The role of the naturopath in Italy

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of the disorder of the patient, using different clinical methods. Each clinical method is a model of knowledge, used as a logical and consistent tool, which allows making diagnosis, prognosis, treatment and prevention with the same paradigm. The different models, integrated with one another and each with the status of clinical method, make an understanding of multiplanar human disorder as a superposition of states possible. Medicine too means a systematic and shared method to fulfil an ethical intention to help, which in turn comes from a theoretical intention of truth (A. Stella). Therefore, there is only one medicine but different models (clinical methods) to practise it. Western medicine is a clinical method based on physiopathology and physiopathography, which names the disorder with the same name of the pathology of the biological body or its functioning. This is not ‘the only’ name but rather ‘one of’ the names that can be given to a human patient’s disorder. In addition to the methods, there are also diagnostic or therapeutic techniques at the service of clinical methods. It seems very important that every doctor is familiar with at least two clinical models of understanding, and therefore that each doctor can make at least two diagnoses on the same patient: this is what we call the clinical methodological bilingualism of doctors. The experience of doctors who can handle two different clinical/diagnostic ‘languages’ is as follows: knowing how to make two types of clinical diagnosis on the same patient, it is structurally avoided that the doctor deals with a disorder as if dissociated from the patient, and at the same time, the patient feels treated as a human being. Not even modern Western medicine with its polytheism of specialties disregards different models of understanding (organisational, legal, physiopathographic, psychological, surgical on the body, psychiatric, etc.). They are techniques or tools while clinical method is a single, logical and coherent, paradigm that includes ‘diagnosis, prognosis, therapy and prevention’. The multiplanar exercise of medicine through the bilingual method also avoids the feeling of frustration of the doctor, due to the awareness of disappointing the patient’s recovery expectations (usually in the case of a chronic disease). http://dx.doi.org/10.1016/j.eujim.2012.07.673 OP-179 Complementary and alternative medicine education for medical profession: a systematic review Chung Vincent Chinese University of Hong Kong, Hong Kong SAR, The People’s Republic of China Aim: To help integrate traditional, complementary, alternative medicine (TCAM) into health systems, efforts are being made to educate biomedical doctors (BMDs) and medical students on TCAM. We systematically evaluated the effect of TCAM education on BMD and medical students’ attitude, knowledge and behaviour towards TCAM utilisation and integration with biomedical medicine. Methods: Evaluative studies were identified from four databases. Methodological quality was assessed using the Med-

ical Education Research Study Quality Instrument (MERSQI). Study outcomes were classified using Kirkpatrick’s hierarchy. Results: A total of 3122 studies were identified and 12 studies of mediocre quality met the inclusion criteria. Qualitative synthesis showed usage of diverse approaches including didactic, experiential learning, varying length, teacher background and intensity of exposure. More positive attitudes and improved knowledge after intervention were noted especially when teachers were BM trained. However, few studies assessed behaviour change objectively. Finally, longer-term objective outcomes such as impact on patient care were not assessed. Conclusions: Lack of use of objective and reliable instruments precludes firm conclusion on the effect of TCAM education on study participants. However, positive changes, although mostly subjectively reported, were noted in most studies. Future evaluation should use validated or objective outcome assessments, and the value of using dual-trained instructors. http://dx.doi.org/10.1016/j.eujim.2012.07.674 OP-180 The role of the naturopath in Italy Zazzaroni Antimo Istituto di Medicina Naturale - Scuola Italiana di Naturopatia, Urbino, Italy The role of the naturopath in Italy is an unregulated profession; despite this, the naturopath has found a way to practise. Unfortunately, little consideration is given to this profession in our country„ is generally poorly qualified in the absence of regulation which means that training and formation given in this field are very varied. There are some colleges that offer 300 h for 3 years of college and others offering more than 1600 h of classroom teaching. Some colleges consider home study as classroom teaching, thereby increasing the number of hours. This means that levels of formation and training of students coming from the various colleges are extremely varied; consequently, levels of preparation are low. In the absence of regulation, it is difficult to ensure quality. Students choosing a college often are not aware of the different standards of training on offer and may sometimes choose the nearest to home for practical and economical reasons. In recent months, the figure of the naturopath is being taken into account by Parliament along with other professions and will be regulated via associations of the category guaranteeing for the user, by law, levels of formation for its students. The Italian College of Naturopathy promoted by the Institute for Natural Medicine is centred on complementary medicines, prevention and lifestyles and has opted for high-quality formation and professionalism for its students. This will pave the way for qualifying the sector in Italy. Our college has adopted the following parameters distinguishing our College of Naturopathy: (1) a high number of hours comparable to a university degree, over 1600 h of classroom teaching, (2) written, oral or practical exams depending on the subject for every topic on the curriculum, (3) didactical material for personal study, hence increasing the number of hours with questions and answers for self–testing, (4)

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teaching of a high standard–apart from each teacher’s own experience, didactical collaboration among our teachers to ensure students are receiving a holistic education is at the forefront of our aims, supported by the fact that over 85% of our teachers have been with the college for over 15 years ensuring didactical continuity and (5) teaching methodology and didactics crossing all subjects, training students to adopt a holistic approach, enabling them to obtain a synthetic analysis with respect to the client resulting in a highly personalised health package. http://dx.doi.org/10.1016/j.eujim.2012.07.675 OP-181 A collaborative post-graduate educational project: the MasterCourse in ‘Health Systems, Traditional and Unconventional Medicine’ Roberti di Sarsina Paolo 1 , Tognetti Bordogna Mara 2 , Gensini Gian Franco 3 1 Observatory and Methods for Health, Department of Sociology

and Social Research, University of Milano-Bicocca 2 University of Milano-Bicocca, Milan 3 University of Florence, Florence, Italy The authors outline the first Italian collaborative postgraduate educational project in the field of traditional and unconventional medicine that is the MasterCourse in ‘Health Systems, Traditional and NonConventional Medicine’. The project between the Observatory and Methods for Health (OsMeSa), Department of Sociology and Social Research of the University of Milano-Bicocca and the Charity Association for Person Centred Medicine, Bologna, Italy, involves as collaborative centres the Center for Integrative Medicine, University Hospital Careggi, Florence Ayurvedic Point School in Milan and Noopolis Foundation in Rome. The Masters Course project aims to provide participants with tools of theoretical and practical knowledge useful for the formation of professionals capable of integrating economic and management aspects with those of clinical care and different medicines. It also provides tools for quantitative and qualitative analysis of health-related issues, aimed at the design and evaluation of health systems at regional, national and international levels and the study of health inequalities. The MasterCourse confers power to tackle the issue of health, person-centred medicine, traditional medicine and non-conventional systems of health-based anthropology, professional growth and expertise to improve the management of the Hospitals, care institutions, health centres, in line with the new demand of care, provides tools for the development of managerial skills in key roles in planning, programming, monitoring and evaluation research, within the complex management of health services and nursing research. The new figure of the Manager of the ‘Health Systems, Traditional and Non Conventional Medicine’ with interdisciplinary skills is aimed at providing employment within the health system (national and/or regional) and the broader context of health systems. The Manager can be placed in the top position in the organisation and manage different types of structures dealing with health:

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management of complex work units (hospital and/or regional) coordinating or consulting within public, private, third sector, as regional departments, regional agencies for health and health services, Ministry, pharmaceutical companies, epidemiological observatories, research centres, hospices, structures dealing with health, research on health systems and on traditional and nonconventional medicine and the University. http://dx.doi.org/10.1016/j.eujim.2012.07.676 OP-182 Clinical phytotherapy today Firenzuoli Fabio 1 , Gori Luigi 1 , Mascherini Vittorio 1 , Vannacci Alfredo 2 , Mugelli Alessandro 1 , Gensini Gian Franco 2 1 Centre

for Integrative Medicine, Department of Pharmacology, Florence University, Careggi General Hospital, Florence, Italy. Reference Centre for Herbal Medicine of Tuscan County, Florence 2 Centre for Integrative Medicine, Florence University, Florence, Italy Herbal medicine is the use of medicinal plants for prevention and treatment of diseases: it ranges from traditional and popular medicines of every country to the use of standardised and titrated herbal extracts. Today, herbal-derived remedies need a powerful and deep assessment of their pharmacological qualities and safety that can currently be realised by new biologic technologies such as pharmacogenomic, metabolomic and microarray methodologies. Explanatory and pragmatic studies are useful and complementary in the acquisition of reliable data for both health caregivers and patients. Evidence-based medicine (EBM) was first conceived by Archibald Cochrane as a cultural and methodological approach to clinical practice to make decisions based on clinical expertise and the most intimate knowledge of the individual patient’s clinical situations; it de-emphasises unsystematic clinical experience as ground for medical decision making and stresses the rigorous analysis of evidence from clinical research. An important problematic of EBM is the difficulty to be easily applied in everyday practice, in an ABC system, especially in the field of complementary medicine and probably pragmatic studies can be a useful tool in reaching this major objective as part of the systematic process of knowledge. Here we report main possibilities and difficulties in applying EBM to phytotherapy, both in teaching and in clinical settings. http://dx.doi.org/10.1016/j.eujim.2012.07.677