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According to the International association for the study of pain (Aisd), chronic pain is «an unpleasant sensory and emotional experience associated with, or resembling, ongoing, or potential tissue damage». The evolution of the definition of chronic pain has recognized the centrality of subjective and multidimensional valence, involving biological, psychological, and social aspects. Hence, there is a need to introduce patient-centered medicine and broaden the chronic pain management modalities. The primary clinical goal purpose does not end with the biological dimension and treatment of pain but should include the patient's individual experience and maintain an interdisciplinary value, including pharmacological therapy, as well as psychological care and integrative interventions. The perspectives illustrated provided the theoretical rationale for the organization of the Pain Clinic at Asst Santi Paolo e Carlo University Hospitals in Milan. The articulation of this care pathway can serve as a model, which can be applied to other clinical settings, where an interdisciplinary and multimodal approach is needed.

Breast cancer is prevalent in females, accounting for 25% of the world's cancers. Prevention is strategic, and the nurse is an active part in educational and preventive programs, highlighting how the need for preventive nature is combined with gender medicine. The objective was to investigate the knowledge of breast cancer prevention among inmates of Bollate prison (Milan). 51% (52) adhered; women had an average age of 44 years (SD: 9.8), and 39% (20) were inmates from 1 to 3 years. 93% (48) knew about breast cancer prevention, 43% (26) had undergone specific preventive checkups outside of the prison, and 62% (31) had performed self-palpation. All women felt it was important to implement prevention in the prison environment. A high percentage of female inmates with an educational qualification was observed to be aware of breast cancer prevention and to have undergone screening programs in their lifetime. Emerges the strong willingness of women prisoners to be involved and the educational role of the nurse in the prison setting also from a gender perspective.

The current CoViD-19 pandemic threatens both physical and psychological well-being. According to the bio-psycho-social model, Units of Clinical Psychology of the Hospitals in Lombardy (Italy) reacted to this risk, offering diversified interventions, described in the present contribution. The medical staff operated on the front line during the emergency: psychologists addressed their needs through individual clinical work, sessions of decompression and debriefing. At the same time, Units of Clinical Psychology supported the hospitalized positive patients by conducting psychological consultations, either on the ward or through devices. Moreover, some hospitals activated helplines to address the needs of the population and family members, who were particularly vulnerable during the relative's illness and after the mourning.

Communicating unexpected and bad news is a stressful yet unavoidable aspect of clinical practice. However, there is a lack of educational models to train clinicians for difficult conversations. This study aims to: describe the main characteristics of the Program to Enhance Relational and Communication Skills (PERCS); present PERCS efficacy at 10 years since its inception in Italy; and illustrate a specific PERCS on organ donation as an example. PERCS is an educational model based on principles of experiential learning, developed at Children's Hospital Boston. PERCS has been offered as a continuing medical education program in an academic hospital in Milan. PERCS workshops last 5 hours and enroll a maximum of 13-15 interdisciplinary participants across levels of experience. The workshops are geared around the simulation and debriefing of difficult conversations. Before and after the workshops, participants rated their perceived preparation, communication and relational skills, confidence, and anxiety on 5-point Likert scales. Pre-post data were analyzed with paired sample t-tests. Between 2008 and 2018, 52 workshops have been offered, involving a total of 602 participants. Participants reported better preparation, confidence, communication and relational skills, and lower anxiety (for all dimensions, p<0.001) after the workshops. The strengths of the PERCS model includes: the integration between teaching specific skills and promoting relational attitudes, the learner-centered method, and its efficacy. Major challenges relate to the assessment of actual behavioral change of participants and long-lasting effect of the program at follow-ups.

Aim: To investigate the prevalence of metabolic syndrome (MS) among nurses, as well as the organizational impact of work-related stress as a consequence of MS among nurses in Italy. To study the organizational models, turnover rates, and job satisfaction among nurses, in a sample of Italian healthcare facilities., Background: MS is considered an important metabolic disorder in the modern world, responsible for diseases with economic effects on hospitals. Shift work (SW) seems to be a risk factor for MS, while the Mediterranean diet appears to be protective. Work-related stress causes loss of working days, and generates high costs for hospitals., Design: Prospective observational study., Methods: The first step will be to create and validate a questionnaire to investigate the prevalence of MS among Italian nurses. The second step will be to estimate the risk of work-related stress. Data regarding absenteeism and turnover will be collected, as indicators of impact on organization., Discussion: This study is the first to investigate the previously describe SW's factors and their impact on organizing nursing work. This study is relevant for the organizations because it helps to define organizational strategies that permit nurses to remain healthy, to be work efficient and therefore to be able to provide high level care.