Bioethics in Italian Medical and Healthcare Education. A Pilot Study.

BACKGROUND AND AIM OF THE WORK: Bioethics is relevant in healthcare and medical schools. However, unlike other foreign countries, its teaching in Italy has only been recently introduced, it is less extensively offered and no academic standards for bioethics education have been established. This research aims at understanding whether university bioethics courses attendees appreciate and consider teaching strategies to be effective with the objective of validating a coherent didactic approach to the discipline and stimulate further discussion on ways to improve it. METHODS: A standardized survey was administered to 1590 students attending undergraduate degree programs in medicine and healthcare at four Italian universities. RESULTS: The majority of interviewees (92.5%) had an interest in bioethics, considered it to be important for any life-sciences-related program (73.5%) and most healthcare (77.2%) and medical students (69.2%) suggested its teaching should be included in their curricula and made mandatory (66.3%) and continuous (57.7%), given its usefulness in clinical practice. Students consider bioethics as a care-integrated practice and appreciate teaching methods where it is integrated into clinical cases. Conceptual specificity and interdisciplinarity may affect the learning process and contribute to enhance students' analytical skills. CONCLUSIONS: Italian bioethics education should be revised to meet students' expectations and preferences. Its complex, multi-disciplinary and transversal nature suggests bioethical education to be flexible and integrated among different disciplines, thus stimulating a broader critical capacity through cases studies and other interactive teaching methods for helping students better deal with bioethics-inherent difficulties and improve the learning process.

Mortality among workers exposed to asbestos at the shipyard of Genoa, Italy: a 55 years follow-up.

BACKGROUND: Exposure to asbestos remains a global issue due to its massive use in the twentieth century and its long environmental persistence. Exposure to asbestos still occurs during dismantling of ships and vessels, buildings renovation, mining operations, and is reported in developing countries. Current estimate report exposure of hundreds of million people in occupational settings in countries where its use remains unregulated. METHODS: We conducted a historical prospective cohort mortality study aimed at estimating mortality from specific causes, the temporal changes of pleural and lung cancer mortality, and the attributable fraction (AF) of lung cancer deaths following asbestos exposure. The study included 3984 shipyard workers employed at the shipyard of Genoa, Italy, between 1960 and 1981 and followed up to December 2014. Standardized Mortality Ratios (SMR) and their 95% confidence intervals (95%CI) were computed. RESULTS: Overall deaths recorded were 3331 (83.6%). Excess mortality was observed for all cancers (SMR = 127, 95%CI:120-134), pleural mesothelioma (575, 469-697), cancers of the larynx (183, 134-244) and of the lung (154, 139-170), and for respiratory tract diseases (127, 114-141), including asbestosis (2277, 1525-3270). Ninety out of 399 deaths (22.6%) from lung cancer were attributed to asbestos exposure. The estimated lung cancer AF was 49.3% in workers with the highest SMR for pleural cancer. Median latency times for pleural and lung cancer were 42.8 years (minimum latency: 9.3 years) and 38.7 years (minimum latency: 6 years). The peak of mesothelioma incidence, expected in Italy in the period 2015-2024, was confirmed. CONCLUSIONS: The long follow-up period of our study allowed the detection of a substantial disease burden following asbestos exposure. These findings support the urgent need for the prevention of asbestos related diseases through the implementation of asbestos ban worldwide, including those countries where asbestos is still mined, manufactured and used.

Occupational exposure to formaldehyde and biological monitoring of Research Institute workers.

AIM: The aim of this study was to verify the presence of a relationship between formaldehyde exposure in the work environment with biological markers of exposure and of effect. METHODS: Exposure to formaldehyde (FA) of 36 workers in different laboratories of a Cancer Research Institute and biomarkers of exposure, such as formaldehyde human serum albumin conjugate (FA-HSA) and biomarkers of effect, such as chromosome aberration (CA), micronuclei (MN) and sister chromatid exchanges (SCEs) were measured in peripheral blood lymphocytes of the same workers. RESULTS: Individual FA levels of exposure ranged from 4.9 microg/m(3) to 268.7 microg/m(3). Subjects with high FA exposure showed a significant increase of the biomarker of exposure FA-HSA, but biomarkers of effect did not show any significant differences. CONCLUSIONS: A significant relationship was observed between occupational exposure to FA and a biological marker of exposure (FA-HSA). The markers of effect used (CA, MN and SCE) failed to indicate the presence of genetic damage.

[From research to users: the Worksafe European Project and the IST-Gaslini Prevention and Safety Project]. / Dalla ricerca all'utenza: il progetto Europeo Worksafe e il progetto IST-Gaslini "Prevenzione & Sicurezza".

OBJECTIVE: The Worksafe Project aims at increasing access to and use of the large amount of data related to the broad sector of health protection of workers and workplace safety recognising the key role of the communication and dissemination of the research results with particular reference to cancer. PARTICIPANTS: Four scientific institutes: National Institute for Research on Cancer, Genoa (IST); Finnish Institute of Occupational Health (FIOH), Helsinki; Karolinska Institutet (KI), Stockholm; International Agency for Research on Cancer (IARC), Lyon, and two technological partners (Softeco Sismat, Genoa; Fundacion Robotiker, Bilbao). RESULTS: The creation of the Worksafe portal, a web based infrastructure that allows knowledge sharing on top of a distributed digital data collection and provides web accessed services addressing a broad interested audience including biomedicine companies universities, research institutions, local and national public organisations and private users.