“Without social there is no health”: Social work perspectives in multidisciplinary healthcare

The pandemic has not just affected the health sphere: strong social effects of the emergency have added to the health risk, stressing on social relations and the deterioration of people’s living conditions, and making those who are already fragile more fragile. Notwithstanding, during the emergency following the COVID-19 pandemic the attention was focused, indeed understandably, on the health aspects, widening the already existing misalignment between the health interventions and the social ones. Emergency oriented efforts and resources more toward a clinical care approach (cure) than toward support for the social and the inclusion aspects (care). Reflecting on the specific area of health care that interacts with social care (and vice versa), shows how the medicalization in managing the emergency have undermined or, at least, weakened the global approach to the person and to vulnerability profiles that should inspire the socio-healthcare integration. The aim of this review is describing the relationship between the health and social systems and the effects of the COVID-19 pandemic on it: a review of studies on the role played by social work in the health sector before and during COVID-19 pandemic emergency shows how much potential there is still to be developed for social work in the health sector that acts together with the personal health services; a care that looks at the person within his or her relationships, community resources and environmental aspects requires an investment toward integration between hospital care, social services and local communities

Towards cross-cultural social work: a teaching approach for development of intercultural competences

Las herramientas profesionales de los trabajadores sociales requeridas por la sociedad contemporánea deben inevitablemente incluir la capacidad de aplicar el conocimiento, de saber cómo actuar y de adquirir nuevas competencias apropiadas para escuchar y para atender a las personas provenientes de diferentes culturas. En relación con el entrenamiento a las futuras generaciones de trabajadores sociales, se debe recordar que tendrán que negociar con una sociedad cada vez más globalizada y afrontar las nuevas demandas hacia la profesión, por la presencia de un número de inmigrantes en Italia en cifras cada vez más altas. La experimentación didáctica llevada a cabo como parte del curso de grado en Trabajo Social de la Universidad de Palermo, en los últimos diez años, ya se ha estado movilizando hacia la integración, en primer lugar, de una conciencia de la necesidad del conocimiento profesional trans-cultural y consecuentemente, como urgentemente, de una planeación y provisión del mejoramiento para las futuras generaciones de profesionales. A partir de esta experiencia se ha estado desarrollando un modelo de enseñanza que permita la integración de una educación académica con las herramientas trasnsculturales y el logro de mayor eficacia, prestando precisamente mayor atención a la diversidad de las vidas de los sujetos en la relación de aiuda social. Entrenar en herramientas interculturales puede conducir a dos objetivos: asegurar la calidad de la atención a la población inmigrante, en términos de brindar igualdad de oportunidades y no-discriminación; transmitir un sentido de seguridad a los trabajadores sociales para generar acuerdos con la población inmigrante, mientras se reduce el estrés y los comportamientos erróneos limitantes. La calidad intercultural de los servicios sociales, con la posibilidad de llevar a cabo un trabajo social transcultural, mejorará los servicios para los inmigrantes (e.g. asistencia para la reintegración social, protección de las especificidades culturales, prevención de la violencia y de la discriminación); igualmente, traerá consigo el rejuvenecimiento de comunidades indígenas, tranquilizando a sus ciudadanos cautelosos y transformando el entero concepto de ciudadanía, en un sentido social más que legal.The professional skills demanded of social workers by contemporary society must unavoidably include the capacity to apply knowledge, to know how to act and acquire the appropriate new competences for listening and taking care of people coming from different cultures. With regard to the training of future generations of social workers it must be remembered that they will have to deal with an increasingly globalized society and face the new demands placed upon the profession by the presence of a greater number of people migrating to Italy in increasingly greater numbers. Teaching experimentation carried out as part of the degree course in Social Work at the University of Palermo over the last ten years has already been moving in the direction of integrating, first of all, an awareness of the need for professional, trans-cultural knowledge and, consequently, also urgently planning and providing an improvement for the future generations of professionals. From this experience a teaching approach is being developed that consents the integration of an academic education with transcultural skills and achieve greater effectiveness precisely by paying more attention to the diversity of the lives of the subjects in the caring relationship. Training in intercultural skills may lead to two objectives: ensuring the quality of care for the migrant population, in terms of equal opportunities and non-discrimination; transmitting a sense of security to social workers in dealings with the migrant population, whilst reducing stress and limiting erroneous behaviour. The intercultural quality of social services, with the possibility of carrying out cross-cultural social work, will enhance services for migrants (e.g. assistance for social integration, protection of cultural specificities, prevention of violence and discrimination); it will also bring about the rejuvenation of indigenous communities, by reassuring its wary citizens and transforming the whole concept of citizenship, in the social rather than legal sense

Transculturality: the new frontier of care relationships

Taking care of migrants constitutes a new challenge for the actual operative structures of the services in general and for the sanitary service in particular, requiring a global and permanent rethinking with regards to both the offer and the procedures for decoding the requests. What determines the complexity of offering care while respecting differences is the fact that it can not be done without the professionals individually deconstructing racism and maturing an anti-racist awareness. However, attention to this question is neither widespread nor shared during the training of doctors and of health service workers in general. It is necessary, therefore, to broaden the traditional staffclient relationship (usually articulated in the dyad staffsubject/client-object) until it is recognized that both parts have a double role, both as a subject and as an object, within the aid process. The transcultural model is based on the concept of reciprocity. What the transcultural relationship involves is a parallel process of a redefinition of identity, both of the doctor or health service worker and of the client: it is necessary for both to question parameters that they considered certain, overcoming their inevitable resistance in the process. It appears necessary to explore within the training programs the strategies that people, in this specific case the professionals whose work regards health, adopt to avoid challenging racism and the implications that these can have in their daily duties

CURA, RELAZIONE, PROFESSIONE: QUESTIONI DI GENERE NEL SERVIZIO SOCIALE

La permanenza di una separazione nei ruoli e nelle mansioni lavorative tra uomini e donne, che riproduce la partizione tra sfera privata, legata al femminile, e sfera pubblica, sbilanciata sul maschile, è particolarmente evidente nelle professioni sociali, assistenziali ed educative anche nei Paesi più economicamente avanzati, a prescindere dalle strutturazioni di welfare. A partire dall’evidenza inequivocabile della prevalenza numerica di donne nel servizio sociale − tratto comune alle pur diverse coniugazioni nelle quali la professione si esprime di Stato in Stato − gli autori discutono della questione del genere nel servizio sociale da diverse angolature, offrendo al lettore una ricca pluralità di temi, tagli teorici e approcci di ricerca. Ricerche nazionali e internazionali mostrano la persistenza di matrici culturali e di stereotipi di genere rispetto alla divisione del lavoro, sin dalla formazione, nella mentalità degli studenti e dei formatori, e spesso anche negli stessi professionisti. Le riflessioni critiche degli autori sono orientate alla ricerca di un antidoto al permanere in statu quo, e insieme allo sviluppo di una modalità di intervento sociale avanzata e di attenzione consapevole rispetto al genere, sia tra professionisti, sia con utenti e clienti dei servizi, diversa a seconda che siano uomini, donne o in un processo di ridefinizione di sé. Percorsi di ricerca che si offrono come contributo verso sviluppi di segno diverso nei molteplici fronti della formazione (universitaria e permanente), della narrazione collettiva e massmediale, della ricerca e riflessività prodotta dalla stessa comunità professionale degli assistenti sociali.The persistence of a separation in roles and work duties between men and women, which reproduces the partition between the private sphere, linked to the feminine, and the public sphere, unbalanced on the masculine, is particularly evident in the social, welfare and educational professions even in the most economically advanced, regardless of welfare structures. Starting from the unequivocal evidence of the numerical prevalence of women in social work - a trait common to even different conjugations in which the profession is expressed from state to state - the authors discuss the gender issue in social work from different angles, offering the reader a rich plurality of themes, theoretical cuts and research approaches. National and international researches show the persistence of cultural matrices and gender stereotypes with respect to the division of labor, right from training, in the mentality of students and trainers, and often also in the professionals themselves. The authors' critical reflections are oriented towards the search for an antidote to remaining in the status quo, and together with the development of an advanced social intervention modality and gender-aware attention, both among professionals and with users and customers of the services, different depending on whether they are men, women or in a process of self-redefinition. Research paths that offer themselves as a contribution towards developments of different character in the multiple fronts of training (university and permanent), of collective and mass media narration, of research and reflection produced by the professional community of social workers

Ensemble modelling, uncertainty and robust predictions of organic carbon in long-term bare-fallow soils

ACKNOWLEDGEMENTS This study was supported by the project “C and N models inter-comparison and improvement to assess management options for GHG mitigation in agro-systems worldwide” (CN-MIP, 2014- 2017), which received funding by a multi-partner call on agricultural greenhouse gas research of the Joint Programming Initiative ‘FACCE’ through national financing bodies. S. Recous, R. Farina, L. Brilli, G. Bellocchi and L. Bechini received mobility funding by way of the French Italian GALILEO programme (CLIMSOC project). The authors acknowledge particularly the data holders for the Long Term Bare-Fallows, who made their data available and provided additional information on the sites: V. Romanenkov, B.T. Christensen, T. Kätterer, S. Houot, F. van Oort, A. Mc Donald, as well as P. Barré. The input of B. Guenet and C. Chenu contributes to the ANR “Investissements d’avenir” programme with the reference CLAND ANR-16-CONV-0003. The input of P. Smith and C. Chenu contributes to the CIRCASA project, which received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement no 774378 and the projects: DEVIL (NE/M021327/1) and Soils‐R‐GRREAT (NE/P019455/1). The input of B. Grant and W. Smith was funded by Science and Technology Branch, Agriculture and Agri-Food Canada, under the scope of project J-001793. The input of A. Taghizadeh-Toosi was funded by Ministry of Environment and Food of Denmark as part of the SINKS2 project. The input of M. Abdalla contributes to the SUPER-G project, which received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement no 774124.Peer reviewedPostprin

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

Design and methodology of the screening for CKD among older patients across Europe (SCOPE) study: A multicenter cohort observational study

Background: Decline of renal function is common in older persons and the prevalence of chronic kidney disease (CKD) is rising with ageing. CKD affects different outcomes relevant to older persons, additionally to morbidity and mortality which makes CKD a relevant health burden in this population. Still, accurate laboratory measurement of kidney function is under debate, since current creatinine-based equations have a certain degree of inaccuracy when used in the older population. The aims of the study are as follows: to assess kidney function in a cohort of 75+ older persons using existing methodologies for CKD screening; to investigate existing and innovative biomarkers of CKD in this cohort, and to align