This medal commemorates the 50 year anniversary of the first world war.  

 Italy was on the winning side in that war.  The medal was
awarded to living individuals who served at least 6 months in the Italian
military before 1920.  This one was awarded to  Lucy Fichera Van der Hoeven's

 grandfather, Salvatore Cafarella.

The follow up photos.  The two colour attachments are from the award dinner
for the above medal.
Standing behind Salvatore is cousin Maria.  At table are Uncle Domenic Cafarella,
Salvatore Cafarella, Uncle Peter Cafarella, Rosa Fichera, and Aunt Toni.  Salvatore's wife Nella
(Sebastianna), among others, was also there but is not pictured.

Aunt Toni was married to Uncle Domenic.  Toni is great granddaughter to
Gaetano and Giovanna Vasquez through Vincezo son of Francesco.  Domenic is
Great grandson through Salvatore son of Domenico.  Maria is their daughter