Annali dell'Istituto Superiore di Sanità
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Funding medical education: should we follow a different model to general higher education?
Get PDFIssue. There has been much recent discussion on the funding of medical education. There has also been much discussion about the funding of higher education more generally. Evidence. The topics of discussion have included the rising costs of education; who should pay; the various potential models of funding; and how best to ensure maximum returns from investment. Implications. Medical education has largely followed the emerging models of funding for higher education. However there are important reasons why the funding models for higher education may not suit medical education. These reasons include the fact that medical education is as important to the public as it is to the learner; the range of funding sources available to medical schools; the strict regulation of medical education; and the fact that the privatisation and commercialisation of higher education may not been in keeping with the social goals of medical schools and the agenda of diversification within the medical student population
National Diabetes Plans: can they support changes in health care systems to strengthen diabetes prevention and care?
Get PDFHealthcare systems do not fit well with the “modern” patient, who has a right to autonomy and self-determination. The services that are designed and delivered in policy contexts are not prone to encourage innovation. National Diabetes Plans, defined as “any formal strategy for improving diabetes policy, services and outcomes that encompass structured and integrated or linked activities which are planned and co-ordinated nationally and conducted at the national, regional, and local level”, may hold a great potential not only to improve prevention and care for type 2 diabetes, but also for transforming healthcare delivery. Today, changes to adapt healthcare delivery tend to be implemented within existing provider structures, with limited understanding of specific context, structures, processes and potential for change. National Diabetes Plan can be a diagnostic tool for barriers, can be a driver for planning the change, and can help develop capacities and competences that are needed to strengthen healthcare systems to better address health promotion and chronic diseases
Medicine saved ethics. Has ethics harmed medicine?
No full textIn an article in The Boston Globe, Steven Pinker holds that the primary moral good of bioethics should be to “get out of the way”. The accusation that bioethics is an obstacle to research because it calls attention to basic principles such as personal dignity and justice is clearly contradicted by the facts. There are, nonetheless, other ways in which bioethics can stand in the way of science, two of which, bureaucratisation and the loss of cultural vivacity, are worth addressing. Ethics committees provide a framework for evaluating problems and determining an appropriate course of action
Incidental findings, genetic screening and the challenge of personalisation
Get PDFGenetic tests frequently produce more information than is initially expected. Several documents have addressed this issue and offer suggestions regarding how this informa-tion should be managed and, in particular, concerning the expedience of revealing (or not revealing) it to the persons concerned. While the approaches to the management of these incidental findings (IFs) vary, it is usually recommended that the information be disclosed if there is confirmed clinical utility and the possibility of treatment or preven-tion. However, this leaves unsolved some fundamental issues such as the different ways of interpreting “clinical utility”, countless sources of uncertainty and varying ways of defining the notion of “incidental”. Guidelines and other reference documents can offer indications to those responsible for managing IFs but should not be allowed to relieve researchers and healthcare professionals of their responsibilities
An ethics for the living world: operation methods of Animal Ethics Committees in Italy
Get PDFIntroduction and objectives. Coinciding with the recent implementation in Italy of the “Directive 2010/63/EU, regarding the protection of animals used for scientific pur-poses”, the Authors would like to analyse the topic of the introduction of ethical com-mittees for animal experimentation in Italy. This paper furthermore aims to underline some critical aspects concerning the actions taken by Italian institutions to comply with the provisions of EU.Results and discussion. The implementation of the recent Italian law (Decreto Legisla-tivo n. 26 on 4 March 2014 Implementation of the Directive 2010/63/EU on the protec-tion of animals used for scientific purposes) leans towards a restrictive interpretation of the European provisions about composition and responsibilities of “Ethical Committee for Animal Experimentation”. In the composition of the bodies mentioned, we note a tendency to restrict the composition to few professional figures contemplated by Ital-ian law, without guaranteeing the independence of each committee; also, an absence of hierarchical relationship between a research institution and his committee is apparent. Moreover, a critical aspect is the lack of decision-making powers of these new organisms in terms of ethical evaluation of protocols and research projects.Conclusions. What EU legislation imposes on the member states is to set up an animal-welfare body (art. 26). This represents a strong incentive for Italy to follow the steps of many other European Countries, where ad hoc ethical committees have been working for a long time. The proper functioning of these bodies may contribute to guarantee the safety and welfare of the animals inside the laboratories, and to balance the protection of animal life and the interests of research.
Foodborne botulism associated with home-preserved turnip tops in Italy
Get PDFIn Italy, foodborne botulism is a rare disease mainly due to home-preserved food. Inthe case reported here, clinical diagnosis was performed on the basis of clinical signsand referred consumption of home-preserved turnip tops in oil. Definitive diagnosis wasperformed by detection of botulinum toxin in sera and neuro-toxigenic organisms instools and leftover food. This case report highlights the need of a high medical awareness,prompt clinical diagnosis, and synergic collaboration among the health authorities for acorrect management of botulism as well as disease containment
Barriers in the management of cancerrelated pain and strategies to overcome them: findings of a qualitative research involving physicians and nurses in Italy
Get PDF Introduction and aims. There are many barriers and obstacles that even today lead toan inadequate treatment of cancer-related pain. The aim is to describe the experiences ofa group of Italian physicians and nurses as far as the nature of these barriers is concernedand the possible tools to be used to overcome them.Material and method. We run 5 focus groups with 42 healthcare professionals (11 physicians,31 nurses) working in 5 hospitals in Italy. The findings of the focus groups wereanalysed according to the “Content Analysis” method.Results. Five main items emerged: the importance of communication, the need for educationregarding pain therapy, the ethnic/cultural/religious differences, the mutual trustand support within the working group, the daily challenges.Conclusion. In harmony with the most recent literature, physicians and nurses voiceabove all their need for an education more directly aimed at overcoming the prevailingbarriers rooted in ignorance, prejudice and fears
TNF-a and IL-10 modulation induced by polyphenols extracted by olive pomace in a mouse model of paw inflammation
No full textPolyphenols from olive are known to possess antioxidant and anti-inflammatory properties. The aim of this study was to study whether or not administration of olive (Olea europaeaL.) polyphenols could have an effect on cytokines as TNF-a and IL-10 in the mouse paw following inflammation induced by carrageenan injection. TNF-a and IL-10 were measured by enzyme-linked immunosorbent assay. Carrageenan decreased IL-10 in the paws, however, this reduction appeared to be less evident in mice treated with carrageenan but administered with polyphenols. As for TNF-a, our findings did not reveal differences between groups but an increase in polyphenol and carrageenan groups if compared to the carrageenan only group. No differences between groups in the serum Glutathione were found. Altogether, this investigation shows that olive polyphenols in the mouse may modulate the levels of cytokines having a role in the process of inflammation as TNF-a and IL-10
Physical activity and health promotion in Italian university
Get PDF[email protected] Introduction. Physical activity, diet plans, the mantainment of a certain Body Mass Index (BMI) and the use of various types of supplementation are common elements in the search for disease prevention, health promotion and well-being. Materials and methods. We analyzed the data regarding Italian university students’ BMI, dieting behaviour, personal body perception, exercise habits, and use of dietary supplements and of doping substances. Results. 13.7% resulted being underweight, 75.1% was in the normal range, 9.8% was overweight, and 1.4% was obese. 11.0% were on a diet. 25.8% of the students reported never doing any type of physical activity. 0.9% admitted consuming doping substances. The percentage of overweight/obese students increases from 8.8% of the 18-21 year olds to 18.1% of the 25-30 year olds. Similarly, the prevalence of overweight/obesity was 18.5% among male population and 7.5% among the female one. Discussion. The data deriving from this questionnaire showed that while the majority of university students has a BMI in the normal range, 11.2% of the study population is overweight/obese. Males present a higher risk of being overweight or obese. An important part of the population showed to be sedentary even though data coming from our study are aligned to further evidence. Conclusion. The most important concern arising from the questionnaire is represented by physical inactivity. Indeed, it is necessary to encourage and plan initiatives aimed at promoting physical activity in university students