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Objectives: to describe and compare the effectiveness of national and local lockdowns in controlling the spread of COVID-19., Methods: a rapid review of published and grey literature on COVID-19 pandemic was conducted following predefined eligibility criteria by searching electronic databases, repositories of pre-print articles, websites and databases of international health, and research related institutions and organisations., Results: of 584 initially identified records up to 5 July 2020, 19 articles met the inclusion criteria and were included in the review. Most of the studies (No. 11) used the reproduction  number (Rt) as a measure of effect and in all of them areduction of the estimated value at post-intervention period was found. The implementation of lockdown in 11 European countries was associated with an average 82% reduction of Rt, ranging from a  posterior Rt of 0.44 (95%CI 0.26-0.61) for Norway to a posterior Rt of 0.82 (95%CI 0.73- 0.93) for  Belgium. Changes in infection rates and transmission rates were estimated in 8 studies. Daily changes in infection rates ranged from -0.6% (Sweden) to -11.3% (Hubei and Guangdong provinces). Additionally, other studies reported a change in the trend of hospitalizations (Italy, Spain) and positive effects on the  doubling time of cases (Hubei, China) after lockdown., Conclusions: results of this rapid review suggest a positive effect of the containment measures on the spread of COVID-19 pandemic, with a major effect in  countries where lockdown started early and was more restrictive. Rigorous research is warranted to evaluate which approach is the most effective in each stage of the epidemic and in specific social contexts, in particular addressing if these approaches should be implemented on the whole population or target specific risk groups.

Objectives: to evaluate the association between socioeconomic position (SEP) and adherence to appropriate antiplatelet therapy (AAT) after percutaneous coronary intervention (PCI) in the year following the discharge., Design: according to scientific guidelines, AAT for PCI patients consists of Clopidogrel for a minimum of 1 month and ideally up to 12 months after discharge, and with Acetylsalicylic Acid (ASA) indefinitely. For each patient, drug claims over a 1-year period after discharge were retrieved from Regional Drug Dispense Registry. Drug use was measured with Proportion of Days Covered (PDC). PDC was computed dividing the total number of dispensed Defined Daily Dose by each patient's follow-up time. Dual antiplatelet therapy with PDC ≥75% and single therapy based on Clopidogrel with PDC ≥75% were considered as AAT. We used a composite area-based index of socioeconomic position by census block of residence built using the 2001 census of Rome, assuming 5 levels (from 1 =High SEP to 5 =Low SEP)., Setting and Participants: study population of 5,901 patients resident in Rome, who underwent their first PCI during 2006-2007 were selected from the Hospital Information System., Main Outcome Measures: proportions of patients treated with AAT by SEP was measured for the overall year and by semester. The association between SEP and adherence to AAT was estimated through logistic regression models adjusting for factors selected by a stepwise procedure (gender, age, comorbidities, discharged from cardiology or coronary care unit, new user of antiplatelet drugs)., Results: 76% of the study population were men, 96% were aged more than 44 years, and 63% belonged to medium-low SEP. In the 1-year follow-up, the proportion of patients adherent to appropriate antiplatelet therapy was 65%; SEP was associated with AAT (OR high vs. low SEP 1.26; 95%CI 1.05-1.51; p trend =0.002)., Conclusions: during the year after discharge, adherence to AAT of PCI patients was unsatisfactory and it decreased overtime more in medium-low SEP patients than in high SEP patients. Strategies to improve adherence to AAT among patients who underwent PCI need to be identified taking into account the multifactorial nature of poor medication adherence, and in particular patients' socioeconomic position.

Objective: To develop and validate a predictive model for the identification of patients with Chronic Obstructive Pulmonary Disease (COPD) among the resident population of the Lazio region, using information available in the regional administrative systems (SIS) as well as clinical data of a panel of COPD patients., Setting and Participants: All residents in the Lazio region over 40 years of age in 2007 (2,625,102 inhabitants), Main Outcome Measures: The predictive model was developed through record linkage of health care related consumption patterns among 428 panel patients with confirmed COPD diagnosis in 2006 and a control group of patients without COPD (selection from outpatients specialized health care registry, 1:4). Hospital admission for COPD was defined a priori to be sufficient to identify a COPD patient. For all other panel patients and controls, specific drug use (minimum 2 prescriptions during 12 months) and hospitalization for respiratory causes during the past 9 years were retrieved and compared between panel and control patients. COPD associated factors were selected through a Bootstrap- Stepwise (BS) procedure. The predictive model was validated through internal (cross-validation-bootstrap) and external validation (comparison with external COPD patients with confirmed diagnosis), and through comparison with other COPD identification approaches., Results: The BS procedure identified the following predictors of COPD: consumption of beta 2 agonists, anticholinergics, corticosteroids, oxygen, and previous hospitalization for respiratory failure. For each patient, the expected probability of being affected by COPD was estimated. Depending on the cut-point of expected probability, sensibility ranged from 74.5% to 99.6% and specificity from 37.8% to 86.2%. Using the 0.30 cut-point, the model succeeded in identifying 67% of patients with diagnosis of COPD confirmed with spirometry. The predictive performance increased with increasing COPD severity. Prevalence of COPD turned out to be 7.8 %. The age-specific estimation was similar to results from other approaches., Conclusion: The predictive model shows good performance to identify COPD patients, even if it does not allow to identify those patients who have not been registered in the regional health care service or do not request any public health care service.

Objectives: to describe the overall and cause-specific mortality among heroin users attending Public Treatment Centers (PTCs) in Italy and to estimate the impact of heroin use on mortality in the general population., Setting and Participants: A cohort of 10,376 patients (8881 men and 1495 women) enrolled over a period of 18 months between september 1998 and september 2000 and followed-up through 31st of March 2001 (VEdeTTE study)., Results: 190 deaths occurred during the study period (153 men and 37 women): 70 deaths were due to overdose (36.8%), 38 to AIDS (20.0%), 30 to violence (15.8%). The direct standardized overall mortality rate per 1000 person/years is 12.0 (CI 95% 5.4-18.6): 12.7/1000 p-y (CI 95% 4.9-20.5) among males and 8.4/1000 p-y (95% CI 4.7-12.2) among females. This study confirms that overdose is the leading cause of death in heroin users (mortality rate 2.6/1000 p-y (95% CI 0.8-4.5) among males and 4.0/1000 p-y (95% CI 0.9-7.2) among females. AIDS mortality rates are 2.6/1000 p-y, 95% CI 0.6-4.6 among males and 1.8/1000 p-y (95% CI 0.4-3.1) among females. The mortality rate for all the other causes is 6.0/1000 p-y (95% CI 0.0-14.0) among males and 2.3/1000 p-y (95% CI 0.9-3.6) among females. The standardized mortality ratios for all causes in comparison to age and gender matched general population show the excess particularly important for females (SMR 6.7; 95% CI 5.7-7.8 for males and SMR 22.8; 95% CI 16.5-31.5 for females). The population attributable fraction highlights that 14.4% (95% IC 10.9-18.5) of deaths in people aged 30-34 in Italy in 2000 could be attributed to heroin addiction; the fraction decreases to 10.7% (95% CI 6.9-15.6) at age 25-29 and to 12.8% (95% CI 9.9-16.2) at age 35-39., Conclusions: Mortality observed in this cohort is lower than that observed in previous studies, mainly due to reduction of AIDS and overdose mortality. The excess mortality over matched population is confirmed. Study population is older than in other studies (mean age at enrollment 31.1; DS 6.2); and the observation time is mainly spent in treatment. The mortality attributable faction shows that almost the 13% of deaths around the third decade of age can be attributed to drug dependence even though it is important to take into consideration the assumptions about drug addiction prevalence in the general population.

Aim: to describe the characteristics and effectiveness of various smoking cessation programs offered by Italian treatment services operating within the National Health Service., Design: prospective longitudinal multicentre study involving 41 smoking cessation services in 16 Italian regions., Study Population: the study population includes patients entering smoking cessation programs between April 2003 and June 2004. The "study population" includes 1226 patients (54.2% males and 45.4% females), mean age 47 years. Patients have a middle/high level of education and a long history of smoking; most are highly dependent on nicotine and report previous attempts to quit smoking., Methods: treatment effectiveness in smoking cessation is assessed six months after entering treatment service. Logistic Regression Model was used to determine the predictors of successfiul cessation, independent of treatment typology. The predictors were included as confounding variables in the logistic regression model that was used to evaluate the effectiveness of treatments. Besides the effect of treatment completion on smoking cessation was estimated., Results: predictors of successful smoking cessation are: being male, presence of a partner, strong motivation to quit, previous attempts to give up smoking, mild nicotine dependence, and not suffering from mood disturbances. All treatments are effective in helping people to stop smoking: cessation rate ranges between 25.00% for patients receiving a single session of motivational counselling and 65.3% for those receiving nicotine replacement therapy combined to group therapy. Compared to a single session of motivational counseling, nicotine replacement therapy combined to group therapy is the most effective therapeutic program (OR 5.4; 95%CI 12.5-12.0). Treatment completion is a strong determinant ofsuccess (OR 4.8; 95%CI 3.5-6.4)., Conclusion: enrolling people in any type of therapeutic program, in particular nicotine replacement therapy combined with group therapy increases the probability of successfully quitting smoking; moreover, patients that begin a smoking cessation program should be encouraged to complete the therapy