Preventive medicine center and health care for students of medicine and health professions at the Sapienza University of Rome: a research protocol

This project aims to develop a Center of Preventive Medicine and Health Care for the students of Medicine and Health profession at Sapienza University of Rome. At the beginning of the university career students, both residents and nonresident s, have to face several difficulties such as: starting smoking or the increase in cigarette consumption ; the independent management of their own health (especially for non residents consequently to the distance of the family doctor) ; unhealthy diet; tuberculosis (TB) biological risk during their university training. These aspects , especially if present at the same time, act as a source stress and adversely affect the quality of life and the academic performance. Specific aims of the project will be: implementing an ambulatory of Preventive Medicine; implementing a virtual ambulatory of general medicine; creating a website on the problems mentioned above. Data collected will be computerized to keep an electronic health record (HER) and to use the information for the purposes of scientific research. The Centre will act in close relationship with the Central Administration, with the Headmasters of the Medical Faculties, and in close collaboration with the Center of Occupational Medicine of Sapienza University

Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation

BACKGROUND: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape

The Italian Wage Curve. The Effects of the Recent Labour Market Reforms.

The Italian Wage Curve. The Effects of the Recent Labour Market Reforms The paper examines some effects of the recent reforms aimed at increasing flexibility in the Italian labour market. It shows their incapability to respond to the “inclusion” problem which still characterises the country. New temporary low-skill jobs were created but the reforms have neither enforced industrial competitiveness nor increased productivity. Far from solving the problems of a dual economy, de-regulation of Italian labour market has reinforced them and has concurrently eroded civil rights thereby making a departure form standards of health and morality. Excessive turnover of workers and firms is a major obstacle to human capital accumulation. A hostile territory produces social inequality, poverty and under- consumption that severely compromises growth. Key words: Labor and Demographic Economics; Wages, Compensation and Labor Costs; Wage Level and Structure; Wage Differentials JEL Classification: J, J3, J31 Final version received May 200

The words of the body: psychophysiological patterns in dissociative narratives

Trauma has severe consequences on both psychological and somatic levels, even affecting the genetic expression and the cell\u2019s DNA repair ability. A key mechanism in the understanding of clinical disorders deriving from trauma is identified in dissociation, as a primitive defense against the fragmentation of the self originated by overwhelming experiences. The dysregulation of the interpersonal patterns due to the traumatic experience and its detrimental effects on the body are supported by influent neuroscientific models such as Damasio\u2019s somatic markers and Porges\u2019 polyvagal theory. On the basis of these premises, and supported by our previous empirical observations on 40 simulated clinical sessions, we will discuss the longitudinal process of a brief psychodynamic psychotherapy (16 sessions, weekly frequency) with a patient who suffered a relational trauma. The research design consists of the collection of self-report and projective tests, pre-post therapy and after each clinical session, in order to assess personality, empathy, clinical alliance and clinical progress, along with the verbatim analysis of the transcripts trough the Psychotherapy Process Q-Set and the Collaborative Interactions Scale. Furthermore, we collected simultaneous psychophysiological measures of the therapeutic dyad: skin conductance and hearth rate. Lastly, we employed a computerized analysis of non-verbal behaviors to assess synchrony in posture and gestures. These automated measures are able to highlight moments of affective concordance and discordance, allowing for a deep understanding of the mutual regulations between the patient and the therapist. Preliminary results showed that psychophysiological changes in dyadic synchrony, observed in body movements, skin conductance and hearth rate, occurred within sessions during the discussion of traumatic experiences, with levels of attunement that changed in both therapist and the patient depending on the quality of the emotional representation of the experience. These results go in the direction of understanding the relational process in trauma therapy, using an integrative language in which both clinical and neurophysiological knowledge may take advantage of each other

A perspective on the Healthgrid initiative

This paper presents a perspective on the Healthgrid initiative which involves European projects deploying pioneering applications of grid technology in the health sector. In the last couple of years, several grid projects have been funded on health related issues at national and European levels. A crucial issue is to maximize their cross fertilization in the context of an environment where data of medical interest can be stored and made easily available to the different actors in healthcare, physicians, healthcare centres and administrations, and of course the citizens. The Healthgrid initiative, represented by the Healthgrid association (http://www.healthgrid.org), was initiated to bring the necessary long term continuity, to reinforce and promote awareness of the possibilities and advantages linked to the deployment of GRID technologies in health. Technologies to address the specific requirements for medical applications are under development. Results from the DataGrid and other projects are given as examples of early applications.Comment: 6 pages, 1 figure. Accepted by the Second International Workshop on Biomedical Computations on the Grid, at the 4th IEEE/ACM International Symposium on Cluster Computing and the Grid (CCGrid 2004). Chicago USA, April 200

Business Models for e-Health: Evidence from Ten Case Studies

An increasingly aging population and spiraling healthcare costs have made the search for financially viable healthcare models an imperative of this century. The careful and creative application of information technology can play a significant role in meeting that challenge. Valuable lessons can be learned from an analysis of ten innovative telemedicine and e-health initiatives. Having proven their effectiveness in addressing a variety of medical needs, they have progressed beyond small-scale implementations to become an established part of healthcare delivery systems around the world