Search

How will the network of Italian mental health services be structured in view of the health care reorganization drawn up by Ministerial Decree no. 77/2022 and by the State-Regions Agreement of December 21, 2022, on the "new methodology for calculating the personnel needs of the National Health System"? Changes concern organizational and structural aspects and the personnel standards needed for the full functioning of the community mental health system. It is undoubtedly a step forward to promote the overcoming of inter-regional inequalities and to quantify personnel needs in an area of public health which in the last decade has seen an increase in the demand for care, made exponential by the effects produced by the COVD-19 pandemic, conflicts and economic crisis. The estimates proposed show that the full application of the standards would lead to an expenditure for mental health equal to 3.6% of the public health funding. [ABSTRACT FROM AUTHOR]

The work and teaching of Franco Basaglia - Italian psychiatrist and neurologist - has shown that it is possible to respond to the needs of people with mental health and addiction problems without applying restrictive measures, or resorting to large depersonalizing institutions, but in a welfare system whose keywords are community, proximity, home care, integrated approach. Today, however, the challenge is on training, where the current contribution of the university does not seem sufficient. There are many skills that require adequate training: from the development of personalized therapeutic-rehabilitative pathways aimed at pursuing goals of capacitation and social inclusion (and not only pharmacological containment of symptoms), to the clinical and psychosocial management of complex cases; from the relationship between psychiatry and justice for offenders with psychiatric disorders, to the relationship with the social policies of local authorities for social and health integration activities.

In this study we examined the characteristics of 60 subjects (49 M and 11 F, average age 32.3) out of 195 post-exposure pharmacological prophylaxis (PEP) to HIV, taken in our hospital from 2001 to 2008. The above-mentioned subjects are sexually exposed (or presumably exposed) to HIV. We considered both their sexual intercourse behaviour and protective measures, and sought to infer some trends in sexual behaviour in Italy. All the subjects were monitored until 180 days after exposure, as established by the national guidelines. Only one of the 60 people presented a seroconversion (he dropped out after a 15-day follow-up and after an inadequate 19-day prophylaxis). Another subject, a homosexual male, never previously tested, resulted positive at time 0 both for HIV-Ab and syphilis tests (due to previous risk-sexual exposure), which caused the suspension of the prophylaxis. No HBV, HCV or syphilis seroconversion occurred. Two other homosexual males showed a previously latent positivity to syphilis tests at time 0.

The production of an effective vaccine for HIV infection is one of the major challenges for the third millennium public health. Here we review published studies addressing the issue of incentives and barriers influencing the choice to participate in a vaccine trial. Currently available literature clearly indicates the need to include psychosocial dimensions in the preparation and implementation of vaccine trials. The underestimation of participants' satisfaction about information communication may lead to non-adherence and to drop-out from the trials. Proper attention to communication skills of professionals involved in participants' enrollment and follow-up is essential to ensure trial success.