–14, with an estimated 79% of the target population vaccinated by May 2025 [8,9,10]. However, data on the prevalence and genotype distribution of HPV in Eswatini are limited, and prevention strategies do not rely on local epidemiological data that are currently missing. Objectives: In line with WHO recommendations for HPV-DNA testing as a primary screening method, this project aims to identify and address implementation challenges by implementing a “screen, triage, and treat” prevention programme featuring non-invasive urine-based HR-HPV testing at St. Philip’s Clinic, a rural primary care centre in the Lubombo region of Eswatini. Specific objectives are to assess feasibility, acceptability, effectiveness, and cost-effectiveness of urine-based HR-HPV testing with the aim to enhance access among adolescent girls and women (AGW). Furthermore, it aims to evaluate the distribution of HPV genotypes in this area of Eswatini. Methods: A 12-month cross-sectional pilot study (February 2023–February 2024) was conducted at St. Philip’s Clinic, Eswatini. Women aged 12-49 presenting for any reason were asked to provide a 30 mL urine sample. A 10 mL aliquot was centrifuged to concentrate viral particles and eliminate debris, and the Xpert® HPV test was performed locally to detect 14 high-risk HPV (HR-HPV) genotypes. W…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Motsa Tengetile
creator: Msibi Velaphi
creator: Mzamo Sikhondze
creator: Alex Nhleko Bongani
creator: Nicole Rose Niemann
creator: Clara Fappani
creator: Maria Gori
creator: Daniela Colzani
creator: Simone Villa
creator: Paola Angelone
creator: Sante Leandro Baldi
creator: Enrica Valentini
creator: Maphalala Gugu
creator: Gcinile Buthelezi
creator: Camilla Torriani
creator: Assefa Mulubirhan Alemayohu
creator: Maria Cristina Monti
creator: Antonella Amendola
creator: Elisabetta Tanzi
creator: Mario Raviglione
rights: Copyright (c) 2025 Motsa Tengetile, Msibi Velaphi, Mzamo Sikhondze , Alex Nhleko Bongani , Nicole Rose Niemann , Clara Fappani , Maria Gori , Daniela Colzani, Simone Villa , Paola Angelone , Sante Leandro Baldi , Enrica Valentini , Maphalala Gugu, Gcinile Buthelezi , Camilla Torriani, Assefa Mulubirhan Alemayohu, Maria Cristina Monti , Antonella Amendola , Elisabetta Tanzi , Mario Raviglione https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29181

Anthropometric Indicators Of Central Obesity In The Identification Of General And Cancer Related Risk Mortality: Findings From The Epic Italian Cohort
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description: Introduction Obesity is a growing risk factor among adults, and its accurate identification remains a public health priority. While body mass index (BMI) is widely used, it does not account for fat distribution [1]. Combining BMI with central obesity indicators – such as waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WtHR) – has been shown to improve mortality risk prediction [2,3]. Nevertheless, these indicators have limitations, such as the absence of standardized measurement procedures [4]. Accordingly, the potential predictive role of non-traditional anthropometric indicators – such as the weight-adjusted waist index (WWI), the conicity index (C-index), and relative fat mass (RFM) – has been highlighted [5-7]. However, their clinical interpretation may be limited by the complexity of the required calculations. Aims To develop a novel, clinically applicable and easily interpretable anthropometric method for the classification of central obesity, and to assess its predictive value for all-cause and cancer mortality in comparison with both traditional (BMI, WC, WHR, WtHR) and non-traditional (WWI, C-index, RFM) anthropometric indicators. Methods This study included 45698 adult men and women from the Italian EPIC cohort (1993–1998). Demographic, lifestyle, and medical history data were collected enrollment using standardized questionnaires. Anthropometric measurements (height, weight, waist and hip circumferences) were used to calculate indicators. To calculate Delta Waist (ΔW) a linear regression was performed on WC as a function of height, weight, sex, age, sex/height and sex/age interaction. The model was weighted based on health risk categories defined by NICE [8]: participants with no increased risk were assigned a weighting factor of 1, those with increased risk a weighting factor of 0.5, and those with high or very high risk a weighting factor of 0. Predicted waist circumference was derived from this model by standardizing age …
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Stefania Arena
creator: Vittorio Simeon
creator: Sabina Sieri
creator: Claudia Agnoli
creator: Fulvio Ricceri
creator: Lorenzo Milani
creator: Benedetta Bendinelli
creator: Melania Assedi
creator: Rosario Tumino
creator: Salvatore Panico
creator: Fabrizio Pasanisi
creator: Carla Pollastro
creator: Simona Signoriello
creator: Mario Fordellone
creator: Paolo Chiodini
rights: Copyright (c) 2025 Stefania Arena , Vittorio Simeon , Sabina Sieri, Claudia Agnoli, Fulvio Ricceri , Lorenzo Milani , Benedetta Bendinelli , Melania Assedi , Rosario Tumino , Salvatore Panico , Fabrizio Pasanisi , Carla Pollastro, Simona Signoriello, Mario Fordellone , Paolo Chiodini https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29182

Dietary Patterns, Metabolomic Profiles, And Metabolic Outcomes By Menopausal Status
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description: Introduction: Menopause is a critical period marked by significant metabolic and hormonal changes that impact cardiometabolic disease risk.[1] Diet plays a crucial role in lipid metabolism and visceral adiposity, key components of cardiometabolic health.[2] Metabolomics, the analysis of small molecules in biological samples, offers a tool for capturing both dietary metabolites and systemic adaptations to habitual diet.[3] In addition to provide a more objective assessment of dietary intake it can reveal different profiles between subgroups of individuals, such as women at different reproductive stages.[4] However, the underlying mechanisms by which diet affects metabolism after menopause are not yet well understood, limiting the development of targeted dietary strategies to mitigate health risks in female populations.[5] Objective: This investigation aimed to examine the role of menopausal status in the association between dietary patterns, metabolomic profiles associated with the dietary patterns, and lipid profile. To achieve this objective, two specific aims were pursued: To determine the metabolomic profile associated with different dietary patterns according to menopausal status To explore how diet influences the lipid profile and visceral fat by menopausal status, considering potential differences in the metabolome. Methods: We conducted a cross-sectional analysis on 1,179 women participating in the Cooperative Health Research In South Tyrol (CHRIS) study,[6] stratifying by menopausal status, defined based on an algorithm incorporating self-reported information and age. We excluded women who were pregnant, non-fasting, or in the menopause transition phase at the study visit. To evaluate the dietary patterns, we derived three well-established healthy dietary indexes: Planetary Health Diet Index (PHDI), Plant-based Diet Index (PDI), and Alternative Healthy Eating Index (AHEI). Additionally, we included the Dietary Inflammatory Index (DII) to specifically investi…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Giulia Barbieri
creator: Naixin Zhang
creator: Marta Trius-Soler
creator: Cristian Pattaro
creator: Marta Guasch-Ferré
creator: Essi Marjatta Hantikainen
rights: Copyright (c) 2025 Giulia Barbieri , Naixin Zhang, Marta Trius-Soler, Cristian Pattaro, Marta Guasch-Ferré, Essi Marjatta Hantikainen https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29189

Health Literacy, Diet, and Lifestyles for the Promotion of Health and Empowerment of University Students and Staff: The “ALFADIET” Study
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description: Introduction Appropriate nutrition and healthy lifestyles are key elements in the prevention of non-communicable diseases and in promoting individual well-being. In this context, health and digital literacy are essential tools to foster people’s empowerment in managing their own health. Universities, as environments with a high concentration of young people and professionals, play a strategic role in health promotion. They have the opportunity to optimize the health literacy of their students and empower them to make informed decisions for themselves and their living environments [1]. Health Literacy, meaning the ability of individuals to meet the complex demands of health in a modern society, has been associated with better health decision-making and is considered a key social determinant of healthier behaviors. Moreover, in the field of nutrition, this competency affects food selection and preparation processes and, more broadly, eating habits, thus contributing to improved health and well-being of individuals [2]. For this reason, it is important to investigate Health Literacy as well as eHealth (defined as the use of information technologies in support of health and related fields) and Digital Health Literacy, all of which are increasingly important in Public Health. Objectives The ALFADIET study aims to analyze eating habits, adherence to the Mediterranean Diet, lifestyles, and levels of Health and Digital Health Literacy among students, faculty, and administrative staff of the University of Catania and the University of Palermo. Methods The population of the “ALFADIET” study will include students, from various degree programs and academic years, as well as teaching and non-teaching staff at the University of Catania and the University of Palermo. The study is based on an innovative real-time data collection methodology using the mobile Ecological Momentary Assessment (mEMA), aimed at capturing participants' daily behaviors. A web-based survey will be designed …
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Martina Barchitta
creator: Andrea Maugeri
creator: Claudia La Mastra
creator: Noemi Cortese
creator: Marco Enea
creator: Laura Maniscalco
creator: Domenica Matranga
creator: Antonella Agodi
rights: Copyright (c) 2025 Martina Barchitta , Andrea Maugeri , Claudia La Mastra , Noemi Cortese , Marco Enea , Laura Maniscalco , Domenica Matranga , Antonella Agodi https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29190

Validity Of Socioeconomic Inequality Indices over Time in Public Health Research: A Case Study on Ivsm and Maternal Data
type: item
description: Introduction In recent years, studies on pregnancy outcomes and reproductive health indicators have increasingly considered the impact of socioeconomic deprivation. Area-based indices such as the Caranci Deprivation Index [1] or Synthetic Index of Socioeconomic Disadvantage (IVSM) from ISTAT [2] are commonly used as proxies to evaluate variations in fertility rates, voluntary and spontaneous abortion, and other maternal-child health outcomes. Moreover, these indices are widely used to examine how socioeconomic disadvantage influences adverse maternal and reproductive health outcomes, as well as accessibility of healthcare services [3-5]. However, both the Caranci Index and IVSM are constructed using data from the 2011 national census. Applying these outdated indicators to more recent healthcare databases risks to introduce bias and misrepresenting the current socioeconomic reality of municipalities. Objectives This study aims to determine a municipality-level socioeconomic score that aligns as closely as possible with the IVSM but based on individual-level health data from birth certificates (CEDAP) collected in the years 2010–2012 that are near the year of IVSM determination. The primary objectives are to estimate a predictive model of the IVSM based on aggregated CEDAP data (2010–2012), to validate the model internally within the same time period, and to test the temporal stability of the derived score by applying it to subsequent years and assessing its consistency with the IVSM. Methods Municipality-level frequencies were calculated for selected sociodemographic variables present in the CEDAP records, including maternal and paternal citizenship, marital status, educational attainment, occupational status, maternal age class, and parity. The IVSM value, available for each municipality from ISTAT (2011), was used as the dependent variable in a General Linear Model (GLM), where independent variables were the proportions of each sociodemographic category in the refe…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Nicola Bartolomeo
creator: Letizia Lorusso
creator: Paolo Trerotoli
rights: Copyright (c) 2025 Nicola Bartolomeo , Letizia Lorusso , Paolo Trerotoli https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29192

Scrolling and Self: How Self-Esteem and Physical Activity Shape the Effects of Intagram Use on Eating Behavior in Universitary Students
type: item
description: Introduction The use of Social Networking Sites (SNS) has been continuously increasing in recent years [1], contributing to the rise of significant behavioral and psychological issues, especially when SNS are used as a coping mechanism for stress and loneliness among young people. One of the most widely used SNS today is Instagram, and several studies indicate that excessive use of this platform may be associated with decreased cognitive functioning in young adults, as well as behavioral and sleep disorders [2]. In addiction, the Instagram platform's focus on food imagery, fitness content, and body aesthetics often perpetuates unattainable beauty standards, potentially triggering disordered eating patterns or body dissatisfaction [3,4]. Moreover, the study by Romero-Rodríguez et al. [5], found that while problematic smartphone use negatively influences self-esteem, the intensity of Instagram use itself was not a direct predictor of self-esteem among university students. This suggests a nuanced relationship between SNS engagement and self-perception, warranting further exploration. Aims This study aimed to explore the relationships between problematic social media use (PSMU), self-esteem, physical activity (PA), and eating behaviors, using a moderated-mediation model. In this study, we tested a moderated-mediation model of how explained variables may be interrelated. The model’s starting point is the well-established link between PSMU and self-esteem, and PSMU and eating behaviour, with the hypothesis that higher PSMU is associated with higher levels of problematic affects and behaviors. We then hypothesized that participants who have higher self-esteem will show better eating habits despite higher levels of PSMU (mediation analysis). Finally, we supposed that physical activity and sedentary levels could moderate the relationship between PSMU and self-esteem (moderation analysis), with a protective role of PA. Methods A cross-sectional study was conducted with 1237 u…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Annalisa Belli
creator: Erica Gobbi
creator: Stefano Amatori
creator: Antonio Preti
creator: Fabrizio Perroni
creator: Marco Bruno Luigi Rocchi
creator: Davide Sisti
rights: Copyright (c) 2025 Annalisa Belli , Erica Gobbi , Stefano Amatori , Antonio Preti , Fabrizio Perroni, Marco Bruno Luigi Rocchi , Davide Sisti https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29193

Epidemiological Approaches to Healthy Ageing Research Using Data from the Share Project
type: item
description: Introduction As populations age, public health systems face the challenge of understanding and supporting healthy ageing trajectories [1]. Life-course transitions – such as retirement – affect health behaviours, psychosocial wellbeing, and cognitive functioning. Longitudinal datasets offer key opportunities to track these changes, but require rigorous analytical strategies to fully exploit their potential in epidemiology [2]. Objectives To provide scientific evidence to support decision-making in response to the needs of an increasingly ageing population, through a Healthy Ageing and life-course research approach, by leveraging the longitudinal and multidimensional potential of SHARE data [3]. Specific objectives are: i) to analyse the short- and long-term impact of retirement on behavioural risk factors (e.g. smoking, alcohol use, food consumption, physical activity) and mental health (e.g. depressive symptoms and suicidality); ii) to evaluate individual, socioeconomic, and environmental determinants of cognitive decline using harmonised cognitive assessment protocols. Methods For the specific objective i) We implemented a longitudinal cohort design using SHARE waves 1-8 (2004–2020), selecting 8,998 individuals aged 50+ employed at baseline and retired during follow-up [3,4]. Retirement timing served as a temporal exposure to construct repeated-measures analyses. Generalised estimating equations (GEE) were applied to model selected outcomes (e.g., smoking, alcohol use, food consumption, physical activity, depressive symptoms), accounting for intra-individual correlation [5]. Time was modelled in different intervals relative to the retirement year. Covariates included sex, age, marital status, education, occupation, and chronic disease. For the specific objective ii) We adopted a retrospective design based on SHARE-HCAP Wave 9 (2021–2022), which included 2,685 individuals aged 65+ from five European countries. Respondents were classified through machine learning tec…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Paola Bertuccio
creator: Giacomo Pietro Vigezzi
creator: Giansanto Mosconi
creator: Anna Odone
rights: Copyright (c) 2025 Paola Bertuccio, Giacomo Pietro Vigezzi , Giansanto Mosconi , Anna Odone https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29195

Perioperative nutritional supplementation to reduce postoperative infections: a systematic review and meta-analysis
type: item
description: Introduction Postoperative infections, including surgical site infections (SSIs), pneumonia, bloodstream infections (BSIs), and urinary tract infections (UTIs), remain among the most frequent and impactful complications following surgery. They contribute substantially to patient morbidity, length of stay, and healthcare costs, despite improvements in surgical techniques and perioperative care. In Europe alone, healthcare-associated infections are estimated to cause over 90,000 deaths annually and impose a burden of more than 500 DALYs per 100,000 population [1]. Despite the adoption of ERAS protocols and prophylactic antibiotics, the incidence of postoperative infections has plateaued in many settings, suggesting the need for adjunctive strategies beyond standard perioperative care. In this context, perioperative nutrition has emerged as a potentially modifiable factor capable of influencing immune responses, gut microbiota, and systemic inflammation. Immunonutrition (enriched with arginine, omega-3 fatty acids, nucleotides), probiotics, synbiotics, and protein supplementation are currently being investigated for their ability to prevent infectious complications and improve surgical outcomes [2,3]. However, the literature is fragmented and results are often inconsistent across interventions and populations [4-7]. Objectives This study aimed to systematically evaluate the efficacy of perioperative nutritional supplementation in reducing postoperative infectious complications in adult surgical patients. The focus on infection stems from its clinical burden and its potential sensitivity to immune-modulating strategies. Secondary outcomes included specific infection types (SSIs, BSIs, UTIs, and pneumonia) and hospital length of stay (LOS), selected for their relevance to patient recovery and healthcare system impact. These outcomes were selected to capture both the direct impact of infections and their broader consequences on patient recovery and resource utilization. M…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Marina Sartini
creator: Alessio Carbone
creator: Martino Oliva
creator: Sara Pessano
creator: Filippo Del Puente
creator: Tania Buttiron Webber
creator: Elisa Schinca
creator: Gianluca Ottria
creator: Chiara Dupont
creator: Carolina Piccinini
creator: Maria Luisa Cristina
rights: Copyright (c) 2025 Marina Sartini, Alessio Carbone , Martino Oliva , Sara Pessano , Filippo Del Puente , Tania Buttiron Webber , Elisa Schinca , Gianluca Ottria , Chiara Dupont , Carolina Piccinini , Maria Luisa Cristina https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29196

https://test-ojs-unimi-it.archicoop.it/index.php/ebph/article/view/29201
type: item
title: Hospitalizations for Mental Health in Migrants and Italian Citizens in the Marche Region Between 2011 and 2023: a Population-Based Study Using Healthcare Utilization Databases (Mighty Project P2022asxkr)
description: Introduction International migration is considered a complex and unstoppable phenomenon. Migrant population is a heterogeneous group of people who experience migration for different reasons and that are considered to be at increased risk of developing mental disorders [1]. Scientific evidence on migrants’ mental health is limited, as is knowledge of their access to and use of specific care services and treatments. As compared to natives, higher rates of involuntary hospitalization were found among migrants in most European countries [1,2]. Aim The aim of the present study was to compare mental health hospitalization rates in Migrants and Italians in Marche Region during 2011-2023, and to investigate their differences according to demographic and clinical characteristics. Methods A cross-sectional population-based study on individuals hospitalized in psychiatric departments of all ages and resident in Marche Region in the period between 2011 and 2023 was conducted, using healthcare utilization databases (Hospital Discharge and Regional Beneficiaries databases). Residents were divided into Migrants from High Migratory Pressure Country (HMPC) and Italians, according to citizenship [3]. The primary diagnosis field of hospital discharge database was used to estimate the prevalence of different types of mental disorder using ICD-9 CM codes (290.*-319.*). Annual age-standardized hospitalization rates were calculated for HMPC Migrants and Italians using the 2019 Italian population [4] as standard, using the direct method. Rates were stratified by sex and the Standardized Rate Ratios (SRR) with 95% Confidence Interval (95%CI) were calculated by sex and year of observations as ratio between HMPC and Italian rates. All data were processed in compliance with the European (GDPR, EU 2016/679) and national privacy laws (D.lgs. 196/2003 and subsequent amendments). Results A total of 59.881 hospitalizations were analyzed, 93.3% of which were of Italians. The mean age was higher in I…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Carmela Centola
creator: Marica Iommi
creator: Andrea Faragalli
creator: Alessandro Fontanarosa
creator: Marco Pompili
creator: Elisa Barbiano di Belgiojoso
creator: Flavia Carle
creator: Edlira Skrami
creator: Rosaria Gesuita
rights: Copyright (c) 2025 Carmela Centola , Marica Iommi , Andrea Faragalli , Alessandro Fontanarosa, Marco Pompili , Elisa Barbiano di Belgiojoso , Flavia Carle, Edlira Skrami , Rosaria Gesuita https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29201

A Framework to Improve Data Quality and Manage Dropout in Web-Based Medical Surveys: Insights from an Ai Awareness Study among Italian Physicians
type: item
description: Background Ensuring data quality in self-reported online surveys remains a critical challenge in digital health research, particularly when targeting healthcare professionals [1,2]. Self-reported data are susceptible to multiple biases, including careless responding, social desirability bias, and dropout-related attrition, all of which may compromise the validity of findings [3,4]. In web-based surveys where researcher oversight is limited, structured quality control measures are essential to detect low-quality responses, minimise sampling bias, and enhance data reliability [5]. Previous studies have demonstrated that inadequate quality checks can lead to inflated error rates, reduced statistical power, and misleading conclusions [6]. Objective This study presents a comprehensive methodological framework for optimising data quality in web-based medical surveys, applied to a national study on AI awareness among Italian physicians. Integrating pre-survey validation, real-time dashboards, response-time filtering, and post-hoc careless responding detection would address key challenges in digital research, while providing a replicable model for future studies. Methods We conducted a national web-based survey using a validated instrument (doi:10.1101/2025.04.11.25325592) via the LimeSurvey platform. The survey incorporated two main sections: (1) a core module assessing knowledge, attitudes and practices regarding AI in medicine; (2) clinical scenarios evaluating diagnostic agreement with AI-generated proposals. Multiple quality control strategies were implemented throughout the survey lifecycle. In terms of survey design and logic, the questionnaire employed an adaptive flow structure, whereby respondents were routed through clinical scenarios relevant to their medical speciality. To reduce the incidence of partial completions and missing data, key questions were marked as mandatory, and completion status was actively tracked. In the monitoring and recruitment phase, a re…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Vincenza Cofini
creator: Eugenio Benvenuti
creator: Martina Mancinelli
creator: Ginevra Di Pangrazio
creator: Laura Piccardi
creator: Mario Muselli
creator: Eleonora Cimino
creator: Loreta Tobia
creator: Leila Fabiani
creator: Stefano Necozione
rights: Copyright (c) 2025 Vincenza Cofini, Eugenio Benvenuti , Martina Mancinelli , Ginevra Di Pangrazio, Laura Piccardi, Mario Muselli, Eleonora Cimino, Loreta Tobia, Leila Fabiani , Stefano Necozione https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29202

Impact of First and Further Decompensation in Metabolic-Dysfunction Associated Compensated Advanced Chronic Liver Disease
type: item
description: BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD) currently stands as one of the foremost global health challenges, with a prevalence of 38% worldwide according to the most recent estimates [1] and with a concerning upward trend due to the parallel anticipated increasing of Diabetes and Obesity epidemic in the coming years [2]. There is a long-standing agreement that the first decompensation - defined as ascites, hepatic encephalopathy (HE), variceal bleeding, and jaundice- appears the pivotal event for patients’ prognosis and marks the transition from the compensated, also known as compensated advanced chronic liver disease (cACLD), to the decompensated stage of cirrhosis [3]. Although only a small fraction of patients dies following the first decompensation episode, the risk of developing further decompensation increases and the median survival dramatically decreases [4]. The occurrence of a further decompensation event - defined according to the Baveno VII Consensus [5] as either the recurrence of the initial event or the development of a second decompensation event - represents a crucial turning point in the natural history of the liver disease, markedly increasing the risk of liver-related death (LR-D) in those patients. AIM We assessed the cumulative incidence of first and further (acute and non-acute) decompensation and evaluated their impact on LR-D in patients with compensated advanced chronic liver disease (cACLD) due to metabolic dysfunction-associated steatotic liver disease (MASLD). METHODS International multicenter retrospective study (17 centers) on 6,061 consecutive patients with clinical (LSM>10 kPa) or biopsy-proven (F3-F4 fibrosis) diagnosis of cACLD due to MASLD. First and further decompensation were defined according to Baveno VII criteria. Competing risk analyses estimated the cumulative incidence of first and further decompensations, treating liver-related death (LR-D), extra-hepatic death (EH-D), and liver transplant…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Gabriele Di Maria
creator: Grazia Pennisi
creator: Vincent Wai-Sun Wong
creator: Victor de Ledinghen
creator: Giada Sebastiani
creator: Mauro Viganò
creator: Anna Ludovica Fracanzani
creator: Luca Miele
creator: Elisabetta Bugianesi
creator: Mattias Ekstedt
creator: Roberta D’Ambrosio
creator: Federico Ravaioli
creator: Filippo Schepis
creator: Fabio Marra
creator: Alessio Aghemo
creator: Gianluca Svegliati-Baroni
creator: Marcello Persico
creator: Luca Valenti
creator: Annalisa Berzigotti
creator: Jacob George
creator: Angelo Armandi
creator: Patrik Nasr
creator: Stergios Kechagias
creator: Antonio Liguori
creator: Dario Saltini
creator: Yuly P. Mendoza
creator: Vincenza Calvaruso
creator: Huapeng Lin
creator: Giuseppe Infantino
creator: Mario Masarone
creator: Nicola Pugliese
creator: Adele Tulone
creator: Vito Di Marco
creator: Calogero Cammà
creator: Salvatore Petta
creator: Marco Enea
rights: Copyright (c) 2025 Gabriele Di Maria , Grazia Pennisi, Vincent Wai-Sun Wong, Victor de Ledinghen , Giada Sebastiani , Mauro Viganò, Anna Ludovica Fracanzani ; Luca Miele ; Elisabetta Bugianesi , Mattias Ekstedt , Roberta D’Ambrosio , Federico Ravaioli , Filippo Schepis , Fabio Marra , Alessio Aghemo , Gianluca Svegliati-Baroni , Marcello Persico , Luca Valenti , Annalisa Berzigotti , Jacob George, Angelo Armandi , Patrik Nasr , Stergios Kechagias, Antonio Liguori , Dario Saltini , Yuly P. Mendoza, Vincenza Calvaruso , Huapeng Lin , Giuseppe Infantino, Mario Masarone , Nicola Pugliese , Adele Tulone , Vito Di Marco , Calogero Cammà , Salvatore Petta , Marco Enea https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29206

Blood Biomarkers of Aging and Multimorbidity Prognosis in Older Adults: Preliminary Results from the Bio-Sign Project
type: item
description: Introduction Increased life expectancy is associated with the presence of multiple chronic diseases (i.e., multimorbidity), affecting health trajectories and care demands of older adults. The identification of a pool of accessible biomarkers that reflects specific endophenotypes of physiological dysregulation, may facilitate prognostication in older adults living with multimorbidity, offering a valuable tool for clinical decision-making and personalized interventions [1-3].The BIO-SIGN project aims to assess how a rich set of novel biomarkers, along with clinical, environmental and behavioral factors, interact in the definition of specific multimorbidity patterns and their association with negative outcomes, specifically all-cause mortality. Objectives First year of the project focused on two different objectives. First objective was the selection of a set of accessible and reliable biomarkers of multimorbidity, through extensive bibliographic research. Second objective was to identify homogeneous groups of multimorbid individuals (≥ 2 diseases), who share similar underlying disease patterns, using two Italian cohorts of randomly selected resident adult individuals. Methods Objective 1. A systematic review was conducted on PubMed and Web of Science to identify peer-reviewed studies assessing the association between individual biomarkers in human fluid samples and multimorbidity. Based on this review, a panel of significant blood biomarkers associated with multimorbidity was selected for further investigation in this study. Objective 2. The identification of multimorbidity patterns involved the two Italian cohorts of CUORE project [4] and Moli-sani project [5] (baselines 2008-2012 and 2005-2010, respectively), which share similar data collection methods. We focused on older adults aged 60-79 years. To ensure consistency and minimize data heterogeneity, a rigorous process of harmonization was applied. Population clinical characteristics were studied and homogeneous gr…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Teresa Dipol
creator: Maria Beatrice Zazzara
creator: Cecilia Damiano
creator: Simona Costanzo
creator: Luigi Palmieri
creator: Augusto Di Castelnuovo
creator: Chiara Donfrancesco
creator: Cinzia Lo Noce
creator: Sara Magnacca
creator: Benedetta Marcozzi
creator: Tiziana Casoli
creator: Anna Picca
creator: Licia Iacoviello
creator: Davide Liborio Vetrano
creator: Graziano Onder
rights: Copyright (c) 2025 Teresa Dipol , Maria Beatrice Zazzara , Cecilia Damiano , Simona Costanzo , Luigi Palmieri , Augusto Di Castelnuovo , Chiara Donfrancesco , Cinzia Lo Noce , Sara Magnacca , Benedetta Marcozzi , Tiziana Casoli , Anna Picca, Licia Iacoviello , Davide Liborio Vetrano , Graziano Onder https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29207

Protact-Us: A Study on the Long-Term Impact of Road Traffic Crashes in Europe
type: item
description: Introduction Despite advancements in emergency care and prevention, many road traffic crash (RTC) survivors suffer from enduring impairments that are insufficiently considered and registered in hospital records or existing surveillance systems. Building upon evidence from prior initiatives [1-3], this study aims to (1) assess the multidimensional long-term outcomes of RTCs, (2) identify early predictors of functional and psychological recovery, and (3) inform data-driven strategies for post-injury rehabilitation and health system planning. Aim The ProtAct-Us from Long-Term Consequences of Road Crashes (ProtAct-Us), a project funded by the European Union, addresses a critical, yet often underexplored, multidimensional aspect of road safety: the long-term consequences of road traffic crashes (RTCs) on individuals' physical, cognitive, psychological, and socio-economic well-being. Methods This multicentre, prospective, observational longitudinal study will be conducted across Germany, Greece, and Italy. The study population comprises adults (≥18 years) involved in RTCs, enrolled through hospitals, trauma centres, or on the accident scene from June to December 2025. Consecutive sampling will be performed until the minimum required sample size of 120 subjects is collected. Informed consent will be obtained in compliance with national regulations. Data will be collected at two timepoints: baseline (within 30 days after the accident) and 12 months post-injury. Validated instruments will be used, covering health-related quality of life (EQ-5D), cognitive function (MoCA), psychological status (CES-D, IES-R), social support (MOS), and economic burden (Muarc). Variables related to injury characteristics, health history, and contextual factors (e.g. access to care, social and work reintegration) will also be recorded. Statistical Analysis Descriptive analyses will summarise the sample's clinical, psychological, and socio-demographic features. Recovery trajectories and outcome p…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Ottavia Eleonora Ferraro
creator: Anna Morandi
creator: Manuela Anelli
creator: Federico Grassi
creator: Viviana Ciprian
creator: Luca Ansaloni
creator: Stefano Perlini
creator: Cristina Montomoli
rights: Copyright (c) 2025 Ottavia Eleonora Ferraro , Anna Morandi , Manuela Anelli , Federico Grassi , Viviana Ciprian , Luca Ansaloni , Stefano Perlini , Cristina Montomoli https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29210

Psychiatric Disorders and Psychoactive Substance Use in Children and Adolescents: A Population-Based Study in Lombardy, 2016–2022
type: item
description: Introduction The World Health Organization (WHO) defines dual diagnosis (DD) as “the coexistence of psychoactive substance use and another psychiatric disorder in the same person” [1]. Clinicians, researchers, and policymakers are concerned with this issue due to the difficulties involved in managing dual diagnoses, including high relapse rates, reduced participation in treatment, and less favourable treatment results [2]. The literature indicates a higher risk of psychoactive substance use disorders in individuals who have grown up with psychiatric disorders [3]. Although psychiatric comorbidity in adults with substance abuse issues is well documented, it has been less thoroughly investigated in adolescents [4]. Nevertheless, it remains a highly relevant issue for national drug and mental health policies. Adolescents with dual diagnoses place a significant social and economic burden on the public healthcare system, as the interaction between substance use and psychiatric disorders creates a vicious cycle that further worsens later difficulties, such as family conflicts, academic problems, and criminal behavior [2]. The aim of the study is to estimate the prevalence of National Health Service users (0-18 years old) who have been diagnosed with psychiatric disorders related to substance abuse in Lombardy between 2016 and 2022. Methods Data Sources and Study Population The data used for this study were drawn from the administrative healthcare utilization databases of the Lombardy Region, which are routinely employed for reimbursement purposes. The observation period spanned from January 1, 2016, to December 31, 2022. The study population included all individuals aged 0–18 years as of December 31 of each year, residing in the Lombardy Region. Case Definition An individual was classified as a case if, at least once during a given year, they either accessed the Emergency Department or were hospitalized. Case identification was based on the presence of specific ICD-9-CM c…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: A. Filosa
creator: M. Franchi
creator: M. A. Costantino
creator: R. Borgatti
creator: M.M. Mensi
creator: E. Fazzi
creator: J. Galli
creator: V. Poli
creator: L.A. Reale
creator: G. Corrao
creator: C. Montomoli
rights: Copyright (c) 2025 A. Filosa, M. Franchi , M. A. Costantino , R. Borgatti, M.M. Mensi , E. Fazzi, J. Galli , V. Poli , L.A. Reale , G. Corrao , C. Montomoli https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29211

Cross-Country External Validation of a Multisource Comorbidity Score
type: item
description: Background The increasing impact of multimorbidity is escalating clinical and economic demands on healthcare systems, underscoring the necessity for effective tools to assess clinical complexity and enhance management strategies [1-3]. The Multisource Comorbidity Score (MCS) is a population-based index based on regional healthcare Utilization databases - hospitalizations and drug prescriptions - of beneficiaries with age equal or greater than 50 years. The MCS was developed in the framework of the Monitoring and Assessing Care Pathways working group of the Italian Ministry of Health, and validated in four Italian regions, showing good performance in predicting mortality, hospitalizations, and healthcare costs [4]. Objective This study aimed to externally validate and adapt the MCS within the Catalan healthcare system, assessing its predictive capability outside the original Italian setting. This validation seeks to determine whether the MCS can serve as transferable tool in other healthcare systems with different data availability. Methods An observational longitudinal study was performed on subjects aged 50 years or older, residing in the health district of Barcelona-Esquerra (ES) continuously during 2014-2015 and followed between January 1st, 2016, and December 31st, 2019. Data were obtained from the Catalan Health Surveillance System [5] which integrates demographic, clinical and healthcare utilization information from several healthcare databases. For this study, we used Catalan healthcare system beneficiary’s, primary care, hospitalization, and pharmacy dispensation databases. First, the MCS with Italian weights (MCS-1) was applied in the Catalonia setting using the same data sources (hospitalization and pharmacy dispensation databases) as in the original Italian version. Second, new MCS weights (MCS-2) were estimated in predicting one-year mortality (primary outcome) in the Catalonia setting using the methodology and data sources as described in [4]. Finally, …
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Alessandro Fontanarosa
creator: Flavia Carle
creator: Roberta Papa
creator: Marco Pompili
creator: Giovanni Corrao
creator: Valero-Bover Damià
creator: Roca Josep
creator: Rubèn González-Colom
creator: Skrami Edlira
rights: Copyright (c) 2025 Alessandro Fontanarosa, Flavia Carle, Roberta Papa, Marco Pompili, Giovanni Corrao, Valero-Bover Damià , Roca Josep, Rubèn González-Colom, Skrami Edlira https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29213

Evaluation of an educational intervention program designed to increase vaccination attitude in prison setting: results from the RISE-Vac project
type: item
description: Introduction Prison population is particularly vulnerable to communicable diseases, including vaccine-preventable infections [1], due to various factors such as low social distancing, high turnover rates, and a high proportion of migrants [2]. However, vaccination coverage among people living in prison (PLP) remains low, largely due to limited access to healthcare services, low levels of vaccine literacy and general health literacy [3]. Additional challenges include persistent vaccine hesitancy and widespread distrust in institutions. Objectives As part of the RISE-Vac project—co-funded by the 3rd EU Health Program—we developed and implemented an evidence-based educational program aimed at boosting vaccination rates in both PLP and prison staff (PS) and evaluated the effect of the intervention on vaccine hesitancy, vaccine literacy and vaccine attitude. Methods We conducted a cross-sectional non-randomised study in 24 prisons of 6 European countries. The sample included 782 PLP and 717 PS members. In participant prisons, an educational program about vaccination for preventable infection diseases was implemented; for PLP, the program consisted in the distribution of educational material (leaflet and a short video) and/or an educational event; for PS, it consisted in a 4-hours online course. Within the study sample, 387 from PLP (49%) and 285 from PS (40%) undertook the intervention. Vaccine hesitancy was measured through a scale previously validated in a sub-cohort of participants – in the following referred to as pre-test [4]. A structured questionnaire was administered to measure vaccine literacy, general health literacy and socio-demographic characteristics of participants. Vaccine attitude was determined as the willingness to accept a vaccine if offered. Linear regression model was applied to assess the effect of the intervention and pre-test on vaccine and general health literacy and vaccine hesitancy. Logistic regression was applied to assess the association be…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Patrizia Giangrande
creator: Marco Fornili
creator: Maria Paola Tramonti Fantozzi
creator: Angela Bardelli
creator: Erica De Vita
creator: Lara Tavoschi
creator: Laura Baglietto
rights: Copyright (c) 2025 Patrizia Giangrande , Marco Fornili , Maria Paola Tramonti Fantozzi , Angela Bardelli , Erica De Vita , Lara Tavoschi , Lara Tavoschi , Laura Baglietto https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29214

Data Harmonization of Psychosocial Questionnaires across Population Cohorts: A Differential Item Functioning Analysis
type: item
description: Introduction Data harmonization is the process of achieving comparability of similar measures collected by separate cohorts by aligning their definitions and measurement formats [1]. In epidemiologic research, and in particular in predictive modelling for chronic noncommunicable diseases, it may facilitate the identification of derivation and external validation cohorts [2]. This process may be particularly challenging when psychosocial variables are amongst the predictors of interest, as different self-report questionnaires measuring the same psychosocial variable might capture different aspects, and even small differences in item wording affect responses [3]. Therefore, measurement invariance; i.e.; whether respondents from different populations (e.g.; at different time periods, or different cultures) with the same latent trait (e.g. depression) level respond similarly, should be preliminarily established to avoid bias in subsequent analyses [4]. Currently, there is little guidance on how to assess this property for data harmonization purposes. A promising framework is Item Response Theory (IRT), a probabilistic approach for modelling the relationship between a latent trait and observed item responses [5]. We designed an international project pooling Italian and German cohorts with recruitment time spanning over a 10-year period, with the aim to identify a restricted set of psychosocial items able to increase the predictive power of established risk prediction models for Cardiovascular Diseases (CVD). Here, we leverage IRT to assess Differential Item Functioning (DIF) in harmonised items, thereby testing whether item characteristics are invariant across the Italian cohorts. Aims To harmonise two questionnaires used in different cohorts to assess depressive symptoms and to evaluate the measurement invariance of the harmonised items across cohorts. Methods The MONICA Brianza study includes three independent cohorts recruited from the Brianza population, Lombardy reg…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Emanuele Maria Giusti
creator: Marco Mario Ferrario
creator: Giovanni Veronesi
rights: Copyright (c) 2025 Emanuele Maria Giusti , Marco Mario Ferrario , Giovanni Veronesi https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29218

Anni di Vita Persi Aggiustati per Disabilita’ per Malattie Amianto Correlate in Italia nel Periodo 2010-2020
type: item
description: Introduzione: Le stime degli anni di vita aggiustati per disabilità (Disability Adjusted Life Years: DALYs) rappresentano uno strumento fondamentale per quantificare il carico globale delle malattie e dei fattori di rischio, utili alla pianificazione delle politiche sanitarie [1]. L’amianto è riconosciuto come cancerogeno certo, responsabile di mesotelioma (M), tumori del polmone, dell’ovaio e della laringe, oltre che di asbestosi e ispessimenti pleurici. Nel 2019, a livello globale, si sono stimati 4.189.000 DALYs attribuibili a patologie derivanti dall’esposizione occupazionale all’amianto. In Italia, tra il 2010 e il 2020 si sono registrati 16.993 decessi per M, mentre dal 1993 al 2021 il Registro Nazionale dei Mesoteliomi (ReNaM) ha censito oltre 35.000 casi incidenti. Obiettivo: Stimare i DALYs attribuibili ad asbestosi e mesotelioma, patologie con elevata frazione eziologica legata all’amianto (rispettivamente 80% e 100%), in Italia nel decennio 2010-2020. Metodi: Sono stati presi in considerazione i decessi per M e asbestosi, i ricoveri ospedalieri per asbestosi e i casi incidenti di M. I DALYs sono stati calcolati come somma degli anni di vita persi per morte prematura (PYLLs) e degli anni vissuti con disabilità (YLDs). I decessi per M (ICD-10: C45) e asbestosi (ICD-10: J61), così come i ricoveri per asbestosi (ICD-9: CM 501), sono stati estratti dalle banche dati elaborate dall’ISS, utilizzando fonti ISTAT e Ministero della Salute. I casi incidenti di M sono stati stimati a partire dai dati ReNaM. Le informazioni sono state stratificate per genere, classe di età e anno di calendario. I PYLLs sono stati calcolati in valore assoluto e come tassi standardizzati (per 100.000 abitanti), a livello nazionale e regionale, applicando i valori di speranza di vita ISTAT, disaggregati per genere, età e anno. Gli YLDs sono stati stimati a livello nazionale considerando i ricoveri per asbestosi e i casi incidenti di M, utilizzando un peso di disabilità pari a 0,217 e una…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Arianna Guaita
creator: Carolina Romano
creator: Giada Minelli
creator: Alessandra Binazzi
creator: Alessandro Marinaccio
creator: Carolina Mensi
creator: Amerigo Zona
creator: Lucia Fazzo
rights: Copyright (c) 2025 Arianna Guaita , Carolina Romano, Giada Minelli , Alessandra Binazzi, Alessandro Marinaccio , Carolina Mensi, Amerigo Zona , Lucia Fazzo https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29219

Adherence to Diabetes Care Pathways and Risk of Diabetes-Related Complications by Citizenship: A Population-Based Study from The Mighty Project (Cup P2022ASXKR)
type: item
description: Introduction National and international guidelines on diabetes recommend continuous monitoring of this condition to prevent short- and long-term complications [1–3]. Adherence to the Diagnostic Therapeutic Care Pathway (DTCP) is evaluated by the Italian Ministry of Health using annual indicators based on five key recommendations [4], to ensure uniformity of care across all regions. However, equitable access to these services remains a public health challenge, particularly for migrant populations, who may face cultural, linguistic, or systemic barriers. Objective Within the MIGrants’ HealTh and healthcare access in ItalY (MIGHTY) project, this population-based study aimed to compare adherence to DTCP in subjects with new diagnosis of diabetes between migrant and Italian populations, and to evaluate the association between citizenship and diabetes complications in the Marche Region, between 2013–2023. Methods A population-based cohort study was conducted using Healthcare Utilization Databases from the Marche Region, including Regional Beneficiary, Hospital Discharge, Drug Prescription, Outpatient Care, and Exemption databases. The cohort of new cases of diabetes included adults (≥18 years) with a first diabetes-related event between 2013 and 2017, defined as: ≥2 prescriptions of glucose-lowering drugs (ATC: A10*) within one year, ≥1 hospitalization with diabetes as primary/secondary diagnosis (ICD-9-CM: 250.*), or ≥1 diabetes exemption (code: 013*); the date of the first event was defined as the index date. Exclusion criteria were being resident in Marche Region for less than two years prior to index date, any diabetes-related events in the two preceding years, and childbirth-related hospitalizations (Major Diagnostic Category 14) during the year of inclusion in the cohort or the two prior years. Subjects were classified as Italian or migrants from High Migratory Pressure Countries (HMPC) based on citizenship [5]. The five recommendations monitored by the Ministry of …
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Marica Iommi
creator: Andrea Faragalli
creator: Alessandro Fontanarosa Alessandro
creator: Marco Pompili
creator: Flavia Carle
creator: Barbiano di Belgiojoso Elisa
creator: Edlira Skrami
creator: Rosaria Gesuita
rights: Copyright (c) 2025 Marica Iommi , Andrea Faragalli , Alessandro Fontanarosa Alessandro, Marco Pompili , Flavia Carle, Barbiano di Belgiojoso Elisa, Edlira Skrami , Rosaria Gesuita https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29221

Evaluation of Vaccination Status of Patients Diagnosis of Multiple Myeloma or Monoclonal Gammopathy of Uncertain Significance: Analysis of Coverage in the Province of Catania
type: item
description: Introduction : The patient diagnosed with multiple myeloma or monoclonal gammopathy of undetermined significance (MGUS) is considered a fragile patient, at risk of severe post-infectious outcomes [1] for which adequate vaccination prevention against pneumococcus and meningococcus, Herpes Zoster virus , influenza virus, SARS-CoV2 is recommended [2]. Despite existing recommendations, there is limited evidence regarding actual vaccination coverage of these patients [3]. Objectives: This study aims to evaluate the vaccination status in a cohort of haemato-oncology patients and to propose strategies to improve their vaccination coverage. Methods : We conducted a retrospective cohort study on 737 patients with multiple myeloma or MGUS diagnosed in the province of Catania in the period 2000-2023, coded by the Integrated Cancer Registry. Vaccination status was retrieved by cross-referencing cases with data in the Provincial Vaccination Registry. Medical records and vaccination data collected during outpatient visits, hospital admissions for possible hospitalization for infectious disease were examined and the presence of infectious disease diagnoses among the causes of death was verified. The data will be presented in aggregate form. The variables considered were: tumor diagnosis, last follow-up date, date of death, date and components of vaccinations performed. Relative risk with 95% confidence intervals on deaths with respect to the vaccination stratum analyzed by type of disease was calculated. Analyses were performed with Stata 17. For all statistical tests, the significance level was set at a p value <0.05. Results : Preliminary results indicate poor adherence to recommended vaccinations. Frequency distribution of variables of vaccination status, post-diagnosis vaccination, cycle completeness and timing of vaccinations were calculated. The observed coverage is 30.9% for influenza, 6% for Varicella Zoster, 39% for SARS-CoV2, 1.5% for meningococcus and 10% for pneumococc…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: A. Ippolito
creator: V. Grieco
creator: A. Romano
creator: M.A. Aiello
creator: A. Torrisi
creator: A. Di Prima
creator: C. Chillari
creator: G. Giorgianni
creator: R. Ragusa
rights: Copyright (c) 2025 A. Ippolito, V. Grieco, A. Romano, M.A. Aiello, A. Torrisi, A. Di Prima, C. Chillari, G. Giorgianni, R. Ragusa https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29223

Determinants of Carbon and Water Footprints of Food Consumption in an Italian Population
type: item
description: Introduction: The environmental impacts of food consumption, specifically carbon footprint (CF) and water footprint (WF), are gaining increasing importance in the context of global sustainability and public health. As global food demand is expected to increase by 35% to 56% between 2010 and 2050 [1] substantial shifts in dietary habits are required to sustain a growing global population while aligning with the One Health approach ​[2]​, and the 2030 agenda for the accomplishment of Sustainable Development Goals (SDGs) established by the Food and Agriculture Organization (FAO) [3]. However, dietary choices are influenced by a complex interplay of factors, including socioeconomic status, cultural traditions, and individual preferences ​[4]. This study evaluates the contribution of different food groups to environmental footprints and examines how health determinants such as gender, age, BMI, geographic location, and adherence to the Mediterranean diet (MD) influence these impacts. The goal is to better understand how dietary habits affect environmental sustainability and to provide data-driven recommendations for policy development. Objectives: To estimate the average daily CF and WF of the study sample, leveraging estimates from the SU-EATABLE LIFE (SEL) Database ​[5]. Furthermore, the study will identify the food groups with the highest and lowest environmental impact and explore how dietary impact varies based on gender, age, Body Mass Index (BMI), education level, geographic region, and adherence to the MD measured through the Mediterranean Adequacy Index (MAI). Methods: This cross-sectional study utilised data from 2,831 participants in the third INRAN-SCAI Survey, conducted across various regions of Italy in 2005-2006. We calculated the environmental footprints by multiplying the daily consumption of each food item (n = 878), classified using the European Food Safety Authority (EFSA) FoodEx2 system, by the footprint coefficients from the SEL database. For items …
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Doriana Lacalaprice
creator: Nicolò Scarsi
creator: Francesco Gianfagna
creator: Andrea Paladini
creator: Stefania Boccia
creator: Roberta Pastorino
rights: Copyright (c) 2025 Doriana Lacalaprice , Nicolò Scarsi , Francesco Gianfagna , Andrea Paladini, Stefania Boccia , Roberta Pastorino https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29225

Sleep Disorders, Smartphone Use and Mental Health: A Cross-Sectional Study on a Sample of Students from the University of Palermo – MORPHEO
type: item
description: Introduction Sleep disorders constitute a significant public health concern recognized by the World Health Organization (WHO) in the ICD (International Classification of Diseases), with notable implications for young populations. Research demonstrates that disrupted sleep patterns significantly impair mental recovery processes and emotional stability [1]. Poor sleep quality contributes to mental health deterioration through disruption of emotional regulation and neurobiological mechanisms. Inadequate sleep compromises hypothalamic-pituitary-adrenal axis function, increasing cortisol production and stress perception, potentially leading to depressive symptoms [2]. Young adults represent the population stratum with the highest smartphone and electronic device usage rates, sometimes developing behavioural dependencies. Studies show that light exposure to these devices before falling asleep significantly disrupts sleep quality [3]. Moreover, excessive smartphone use is associated with reduced cognitive performance, negatively affecting work efficiency and academic achievement [4]. This study investigates the interactions between sleep disorders, mental health, electronic device usage, and academic performance among university students. We specifically examine how sleep quality and quantity influence students' psychological functioning, with particular attention to psychological distress. Methods The Pittsburgh Sleep Quality Index (PSQI) [5], the Kessler Psychological Distress Scale (K10) [6] and the Smartphone Application-Based Addiction Scale (SABAS) [7] were used to assess sleep quality, mental distress and problematic smartphone use, respectively. Descriptive statistics were expressed as Mean (SD), for continuous variables, and as count/percentages for categorical variables. “Good sleepers” and “Poor sleepers” were compared using Chi-square test or Fisher's exact test for categorical variables, and Student's t-test or the Wilcoxon-Mann-Whitney test for continuous var…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Manuela Lodico
creator: Laura Maniscalco
creator: Silvana Miceli
creator: Marco Enea
creator: Domenica Matranga
rights: Copyright (c) 2025 Manuela Lodico , Laura Maniscalco , Silvana Miceli , Marco Enea , Domenica Matranga https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29229

Evaluating the Use of Cluster Analysis to Detect and Correct Selection Bias in Single-Center Observational Research on Voluntary Terminations of Pregnancy
type: item
description: Introduction Voluntary termination of pregnancy (VTP) has always been debated within the general population. The circumstances leading women to choose VTP are multifaceted, and it remains challenging to identify patterns leading women to opt for this procedure [1, 2]. Up to now, numerous studies have focused on characterizing demographic or psychological profiles of women within specific geographic regions [3, 4]. Due to the sensitive nature of the decision and privacy requirements, studying population clusters in VTP presents inherent methodological limitations. While these challenges can be partially mitigated, they risk a potential selection bias during cohort formation. In these cases, a monocentric study may introduce biases that could arise primarily from the selection of the study centre and secondarily from the difficulty of properly recruiting a sample representative of the entire population. In this context, cluster analysis conducted first on the general population and subsequently applied to the selected sample could clarify the nature of the selection process that occurred, thereby enabling better estimation of the final conclusions [1, 2]. In general, clustering demonstrated efficiency and feasibility to handle large datasets [5, 6]. In particular, the use of hierarchical clustering procedure is able to choose the optimal number of clusters in the population with a readily available stopping rules, without a priori selection of number of clusters [7]. This approach aligns with contemporary efforts to leverage data-driven methodologies in reproductive health research while addressing ethical considerations inherent to studies of private medical decisions. Objective The aim is to evaluate the effectiveness of a clustering method in detecting selection bias within a sample from a monocentric observational study, to generalize the findings from the small sample to the broader population and draw valid inferences from the results. Methods We used a retrospe…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Letizia Lorusso
creator: Bartolomeo Nicola
creator: Paolo Trerotoli
rights: Copyright (c) 2025 Letizia Lorusso, Bartolomeo Nicola , Paolo Trerotoli https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29231

Trajectories of Adherence to Biologics in Patients with Rheumatoid Arthritis and Risk of a Secondary Immuno-Mediated Inflammatory Disease: A Large Multi-Database Italian Study
type: item
description: Background Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease (IMID) with a global prevalence of approximately 1%. The therapeutic strategy, aiming at achieving low disease activity, includes both conventional and biologic disease-modifying anti-rheumatic drugs (bDMARDs). Evidence from the literature suggests that patients with one IMID are at higher risk of developing another. However, data are lacking on the association between the occurrence of secondary IMIDs and longitudinal adherence to bDMARDs. Aim To evaluate the association between adherence trajectories to bDMARDs and the occurrence of secondary IMIDs in patients with RA. Methods We conducted a population-based retrospective observational cohort study using administrative data [1]. We included residents of the participating regions from 2010 to 2023 who had at least one biologic dispensing approved for RA, and a diagnosis of RA identified though a validated algorithm. We excluded individuals younger than 18 years, had less than one year of continuous enrolment (look-back), were prevalent users of RA bDMARDs, were treated with rituximab as index drug, or had a diagnosis of any IMID other than RA during the look-back period. The first dispensing date of a bDMARD was defined as the index date. Patients were observed over a two-year period: the first year (exposure period) to assess adherence, and the second year (follow-up period) to monitor the occurrence of secondary IMIDs, death, or end of the study period—whichever came first. During the exposure period, patients were censored if they developed cancer, became pregnant, or died. Treatment coverage was estimated assuming a daily intake of one Defined Daily Dose. We assessed adherence to bDMARDS monthly over the exposure period using the Medication Possession Ratio. Adherence trajectories were identified using Group-Based Trajectory Modeling (GBTM) [2,3]. We used a Cox proportional hazards model to estimate the hazard ratio, and correspondi…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: S. Giometto
creator: I. Convertino
creator: G. Pellegrini
creator: R. Campelo
creator: G. Limoncella
creator: A. Spini
creator: M. Massari
creator: S. Spila-Alegiani
creator: E. Carrasquinha
creator: M. Tuccori
creator: G. Trifirò
creator: E. Lucenteforte
rights: Copyright (c) 2025 S. Giometto, I. Convertino, G. Pellegrini , R. Campelo , G. Limoncella , A. Spini , M. Massari , S. Spila-Alegiani , E. Carrasquinha , M. Tuccori , G. Trifirò , E. Lucenteforte https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29232

A Randomized Controlled Field Trial: A Gamified Training Course on Workplace Health and Safety Prevention for Middle School Students – "Let's Play 81!"
type: item
description: Introduction Injury prevention and the promotion of health in the workplace are priority objectives starting from school age. Early and effective training can help develop a safety culture in future workers. However, traditional methods often fail to engage students. Gamification, the integration of game elements into educational contexts, has emerged as a promising strategy to increase engagement, improve learning, and enhance working memory [1-5]. Objectives To evaluate the effectiveness of the gamified training course "Let's Play 81!" (“Giochiamo a 81!”) in promoting and improving knowledge of workplace health and safety, in reference to the contents of Italian Legislative Decree 81/2008 [6], among middle school students. Methods A teaching kit was created, consisting of a box (30×20×10 cm) containing an operational manual and the materials necessary for three different types of games: a role-playing game ("81 si gira!"), a board game ("Riduci il premio") and a card game ("Mettici la mano") [7]. The games were designed to reinforce the key concepts of Legislative Decree 81/2008, with particular attention to the duties and responsibilities of key figures in prevention (company owner, safety executive, operator in charge, Prevention and Protection Service Manager, security officer, inspector, occupational health physician, workers’ safety representative and a simple worker). The study was conducted following CONSORT guidelines [8]. The study was set in third-year classes from three middle schools of Rome. A 15-question quiz was administered to both the intervention group (IG) and the control group (CG) at the beginning (T0) and at the end of the training day (T1). "Score81" was calculated (range 0–15), based on the number of correct answers of the quiz. The quiz, validated in a previous study with an adult population (Cronbach’s α > 0.70), required one correct answer among four alternatives, including the "don’t know" option. The intervention included a 1-hour lect…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Alice Mannocci
creator: Guendalina Capece
creator: David Shaholli
creator: Francesco Belsito
creator: Ilaria Frantellizzi
creator: Bruno Gerace
creator: Floranna Guarente Lombardo
creator: Jessica Prataviera
creator: Mren Quesada Ramos
creator: Claudia Sarcoli
creator: Ginevra Duraturo
creator: Antonietta Monteduro
creator: Giuseppe La Torre
rights: Copyright (c) 2025 Alice Mannocci , Guendalina Capece , David Shaholli, Francesco Belsito, Ilaria Frantellizzi, Bruno Gerace , Floranna Guarente Lombardo , Jessica Prataviera , Mren Quesada Ramos , Claudia Sarcoli , Ginevra Duraturo , Antonietta Monteduro , Giuseppe La Torre https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29233

Validation Protocol of the Italian Version of the Internet Related Measures (IRM) Questionnaire and Assessment of Internet Use Among High School Students in Italy: A Multicenter Study
type: item
description: Introduction Internet use has become an integral part of adolescents’ daily lives, a trend that intensified during and after the COVID-19 pandemic [1]. Alongside the increase in online activity, adolescents are now more exposed to digital threats such as harmful content (e.g., self-harm, radicalization), sexual exploitation, and cyberviolence [2]. Scientific literature highlights that some groups of adolescents—particularly those with psychological, familial, or social vulnerabilities—are more likely to encounter these risks [3,4]. In the Italian context, however, validated tools to assess Internet use and related risks are often outdated and lack cultural and technological relevance. This gap hinders effective screening and prevention efforts in schools. The present study addresses this need by validating an internationally adopted tool—the Internet Related Measures (IRM) questionnaire—for use with Italian adolescents, ensuring both scientific accuracy and contextual relevance. Objectives The study aims to: Validate the Italian version of the Internet Related Measures (IRM) questionnaire through linguistic, cultural, and psychometric adaptation; Explore and describe patterns of Internet use and perceived online risks among high school students in Lombardy. Methods This study will adopt a multicenter design and will involve students attending upper secondary schools (scuole secondarie di secondo grado) across the Lombardy region in Northern Italy. Participants will complete a structured questionnaire comprising sociodemographic items (age, gender, ethnicity, school attended) along with the Italian version of the IRM questionnaire. Descriptive statistics will summarize participant characteristics and Internet use patterns. Means and standard deviations will be used for normally distributed variables; medians and interquartile ranges for non-normally distributed data; and frequencies and percentages for categorical variables. Psychometric properties of the IRM will be…
subject: Congress Abstract - Section 1: Epidemiologia Generale
  topic: section
creator: Carlo Marinoni
creator: Simona Carla Silvia Caravita
creator: Maria Assunta Zanetti
creator: Simona Villani
creator: Camilla Torriani
rights: Copyright (c) 2025 Carlo Marinoni, Simona Carla Silvia Caravita , Maria Assunta Zanetti , Simona Villani , Camilla Torriani https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-08
publication date: 2025-09-08
doi: 10.54103/2282-0930/29237