The Ministry of Health (Italian: Ministero della Salute) is a governmental agency of Italy. Its headquarters are in Rome and is led by the Italian Minister of Health.The Ministry developed the Italian Food Pyramid (Piramide Alimentare Italiana) to guide food and meal planning. The divisions show healthy intake of water, fruits and vegetables, starches (bread, biscotti, pasta, etc.), protein (meat, cold cut meats, eggs, fish, etc.), milk and dairy, and occasional uses (oils, sweets, and alcohol). The pyramid is intended to represent the variety of foods eaten over an entire week, averaged into daily portions.An example of their legislation is the Italian Device Registration to meet (and exceed) the EEC's Medical Devices Directive..
Klebsiella pneumoniae is a major cause of bloodstream infections worldwide and is increasingly associated with multidrug resistance, particularly to carbapenems and colistin, which severely limits treatment options. This study investigated the genomic epidemiology of K. pneumoniae bloodstream infection (BSI) isolates collected in Thailand between 2020 and 2024. A total of 227 K. pneumoniae BSI isolates collected nationwide through the National Antimicrobial Resistance Surveillance Center, Thailand were subjected to antimicrobial susceptibility testing and whole-genome sequencing, followed by multilocus sequence typing, AMR gene detection, plasmid profiling, virulence scoring, phylogenetic analysis, and genotype–phenotype correlation. Among the isolates, 199 were resistant to carbapenems, seven were resistant only to colistin, and 21 were not resistant to either carbapenems or colistin. Three high-risk sequence types (ST) (ST16, ST147, and ST231) predominated in most regions, whereas the south showed greater clonal diversity. ST16 isolates commonly co-harbored blaNDM−1 and blaOXA−232 and had high rates of carbapenem and colistin co-resistance. ST231 isolates exhibited carbapenem resistance along with rmtF1-mediated aminoglycoside resistance, whereas ST147 isolates demonstrated high genomic plasticity and resistance diversity. Rare ST isolates carrying mcr genes and hypervirulent ST23 and ST268 lineages were also identified, with ST268 resistant to all carbapenems tested. These findings highlight the dissemination of high-risk clones in Thailand and underscore the need for real-time genomic surveillance and molecular diagnostics to inform infection control and national AMR strategies.
Background Despite increasing awareness of socioeconomic status’s (SES) association with health outcomes, there is no widely accepted and rapidly implementable estimation of SES measures in resource-limited settings. An exception is the Demographic and Health Surveys (DHS)’s wealth quintile index constructed from household ownership assets. To facilitate health equity surveillance, method of individual SES estimation requiring fewer number of household assets is needed. The objective of this study was to identify the DHS assets most relevant for measuring SES in Cameroon. Methods Participants interviewed with a structured questionnaire included stakeholders involved in the design and implementation of DHS in Cameroon for many years. Using a 5-point Likert scale, experts graded DHS assets’ likelihood to measure SES. The questionnaire was strongly reliable (Cronbach’s alpha: 0.943, 95% CI: 0.920–0.961, p < 0.001) for using the 29 items retained to measure SES. Results The probabilities of agreeing that an asset can be a useful measure of SES varied from 0.016 to 0.047. The 12 DHS assets most likely to measure SES included having Refrigerator(85.3%), Television(83.8%), Laptop(79.4%), Mixer(77.9%), Computer(77.9%), Agricultural land(77.9%), Cable/Satellite(76.5%), Cell phone(76.5%), Modem/Internet key(73.5%), Water pump(72.1%), Car/truck(72.1%) and Gas stove(72.1%) with a respective probability (prior) of 0.047, 0.046, 0.044, 0.043, 0.043, 0.043, 0.042, 0.042, 0.041, 0.040, 0.040 and 0.040. Conclusions This research underscores the importance of integrating local expert insights to refine the measurement of SES, promoting improved health outcomes in populations, particularly in Cameroon. Future research should explore the application of this expert-opinion-driven framework in various contexts to create more comprehensive, robust, and reliable SES indicators.
Neurosurgical education is shifting toward methods that foster clinical reasoning and decision-making beyond traditional lectures. Small group discussions (SGD) promote collaborative learning, while clinical preceptorships (CP) offer individualized, hands-on training. However, limited research has compared their effectiveness in undergraduate neurosurgical education. This study evaluates the impact of CP and SGD on knowledge acquisition and clinical preparedness among sixth-year medical students. In 2024, a quasi-experimental study involving 48 participants was conducted, including 31 sixth-year medical students assigned to either CP (n = 15) or SGD (n = 16), and 17 recently graduated physicians who served as the control group. Both groups completed pre- and post-intervention assessments that covered neurosurgical theory and clinical scenarios, based on the minimum requirements set by the Medical Council. Post-intervention outcomes were analyzed using t-tests. Correlation analysis examined the relationship between time and topic-specific retention. The control group consisted of interns rotating in the department of surgery who trained via the traditional method. Post-intervention, both CP and SGD improved post-test scores. The SGD format required 1.5 h for 5–6 students, whereas the CP format required 1 h per student, with this difference being statistically significant (p < 0.001). CP students, however, significantly outperformed SGD in CT interpretation (85.0
BackgroundSpatial neglect is a common and disabling cognitive consequence of stroke, associated with reduced functional independence, prolonged hospitalization, and increased healthcare and societal burden.ObjectiveThe aim of this paper is to describe the development of a Clinical Practice Guideline (CPG) for the diagnosis and treatment of spatial neglect in stroke patients.MethodsThe guideline was developed by an interdisciplinary expert Panel following the GRADE approach, supported by systematic reviews of the literature. Four clinical questions addressed the effectiveness of prism adaptation therapy (PAT) and visuospatial training (VST), optimal timing of treatment initiation, and the accuracy of neglect-specific versus generic ADL assessment tools.ResultsEvidence from randomized controlled trials indicates that both PAT and VST yield small, short-term improvements in ADL performance and neglect severity; however, overall certainty of evidence remains very low due to methodological limitations. Based on this evidence, the Panel developed two conditional recommendations in favor of using PAT and VST for the rehabilitation of patients with peri-personal neglect. No studies examined optimal timing, leading the Panel to issue Good Practice Statements recommending initiation within 4-7 days post-stroke. Observational evidence supports the use of neglect-specific tools, particularly the Catherine Bergego Scale (KF-NAP version) and the semi-structured Zoccolotti scale, which outperform generic ADL measures.ConclusionsThis CPG represents the first coordinated national effort in Italy to standardize the diagnosis and rehabilitation of post-stroke spatial neglect within the National Health Service. The CPG provides two conditional recommendations for treatments along with practical indications to support implementation and future research.
