Flavia Beccia

Introduction Cancer literacy (CL) is essential for enabling informed decision-making, prevention, early detection and adherence to treatment. However, disparities in CL across Europe, coupled with the spread of disinformation, limit equitable access to cancer care. This protocol describes a collection of scoping reviews to document the state of CL, misinformation narratives and education and training initiatives and identify barriers and facilitators. This work is embedded within the activities of the Beating Cancer Inequalities through Literacy in Europe project and encompasses nine consortium countries across Europe: Romania, Portugal, Belgium, Bulgaria, Montenegro, Ukraine, Italy, Ireland and Moldova. Methods and analysis The protocol follows the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews(PRISMA-ScR) checklist, guided by the Population, Concept, Context framework. Searches will be conducted in PubMed, supplemented by grey literature, capturing results from January 2015 to December 2025. Eligible records will undergo full-text review. Data will be extracted into predefined categories reflecting the topics of interest, developed by the research team before extraction to include key study information. Then, sources in local languages are provided by the partners, included and validated by native-speaking team members, adding to the results found by the researchers. Ethics and dissemination No ethical approval is required. Findings will be disseminated via peer-reviewed publications, project reports and stakeholder workshops. Study registration Open Science Framework (10.17605/OSF.IO/9AQSX).

Personalized medicine’s innovative approaches rely on the public's awareness and proficiency. We distributed an online survey to 6581 respondents

Introduction: Personalized Medicine (PM) tailors prevention and treatment to individuals based on their unique characteristics. It has the potential to improve health outcomes and healthcare sustainability by optimizing resource allocation. Both the European Union (EU) and China have prioritized PM in their health strategies. The IC2PerMed project was established to foster collaboration between the EU and China by developing a joint PM roadmap.Methods: To assess the state of PM in the EU and China, the project conducted a comprehensive mapping of relevant policies, programs, funding mechanisms, and health ecosystems. Additionally, three Delphi surveys were carried out, identifying 65 priorities, which were synthesized into a set of strategic actions.Results: The main output of the project is a joint roadmap for implementing PM in the EU and China. The roadmap promotes best practice exchange and addresses potential barriers to PM adoption. It outlines structural actions including enhancing health literacy, fostering intersectoral and international collaboration, ongoing review of emerging technologies, and facilitating innovation market entry through needs assessment and Health Technology Assessment. Key enablers such as data interoperability and shared standards are highlighted, along with ethical, social, and regulatory considerations that are universally relevant to PM implementation.Discussion: A shared action plan can guide health policy and help policymakers understand the interconnection between healthcare, the economy, and society. By supporting international projects and investing in research and innovation, stakeholders can advance global healthcare.

This national expert-based Delphi-consensus aims at formulating recommendations on the management of dementia care in Italy. This effort seems important and timely given in light of a new scenario arising from a new biological definition of Alzheimer’s disease (AD) and the availability of disease-modifying treatments (DMTs). Methods: the Steering Committee of the Italian Neurological Society for dementia (SINdem) created appropriate statements. Invited SINdem experts were requested to vote on the statements according to a modified three-round Delphi method. Only those statements reaching Grade A (full agreement ≥ 75%) or B (overall agreement ≥ 80% and full disagreement < 5%) were included in the final document. Round answers’ consistency was graded using the Cohen’s k and within-class correlation coefficient. Results: Forty-six experts voted on 20 statements, which focused on the following aspects: i) organization of care services from early diagnosis to the management of advanced clinical stages; ii) access to biomarkers for a biological diagnosis of AD; iii) requirements necessary for the administration of DMTs; iv) main actors and pathways for the management of patients suffering from cognitive disorders. At the end of the process, 4 statements (20%) received a Grade A consensus, while 16 (80%) reached a Grade B consensus. Although the responses reflect heterogeneity among Italian regions, there was a fair degree of consistency for all statements. Conclusion: The high strength of this expert-based Delphi-consensus may offer guidance for improving the patient’s journey of individuals with cognitive decline from a biological diagnosis to DMTs administration and may possibly offer hints to the Health Systems on dementia.

Background: Indoor air is an important public health issue and the COVID-19 pandemic has highlighted even more the importance of indoor air quality in schools. One of the main measures to preserve good indoor air quality is to maintain adequate indoor air exchange, and energy-efficient mechanical ventilation has been shown to be effective in improving indoor air quality and health of the occupants. Methods: A pre-post study and trend analysis will be carried out. As the project involves the installation of Controlled Mechanical Ventilation (CMV) systems in schools, the primary aim of the study is to assess the perceived indoor air quality in classrooms in a population of primary and secondary school students without (pre-installation) and with (post-installation) CMVs. The secondary aim is the assessment of health outcomes, investigating the prevalence of dermatological, respiratory, ocular and general disorders reported before and after the intervention, and stratifying by sociodemographic variables. The evaluation of the effectiveness of CMV systems on air quality will be evaluated through chemical-physical and microbiological sampling after the installation of CMVs. The perceived air quality and health assessment will be performed through a survey, distributed before and after CMVs installation. Conclusions: The present study protocol aims to highlight the importance of indoor air quality for students and school personnel, as well as propose new strategies and measures to deal with this raising issue, enacting measures and systems that will be sustainable from an environmental, energetical, and acoustic point of view, while still ensuring the best possible health outcomes.

Personalized medicine (PM) has the potential to revolutionize healthcare by delivering treatments tailored to individual patients based on their unique characteristics. However, ensuring its effective implementation presents complex challenges, particularly in terms of long-term sustainability. To address these challenges, the IC2PerMed project fosters collaboration between the European Union and China. This study, building on insights from the project, aims to identify key priorities for advancing PM, focusing on Clinical Studies and Funding Systems, with special attention to optimizing resource management, distribution, and protection to support sustainable development. A two-round Delphi survey was conducted to achieve consensus on common priorities among China and Europe related to Clinical Studies and Funding Systems. Consensus was measured using the Content Validity Index, requiring an agreement level of 80% or higher for item inclusion. The survey identified 20 key priorities in PM research, split evenly between research initiatives and funding mechanisms. Notable priorities include developing technology for deep phenotyping, standardizing methodological approaches, and fostering public–private collaborations. In funding, the emphasis was placed on involving patient voices in research design and establishing synergies among funders to support larger projects. The findings underscore the importance of structured collaboration between Europe and China in advancing personalised medicine. By addressing identified priorities in research and funding, this initiative can significantly enhance the efficacy of PM, ultimately improving healthcare outcomes globally. The study sets a precedent for future international partnerships aimed at fostering innovation in health sciences.

: The COVID-19 pandemic has highlighted that health services preparedness is crucial. Indeed, effective planning enables streamline operations, optimized resource allocation, and transparent communication during crises. Within this context, our analysis aims to assess EU countries’ healthcare systems preparedness, by policies analysis and capacity factor analysis, and relationship with COVID-19. We reviewed policies regarding influenza, antimicrobial resistance (AMR), and climate change in EU countries, using a web-screening of national and international authorities and institutions. Furthermore, we performed a factor analysis on WHO’s States Party Self-Assessment Reporting (SPAR) and evaluated the results using an iterated principal factor analysis with promax rotation. Few countries updated their policies after the pandemic, particularly regarding influenza plans. Italy stands out as an exception, having updated its national plan in 2021, while other countries maintain pre-COVID plans. Regarding AMR, only few countries, including Sweden, Netherlands, Malta, Germany, Spain, Belgium, and France, updated their plans post-pandemic, while Estonia and Romania lack plans entirely. Addressing the climate crisis and its impacts on health and healthcare resilience, all EU countries aligned with the EC regulation on climate action through National Energy and Climate Plans in 2023. Moreover, EU countries had average preparedness level of 75.77 (SD: 8.23), calculated on SPAR 2022, with significant disparities. Three major factors contribute to preparedness levels: planning, service delivery, and specific subtopics (e.g. food safety, radiation, infectious diseases). Our findings reveal the complexity of preparedness, showing diverse approaches across countries, despite EU regulations and WHO guidelines. International collaboration is crucial to standardize policies and enable countries to leverage successful examples, improving public health outcomes. Key messages: • Health services preparedness, underscored by the COVID-19 pandemic, is crucial for effective planning and crisis management. • The analysis demonstrates varying levels of preparedness across EU countries, with differences in policy updates and adherence to international guidelines.

: Health literacy is pivotal for advancing public health, empowering individuals to grasp health information and make informed decisions. However, health literacy levels are often influenced by social and economic factors, with lower levels correlating with reduced disease-specific knowledge and underutilization of preventive health services. As healthcare technology rapidly evolves, particularly with the advent of personalised medicine (PM) and novel genetic testing methods, there’s an increasing demand for heightened health literacy to effectively navigate these transformative innovations and optimize health outcomes. The European ExACT project aims to assess the understanding of PM and related technologies across the EU. In this context, through a survey conducted in several European countries, including Italy, France, Spain, Poland, the Netherlands, Romania, Hungary, and Germany, demographic data and attitudes towards PM, genetic testing, health portals, and big data were gathered. Logistic regression analysis identified factors influencing knowledge and attitudes. Among 6581 respondents, the results highlight a broad awareness of genetic testing (81%) and health portals (54%) yet a lesser familiarity with PM (48%) and big data (37%). Education level, age, and gender influenced awareness, with Hungary showing significant awareness across all topics (OR 2.09 95%CI 1.46-2.98), Spain excelling in big data (OR 1.88 95%CI 1.55-2.27), and Poland leading in genetic testing knowledge (OR 2.68 95%CI 1.82-3.96). Differences between countries may indicate successful policies and factors that can be replicated. Overall, the study emphasizes the importance of enhancing health literacy and sheds light on the predicting role of sociodemographic factors. It underscores the significance of bolstering health literacy to effectively navigate the advancements in PM and digital health, improving health outcomes in light of these evolving healthcare landscapes. Key messages: • In Europe, awareness of personalised medicine, health portals and big data is lacking. Educational initiatives are crucial for effective navigation of innovations, considering regional differences. • Social and economic factors affect health literacy levels, impacting disease-specific knowledge and healthcare utilization.

: Concurrent disorders (COD), historically defined by the World Health Organization as the simultaneous presence of a psychoactive substance use disorder and another psychiatric disorder within the same individual, pose a significant challenge to public mental health. In today’s global landscape of mental health services, the prevalence of COD is on the rise, underscoring the need for an integrated approach to management. This review aims to provide an overview of existing global models and the evaluation approaches. This systematic review examined research evidence in PubMed, Scopus and Web of Science up to 2023 regarding integrated management systems for COD. Following PRISMA guidelines, we included articles describing specific models and evaluating the effectiveness of integrated versus non-integrated approaches. Quality assessment was conducted using the appropriate scales. Out of 7700 screened articles, 18 were included, all of fair or good quality. A diverse array of patient care models, programs, and interventions addressing comorbidities between mental health and substance use disorders emerged. The majority of studies focused on clinical outcomes, particularly alcohol and drug dependence, with global mental health consequences also under examination. Psychodiagnostics and social outcomes were also considered in a significant portion of the research, shedding light on health services utilization patterns. The integrated model for concurrent disorders in psychiatry stands as an effective approach, yet its implementation encounters challenges. This study showcases successful integration examples, providing valuable insights for policymakers and healthcare professionals to enhance existing models or develop new ones, particularly within European healthcare reforms like Italy’s restructuring of primary care, where they could serve as a criterion for the setting and organization of community houses. Key messages: • COD, involving both substance use and psychiatric disorders, present a significant challenge to public mental health. Rising prevalence underscores the need for integrated management approaches. • Insights from successful integration examples offer valuable guidance for healthcare professionals and policymakers, particularly within healthcare reforms like Italy’s restructuring of primary care.