Achille Sclavo (1861-1930) and His Innovative Contributions to Italian Preventive Medicine and Healthcare Policy.

Achille Sclavo was a scientist with a multifaceted personality; throughout his life, he steadfastly maintained his commitment to research and teaching, while also gaining precious experience as an educator, politician and entrepreneur. He carried forward these various activities with the aim of bringing relief to a country smitten by epidemic diseases, of spreading the gospel of hygiene, and of creating and training medical and healthcare personnel that would be able to tackle the difficult problem of public health in Italy at the beginning of the twentieth century. In this regard, Achille Sclavo can undoubtedly be considered a precursor of modern public health and preventive medicine.

Soft Skills Are Hard Skills-A Historical Perspective.

The increasingly swift changes in the field of medicine require a reassessment of the skills necessary for the training of technically qualified doctors. Today's physicians also need to be capable of managing the complex issue of personal relationships with patients. Recent pedagogical debates have focused on so-called "soft skills", whose acquisition is presented in literature as a quite recent addition to medical studies. Moreover, the historical investigation of deontological texts dating from the mid-nineteenth century back to the Hippocratic Oath shows that medicine has always discussed the need to integrate technical expertise in medicine with specific personal and relationship-based skills. Debates have often circled around whether these "soft skills" could actually be taught or how they could be successfully transmitted to training physicians. The belief that defining medicine is more complex than defining other similar sciences and that the instruments to be used in the relationship with patients cannot be limited to those provided by technical aspects shows a new awareness. Today, this view is often stated as an innovative realization on the part of doctors with regard to the complexity of training and action in a delicate area in which they are entrusted with the management of the balance of the system that is the human body.

The challenges of urban family physician program over the past decade in Iran: a scoping review and qualitative study with policy-makers.

Introduction: Despite all the advantages of urban family physician program (UFPP), there is still a gap between UFPP and what is actually achieved by the community after its implementation in Iran. In response, this study attempted to review published studies related to the barriers to the implementation of the UFPP in Iran as well as potential solutions to improve it. Further, a qualitative study was conducted to learn the perspectives of experts at the national level and in the Fars province in order to better understand the program's challenges. Methods: This study was conducted in two phases. First, a scoping review was done, aiming to identify the common barriers and potential solutions to implementing UFPP in Iran. Second, a qualitative study using semi-structured interviews was conducted to investigate the views of decision- and policy-makers regarding barriers to and solutions for implementing the UFPP in the Fars province over the last decade. The findings were classified using the five control knobs framework (organization, financing, payment, regulation, and behavior). Results: The most common barriers to UFPP were: 1) organization (ununited stewardship function of the Ministry of Health, weak management and planning, inadequate training of human resources, and a weak referral system); 2) financing (fragmented insurance funds, insufficient financial resources, and instability of financial resources); 3) payment (inappropriate payment mechanisms and delay in payments); 4) regulation (cumbersome laws and unclear laws); and 5) behavior (cultural problems and conflict of interests). On the other hand, several solutions were identified to improve the implementation of UFPP, including: enhancing the role of government; improving the referral system; providing comprehensive training for UFPP providers; considering sustainable financial resources; moving towards mixed-payment mechanisms; employing appropriate legal and regulatory frameworks; enhancing community awareness; and elevating incentive mechanisms. Conclusion: Our research found that, despite the UFPP having been in place for a decade in Iran, there are still significant challenges in all five components. Therefore, the promotion of this program requires solving the existing implementation challenges in order to achieve the predetermined goals. The ideas in this study can be used to improve the current program in Fars Province and bring it to other cities in Iran.

[Enrico Bottini (1835-1903), Italian Physician and Politician: A Master of Antisepsis and a Pioneer of Modern Surgery] / Enrico Bottini (1835­1903), medico e politico Italiano: Maestro dell'anti-sepsi e pioniere della chirurgia moderna

Enrico Bottini (Stradella, Pavia, 7 September 1835 - Porto Maurizio, Sanremo, 11 March 1903) was a multifaceted surgeon, who left a strong mark in modern surgery, not only Italian but worldwide. A pupil of Porta and Ribeti, as well as the distinguished French surgeon and anatomist Charles-Marie-Édouard Chassaignac, he has dedicated himself throughout his career to various areas of medicine, ranging from bacteriology and anti-sepsis (use of a derivative of phenic acid) to urological surgery (the so-called "endo-urethral galva-cauterization", also called Bottini's operation, or Perineal incision according to Bottini). He has also successfully dedicated himself to gynecology (trans-vaginal hysterectomy for uterine cancer and surgical treatment of vesicovaginal fistulas), maxillofacial surgery (endo-oral resection of the maxilla, subperiosteal resection of the mandible for the treatment of the stable jaw, total amputation of the larynx and the tongue for carcinomas), the dermosurgery (use of the electrocautery), and the vascular surgery (resection of the inferior vena cava). He was also an important Italian politician, first as a deputy and then as a senator.