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Non-thermal food processing technologies are becoming more important in the organic food sector because, beyond preserving the organic feature, they could offer organic products with additional benefits in terms of enhanced nutritional content and healthiness as well as better sensory properties that could satisfy the more complex demands of organic consumers. Berries have a well-known health benefits and show increasing market shares in European markets while dehydration can increase the food convenience in terms of extended shelf-life. This study investigates for the first time organic consumers' stated preferences, attitudes and individual differences for a non-thermal organic processing technology. Specifically, we investigated consumers' preferences for organic dried strawberries varying in drying technology used, such as the most conventional (i.e. thermal) air drying and the most innovative (i.e. non-thermal) microwave drying, origin, price levels, and nutrient contents in three European countries: Norway, Romania and Turkey. Data from a total of 614 consumers were collected through an online choice experiment. Results show that on average consumers prefer organic dried strawberries produced with air drying technology that have national origin, with natural nutrient content and at low price, but country and individual differences are identified. Consumers who showed least rejection for microwave dried products are young, mostly from Norway and have higher positive attitudes towards new food technologies. Consumers who showed most rejection for microwave dried products are older, mostly from Turkey and have higher positive attitudes for organic, natural and ecological products. Organic producers who adopt microwave drying might better inform consumers about the characteristics, the process and highlight the nutritional benefits of such technology. Finally, this research informs policy makers about the need to define and regulate more clearly microwave drying as an organic technology, as well as to regulate labelling to ensure that consumers are not misled and correctly informed about the new technology.

The organic food market grew steadily during the past decade (Hamm and Gronefeld 2004, Spiller 2006). This increase is accompanied by challenges in market structures, distribution channels as well as differentiation of expectations and buying motives of organic food consumers. On this regard, the “hedonistic” motives for purchasing of organic food, that also include sensory features like taste or appearance, gained importance in comparison to other motivations. Therefore, some scientists pointed out that sensory attributes are important elements that should be taken into account in the marketing strategies by organic food distributors (Brennan and Kuri 2002, Padel and Midmore 2005) than even before. The objective of this paper is to explore sensory experiences, expectations and perceptions of Italian and German organic consumers underlining differences between the two countries when purchasing and eating organic food. Ten focus group interviews composed by 6-10 consumers were performed during 2009 in different locations in Italy and Germany. The focus groups content was transcribed and then analyzed using qualitative content analysis. Results indicated that, although sensory attributes are not the main purchase driver, taste and, especially for Italy, odour are the most important sensory features taken into account by organic consumers especially for the first purchase. However, it seems that the ability to differentiate between various categories of sensory perception is characterized by a low level of development which may limit the set of possibilities when trying to reach consumers by affecting their senses. Furthermore, consumers were able to mention several aspects such as intensity, naturalness and authenticity that they consider to be important when it comes to the sensory properties of organic products. Other findings suggests that sensory perception is a learnable ability which offers an opportunity for the actors of the organic food market to bring their customers closer to their products by a corresponding training of consumers’ sensory abilities. Regarding the concept of standardisation consumers pointed out that sensory properties should not be standardized, especially for heavy users. In both countries, one part of the organic consumers seem to appreciate sensory marketing activities whereas another part apparently does not. For Italian consumers who appreciate sensory marketing, non-subjective as well as subjective marketing information is considered to be suitable, whereas in Germany non-subjective aspects seem to be predominant. Further research may be useful in order to detect the right marketing tools that are able to support a sensory-based strategy of product presentation and positioning., Proceedings in Food System Dynamics, Proceedings in System Dynamics and Innovation in Food Networks 2012

The article explores sensory experiences and expectations of organic producers regarding the consumer relevant-information for sensory properties of organic products. Individual interviews to ten prominent Italian organic producers were administered and analysed using both qualitative and quantitative content analysis and conceptual mapping. Findings show that organic producers carry out sensory analysis generally in a non-systematic and non-standardized way. However, despite high costs and lack of expertise, they state the need to improve reliability and to increase sensory tests on their products in order to better meet consumer wants. The negative influence of variability in sensory features of organic products during the shelf-life was highlighted and the need of training initiatives to improve consumer's sensory knowledge and skills was expressed. From these findings, suggestions for further research are provided.

EC Regulation no.178/2002 introduced mandatory traceability for all food operators, but they can choose the level of traceability capacity. We propose a conceptual model incorporating three distinct indices of traceability capacity – breadth, depth and precision - that affect associated costs and benefits. We empirically test the model by regression analyses, using data collected on a sample of 60 Italian fish processors/wholesalers. While higher precision corresponds with larger perceived benefits, an increasing traceability breadth raises both the implementation and the operating costs. A measure of the extent of the discrepancy between expected and actual costs and benefits is also established. Implications are discussed in light of future uptake of continuously advancing traceability technologies and services.

This study is aimed at exploring perceptions of European gatekeepers toward renowned Thai fruit and coffee products protected by geographical indication (GI) and factors influencing purchasing decision of gatekeepers toward imported food products. Sixteen qualitative interviews with distribution channel gatekeepers were administered in Austria, Italy, and Switzerland in 2010. Content analysis and concept mapping were used to analyze data. Results show that Thai GI products might be interesting for European gatekeepers, but the GI attribute alone might not be sufficient to ensure that the product is successful. Support of consistent information and promotion campaigns and fulfillment of other gatekeepers’ requirements of both products and suppliers are necessary.

The paper proposes a model in which it is hypothesized that firm characteristics influence both costs and benefits of traceability. The proposed model differentiates between aggregate measures and specific categories, as well as between expected costs and benefits on the one hand and perceived actual outcomes on the other, and is tested in a series of regression analyses based on a survey sample of 60 Italian fish processors. The findings indicate that firm characteristics are not strongly associated with any specific cost or benefit measure. However, expected overall benefits are highly significantly impacted by firm size and the number of quality management systems certified, while actual overall benefits only by firm size. Finally, the study also finds considerable discrepancies between expected and actual costs and benefits. The managerial implications of the findings are discussed., International Journal on Food System Dynamics, Vol 2, No 4 (2011)

We explore sensory experiences and expectations of Italian and German organic consumers when purchasing and eating organic food. Ten focus group interviews were performed and the results were analyzed using qualitative content analysis. Outcomes indicated that although sensory attributes are not the main purchase drivers, flavor and odor are the most important in driving consumers' choice. Findings also suggested that training consumers' sensory abilities offers new market opportunities to organic marketers. From a marketing perspective, Italian consumers seem to equally appreciate nonsubjective as well as subjective marketing information about organic products, whereas in Germany non subjective aspects appear to be predominant.

Il marketing sensoriale riveste un ruolo particolarmente decisivo quando si parla di prodotti biologici, a cui sempre più consumatori guardano con interesse.

This study aims to analyse the influence of information on consumers’ liking and sensory perceptions. A sample of 301 Italian consumers of organic food products participated in a survey performed from November 2010 to January 2011. Consumers were recruited according to age, gender and frequency of consumption of organic foods (they were divided into light and heavy users). Consumers stated their preferences for “core organic” attributes, labels and information on food products and performed blind tests and branded tests on strawberry yogurt and cookies. In the branded tests, sensory test was combined with provision of different information, such as ingredients and the organic logo. Overall liking and sensory perceptions were elicited after blind tasting and after tasting of labelled products. Data was analysed by using descriptive analysis, an independent T-test and a paired T-Test. Stated preferences revealed that consumers appreciate “core organic” attributes, like artisanal production and variability of products’ sensory attributes; heavy and light users show significant differences in preference for whole grain products. Considering labels and information on food products, heavy users appeared to be more familiar with label reading, thus implying higher awareness about usefulness of information delivered on labels. Comparing blind and branded tests, results showed that information affects the overall liking of products and consumers’ perception of product specific sensory attributes; moreover, we cannot find significant differences in the way heavy and light users are affected by information. In conclusion, the survey showed that the influence of food product information on sensory perceptions depends on product category, sensory attributes and the type of information provided. These findings suggest that information (e.g. ingredients, logos, etc.) could be used by the food industry to fill the gap between consumers taste expectations and their actual experience.

Investigated is the premise that co-operative organisational structures, for reasons of their long-term socially responsible origins are at the forefront of development of local and sustainable food systems and are thereby in a position to offer a specific contribution to sustainable business development. To this end retail co-operation is highlighted because of its ideals: member mutualism and community/stakeholder centred business (Hingley, 2010; Novkovic, 2008); with the focus on retailer cooperative businesses in Europe. The context of the paper is in the supply of local and sustainable food, and retailer cooperatives as their entry points within local conditions. Emphasis is on localised food networks and connection between environmentally as well as socially sustainable production, distribution and consumption (Duffy et al, 2005; Jones et al, 2004; Weatherell et al, 2003). Two key research questions are proposed: Does the co-operative organisational structure and ethos contribute specifically and uniquely to sustainable local food marketing? Secondly, do European retailer co-operatives express support for relocalising food systems; and what contribution do they make concerning sustainable food and their relationships with local food suppliers? The paper is structured in the following way. The concept and context of sustainability in food production, marketing and distributive systems is explored; and an understanding of the importance of the definition of local food outlined. The historical and contextual development and business orientation of retailer co-operatives is investigated, specifically concerning their impact on ethical and socially oriented business, which has reached more recent attention as a business model and philosophy under the guise of Corporate Social Responsibility- CSR. This study makes a contribution to knowledge concerning the role of co-operatives and the co-operative ethos in sustainable food system production and development of the local food economy; and thereby a positive contribution to (most notably) sustainable communities. Co-operative ethos concerning responsible and ethical behaviour is to the fore in co-operative retailer chains in the two European countries investigated, and this corroborates prior studies linking the distinct inclination and contribution of co-operative retail businesses in building and maintaining community networks/social responsibility and so forth; via support for local food networks (Hingley, 2010).

Le imprese operanti nel comparto agroalimentare, in costante evoluzione, sono alla ricerca di nuovi approcci per soddisfare le aspettative dei consumatori. Negli ultimi anni si e diffuso un nuovo approccio di marketing, basato su un paradigma chiamato gmarketing esperienzialeh, che si propone di coinvolgere i clienti in indimenticabili esperienze emotive. In questo contesto, il marketing sensoriale potrebbe diventare uno strumento strategico per rispondere alle nuove esigenze ed aspettative dei consumatori. Con particolare riferimento al comparto biologico, attualmente sembra che i consumatori prestino piu attenzione agli aspetti "edonistici" (salute, gusto e benessere) durante l'acquisto di alimenti biologici, piuttosto che ad aspetti "altruistici" come la protezione dellfambiente e il benessere animale. Cio conferma il ruolo svolto dagli attributi sensoriali nell'orientare le scelte alimentari in generale (Shepherd et al. 2005) e motiva lfimportanza conferita da parte degli operatori alimentari biologici agli attributi sensoriali nellfimpostazione delle strategie di marketing (Brennan, Kuri 2002; Padel, Foster 2005). Numerosi studi hanno infatti rivelato che gusto e aspetto sono tra i criteri di scelta piu importanti per lfacquisto di prodotti alimentari biologici (Aertsens et al. 2009; Castellini et al. 2008; Kuhar, Juvan.i. 2010); gli attributi sensoriali diventano inoltre estremamente importanti per specifici segmenti di consumatori di prodotti biologici, che hanno un approccio piu pragmatico (Pellegrini, Farinello 2009; Zhao et al. 2007) e tendono a valutare i prodotti secondo gli stessi parametri applicati ai prodotti convenzionali (Berardini et al. 2006). Il presente lavoro analizza le esperienze di alcuni operatori della filiera biologica italiana, con particolare riferimento agli attributi sensoriali dei prodotti biologici e alle preferenze dei consumatori relative alla qualita sensoriale dei prodotti alimentari biologici. La ricerca ha un duplice obiettivo: a) fornire spunti utili per lo sviluppo di ulteriori indagini presso i consumatori; b) identificare alcuni elementi chiave che potrebbero costituire la base per indagini piu approfondite sullo stato dellfarte del ruolo svolto dagli aspetti sensoriali nel business degli operatori biologici italiani.

This paper explores in-depth sensory experiences, expectations and perceptions of organic producers regarding the role played by sensory properties in organic market, using a qualitative marketing research technique. Ten in-depth interviews supported by semi-structured questionnaire were performed in Italy during 2009. Findings shows that organic producers stated that sensory tests are mainly carried out empirically, they are not systematic and often performed by non trained assessors, even if they are completely aware of the importance of sensory information. Interviewees think that sensory attributes may play a primary or at least complementary role in consumer choice in order to adding-value and drivers for purchase motivations, but at the same time highlighted also the negative influence of variability in sensory features and the key role played by sensory education and training. Finally, organic producers expressed the need and the intention to plan scientific sensory tests with trained personnel in order to improve sensory properties of organic food although smallest companies declared difficulties since the high costs of sensory analysis., Proceedings in Food System Dynamics, Proceedings in System Dynamics and Innovation in Food Networks 2011

This study is aimed at exploring perceptions of European gatekeepers towards renowned Thai fruit and coffee products protected by geographical indication (GI) and factors influencing purchasing decision of gatekeepers towards food products imported from Thailand. Sixteen qualitative interviews with distribution channel gatekeepers were administered in Austria, Italy and Switzerland in 2010. The interviewees are food distribution practitioners and experts and are key informants for imported fruits and coffee in Europe and they were asked for an opinion about recognition of Thai GIs in the EU system. Content analysis and concept mapping were used to analyze data. Results show that Thai GIs products might be interesting for European gatekeepers, but the GI attribute alone might not be sufficient to ensure the product is successful. Support of consistent information and promotion campaigns and fulfillment of other gatekeepers’ requirements of both products and suppliers are also necessary. Eight major factors have been identified, which influence European gatekeepers’ decision to purchase imported food products: quality, price, food safety, environmental aspects, social aspects, business relationship, consumer awareness and preference, and competitors. Results are useful to develop appropriate managerial marketing strategies to introduce these GI products into the EU market.

The organic food market is characterized by an uninterrupted growth during the past decade (Fibl, 2010; Spiller, 2006; Hamm and Gronefeld, 2004). Between 2006-2007, the organic food market in Europe is growing on average about 10% per year with an average per-capita spending of 27 Euros across all European countries (Padel et al., 2009). This increase is accompanied by challenges in market structures, distribution channels as well as differentiation of expectations and buying motives of organic food consumers. On this regard, the “hedonistic” motives for purchasing of organic food such as health, taste and wellness gained importance in comparison with the “altruistic” purchasing motives such as environmental protection and animal welfare. Therefore, some scientists pointed out that sensory attributes are important elements that should be taken into account in the marketing strategies by organic food distributors (Brennan and Kuri, 2002, Padel and Foster, 2005) than even before. On this regard, available literature lacks of empirical research investigating experiences and expectations of organic consumers which may support organic food producers, processors and distributors in drafting their marketing strategies. The objective of this paper is to explore in-depth sensory experiences, expectations and perceptions of organic consumers when purchasing and eating organic food, using qualitative marketing research techniques. The output of this research will be the identification of some key elements which may make researchers able to address further research and may provide useful recommendations to food industry practitioners interested in marketing organic food. Focus group interviews supported by semi-structured questionnaire were performed during 2009; five groups composed by 6-10 organic food consumers in different locations in Italy were invited to join group discussions focused on their approach to sensory characteristics of food. Each interview had a duration of about 1 hour has been video recorded. The interviews content was transcribed and then analyzed with the method of content analysis. The results indicate that some consumers still appear to be confused about the meaning of the term „organic food‟. The term is often associated with a set of desired features of food such as naturalness, freshness, but without any reference to the method of production, or with other types of niche products, such as artisanal or “home made” foods, etc. Although it is not possible to draw reliable conclusions on the basis of a qualitative approach like this, we may make an attempt to raise hypotheses that can be tested in a following research based on a quantitative approach. Based on the analysis of interviews contents, the sensory and safety attributes seem to be more relevant to consumer choice for older participants (46-75 years) than younger (18-45 years), the latter paying more attention to environmental protection, animal welfare, absence of chemical preservatives or additives when they purchase organic food. This is presumably because childhood memories seem to be important for older participants, as they apparently serve as a “personal sensory-quality term of reference” when taste experiences of the childhood or former times are compared with nowadays sensory characteristics of food, suggesting that education and training on food taste may play a role in shifting preferences. However, basically sensory attributes still appear to be less important than other attributes such as environmental protection, animal welfare, absence of additives, etc., consumers take into account when purchasing and eating organic food. Consumers largely agree that organic food should be different from conventional ones in terms of shape, odour, colour, taste, texture, etc, but variety is also expected and between organic food themselves. Few consumers, however, also expect that organic food may mimic some successful branded products. Appea...

This paper investigates the rationale for local and sustainable food systems and retailer co-operatives as their entry points within local conditions. Emphasis is on localised food networks and connection between socially as well as environmentally sustainable production, distribution and consumption. Investigated is the premise that co-operative organisational structures, for reasons of their long-term socially responsible origins are at the forefront of development of local and sustainable food systems and are thereby in a position to offer a specific contribution to market development. Two key research questions are proposed: Firstly, is there a pre-determination of co-operatives to issues of sustainable and local food sourcing given the historical and practical context of their ethical/socially responsible and stakeholder-based business model? Secondly, do co-ops express support for re-localising food systems and what contribution do they make concerning sustainable food and their relationships with local food suppliers? The method of investigation is through a two country retailer co-operative sector analysis and comparison (Finland and Italy). The enquiry is qualitative and exploratory in nature in the form of an embedded, multiple case design. The paper makes practical and theoretical contribution to knowledge concerning interpretation of ‘localness’ in food, the role of co-operatives and the co-operative ethos in sustainable food systems and the development of the local food economy. Results of the study show a positive relationship between co-operative ethos and (social) sustainability in local food, but the de-centralised nature of retailer co-operation also provides a barrier to replication of good practice.

Since 2005, the implementation of a traceability system is mandatory to all European food chain operators. The balance of costs to build and maintain the traceability system and benefits of traceability depends on the firm’s traceability objectives and its resources, as reflected in characteristics, such as adopted quality management systems (QMS) or firm size. Mora and Menozzi (2005) mention that the cost of traceability is lower when firms already have a QMS in place. Moreover, US producers exporting to multiple destinations, in particular EU and Japan, need to comply with more stringent traceability regulations (De Souza Monteiro and Caswell 2004). This may request the adoption of more sophisticated and costly traceability systems. Food operators tend to have a good understanding of traceability cost, while performance benefits are usually more difficult to grasp (Verdenius 2006). This research aims at improving the understanding of how expected and actual costs and perceived benefits are influenced by firm characteristics (Meuwissen et al. 2003). This paper proposes a conceptual decision model that incorporates firm characteristics and both expected and actual costs and benefits of traceability. It is hypothesized that firm characteristics influence both expected and actual costs and benefits, while the level of traceability is influenced by expected and actual costs and perceived benefits as well as firms’ characteristics. Costs can be divided into implementation and operation/maintenance costs. Benefits can arise from compliance with regulatory requirements, enhanced recall performance, improved marketing performance and increased supply chain efficiency (Sparling and Sterling 2004). The analysis uses a sample of 60 Italian fish processing businesses that were surveyed in 2008. Indicators of firm’s characteristics such as number of QMS certifications, operations complexity, firm size and complexity of customer requirements, are entered as independent variables in regression analyses to predict expected and actual costs and perceived benefits which were measured on 9 point semantic scales and constant sum scales. The findings show that none of the firm characteristics investigated influence costs, while firm size and QMS certifications influence benefits in different ways. Somewhat surprisingly, firm size was found to be negatively correlated with expected and actual benefits; i.e. larger firms reported lower benefits both expected ex ante and realized ex post traceability system implementation. Finally, the number of QMS certifications is positively associated with expected benefits; i.e. expected benefits increase with the number of QMS certifications acquired by a firm, but no association with actual perceived benefits of traceability was found., Proceedings in Food System Dynamics, Proceedings in System Dynamics and Innovation in Food Networks 2010

Organic food’s initial attraction to the public was that it was perceived to be healthier and tastier, but scientists and policy makers have mainly stressed the benefits to the environment of organic and sustainable farming. Scientific support for marketing actions addressed to those who want to be healthier and who want to enjoy better taste, and are willing to pay more for these benefits is scarce. Past research has produced little clear evidence about the importance of sensory characteristics such as taste, smell, appearance etc in consumers’ preferences with regard to organic food. The Ecropolis project, funded by the E.U., was set up with the aim of investigating the role of the senses in consumers’ preferences regarding organic food, and leading to research into how best to satisfy those preferences. This deliverable is aimed at providing a solid basis for such research with an in-depth review of, and two reports on, the relevant scientific literature. The first report (Annex I) regards what consumers expect from organic products in terms of taste, smell, appearance, etc and how these expectations are (or are not) met; the second is about the science of the senses (Annex II). The first project tasks included creating and agreeing on a glossary of terms, deciding on search criteria (key words, etc.), setting up a bibliographical data base, preparing then circulating the above-mentioned reports, and finally preparing a summary of the reports. The report on consumers expectations highlights the suggestion that while organic food has traditionally been marketed through specialized retailers, its market share will only grow significantly if it is promoted by multiple retailers. Research literature from all over the world seems to agree in indicating that consumers’ choices are largely motivated by health, the environment, price and social status. Other considerations include ethics, the localness of the product and lifestyle choices. The literature also indicates that the organic market will expand significantly only if consumers are more willing, and able, to recognize quality, but this presents serious issues. When buying the product they cannot personally verify its quality and genuineness and thus must rely on regulation and inspection bodies. The recognition of quality can also be encouraged by effective communication by producers and retailers through appropriate branding, labelling and presentation. There are connections between this information and questions of sense perception, but researchers disagree about how important the latter is in influencing the customer, and in which ways it does so. The following report focuses, in fact, on the science of the senses, which tries to analyze in detail people’s responses to food, despite the many potential pitfalls in carrying out the research which might influence the reliability of the results. There is broad agreement on two points: - there is no proof that organic food is more nutritious or safer, and - most studies that have compared the taste and organoleptic quality of organic andconventional foods report no consistent or significant differences between organic and conventional produce. Therefore, claiming that all organic food tastes different from all conventional food would not be correct. However, among the well-designed studies with respect to fruits and vegetables that have found differences, the vast majority favour organic produce. Organic produce tends to store better and has longer shelf life, probably because of lower levels of nitrates and higher average levels of antioxidants. The former can accelerate food spoilage, while antioxidants help preserve the integrity of cells and some are natural antibiotics. The first conclusion may, however, depend on factors not directly connected to organic farming, such as harvesting and storage methods and the type of land used for growing the food. About the second finding it must be considered that measuri...

Governments view agri-food traceability as a tool to protect public, animal and plant health and to protect buyers against fraud (Food Standards Agency 2002). At the firm level, however, the level of traceability is determined by expected and actual costs and benefits. Costs can be divided into implementation (or set up) and operation (or maintenance) costs. Benefits can arise from compliance with regulatory requirements, enhanced food safety and recall performance, improved marketing performance and increased supply chain efficiency (Sparling and Sterling, 2004). While food operators tend to have a good understanding of the likely cost of traceability, performance or competitiveness benefits are more difficult to grasp (Verdenius 2006). While governments around the world support food operators in the implementation of traceability practices and systems, there is a clear need for research to understand how food operators’ perceptions of costs and benefits affect the level of traceability implementation (Meuwissen et.al 2003). In particular, there has been no research to date that documents and analyses how government support affects business performance. This paper aims to contribute to closing this research gap. It proposes a conceptual decision model that incorporates both expected and actual costs and benefits of traceability in the analysis. Received government support, amongst other firm characteristics, is hypothesized to affect actual costs and benefits via expected costs and benefits and the chosen traceability level/sophistication. The analysis uses a sample of 60 Italian fish processing businesses that were surveyed in spring 2008. The results show that food operators who received government support adopted a higher level of traceability, and reported a higher level of expected and actual costs and benefits, in comparison to food operators who did not receive any kind of support. However, these operators also reported actual benefits to be smaller than expected, mainly because of overly optimistic expectations about the impact of traceability implementation on prices and market share.

Il capitolo descrive le problematiche psichiche di più frequente riscontro tra i migranti e la loro gestione. La trattazione dei problemi psichici tra i migranti è motivato da almeno tre ragioni: 1) la cura del paziente migrante richiede particolari competenze relazionali, dato che la comunicazione medico-paziente presenta importanti ostacoli e difficoltà; 2) i migranti non sono una categoria diagnostica psichiatrica, tuttavia presentano con frequenza più elevata rispetto alla popolazione nativa alcuni problemi di salute psicofisica; 3) tali problemi richiedono interventi medici e psicosociali specifici, che, sebbene sempre meglio descritti dalla letteratura internazionale, sono ancora carenti in Italia. I disturbi psichici vanno considerati nel più ampio contesto dei problemi sanitari dei migranti. Questi pazienti sono infatti colpiti da malattie da fragilità sociale (patologie odontostomatologiche, respiratorie, ginecologiche, dermatologiche), collegate allo scadente status socio-economico ed al basso livello di integrazione sociale. Inoltre, a fronte di un rapido crescere della popolazione immigrata in Italia, l’acceso alle cure primarie è ancora inadeguato con un eccesso di ricoveri e di interventi in regime di urgenza, costosi e al tempo stesso scarsamente efficaci. A fronte di un insufficiente utilizzo dei servizi territoriali, il pronto soccorso diventa la via di accesso alle cure privilegiata ma tardiva, solo nel momento in cui la patologia non è più controllabile. Risultano infatti a carico dei migranti il 16% dei ricoveri pur rappresentando essi a livello nazionale il 5% della popolazione regolarmente residente. Il grado di accessibilità e fruibilità dei servizi sanitari rappresenta una questione cruciale per la salute del migrante, dipendendo la prima prevalentemente dalla normativa, la seconda dalla capacità “culturale” dei servizi di adeguare le risposte alle necessità dei nuovi utenti. Le Aziende USL hanno istituito programmi specifici, con l’intento di coordinare l’attività dei servizi pubblici con i diversi centri di volontariato e di offrire servizi ed interventi appropriati. In alcuni Servizi di salute mentale sono stati attivati ambulatori dedicati che si avvalgono di psichiatri con competenze transculturali e che collaborano con mediatori culturali e Servizi sociali del Comune. In bibliografia sono riportati una serie di “indirizzi utili” a questo proposito. Un ruolo fondamentale è detenuto dagli interventi di facilitazione di accesso alle cure e di potenziamento delle capacità di diagnosi e cura dei disturbi psicofisici dei migranti in medicina generale. Gli esperti internazionali suggeriscono di promuovere in medicina generale lo sviluppo di abilità diagnostiche, relazionali e gestionali del paziente proveniente da altre culture, attraverso campagne educative mirate e la strutturazione di una collaborazione stretta con i servizi territoriali di salute mentale.