Gender-Based Violence is a Never to be Forgotten Social Determinant of Health: A Narrative Literature Review

Gender-based violence (GBV) has been internationally recognized as a serious and pervasive phenomenon affecting women’s lives and health. The World Health Organization (WHO) reports that about 30% of women have experienced worldwide some form of violence. GBV (in addition to clearly visible immediate effects) induces long-term effects, including an increased incidence of many noncommunicable diseases such as diabetes or cancer. In the last few years, it has also been demonstrated that the signs of violence interfere with genome plasticity and gene expression through epigenetic mechanisms. The underestimation of the problem does not allow us to put in place preventive health mechanisms that could cushion the damage (prevent post-traumatic stress disorders—PTSDs—and the evaluation of epigenetic changes) to avoid the onset of the diseases. Appropriate interventions could reduce many of these long-term health effects while failure to intervene could be a significant source of health inequalities. The aim of this narrative review is to summarize the available evidence on the relationship between GBV, its long-term effects on health, and as victims’ living conditions, and socioeconomic position of determining both

“Opzioni e propensioni di un campione di medici “intensivisti” riguardo all’interruzione e la sospensione delle cure nei malati terminali in casi eticamente problematici (il questionario Ethicatt).”

Gli Autori riferiscono i risultati ottenuti dalla somministrazione ai medici dei reparti di terapia intensiva dell’Ethicatt Questionnaire-Doctor realizzato nel contesto del più ampio studio approvato dalla Commissione Europea nell’ambito del V Programma quadro per il finanziamento alla ricerca, condotto dalla Facoltà di Sociologia dell’Università di Roma La Sapienza, sul tema “Life and death in intensive care units in Europe. The ethics of decision-making about end of life”. Sono state estrapolate le risposte date ai quesiti relativi alla decisione di sospendere o rifiutare trattamenti ai malati terminali ed i risultati dimostrano l’affermazione del principio di equivalenza morale fra il non intraprendere ed il sospendere una terapia, pur permanendo, tuttavia, una profonda differenza sul piano psicologico, per cui molti medici hanno più difficoltà a sospendere piuttosto che a rifiutare un trattamento

Quality of life after brain injury (QOLIBRI): Italian validation of the proxy version

To validate the proxy version of the Quality of Life after Brain Injury (QOLIBRI) questionnaire to utilize caregivers for comparison and to evaluate the correspondence between patients’ self-perceived and caregivers’ perception of patients’ Health-Related Quality of Life (HRQoL). Ninety-two patients with severe TBI and their main caregivers were enrolled. Patients’ and caregivers’ HRQoL was assessed by the Patient-QOLIBRI (Pt-QOLIBRI) and the Proxy-QOLIBRI (Pro-QOLIBRI), respectively. The Pro-QOLIBRI is a modified version of the QOLIBRI to investigate caregivers’ perception of patients’ HRQoL (Pro-QOLIBRIpatient-centered), and their degree of satisfaction and botheredness (Pro-QOLIBRIcaregiver centered). The patients’ disability and their social reintegration was investigated by means of Glasgow Outcome Scale Extended and Community Integration Questionnaire. Pro-QOLIBRI has good internal consistency and homogeneity. There was also positive correlation between the level of satisfaction measured by Pro-QOLIBRI but not by Pt-QOLIBRI, and the disability severity and social integration of the patients. The comparison between the Pt-QOLIBRI and Pro-QOLIBRI confirmed the usefulness of the Pro-QOLIBRI, especially the caregiver-centered version, to predict the social reintegration of survivors. To our knowledge this is the first study that correlates the HRQoL of survivors, as self-perceived and as perceived by the caregivers with social reintegration

Health-related quality of life after traumatic brain injury: Italian validation of the QOLIBRI

The QOLIBRI (Quality of Life after Brain Injury) is a new international health-related quality of life (HRQoL) instrument developed for assessing the consequences of traumatic brain injury (TBI). We report the results of the Italian validation of the QOLIBRI. A total of 147 participants with TBI who had previously been discharged from the Santa Lucia Foundation rehabilitation hospital were recruited to investigate the concurrent validity of the Italian version of the QOLIBRI and to compare this instrument with several functional and cognitive-behavioral scales, taking into account various clinical parameters. The QOLIBRI met the standard criteria for internal consistency, homogeneity and test-retest reliability. The results suggest that it is very sensitive in relation to outcome as measured by the Extended Glasgow Outcome Scale (GOS-E) and other instruments for functional assessment of disability, emotions and subjective health status, including the Hospital Anxiety and Depression Scale and the Short-Form 36. The QOLIBRI avoids some of the limitations of traditional scales for quantifying residual functional capacity, such as the Glasgow Outcome Scale and the GOS-E, and may contribute to the achievement of better quality-controlled care, medical decision-making, rehabilitation planning, and measurement of well-being and HRQoL from the patient’s perspective. However, a longitudinal study is needed to assess the responsiveness of the QOLIBRI to changes over time

Quality of life in persons after traumatic brain injury as self-perceived and as perceived by the caregivers

The primary aim of the study was to adopt QOLIBRI (quality of life after brain injury) questionnaire in a proxy version (Q-Pro), i.e., to use caregivers for comparison and to evaluate whether TBI patients’ judgment corresponds to that of their caregivers since the possible self-awareness deficit of the persons with TBI. A preliminary sample of 19 outpatients with TBI and their proxies was first evaluated with the Patient Competency Rating Scale to assess patients’ self-awareness; then they were evaluated with the QOLIBRI Patient version (Q-Pt) and a patient-centered version of the Q-Pro. Subsequently, 55 patients and their caregivers were evaluated using the patient-centered and the caregiver-centered Q-Pro versions. Q-Pt for assessing Quality of Life (QoL) after TBI, as patients’ subjective perspective and Q-Pro to assess the QoL of patients as perceived by the caregivers. The majority of patients (62.2%) showed better self-perception of QoL than their proxies; however, patients with low self-awareness were less satisfied than patients with adequate self-awareness. Low self-awareness does not impair the ability of patients with TBI to report on satisfaction with QoL as self-perceived