Italian Programs Research Articles

Growth models for the progress test in Italian dentistry degree programs

Growth models for the progress test in Italian dentistry degree programs

Teaching the polycrisis: Assessing the effect of pluralist education in Italian economics programs

This paper presents the results of a survey of economics students in Italy. The survey was motivated by a review of the curriculum of Italian economics programs and was designed to assess the links between how pluralist students claimed their economics education was, and their assessment of how adequately various topics were taught, how well they thought their education contributed to the development of a number of skills, and their overall satisfaction with their degree program. The results of our survey were then analyzed using an ordered logit model which found large and significant links between pluralism and student satisfaction, reported topical coverage and the formation of some skills. No statistically negative correlations between pluralism and any skill or topics were found. A categorization of the results of an open-ended question from the survey asking students what they would change about their education “if they had a magic wand” is also presented. The results of the study point to increasing pluralism as an intriguing option for departments looking to attract and retain students and as a useful tool for training economists who are prepared to face current and future global economic challenges as represented in the concept of the polycrisis.

Organizational impact of systemic implementation of digital breast tomosynthesis as a primary test for breast cancer screening in Italy.

We present a comprehensive investigation into the organizational, social, and ethical impact of implementing digital breast tomosynthesis (DBT) as a primary test for breast cancer screening in Italy. The analyses aimed to assess the feasibility of DBT specifically for all women aged 45-74, women aged 45-49 only, or those with dense breasts only. Questions were framed according to the European Network of Health Technology Assessment (EuNetHTA) Screening Core Model to produce evidence for the resources, equity, acceptability, and feasibility domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) decision framework. The study integrated evidence from the literature, the MAITA DBT trials, and Italian pilot programs. Structured interviews, surveys, and systematic reviews were conducted to gather data on organizational impact, acceptability among women, reading and acquisition times, and the technical requirements of DBT in screening. Implementing DBT could significantly affect the screening program, primarily due to increased reading times and the need for additional human resources (radiologists and radiographers). Participation rates in DBT screening were similar, if not better, to those observed with standard digital mammography, indicating good acceptability among women. The study also highlighted the necessity for specific training for radiographers. The interviewed key persons unanimously considered feasible tailored screening strategies based on breast density or age, but they require effective communication with the target population. An increase in radiologists' and radiographers' workload limits the feasibility of DBT screening. Tailored screening strategies may maximize the benefits of DBT while mitigating potential challenges.

The Italian adaptation of the Mini-SIPS, a tool for early detection of individuals at clinical high risk and first episode of psychosis: A preliminary study of implementation in an Italian FEP program.

The study aims are to present the Italian adaptation of the Abbreviated Clinical Structured Interview for DSM-5 Attenuated Psychosis Syndrome (Mini-SIPS) and illustrate its implementation in a clinical setting. The Mini-SIPS was developed from the original extended version as a tool designed to identify, within the clinical high risk (CHR) framework, the DSM-5 Attenuated Psychosis Syndrome (APS) and to be implemented in clinical settings. The Mini-SIPS was translated in Italian by a Yale-certified SIPS trainer, then back-translated in English by a trained psychologist, then approved by the Mini-SIPS authors. Since September 2021, the adapted Italian version of the Mini-SIPS has been implemented at the First Episode Psychosis (FEP) Program in Ferrara, Italy. The Italian version of Mini-SIPS was successfully administered to 15 individuals subsequently referred to the First Episode Psychosis service in Ferrara. Within this sample, the tool has proven to be both an effective and efficient tool for the identification of CHR and FEP, and a valid instrument to help with the differential diagnosis. It also performed as a valuable guide for retrieving information about psychiatric history, to date the onset of APS and/or full-blown psychosis, to track the progression from CHR to psychosis or to symptoms resolution and to describe patients' pathways to care. The Mini-SIPS is an efficient and easy-to-use interview to identify the early stages of psychosis and established psychosis in clinical contexts. The Italian adaptation of this interview could be effectively implemented in other Italian FEP Programs as a screening and monitoring tool. Formal validation of the instrument is needed to assessed validity and reliability in the diagnosis of the CHR and FEP.

Study Protocol for the Residents' Mental Health Investigation, a Dynamic Longitudinal Study in Italy (ReMInDIt).

Medical residents constitute a vulnerable population susceptible to mental health disorders. In Italy, this was evident during the COVID-19 pandemic, when medical residents served on the front line and provided significant support to healthcare services. Therefore, the working group on "Public Mental Health" of the Medical Residents' Council of the Italian Society of Hygiene, Preventive Medicine, and Public Health (S.It.I.) designed the "Residents' mental health investigation, a dynamic longitudinal study in Italy" (ReMInDIt). This longitudinal study aims to assess the mental status of medical residents and to explore potential cause-effect relationships between risk/protective factors (identified among sociodemographic, residency program, and lifestyle characteristics) and mental health outcomes (anxiety and depressive symptoms). Data will be collected from a study population of 3615 residents enrolled in Italian residency programs in public health, occupational medicine, and forensic medicine through an online questionnaire that includes validated tools, requires 10 min for completion, and is disseminated by the residents' Councils. It will be followed by a follow-up administration after 12 months. The ReMInDIt study will play a significant role in generating evidence crucial for enhancing mental health services and promoting protective factors for the mental well-being of this important segment of healthcare professionals.

Gender Gap in academic medicine: a narrative review and the Italian forensic context.

Gender gap is a neologism that identifies the disparity between social and professional conditions experienced by females compared to males. The disparity increases as one ascends the academic hierarchy. In recent years, the debate has expanded, and more options have been planned for the elimination of the current gender gap. This research was conducted by examining the landscape of the gender gap, particularly in the academic forensic medicine field. Our analysis involved reviewing papers published between 2006 and 2024, identified through electronic database searches (PubMed). The search terms used were: "gender gap" AND "academic" AND "medicine" AND "leadership." In total, we analyzed 85 papers. Additionally, we examined data from forensic medicine residency programs. The representation of women in medicine is well-known. Despite the increasing number of women in leadership positions in medicine, they still lag significantly behind men. These data highlight a situation that could be seen as grounds for an accusation of "academic abuse". In the Italian forensic residency programs, less than 20% are led by women, and among these, not all hold the rank of full professor. Although a certain rebalancing is already underway, the gap is still significant. There are already regulations obliging local authorities to promote gender equality in councils, companies, and institutions under their jurisdiction. It would be desirable to consider minimum quotas for female participation in university competitions. This would be a first step toward eliminating the gender gap in academic and forensic medical fields.

The introduction of surgical simulation on three-dimensional-printed models in the cardiac surgery curriculum: an experimental project.

Training in congenital cardiac surgery has become more and more difficult because of the reduced opportunities for trainees in the operating room and the high patient anatomical variability. The aim of this study was to perform a pilot evaluation of surgical simulation on a simple 3D-printed heart model in training of young surgeons and its potential inclusion in the curriculum of residency programs. A group of 11 residents performed a surgical correction of aortic coarctation using a 3D-printed surgical model. After teaching the surgical procedure, a simulation was performed twice, at different times, and was evaluated quantitatively and qualitatively by a senior surgeon. A 3D model-based training program was then developed and incorporated into our cardiac surgery training program. A significant improvement in surgical technique was observed between the first and second surgical simulations: median of 65% [interquartile range (IQR) = 61-70%] vs. 83% (IQR = 82-91%, P < 0.001). The median time required to run the simulation was significantly shorter during the second simulation: 39 min (IQR = 33-40) vs. 45 min (IQR = 37-48; P = 0.02). Regarding the simulation program, a basic and an advanced program were developed, including a total of 40 different simulated procedures divided into 12 sessions. Surgical simulation using 3D-printing technology can be an extremely valuable tool to improve surgical training in congenital heart disease. Our pilot study can represent the first step towards the creation of an integrated training system on 3D-printed models of congenital and acquired heart diseases in other Italian residency programs.

Migration, language, and variation: the challenge of foreign speakers to detect Italian linguistic varieties

In the last decades, Italy has been affected by new migratory waves which enriched its varied sociolinguistic landscape. If on one hand Italy has been dealing with the integration of new immigrants in the society, on the other foreign immigrants need to cope with the extreme sociolinguistic complexity which defines the Italian linguistic reality. The present study aims to examine how foreign speakers perceive regional linguistic variation of Italy. A perceptive experiment was conducted on 44 foreign respondents to test their linguistic perception of six regional Italian varieties. Results showed that Italian’s explicit learning helps linguistic comprehension, but it is not enough to grasp differences between regional varieties of Italian, and this could cause comprehension difficulties for the unrepresented varieties in Italian language programs. We suggest that the enhancement of Italian regional varieties’ representation could foster new immigrants’ integration in the welcome society.

Architecture of Medieval Armenia as a Field of Research for Russian and Italian Scholars: Comparative Analyses of the Historiography

For the first time in the literature, this study provides an analysis of the activities of two major architectural–archeological missions that investigated the architectural heritage of the Armenian Highlands: the Russian Ani Archaeological Expedition (1892–1893 and 1904–1917) and the Italian academic programs of the Universities of Rome and Venice and that of Milan Polytechnic (from 1966 to the 1980s). In this article, the results of the conducted research are compared, and their contribution to the development of the history of medieval architecture is evaluated. The differences in the results are related to the chronological distance between the missions, as well as the main focus of each work: the activities of the Russians are primarily archeological, while those of the Italian groups are architectural. The head of the Ani Institute, Nikolay Marr, set himself the task of exhibiting the original artifacts in the museum he had created in the medieval capital of Armenia, Ani, while the Italian professors relied on photography for both permanent and touring exhibitions. The second mission was in unspoken contact with the first, forming a kind of time-stretched dialog. Although, by the 1970s, almost none of the participants in Marr’s expedition remained alive, his scientific works were periodically being published, with some still waiting their turn in the scientific archives.

State-of-the-art review of the T/H system codes RELAP5 for HLM applications

Thermal-hydraulic code RELAP5, originally developed by INEEL under NRC contract for LWRs LOCA analysis, has been extensively validated and it is actually used worldwide as a best estimate code for LWRs transient analysis. This code was chosen in the early 2000s as the reference code for the thermal-hydraulics and accident analysis of Heavy Liquid Metal Fast Reactors within the frame of Italian research programs. Several original RELAP5 routines have been updated in order to implement suitable correlations generating the reference physical and thermodynamic properties for Lead and Lead-Bismuth Eutectic fluids. Similarly, some specific heat transfer correlations for liquid metals have been added. In almost twenty years, ENEA has conducted an extensive validation program to demonstrate the capability of the code to simulate the thermal–hydraulic behaviour of heavy liquid metal systems. This program was mainly conducted on the facilities of the Brasimone center (CHEOPE, CIRCE, NACIE), but also used data from international programs (MEGAPIE International Experiment and LACANES Benchmark OECD/NEA). Furthermore, the participation of ENEA in the projects financed by the European Commission in several Euratom programs for the study and design of HLM-cooled reactors (ELSY, SEARCH, MAXSIMA, LEADER, SESAME. MYRTE) has allowed to increase the confidence on the transient and accidental analyses conducted with RELAP5 also through the comparison with the results of other codes. RELAP5 is currently a reliable tool both as a support to reactor design (safety by design) and for accidental analyses.

A survey on preferences, attitudes, and perspectives of Italian urology trainees: implications of the novel national residency matching program.

Since 2014, a new residency program selection process has been established with a national examination. The aim of this study was to assess characteristics, career goals, and practice preferences of current Italian urology residents. A web-based survey of 25 items performed from May 2021 to September 2021 was sent to 585 Italian urology residents. Descriptive analyses were conducted to describe the surveys' domains: demographics characteristics, studies, plans for fellowship training, interest in the urology field, and career expectations. Four hundred and one residents completed the online survey (response rate 68.5%). Most residents were male (70.3%), with a median of 29 (IQR 28-31) years. Urology was the first chosen School in 325 (81.0%) cases, and 174 (43.4%) trainees have chosen to remain in the same University. Uro-oncology was the main field, and endourology the main subspeciality of interest, respectively. More than 40.0% of residents expressed a good level of satisfaction for the training urological course. 232 (57.2%) residents were strongly interested in seeking a hospital career, followed by private career (43.4%) and academic career (20%). After the introduction of the novel national residency matching program the Italian Urology trainees showed a good satisfaction level. Further improvements of the Italian residency programs should be focused on the training network within and outside the main School of Urology.

Clinical research: the great absentee of the Italian University training programs?

Background: In an era where clinical trials have become more and more complex and regulatory authorities impose very high quality standards, the education of clinical research professionals becomes crucial. As one of ICH-GCP guiding principles, adequate training should be ensured and included in educational programs. Methods: In 2021, the Italian Group of Data Managers and Clinical Research Coordinators shared among professionals involved in clinical research an online survey aimed at investigating quality and characteristics of clinical research training provided during undergraduate and postgraduate Italian programs. Results: The survey was completed by 280 professionals: 178 study coordinators, 29 clinical research associates, 20 project managers, 7 study nurses, and 44 others. The majority were 25-45 years old (n = 242, 86.4%), worked at experimental sites (n = 211, 75.4%), and almost all (n = 252, 90.0%) had at least a master’s degree, mainly in biology/biotechnology (n = 162, 57.9%) and pharmacy (n = 64, 22.9%). Clinical research education during the degree courses was considered poor by 73.6% (n = 206). The knowledge on clinical research professional world at the time of graduation was considered poor by 71.1% of participants (n = 199), like the knowledge of related career opportunities (71.1%, n = 199, poor). According to 85.0% of professionals (n = 238) additional postgraduate trainings were needed, mainly university master courses (47.50%, n = 133) and private institution courses (47.86%, n = 134). Postgraduate trainings were considered very useful by 71.4% (n = 200) of responders. Conclusion: Our data suggest undergraduate programs on clinical research education failing at providing even the basic information on clinical research. Therefore, most professionals resort to specific additional postgraduate courses.

Risk prediction for advanced neoplasia using longitudinal adherence measures to fecal immunochemical test-based colorectal cancer screening programs

BackgroundPatterns of longitudinal adherence may predict advanced neoplasia (AN) detection in subsequent rounds of colorectal cancer (CRC) screening. However, after more than five rounds, it is important to obtain a simplified measure. The aim was to determine the best simplified measure of longitudinal adherence to predict AN detection in CRC screening. MethodsIndividuals with four invitations from a Dutch Fecal immunochemical testing (FIT-)based pilot study and two Italian FIT-based CRC screening programs were included. We calculated AN detection in the fourth round, stratified by prior adherence. Five simplified measures were compared to full information (permutations) using chi-squared goodness-of-fit: adherence previous invitation, consistency, frequency, frequency + adherence previous invitation, and proportion of invitations covered. ResultsAN detection in the fourth round was highly dependent on prior adherence behavior. For inconsistent adherence, detection in the fourth round was strongly dependent on frequency and time since last participation. The performance of the simplified measures to capture this variation differed considerably. ‘Adherence previous invitation’ scored worst in predicting AN detection. ‘Frequency+adherence previous invitation’ had lowest chi-squared goodness-of-fit. DiscussionThe simplified measure ‘frequency+adherence previous invitation’ is the best measure to reflect patterns of longitudinal adherence and could be used to emphasize to individuals the importance of CRC screening.

Impact of colorectal cancer screening on incidence, mortality and surgery rates: Evidences from programs based on the fecal immunochemical test in Italy.

Fecal immunochemical tests (FIT) are among the most commonly used tests for colorectal cancer (CRC) screening programs worldwide. However, no randomised controlled trials have been carried out evaluating the impact of FIT-based screening programs (FIT-progr) on CRC incidence and mortality rates. Italian FIT-progr represent one of the most widespread and established experience worldwide. This paper reviews the evidence on the impact of FIT-progr on CRC incidence, tumor stage at diagnosis, mortality and surgery rates, deriving from Italian routine programs, i.e., outside the research setting. Unfortunately, the application of FIT-progr in Italy can be considered as an unplanned experimental model, due to the differences between Regions, both in health system management and adherence of the target population to the screening programs. The analysis of the manuscripts considered in the review, confirms that FIT-progr are effective in reducing CRC incidence and mortality rates and in improving the rate of endoscopic treatment of early invasive lesions. The review also highlights that FIT-progr are less performing for proximal colon than for distal colon and rectum.

New recommendations on mammography screening for women over 70 years

The new recommendations of the European Council (December 2022) indicate to the Member States to implement mammography screening programs for women aged 45 to 74 and make explicit reference to the European guidelines produced by the ECIBC (European Commission Initiative on Breast Cancer) for operational indications. For women aged 70-74, the ECIBC suggests a three-year interval, rather than two years, and the process of adaptation and adoption of the guidelines in Italy has taken this recommendation as it is. Previous indications for Italian screening programs proposed a two-year interval for all women over 50 years of age. The intervention analyzes the rationale and interpretation of the evidence that led to the formulation of the different recommendations. It discusses whether the new recommendations fit into the perspective of risk-stratified screening that is under evaluation by several studies. it analyzes some of the critical issues of the methodology for developing recommendations in defining the characteristics of complex interventions, in particular the difficulties that the formulation of dichotomous questions finds in answering questions such as what is the best age to stop screening and what is the best interval at any age, which require an analysis of a continuous variable as age or interval duration. Finally, the opportunities and limitations in producing evidence regarding the best interval to adopt in mammography screening are discussed.

Caring masculinities in prison? Social workers and programs dealing with incarcerated fatherhood

AbstractThe article explores how fatherhood in prison is conceived and supported by policy intervention in Italy. Despite the fact that, in 2020, 96% of adults detained in Italian prisons were men and half of them had at least one child, fatherhood in prison, a gendered space and institution where masculinities are (re)produced, is an underdeveloped research topic. Adopting a caring masculinity perspective, we focus on incarcerated fatherhood to investigate if and how Italian social programs that deal with incarcerated parents target fathers and, if so, to what extent they promote caring masculinities. To this aim, we will combine an analysis of social programs for incarcerated fathers in Italy, almost entirely run by third sector organizations, with discursive interviews with educators, welfare workers, and third sector stakeholders who participated in the implementation of a project for incarcerated parents in a north Italian prison. The results of our analysis show that involved fatherhood is not only denied to incarcerated men; it is also not allowed in an institution, such as a prison, where domination is the keyword.

Point-of-care ultrasound training for residents in anaesthesia and critical care: results of a national survey comparing residents and training program directors’ perspectives

BackgroundPoint-of-care ultrasound (POCUS) has become an essential tool for anaesthesia and critical care physicians and dedicated training is mandatory. This survey describes the current state of Italian residency training programs through the comparison of residents’ and directors’ perspective.MethodsObservational prospective cross-sectional study: 12-question national e-survey sent to Italian directors of anaesthesia and critical care residency programs (N = 40) and residents (N = 3000). Questions focused on POCUS teaching (vascular access, transthoracic echocardiography, focused assessment for trauma, transcranial Doppler, regional anaesthesia, lung and diaphragm ultrasound), organization (dedicated hours, teaching tools, mentors), perceived adequacy/importance of the training and limiting factors.ResultsFive hundred seventy-one residents and 22 directors completed the survey. Bedside teaching (59.4–93.2%) and classroom lessons (29.7–54.4%) were the most frequent teaching tools. Directors reported higher participation in research projects (p < 0.05 for all techniques but focused assessment for trauma) and simulation (p < 0.05 for all techniques but transthoracic echocardiography). Use of online teaching was limited (< 10%); however, 87.4% of residents used additional web-based tools. Consultants were the most frequent mentors, with different perspectives between residents (72.0%) and directors (95.5%; p = 0.013). Residents reported self-training more frequently (48.5 vs. 9.1%; p < 0.001). Evaluation was mainly performed at the bedside; a certification was not available in most cases (< 10%). Most residents perceived POCUS techniques as extremely important. Residents underestimated the relevance given by directors to ultrasound skills in their evaluation and the minimal number of exams required to achieve basic competency. Overall, the training was considered adequate for vascular access only (62.2%). Directors mainly agreed on the need of ultrasound teaching improvement in all fields. Main limitations were the absence of a standardized curriculum for residents and limited mentors’ time/expertise for directors.ConclusionPOCUS education is present in Italian anaesthesia and critical care residency programs, although with potential for improvement. Significant discrepancies between residents’ and directors’ perspectives were identified.

Knowledge Transfer in Doctoral Education During the Pandemic Time: An Exploratory Study of the PhD Students’ Experiences

The research aims to explore how PhD students interacted with professors and peers and transferred knowledge during pandemic time. We firstly aim to provide an overview of communication media used by students, as well as to classify them for different kinds, social presence, and media richness. Furthermore, our research also aims to explore how doctoral students took their courses by interacting with professors and with peers, in terms of learning (KT) and social exchange relations (LMX, TMX, POS), through online learning platforms and communication media. We conducted exploratory research on 25 PhD students from 5 Italian PhD Programs in ‘economic and statistical sciences’ area. Data was collected through (a) the focus group interview with PhD students for collecting their opinions and experiences on the usage of media for communicating with professors and peers and (b) an online questionnaire aimed to measure their experiences or perceptions on technology usage and social relations. Results shown that PhD students used e-learning platform for communicating with peers and professors, so developing good social relations -even at a distance- which have encouraged knowledge transfer among them.

Cory Pesaturo: A Musician on a Mission

Cory Pesaturo: A Musician on a Mission

Reflective Learning Through Observation, Performance and Design: Intermediate Italian Beyond the Textbook

Abstract This paper presents in detail a curricular redesign project undertaken by a faculty working group at Duke University, aiming to organize teaching and learning around real-world tasks. This new intermediate Italian course design imagines the student assuming various roles throughout the learning experience: those of an engaged observer, a performer, a maker and creator, and a reflective participant in the community. In addition to discussing the overall curricular structure and pedagogical principles of the new course, the article describes specific activities that can be readily adapted to a wide range of Italian language programs.