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AbstractThe Convention on the Rights of Persons with Disabilities has brought about a major shift in our understanding of and approach to disability, not least in terms of its implications for other frameworks of international law. Yet, considerations with regard to disability in the context of international humanitarian law (IHL) remain the exception, meaning that persons with disabilities in practice often do not benefit from the same degree of protection as others who find themselves in situations of armed conflict. These shortcomings can be further exacerbated by an interplay between impairment and other individual characteristics such as gender and age, resulting in at times exceptional disadvantages faced by women and girls with disabilities. The present article therefore aims to propose ways in which our modern-day understanding of disability may inform the interpretation and application of IHL, as well as to showcase how the interaction between disability and other characteristics such as gender and age will shape said interpretation and application.

Cigarette consumption has increased steadily throughout this century in Italy. There were marked increases in three periods: in the 1920s, in the 1950s possibly due to the spread of smoking among young men, and in the 1970s in part due to smoking among women. The average number of cigarettes per adult per day sold legally in 1980 was 6.9 but, taking smuggling into account, the actual average number of cigarettes smoked per day is likely to range between eight and nine. Data from a national sample-based survey conducted in 1980 showed that smoking prevalence in men was broadly similar within age groups, geographical area, education, and socioeconomic groups. Smoking in women, on the other hand, was concentrated in younger and more educated women living in larger towns and in richer areas of the country. This pattern is typical of a recent rapid spread of smoking among women. The average tar yield of Italian cigarettes in 1983-4 was about 17 mg. Tar yield was strongly and negatively correlated with price (r = -0.55). This abnormality should be urgently reversed by government intervention. No material increase in lung cancer mortality in young women was evident up to the lat 1970s. Lung cancer death rates in men correlated closely with the observed changes in cigarette consumption. The highest mortality rates (about 7, 20, and 50/100 000 respectively in the age groups 35-39, 40-44, and 45-49) were reached by the generation born around 1927-30, and the rates have remained fairly constant around these maximum levels for those born up to 1940. As a consequence, Italian lung cancer death rates in middle-aged men (45 to 54) are currently the highest registered in developed countries, and large upward trends are currently detectable in older men.

Luigi Mangiagalli (1850-1928) is a well known figure and a "foundingfather" of obstetrics and gynecology in Italy, but less recognized are the widerange implications of his work on a public health and social level. In fact, apartfrom its surgical, clinical and academic values, all the activities of Mangiagallihad a public health, and hence a political relevance. Thus, when at age 27 hewas named professor of Obstetrics and Gynecology in Sassari, Sardinia, he notonly focused on the improvement of the local obstetrics clinic -when he arrivedthere were no beds and only a one broken forceps- and the control of puerperalinfections, but also to the control of malaria and syphilis in pregnancy.

Background: Breast cancer mortality in European women has been falling for three decades. We analysed trends in mortality from breast cancer in Europe over the period 1980 e 2017 and predicted number of deaths and rates to 2025. Methods: We extracted death certification data for breast cancer in women for 35 European countries, between 1980 and 2017, from the World Health Organisation database. We computed the age-standardised (world standard population) mortality rates per 100,000 person-years, by country and calendar year. We obtained also predictions for 2025 using a joinpoint regression model and calculated the number of avoided deaths over the period 1994e2025. Results: The mortality rate declined from 15.0 in 2012 to 14.4 in 2017 per 100,000 women (3.9%) for the European Union (EU)-27. This fall was greater in the EU-14 (5.2%), whereas rates rose in the transitional countries during this period by 1.9%. Mortality rate predictions across Europe are expected to reach relatively uniform levels in 2025. During the studied period, favourable trends in mortality emerged in most countries, with the greatest decrease in Denmark, whereas Poland and Romania showed an upward trend. The largest predicted decrease in breast cancer mortality was estimated for the United Kingdom (12.2/100,000 women in 2025), leading to the estimated avoidance of 150,000 breast cancer deaths over the period 1994e2025 and 470,000 in the EU-27.

Background: The process of social, political and economic transformation, which took place in Central and Eastern Europe in the early 90's, has affected many spheres of Europeans' lives, including health-associated issues. These changes also had an impact on mortality rates due to cervical cancer (CC). Therefore, the aim of this study was to analyse CC mortality trends in Europe after 1990. Methods: Data on death due to CC, uterine cancers and unspecified uterine cancers, in women aged 20–44, were taken from the WHO Mortality Database. Trends in European countries between 1990 and 2017 were assessed using the Joinpoint Regression Program. Results: Most of the countries experienced a decrease in CC mortality. Although the lowest rates were observed in EU15 Member States, the highest decreases were observed in Central and Eastern Europe. However, there are still differences in mortality in these countries. There are also a few countries like Belarus, Latvia and Ukraine, which experienced an increase in mortality. The range of mortality across Europe in 2017 was between 0.6 and 5.2/100,000 women. Conclusions: It is essential to introduce well-organised screening programmes for early detection of CC with coverage of a correspondingly high percentage of the population, particularly in East-Central Europe, as well as to introduce high-coverage HPV vaccination in all European countries.

Background: Pancreatic cancer (PC) is one of the deadliest cancers worldwide for which little clinical progress has been made in the last decades. Furthermore, increased trends of PC mortality rates have been reported in Westernised countries. PC is usually diagnosed in advanced stages, precluding patients of an effective treatment. Identifying high-risk populations and early detection markers is the first and crucial step to impact on these figures and change the PC horizon. Aims/Objectives: To discuss the published body of evidence on host and tumor genomics promising markers for primary and/or secondary personalised PC prevention, as well as the future perspectives in the field. Methods: A review of the literature was performed to identify germline and tumor DNA and RNA markers that showed potential usefulness in defining the high-risk population, diagnosing the disease early, and identifying new carcinogens associated with PC. Results: Only high-penetrance inherited mutations are used, at present, to define the high-risk PC population. Although there are some promising genomics markers to be used as early detection tests, none has been validated adequately to be integrated into the clinics routine. Conclusions: Despite of important efforts made in the recent time, little progress has been made to better characterise high-risk PC populations and to identify genomics-based markers for its early diagnosis. PC rates continue to rise, and this disease is becoming a real public health problem in the Westernised world. International and multidisciplinary strategies to identify new markers and properly validate the promising ones are urgently needed to implement cost-efficient primary and secondary prevention interventions in PC.

OBJECTIVE--To quantify patterns and trends in incidence of AIDS associated with transfusion of blood and its products in 14 European countries and the United States. DESIGN--Data were derived from the World Health Organisation's European non-aggregate AIDS dataset and, for the United States, from the Centers for Disease Control AIDS public information dataset. Rates were standardised by using the world standard populations and adjusted for reporting delays in each country. SUBJECTS--Cases of AIDS in patients with haemophilia and recipients of transfusions. RESULTS--Overall, between 1985 and 1993 almost 6000 cases of AIDS associated with transfusions were registered in the 14 European countries considered and over 8000 in the United States between 1985 and 1992. Most European countries had annual age adjusted rates lower than 0.5 per million children aged 12 or less and between 1 and 2 per million adults. The United States had rates around 1 per million children and 5 per million adults in the most recent period. For children, the highest rates were generally reached in 1985-7, whereas in adults the highest rates were in the late 1980s. France had the highest overall incidence of AIDS related to transfusion in Europe (3.3 per million). Romania had a major epidemic in children (over 30 cases per million children in 1988-90). Incidence rates of AIDS associated with transfusion were still increasing in some southern European countries in the early 1990s. CONCLUSIONS--Apart from in France and Romania it is clear that rates of bloodborne AIDS in European countries are lower than those registered in the United States.

EUROCARE-5 data were used to provide an estimate of the potential number of lives saved by a series of assumptions about improving management for selected cancers in the European Union. Age-standardized mortality analyses allowed comparisons among different years and countries with different age distributions. Strategies to monitor and improve outcomes for cancer patients will have to be deliverable in the context of an ever-increasing number of older cancer patients.