The main aim of the study is to critically analyze the impact of defense medicine in the Italian healthcare system, considering the rapid spread of this phenomenon in the last years and its influence in the everyday medical practice. The authors use the Amenable Mortality Index (i.e. the number of premature deaths which could have been avoided in individuals younger than 74 years of age) to rate the performance status of the analyzed healthcare system and to compare different countries and Italian regions. The result of the study is that the Italian health system is valid, despite the economic difficulties of the last years, but much can be done to ameliorate its status. In fact, the authors want to promote a “no-blame culture” as an important factor for the overall improvement of the NHS, focusing only on patients’ health.
Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population’ health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP) as “the process of enabling people to increase control over and to improve their health and well-being”. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society’s sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics.
Genetic testing is a medical tool employed to screen changes in genes linked to cancer and other genetic diseases. Genetic tests are available for breast, ovarian, colon, thyroid, and some other cancers and they represent the main tool for early identification of the “risk” subjects. The choice to undergo genetic testing by a healthy or affected cancer patient with family history of the cancer has to be the fruit of a careful and prudent assessment of the advantages and disadvantages discussed during oncogenetic counselling. The latter, in turn, in the case of a patient's positive and informed choice, must constantly affiliate the genetic testing, in order to preserve the prediction and information role of the test as much as possible.
Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) and its etiology is multifactorial and involves a combination of genetic and environmental factors. The interaction of these factors causes an imbalance in the microbiota, leading to the activation of several immunological and inflammatory mechanisms. From an immunological point of view, there seems to be an involvement of the TIM-3/galectin-9 pathway an of the autoregulation of LyTh1. The studies show that in patients with CD the autoregulation of LyTh1 is lost due to a reduced concentration of galectin-9 and a reduced TIM-3 expression in LyTh1. This could be one of the reasons for the state of perpetual activation in LyTh1, resulting in the chronic inflammatory process.
In the senile population, regular physical activity and reduction of a sedentary lifestyle lead to a series of positive effects. Such as, increased independence in daily activities and personal care, higher self-esteem, a better quality of life, a higher life expectancy and a decrease in mortality. Moreover, physical, psychological, and cognitive functions can also improve. With regards to this notion, the Walking Football (WF) activity was started in England; a sport designed for the needs population segment, who, due to overweight and other typical diseases of old age, has a limited mobility and can only play sports with lowmoderate cardiovascular effort. WF is a new sport mainly created for people over 50, i.e. the population diagnosed with chronic degenerative diseases, and the actual increase of obesity gradually cause to abstain from a regular physical activity. The game is played 7 vs. 7 and all players must only walk; running is considered a foul. To avoid sudden movements and reduce the risk of injury, the ball must be always kept on the ground, and slide tackles and an aggressive behavior are prohibited. This sport, a slow variation of football, is considered a low risk sport activity for the low incidence of traumatic events and can be practiced safely because the cardiovascular effort is minimum. WF comes directly from football, which is considered the most popular sport in the world. It is also associated with positive social and motivational factors that may facilitate compliance to the sport, which help maintain a physically active lifestyle. WF is still not widespread in Italy, and our hope is that it can become, in a short time, a reference for the sports designed for the elderly.
Gratification is one of the functions necessary for the satisfaction of basic needs geared towards welfare and reproduction, which evolved in higher animal species. Over the years, several studies on the mechanisms through which gratification exerts its effects on the nervous system and is associated with feelings of pleasure have shown that the dopa-minergic system is the most important circuit acting as a biological basis for gratification. This article will review the current knowledge on the response of the midbrain dopa-minergic system to appetitive and aversive stimuli, as well as the role played within this context by the Lateral Habenula, a structure that has attracted great interest among re-searchers in the recent years.