bluuebunny/crossref_metadata_2025 huggingface dataset:
L'accesso ospedaliero: un'esperienza di riorganizzazione secondo l'approccio Lean Thinking
Authors: Mignardi Licia
Published: June 2021

- 013 The objective of making the admission to hospital services more efficient and effective can be pursued using diverse methods and organisational approaches. Lean thinking and theory of constraints - used in industry and manufacturing - have proved to be valuable for business process reengineering also within the healthcare sector. When changing and improving the hospital admission, lean thinking is a radical approach which requires addressing the whole process and not only single components in isolation. Applying the key principle of the Toyota production system, when increasing product/service value for customers/patients, all processes need to be redeveloped. The focus is not only on better hospital admission procedures, but concentrates also on creating a system where each step pulls the patients towards it when it is ready, from discharge backwards. The OLA project (in Italian "Organizzazione Lean dell'Assistenza") developed by the Local Health Authority of Florence shows how industrial systems such as lean thinking can be used to deliver higher quality health care. Relevant achievements are characterised by a strong strategic vision provided and continuously sustained by the executive leadership. Rigorous methodology and constant professional involvement and participation to the project are equally critical requirements.

Keywords: hospital admission; lean thinking for healthcare sector; business process reengineering; efficiency; continuous improvement.
Gruppi di sostegno telematici, pazienti-consumatori e medicalizzazione: il caso delle patologie controverse
Authors: Barker Kristin K.
Published: June 2021

- This article illustrates the role electronic support groups play in consumerdriven medicalization. The analysis is based on an observational study of a year in the life of an electronic support group for sufferers of the contested illness fibromyalgia syndrome. The analysis builds on and extends scholarship concerning the growing influence of lay expertise in the context of medical uncertainty by showing how the dominant beliefs and routine practices of this electronic community simultaneously (and paradoxically) challenge the expertise of physicians and encourage the expansion of medicine's jurisdiction. Drawing on their shared embodied expertise, participants confirm the medical character of their problem and its remedy, and they empower each other to search for physicians who will recognize and treat their condition accordingly. Physician compliance is introduced as a useful concept for understanding the relationship between lay expertise, patient-consumer demand, and contemporary (and future) instances of medicalization.

Keywords: electronic support groups; ICT; health care; medicalisation; fibromyalgia syndrome; contested illness.
La sociologia della malattia in Achille Ardigň e nei classici della sociologia della salute
Authors: Maturo Antonio
Published: June 2021

- This charter describes the main theoretical sources used by Achille Ardigň to develop his theory of sociology of health and illness. The influence of Durkheim might be found in the interest Ardigň has for the nexus between social integration and health. Ardigň recognizes the founding father' role of Parsons in the sociology of health, yet he criticizes Parsons because he is too much concerned with the systemic integration and because he doesn't pay attention on empathy. Moreover, the theory of the sick role is tailored on people suffering only for acute diseases - today, more importance should be given to chronic conditions. Some answers to the weak points of Parsons and Durkheim theories are found in phenomenology and its concepts (empathy, Lebenswelt, Körper). In order to avoid to become too much subjectivist, Ardigň integrates, in his sociology, but only partially, the views of the conflictualistic approaches on illness and social stratification. My final proposal is to consider Achille Ardigň as a very eclectic scholar.

Keywords: Ardigň, sociology of health, empathy, Parsons, Durkheim, Illich.

Parole chiave: Ardigň, sociologia della salute, empatia, Parsons, Durkheim, Illich.
Quale rete sviluppare per superare la crisi del welfare sanitario: la probabile risposta di Achille Ardigň
Authors: Colozzi Ivo
Published: June 2021

- Ardigo's interest for the topic of the opportunities offered by the development of information communication technologies in the field of health services is referred to the question of the overcoming of the crisis of "transation" between welfare system and life's worlds. Moruzzi, who has developed Ardigo's approach on this topic, writes that Internet may be the link between micro and macro if it will be able to differentiate itself by the national health service and to create, thanks to the development of new technologies, a new cooperation between public and private (profit and non profit) actors at the service of the sick person (subsidiarity). In the Introduction to Moruzzi's book, instead, Ardigň says that the development of the social networks of care is more important than the development of new technologies.

Keywords: development, welfare system, health service, technologies, social networks, Ardigň.

Parole chiave: sviluppo, sistema di welfare, servizio sanitario, tecnologie, reti sociali, Ardigň.
Il ruolo dei mondi vitali nella salute
Authors: Guarino Francesca
Published: June 2021

- Achille Ardigň had the prominent role of introducing the concept of Lebenswelt in Italy. By the way, his point of view is nearly peculiar from the methodological individualism adopted by the phenomenological approach as it emerges in sociology and so on, in health sociology. In this contribute the aim is to give some keys to explicate this difference, that is first of all an epistemological difference, starting from the reason that life-world has never assumed by itself, but is always taken in an ideal-typical and historical interaction with social system, including health system. The concept of empathy is consequentially given. By that, the importance of social support in a positive connection with health and life quality can be observed for itself, or as strictly linked with the formal system possibilities, according with Ardigň suggestions. Actually new technology can be the way of doing that. e-Care project, as it is developed for the aged people and with the net support, is a practical example of an innovative interaction between informal social and formal care institutions. The result is an application of a sensate pact between life-world and system, for improving health.

Key words: social support; life-world, social system, empathy, health, social capital.

Parole chiave: supporto sociale, mondo della vita, sistema sociale, salute empatia, capitale sociale.
Achille Ardigň e l'innovazione delle politiche socio-sanitarie negli anni '80 e '90
Authors: Porcu Sebastiano
Published: June 2021

- Sebastiano Porcu reconstructs some aspects of Achille Ardigň's activity, especially during the 80's and the early 90's, in his roles as advisor to the Consiglio Sanitario Nazionale and the Consiglio Nazionale dell'Economia e del Lavoro, to innovate health and social services and policies in Italy.

Keywords: innovation, integration, differentiation, inclusion, old people, social-health district.

Parole chiave: innovazione, integrazione, differenziazione, inclusione, anziani, distretto socio-sanitario
Achille Ardigň e le malattie della povertÀ
Authors: Cevenini Marco
Published: June 2021

I have met Achille Ardigň during a conference promoted by the Brotherhood of the Mercy in Bologna on the illnesses of the poverty and the social exclusion developed him in the 1987. Ardigň had stuck with enthusiasm as Christian and studious man of the social phenomena and with his ability of careful analysis of the phenomena, that nothing left to the vague one but everything he understood in a continuous comparison among opposite demands and you ever discount. It immediately appeared him clear that it was necessary to see the select tides of social and health policies, that favored the refuge of a suffering and marginalized humanity again, rather than to introduce effective intermediary filters, constituted by iintegrated public services of sanitary aid, psychiatric, housing, working. From the conference (and from Ardigň) an articulated thought emerged and defined, whose validity is still actual later almost 20 years; a thought that keeps on not being of easy translation inside our materialistic society, perhaps because it has to the base a defective mechanism, a sin of origin.

Keywords: christian, scholar of social phenomena, Biavati ambulatory, selfexclusion, poverty, solidarity volunteers

Parole chiave: cristiano, studioso dei fenomeni sociali, ambulatorio Biavati, auto-emarginazione, povertÀ, volontari della solidarietÀ.
Ricordando un "Maestro"
Authors: Lorenzi Enrico
Published: June 2021

- I met Achille Ardigň at "his" Postgraduale School in Medical Sociology, attended at the Faculty of Political Sciences of Bologna, and during his period as Extraordinary Commissioner of the Orthopedic Institute Rizzoli (1994-2001), working closely with him during the whole period in which he was Commissioner. I have always regarded this period as the most interesting of my entire career at the Institute, appreciating his political and administrative skills and his testimony as an "adult" believer who knew how to claim at any time, besides the possibility to exercise with responsibly their "gifts" in the heart of the Church community.

Keywords: clipboard, humility, gifts, Catholic, third sector, teacher of life.

Parole chiave: appunti, umiltÀ, carismi, cattolico, terzo settore, maestro di vita.
Ardigň, Commissario Straordinario dell'IRCCS Istituti Ortopedici "Rizzoli"
Authors: Morini Danilo
Published: June 2021

- The author, after remembering Achille Ardigň for his first and youthful opportunity to meet in 1952 and for some joyful moments of relationships between Ardigň and Giuseppe Dossetti in Rossena Castle in 1951, examines and describes the activities of Ardigň as Extraordinary Commissioner of Rizzoli, with particularly regards demonstrated to the needs of the hospital and the establishment and operation of the Mixed Committee for the quality control by the side of the consumers.

Keywords: Achille Ardigň, Extraordinary Commissioner, Rizzoli, hospital, side of the consumers, quality control.

Parole chiave: Achille Ardigň, Commissario straordinario, Rizzoli, ospedale, dal lato degli utenti, controllo qualitÀ.
Un ricordo del prof. Achille Ardigň
Authors: Mengoli Paolo
Published: June 2021

- I met Achille Ardigň at the beginnings of the years '70 in the Sacristy of S. Procolo in Bologna. We were a group of young people, adherent to St. Vincent de' Paul where we weekly met poor and disinherited people, a lot of which sleept in the town dormitory in Bologna. It was the beginning of a service of charity that allowed us young people, to touch with hand so many situations of extreme poverty.

Keywords: charity, immigration, volunteers, marginalized, diseases of poverty, Irnerio-Biavati.

Parole chiave: caritÀ, immigrazione, volontariato, emarginati, malattie della povertÀ, Irnerio-Biavati.
Scritti editi e inediti di Achille Ardigň relativi alla sociologia della salute
Authors: Ricchini Alice , Cavallaro Tommaso
Published: June 2021

- The authors present the result of a deep research of the sources and documents about Achille Ardigň's unpublished and published writings in sociology of health.

Key words: Achille Ardigň, documents, unpublisched writings, published writings, bibliography, sociology of health .

Parole chiave: Achille Ardigň, documenti, scritti inediti, scritti editi, Bibliografia, sociologia della salute.
Le sociologie invisibili
Authors: Scarcella Prandstraller Stefano
Published: June 2021

- In Italy, the acknowledgement of practical relevance and usefulness of the sociological knowledge is still an open problem, in the frame of a general condition of weakness of knowledge workers, both in society and in the labour market. Anyway, beside the "visible sociologies", that is the "official" and legitimate ones, which mainly find place in the academic world and health services, others sociological approches are emerging. These latter are "invisible", because not recognized in specific professional profiles, even if they find place in many different public and private working places.

Keywords: sociology, visibility, professional, legitimate knowledge, association.

Parole chiave: sociologia, visibilitÀ, professionale, saperi legittimi, associazione.
Innovazione ed efficacia: il coinvolgimento del sociologo in una Divisione di Medicina Interna
Authors: Cersosimo Giuseppina
Published: June 2021

- Sociologists' work in hospitals has some deep historical roots, as it is shown by the studies of Goffman, Garfinkel or Strauss. This article points out that the involvement and the capability of health sociologists may result in good ouputs in a division of internal medicine. The sociologist in health setting is needed for civic empowerment, proposals and promotion. Moreover, the medical sociologist creates connections between different resources for individual or collective projects, as also for preventive or innovative undertakings.

Keywords: innovation, effectivness, sociologist of health, empowerment, prevention, hospital.

Parole chiave: innovazione, efficacia, sociologo della salute, responsabilitÀ, prevenzione, ospedale.
La pianificazione socio-sanitaria: ruolo e funzioni del sociologo della salute
Authors: Perino Annamaria
Published: June 2021

- In the first part of the essay, after pointing out the need for an integrated work between social services and health-care services, the topic of planning and defining features, objectives and instruments is introduced. In the second part, referring to an empirical research recently made in Italy, Perino describes the role and functions of the sociologist of health in the processes of planning, with particular attention to critical and unsolved issues. Annamaria Perino suggests that in order to be innovative, the medical sociologist should redefine his/her identity.

Key words: integration, planning, exploration, mediation, reflexivity, sociology of health.

Parole chiave: integrazione, pianificazione, esplorazione, mediazione, riflessivitÀ, sociologia della salute.
Genetic manipulation on human beings
Authors: Zacchigna Serena , Giacca Mauro
Published: June 2021

Since the early days of gene therapy, both the scientific community and the public have perceived the ethical challenges intrinsic to this discipline. First, the technology exploited by gene therapy is still experimental and burdened by important safety issues. Second, in several instances gene therapy aims at stably modifying the genetic characteristics of individuals. Third, the same modifications could in principle be applied also to embryos, foetuses or germ cells. Finally, while gene therapy applications are generally accepted for therapeutic purposes, the same gene transfer technologies could also be exploited to improve the aesthetic appearance, or the physical and intellectual performance of people. The definition of suitable guidelines for a controlled, ethically accepted translation of gene therapy to the clinics remains a major challenge for the near future.
Cloning and stem cells
Authors: Redi Carlo Alberto , Monti Manuela
Published: June 2021

Cloning, the generation of genetically identical individuals, frequently occurs in plants and in several animal groups. Nowadays cloning is technically reproducible thanks to both embryo splitting and somatic cell nuclear transfer thus playing an important role in zootechnical applications (i.e., to increase transgenic animals for drug production) and in biomedicine (i.e, to produce embryonic stem cells in animal models, cybrids, etc.). The relevant historical advancements of these techniques and the related ethical issues are discussed. A brief review of the formation of a new individual as "a process" clearly leads to the impossibility for the biologist to unambiguously determine at which stage a new individual is first formed. However, the application of the scientific method to this issue produces a communal statement independent from ideological or religious opinion: ontogenetically, the material-energetic process originating and identifying a new individual is coincident with the moment in which the first genetically active copy of his genome is formed. Even the critical production of patient-specific stem cells (therapeutic cloning) it is most likely to be superseded and devoided of any ethical concerns thanks to the technical advancements developed by Shinia Yamanaka on the genetic reprogramming of terminally differentiated nuclei. The production of specific cell types might address the therapy of nearly all the pathologies. Noteworthy, starting April 2009 but actually beginning August 2010, the FDA gave green light to the first trial based on the administration of neuronal cells derived from human embryonic stem cells to 11 patients with severe spinal cord injury. Bio-political topics are briefly frameworked within the elaboration of ethical principles and laws that respect multiple values, which are necessary in multi-ethnic cultures.
The Lombroso biologism: a centenary of controversies
Authors: Sidoti Francesco , Gammone Mariateresa
Published: June 2021

In the centenary of his death, Lombroso spreads yet polemics. A Court stated for the first time the juridical relevance of behavioural genetics. Some say Lombroso criminology prelude, without knowing it, the discovery of genetic factors of development and brain function, and thus of the behaviour. Even if sincere supporter of enlightened institutional interventions, Lombroso was wrong from many points of view and polemics show the greatness of science to discuss, recognize, correct his errors and errors of medicine in the time in which he lived. The blunders of Lombroso teach how much caution is needed to assess the results of research. The significance of the biological factor remains a problem and a challenge. Today many fear that after having avoided the medicalization of crime, we can fall into bio-medicalization of crime. In the next centenary, the Lombroso biologism will be seen in the light of the consequences of our ability in applying contemporary genetics breakthroughs.
Why we cannot consider ourselves Darwinists anymore (Why Dunant won over Darwin)
Authors: Cipolla Costantino
Published: June 2021

The new developments in medicine pose serious questions on the assumption of Darwinistic views. Considering the sixty or more operative specialities (and the sub-specialities), the new borders of medicine, at least in the rich Western countries, may be summarized in three main branches: genetic-based medicine, or predictive medicine; regenerative medicine of organs, for an organic life without physical death, even with the death of self-consciousness; adaptive medicine, based on the adaptation to the self-conscious aims of a person, or enhancement medicine. These three kinds of applied science, in different and peculiar ways, put the free game of the natural Darwinistic evolution in crisis turning it on itself.
Qualitative and quantitative methodologies in comparative research: An integrated approach?
Authors: Scambler Graham
Published: June 2021

This paper starts by characterizing conventional notions of quantitative ‘versus' qualitative research and considers their potential displacement by ‘mixed-methods' research. The claim that mixed-methods research is necessarily an advance on its predecessors is critiqued. Using a critical realist approach favouring retroductive and abductive rather than inductive and deductive research strategies, it is suggested that the theoretical dimension implicit in all research is too often neglected. It is further contended that ‘making a case' empirically amounts to much the same things as ‘making a case' theoretically. More ‘metareflection' is commended. Brief references is made to the literature on health inequalities to add some flesh to the bones of the argument.
Using qualitative methods in comparative research
Authors: Barbour Rosaline S.
Published: June 2021

Although quantitative and qualitative approaches are sometimes presented as being in opposition to each other, it is argued that they can, more usefully, be viewed as complementary. Qualitative work can make an important contribution both to pan-European and country-specific comparative research. Most studies have capitalized on qualitative methods at the outset of projects (principally for their ability to develop survey instruments) and, perhaps, less frequently, in order to enhance cultural sensitivity of such tools. However, more imaginative sequencing of methods can pay enormous dividends. Qualitative methods can also furnish hypotheses for investigation in quantitative phases of research studies, and can also be employed in order to better understand the mechanisms linking variables as identified by quantitative work. In particular, qualitative methods can be used to advantage in exploring surprising or anomalous findings. Stand-alone qualitative studies are also valuable, and can address comparison, since they can be harnessed to study change over time or, even, cross-country comparisons. If we are to realize the full potential of qualitative studies in comparative research, however, we need to pay attention to research design issues, seeking to be more imaginative in our sequencing of methods and appreciating the potential of purposive sampling to illuminate comparisons.
Combining data from different sources in Medical Sociology: Chance, problems, and pitfalls
Authors: Geyer Siegfried
Published: June 2021

In this paper it is considered how data from different origins and of different qualities can be combined in order to arrive at a more complete picture of phenomena considered in empirical research. It is shown how qualitative and quantitative data can be compared in meaningful ways, and how they can be analyzed together in statistical analyses. In addition to respondent-based information registry data may be used. This makes it possible to add information that are unaffected from memory distortions, non-response problems and from social desirability bias, but registry information have their particular weaknesses that need to be taken into account. Finally aggregate-level data may be used. Although they are only second best if standing alone, aggregated data may act as contextual information that may be used for performing multi-level analyses. Finally a study on the role of social factors in the course of breast cancer as an example is described where data from different sources are combined in order to tackle complex health-related research questions.
The European Social Survey (ESS) and comparative health research
Authors: Eikemo Terje Andreas
Published: June 2021

The present article represents the first attempt to collect all health-related ESS articles for a systematic review. Although the European Social Survey (ESS) is not primarily a health survey, we have seen an increasing use of data from the ESS in comparative health research in the last few years, and the number is increasing year by year. The present article mainly aims at describing the findings from these studies and to highlight the main methodological differences between these studies. Although a synchronisation of methodological approaches would increase the comparability between ESS studies, the varying approaches are one of the main features that increase the interest in the ESS: both because it improves the robustness of the results, but also because it reflects the flexibility that the ESS offers as a data source. Twenty-one studies using the ESS for health-comparative analyses could be found and the number of studies is increasing year by year. A key result from these studies is that fundamental inequalities continue to exist according to many socio-economic indicators in the Nordic countries despite high living standards and egalitarian policies.
Health care outputs, outcomes and performance: a review of the debate
Authors: Genova Angela
Published: June 2021

Comparative studies on health systems in Europe show growing convergence in terms of general characteristics, while insufficient attention is paid to the overall range of varying welfare policies within which the health systems operate. By developing the theoretical model of health systems, this work puts forward the construction of an analytical approach able to contextualise health policies within the relative welfare systems. It proposes health regimes as an analytical category, defined on the basis of the different roles played by the actors called on to respond to health needs: the state, the market, the services sector and the family. Through a comparative study of a number of indicators, it outlines the four main ideal types of health regime in Europe. The attention on the contexts in which health systems operate makes it possible to recognise and valorise the contribution that the various actors make in responding to health needs, thus promoting a more complete vision for the analysis of health policies in Europe.
Italian Lifestyles and Drinking Cultures
Authors: Collicelli Carla
Published: June 2021

Lifestyles, particularly when it comes to food and beverage consumption, evolve in line with social change in its broadest manifestations. Unsurprisingly, therefore, in recent years Italy has witnessed contradictory trends in this specific field. On the one hand, awareness of and the focus on the importance of a healthy diet and of avoiding excesses are growing. On the other, consumption of unhealthy food, drinks, over-the-counter drugs and psychoactive drugs, is on the rise, primarily in conjunction with the spread of a culture which embraces free time and socializing.
Admonishing without repressing. Promoting self-regulation in responsible and effective policy contexts
Authors: Contel Michele
Published: June 2021

In this article, part 1 explores how the role of emotions, considered as a major factor in shaping individual behaviour is extended to take into account social rules and sanctions. Relying extensively on the notion of emotion developed by Martha Nussbaum as a "form of judgement", a positive outcome of the emotion based theory of health and well being is build around the concept of persuasion, interpreted as rational action based on a weak support of reasons. Good habits - emotionally conveyed, are often better influent than purely rational reasons, a lesson that can turn useful with reference to prevention policies. In part 2 recent reviews on the impact of advertisements of alcoholic beverages are analysed. It results that only a weak connection between advertisement and the decision to drink (or to increase drinking behaviour) is clearly deducible. This in turn does not support strong anti-alcoholic beverages recommendations as frequently happens in many official publications put forward by policy makers and public bodies. Generalisation of risk, in particular, is a negative by-product of these publications that make a point in representing themselves as scientifically underpinned. Part 3 explores theoretically the relationship between self-regulation and norm. It outlines an attempt to design approaches to prevention that are both non repressive and effective. Exploiting the notion of reflective judgement, as originally expressed by Kant, the category of "example" and "exemplary action" is alluded to in order to develop policy paths inspired by the basic idea that public power has everything to gain from facilitating positive persuasion networks when creating regulatory and practical processes to oppose substance abuse, compared to repressive or punitive choices addressed at criminalising behaviour involving abuse, unilaterally placing the responsibility on the subject, perceived as the transgressor of a consolidated rule.
Salute, vulnerabilitÀ e fragilitÀ: fra determinanti e disposizioni
Authors: Niero Mauro
Published: June 2021

Boundary lines between medicine and social sciences have often been crossed in either direction during the course of their history. Lately the re-discovery of social determinants in health inequalities recalls the tradition of the socio-medical inquiries that that characterized the XIX and the XX century, while the epidemiological scenario of the latter has long included social daily life functioning in the evaluation, prevention and care of most important chronic diseases. Vulnerability is a new concept for the explanation of health inequalities. It is not a causal but a dispositional concept so it triggers events under certain environmental circumstances; it is systemic in its essence, being complementary to resilience; it was first applied to the socio-ecological environments of the third world. It was recently regarded as suitable for the western post-modern risk societies in health sociology in particular by describing both systems undergoing fatal shocks (i.e. pandemic/epidemic risk fatalities) as well as vulnerable trajectories throughout individual course of lives. By including basic factors such as social determinants of inequality vulnerability contends with frailty its importance in medical sciences, while, as a disposition, it is increased or decreased by socio-structural as well as individual action. Its inclusion in health sociology studies requires middle range theories such as those on coping and on social capital both at the individual and community level.
Vulnerability, change and social dynamics
Authors: Bertin Giovanni
Published: June 2021

Experts have demostrated the importance of social determinants for human health. People in need are the most vulnerable because they are more frequently exposed to social risks and have less social resources for dealing them. Social vulnerability affects health through a multifactorial process. Exposure to risks, stress, social-evaluative threats and low social cohesion are related to each other as well as with social inequality.
Determinanti sociali, stili di vita e stato di salute
Authors: Campostrini Stefano
Published: June 2021

The link between social determinants, risk factors and health outcome is globally quite demonstrated. Much research is still needed to better understand the mechanism underneath these relationships. Although, study is still needed to define better measures of social determinants (both in relation to health outcome and risk factors), already existing data collection system on risk factors - surveillance - can offer several information on these relationships. Particularly, the observation of changes over time and trends can offer unique information on the effectiveness of health promotion programs and policies in decreasing (increasing) health inequalities.
Benessere tra differenze e disuguaglianze di genere in salute
Authors: Biancheri Rita
Published: June 2021

Up to now, in the traditional biomedical paradigm the terms "sex" and "gender" have either been used synonymously and the insertion of gender among the determining elements of conditions of wellbeing/disease has been difficult, and obstructed by disciplinary rigidities that retarded the acceptance of an approach which had already been largely found to be valid in other areas of research. The effected simplification demonstrated its limitations in describing the theme of health; but if, on the one hand, there has been a growing awareness of a subject which can in no way be considered "neutral", on the other hand there continues to be insufficient attention, both in theoretical analysis and in empirical research, given to female differences. The article is intended to support that the sick individual is a person, with his/her genetic heritage, his/her own cultural acquisitions and personal history, and own surrounding life context; but these and similar factors have not traditionally been taken into consideration by official medicine and welfare systems, despite a hoped-for socio-health integration.
Well-being: between gender inequalities and health
Authors: Biancheri Rita
Published: June 2021

Up to now, in the traditional biomedical paradigm the terms "sex" and "gender" have either been used synonymously and the insertion of gender among the determining elements of conditions of wellbeing/disease has been difficult, and obstructed by disciplinary rigidities that retarded the acceptance of an approach which had already been largely found to be valid in other areas of research. The effected simplification demonstrated its limitations in describing the theme of health; but if, on the one hand, there has been a growing awareness of a subject which can in no way be considered "neutral", on the other hand there continues to be insufficient attention, both in theoretical analysis and in empirical research, given to female differences. The article is intended to support that the sick individual is a person, with his/her genetic heritage, his/her own cultural acquisitions and personal history, and own surrounding life context; but these and similar factors have not traditionally been taken into consideration by official medicine and welfare systems, despite a hoped-for socio-health integration.
Diseguaglianze sociali di salute: lo stigma
Authors: Lonardi Cristina
Published: June 2021

This essay offers a reading of the social inequalities in health through the Health Related Stigma perspective, explaining its different meanings and its deeper implications in the lives of those affected by stigma.
Social capital and health
Authors: Tronca Luigi
Published: June 2021

This paper provides a sociological overview of the concept of social capital and explores how it is related to the notion of health. The theoretical section of the study addresses the issue of an operational definition of social capital and conducts detailed analysis of the dimensions and forms of the concept that stand out in terms of importance in the field of health research. It also takes into consideration the most significant causal mechanisms identified between social capital and health outcomes. The empirical part of the paper features analysis of data on the connection between social capital and self-perceived health, collected during the first survey conducted in Italy by the Osservatorio sulle Strategie di Consumo delle Famiglie (Observatory on Consumption Strategies in the Family). The survey shows that community social capital, generally expressed in terms of family trust, may, depending on the subject's social milieu of origin, not play any role in determining the level of self-perceived health in Italy. Alternatively, it may play either of two roles, acting as a multiplier or a substitute with regard to positive causal processes determined by parameters of a socio-demographic nature.
Frailty, theory and practice: from a project aimed at identifying determinants of clinical fragility and social vulnerability in order to suggest improving approaches to high risk populations
Authors: Apolone Giovanni , Greco Maria Teresa , Roberto Anna
Published: June 2021

The study titled "Economic and financial sustainability of healthcare services, equity, and quality of care: objectives pursued through a strategic alliance between healthcare, research, and the general public" launched the project "Frailty- Vulnerability in Health", based on the hypothesis that social variables may also affect access to health care. A pilot study was conducted on a sample of patients of a general practice and, from its results, a more extensive study was designed to identify the epidemiology of frailty and vulnerability and to evaluate health service access indicators. This article focuses on the pilot study's results and on the design of the main study.
Healthcare Governance and Voluntary Associations in Italy: an Overview
Authors: Fazzi Luca
Published: June 2021

This article develops a theoretical and empirical understanding of the governance processes between voluntary organizations and public health institutions in Italy. In theory, governance process allows to mitigate coordination failures between the public and voluntary agencies and to improve service delivery through community engagement. The article shown that governance between public and voluntary sector can produce very different levels of democratization and improvement of health and social programs. In some conditions, it may be that valorizing the voluntary sector can effectively renew and improve health policies, while in others the exact reverse may happen. The article offers an analysis of the main factors that influenced this result.
Democratic paradigm and participation in the health sector: the Tuscan case
Authors: Cervia Silvia
Published: June 2021

During the new modernity, with the emergence of the question of the democratic deficit in health-care, we have seen the spread of new forms of participatory regulation. However, that this goal has been reached cannot be taken for granted, especially when one considers that these practices are often promoted by dominant players in the field and how they tend to maximise their profit. This article aims to expose the rhetoric of participation in the institutional practice in the Tuscan Region analysing its effects in relation to the redistribution of power in the decision-making process.
From Autoreferentiality to Interdipendence: healthcare, social welfare and local service's governance in Sicily
Authors: Severino Sergio , Di Venti Paolo
Published: June 2021

This paper argues a critical reflection about the dynamics of the Sicilian Health System. The analysis of its internal reforms shows the effort to achieve a gradual decentralization of management and control bodies. It was conceptualized as a de-generalization process, described starting from the von Bertalanffy's General Systems Theory. This latter allows to fit the concept of complexity to the social systems dynamic's, characterized by specific rules and standards aimed to an ever new fitting to the environment.
The Social-Health information System of Ausl Piacenza: the model, the choices and the development course
Authors: Soro Giovanni Maria
Published: June 2021

The social-sanitary integration depends on the capacity to disegn a clear organization and to implement efficient operations system. The Sociosanitary Information System of AUSL Piacenza, based on the regional strategy and governance, would be a proposal to have a positive answer for these managerial needs. The operating model determines a new approach about health territorial services across a unitary path with the stakeholders.
Citizens participation in South European countries health systems: Italy, Portugal and Spain
Authors: Serapioni Mauro , Dolores Sesma , Lopes Ferreira Pedro
Published: June 2021

The purpose of this study was to analyse the health systems in Spain, Italy and Portugal from the perspective of the Southern European countries Social Protection. Through a review of the sanitary regulations, health plans and literature on specific health experiences, published in recent years in Spain, Italy and Portugal, the practices of participation, in these three countries, were studied. Some of the research results are noteworthy: a) Citizens' participation in the decision making process on health has become the focus of attention of the public policies only after the 1990; b) there has been a significant progress in the regulatory framework and in the acknowledgement of users' rights; c) the development and implementation of participatory mechanisms were insufficient and limited to certain regions.
Un paradosso francese secondo gli epidemiologi. Sullo sviluppo della Sociologia della salute in Francia
Authors: Calvez Marcel
Published: June 2021

The article discusses a paradox pointed out by epidemiologists and consisting in the quasi-absence of French sociologists in research on social determinants of health whereas references to Durkheim and Bourdieu are central in that field. It considers the handbooks of medical sociology and sociology of health published since the 1970s and gives an overview of the theoretical frameworks in use in French sociology of health. It examines the formation of this orientation in three periods to which correspond three layers of research topics and approaches: the foundation in the 1960s in which American medical sociology compensates partly the limitations of French sociology, the institutionalization in the 1970s marked by a firm orientation towards qualitative sociology, and the consolidation during the Aids years. These orientations are replaced in their institutional context and related to strategic choices made by researchers.
Development of Sociology of Health: a review of the contexts and phases, themes and future in India
Authors: Akram Mohammad
Published: June 2021

Health is multi-dimensional and its determinants are not just bio-medical, but also socio-cultural and politico-administrative. Sociology of health developed in twentieth century as a specialized branch of sociology to address the widening health needs of human population. Sociology of health in India passed through several phases and complemented as well incorporated disciplines often identified as medical sociology and sociology of medicine. Parsonian system theory, interactionist perspective, conflict approach, phenomenological approach and empiricism have lasting impact on various researches conducted in India in last six decades. This paper is analytical in nature and focuses on four aspects: (i) development of sociology of health as an independent branch of sociology; (ii) three phases of its development in India; (iii) contexts and popular themes; and (iv) its future.
Autodeterminazione, best interest e nuove evidenze diagnostiche nei casi di stato vegetativo e di minima coscienza
Authors: Zullo Silvia
Published: June 2021

Recent studies on patients in a vegetative state undergoing functional magnetic resonance imaging have allowed to better differentiate the vegetative state from the minimally conscious state and have shown the possibility that in the future we can detect the permanence in these patients of islands of consciousness. Such evidence might further increase the legal and moral dilemmas raised by these cases, since the scientific future advancements will make increasingly complex to apply the principle in dubio pro vita on the patient who provide signals in a reverse direction.
Con e per il consenso informato alle cure
Authors: Pelotti Susi
Published: June 2021

The concept of informed consent is revisited in the light of the new development toward the model of "shared decision making". Consenting practice is not a defense against ligation or a formal procedural step, but it represents a process for helping patient to make a choice through a new relationship in which clinicians and patients work together using clinical evidence and patient's informed preference. Shared decision making is considered an ethical imperative, but is not yet the norm. Validated decision supports and training are needed for its implementation.
Tra "droghe intelligenti" e antidepressivi: un'analisi culturale sull'utilizzo di farmaci tra gli studenti universitari
Authors: Collin Johanne , Simard Julien , Collin-Desrosiers Hugo
Published: June 2021

In recent years, there has been a growing concern for the non-medical use of prescription drugs by young adults, e particularly college e university students. These expanding practices of pharmaceutical drug use have been associated with different phenomena such as physical e cognitive enhancement, non-medical prescription drug use e recreational use. All of these various consuming practices involve a blurring of the boundaries between curing, preventing e enhancing e between recreational e productive activities. Some studies show the importance of linking pharmaceutical drug use with broader issues among students in academic settings, such as competitiveness, pressure, stress, depression e mental health issues. The main objective of this article is to explore some of the perceptions e rationales that underlie the use of non-medical e medical prescription drugs, natural products, energy drinks e other pharmaceutical or natural substances among university students in Montreal (Canada). Focus-groups e indepth, semi-structured interviews were realized with a sample of 42 students in order to link the consumption cultures of the participants with other variables, such as their lifestyle, their experience of psychological distress e anxiety e their need of achievement. Focusing on the young population fulfills the function of sociological forecast about the future trends in the expansion of pharmaceutical drug use for the management of everyday life in contemporary Western societies.
Consumatori ambivalenti. Uso strategico di farmaci e gestione dell'identitÀ tra studenti universitari con ADHD
Authors: Loe Meika , Cuttino Leigh
Published: June 2021

Drawing on interview data, this article examines how college students experience "the medicated self" in the context of ADD/ADHD. We find that many ADHDdiagnosed students taking psychostimulants are ambivalent users, who actively construct how they are shaped by the behavioral effects of medicine. Pharmaceutical enhancement may be perceived by students as necessary in the context of a competitive academic ethic. In this context something akin to Annette Lareau's concept of concerted cultivation can thrive, as students themselves practice what we call concerted medicalization in an attempt to literally embody the academic ideal. However, while medicine may enable students to manage academic performance and take control of "disordered bodies, many remain uneasy about the extent to which they feel controlled by a drug. In the context of medical ambivalence, ADHD students engage in reflexive identity management and strategic pharmaceutical use to achieve some semblance of self control and self preservation during their college years. As their college education comes to a close, many prepare to return to what they construct as their authentic, non-medicated selves as they enter the work world.
Potenziamento della capacitÀ mentale? Dalla medicalizzazione della cognizione alla farmacologizzazione delle routine mental life
Authors: Coveney Catherine , Gabe Jonathan , Williams Simon
Published: June 2021

Sociological engagement with debates around the promise, problems and prospects of pharmaceutical cognitive enhancment is still at an early stage. In this paper we attempt to explore how the prospect of cognitive enhancement can be understood using existing sociological concepts of medicalisation, biomedicalisation and pharmaceuticalisation. Drawing on two case studies, that of Mild Cognitive Impairment (MCI) and the use of modafinil to enhance alertness, we discuss the idea of enhancement medicine and the use of cognitive enhancers outside of medical authority. We suggest that whilst all three of the above concepts shed important light on these developments, overlapping and converging as they do in various ways, pharmaceuticalisation provides a more precise sociological term of reference. We end with some suggestions for a research agenda for tracing and tracking trends in pharmaceutical cognitive enhancement over time.
Social Justice and Human Enhancement in Today's Bionic Society
Authors: Maturo Antonio
Published: June 2021

The use of substances that improve cognitive abilities is now more and more common in many countries. These treatments are not aimed at curing pathologies, but rather at enhancing normal human capabilities, i.e., people are using pharmaceutical products to alter their biological makeup. The following article investigates this phenomenon and questions the role of the State in relation to this practice. The article concludes with an explanation of why the State, unlike what some bioethicists have proposed, should not support the use of cognitive enhancers.