Italian Situation Research Articles

The challenge of antimicrobial resistance (AMR): current status and future prospects.

Antimicrobial resistance (AMR) represents a critical global threat, compromising the effectiveness of antibacterial drugs as bacteria adapt and survive exposure to many classes of these drugs. This phenomenon is primarily fueled by the widespread overuse and misuse of antibacterial drugs, exerting selective pressure on bacteria and promoting the emergence of multi-resistant strains. AMR poses a top-priority challenge to public health due to its widespread epidemiological and economic implications, exacerbated not only by the diminishing effectiveness of currently available antimicrobial agents but also by the limited development of genuinely effective new molecules. In addressing this issue, our research aimed to examine the scientific literature narrating the Italian situation in the common European context of combating AMR. We sought to delineate the current state of AMR and explore future prospects through an analysis of strategies to counter antibacterial drug resistance. Adopting the "One Health" model, our objective was to comprehensively engage diverse sectors, integrate various disciplines, and propose programs, policies, and regulations. This narrative review, based on PubMed research related to antibiotic resistance, emphasizes the urgent need for a coordinated and proactive approach at both national and European levels to mitigate the impact of AMR and pave the way for effective strategies to counter this global health challenge.

Inclusive teaching of Italian L2/LS between language and gender identity

In some cases, the teaching of Italian as an L2/LS language continues to perpetuate gender stereotypes, sexist or discriminatory elements. When this is not the case, however, it often fails to offer those approaching the study of Italian the tools and materials to address relevant issues and themes in the contemporary debate such as gender identity and the importance of using inclusive language. Aware that the didactics of Italian can be a fundamental tool for building a context of coexistence of differences, we want to reflect on the Italian situation and present some didactic proposals that can allow to combine in the Italian classroom a language education a reflection on gender identity.

Adopting the fuzzy approach to analyze food poverty in Italy: A study on vulnerable households using household budget survey data

Besides international efforts to address poverty and hunger, there are still many disparities among households, therefore innovative approaches and techniques are required to address the multiple facets of poverty, especially food poverty.Given the complexity in defining this phenomenon, the fuzzy approach based on an expenditure-related metric is adopted as it provides valuable insights into the Italian food poverty situation thus improving the results generally provided using by the classical binary (or crisp) set theory.By considering the equivalised household food expenditure obtained from the 2021 Italian Household Budget Survey data, the fuzzy set approach is used to measure food poverty paying particular attention to vulnerable households at a detailed territorial level. The results show that food poverty is lower in the Northern-Central regions than in Southern Italy and highlight the vulnerability of families with children and single-parent households.

Enforcement of alternative measures to detention in EU countries: The Italian situation

Enforcement of alternative measures to detention in EU countries: The Italian situation

Could the contraceptive counselling improve contraceptive choice after abortion? A multicentric study to evaluate patients’ perception

Introduction24 % of abortion in Italy are repeated procedure. The cause of repeated abortion can be traced back to the inadequacy of the contraceptive counseling during the previous admission or to the adoption of an ineffective contraception method.This study aims to evaluate the Italian situation on the perceived quality of contraceptive counselling by patients undergoing abortion. The second aim is to verify if the chosen methods were available for immediate start. Study designMulticentric, prospective, non-interventional, non-randomized, non-pharmacological clinical observational study. We analyzed anonymous questionnaires on contraceptive counseling and LARC (Long Acting Reversable Contraceptives) availability and SARC (Short Acting Reversable Contraceptives) prescription at hospital discharge, distributed to women who requested abortion. Results1074 participants on 15 hospitals through Italy. 82 % of the interviewees reported that they had received correct information regarding contraception. 74 % of the patients who chose LARC methods reported to have them inserted at the time of abortion. 73 % of women who had chosen a SARC method stated that they had received the prescription before discharge. After contraceptive counselling, we reported a significative reduction of “none or natural methods use” and a significant increase of SARC and LARC use compared to before the abortion. ConclusionContraceptive counselling could allow a better contraceptive choice in patient who required abortion and we hope that future strategies will implement LARC choice. We think that a greater availability of LARC at an affordable price at the time of abortion could improve LARC choice. In case of SARC choice, we have to implement the prescription at hospital discharged.

Characteristics of the health districts in Italy and their implication in primary health care policies: an analysis of socio-demographic trends.

The Health District (HD) is a critical component of Italy's National Health Service, responsible for ensuring Primary Health Care (PHC) services in response to community health needs. The Italian government established a national strategic reform program, the National Recovery and Resilience Plan (PNRR), starting in 2022, with a series of health interventions to reorganize the PHC setting, the main reform being the Ministerial Decree 77/2022 (DM77). Our study aimed to provide a description of socio-demographic data and to assess the correlation between HDs, in order to suggest health intervention priorities in PHC reforms. We conducted our analysis using a cross-sectional record linkage of data from multiple sources to compare organizational and socio-demographic variables. A dataset was created with each of the 21 Italian Regions' HDs data of population, land area, mean age, ageing index, old-age dependency ratio, birth rate and death rate. The Inland Areas Project data was integrated for a socio-economic perspective. Our study identified comparable groups of HDs, considering demographical, socio-economic and geographical aspects. The study provides a baseline understanding of the Italian situation prior to the implementation of DM77. It also highlights that inhabitants number cannot be the only variable to take into account for the definition of Italian HDs organisation and PHC reform, providing intercorrelated variables that take into account geographic location, demographic data, and socio-economic aspects. By acknowledging the interplay of demographic, socio-economic, and geographic factors, policymakers can tailor interventions to address diverse community needs, ensuring a more effective and equitable PHC system.

ANMCO Position paper - 2023 ANMCO States General: The shortage of healthcare personnel in the cardiology field

Over the latest years, a worrying progressive reduction of medical specialists has been observed in Italy and in other European and non-European countries. This trend is assuming alarming proportions, especially considering the continuous population aging and the concomitant increase in the prevalence of chronic cardiovascular disease. The underlying reasons are complex and multifactorial. The purpose of this document, derived from the collegial discussion held during the 2023 ANMCO States General is to highlight the current critical issues regarding the lack of healthcare personnel in the cardiology field, examining the current and future Italian situation and proposing some potential strategies to counteract this alarming phenomenon.

Left ventricular assist device and transcatheter edge-to-edge mitral valve repair in advanced heart failure: allies or enemies?

The implantation of left ventricular assist devices (LVADs) has been increasing, with good long-term results, in parallel with a growing population with advanced heart failure (HF). However, in some European countries, LVADs are still underused, with one of the main issues being the patient's late referral. On the contrary, the use of transcatheter edge-to-edge mitral valve repair (TEER) has exponentially increased over the past decade, expanding its potential use even in patients on the heart transplantation waiting list. Even though the study populations of the main trials that investigated the prognostic impact of LVAD and TEER are different, in clinical practice a clear distinction might not be so clear. Therefore, patients with refractory HF symptoms and significant mitral regurgitation should be thoroughly evaluated through a multidisciplinary Heart Team meeting with both an advanced HF specialist and interventional cardiologist, to avoid futile procedures and to define the optimal timing for advanced HF therapies, when they are indicated. We analyzed the main available studies and registries on both TEERs and LVADs and we compared their populations and outcomes, to provide the current evidence on the use of LVAD and TEER in the HF population, especially in the light of the recently released 5-year follow-up results, giving some insights on the Italian situation, and finally to stress the importance of a solid HF network between hospitals, aiming for advanced HF patients' timely referral for LVAD or heart transplants.

Managing BEV Charge to Obtain a Positive Impact on a National Power System

This paper’s research question is to evaluate the potential impact of large numbers of battery electric vehicles (BEVs) on the future electric grid, and whether the flexibility of BEV charging can induce enough system benefits to remunerate BEV users for the change in their recharging pattern. The considered scenario refers to the Italian situation and what might occur through the year 2040, where a share of BEV stock of 40% can be foreseen, as well as significant increases in PV and wind generation. Although this study is focused on Italy, its results are applicable, with minor differences, to several EU countries. This paper first shows that the future impact of increasing penetration of BEVs appears to be compatible with the expected growth of generation from renewable energy sources (RES) and the corresponding reduction in fossil fuel-based generation. It also gives an estimate of the CO2 emission reduction resulting from these changes, considering an unmanaged BEV charge profile and two different managed profiles that shift the car’s charging period to hours of the day when they have no negative impact on the grid and maximize the utilization of RES. Finally, it shows an evaluation of the economic benefits of displacing private car charging ranging from 4 to 10 cEUR/kWh, which could be used as tariff incentives to stimulate this displacing in recharging time.

Planning and meta-planning to cope with disruptive events: what can be learnt from the institutional response to the Covid-19 pandemic in Italy

The Covid-19 pandemic has been analysed and discussed from many disciplinary perspectives. An aspect that still needs critical exploration is the role—that is, the modes and forms—of regulatory interventions during the pandemic. It is interesting to note in this regard that, in many studies, regulatory measures are labelled “non-pharmaceutical interventions”, as if they do not have any specificity on their own and only represent a theoretically residual category. The main aim of this article is instead to focus on the distinctive features of normative measures as such. As regards the article’s focus, it centres on the normative interventions in the first period of the pandemic—that is, 2020—with particular reference to Italy. We have chosen to focus on this period because the most extensive and severe restrictions introduced to combat Covid-19 were established at that time. And we have chosen to consider Italy because it was the first country, after China, to be hard hit by the virus and to react in a draconian manner. As regards the methodology, the article is based, in general and primarily, on an extensive interdisciplinary literature review. With reference to the Italian case, the study is additionally based on: first-hand data collection and analysis (especially concerning Italian normative measures mainly issued at the national level: their type, frequency, target, hierarchical relationships); second-hand data and analysis (for instance as regards the effectiveness of Italy’s and other countries’ regulatory measures). In discussing the Italian response to the Covid-19 pandemic, certain weaknesses have been identified; and possible lessons have been highlighted, in terms of both “planning” (i.e. the necessity to better pre-define concrete and circumscribed sets of actions) and of “meta-planning” (i.e. the necessity of better planning the way in which public authorities could and should plan and act). Although this article is mainly based on the Italian situation, what we can learn from this case is largely generalizable.

A no-win situation: psychiatrists navigating competing obligations between free will, paternalism, duty of care, and position of guarantee

This paper examines the ethical tensions psychiatrists encounter in balancing competing obligations to patients and society, heightened in the COVID-19 era. With reference to the Italian situation, legal concepts such as duty of care or the rule of law defined “position of guarantee” engender heightened duties of care but generate discordance concerning patient autonomy. As a matter of fact, Italian psychiatrists are considered responsible for the effects of their interventions on patients and their behaviors. Consequently, managing involuntary treatment, assessing risk, and worrying about liability strain practitioners' efforts to uphold non-maleficence. As mental healthcare needs escalate globally amidst resource constraints, the application of ethical principles is imperative. Evidence-based approaches prioritizing collaborative harm reduction over social control must be reinforced through education, oversight, and organizational policies. With balanced civil commitment criteria and realistic expectations acknowledging risk prediction limits, therapeutic alliances can be maintained. Greater investment in community-based systems can mitigate coercion and marginalization. Psychiatrists worldwide endeavor to uphold beneficence and non-maleficence within shifting accountability landscapes. This perspective advocates collective efforts to promote patient welfare through equitable, quality care. Navigating the multifaceted nexus of competing obligations demands thoughtful dialogue and judicious reforms responsive to both practitioner and patient needs. By engaging with ethical complexities with scientific rigor and compassion, psychiatry can uphold humane, ethical standards despite mounting challenges.

Sexualised drug use and chemsex in Italy: A questionnaire study based on a cohort of clients attending a STI outpatient service in Milan.

Chemsex is a heterogeneous phenomenon with differences in distribution, setting, motivations and type of substances consumed between countries. The lack of data at national level of the Italian situation creates a perception of reduced need for intervention. Anonymous paper questionnaires were distributed to patients who had registered themselves at the STI Department IRCCS Ca' Granda Policlinico in Milan. A significant association was demonstrated between use of sexualised drugs, chemsex and the following variables: (1). Number of partners: in the group of clients with more than five partners, sexualised drug users were more than twice compared with those in the group with less than five partners (35.2% vs 16.2%) p<0.0001. (2). Use of dating apps: more than one out of two persons who used drugs during sex affirmed looking for partners on internet, p = 0.0059. (3). Low condom uses with occasional partners: percentage of individuals who declared not to use condoms or devices during their sexual encounters with occasional partners is more than twice as high in the sexualised drug users group with respect to controls (44.6% vs 21.4%); p = 0.0006). (4). Use of post exposure prophylaxis (PEP): among the PEP users, more than half participants belonged to the sexualised drug users' group; p = 0.0021. Sexualised drug use and chemsex are frequently practiced in Milan. This survey identified a specific population with higher-risk sexual behaviours and increased incidence of acute bacterial STIs.

Retrospective Analyses of COVID-19 and Population Ageing Effects on Italian Mortality during the Pandemic.

The spread of COVID-19 led to an extremely high number of deaths in Italy in 2020 with respect to previous years. Because the total number of deaths may depend on both the population structure and the mortality rate by age groups, a detailed overview of the Italian pandemic situation is here provided by following two main lines of inquiry: (i) checking for similarities and differences among mortality rates per age groups before and during the COVID-19 spread; (ii) analyzing the responsiveness of the Italian population structure to different mortality rates. Real-based evidence led us to conduct analyses for two groups associated with different population stages of life, referred to as younghood and adulthood periods. We focus on the Italian pandemic from February 2020 to March 2021. Our study helps to understand why elders dramatically impacted the total number of deaths. In addition, it reveals how badly the 2020 Italian population structure would have reacted to mortality rates already faced in the past. Finally, politicians, scientists, and journalists' statements and other ways of communicating information about COVID-19 are questioned in the light of scientific data available at that time.

The several faces of the medicalization of birth. Italy and its peculiarities.

Medical-scientific advances in maternal care gradually improved the health of mothers and new-borns. However, this has contributed to increasing levels of medicalization, defined as the overuse of medical interventions even in low-risk pregnancies and childbirths. In Italy pregnancy and birth still appear to be rather medicalized than in the rest of Europe. Moreover, the uneven distribution of these practice over the territory appears to be evident. The purpose of this article is to both highlight and explain the Italian peculiarity in terms of high medicalization of childbirth and its territorial variability. The extensive literature on medicalization of childbirth was systematized by some scholars who use childbirth as a case study to distinguish four meanings of medicalization, by classifying them into two generations of theories. Alongside this literature several studies attempted to interpret differences in maternity model of care showing the important role played by path dependence. In the European scenario, Italy stands out for its high percentage of cesarean sections, but also for its excessive recourse to antenatal visits during pregnancy and the application of interventions during labor and vaginal births. Going into regional detail, however, Italian situation appears rather uneven: relevant differences emerge in relation to medicalization of both pregnancy and birth. The article explores the possibility that areas whit different sociocultural, economic, political and institutional background may have introjected different meanings of medicalization, thus reproducing different maternity models of care. In fact, the simultaneous presence, in Italy, of four different meanings of medicalization seems to be rooted. Even with some similar traits, different conditions and situations emerge in different geographical areas, leading to the prevalence of one meaning rather than another and resulting on different outcomes in terms of medicalization. The data presented in this article seem to deny the existence of a national maternity model of care and. On the contrary, they confirm the idea that medicalization is not necessarily linked to the different health conditions of mothers in different geographical areas and that a path dependent variable is able to explain it.

Putting Education Back at the Center: Some Reflections and Proposals on the Italian Situation

In this article, I address issues of inequality in Italy and, in particular, the role that education can play in fighting inequality. Moving beyond the nevertheless real problem of the scarcity of funds allocated by the Italian governments to education, I focus on the objectives that should inform spending criteria, thus emphasizing the importance of truly inclusive education, achievable through an ambitious path of comprehensive and incisive reforms. A country that does not excel in the civic sense and that for some scholars is even becoming less civilized, Italy should put education back at the center not only as a matter of social justice, but also to avert decline and improve the quality of its democratic coexistence.&#x0D; &#x0D; Received: 22 February 2023 / Accepted: 27 April 2023 / Published: 5 May 2023

Indelible: Violence Against Women and Their Resistance to It in the Visual and Performing Arts in Italy and Beyond.

The visual and performing arts can be instrumental in exposing the complexity of the numerous forms violence against women and girls takes, and in exploring old and new forms of resistance. The articles in this special issue emerged from a three-year project of the Visual and Performance Studies Research Group funded by the Australasian Centre for Italian Studies (ACIS) to examine the representation of violence against women and their resistance to such violence in Italy and beyond and contribute to analysis and understanding of how gendered violence and resistance to it are represented in the arts. A key strand concerned the arts in contemporary Italy, but its scope was broad and encouraged comparison with other societies in order to share significant aspects of the Italian situation with a wider audience, highlight the global scale of the problem, and help identify opportunities for collective resistance. This scope is reflected in the four pieces here, which examine the possibilities that different forms of representation can offer either to reinforce or contest violence against women.

Dentistry and Gender Gap: An Overview of the Italian Situation.

Recently, the issue of the gender gap in dentistry and in the leadership in the dental field has placed new challenges on dental profession representatives and politicians. Indeed, the inequity between genders in healthcare workforces represents a limit to the progression of those in the professions, inhibiting talented colleagues from accessing high positions in the academic world and not providing adequate role models to inspire future generations. The Italian population practicing dentistry in 2021 was composed of 74% males and 26% females. The aim of this study is to analyze the level of the gender gap in the dental field in Italy by focusing on the gender distribution of professional leaders in institutional category associations and invited speakers at dental conferences accredited for the Continue Education in Medicine program. The search strategy considered three different fields in the national dentistry scene: the dental committee boards, the union category associations, and the cultural field. The roles in the dental boards were retrieved from the website of the National Medical and Dental Committee from 2018 to 2022; the roles in the union category associations at the provincial, regional, and national levels were retrieved from the related web pages, considering the period from 2018 to 2021; and the information about the speakers at national conferences from 1 January 2019 to 31 December 2021 was retrieved from the National Agency for Regional Health Services (Agenzia nazionale per i servizi sanitari regionali (AGENAS)) websites. The extracted data were grouped and examined using descriptive statistics (frequency), and due to the categorical nature of the data, non-parametric tests (chi-square tests) were used to assess any differences between the two genders. The null hypothesis was that there were no statistical differences between the two genders' distributions. A p-value was considered significant when <0.05. In addition, aiming to understand the representation of male and female dentists, a comparison of the distributions of males and females in the dental boards with the percentages of female and male dentists operating in Italy in 2021 was performed using a binomial test. The analysis of the data regarding the composition of the dental boards and of the union category association boards revealed a statistically significant difference in the distribution of the roles between the two genders at the regional and local levels, with a p-value of <0.05, and a significantly low representation of the women practicing dentistry (p < 0.05). In Italy, women practicing dentistry are underrepresented in dental organizations and in cultural events, given the low numbers of female dentists in leadership and/or speaker roles in the years 2018-2021. Even though the glass ceiling effect continues to affect Italian female dentists, initiatives and political measures have been taken to improve this condition and reach gender equity.

Interlinguistic Relations and Linguistic Rights in Ukraine and Italy: A First Comparison

Studies on interlinguistic relations and linguistic rights are relevant in the contemporary European socio-political framework and in Ukraine. Since this is our first attempt (2013-14) to handle the issue of linguistic rights in general, and those of Ukraine in particular, the theoretical framework will rely upon the already established international criteria on linguistic rights (e.g. European Charter for Regional or Minority Languages 1992; Ukrainian Constitution 1992 etc.). In this article we shall compare Italian language situation and its approach to minority languages with the Ukrainian experience. Special attention will be paid to the case of the Trentino-Alto Adige / Süd Tirol (Italy) compared with the contested linguistic rights in the Donbass area and Crimea (Ukraine).

A Policy Roadmap for the Energy Renovation of the Residential and Educational Building Stock in Italy

The building sector is crucial in all of the possible net zero scenarios suggested for the European Union. In this area, the Italian situation is exemplary. Italy suffers from an aging and low-performance building stock and needs to increase its annual rate of energy retrofits in order to achieve its 2030 and 2050 targets. Even though since at least 2007, several different incentives schemes intended to stimulate energy-efficiency interventions have been in place, Italy has not been sufficiently able to promote deep retrofits. In 2020, in order to help the economy recover after the lockdowns that were introduced to face the first phase of the COVID-19 pandemic, the existing incentives were increased to up to 110% of investments for interventions that improved the energy class by at least two grades. This so-called “Superbonus” was also extended to the public social housing sector thanks to a credit assignment scheme. Given the results of this provisional phase, a possible policy roadmap for the energy renovation of the residential and educational building stock in Italy is presented in this paper through an analysis of data related to the implementation of current instruments in terms of number of interventions, investment needed, energy savings and evaluation of potential benefits and costs that can derive from an increase in the current deep-renovation rate. Through definition of a long-term renovation strategy, this paper illustrates how market barriers and other issues in instrument design can be tackled and how policymakers can help to develop a sustainable long-term roadmap for energy-efficient buildings. Beyond the residential sector, public buildings, particularly educational buildings, are taken into consideration as well, as they are places of collective use that represent the social values of fairness and sustainability and can therefore have an exemplary role for private initiatives.

At home there are unknown possibilities. A comparative research on oikophobia

This essay presents an overview of the main results of the burglaries research, a little-discussed and studied topic. Collection, organization, and analysis of empirical data have been carried out by two working groups at the university of L'Aquila and at the IULM University of Milan. Research has gone on for twenty years and has accumulated an impressive amount of data, from a comparative perspective and with extensive references to the classics of sociology, criminology, philosophy, political science, and literature. Starting from the Italian situation, comparisons are presented regarding the situation existing in other European countries, because the differences between various areas are very significant. This essay explores also the themes of the relationship between the house and democracy, treated in a sociological tradition that includes authors such as Max Weber and Anthony Giddens. The idea of an unmotivated aversion to one's home environment has had some success in Roger Scruton's use of it.