Exploring the link among state of mind concerning childhood attachment, attachment in close relationships, parental bonding, and psychopathological symptoms in substance users

In the present study, we have explored the link among styles of attachment and psychopathology in drug users. We know that insecure attachment predisposes the individuals the development of drug-addiction and psychopathological symptoms. However, we do not know which attachment is more frequent in drug users and which is related to particular psychopathological symptoms. The aim of the present work is to explore the relationship between childhood attachment state of mind, attachment in close relationships, parental bonding and psychopathology in sample of Italian substance users

Allogeneic versus Autologous: ethical issues in umbilical cord blood use

OBJECTIVE. To analyse some ethical issues involved in umbilical cord blood (UCB) collection, storage and use. MATERIALS AND METHODS. Ethical issues were addressed in the light of the wellknown fundamental ethical principles for biomedicine: beneficence/non maleficence, respect for autonomy and justice. Specific issues that have been debated concerning the clinical utility of autologous use compared with allogeneic use for transplantation, the validity of informed consent, especially in private UCB banking, and finally the controversial question of private UCB banking for-profit compared to public UCB banking non-profit. RESULTS. Our ethical analysis has highlighted that the allogeneic UCB use for transplantation, compared to autologous UCB use, seems to fulfil the principle of beneficence/non maleficence as it provides “logistic” and clinical benefits and it decreases risks; the acquisition of informed consent requires some counselling, particularly for autologous collection; finally, public UCB banking seems to fulfil the criteria for justice more than private ones. CONCLUSION. Present and future therapeutic UCB possibilities for treating a wide variety of diseases need to increase the number of UCB units available. For this purpose, a “gift” culture and a “solidarity chain” between donors and recipients are requested. Moreover, in recent years, a further and emerging model of bank seems usable, i.e. “hybrid” banking

Allogeneic versus Autologous: ethical issues in umbilical cord blood use

OBJECTIVE. To analyse some ethical issues involved in umbilical cord blood (UCB) collection, storage and use. MATERIALS AND METHODS. Ethical issues were addressed in the light of the wellknown fundamental ethical principles for biomedicine: beneficence/non maleficence, respect for autonomy and justice. Specific issues that have been debated concerning the clinical utility of autologous use compared with allogeneic use for transplantation, the validity of informed consent, especially in private UCB banking, and finally the controversial question of private UCB banking for-profit compared to public UCB banking non-profit. RESULTS. Our ethical analysis has highlighted that the allogeneic UCB use for transplantation, compared to autologous UCB use, seems to fulfil the principle of beneficence/non maleficence as it provides “logistic” and clinical benefits and it decreases risks; the acquisition of informed consent requires some counselling, particularly for autologous collection; finally, public UCB banking seems to fulfil the criteria for justice more than private ones. CONCLUSION. Present and future therapeutic UCB possibilities for treating a wide variety of diseases need to increase the number of UCB units available. For this purpose, a “gift” culture and a “solidarity chain” between donors and recipients are requested. Moreover, in recent years, a further and emerging model of bank seems usable, i.e. “hybrid” banking

Keeping secrets from friends: Exploring the effects of friendship quality, loneliness and self-esteem on secrecy

The tendency to keep secrets in adolescents has been studied in particular in their relationships with their parents and associated with psychosocial disadvantages. The current study focused on peer relationships and investigated the effects of friendship quality, loneliness in a multidimensional perspective, and self-esteem on secrecy from friends. Italian adolescents (N= 457; 47% male; 100% white) aged between 13 and 19 years (M = 16.11; SD = 1.53) reported their secrecy from friends, peer and parent-related loneliness, aversion and affinity for aloneness, their self-esteem and the quality of their relationships with their friends. The results showed that peer-related loneliness, affinity for aloneness and self-esteem in particular affect keeping secrets from friends, independent of the participant’s gender. Moreover, peer-related loneliness and affinity for aloneness mediated the relationship between self-esteem and secrecy. The data were discussed in the light of adolescence developmental tasks

TERMS AND SIGNIFICANCE IN TRANSPLANTATION MEDICINE

Determining and defining human death in age of life-sustaining technologies is a matter of controversy and touch on some of society\u2019s deepest human questions. A great part of controversy seem to be caused by an imprecise, ambiguous, confusing and misleading use of terms. Medical literature in English language and web sites in Italian language concerning human death, organ donation and transplantation have been studied. We have found a deep gap between medical use of some terms and their common use

Clinical ethics consultation as \u201cshared document\u201d. Emerging ethical and medico-legal issues: Sacchini D., Corsano B., Refolo P., Minacori R., Spagnolo A.G.the experience of IBioMedH-UCSC CEC Service (2005-2016)

Background The clinical ethics consultation (CEC) aims to help patients, relatives, caregivers and healthcare professionals to cope with ethical issues arising in patient care. CEC can be drafted in two different ways: 1. CEC provided by clinical ethics consultant requested by clinical wards; 2. CEC as \u201cshared decision-making document\u201d (SDM-D) among different \u201cbedside\u201d stakeholders (patient, relatives, healthcare professionals, health managers) aimed at an agreed advanced clinical planning, namely in dilemmatic/uncertain settings. In fact, SDM is \u201can approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences\u201d (Elwyn et al., 2010) Aim Assessing rising ethical/medico-legal issues in clinical cases requested for CEC and addressed through SDM-D. Methods We examined retrospectively SDM-Ds provided by IBioMedH-UCSC CEC Service and requested from different clinical Departments of \u201cA. Gemelli\u201d University Hospital Foundation (starting from January 2005 to December 2016), examining clinical indication, patient\u2019s preferences, quality of life; context, in the light of personalist bioethical approach (Sgreccia, 1986).. Results 53 SDM-Ds out of 173 CECs were setup from 2005 to 2016. Clinical Departments that requested clinical ethics consultation were: Reproductive and maternal-Foetal Diseases (15, 28%); Internal Medicine & Infectious Diseases (12, 23%); Pediatrics and Neonatal care (11, 22%); Neurology (9, 15%); Hospice (3, 6%); Intensive Care Unit (2, 4%); Surgery (1, 2%). The following main ethical issues were recognized: cardiopulmonary resuscitation; tracheostomy, ectopic pregnancies; inducing childbirth; mechanical ventilation; palliative sedation. Possible ethical/medico-legal issues were identified: problems of communication and understanding between the parties; patients/family difficulties to identify benefits/burdens of treatments proposed by physicians and the patient\u2019s best interest; incomplete patient\u2019s understanding of physician\u2019s clinical goals; the patient/family request to join the discussion and to share the decisions concerning treatments; the fear of family that the doctors are not doing enough for the patient; for end-of-life patients, the fear that doctors will do unnecessary treatments that produce suffering; the patients/family perception to have distant and seemingly irreconcilable positions with those of the doctors. The different reasons for dissatisfaction of patients/family seems related not to physicians\u2019 technical skills, but to relationship issues. We observed that relationship difficulties could complicate other issues. In all cases examined, SDM helped to overcome potential conflicts, incomplete understandings or misunderstandings. The consequence of SDM was that no complaints has subsequently developed from these cases, some of which were particularly sensitive. Conclusion In our experience, the CEC provided through SDM-D can help: the optimization of the choice of proportionate treatments; to strengthen patients/family-doctors relationship and, at the same time, reduce the risk of complaints/disagreement; to analyse from the ethical point of view, for all the parties, the most problematic aspects of clinical situations and the possible solutions for a really SDM. The CEC-SDM-D can also clarify the goals of care for patient\u2019s best interest