One of the most awkward features of our modern society is people discrimination based upon healthcare rights and free access to treatments. A large part of mankind suffers and dies due to foreseeable and preventable causes, for diseases perfectly curable by the modern medicine and pharmacology. Numbers for this injustice are terrifying: according to the last WHO report, in poor countries people die 10 times more than in industrialized nations, and this factor becomes 100 if one considers people between 0 and 10 yrs, and 300 if only newborns are taken into account. A complex problem, produced by a series of concomitant causes often acting together with a dramatic synergic effect. Among these factors, we enumerate for sure drug-related market strategies aiming mainly at achieving private financial profits, although this means to bypass and often trample down the human rights.

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Drug’s registration with the Agenzia Italiana del Farmaco (AIFA) or the European Medicines Agency (EMEA) is also needed during the “clinical experimental” phase of the drug. After registration, the drug may be placed in the market. Let’s now see how research works in practice: the time from the discovery of the molecule to registration can reach up to 10 years or more. The costs of all this research are around €1Bn. We now realise how expensive it is for a pharmaceutical company to invest in research; it’s really expensive.

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I am Fernanda Morrone and I have been teaching for twelve years at the Pontifical Catholic University of Porto Alegre, which has about 3,000 enrolled students. I am the director of the Pharmacology Laboratory, where 25 doctoral, masters and undergraduate level students work, as well as a number of other professors. We do research on new pharmacological treatments. 

In a culture that is marked by competition and individualism, I try to teach the students the importance of establishing a relationship with their patients and of collaborating with colleagues.
Therefore, I feel that I have to be the first one to live this out. Every day, when I go to the university, I know that I am going to listen to everyone, without making distinctions, by putting the other person before my own interests. I try to share ideas with the other professors, as well as financial resources, and this way of operating is contagious. In the laboratory, the students work not only their own research projects, but each one helps the others with their projects when needed. In this way, the articles that are published are a result of this collective effort, which however does not exclude the personal responsibility that each one has in them.

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We would like to start from ‘that’ inclined plan which leads us gradually to fulfil ourselves as health workers, or our training to become so.

I am sure that most of us have embarked on this journey with great enthusiasm, driven by the desire to quickly become a good doctor, a good nurse, a good physical therapist and so on, but I suppose also that each of us has already experienced the moment that this enthusiasm is restrained by the first difficulties, when it seems that our goal becomes a real challenge.

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My name is Joseph and I am doing my Research Doctorate in Biology at the University of Bari. My experience in the laboratory, which still continues today, began about two years before writing my graduate thesis, while doing an internship in an immunology lab.
Since the very first months of this experience, I was struck by an attitude that the researchers I was working with naturally displayed, but which I did not like at all. In fact, there was an extreme jealousy between them over the protocols that were optimized for the experiments for which one was responsible, or over the “recipes” of strange reagents used. This was certainly due to the intense work of reading numerous scientific publications on the part of those researchers, and this explained the total attachment they had to their protocols. A while later, when I had established more confidential relationships with them, they explained to me, almost with a smile, that there is generally a lot of jealousy over these protocols because they give the researcher an exclusive importance, so that “one cannot do without him/her.”
I, who during my previous 5 years of university, had tried to live my studies with detachment: from my own notes or the professors’ lecture notes. I was used to a sharing among my colleagues that I could no longer find in the laboratory.

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In trying to answer the fundamental question: “What is it that makes a good teacher in medicine?” we should consider the context in which the teacher nowadays performs his role as an educator.

Let us try to briefly outline the image of medicine in society:
- A rapid succession of scientific discoveries which are clearly important but which often express medicine as becoming always more technological, hence obscuring its human dimension based on relationships,
- The criticisms and almost daily polemics resulting from cases of malpractice that demand from us a change in the way medicine is practiced by some persons but at the same time obscures the commitment and the dedication of many good professionals,
- The constraints of a health system in which the doctor may feel deprived of his role in order to obey rigid economic and organisational criteria.
One could ask whether young people still want to want to take up this profession. Yet if we observe the numbers of applications for entry into the biomedical faculties, we could conclude that the numbers of those who would like to take up education in this field are very high.
Recently there has been some discussion as to whether the selection tests are still valid since they do not look into attitudes and motivations, but prefer a knowledge of notions that is isolated from the preceding educational process.

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Gamechu was a two year old child that arrived at the rural Ethiopian hospital where I worked because of an abdomonial mass. Immediately upon examining him I noticed that he was severely malnourished and in his abdomen I felt a hard mass that I suspected to be a tumor.

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Drug production is a long process consisting of various steps, each with a well defined goal. Given the biological target, a specific candidate molecule has to be identified. A first basic pharmacological and biochemical screening allows to isolate among thousands molecules 20-30 leader compounds, namely the precursors of a real drug. As soon as chemical and physical features are defined, animal trials begin by testing acute and chronic toxicity; if a compound assigned to become a drug has shown a good efficacy and safety profile, clinical trials can start. Clinical trials are powerful tools to verify if novel drugs can be suitable for people; nevertheless, the relevance of a research can not justify a violation of human rights and dignity. After aberrant trials carried out in Nazi concentration camps the international scientific community has set up ethical rules for human trials: the Nuremberg Code (1949), in which is solemnly proclaimed that “subject’s voluntary consent is absolutely needful”, and the Declaration of Helsinki (1964, then updated in 2004), regulating the rights of humans involved in drug trials.

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My book was published at the beginning of the year. Its title? Soul Matters: the spiritual dimension within healthcare.
Why write such a book? I am a GP (General Practitioner) and that means Family Doctor in Great Britain. We look after people from the womb to the grave. In Great Britain, most people are treated in the community. Only a minority ever see a specialist, few go to hospital – at least that would be the idea. We treat illness and disease but we also try to prevent them. Sometimes I have to go to visit someone at home usually because of the seriousness of the illness or the patient’s poor mobility. This is what happened with Molly – at least that is what I call her in the book. She is stricken with rheumatoid arthritis and her hands demonstrate its classical destructive pathology. She had three strokes with a legacy of unilateral paralysis. However what struck me about her was not the typical presentation of a rheumatoid arthritis case or of a cerebrovascular accident, but her tranquillity in the face of the tragic disintegration of her body. Molly’s case left me thinking and I wondered if I would have been able to face such illness in the way she did. I asked myself, “What inner resources do patients use to face illness?” Molly is only one of many examples. I subsequently did a qualitative study for a Master’s degree and researched this area and years later, the book emerged.

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Engaging Urban Aboriginal Australians in Health Care

A Person-Centered Primary Health Care Response

In this presentation I will highlight the importance of a person-centered approach in engaging vulnerable urban Australian Aboriginal patients in primary health care. I will draw on my experience as a general practitioner working within a team in a Multidisciplinary Community Health Service which serves a relatively high proportion of urban Aboriginal Australians in its catchment area. Many of the challenges faced can be seen to relate to globalisation- the human story of migration over the millennia, and in the Australian context over the past 250 years- with its continuing impact on the local indigenous peoples.

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International CongressWhere is Medicine going? Challenges of Globalisation, Sustainability, Patient-Centred Care

Padua, 18th-19th October 2013

Aula Morgagni, University Hospital


medical professionalism
health: does it belong to everyone or to the priviledged few?
global health and health determinants
the challenges of health care in a globalised world
are we limited by resources? the challenge of the welfare state
how to reconcile the quality of health care with our limited resources
choosing wisely: doing more is not always doing better
waiting lists: the local justice criterion

We are extending the deadline for submission of abstracts: the new deadline is 15 september  2013!

The Scientific Committee of the Congress welcomes FREE COMMUNICATIONS.

We have booked a wide number of rooms for this Conference in several hotels. All reservations must be made by the participants themselves contacting the hotel directly; please DO NOT USE THE HOTEL ON-LINE BOOKING FORM but write an e-mail or fax reporting the conference title "Where is Medicine going?" when booking.
Please note that early booking is necessary; these special rates are guaranteed only by (see hotel details). After that the hotel is free to sell his rooms at its usual commercial rates.


The name badge issued to delegates on registration serves as an admission pass to all scientific sessions, coffee breaks and lunch. Delegates are asked to ensure that they wear their name badges at all times.

The official languages of the Congress will be Italian and English. Simultaneous translation will be available.

By car: A4 highway (Milano-Venezia), Padova Ovest exit. A13 highway (Bologna-Padova), Padova Sud exit.
By train: Padova railway station. Direct railway connections with the national network: Milan, Bologna, and Venice.
By plane: International airport "Marco Polo" at Tessera (10 km from Venice)
Airport "Valerio Catullo" at Villafranca (Verona)
Treviso airport
Airport Shuttle Service: ;

Information links:

PaduaProbably better known as the city of St. Anthony or as the economic capital of Veneto, Padua is one of the most important art cities in Italy. An ancient legend goes that the Greek hero Antenor was the founder of the town. The historical Padua was actually founded over 3000 years ago, during the Paleoveneti age, in a loop of the river Brenta. In the 4th century b.C. it became the most important centre of the ancient Veneti people. Allied to the Romans against the Gauls and since 49 b.C. a municipium, Patavium was one of the most flourishing towns of the Roman Empire.

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