La salute detenuta: tra diritto e sicurezza”. Un’ indagine nella Casa Circondariale di Rimini.

The survey approachs the issue of health and the problem of its effective protection in a context of deprivation of liberty and coercion, which is the prison. The theoretical reflection born from the reform of the Legislative Decree 230/99 which marked the transition from an employee by the Prison Health within prison a fully integrated in the National Health Service. The comparison between an institution of health promotion and institution of punishment which may operate on the same subject held produces multiple attrits, making their relationship problematic. The work shows the daily difficulties in the management of prison health within the institution, physician-patient between different health care roles, and between the latter and prison workers. The coexistence, in fact, is not always harmonious though quite often it is common sense and the willingness of operators to reduce barriers: overcrowding, limited resources and insufficient staff make the application of the rule and therefore the right to goal a difficult to be pursued. It is designed for a scheme of semi-structured interview essay is divided into 3 sections covering: "staff and its functions", "health reform" and "health of the prisoner"; questions were directed to doctors, nurses and psychologists engaged inside the prison of Rimini with the specific aim of examining the ambivalent relationship between the demand for health care in prisons and the need for security and a clear - albeit partial - point of view. We tried to reconstruct the situation of prison health care through the perception of prison operators, capturing the problematic issues that deal on both issues is instrumental to the experience of persons detained by analyzing, in terms of operators , what happens inside of a prison institution in everyday health care.

The impact of cardiac rehabilitation on lifestyles, psychological correlates and the clinical course of cardiac disease

Objectives: The aim of this research was to evaluate the impact of Cardiac Rehabilitation (CR) on risky lifestyles, quality of life, psychopathology, psychological distress and well-being, considering the potential moderating role of depression, anxiety and psychosomatic syndromes on lifestyles modification. The influence of CR on cardiac morbidity and mortality was also evaluated. Methods: The experimental group (N=108), undergoing CR, was compared to a control group (N=85) of patients affected by cardiovascular diseases, not undergoing CR, at baseline and at 1-month, 6- and 12-months follow-ups. The assessment included: the Structured Clinical Interview for DSM-IV, the structured interview based on Diagnostic Criteria for Psychosomatic Research (DCPR), GOSPEL questionnaire on lifestyles, Pittsburgh Sleep Quality Index, Morisky Medication Adherence Scale, MOS 36-Item Short Form Health Survey, Symptom Questionnaire, Psychological Well-Being Scale and 14-items Type D Scale. Results: Compared to the control group, CR was associated to: maintenance of the level of physical activity, improvement of correct dietary behaviors and stress management, enhancement of quality of life and sleep; reduction of the most frequently observed psychiatric diagnoses and psychosomatic syndromes at baseline. On the contrary, CR was not found to be associated with: healthy dietary habits, weight loss and improvement on medications adherence. In addition, there were no relevant effects on sub-clinical psychological distress and well-being, except for personal growth and purpose in life (PWB). Also, CR did not seem to play a protective role against cardiac recurrences. The presence of psychosomatic syndromes and depressive disorders was a mediating factor on the modification of specific lifestyles. Conclusions: The findings highlight the need of a psychosomatic assessment and an evaluation of psychological sub-clinical symptomatology in cardiac rehabilitation, in order to identify and address specific factors potentially associated with the clinical course of the heart disease.

Dati preliminari dello studio multicentrico caso-controllo "Grave danno epatico acuto indotto da farmaci"

Il danno epatico indotto dall'assunzione di farmaci viene comunemente indicato con il termine inglese DILI (Drug-Induced Liver Injury). Il paracetamolo rappresenta la causa più comune di DILI, seguito da antibiotici, FANS e farmaci antitubercolari. In particolare, i FANS sono una delle classi di farmaci maggiormente impiegate in terapia. Numerosi case report descrivono pazienti che hanno sviluppato danno epatico fatale durante il trattamento con FANS; molti di questi farmaci sono stati ritirati dal commercio in seguito a gravi reazioni avverse a carico del fegato. L'ultimo segnale di epatotossicità indotto da FANS è associato alla nimesulide; in alcuni paesi europei come la Finlandia, la Spagna e l'Irlanda, la nimesulide è stata sospesa dalla commercializzazione perché associata ad un'alta frequenza di epatotossicità. Sulla base dei dati disponibili fino a questo momento, l'Agenzia Europea dei Medicinali (EMA) ha recentemente concluso che i benefici del farmaco superano i rischi; un possibile aumento del rischio di epatotossicità associato a nimesulide rimane tuttavia una discussione aperta di cui ancora molto si dibatte. Tra le altre classi di farmaci che possono causare danno epatico acuto la cui incidenza tuttavia non è sempre ben definita sono gli antibiotici, quali amoxicillina e macrolidi, le statine e gli antidepressivi.Obiettivo dello studio è stato quello di determinare il rischio relativo di danno epatico indotto da farmaci con una prevalenza d'uso nella popolazione italiana maggiore o uguale al 6%. E’ stato disegnato uno studio caso controllo sviluppato intervistando pazienti ricoverati in reparti di diversi ospedali d’Italia. Il nostro studio ha messo in evidenza che il danno epatico da farmaci riguarda numerose classi farmacologiche e che la segnalazione di tali reazioni risulta essere statisticamente significativa per numerosi principi attivi. I dati preliminari hanno mostrato un valore di odds ratio significativo statisticamente per la nimesulide, i FANS, alcuni antibiotici come i macrolidi e il paracetamolo.

Psychosocial correlates of rehabilitation from stroke: a longitudinal study

The general aim of this dissertation was to uncover the association between psychosocial factors and rehabilitation outcome after stroke. METHOD. A sample of patients with stroke (n=40) and their caregivers (n=36) were assessed at admission to and six months after discharge from rehabilitation hospital, using the following instruments: Structured Clinical Interview for DSM-IV, structured interview based on Diagnostic Criteria for Psychosomatic Research, Symptom Questionnaire, Psychosocial Index, Psychological Well-Being Scales, and Family Assessment Device. 40 subjects from the general population underwent the same psychological assessment. In addition, patients' functional status was measured using the Functional Independence Measure. RESULTS. Stroke survivors reported lower education and higher alcohol consumption than controls. No significant differences emerged between the two groups in the prevalence of psychiatric diagnoses or psychosomatic syndromes, however patients reported significantly higher levels of anxiety, depression, somatic symptoms, and lower autonomy than controls. Caregivers reported significantly higher scores in anxiety, depression, and somatic symptoms compared to normative data, while no impairments emerged in psychological well-being and family functioning. At six-month follow-up, in patients a significant decrease in smoking habit and an increase in DSM diagnoses were reported. Both stroke survivors and caregivers showed significant reductions in anxiety, with patients displaying also a decrease in somatic symptoms, an increase in stress and a deterioration in quality of life. Significant deteriorations in several aspects of family functioning was perceived only by patients. An association between patients' functional recovery in the cognitive domain and family behavior control emerged. For caregivers, family functioning significantly predicted hostility and somatic symptoms were associated with family affective involvement. CONCLUSIONS. These data highlight the utility in the Italian setting of the adoption of a psychosocial assessment and a family-systems approach in stroke rehabilitation, in order to development interventions properly targeted to the characteristics of patients and their family members.

Equità di genere e pratiche trasformative in educazione fisica

A partire da un paradigma ecologico ad indirizzo critico, seguendo il filone degli studi femministi, le finalità della ricerca sono state: smascherare le forme di oppressione di genere nei contesti educativi (finalità trasformativa) e produrre un sapere utile alla pratica (finalità emancipativa). Data la complessità del contesto educativo scolastico e dell’argomento stesso che interseca vari domini di sapere, è stato adottato un approccio metodologico di metodo misto (mixed method) per poter dapprima costruire una configurazione del fenomeno oggetto d’interesse attraverso strumenti quantitativi e poi approfondirlo attraverso l’impiego di tecniche qualitative. Gli strumenti utilizzati sono stati: il questionario, l’intervista strutturata, le osservazioni, le biografie professionali, i focus-group. In sintesi, le evidenze emerse in letteratura ed empiriche mettono in luce la presenza di stereotipi di genere nelle lezioni di EF, sotto forma di pratiche inconsapevoli che gli insegnanti riproducono a seguito di un habitus socializzato in forma binaria secondo i due sessi e gerarchizzato. La dipendenza dell’EF dal mondo sportivo, dove gli stereotipi di genere sono presenti per ragioni storico-culturali e dal quale gli insegnanti attingono spesso parte del loro sapere professionale, li rende partecipi inconsapevoli del sistema di rinforzo degli stereotipi stessi, attraverso le pratiche che vanno sotto il nome di curricolo nascosto. Il termine nascosto sottolinea l’inconsapevolezza di tali pratiche, appunto nascoste alla coscienza e si deduce che la possibilità di svelarle necessita di una formazione specifica per gli insegnanti, una formazione che attinga ai processi riflessivi.

Italian higher education students’ perspectives on internationalization at home and their identity as English as lingua franca users

This study aims to explore the Italian students’ perspectives on using English in English-medium instruction (EMI) programs in light of the practices of internationalization at home (IaH) at the University of Bologna (UNIBO) in Italy and further investigates whether these attitudes affect their language identity as English as lingua franca (ELF) users. To serve this aim, a mixed-method approach was adopted to collect quantitative and in-depth qualitative data in two phases through an online survey and a semi-structured interview. A total number of 78 Italian students participated in the survey, out of which 14 participants were interviewed. The findings of the online survey indicated that most participants (92%) held a positive perspective toward the use of English in EMI programs and the findings from the interviews were in line with the results of the survey. However, the purpose of the interviews was to explore the participants’ views on their language identity as ELF users. Thematic analysis of the interviews revealed that students experience emotional, cognitive, and social transitions in EMI programs in response to their shift from a non-EMI to an EMI academic setting. Overall, all the above-mentioned transitions were positive and could lead to personal development. However, it can be concluded that the EMI context provides few opportunities for the emergence of significant new subject positions mediated by English in this study. The focus on students’ perspectives on the use of English in EMI programs can contribute to the improvement in language policy planning and internationalized curriculum design by policymakers and alleviate tensions over the controversial issue of the Englishization of higher education by considering how EMI students perceive their use of English as ELF users not superior standard English users.