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Background Since the 60s, the recovery‐oriented approach has greatly influenced mental health policy and practice, and much research has been devoted to exploring it. In the face of a generic definition of the ‘recovery’ construct, to which many articles refer, a closer examination of the literature reveals a plurality of theories and ways about how changes related to the recovery occur and how to evaluate them. Aims This narrative review explores the different definitions of recovery available in the literature, by investigating the adjectives that qualify it and the theoretical construct the adjective refers to. Method From the online databases PubMed, Scopus, Google Scholar and PsycINFO, 43 articles were selected for the review. Results Seven definitions of recovery emerged, each supported by specific theoretical perspectives: clinical, personal, narrative, social, family, cultural and relational recovery. The adjectives refer to theoretical frameworks often very distant from each other and in epistemological competition; nevertheless, many papers assume a reconcilability and possible integration. The authors critically discuss the advantages and risks of considering such different constructs as complementary. Conclusions Keeping theoretical descriptions and models of healing open and plural means enabling mental health practitioners not to monologise discourses of change by imposing their point of view on users. It means supporting users to authentically seek their healing pathways without conforming to clinicians' expectations. It also means abandoning misleading and naive simplifications and strictly using the appropriate terms relevant to the specific healing construct that researchers refer to from time to time. This is particularly important when it comes to the relational component, which seems to be receiving more and more attention in the literature, and about which there is more confusion. Patient or Public Involvement The study involved two experts by experience, or peer support specialists, in a more than active role as components of the research team. They participated equally with the other team members in all phases of the work: the design and conduct of the study, the discussion of findings and advice about implications and dissemination.

Background The start-up of the Turin municipal solid waste incineration plant (2013) was accompanied by surveillance of health effects, which included a human biomonitoring campaign. Here we present the results of the risk perception survey of local residents before the plant went into operation. Methods The survey sample was 394 local residents: 198 residing near the plant (exposed group) and 196 residing in an area distant from the plant site (unexposed group). The survey questionnaire investigated awareness of environmental and health issues, including a section on the perception of environmental health risks. Multivariate Poisson regressions were performed to determine the differences in risk perception between the two groups (exposed vs. unexposed). Results The exposed group was more concerned about natural hazards (prevalence ratio [PR] 1.61; 95% confidence interval [CI] 0.99–2.61), anthropogenic hazards (PR 1.35; 95% CI 1.03–1.77), and waste management (PR 1.19; 95% CI 0.94–1.50). There were no significant differences in opinions about environmental pollution-related diseases between the two groups, though the exposed considered themselves to be at risk for developing these diseases. The survey population placed its trust more in health care providers than in any other category. Conclusions The risk perception survey questionnaire yielded data that enabled a better understanding and interpretation of the social context: residents living near the incineration plant were more concerned than those living distant from it, especially about anthropogenic hazards. This information was subsequently incorporated into the design the communication tools.

Sharing narratives about recovery is a central activity in peer support work. Researchers have so far investigated many issues related to recovery narratives, but have paid no attention to how the building and sharing of one's story are modified during training courses. This study examines the beliefs of participants in the first national training to become Peer Support Worker (PSW), funded by the Italian Ministry of Health in 2022-23, regarding how to craft their recovery story to make it 'professional'. 16 PSWs were interviewed at the end of the course. Implicit theories and beliefs were the focus of the semi-structured interviews. Answers were transcribed and analysed through thematic analysis. The training represents a decisive moment for socialising the 'unwritten rules' about how to build and tell personal experiences. Seven main themes emerged: the story-sharing as the most important tool to understand what happened, as a 'passage' of status that changes the feeling between the person and the story through the presence of others, the need for a method for structuring the story, the emotion control as prerequisite for maintaining the right distance between one's story and the user's story-not imposing oneself on the other's experience, the relevance of acting as strategic story director, accepting stories without happy ending and story-sharing for cultural and social change. Results have been discussed with the contribution of PSW, highlighting the potentials and risks. Training should develop competencies in expressing the story without standardising it, thereby avoiding the reification of the recovery journey into a single version. Story-sharing should not be considered merely as the enactment of a favourable recovery journey; even stories that do not have a happy ending, or that do not adhere to the canons of the 'recovery genre', have dignity and social utility. In a nutshell, the PSW must be helped in becoming the filmmaker of the story rather than the performer of a static script. The PSWs involved played a fundamental role in participating actively by deciding to make available their narratives, reading the results and commenting on them.

The role of the Peer Support Worker (PSW) has gained increasing prominence in mental health services, yet its institutionalisation raises questions about balancing autonomy and assimilation into service logics. This study examines the narrative positionings of three PSWs, focusing on how they construct professional identity in relation to mandate, collaboration with practitioners, and service organisation. A qualitative design was adopted using semi-structured interviews with three PSWs. Data were analysed through Positioning Theory (Davies and Harré 1999) and Bamberg's three-level model (2022), which investigates positioning in relation to temporality, the other and agency. Particular attention was given to positions regarding the professional mandate, collaboration with practitioners, psychiatric and psychotherapeutic practices, and the services in which participants had placements or are currently engaged. PSW positioning emerged as dynamic and multifaceted, constantly negotiated between institutional mandates and fidelity to lived experience. Three configurations were identified: (1) a critical and independent stance, maintaining symbolic distance from services whilst collaborating with them; (2) an integrated stance, balancing institutional logics with attentiveness to user experience; and (3) a fluid stance, affirming the coexistence of PSW and service-user roles and challenging conventional boundaries between clinical and experiential knowledge. Across all narratives, PSWs located themselves in liminal spaces that foster transformative possibilities for mental health services. PSW identity is not fixed but articulated through multiple positionings, ranging from critical autonomy to institutional integration and fluid coexistence of service-user and professional roles. This plurality, rather than constituting ambiguity, represents an epistemic and ethical resource that extends the transformative potential of services beyond the dichotomy of transformation versus assimilation. Recognising this plurality means valuing PSW agency and fostering flexible, participatory practices responsive to the complexity of lived experience. The research team included both academics and PSWs in a co-participatory design initiated through voluntary applications. Only interviews with explicit consent were included. The first draft of the analyses was submitted for participant validation: each PSW reviewed their own transcript and related comments, with the option to modify or expand the analysis. Materials were then shared within the group to enable collective reflection and refinement of interpretation. Through this collective process, the group co-authored the present version of the article. Does not fit.

Resumo O objetivo desta pesquisa foi analisar os pontos críticos para a implementação da abordagem do diálogo aberto na atenção à crise psicótica. Trata-se de estudo qualitativo, utilizando os formulários preenchidos por profissionais de saúde mental que participaram de um seminário sobre a temática, realizado por Jaakko Seikkula em 2015, na Itália. Foram analisados 83 formulários com questões abertas autoaplicadas para detectar o perfil sociodemográfico dos participantes, convidando-os a indicar os pontos críticos da implementação do diálogo aberto. Os resultados foram organizados a partir dos sete princípios da abordagem e analisados segundo o conceito weberiano de tipo ideal de criticidade, sendo dispostos em dois tipos ideais: o organizacional e o cultural. Na percepção dos participantes a transferência dessa modalidade terapêutica para a Itália não parece livre de obstáculos. Os princípios de maior preocupação entre os profissionais enfermeiros e médicos foram: ajuda imediata, rede social, flexibilidade e mobilidade. Diante disso, reflete-se sobre os impasses perante a necessidade de mudar concepções, organizações, saberes e práticas de cuidado em saúde mental comunitária no contexto da desinstitucionalização. Abstract This study sought to analyze the critical points to implement the Open Dialogue approach in psychotic crisis care. This qualitative study was based on the analysis of an open-ended questionnaire developed by mental health professionals who participated in a seminar on the subject conducted by Jaakko Seikkula in 2015, in Italy. Eighty-three self-administered questionnaires were analyzed to detect the participants’ sociodemographic profile and their perception of the critical points of the implementation of Open Dialogue. The results were organized according to the seven principles of the approach and analyzed according to Weber’s Ideal Type into two Ideal Types: organizational and cultural criticalities. In the participants’ perception, the implementation in Italy of this therapeutic modality does not seem obstacle-free. The principles of greatest concern among nurses and physicians were immediate help, social networking, flexibility, and mobility. This paper thus reflected on the impasses regarding the need for a reframing in the conceptions, organizations, knowledge and practices of community mental health care in the context of deinstitutionalization.

When the Turin incinerator went into operation in 2013, it was accompanied by surveillance of health effects that included a human biomonitoring survey of 394 residents. They responded to items investigating their awareness of environmental and health issues and perception of environmental health risks. In this study, we compared the questionnaire responses before plant startup and at 3 years of operation. To accomplish this, we investigated changes in perceived risk and evaluated the efficacy of communication strategies. A total of 344 participants equally distributed in an exposed and an unexposed group responded to the follow-up questionnaire. Survey items investigated the perception of a relationship between illness and exposure to environmental pollution, feeling at risk of developing an illness, and concern about natural and anthropogenic hazards. The proportion of ‘certain’ and ‘very probable’ responses was compared to the total using the difference-in-differences method. Analyses showed an overall decrease in the differences between the two groups, which suggests that the communication actions undertaken for the exposed group were effective. Future communication plans should also include initiatives targeting the unexposed group.

Compared to hosting populations, immigrants are usually considered more vulnerable to communicable diseases, many of which are vaccine-preventable. This study aims to estimate vaccination coverage (VC) and timeliness in children born to women from high migratory pressure countries (HMPC) and to evaluate factors affecting differences with children born to Italian women or women from advanced development countries (ITA + ADC). We retrospectively analysed data of children born in 2009–2014 and resident in areas served by three local health units in the cities of Rome (n = 40,284), Turin (n = 49,600), and Treviso (n = 20,080). Data were retrieved through record-linkage of the population, vaccination, and birth registries. We used the Kaplan-Meier method to estimate VCs at different ages for the 3rd dose of vaccine against tetanus and the 1st dose of vaccines against measles and meningococcal group C. Factors affecting differences in VCs by citizenship were evaluated using log-binomial models. In Rome, VCs at 2 years of age were consistently higher in children born to ITA + ADC women than in children born to HMPC women, while differences in VCs by citizenship varied according to antigen and birth-cohort in Turin and Treviso, respectively. Where differences were observed, these were only partially explained by the mother’s socio-demographic characteristics, level of utilisation of health-services during pregnancy, and maternal, perinatal, and neonatal outcomes. Finally, we observed a reduction of VCs in recent birth cohorts (2012–14 vs. 2009–11), especially in children born to ITA + ADC women. Differences in VCs by citizenship were not homogeneous and varied according to geographical context, antigen, and birth-cohort. These differences are likely to be also affected by informal barriers (e.g., linguistic and cultural barriers), which should be addressed in implementing strategies to increase vaccine uptake in foreign children. Moreover, our results suggest that effective strategies to promote vaccinations in the autochthonous population are also needed.

Only few studies on the health effect of waste incinerators were focused on human biomonitoring (HBM). Our aim is to describe a protocol for assessing early variation of selected items in a population group living close to a waste incinerator in Turin, Italy. A cohort of 394 subjects was randomly selected, among residents near the incinerator and residents far from it. To achieve this sample size, 765 subjects were contacted. The cohort was monitored before the start-up of the plant and will be followed up 1 and 3 years after, with measurements of respiratory function, selected blood and urine parameters including 19 metals, 17 congeners of PCDDs/Fs, 12 congeners of DL-PCBs, 30 congeners of NDL-PCBs, 11 OH-PAHs, specific hormones (T3, T4, TSH, cortisol and ACTH) and common health parameters. The same protocol is applied for plant workers and breeders living near the plant. Individual exposure to urban pollution and waste incinerator fallout were assessed through the use of mathematical models. Information on individual habits was assessed using a specific questionnaire. SPoTT is the first Italian study that adopts a longitudinal design of appropriate statistical power to assess health impacts of waste incinerator plants’ emission. The initial results comparing the baseline to the first follow-up are due at the end of 2016.

Background: This randomized prospective study compared the outcome of circular hemorrhoidectomy according to the Hospital Leopold Bellan (HLB) technique (Paris) with Longo stapled circumferential mucosectomy (LSCM) in two homogeneous groups of patients affected by circular fourth-degree hemorrhoids with external mucosal prolapse. Methods: From December 1996 to December 1999, 80 consecutive patients with fourth-degree hemorrhoids and external mucosal prolapse were randomly assigned to two groups. Forty patients (group A: 18 men, 22 women, mean age 50.5 years, range 21 to 82) underwent HLB hemorrhoidectomy, and 40 patients (group B: 15 men, 25 women, mean age 51.0 years, range 29 to 92) underwent LSCM. Before surgery, all patients were selected with a standard questionnaire for symptom evaluation, full proctological examination, flexible rectosigmoidoscopy, dynamic defecography, and anorectal manometry. No significant differences among the two groups were found. All patients were controlled with follow-up questionnaire and with clinical examination at 1, 2, 4, 12, and 54 weeks after the operation. A postoperative manometry was performed 3 months after surgery. Results: The length of the operation was significantly lower in group B (25 ± 3.1 SD versus 50 ± 5.3 minutes, P <0.001). Mean hospital stay was 3 ± 0.4 days in group A and 2 ± 0.5 days in group B ( P <0.01). Mean duration of inability to work was 8 ± 0.9 days in group B and 15 ± 1.4 days in group A ( P <0.001). Postoperative pain was significantly lower in group B ( P <0.001). Mean length of follow-up was 20 ± 8.0 months in group A and 20 ± 7.8 months in group B. Late complications were similar in the two groups, with 0%, at present, recurrence rate. Conclusions: Our results confirm that both operations are safe, easy to perform, and effective in the treatment of advanced hemorrhoids with external mucosal prolapse. However, the LSCM seems to be preferable owing to the fewer postoperative complications, easier postoperative management, and shorter time to return to work. A longer follow-up is required to confirm the true efficacy of this surgical method.

Background Gastrointestinal nematode (GIN) infection is one of the main constraints to sheep production both in temperate and tropical countries. Economic losses caused by GIN are related to decreased production, treatment costs and even animal death. The present paper was aimed at assessing the anthelmintic efficacy (based on faecal egg count reduction) of moxidectin and ivermectin both admistered per os at dose rate of 0.2 mg/Kg body weight and the benefit of anthelmintic treatments on milk production in a commercial dairy sheep farms in central Italy whose animals were naturally infected by GIN. Results The treatment with moxidectin was highly effective (> 98%) from day 7 until day 75, and effective (90-98%) until day 105. The treatment with ivermectin was highly effective (> 98%) from day 7 until day 14, effective (90-98%) at day 28 and moderately effective (80-89%) on day 45. The milk productions in the treated groups were significantly higher than those of the control group. Conclusion In conclusion, the results of the present study demonstrated that moxidectin and ivermectin adminstered per os according to the manufacturer's instructions were both effective and safe anthelmintics in sheep. The total milk production was higher in the treated groups than the control group. Overall, animals treated with moxidectin had a milk production 40.8% higher than control group; whereas animals treated with ivermectin had a milk production 32.2% higher than control group.