Budget impact analysis of introducing digital breast tomosynthesis in breast cancer screening in Italy.

PURPOSE: This study quantifies the impact on budget and cost per health benefit of implementing digital breast tomosynthesis (DBT) in place of digital mammography (DM) for breast cancer screening among asymptomatic women in Italy. METHODS: A budget impact analysis and a cost consequence analysis were conducted using parameters from the MAITA project and literature. The study considered four scenarios for DBT implementation, i.e., DBT for all women, DBT for women aged 45-49 years, DBT based on breast density (BI-RADS C + D or D only), and compared these to the current DM screening. Healthcare provider's perspective was adopted, including screening, diagnosis, and cancer treatment costs. RESULTS: Introducing DBT for all women would increase overall screening costs by 20%. Targeting DBT to women aged 45-49 years or with dense breasts would result in smaller cost increases (3.2% for age-based and 1.4-10.7% for density-based scenarios). The cost per avoided interval cancer was significantly higher when DBT was applied to all women compared to targeted approaches. The cost per gained early-detected cancer slightly increases in targeted approaches, while the assumptions on the clinical significance and overdiagnosis of cancers detected by DBT and not by DM have a strong impact. CONCLUSIONS: Implementing DBT as a primary breast cancer test in screening programs in Italy would lead to a substantial increase in costs. Tailoring DBT use to women aged 45-49 or with dense breasts could enhance the feasibility and sustainability of the intervention. Further research is needed to clarify the impact of DBT on overdiagnosis and the long-term outcomes.

Organizational impact of systemic implementation of digital breast tomosynthesis as a primary test for breast cancer screening in Italy.

PURPOSE: We present a comprehensive investigation into the organizational, social, and ethical impact of implementing digital breast tomosynthesis (DBT) as a primary test for breast cancer screening in Italy. The analyses aimed to assess the feasibility of DBT specifically for all women aged 45-74, women aged 45-49 only, or those with dense breasts only. METHODS: Questions were framed according to the European Network of Health Technology Assessment (EuNetHTA) Screening Core Model to produce evidence for the resources, equity, acceptability, and feasibility domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) decision framework. The study integrated evidence from the literature, the MAITA DBT trials, and Italian pilot programs. Structured interviews, surveys, and systematic reviews were conducted to gather data on organizational impact, acceptability among women, reading and acquisition times, and the technical requirements of DBT in screening. RESULTS: Implementing DBT could significantly affect the screening program, primarily due to increased reading times and the need for additional human resources (radiologists and radiographers). Participation rates in DBT screening were similar, if not better, to those observed with standard digital mammography, indicating good acceptability among women. The study also highlighted the necessity for specific training for radiographers. The interviewed key persons unanimously considered feasible tailored screening strategies based on breast density or age, but they require effective communication with the target population. CONCLUSIONS: An increase in radiologists' and radiographers' workload limits the feasibility of DBT screening. Tailored screening strategies may maximize the benefits of DBT while mitigating potential challenges.

Is wine perception influenced by sustainability information? Insights from a consumer experiment with fungus resistant grape and organic wines.

Literature has highlighted that the organic attribute has heuristic value for many consumers, representing an overarching signifier of positive characteristics. Nowadays a plethora of alternative systemic approaches side organic production in the aim to improve the overall sustainability of the agrifood sector. Current study, based on blind and informed tasting, measured sustainability information influence on respondents' (n = 162) perceptions of organic and fungus-resistant grape (FRG) white wines. Findings of the within-subject non hypothetical experiment revealed that information has a stronger, positive impact on participants' perception of organic wine (increasing 13 % monetary preferences) compared to FRG wine (+9%). Additionally, attitudinal characteristics driving consumers' preferences towards FRG wine diverge from organic core motivations.

The impact of nutri-score on consumers' preferences for geographical indications. Evidence from a non-hypothetical experiment.

The EU Farm to Fork strategy (F2F) promotes the compulsory adoption of a nutritional front of pack label to improve the diets of the citizens, supporting healthier food choices. In the public debate, Nutri-Score (NS) is the most favored candidate. Although being widely supported, oppositions on the political and producer levels are raised against the NS, due to the economic impact it could have on specific food sector, and specifically on Geographical Indications (GIs). Recent literature has stressed the need to explore it in more detail. The current study contributes to fill this gap by analyzing consumers' monetary preferences for GI products labelled with different NS levels. An incentivized non-hypothetical experiment was conducted on 188 Italian consumers. Different products representing different levels of NS were used. Specifically, a conventional pasta and the Pasta di Gragnano PGI (NS = A), a conventional flatbread (piadina) and the Piadina Romagnola PGI (NSC), and a conventional hard cheese and the Parmigiano Reggiano PDO (NS = D) were considered in the survey. Results reveal that the NS elicits favorable responses and unfavorable reactions in consumers' preferences, aligning with expectations for A and D scores, respectively. The perceived healthiness of the product significantly affects consumers' WTP, increasing it. Results stress the need to have effective communication strategies within the EU to reach the F2F goals. NS diminishes the premium in prices associated with GIs independently from its level, when considering those consumers who value more the GIs. However, the most well-known GIs does not suffer from this negative effect of the NS, as the positive value associated to the GI offset the negative effect of the NS.

Disparities in access to breast, colorectal, and cervical cancer screening programmes have intensified during the pandemic period. Findings of a health equity audit conducted by the Pavia Healthcare Protection Agency (Lombardy Region, Northern Italy)

OBJECTIVES: to evaluate the disparities in access to cancer screening programmes in the Province of Pavia (Lombardy Region, Northern Italy), along with identifying the factors influencing these disparities; to assess the impact of the pandemic emergency on invitation and screening coverage in the three organized screening programmes, which are provided free of charge to the target population. DESIGN: observational retrospective study covering both the pre-pandemic and the pandemic periods. SETTING AND PARTICIPANTS: for breast cancer screening, the eligible population comprises women aged 45 to 74; colorectal cancer screening is offered to men and women aged 50 to 74; cervical cancer screening is tailored based on women age. The management of all three screening programmes is overseen by the Health Protection Agency of Pavia, which proactively invites the eligible population through invitation letters. MAIN OUTCOMES MEASURES: for each screening programme, the examination coverage (the number of screened individuals out of the total eligible population) was analysed considering its influencing factors, with a specific emphasis on equity-related factors such as demographics (sex, age), geographic factors (country and continent of birth, residential district), comorbidities. RESULTS: the SARS-CoV-2 pandemic has led to a reorganization of healthcare services and to a reduction of the offer, resulting in an overall reduction in test coverage for all three programmes (-16.3% for breast and colorectal cancer screening, -8.5% for cervical cancer screening). The disparities in coverage among various population groups, reflecting inequalities in access, further escalated from the pre-pandemic to the pandemic period. Noteworthy, equity-related predictors of reduced screening access were non-Italian nationality and residency in rural or mountainous districts. CONCLUSIONS: during periods of healthcare system strain, such as the pandemic, disparities in access can become more pronounced. It is crucial to implement measures for enhancing access to screening in a more equitable manner.

Exploring future perspectives and pipeline progression in vaccine research and development.

Introduction: The COVID-19 pandemic had a profound impact on vaccines' Research and Development, on vaccines' market, and on immunization programmes and policies. The need to promptly respond to the health emergency boostered resources' al-location and innovation, while new technologies were made available. Regulatory procedures were revised and expedited, and global production and distribution capacities significantly increased. Aim of this review is to outline the trajectory of research in vaccinology and vaccines' pipeline, highlighting major challenges and opportunities, and projecting future perspectives in vaccine preventables diseases' prevention and control. Study Design: Narrative review. Methods: We comprehensively consulted key biomedical databases including "Medline" and "Embase", preprint platforms, including"MedRxiv" and "BioRxiv", clinical trial registries, selected grey literature sources and scientific reports. Further data and insights were collected from experts in the field. We first reflect on the impact that the COVID-19 had on vaccines' Research and Development, regulatory frameworks, and market, we then present updated figures of vaccines pipeline, by different technologies, comparatively highlighting advantages and disadvantages. We conclude summarizing future perspectives in vaccines' development and immunizations strategies, outlining key challenges, knowledge gaps and opportunities for prevention strategies. Results: COVID-19 vaccines' development has been largely supported by public funding. New technologies and expetited autho-rization and distribution processes allowed to control the pandemic, leading vaccines' market to grow exponentially. In the post-pandemic era investments in prevention are projected to decrease but advancements in technology offer great potential to future immunization strategies. As of 2023, the vaccine pipeline include almost 1,000 candidates, at different Research and Development phase, including innovative recombinant protein vaccines, nucleic acid vaccines and viral vector vaccines. Vaccines' technology platforms development varies by disease. Overall, vaccinology is progressing towards increasingly safe and effective products that are easily manufacturable and swiftly convertible. Conclusions: Vaccine research is rapidly evolving, emerging technologies and new immunization models offer public health new tools and large potential to fight vaccines preventables diseases, with promising new platforms and broadened target populations. Real-life data analysis and operational research is needed to evaluate how such potential is exploited in public health practice to improve population health.

Vaccination strategies for high-risk and fragile populations in Lombardy (Italy): a region-wide assessment of hospital-based models and best practices.

Background: Subjects with selected underlying medical conditions are at higher risk of infection and severe outcomes from vaccines preventable diseases. While most countries adopt life-course approaches to vaccination, high-risk group immunization programmes could maximize individual protection, while contributing to population health. The COVID-19 pandemic stimulated the planning and implementation of successful hospital-based high-risk groups' immunization models. However, in Italy, high-risk subjects' vaccine coverage is not actively monitored at the national or regional level, nor shared guidelines exist yet on hospital-based immunization programmes. Study Design: The study reports findings from a region-wide assessment of the availability, characteristics, and setting-specific features of hospital-based immunization programmes for high-risk subjects in the Lombardy region. Methods: Fondazione The Bridge a not-for-profit organization based in Milan, in collaboration with the Prevention Unit of the Lombardy Region Directorate for Welfare, and the University of Pavia coordinated a project aimed at bringing together regional health institutions, key stakeholders, academic experts, scientific societies and patients' associations to assess high-risk subjects' barriers to vaccine uptake and inform preventive programmes and policies. In this context, we designed and implemented a survey to systematically map the existence and characteristics of hospital-based immunization programmes targeting high-risk subjects. The survey was proposed to all 115 hospital medical directions of the Lombardy region. Results: We collected data from 97 hospital medical directions, with a response rate of 85%. Among respondents, 24% were publi-cly managed hospitals, 17% were Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) and 59% accredited private hospitals. Overall, 51.5% facilities in the Lombardy Region reported to actively administer vaccines to high-risk subjects in hospital settings, the prevalence being 89.6% in public hospitals. Among hospitals where vaccines are actively administered, 46% reported to have centralized vaccines ambulatory clinics, while 54% reported to administer vaccines in the context of inpa-tient care, within clinical wards. In 14% of hospitals vaccination counselling is carried out at the hospital level, while patients are referred to community services for the vaccine administration, 58% have established clinical pathways and formalized internal procedures to integrate vaccine prevention within the clinical care. Conclusions: Half of hospital facilities in the Lombardy Region administer vaccines to high-risk patients. Hospital-based im-munization models vary widely by vaccines programmes, organizational aspects, vaccines procurement and workforce involved. Identifying best practices and effective models can help tackle current challenges and improve immunization coverage for at-risk groups.

"Leo&Giulia standing for public health": an animated series to promote the values of public health among school-aged children. Best practices and field-trial protocol.

Background: The "Leo&Giulia standing for public health" project is an innovative digital health education model targeting primary school children. The project, developed during the COVID-19 pandemic, aims to educate primary school-aged children about public health issues through an animated cartoon series. It highlights the importance of early-life health promotion and the potential role of educational settings in shaping health behaviours. Study design: A 2-year school-based cluster-randomized controlled community trial will be conducted among 8-10-year-old pupils in the province of Pavia, Northern Italy. Methods: The intervention group will receive an educational programme via a new episode of "Leo&Giulia" animated series, focusing on smoking prevention. The study will assess changes in knowledge, attitudes towards smoking, and communication about smoking risks among peers and parents. The trial involves baseline and follow-up assessments through questionnaires targeting both children and parents. Results (expected): We assume that children in the intervention group will demonstrate increased knowledge and awareness of smoking-related health risks and develop negative attitudes towards tobacco use compared to the control group. Enhanced communication about tobacco harms among peers and between children and parents, as well as increased parental involvement in anti-smoking socialization practices, are expected secondary outcomes. Discussion and Conclusions: "Leo&Giulia" integrates health education into the school curriculum, leveraging the appeal of animated content to engage children in public health topics. The project is expected to contribute to the field of health education by demonstrating the effectiveness of digital health interventions in childhood, foreseeing potential long-term impacts on health behaviors and in shaping future public health strategies.

Senior citizens' vitamin D supplements intake: evidence from Denmark.

BACKGROUND: Several public interventions have been designed in recent years to urge the intake of vitamin D supplements among the senior population to avoid the direct and indirect consequences associated with vitamin D deficiency. However, the effectiveness of these public campaigns remains quite limited. In an online survey, the current study investigates attitudes towards vitamin D supplements intake and associated behaviours in a representative sample of Danish senior citizens (N = 554) - that is, individuals aged 55 years and above. RESULTS: Approximately half of the sample reported taking vitamin D supplements in the preceding year. Furthermore, being male and having a positive perception of individuals' own health status increased the probability of being a non-user. Increasing confidence in the information provided by health authorities (such as medical doctors and pharmacies) is particularly critical for enhancing the likelihood of non-users to purchase vitamin D supplements. However, also encouraging the uptake of vitamin D supplements in specialized supermarkets with stands and promotions seems an appealing and practical solution to increase seniors' uptake of vitamin D supplements. CONCLUSIONS: The present study outlines the characteristics of senior Danish non-users of vitamin D supplements. Additionally, the research provides information on the strategies that could be applied by public organizations to foster vitamin D supplements intake among this target segment of the population. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

This cookie will save the planet! The effect of a private sustainability claim on consumers' expectations.

Current study investigates whether a private, sustainability claim has an impact on individuals' sensory and non-sensory expectations (halo effect) and quantifies such impact on individual monetary preferences. An incentive-compatible artefactual field experiment was performed by recruiting regular buyers and consumers of the investigated product (cookies). Results reveal that the sustainable agriculture claim generates high (unrelated) expectations and a statistically significant premium price compared to the conventional counterpart. Additionally, these expectations, together with respondents' trust in the claim, are the drivers of the price premium. Findings suggest the need for policy makers and consumer advocates to scrutinize the potential drawbacks of private sustainability claims on food products.

Loss framing effect on reducing excessive red and processed meat consumption: Evidence from Italy.

A reduction of meat consumption is crucial for addressing public health problems, especially in industrialized countries. Among low-cost interventions, emotionally provocative health-information strategies could be effective options in fostering meat reduction. Through an online experimental survey, administrated to a quota-based national sample (N = 1142), this study analysed the profile of Italians consuming red/processed meat above World Health Organization (WHO) recommended amounts. Via a between-subjects design, the research tested whether two health frame-nudges (societal impact and individual impact of over consumption) persuaded these individuals to reduce future meat consumption. Results showed that adhering to an omnivore diet, higher consumption of meat than peers, household size (larger) and positive moral perception of meat consumption increased the likelihood of overconsumption. In addition, both nudges proved to be effective in positively impacting future intentions to reduce meat consumption among individuals exceeding WHO recommended amounts. The two frame-nudges were more effective among females, respondents with children in the household and individuals with a low health status perception.

Nudging low-medium income mothers towards healthy child options in an online restaurant scenario.

Helping mothers make the healthiest choices for their children when eating out can contribute to preventing the prevalence of childhood overweight and obesity, particularly in economically disadvantaged classes. Herein, we tested whether two different nudges (a default option and a social norm prompt) could guide low- and middle-income mothers towards healthier children's menu choices in a fictive restaurant setting and investigated the drivers of healthy child menu selection. A cross-sectional online survey was performed among 809 Italian mothers with children aged between 3 and 12 years, and a between-subjects design (control, nudge 1, and nudge 2) was applied. The findings revealed that both nudges had no significant effect on the number of healthy menu selections compared with the healthy choices made in the control condition. Furthermore, considering the entire sample, the results show that certain characteristics of a mother (e.g., authoritative parenting style) and child (younger age) duo increase the likelihood of the former selecting a healthy children's menu. Similarly, a positive correlation between the likelihood of choosing a healthy children's menu and the mother's involvement in the child's nutrition (meal preparation and weekly diet) was observed.

Factors influencing independent older adults (un)healthy food choices: A systematic review and research agenda.

Population aging, the epidemiological transition, and associated lifestyle changes are among the major drivers of the increased incidence and prevalence of non-communicable diseases. Preparing for change is essential to ensure progress towards achieving the goals outlined in the 2030 Agenda for Sustainable Development. The first step for health care providers is to build specific programs or interventions that guide healthy long-term food choices during old age. Thus, identifying and understanding the specific factors that influence the food choices of elderly adults and how these factors limit or encourage food consumption is imperative. The current review aimed to identify how personal, social, cultural, psychological, situational and intrinsic/extrinsic aspects of food guide or hinder the dietary choices of independent elderly individuals (aged 65 years and older) towards both healthy and unhealthy food choices. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Thirty-seven papers satisfied the screening. Results are schematized through the Mojet model by framing all potential drivers that guide the independent elderly respectively to make healthy and less healthy choices in their diet. Findings revealed that food choices of independent older adults are shaped by a multitude of factors and sub-factors that may serve to promote or limit the desire and ability to consume a healthy food. Situational, socio-demographic, and psychological factors were the most investigated in the analysed literature, albeit with different aspects and dimensions. Future studies should extend the analysis including multiple factors and evaluate possible interactions between different dimensions. A research agenda provided insights for scholars and policymakers interested in further investigating the factors that influence food choices of this target group.

Consumer acceptance of fungus-resistant grape wines: Evidence from Italy, the UK, and the USA.

While there is evidence of consumers' interest in wine sustainability, acceptance of innovations in wine production is not guaranteed. The current study addresses this issue by analyzing consumers' acceptance of fungus-resistant grape (FRG) wines, a sustainable innovation that can substantially reduce the need for chemical inputs in viticulture. To do so, by means of an online survey including large samples of regular wine drinkers in Italy (N = 752), the UK (N = 858) and the USA (N = 856), the study compares individuals' preferences for conventional wines with preferences for FRG wines. The study also explores whether FRG wine acceptance is influenced by informal or formal purchase occasion, by different types of information regarding the product, and by individual attitudinal characteristics. The findings show a general acceptance of FRG wines among consumers. In particular, consumers' preferences for FRG wines on formal occasions are not significantly different from their preferences for conventional wine, whereas on informal occasions, consumers prefer FRG wines over conventional wines. Regarding the impact of information on participant choice, participants informed about the potential effects of FRG on sensory wine characteristics had lower preferences for FRG wines than those who read an information script regarding crop biodiversity. Last, individuals' sustainability concerns and food technology neophobia had positive and negative influences on FRG acceptance, respectively. Overall, this research provides wineries, nurseries and policy-makers with important insights concerning the market potential of FRG wines in three key markets.

Impact of the COVID-19 pandemic on physical activity among university students in Pavia, Northern Italy.

AIM: To evaluate the University of Pavia students about physical activity (PA) changes before, during and after the COVID-19 pandemic. METHODS: The International Physical Activity Questionnaires (IPAQ) survey was employed to evaluate the PA in three periods: the pre-pandemic period, during national stay-at-home order (March 9th - May 4th 2020), current PA. Exercise intensity for each period was defined using the Metabolic Equivalent of Task (Met) as unit of measurement. The questionnaire was administered online to university students from June 9th to July 4th 2021, structured in four sections, also collecting demographic data. RESULTS: 55,6% of the study population reported a significant decrease in PA during lockdown. The number of active/very active subjects dropped from 72.2% in pre-pandemic period to 29.6% during containment measures. 50% reported a substantial increase in moving out of the lockdown. Stay-at-home order was associated with an increase in sedentary lifestyle (68.5%), which sharply decreased moving out from lockdown (two-third of study population). Average time in minutes spent sitting was 612 before pandemic, 844 during the pandemic and 670 after social restrictions. CONCLUSIONS: Lockdown had a negative impact on PA among the university students leading to an increase in sedentary behaviours. Following the gradual relaxation of the restrictive measures, situation has improved, without however returning to pre-pandemic level. It is of fundamental importance to study new strategies to promote healthy lifestyles while coping with the on-going pandemic.

Role of information in consumers' preferences for eco-sustainable genetic improvements in plant breeding.

Consumers' preferences for products derived from genetic improvements and innovations in plant breeding are often conditioned by technophobia and negative public imaginaries. The current study addresses this issue by analyzing consumers' monetary preferences for a win-win innovation (generating gains for both private actors and the community) in the viticulture sector, namely fungus resistant grapes (FRG). The use of these grapes reduces the quantity of chemical inputs applied to vineyards, simultaneously improving firms' economic performance. This study aimed to assess whether consumers prefer wines originating from FRG varieties to conventional wines. In particular, through an experimental online survey involving 627 Italian regular wine drinkers, the study compares individuals' willingness to pay (WTP) for conventional wines with the WTP for two FRG wines produced with two different techniques: horticultural hybridization and genome editing. The study also assesses the potential effect of polarized media coverage on preferences by testing, in a between-subjects experimental design, two diverging (positive/negative) information scenarios, and the core drivers of these preferences. The findings suggest that respondents express a premium price for horticultural FRG wines compared to conventional wines (+9.14%) and a strong discount for genome edited FRG wines (-21.13%). The results also reveal that negative information reduces consumers' WTP for horticultural FRG wines, while positive information increases their WTP for genome edited FRG wines. Last, the study highlights that individuals concerned with food sustainability issues and knowledgeable about wine are more likely to accept both FRG typologies. Overall, the study confirms the crucial role of appropriate information for market acceptance of innovations based on plant genetics to foster the adoption of sustainable pest-reducing practices in wine production.

Do consumers understand health claims on extra-virgin olive oil?

Health claims have been introduced in food labelling to support consumers' awareness of healthy food choices and to enhance a healthy diet. Even though many countries around the world have developed legislation and guidelines to regulate the introduction of health claims on food labels, there is the evidence that many consumers do not understand the meaning of these claims. This study analyses whether Italian consumers really understand authorized health claims on extra-virgin olive oil and what are the drivers of such understanding. An Olive Oil Health Claims Understanding index was constructed and embedded in a structured questionnaire, which was then administered to a representative sample of Italian household members who are responsible for food shopping (N = 1,030). Results from the survey showed that only 36% of the respondents understood the meaning of the authorized health claims on extra-virgin olive oil. Moreover, the findings confirmed that the understanding of health claims is related to socio-demographic, personal and psychographic characteristics of consumers, as well as to their attitudes toward using food as medicine. Outcomes also proved the central role of nutrition knowledge in affecting understanding of health claims.

Differences in Astringency Subqualities Evaluated by Consumers and Trained Assessors on Sangiovese Wine Using Check-All-That-Apply (CATA).

The astringency of red wine represents an important factor of quality and liking evaluation by consumers, but it is sometimes associated to a negative feature. We studied the differences in astringency subqualities of Sangiovese wines between consumers and trained assessors. Wines belonging to three denominations (Chianti Classico, Toscana, Morellino di Scansano) and a Chianti Classico specification (Chianti Riserva), from three price ranges (low, medium, high) were evaluated. Regular wine consumers and trained panel assessed the wines applying the Check-All-That-Apply (CATA) questionnaire relative to six astringency attributes (silk, velvet, dry, aggressive, hard, mouthcoat). Differences between panels were more associated with the high-price wines, which were characterised by negative subqualities for consumers. Preference maps revealed that mouthcoat was the term mainly associated with consumers' liking, while other subqualities as persistent, rich, and full-body, provided by the trained assessors, may represent the drivers of liking for Sangiovese wine. This study has demonstrated that a trained sensory panel provides highly valuable information regarding the mouthfeel characteristics of Sangiovese wines and the attributes driving consumer liking.

Consumers' reactions to nutrition and ingredient labelling for wine - A cross-country discrete choice experiment.

The purpose of this study is to examine consumers' reactions to the introduction of nutrition and ingredient labelling for wine, a product that is so far still exempt from mandatory nutrition and ingredient labelling. It also analyses the effect of positive and negative information about the use of ingredients in wine on consumers' choice. Representative samples for wine consumers from three distinctly different countries representing old and new wine markets (Australia, n = 745; Germany, n = 716; Italy, n = 715) completed a discrete choice experiment (DCE) with graphically simulated wine back labels. For each country, respondents were randomly allocated to a reference group and two different treatment conditions where they received newspaper-like information (positive, negative) before making choices. Results for the reference condition show that consumers across all three countries have a significant positive utility for detailed nutrition information. Instead, ingredient information only receives a positive utility in Italy, whereas German and Australian respondents do not receive utility from ingredient labelling. When consumers in the treatment group are confronted with negative media information the attribute importance of ingredients significantly increases across all three countries, clean labelled products without ingredients are preferred, and a significantly higher share of consumers in Germany and Italy prefer not to buy any wine. The treatment effect of positive media information on consumers' wine choice is lower than that of negative information. The results of the study have implications for the pending new regulation of wine labelling and for communication strategies of the wine industry that should actively inform consumers about the necessity of ingredients in wine production.

Purchasing Drivers of Fresh Citrus Fruits in Urban Italy: Is It All about Taste?

While the medical community supports the growth of citrus consumption as part of a healthy diet, there is limited knowledge about consumer preferences for these fruits. The current study analyzed the purchasing patterns and drivers of fresh citrus fruits from a convenience sample of 346 Italian food shoppers. Results revealed that clementines were the citrus fruit purchased most, followed by oranges and tangerines. Sweetness and smell were important product attributes for respondents. Different drivers affect the purchasing frequencies of various citrus fruits. Taste motivation, with a specific preference for acidity, impacts orange purchasing. Similarly, clementines are purchased primarily for taste motivation, however, the core sensory attribute for respondents in this case was sweetness. Meanwhile, for tangerines, the taste motivation is less important than the energy motivation, and the size together with the color are the core purchasing drivers. These outcomes provide food scientists, agronomists and market practitioners with new insights into Italian consumers' preferences for citrus fruits, thus contributing to a potential expansion of this market.