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Purpose: To analyse prospective teachers’ interest in global citizenship education (GCE) and the inclusion of GCE-related issues in a teaching programme in Italy.Design/methodology/approach: Administration of an online questionnaire to pre-service teachers attending a course for becoming pre-primary and primary school teachers, and discussion of the main results.Findings: Pre-service teachers are provided with basic discipline-related and pedagogical knowledge that is not directly linked to GCE but allows the implementation of GCE in their classrooms. Findings also suggest the influence on prospective teachers’ self-preparedness and confidence of the learning opportunities that occur in non-formal and informal contexts.Research implications: There should be further analysis of the relations between GCE and students’ interests, their opportunities to learn about GCE, their degree of global engagement, and civic and citizenship education for the enhancement of pre-service training curricula.

Globalization and its impact on contemporary societies have gained new impetus with the notions of global citizenship education (GCED) and education for sustainable development (ESD), considered, together with civic and citizenship education (CCE), as a means for promoting students’ engagement in global/local issues and providing them with the awareness and skills to develop a deeper understanding of, and response to, contemporary issues. Research has shown that GCED and ESD, intended as two interrelated and intersecting fields, have strong associations with CCE and how citizenship is conceived in the post-national and global era. This paper aims to examine the issue of GCED/ESD achievement measurement within the field of civic and citizenship education. Combining analysis of the assessment frameworks and of data from the IEA ICCS (2016, 2022) achievement test (the civic knowledge test ), it discusses the integration of the conceptualization and measurement of student achievement in civic knowledge with an ex-post operationalization and measurement of student achievement in concepts and content associated with GCED and ESD (for ICCS 2016) and subsequently analyses the associations between test items related to the GCED/ESD domain and those related to “the other CCE” domain in ICCS 2022. Results highlighted the progressive relevance of GCED/ESD in the ICCS studies and the blurred boundaries between GCED/ESD and CCE both in ICCS 2016 and 2022. In disentangling the implicit, growing interrelationship among these areas (theoretically and from a measurement perspective), research findings also showed the evolution of the concept of civic and citizenship education itself.

The implementation of global citizenship education (GCE) represents a challenge for the school system in Italy in terms of curriculum planning, teaching methods and contents. After a thorough overview of the Italian educational scenario on GCE, this article aims to present a learning unit on GCE related issues implemented in an Italian 8th-grade class. The study then highlights the educational implications in translating GCE international models into the Italian classroom practice. Its main assumptions focus on the key elements for students' effective learning and on the limitations that characterise the Italian educational system in relation to GCE at the curriculum, school and teaching levels. The implications highlighted in this article are strongly intertwined with the need to plan and implement GCE jointly, within a whole-school approach, and the relevance of the modalities in which GCE instructional contents are selected and presented. (DIPF/Orig.).

Civic engagement represents a key aspect of a democratic society and is itself a multidimensional construct. Research has shown that the promotion of civic engagement is an important component of civic and citizenship education intended in a broad sense, pertaining to formal, non-formal and informal learning situations. Within a national scenario characterised by increasing levels of general institutional disaffection and a lack of electoral and political involvement, the recent reform in the area of civic and citizenship education (Law 92/2019) has led to lively debates on the status of its implementation in Italian schools and recent research at the national level has highlighted the lack of activities to promote students’ engagement. This study further investigates the ICCS 2016 findings on civic engagement of Italian students with two objectives: to identify possible groups of Italian eighth-grade students on the basis of their level of civic engagement and to examine the associations among these groups and some key factors reflecting school contexts and students’ attitudes and behaviours. To reach these goals, the data analyses encompassed a latent profile analysis and a logistic regression model. The latent profile analysis allowed the identification of three groups of Italian students: disengaged, moderately engaged and engaged students. The results of the regression model showed that engaged students were characterised by a higher level of citizenship self-efficacy. These findings confirm those of previous research on the key role of internal self-efficacy in promoting students’ civic engagement.

La formazione professionale in servizio dei docenti di scuola secondaria superiore presenta in Italia alcuni aspetti specifici, riconducibili alla complessità dei contenuti disciplinari oggetto dell’insegnamento secondario e alla parcellizzazione delle attività di insegnamento-apprendimento all’interno del monte orario assegnato al docente reponsabile della singola materia. Recenti studi sulla formazione orientata allo sviluppo della professionalità docente hanno messo in evidenza la necessità di superare sterili contrapposizioni tra lo sviluppo/l’aggiornamento in relazione ai contenuti disciplinari e le questioni educative legate a quegli stessi contenuti, proponendo modelli di sinergia tra questi due elementi un tempo inutilmente contrapposti (Buchmann 1984; Shulman 1986; Neumann et al.,

Introduction Patients with psoriasis (PsO) and permanent spinal cord injuries (SCI) resulting in paraplegia and tetraplegia may experience a higher rate of infections compared to patients with PsO without SCI. It can result in further challenges for therapeutic management with immunosuppressants (biological and non-biological treatments). Thus,  we aimed to evaluate the rate of infections in patients with PsO and SCI treated with systemic immunosuppressants. Methods This multicenter, retrospective observational study enrolled patients with PsO and traumatic SCI undergoing systemic immunosuppressive treatments for at least 5 years. All patients were evaluated by experienced, board-certified dermatologists and neurologists. Demographic and clinical data were collected. Results We enrolled 23 patients with SCI (16 with paraplegia and 7 with tetraplegia) treated with methotrexate (MTX) and different biologics (tumor necrosis factor (TNF) inhibitors (i) and interleukin (IL)-17i/IL-23i). Globally, patients with SCI treated with MTX displayed higher rates of infection compared to those treated with biologics. Patients with paraplegia had lower rates of infection compared to patients with tetraplegia during anti-psoriatic therapies ( p  < 0.05). Those treated with TNFi had greater rates of infection than those treated with IL-17i/IL-23i ( p  < 0.001). Patients with psoriatic arthritis (PsA) experienced a significant diagnostic delay and clinical monitoring of PsA severity was challenging. Conclusion In patients with moderate-to-severe PsO and concurrent traumatic SCI, dermatologists should consider using IL-17i/IL-23i as first-line therapy.

Background Checkpoint immunotherapy unleashes tumor control by T cells, but it is undermined in non-immunogenic tumors, e.g. with low MHC class I expression and low neoantigen burden, such as neuroblastoma (NB). Endoplasmic reticulum aminopeptidase 1 (ERAP1) is an enzyme that trims peptides before loading on MHC class I molecules. Inhibition of ERAP1 results in the generation of new antigens able of inducing potent anti-tumor immune responses. Here, we identify a novel non-toxic combinatorial strategy based on genetic inhibition of ERAP1 and administration of the HDAC inhibitor (HDACi) entinostat that increase the immunogenicity of NB, making it responsive to PD-1 therapy. Methods CRISPR/Cas9-mediated gene editing was used to knockout (KO) the ERAP1 gene in 9464D NB cells derived from spontaneous tumors of TH-MYCN transgenic mice. The expression of MHC class I and PD-L1 was evaluated by flow cytometry (FC). The immunopeptidome of these cells was studied by mass spectrometry. Cocultures of splenocytes derived from 9464D bearing mice and tumor cells allowed the assessment of the effect of ERAP1 inhibition on the secretion of inflammatory cytokines and activation and migration of immune cells towards ERAP1 KO cells by FC. Tumor cell killing was evaluated by Caspase 3/7 assay and flow cytometry analysis. The effect of ERAP1 inhibition on the immune content of tumors was analyzed by FC, immunohistochemistry and multiple immunofluorescence. Results We found that inhibition of ERAP1 makes 9464D cells more susceptible to immune cell-mediated killing by increasing both the recall and activation of CD4 + and CD8 + T cells and NK cells. Treatment with entinostat induces the expression of MHC class I and PD-L1 molecules in 9464D both in vitro and in vivo. This results in pronounced changes in the immunopeptidome induced by ERAP1 inhibition, but also restrains the growth of ERAP1 KO tumors in vivo by remodelling the tumor-infiltrating T-cell compartment. Interestingly, the absence of ERAP1 in combination with entinostat and PD-1 blockade overcomes resistance to PD-1 immunotherapy and increases host survival. Conclusions These findings demonstrate that ERAP1 inhibition combined with HDACi entinostat treatment and PD-1 blockade remodels the immune landscape of a non-immunogenic tumor such as NB, making it responsive to checkpoint immunotherapy.

The combination of chemotherapeutic agents with immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment. However, its success is often limited by insufficient immune priming in certain tumors, including pediatric malignancies. In this report, we explore clinical trials currently investigating the use of immunogenic cell death (ICD)-inducing chemotherapies in combination with ICIs for both adult and pediatric cancers. Given the limited clinical data available for pediatric tumors, we focused on recent preclinical studies evaluating the efficacy of these combinations in neuroblastoma (NB). Finally, to address this gap, we propose an innovative strategy to assess the impact of ICD-inducing chemotherapies on antitumor immune responses in NB. Using tumor spheroids derived from a transgenic NB mouse model, we validated our previous in vivo findings concerning how anthracyclines, specifically mitoxantrone and doxorubicin, significantly enhance MHC class I surface expression, stimulate IFNγ and granzyme B production by CD8+ T cells and NK cells, and promote immune cell recruitment. Importantly, these anthracyclines also upregulated PD-L1 expression on NB spheroids. This screening platform yielded results similar to in vivo findings, demonstrating that mitoxantrone and doxorubicin are the most potent immunomodulatory agents for NB. These data suggest that the creation of libraries of ICD inducers to be tested on tumor spheroids could reduce the number of combinations to be tested in vivo, in line with the principles of the 3Rs. Furthermore, these results highlight the potential of chemo-immunotherapy regimens to counteract the immunosuppressive tumor microenvironment in NB, paving the way for improved therapeutic strategies in pediatric cancers. They provide compelling evidence to support further clinical investigations of these combinations to enhance outcomes for children with malignancies.

Background Postnatal depression is a non-psychotic depressive disorder that begins within 4 weeks of childbirth and occurs in 13% of mothers and 10% of fathers. A prospective study with the aim to evaluate the prevalence of postnatal depression by screening parents with the Edinburgh Postnatal Depression Scale (EPDS) in the Italian paediatric primary care setting was performed. Methods Mothers and fathers of infants born between 1 February and 31 July 2012, living in Italy’s Milan-1 local health unit area, represented the target population of this pilot study. Parents attending well-child visits at any of the family paediatricians’ offices between 60 to 90 days postpartum were asked to participate in the screening and to fill out the EPDS questionnaire. A cut-off score of 12 was used to identify parents with postnatal depression symptoms. Maternal and paternal socio-demographic variables and information concerning pregnancy and delivery were also collected. To investigate the association between screening positivity (dependent variable) and socio-demographic variables and factors related to pregnancy and delivery, a Pearson’s χ2 test was used. Moreover, a stepwise multivariate logistic regression was carried out to evaluate the risk factors that most influence the probability of suffering from postnatal depression. Results In all, 126 out of 2706 (4.7%, 95% CI 3.9–5.5%) mothers and 24 out of 1420 (1.7%, 95% CI 1.0–2.4%) fathers were found to be positive for depressive symptoms. Women with mood disorders and anxiety during pregnancy were at increased risk of postpartum depression (OR 22.9, 95% CI 12.1–43.4). Only 11 mothers (8.7%) positive to EPDS screening attended a psychiatric service, and for 8 of them the diagnosis of postnatal depression was confirmed. Conclusions The prevalence of postnatal depression was lower than previously reported. Routine screening resulted ineffective, since few mothers found positive for depression symptoms decided to attend psychiatric services.

The study describes the spread of carbapenem-resistant Klebsiella pneumoniae (CRKP) in a regional healthcare network in Italy. The project included several stages: (1) Establishment of a laboratory-based regional surveillance network, including all the acute care hospitals of the Marches Region (n = 20). (2) Adoption of a shared protocol for the surveillance of Multi-Drug Resistant Organisms (MDROs). Only the first CRKP isolate for each patient has been included in the surveillance in each hospital. The anonymous tracking of patients, and their subsequent microbial records within the hospital network, allowed detection of networks of inter-hospital exchange of CRKP and its comparison with transfer of patients within the hospital network. Pulsed-Field Gel Electrophoresis (PFGE) analysis has been used to study selected isolates belonging to different hospitals. 371,037 admitted patients have been included in the surveillance system. CRKP has shown an overall incidence rate of 41.0 per 100,000 days of stay (95% confidence interval, CI 38.5–43.5/100,000 DOS), a CRKP incidence rate of isolation in blood of 2.46/100,000 days of stay (95% CI 1.89–3.17/100,000 days of stay (DOS) has been registered; significant variability has been registered in facilities providing different levels of care. The network of CRKP patients’ exchange was correlated to that of the healthcare organization, with some inequalities and the identification of bridges in CRKP transfers. More than 73% of isolates were closely related. Patients’ exchange was an important route of spread of antimicrobial resistance, highlighting the pivotal role played by the hub, and selected institution to be used in prioritizing infection control efforts.