Undereating and Overeating: A Fiscal Measure against a "Contemporary Malaise"

This dissertation is intended to draw the attention of the reader on the issue of eating disorders, with a special focus on binge eating disorder. Beyond a simplified description of the diagnostic criterions adopted to identify and distinguish among the most diffused eating disorders, namely anorexia nervosa, bulimia nervosa, and binge eating disorder, this thesis investigates throughout the “triggering” and “substantiating” causes of such disorders. Unfortunately, the understanding of the determinant causes of eating disorders is still limited; this is due to the fact the etiopathogenesis of these disorders is multifactorial, it involves not only psychological and social aspects but also genetic ones. This essay actually supports the hypothesis that people’s poverty of relational goods is a major source of contemporary uneasiness and, in the context of the unbridled diffusion of eating disorders, it aims at proposing a fiscal policy ultimately devoted to improve “collective” social capital as a potential - at least partially - remedy against this class of psychiatric pathologies

Effectiveness of measures to preserve labour and childbirth companionship at the times of COVID-19 outbreak

Introduction: Although childbirth services were accessible after COVID-19 outbreak, the measures taken by the Italian Government for contagion containment required some restrictions on the presence of trusted persons for mothers, forcing them to isolation during hospitalization. To preserve companionship, the Regional Health Authority of Tuscany issued a resolution providing partners with the possibility to be present during labour and childbirth for non-asymptomatic women. Objectives: In this study, we: 1) analyse the impact of pandemic on companionship in terms of significant reduction of the possibility for women to be accompanied by a trusted person during labour and childbirth; and 2) ascertain if the regional resolution issued was effective in containing the reduction of companionship. Methods: We performed an interrupted time series analysis to measure the variation of the possibility for women to be accompanied by a trusted person during labour and childbirth, in response to formalization of lock-down due to COVID-19 outbreak and the introduction of the regional resolution aimed at contrasting negative effects on companionship. Results and conclusions: The ITS analysis showed that there was a significant decrease in the women-reported experience of companionship in the month of the formalization of lock-down, namely March 2020, followed by a slight increase in the upcoming months. A trend reversal was observed after May 2020, when the regional resolution was fully operational

Learning from Excellence to Improve Healthcare Services: The Experience of the Maternal and Child Care Pathway

The ability to deal with adversity and the resilience of people and groups are shown to depend positively on the tendency to nurture positivity. Therefore, the aim of this study is to evaluate whether Learning from Excellence (LfE) can be an effective method to manage systematic health systems, when transparent disclosure and benchmarking of data are adopted in performance evaluation. This study consists of a quantitative and a qualitative phase. In the former, maternal care is investigated at the regional level, starting from performance data and indicators of the maternity pathway referred to 98 healthcare providers in 10 Italian regions, that share the same evaluation system. The second phase investigates qualitatively the organizational determinants and the experience of professionals involved in the pathway, through the organization of on-site workshops. We identified the seven best practices among the 42 units of analysis. Communication, trust and shared goals among health professionals involved in the pathway emerged as core themes from the qualitative analysis. This study confirms that LfE under the conditions of benchmarking assessment and transparent disclosure of data can be implemented systematically in management practice, in order to boost health personnel’s resilience and, in general, the organizational climate in the working environment

Promoting healthy eating habits among youth according to their preferences: Indications from a discrete choice experiment in Tuscany

Abstract Introduction The incidence of overweight among youth in Western Countries requires the implementation of initiatives to promote healthy lifestyles. Although under particular conditions obesity is not preventable, drawing attention on factors affecting teenagers' preferences can ameliorate the efficacy of public interventions designed for health promotion. Methods This study aims at eliciting teenagers' food preferences through a discrete choice experiment, conducted in Tuscany using a webAPP survey, with the participation of more than 4,700 teenagers. Respondents expressed their preferences for breakfast food based on three attributes: food quality, packaging and claim. The survey also collected information on respondents' socio-demographic characteristics, social influence and media use for food information. Results Teenagers' preferences for healthy foods seem positively related with their own level of food literacy. The tendency of respondents to read labels and nutritional facts is positively associated with preferences for healthier foods. Peers' influence is not significant, while family influence has a positive impact on teenagers' healthy choices. Internet usage is associated with unhealthy choices with a healthy aspect. Conclusion The results can be useful in defining effective actions for the promotion of healthy behaviors among teenagers, either in communication and awareness campaigns or in education and activation initiatives, with respect to the reading and interpretation of nutritional facts and labels, the role of family and friends, and the use of media

Image enhancing drugs: A narrative review on the motivational risk factors influencing skin lightening use

Abstract Introduction In societies that place a great emphasis on physical appearance and body aestheticism, the use of image enhancing drugs (IEDs) has become increasingly widespread. Of particular concern is the use of skin lightening drugs, which might contain undisclosed and harmful ingredients of potential adulterated nature. These products are frequently advertised on social media platforms and elsewhere and used without medical consultation. Methods An explorative literature search was carried out in PubMed, Scopus, CINHAL, and ProQuest to better understand the motivational risk factors associated with skin lightening and assess their relation to body image, self-esteem, and other psychological disorders. All studies published until December 2020 were included in the review. Results A number of non-psychological factors can be associated with this practice. These include: (a) sociocultural i.e., achieve different social and cultural benefits, and (b) skin conditions such as hyperpigmentation lesions. Conversely, psychological factors can be correlated to (a) low self-esteem, (b) body image disturbances, and (c) other psychological factors like history of trauma and depressive symptoms. Conclusion Skin lightening remains a poorly studied and understood multifactorial phenomenon. More extensive research is needed to improve current clinical practice and raise public awareness on this dangerous practice

Assessing problematic use of social media: where do we stand and what can be improved?

© 2022 The Authors. Published by Elsevier Ltd. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, https://creativecommons.org/licenses/by/4.0/The increased popularity of social media has brought clinicians and researchers to question the potential problematic outcomes of such Internet-based applications. Over the past two decades, an increasing number of studies identified the so-called problematic use of social media (PUSM), which led to the development of various assessment tools requiring constant revisions because of the ever-evolving nature of the Internet. This review summarizes the most frequently used measurement tools in PUSM research while suggesting best practices and directions for future research based on the most recent evidence in the field.Peer reviewedFinal Published versio

Evaluating Healthcare Performance in Low- and Middle-Income Countries: A Pilot Study on Selected Settings in Ethiopia, Tanzania, and Uganda

The literature reports some experiences regarding the design of integrated healthcare Performance Evaluation Systems (PES) applied in Low- and Middle-income Countries (LMIC). This study describes the design of an integrated and bottom-up PES aimed at evaluating healthcare services delivery in rural settings. The analysis involved four hospitals and their relative health districts in Ethiopia, Tanzania, and Uganda. The evaluation process was undertaken for those indicators that could be evaluated using the same reference standard. The evaluation scores were determined through the international standards identified in the literature or through benchmarking assessment. Both administrative and health data were extracted from the hospitals’ registers and District Health Information Systems (DHIS) from 2017 to 2020. We defined 128 indicators: 88 were calculated at the hospital level and 40 at the health district level. The evaluation process was undertaken for 48 indicators. The evaluated indicators are represented using effective graphical tools. In settings characterised by multiple healthcare providers, this framework may contribute to achieving good governance through performance evaluation, benchmarking, and accountability. It may promote evidence-based decision-making in the planning and allocation of resources, thus ultimately fostering quality improvement processes and practices, both at the hospital and health district level