BACKGROUND
Despite increasing recognition of their central role, General Practice (GP) and Primary Health Care and Community Medicine (PCCM) remain structurally and academically fragmented in Italy, limiting the development of a coherent scientific and professional identity.
AIM
To explore clinicians' and trainees' perspectives on barriers and facilitators to developing a unified postgraduate specialty curriculum in GP, PCCM, and to identify conditions for change.
METHODS
We conducted a participatory action research study, integrating a structured workshop with constructivist grounded theory analysis. Forty-four primary care professionals generated 176 qualitative data units, which were iteratively coded and organised into themes.
RESULTS
Five interrelated themes emerged: (1) lack of interprofessional literacy; (2) power dynamics and professional tribalism; (3) recognition of a shared cultural matrix; (4) need for academic and professional identity; and (5) importance of building collaborative projects. Barriers extended beyond knowledge gaps to institutional fragmentation and status asymmetries. Participants identified a shared person-centred care model as a basis for integration, while the absence of a recognised scientific disciplinary sector was seen as a major barrier to legitimacy, research capacity and workforce attractiveness.
CONCLUSIONS
Developing a unified specialty in GP, PCCM is not merely a medical education reform but a strategic institutional priority for the National Health Service. Establishing a dedicated scientific disciplinary sector and a pre-postgraduate curriculum is essential to address workforce shortages, enhance professional attractiveness and reorient medical education and doctors identity towards community-based care. To be truly transformative, this innovation requires institutional and policy changes grounded in the recognition that medical education policy is also healthcare policy.
Viviana Forte, G. Sessa, Vincenzo Lavecchia et al.· Recenti progressi in medicin...· 1 citation
Background A hyperthymic temperament and high perceived energy are often framed as positive dispositional traits, particularly in later life. Indeed, these characteristics are generally associated with a greater tendency to preserve autonomy and with more favorable outcomes in terms of health, engagement, and participation in community life-key dimensions of successful aging. However, the relationship between elevated perceived energy and cognitive performance in older adults remains insufficiently explored. Therefore, this exploratory study aimed to compare cognitive performance and well-being in older adults with different self-reported levels of subjective energy, and to explore potential phenotypic heterogeneity within this population. Methods We conducted a cross-sectional study on older adults from the general population. Participants were classified as having higher versus lower levels of perceived energy based on item 10 of the Short Form Health Survey (SF-12) questionnaire. Cognitive performance was assessed using the Addenbrooke’s Cognitive Examination-Revised (ACE-R). Depressive symptoms were evaluated with the Patient Health Questionnaire-9 (PHQ-9), biological and behavioral rhythm regulation with the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), and quality of life with the SF-12 were also evaluated to characterize overall well-being. Results Statistically significant difference emerged in global cognitive performance between individuals with higher versus lower perceived energy (ES ACE-R p=0.012). Although subscale scores were within the normative range in both groups, individuals with higher perceived energy consistently showed significantly lower scores in language (p = 0.011) and attention/orientation (p = 0.049) compared to the lower perceived energy group. Interestingly, the higher perceived energy group also reported fewer depressive symptoms (p = 0.013), better social and behavioral rhythm regulation (p = 0.005), and higher quality of life (p < 0.001). Discussion/Conclusions Hyperenergy in older adults with preserved well-being is not associated with global cognitive impairment, but rather with subtle domain-specific performance variations, suggesting a heterogeneous underlying profile. These findings support a high-energy profile that does not appear to be associated with functional impairment, but is instead characterized by preserved or enhanced functioning and overall well-being, despite selective areas of lower performance. Longitudinal studies are needed to clarify its clinical and cognitive implications.
Orsola Marra, D. Primavera, Giulia Cossu et al.· Frontiers in Psychiatry· 0 citations