Suchergebnisse

RésuméDans cet article, je propose une analyse critique de la réponse des trois principaux théoriciens de l'interculturalisme majoritariste – Gérard Bouchard, Jérôme Gosselin-Tapp et Michel Seymour – à la question des minorités internes. Cette question est de savoir comment protéger le droit des minorités religieuses de pratiquer leur religion (tel que créé ou facilité par le multiculturalisme ou l'interculturalisme) sans violer le droit des femmes en leur sein de mener une vie exempte d'oppression (tel que défendu par le féminisme). Je soutiens que la réponse de ces auteurs est ambiguë, en ce sens qu'elle embrasse simultanément deux postures – la fermeté et la flexibilité – qui, lorsque considérées ensemble, sont contradictoires et, lorsque considérées séparément, présentent des problèmes spécifiques. Si dans le cas particulier du foulard islamique, ces auteurs élargissent momentanément leur perspective, leurs arguments à ce chapitre commandent des nuances importantes pour le moment absentes de leur raisonnement.

Emissions of nitrogen oxides (NOx) from combustion systems remain a lingering environmental issue, being these species either greenhouse gases or acid rain precursors. Moderate or Intense Low-oxygen Dilution (MILD) combustion can reduce the emissions of NOx thanks to its characteristic features (i.e. homogeneous reaction zones, reduced temperature peaks, diluted mixtures of reactants) that influence and change the main chemical pathways of NOx formation. A summary of the relevant routes of formation and destruction of NOx in MILD combustion is presented in this review, along with the identification of the sources of uncertainty that prevent reaching an overall consensus in the literature about the dominant NOx chemical pathway in MILD regime. Computational Fluid Dynamics (CFD) approaches are essential tools for investigating the critical phenomena occurring in MILD combustion and the design of pollutant-free turbulent combustion systems. This paper provides an outline of the modeling approaches employed in CFD simulations of turbulent combustion systems to predict NOx emissions in MILD conditions. An assessment of the performances of selected models in estimating NOx formation in a lab-scale MILD combustion burner is then presented, followed by a discussion about relevant modeling issues, perspectives and opportunities for future research. ; This work has been financially supported by the Wiener Anspach Foundation and has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme under grant agreement No. 714605. ; info:eu-repo/semantics/published

The Administrative Data Research Network (ADRN) facilitates access to de-identified administrative data for researchers. Under a complex and dynamic data sharing legal framework in the UK, the Network is a partnership of UK Universities, government departments, national statistical authorities, funders and research centres and it aims to deliver a service enabling secure and lawful access to de-identified linked administrative data to researchers.nbsp;As one of the 'front doors' to the ADRN, the Administrative Data Service is liaising with data owners, researchers and experts in data linkage and data governance to facilitate access to administrative data. In addition to providing guidance on processes and an infrastructure addressing some of the concerns on information governance and data security through dedicated 'secure environments' as points of access. Quite often, we find ourselves in the 'middle' of these discussions, as we negotiate access and translate requirements and repurpose documentation to ensure the project resonates with a variety of agendas and priorities.nbsp;The poster will provide an overview of recent work in the area and how we have dealt with challenges up to now. We will summarise work done in trying to streamline application processes for different data providers in different data domains in the UK (e.g. education, health, crime, benefits and labour market). We will talk about how ADRN has been working alongside government departments to design and implement streamlined approaches to administrative data access in the UK and how we are supporting researchers when they apply to access administrative data for their research in the areas of ethics, consent, legal pathways to access, methodology and data availability. And how it's not just about data meeting in the middle, it's primarily about people.

The Administrative Data Research Network has been created to arrange access to data which are historically difficult to obtain. In the initial phase of the Network researchers have requested any data which they think will be useful, with the task of establishing the practicalities of data availability, useability and accessibility a responsibility of the ADRN. This 'offer' has presented some unique challenges for the Administrative Data Service - the section of the ADRN which has led many of the discussions with UK government departments - and has created a mix of responsibilities and expectations between User and Service which are different from those experienced by many, traditional, data access services.This presentation will outline: 1) why the ADRN model was adopted and how it was useful in the context of the service, 2) the challenges that became apparent when ADRN began to operate – and the difficulties that were experienced because of the working model and 3) the solutions that the service put in place to enable effective user support and management in a highly challenging environment (as well as some of the blue-sky thinking that we've done about the ideal solutions for the future). Food for thought for anyone involved in a data service that needs to cope with the 'new and novel'.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. The first case of pneumonia was reported on 8 December 2019 and identified on 7 January 2020 as COVID-19. On 9 March 2020, to stop the spread of COVID-19 cases, the Italian government declared a health emergency, forcing all citizens to go into lockdown. Suddenly, schools were constrained to using distance learning strategies with little or limited experience on the topic. Particularly, in the southern regions of Italy, approximately 20% of the students did not have access to any devices and were excluded from learning, producing a direct risk of increased adolescent delinquency. This research team intended to report the results of an observational study that focused on the perceptions of distance learning in adolescents from secondary school in Naples (Italy) between April and May 2020. The questionnaire comprised 11 questions focused on the perceptions of distance learning in comparison to live classrooms, relationships with peers and teachers, and levels of anxiety. The study is amongst the first to report the effect of the pandemic from a student-centred perspective and hopes to produce information to develop future research on asynchronous learning.

Background/Aims: Liver biopsy for hepatocellular carcinoma (HCC) detection is largely restricted to small hepatocellular lesions, which are often morphologically challenging, requiring careful distinction between dysplastic nodules (high-grade) and well-differentiated HCC. Methods: We investigated the diagnostic accuracy of a panel of markers (HSP70 G PC3 and GS), previously tested in resection specimens, in a series of liver biopsies of large regenerative nodules (n = 13), low-grade dysplastic nodules (n = 21), high-grade dysplastic nodules (n = 50), very well-differentiated (VWD) (n = 17), well-differentiated (WD-G1) (n = 40) and G2-3 (n = 35) HCC. Results: Almost all cases of large regenerative and low-grade dysplastic nodules did not stain while high-grade dysplastic nodules showed 1 marker (22%) but never 2 or 3. For HCC detection the overall accuracy of marker combination was 60.8% (3 markers) and 78.4% (2 markers) with 100% specificity. When restricted to VWD + WD-G1 HCC the accuracy was 57% (3 markers) and 72.9% (2 markers) with 100% specificity. Conclusions: This panel proved useful to detect well-differentiated HCC in biopsy. Two immunoreactive markers (out of 3) are recommended as the most valuable diagnostic combination for HCC detection. The diagnostic accuracy of the panel could be improved using additional markers, as suggested by studies of expression profiling in other human models. (c) 2009 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. ; This work was supported by a grant (0620210) from the National R&D Program for Cancer Control, Ministry of Health & Welfare, and by the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (MOST) (R13-2002-054-03004-0), Republic of Korea (Y.N. Park, J.J. Jang and E. Yu) and by the Italian MURST (FIRST 2006). ; Seimiya M, 2008, HEPATOLOGY, V48, P519, DOI 10.1002/hep.22364 ; Abdul-Al HM, 2008, HUM PATHOL, V39, P209, DOI 10.1016/j.humpath.2007.06.004 ; Forner A, 2008, HEPATOLOGY, V47, P97, DOI 10.1002/hep.21966 ; Forner A, 2008, HEPATOLOGY, V47, P5, DOI 10.1002/hep.22152 ; Bioulac-Sage P, 2007, HEPATOLOGY, V46, P740, DOI 10.1002/hep.21743 ; Roncalli M, 2007, HEPATOL RES, V37, pS125, DOI 10.1111/j.1872-034X.2007.00175.x ; Audard V, 2007, J PATHOL, V212, P345, DOI 10.1002/path.2169 ; Di Tommaso L, 2007, HEPATOLOGY, V45, P725, DOI 10.1002/hep.21531 ; Park YN, 2007, CANCER, V109, P915, DOI 10.1002/cncr.22460 ; HYTIROGLOU P, 2007, GASTROENTEROL CLIN N, V36, P867 ; Liu L, 2006, CANCER RES, V66, P11851, DOI 10.1158/0008-5472.CAN-06-1377 ; Llovet JM, 2006, GASTROENTEROLOGY, V131, P1758, DOI 10.1053/j.gastro.2006.09.014 ; Yamauchi N, 2005, MODERN PATHOL, V18, P1591, DOI 10.1038/modpathol.3800436 ; Bruix J, 2005, HEPATOLOGY, V42, P1208, DOI 10.1002/hep20933 ; Lorinc E, 2005, HISTOPATHOLOGY, V46, P642, DOI 10.1111/j.1365-2559.2005.02139.x ; Kojiro M, 2005, SEMIN LIVER DIS, V25, P133 ; Dray M, 2005, PATHOLOGY, V37, P112, DOI 10.1080/00313020500058607 ; RONCALLI M, 2004, LIVER TRANSPLANT, V10, pS9 ; Paradis V, 2003, AM J PATHOL, V163, P733 ; Capurro M, 2003, GASTROENTEROLOGY, V125, P89, DOI 10.1016/S0016-5085(03)00689-9 ; Chuma M, 2003, HEPATOLOGY, V37, P198, DOI 10.1053/jhep.2003.50022 ; Sparrow LE, 1998, AM J DERMATOPATH, V20, P255 ; CHRISTA L, 1994, GASTROENTEROLOGY, V106, P1312 ; 34

Low-temperature scanning tunneling microscopy and spectroscopy has been used to image the vortex core and the vortex lattice in FeSe single crystals. The local tunneling spectra acquired at the center of elliptical vortex cores display a strong particle-hole asymmetry with spatial oscillation, characteristic of the quantum-limit vortex core. Furthermore, a quasihexagonal vortex lattice at low magnetic field undergoes noticeable rhombic distortions above a certain field ∼1.5 T. This field H∗ also reveals itself as a kink in the magnetic field dependence of the specific heat. The observation of a nearly hexagonal vortex lattice at low field is very surprising for materials with an orthorhombic crystal structure and it is in apparent contradiction with the elliptical shape of the vortex cores. These observations can be directly connected to the multiband nature of superconductivity in this material, provided we attribute them to the suppression of superconducting order parameter in one of the energy bands. Above the field H∗ the superconducting coherence length for this band can well exceed the intervortex distance which strengthens the nonlocal effects. Therefore, in addition to multiple-band effects, other possible sources that can contribute to the observed evolution of the vortex-lattice structure include nonlocal effects which cause the field-dependent interplay between the symmetry of the crystal and vortex lattice or the magnetoelastic interactions due to the strain field generated by vortices. © 2019 American Physical Society. ; Citrus Research and Development Foundation, CRDF ; Government Council on Grants, Russian Federation ; Russian Science Foundation, RSF: 17-12-01383, 18-72-10027 ; Ministero dellâ Istruzione, dellâ Università e della Ricerca, MIUR ; Foundation for the Advancement of Theoretical Physics and Mathematics: 17-11-109 ; Ministero dellâ Istruzione, dellâ Università e della Ricerca, MIUR ; Kazan Federal University ; Office of Science, SC ; Division of Materials Sciences and Engineering, DMSE ; Russian Foundation for Basic Research, RFBR: 17-52-12044 ; Ministry of Education and Science of the Russian Federation, Minobrnauka ; Temple University, TU ; Argonne National Laboratory, ANL ; Nanjing University of Science and Technology, NUST: K2-2017-084 ; Drexel University ; The authors would like to acknowledge fruitful discussions with V. Kogan and T. Hanaguri. We also would like to acknowledge technical support during the early stage of these measurements from S. A. Moore. The work at Temple University, where low temperature scanning tunneling measurements were performed, was supported by US Department of Energy, Office of Science, Basic Energy Science, Materials Sciences and Engineering Division under Award No. DE-SC0004556. The work at Drexel University and at the M.V. Lomonosov Moscow State University was supported by the US Civilian Research and Development Foundation (CRDF Global). The work in Russia has been supported in part by the Ministry of Education and Science of the Russian Federation in the framework of the Increase Competitiveness Program of NUST MISiS Grant K2-2017-084, by Act 211 of the Government of Russian Federation, Contracts No. 02.A03.21.0004, No. 02.A03.21.0006, and No. 02.A03.21.0011 and by the Russian Government Program of Competitive Growth of Kazan Federal University. One of the authors (C.D.G.) would like to acknowledge partial support from MIUR (Ministry of Education, Universities and Research of the Italian Government). The work in IPM RAS (Nizhny Novgorod) was supported in part by the Russian Science Foundation (the calculation of the vortex-lattice characteristics Grant No. 18-72-10027; the calculation of the vortex-core deformation and the analysis of the experimental data Grant No. 17-12-01383), the Russian Foundation for Basic Research (Grant No. 17-52-12044), and Foundation for the Advancement of Theoretical Physics and Mathematics "BASIS" (Grant No. 17-11-109). The work at Argonne National Laboratory was supported by the US Department of Energy, Office of Science, Basic Energy Science, Materials Sciences and Engineering Division.

BACKGROUND: the mixed and complex nature of industrially contaminated sites (ICSs) leads to heterogeneity in exposure and health risk of residents living nearby. Health, environment, and social aspects are strongly interconnected in ICSs, and local communities are often concerned about potential health impact and needs for remediation. The use of human biomonitoring (HBM) for impact assessment of environmental exposure is increasing in Europe. The COST Action IS1408 on Industrially Contaminated Sites and Health Network (ICSHNet) decided to reflect on the potential and limitations of HBM to assess exposure and early health effects associated with living near ICSs. OBJECTIVES: to discuss challenges and lessons learned for addressing environmental health impact near ICSs with HBM in order to identify needs and priorities for HBM guidelines in European ICSs. METHODS: based on the experience of the ICSHNet research team, six case studies from different European regions that applied HBM at ICSs were selected. The case studies were systematically compared distinguishing four phases: the preparatory phase; study design; study results; the impact of the results at scientific, societal, and political levels. RESULTS: all six case studies identified opportunities and challenges for applying HBM in ICS studies. A smart choice of (a combination of) sample matrices for biomarker analysis produced information about relevant time-windows of ex posure, which matched with the activities of the ICSs. Combining biomarkers of exposure with biomarkers of (early) biological effects, data from questionnaires or environmental data enabled fine-tuning of the results and allowed for more targeted remediating actions aimed to reduce exposure. Open and transparent communication of study results with contextual information and involvement of local stakehold ers throughout the study helped to build confidence in the study results, gained support for remediating actions, and facilitated sharing of responsibilities. Using HBM in these ICS studies helped in setting priorities in policy actions and in further research. Limitations were the size of the study population, difficulties in recruiting vulnerable target populations, availability of validated biomarkers, and coping with exposure to mixtures of chemicals. CONCLUSIONS: based on the identified positive experiences and challenges, the paper concludes with formulating recommendations for a European protocol and guidance document for HBM in ICS. This could advance the use of HBM in local environmental health policy development and evaluation of exposure levels, and promote coordination and collaboration between researchers and risk managers.

SENTIERI Project (Mortality study of residents in Italian polluted sites) studies mortality of residents in the sites of national interest for environmental remediation (Italian polluted sites, IPS). IPSs are located in the vicinity of industrial areas, either active or dismissed, near incinerators or dumping sites of industrial or hazardous waste. SENTIERI includes 44 out of 57 sites comprised in the "National environmental remediation programme". For each IPS contamination data were collected, both from the national and local environmental remediation programmes. Contamination data are mainly for private industrial areas; municipal and/or green and agricultural areas were poorly studied, therefore it is difficult to assess the environmental exposure of populations living inside and/or near IPSs. Each one of 44 SENTIERI IPSs includes one or more municipalities. Mortality in the period 1995-2002 was studied for 63 single or grouped causes at municipality level computing: crude rate, standardized rate, standardized mortality ratios (SMR), and SMR adjusted for an ad hoc deprivation index. Regional populations were used as reference for SMR calculation. The deprivation index was constructed using 2001 national census variables on the following socioeconomic domains: education, unemployment, dwelling ownership and overcrowding. A characterizing element of SENTIERI Project is the a priori evaluation of the epidemiological evidence of the causal association between cause of death and exposure. Exposures for which epidemiological evidence was assessed are divided into IPSs environmental exposures and other exposures. The former are defined on the basis of the decrees defining sites' boundaries; they are coded as chemicals, petrochemicals and refineries, steel plants, power plants, mines and/or quarries, harbour areas, asbestos or other mineral fibres, landfills and incinerators. The other exposures, considered for their ascertained adverse health effects are: air pollution, active and passive smoking, alcohol intake, occupational exposure and socioeconomic status. The epidemiologists in SENTIERI Working Group (WG) developed a procedure to examine the epidemiological literature published from 1998 to 2009; the WG identified a hierarchy in the literature examined to classify each combination of cause of death and exposure in terms of strength of causal inference. The selected epidemiological information included primary sources (handbooks and Monographs and Reports of international and national scientific institutions), statistical re-analyses, literature reviews, multi-centric studies and single investigations. This hierarchy relies on the epidemiological community consensus, on assessments based on the application of standardized criteria, weighting the studies design and the occurrence of biased results. Therefore, to put forward the assessment, the criteria firstly favoured primary sources and quantitative meta-analyses and, secondly, consistency among sources. The epidemiological evidence of the causal association was classified into one of these three categories: Sufficient (S), Limited (L), and Inadequate (I). The procedures and results of the evidence evaluation have been presented in a 2010 Supplement of Epidemiologia & Prevenzione devoted to SENTIERI. SENTIERI studied IPS-specific mortality and the overall mortality profile in all the IPSs combined. Some IPS-specific results are noteworthy and are herementioned. The presence of asbestos (or asbestiform fibres in Biancavilla) was the motivation for including six IPSs (Balangero, Emarese, Casale Monferrato, Broni, Bari-Fibronit, Biancavilla) in the "National environmental remediation programme". In these sites (with the only exception of Emarese) increases in malignant pleural neoplasm mortality were observed, in four of them the excess was in both genders. In six other sites (Pitelli, Massa Carrara, Aree del litorale vesuviano, Tito, Area industriale della Val Basento, Priolo), in which additional sources of environmental pollution were reported, mortality from malignant pleural neoplasm was increased in both genders in Pitelli, Massa Carrara, Priolo and Litorale vesuviano. In the twelve sites where asbestos was mentioned in the decree, a total of 416 extra cases of malignant pleural neoplasms were computed. Asbestos and pleural neoplasm represent an unique case. Unlike mesothelioma, most causes of death analyzed in SENTIERI have multifactorial etiology, furthermore in most IPSs multiple sources of different pollutants are present, sometimes concurrently with air pollution from urban areas: in these cases, drawing conclusions on the association between environmental exposures and specific health outcomes might be complicated. Notwithstanding these difficulties, in a number of cases an etiological role could be attributed to some environmental exposures. The attribution could be possible on the basis of increases observed in both genders and in different age classes, and the exclusion of a major role of occupational exposures was thus allowed. For example, a role of emissions fromrefineries and petrochemical plants was hypothesized for the observed increases in mortality from lung cancer and respiratory diseases in Gela and Porto Torres; a role of emissions frommetal industries was suggested to explain increased mortality from respiratory diseases in Taranto and in Sulcis-Iglesiente-Guspinese. An etiological role of air pollution in the raise in congenital anomalies and perinatal disorders was suggested in Falconara Marittima, Massa-Carrara,Milazzo and Porto Torres. A causal role of heavy metals, PAH's and halogenated compounds was suspected for mortality from renal failure in Massa Carrara, Piombino, Orbetello, Basso Bacino del fiume Chienti and Sulcis-Iglesiente- Guspinese. In Trento-Nord, Grado and Marano, and Basso bacino del fiume Chienti increases in neurological diseases, for which an etiological role of lead, mercury and organohalogenated solvents is possible, were reported. The increase for non- Hodgkin lymphomas in Brescia was associated with the widespread PCB pollution. SENTIERI Project assessed also the overall mortality profile in all the IPSs combined. The mortality for causes of death with a priori Sufficient or Limited evidence of causal association with the environmental exposure showed 3 508 excess deaths for all causes, corresponding to 439 per year; the number of excess deaths was 1 321 for respiratory diseases, 898 for lung cancer and 588 for pleural neoplasms. When considering excess mortality with no restriction to causes of death with a priori Sufficient or Limited evidence of causal association with the environmental exposure, the number of excess deaths for all causes was 9 969 (SMR 102.5, about 1 200 excess deaths per year; the excess was 4 309 for all neoplasms (SMR 103.8, about 538 excess deaths per year), 1 887 for circulatory systemdiseases, and 600 for respiratory systemdiseases. Most of these excesses were observed in IPSs located in Southern and Central Italy. The distribution of the causes of deaths showed that the excesses are not evenly distributed: cancer mortality accounts for 30% of all deaths, but it is 43.2% of the excess deaths (4 309 cases out of 9 969). Conversely, the percentage of excesses in noncancer causes is 19%, while their share of total mortality is 42%. SENTIERI is affected by some limitations, such as the ecological study design and a time window of observation possibly inappropriate to account for induction-latency time; the analyzed outcome (mortality instead than incidence) might be unsuitable as well. Despite its limitations, SENTIERI documented increased mortality for single IPSs and an overall burden of disease in residents in Italian polluted sites. These excesses could be attributed to multiple risk factors, that include also the environmental exposures. The study results will be shared with the Ministries of Health and Environment, Regional governments, Regional environmental protection agencies, Local health authorities and municipalities. A collaborative approach between institutions in charge of environmental protection and health promotion will foster, among else, a scientifically sound and transparent communication process with concerned populations. ; Il Progetto SENTIERI (Studio Epidemiologico Nazionale dei Territori e degli Insediamenti Esposti a Rischio da Inquinamento) riguarda l'analisi della mortalit? delle popolazioni residenti in prossimit? di una serie di grandi centri industriali attivi o dismessi, o di aree oggetto di smaltimento di rifiuti industriali e/o pericolosi, che presentano un quadro di contaminazione ambientale e di rischio sanitario tale da avere determinato il riconoscimento di "siti di interesse nazionale per le bonifiche" (SIN). Lo studio ha preso in considerazione 44 dei 57 siti oggi compresi nel "Programma nazionale di bonifica", che coincidono con i maggiori agglomerati industriali nazionali; per ciascuno di essi si ? proceduto a una raccolta di dati di caratterizzazione, e successivamente a una loro sintesi. La maggior parte dei dati raccolti proviene dai progetti di bonifica ipotizzati per i diversi siti, da cui si evince che oggetto di caratterizzazione e di valutazione del rischio sono state prevalentemente le aree private industriali, quelle, cio?, ritenute causa delle diverse tipologie di inquinamento (definite in SENTIERI esposizioni ambientali). Le aree pubbliche cittadine e/o a verde pubblico e le aree agricole comprese all'interno dei SIN sono state poco investigate. I SIN studiati sono costituiti da uno o pi? Comuni. La mortalit? ? stata studiata per ogni sito, nel periodo 1995-2002, attraverso i seguenti indicatori: tasso grezzo, tasso standardizzato, rapporto standardizzato di mortalit? (SMR) e SMR corretto per un indice di deprivazione socioeconomica messo a punto ad hoc. Nella standardizzazione indiretta sono state utilizzate come riferimento le popolazioni regionali. L'indice di deprivazione ? stato calcolato sulla base di variabili censuarie appartenenti ai seguenti domini: istruzione, disoccupazione, propriet? dell'abitazione, densit? abitativa. Gli indicatori di mortalit? sono stati calcolati per 63 cause singole o gruppi di cause. La presenza di amianto (o di fibre asbestiformi a Biancavilla) ? stata la motivazione esclusiva per il riconoscimento di sei SIN (Balangero, Emarese, Casale Monferrato, Broni, Bari-Fibronit e Biancavilla). In tutti i siti (con l'esclusione di Emarese) si sono osservati incrementi della mortalit? per tumore maligno della pleura e in quattro siti i dati sono coerenti in entrambi i generi. In sei siti con presenza di altre sorgenti di inquinamento oltre all'amianto, la mortalit? per tumore maligno della pleura ? in eccesso in entrambi i generi a Pitelli, Massa Carrara, Priolo e nell'Area del litorale vesuviano. Nel periodo 1995-2002 nell'insieme dei dodici siti contaminati da amianto sono stati osservati un totale di 416 casi di tumore maligno della pleura in eccesso rispetto alle attese. Quando gli incrementi di mortalit? riguardano patologie con eziologia multifattoriale, e si ? in presenza di siti industriali con molteplici ed eterogenee sorgenti emissive, talvolta anche adiacenti ad aree urbane a forte antropizzazione, rapportare il profilo di mortalit? a fattori di rischio ambientali pu? risultare complesso. Tuttavia, in alcuni casi ? stato possibile attribuire un ruolo eziologico all'esposizione ambientale associata alle emissioni di impianti specifici (raffinerie, poli petrolchimici e industrie metallurgiche). Tale attribuzione viene rafforzata dalla presenza di eccessi di rischio in entrambi i generi, e in diverse classi di et?, elementi che consentono di escludere ragionevolmente un ruolo prevalente delle esposizioni professionali. Per esempio, per gli incrementi di mortalit? per tumore polmonare e malattie respiratorie non tumorali, a Gela e Porto Torres ? stato suggerito un ruolo delle emissioni di raffinerie e poli petrolchimici, a Taranto e nel Sulcis-Iglesiente-Guspinese un ruolo delle emissioni degli stabilimenti metallurgici. Negli eccessi di mortalit? per malformazioni congenite e condizioni morbose perinatali ? stato valutato possibile un ruolo eziologico dell'inquinamento ambientale a Massa Carrara, Falconara, Milazzo e Porto Torres. Per le patologie del sistema urinario, in particolare per le insufficienze renali, un ruolo causale di metalli pesanti, IPA e composti alogenati ? stato ipotizzato a Massa Carrara, Piombino, Orbetello, nel Basso bacino del fiume Chienti e nel Sulcis-Iglesiente-Guspinese. Incrementi di malattie neurologiche per i quali ? stato sospettato un ruolo eziologico di piombo, mercurio e solventi organo alogenati sono stati osservati rispettivamente a Trento Nord, Grado e Marano e nel Basso bacino del fiume Chienti. L'incremento dei linfomi non-Hodgkin a Brescia ? stato messo in relazione con la contaminazione diffusa da PCB. Ulteriori elementi di interesse sono stati forniti dalle stime globali della mortalit? nell'insieme dei siti oggetto del Progetto SENTIERI. In particolare, ? emerso che la mortalit? in tutti i SIN, per le cause di morte con evidenza a priori Sufficiente o Limitata per le esposizioni ambientali presenti supera l'atteso, con un SMR di 115.8 per gli uomini (IC 904.4-117.2, 2 439 decessi in eccesso) e 114.4 per le donne (IC 902.4-116.5; 1 069 decessi in eccesso). Tale sovramortalit? si riscontra anche estendendo l'analisi a tutte le cause di morte, cio? non solo per quelle con evidenza a priori Sufficiente o Limitata: il totale dei decessi, per uomini e donne, ? di 403 692, in eccesso rispetto all'atteso di 9 969 casi (SMR 102.5%; IC 902.3-102.8), con una media di oltre 1 200 casi annui. Si ritiene opportuno ricordare che il Progetto SENTIERI, per obiettivi, disegno e metodi, rappresenta uno strumento descrittivo che verifica, in prima istanza, se e quanto il profilo di mortalit? delle popolazioni che vivono nei territori inclusi in aree di interesse nazionale per le bonifiche si discosti da quello cause delle popolazioni di riferimento. Ai fini dell'interpretazione dei risultati, si ricorda che la presenza di eccessi di mortalit? pu? indicare un ruolo di esposizioni ambientali con un grado di persuasivit? scientifica che dipende dai diversi specifici contesti; invece, un quadro di mortalit? che non si discosti da quello di riferimento potrebbe riflettere l'assenza di esposizioni rilevanti, ma anche l'inadeguatezza dell'indicatore sanitario utilizzato (mortalit? invece di incidenza) rispetto al tipo di esposizioni presenti, o della finestra temporale nella quale si analizza la mortalit? rispetto a quella rilevante da un punto di vista dell'esposizione. La condivisione dei risultati con i ministeri della salute e dell'ambiente, le Regioni, le ASL, le ARPA e i Comuni interessati consentir? l'attivazione di sinergie fra le strutture pubbliche con competenze in materia di protezione dell'ambiente e di tutela della salute, e su questa base l'avvio di un processo di comunicazione con la popolazione scientificamente fondato e trasparente. Parole chiave: siti di interesse nazionale per le bonifiche (SIN), mortalit? geografica, impatto sanitario ambientale, Italia

Background: Family caregivers of patients with dementia are at high risk of stress and burden, and quarantine due to the coronavirus disease 2019 (COVID-19) pandemic may have increased the risk of psychological disturbances in this population. The current study was carried out during the national lockdown declared in March 2020 by the Italian government as a containment measure of the first wave of the coronavirus pandemic and is the first nationwide survey on the impact of COVID-19 lockdown on the mental health of dementia informal caregivers. Methods: Eighty-seven dementia centers evenly distributed on the Italian territory enrolled 4,710 caregiver–patient pairs. Caregivers underwent a telephone interview assessing classical symptoms of caregiver stress and concern for the consequences of COVID-19 infection on patient's health. We calculated prevalence of symptoms and regressed them on various potential stress risk factors: caregivers' sociodemographic characteristics and lifestyle, patients' clinical features, and lockdown-related elements, like discontinuity in medical care. Results: Approximately 90% of caregivers reported at least one symptom of stress, and nearly 30% reported four or more symptoms. The most prevalent symptoms were concern for consequences of COVID-19 on patient's health (75%) and anxiety (46%). The main risk factors for stress were identified as a conflicting relationship with the patient and discontinuity in assistance, but caregiver's female sex, younger age, lower education, and cohabitation with the patient also had an impact. Availability of help from institutions or private individuals showed a protective effect against sense of abandonment but a detrimental effect on concern about the risk for the patient to contract COVID-19. The only protective factor was mild dementia severity, which was associated with a lower risk of feeling isolated and abandoned; type of dementia, on the other hand, did not affect stress risk. Conclusion: Our results demonstrate the large prevalence of stress in family caregivers of patients with dementia during the COVID-19 pandemic and have identified both caregivers and situations at a higher risk of stress, which should be taken into account in the planning of interventions in support of quarantined families and patients.