Citizenship education through practices and representations

La investigación se llevó a cabo en los años 2008 y 2009, con la intención de identificar las prácticas de educación para la ciudadanía más difundidas en la escuela secundaria superior italiana y las representaciones más comunes presentes entre los estudiantes y profesores. Se suministraron 1308 cuestionarios, en 76 clases, correspondientes a tres regiones de Italia (Emilia-Romagna, Lombardía y Sicilia), 68 fichas han sido recopiladas a partir de los sondeos de 46 profesores. Diez de estos 46 profesores fueron también entrevistados directamente. El estudio describe las prácticas más difundidas y los temas fundamentales (predomina la prevención de accidentes de tráfico, medidas preventivas de la salud en general, con especial atención a las drogas, el alcohol, las enfermedades de transmisión sexual y el SIDA.) Se observa una presencia muy limitada de proyectos específicos de dimensión jurídica, política y ética, de la ciudadanía, en cambio los estudiantes muestran expectativas y un deseo de intervención sobre la ciudadanía. También parece importante el análisis de las representaciones implícitas identificadas en las respuestas abiertas de los estudiantes.This research was conducted in 2008 and 2009, and sought to identify the most popular practices of citizenship education in secondary school, as well as the most common representations among students and teachers. 1308 open-ended questions questionnaires were administered to 76 classes across three Italian regions (Emilia-Romagna, Lombardy and Sicily); 68 monitoring cards were compiled by 46 teachers. Ten out of these 46 teachers were also interviewed directly. The study describes the most common practices and the privileged topics (road accidents and health care prevention in general with particular regard to drugs, alcohol, sexually transmitted diseases and HIV were among the most popular). The evidence shows a very limited number of projects specifically related to the legal, political and ethical dimensions of citizenship, whilst students express expectation and desire for intervention. Furthermore, the analysis of the implicit representations identified in the open-ended responses provided by the students seems particularly significant.peerReviewe

Hyaluronic acid enhance polynucleotides effect on cultured dermal fibroblasts

Polynucleotides (PNs) and Hyaluronic Acid (HA) are compounds widely used to promote tissue regeneration, mainly in cutis and cartilage. PNs efficacy has been demonstrated in vitro on cultured dermal fibroblasts and osteoblasts, and in animal models where it has been demonstrated to increase dermal regeneration. PNs effects are mediated mainly through the activation of P2P purinergic receptors, which are expressed on fibroblasts and on mesenchymal-derived cells. HA, the most abundant and non solphorate glycosaminoglycan (GAG) produced by fibroblasts, is envolved in several biological effects which are different in response of the sizes of HA molecules. When used as non fragmented, (about 2 Kd) HA has both an anti-inflammatory and antiapoptotic effects and it stimulates cell migration. In this study we have analyzed the effect of a mixture of PNs and HA, in order to verify a possible synergic effect, on human dermal fibroblasts. Effects on cell proliferation were evaluated with MTT assay and cell culture protein content. Dose-response curves showed higher effects on cell proliferation when PNs were used in the presence of HA. In particular we observed that, the addiction of HA determined a peak of activity with a reduction of of about a third of PNs dose. These preliminary data are suggesting for a joint use of HA and PN in tissue regeneration, mainly in clinical situation, like for example cutaneous burn in with the presence of PN induce a more rapid regeneration by means of more rapid cell ingrowth, collagen and VEGF production. At the same time HA support cell migration and contribute to reduce inflammatory processes

Effect of the Purinergic Inhibitor Oxidized ATP in a Model of Islet Allograft Rejection

The lymphocytic ionotropic purinergic P2X receptors (P2X1R-P2X7R, or P2XRs) sense ATP released during cell damage-activation, thus regulating T-cell activation. We aim to define the role of P2XRs during islet allograft rejection and to establish a novel anti-P2XRs strategy to achieve long-term islet allograft function. Our data demonstrate that P2X1R and P2X7R are induced in islet allograft-infiltrating cells, that only P2X7R is increasingly expressed during alloimmune response, and that P2X1R is augmented in both allogeneic and syngeneic transplantation. In vivo short-term P2X7R targeting (using periodate-oxidized ATP [oATP]) delays islet allograft rejection, reduces the frequency of Th1/Th17 cells, and induces hyporesponsiveness toward donor antigens. oATP-treated mice displayed preserved islet grafts with reduced Th1 transcripts. P2X7R targeting and rapamycin synergized in inducing long-term islet function in 80% of transplanted mice and resulted in reshaping of the recipient immune system. In vitro P2X7R targeting using oATP reduced T-cell activation and diminished Th1/Th17 cytokine production. Peripheral blood mononuclear cells obtained from long-term islet-transplanted patients showed an increased percentage of P2X7R+CD4+ T cells compared with controls. The beneficial effects of oATP treatment revealed a role for the purinergic system in islet allograft rejection, and the targeting of P2X7R is a novel strategy to induce long-term islet allograft function

Effect of the Purinergic Inhibitor Oxidized ATP in a Model of Islet Allograft Rejection

The lymphocytic ionotropic purinergic P2X receptors (P2X1R-P2X7R, or P2XRs) sense ATP released during cell damage-activation, thus regulating T-cell activation. We aim to define the role of P2XRs during islet allograft rejection and to establish a novel anti-P2XRs strategy to achieve long-term islet allograft function. Our data demonstrate that P2X1R and P2X7R are induced in islet allograft-infiltrating cells, that only P2X7R is increasingly expressed during alloimmune response, and that P2X1R is augmented in both allogeneic and syngeneic transplantation. In vivo short-term P2X7R targeting (using periodate-oxidized ATP [oATP]) delays islet allograft rejection, reduces the frequency of Th1/Th17 cells, and induces hyporesponsiveness toward donor antigens. oATP-treated mice displayed preserved islet grafts with reduced Th1 transcripts. P2X7R targeting and rapamycin synergized in inducing long-term islet function in 80% of transplanted mice and resulted in reshaping of the recipient immune system. In vitro P2X7R targeting using oATP reduced T-cell activation and diminished Th1/Th17 cytokine production. Peripheral blood mononuclear cells obtained from long-term islet-transplanted patients showed an increased percentage of P2X7R+CD4+ T cells compared with controls. The beneficial effects of oATP treatment revealed a role for the purinergic system in islet allograft rejection, and the targeting of P2X7R is a novel strategy to induce long-term islet allograft function

Expert clinical pharmacological advice may make an antimicrobial TDM program for emerging candidates more clinically useful in tailoring therapy of critically ill patients

Background Therapeutic drug monitoring (TDM) may represent an invaluable tool for optimizing antimicrobial therapy in septic patients, but extensive use is burdened by barriers. The aim of this study was to assess the impact of a newly established expert clinical pharmacological advice (ECPA) program in improving the clinical usefulness of an already existing TDM program for emerging candidates in tailoring antimicrobial therapy among critically ill patients. Methods This retrospective observational study included an organizational phase (OP) and an assessment phase (AP). During the OP (January-June 2021), specific actions were organized by MD clinical pharmacologists together with bioanalytical experts, clinical engineers, and ICU clinicians. During the AP (July-December 2021), the impact of these actions in optimizing antimicrobial treatment of the critically ill patients was assessed. Four indicators of performance of the TDM-guided real-time ECPA program were identified [total TDM-guided ECPAs July-December 2021/total TDM results July-December 2020; total ECPA dosing adjustments/total delivered ECPAs both at first assessment and overall; and turnaround time (TAT) of ECPAs, defined as optimal (< 12 h), quasi-optimal (12-24 h), acceptable (24-48 h), suboptimal (> 48 h)]. Results The OP allowed to implement new organizational procedures, to create a dedicated pathway in the intranet system, to offer educational webinars on clinical pharmacology of antimicrobials, and to establish a multidisciplinary team at the morning bedside ICU meeting. In the AP, a total of 640 ECPAs were provided for optimizing 261 courses of antimicrobial therapy in 166 critically ill patients. ECPAs concerned mainly piperacillin-tazobactam (41.8%) and meropenem (24.9%), and also other antimicrobials had >= 10 ECPAs (ceftazidime, ciprofloxacin, fluconazole, ganciclovir, levofloxacin, and linezolid). Overall, the pre-post-increase in TDM activity was of 13.3-fold. TDM-guided dosing adjustments were recommended at first assessment in 61.7% of ECPAs (10.7% increases and 51.0% decreases), and overall in 45.0% of ECPAs (10.0% increases and 35.0% decreases). The overall median TAT was optimal (7.7 h) and that of each single agent was always optimal or quasi-optimal. Conclusions Multidisciplinary approach and timely expert interpretation of TDM results by MD Clinical Pharmacologists could represent cornerstones in improving the cost-effectiveness of an antimicrobial TDM program for emerging TDM candidates

Antiretroviral therapy in HIV/HCV co-infection Italian consensus workshop

About 50% of people living with the HIV infection in Italy are co-infected with HCV. In this group of patients, the primary cause of mortality is liver disease, which accounts for up to 14% of deaths. HIV/HCV co-infection also exposes patients to a higher risk of progression to AIDS, a faster evolution towards cirrhosis, more frequent drug toxicity, and lower tolerance for antiretroviral therapy. Moreover, HCV infection can play a part in increasing immune system depression; neurological, cognitive and renal damage; and bone fragility. Hence an optimal antiretroviral regimen needs to be chosen for co-administration with anti-HCV therapy and timed appropriately to improve the prognosis of co-infected HIV/HCV patients. Unfortunately, however, data on the safety and efficacy of antiretroviral drugs in these patients is scarce, as are studies of pharmacokinetics in patients with advanced liver impairment. Furthermore, restoring adequate immune constitution seems not to slow the progression of liver disease, and the metabolic and hepatic toxicity of some antiretroviral drugs can even contribute to inflammatory and fibrogenic processes. It is therefore essential that HIV/HCV co-infected patients receive only medications capable of ensuring the best immune recovery but possessing the lowest potential to trigger immune reconstitution syndrome or hepatic and metabolic damage