ABSTRACT
Specific Learning Disorders (SLDs) affect specific abilities in individuals with an otherwise normal academic development. Among Italian School population, their reported prevalence is between 2.5% and 3.5%. Dysfunctions at the base of these disorders interfere with the normal acquisition process of reading, writing and/or mathematical abilities, leading to various degrees of adjustment difficulties in the affected individuals. The aim of this study was to assess the support that Italian Government offers to its citizens affected with SLDs, with a particular focus on assistance during the school-age years, particularly through the introduction of the Law 170/2010 and successive guidelines, supplementing the existing regulations to offer more efficient means and legal instruments aimed at achieving earlier diagnoses.
Subject(s)
Disabled Persons/legislation & jurisprudence , Specific Learning Disorder/rehabilitation , Child , Disabled Children/legislation & jurisprudence , Dyslexia , Early Diagnosis , Humans , Italy , Male , PrevalenceABSTRACT
Road traffic accidents (RTA) are a serious issue in all industrialized countries and have dramatic social and healthcare-related implications. Fatigue (sleepiness) is the principal identifiable and preventable cause of road traffic accidents. Obstructive sleep apnoea syndrome (OSAS) and narcolepsy are two of the leading causes of excessive daytime sleepiness. In this article, the authors analyze the current Italian legislation regarding driving licence issuance and fitness to drive, in order to evaluate the potential implications of sleep disorders, particularly OSAS and narcolepsy. In European Legislation and in Italy, OSAS and narcolepsy are not included among the illnesses or invalidating conditions that limit the fitness to drive for driving licence issuance purposes. In fact, they are not included in the Annex III of the European Council Directive 91/439/EEC of the 29th of July 1991 on driving licences. Some Countries of the European Union (Belgium, France, Finland, Great Britain, the Netherlands, Spain and Sweden) had implemented the 91/439/EEC Directive with national restrictions on driving licence issuance policies in case of OSAS and narcolepsy. Given the well-established scientific evidence available, in Italy, the lack of legislation regulating the assessment of the psychophysical requisites for the issuance and renewal of driving licences of individuals affected by sleep disorders seems extremely worrying. Furthermore, the current lack of legal obligation in Italy for healthcare facilities to disclose such diagnoses to the organs responsible for issuing driving licences (such as the Motorizzazione Civile - the Department of motor vehicles) remains the subject of heated debate.
Subject(s)
Automobile Driving/legislation & jurisprudence , Disorders of Excessive Somnolence/diagnosis , Health Policy/legislation & jurisprudence , Narcolepsy/diagnosis , Policy Making , Sleep Apnea, Obstructive/diagnosis , Accidents, Traffic , Disorders of Excessive Somnolence/prevention & control , European Union , France , Humans , Italy , Sleep Apnea, Obstructive/prevention & control , Spain , United Kingdom , WakefulnessABSTRACT
A fourth case of symptomatic porphyria associated with hemodialysis for chronic renal failure is reported. Subepidermal bullous dermatoses of patients who have undergone hemodialysis have not usually been associated with elevated porphyrin levels. However, this patient and three previously reported cases have been found to have abnormal porphyrin study results in association with skin lesions typical for porphyria cutanea tarda, occurring after hemodialysis. Hemodialysis does not effectively decrease circulating plasma uroporphyrin levels, although some dialysis of uroporphyrin into the dialysate could be measured in this case. Evaluation of bullous or porphyrialike dermatoses in patients treated with hemodialysis should include adequate testing for increased porphyrin levels.
