Davide Ticchi - Academia.edu (original) (raw)

Papers by Davide Ticchi

Interactive Cardiovascular and Thoracic Surgery, Sep 26, 2017

OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely c... more OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely clear-cut. Patients interested in treatment are referred for evaluation by numerous different specialists, but psychosocial counselling is currently not included in this process. Our objective was to assess whether PE patients would be interested in formal assistance with the decision-making process surrounding PE surgery using narrative therapy principles. METHODS: Ninety-seven untreated PE patients at 5 different institutions in 4 countries completed a questionnaire consisting of 13 questions, with 3 questions specifically evaluating interest in narrative therapy. RESULTS: Eighty-two percent of participants were interested in narrative therapy to assist with the decision-making process surrounding PE surgery. Individuals most interested in narrative therapy tend to be more interested in correction (P < 0.05) to improve the way they feel about their body (P < 0.05). CONCLUSIONS: The majority of PE patients are interested in narrative therapy to aid the decision-making process about treatment. We propose that narrative therapy should be offered to PE patients during the treatment evaluation process to address the psychosocial difficulties associated with PE and the surgical decision-making process overall. Future studies should assess the effectiveness of this interdisciplinary model.

OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely c... more OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely clear-cut. Patients interested in treatment are referred for evaluation by numerous different specialists, but psychosocial counselling is currently not included in this process. Our objective was to assess whether PE patients would be interested in formal assistance with the decision-making process surrounding PE surgery using narrative therapy principles. METHODS: Ninety-seven untreated PE patients at 5 different institutions in 4 countries completed a questionnaire consisting of 13 questions , with 3 questions specifically evaluating interest in narrative therapy. RESULTS: Eighty-two percent of participants were interested in narrative therapy to assist with the decision-making process surrounding PE surgery. Individuals most interested in narrative therapy tend to be more interested in correction (P < 0.05) to improve the way they feel about their body (P < 0.05). CONCLUSIONS: The majority of PE patients are interested in narrative therapy to aid the decision-making process about treatment. We propose that narrative therapy should be offered to PE patients during the treatment evaluation process to address the psychosocial difficulties associated with PE and the surgical decision-making process overall. Future studies should assess the effectiveness of this interdisci-plinary model.

Artikkel annab ülevaate narratiivteraapia teoreetilistest alustest ja selle meetodi kasutamisest ... more Artikkel annab ülevaate narratiivteraapia teoreetilistest alustest ja selle meetodi kasutamisest seoses kehakuvandi kujunemisega teisme- ja noorukieas. See on kirjutatud sooviga aidata kaasa teooria ja praktika lõimimisele kliinilises ja rakenduslikus sotsiaaltöös. Ülevaade põhineb narratiivteraapia kasutamise juhistel ja kirjandusallikatel, ühtlasi on artiklis kirjeldatu ka minu doktoriõpingute teema.
Tutvustan analüüsi aluseks olevat teaduskirjandust ja materjale narratiivteraapia kohta, alustades selle poststrukturalistliku teraapiameetodi kõige üldisemast raamistikust ning liikudes kitsamate kehakuvandit puudutavate alateemadeni. Narratiivteraapia põhimõtteid saab kasutada nii töös inimestega, kellel on moonutatud arvamus oma välimusest (nn keha düsmorfiline häire) kui ka näiteks kaasasündinud rindkere moonutusega inimeste puhul: mõlemal juhul võib tulla kõne alla kas kirurgiline või mittekirurgiline korrektsioon. Jättes kõrvale meditsiinilised sekkumised, analüüsin oma uurimistöös nii kirjandusest pärinevaid kui ka teraapia eri osapooltelt (noorukid ise, nende pered, terapeudid ja arstid) kogutud andmeid selle kohta, kuidas narratiivteraapia soodustab positiivse kehakuvandi kujunemist teismelistel ja noorukitel, võttes arvesse ka teraapias osalevate noorte sotsiaalkultuurilist konteksti. Kuna narratiivteraapia põhimõtteid saab kasutada igasuguse nõustamise puhul, siis pakuvad artikli järeldused huvi lugejatele, kes soovivad rohkem teada saada sellest lähenemisviisist ja selle kasutamise võimalustest rakenduslikus sotsiaaltöös.

TERVIST! Tartu Tervishoiu Kõrgkooli Ajakiri, Sep 24, 2015

After three springs teaching medical anthropology to nursing and midwifery students at Tartu Terv... more After three springs teaching medical anthropology to nursing and midwifery students at Tartu Tervishoiu Kõrgkool, I can say that through our meetings we both learned something from each other. The reason why I also learned from the students is not only that I am a foreigner, and thus I have always some new meaning to put into context, but also the fact we often started from scratch to understand who nurses, midwifes and other health care professionals are today, in Estonia and abroad. It is no surprise that on the front cover of a book students reviewed and presented in class, the subtitle nursing reconsidered is a claim in capital letters that speaks to those persons who “didn’t know that angels flew this low!” before being patients for the first time, and also to professionals who reason about their function in post-modern societies.

Pain Without Boundaries: Inquiries Across Cultures, Jan 20, 2014

Nowadays, the concept of pain has been remodelled due to certain pathologies, such as chest wall ... more Nowadays, the concept of pain has been remodelled due to certain pathologies, such as chest wall deformities (CWDs), obesity, and other conditions that may lower one’s body-esteem. Thus, an increased number of surgeons propose new procedures to correct physical stigmas, positively influencing the self-confidence and wellbeing of patients. ‘Among the therapeutic armamentarium, nowadays classical techniques and new approaches make us able to choose the more appropriate for the single patient, according to the surgeon’s experience and preference but in particular tailoring the treatment on the individual clinical and psychological needs. A multidisciplinary approach is advisable in order to manage CWDs in all their complexity.’1 Thus, specialised medical anthropologists understand both patients who take their body’s look as a social deviation, and those who consider it an integrative aspect of their personhood. Because of the high stakes of surgery, throughout the preoperative phase specialists assess the motivations and expectations of deformed patients. In this chapter, I explore narratives of body image disturbance among teenagers, illustrating how the expertise of medical anthropologists may provide them with more insight into their own self-consciousness.

Normal Deformities - Those Who Make Me Feel Like Many others / Normaalsed moonutused: need, kes panevad mind tundma nagu paljud teised, May 30, 2014

This dissertation aims to make patients and therapists more aware of the psycho-social and anthro... more This dissertation aims to make patients and therapists more aware of the psycho-social and anthropological issues related to chest wall deformities (Pectus Excavatum, Pectus Carinatum, Poland syndrome and so on). Stories of 'normal deformities' were recorded at two children’s hospitals: Gaslini di Genova (in Italy) and Tallinna Lastehaigla (in Estonia). In both settings, many deformed youngsters wanted to rid themselves of their uncomfortable 'stigma' through corrective surgery. Such a scenario allowed the collaboration between a social scientist and two surgeons. It inspired a counselling psychology and medical anthropology meshwork which encompasses the asymmetries of lived experience when being conscious of chest wall deformities. Indeed, by listening, questioning and sharing with the accounts of patient participants, owing to Interpretative Phenomenological Analysis, we enter from this point forward into the kernel of a life-world for informants and the medical milieu of body image disturbance (Smith, Flowers & Larkin, 2009).
The first-hand narratives recounted also inform an assessment model described in the last chapter. This chronicles, perhaps even measures the degree of well-being for patients, both in their social and private surrounding. Moreover, a discourse on family resilience and resistance often appears throughout the dissertation. It assumes that how parents behave may strongly encourage or hinder the success of teenagers in coping with their own ‘stigma’, thus unfolding a lingering influence upon ‘normals’ who turn to those who do not feel like many others. Taking into account the works of Gelya Frank, Erving Goffman and Linda Finlay, ultimately this project aims to increase the attunement of therapists to patients – with their physical stigma, either medically diagnosed or imagined.

Conference Presentations by Davide Ticchi

Pectus Excavatum Severity: Multicenter questionnaire demonstrates that symptoms progress after Haller index remains stable

BACKGROUND Pectus Excavatum (PE) accounts for 90% of chest wall deformities and has an estimated ... more BACKGROUND Pectus Excavatum (PE) accounts for 90% of chest wall deformities and has an estimated incidence of about 1 in 500. Some PE patients are asymptomatic while others may experience medical symptoms (e.g., dyspnea on exertion, chest pain, palpitations) or psychosocial symptoms (e.g., body image concerns, depression). There is a great deal of controversy surrounding the Haller index (HI), a measurement used to classify the severity of PE. It is defined as a ratio of the width to the depth at the deepest point of the deformity. Many leading health insurance companies rely on HI to determine if an individual qualifies for surgical treatment. Previous studies correlating HI with cardiopulmonary signs and symptoms have shown mixed results. For example, a recent study by Ewert et al., 2016 showed that HI does not correlate with subjective physical complaints in PE. HYPOTHESIS To demonstrate our idea that HI has poor utility in defining PE, we tested the hypothesis that PE symptoms worsen even after HI remains stable. METHODS Survey-data was collected from a total of N=98 PE patients at five different institutions in four countries: Costa Rica, Italy, Denmark, and Switzerland. The survey consisted of 13 questions and was only given to patients who have not yet had surgical or non-surgical treatment. RESULTS Pearson correlations were computed between HI and all 13 questions in our survey, of which none were statistically significant. Notably, HI does not correlate with symptom occurrence (Pearson correlation r = 0.09, p = 0.486, n = 68). It also does not correlate with interest in treatment (r = 0.014, p = 0.91, n = 68) or cosmetic dissatisfaction (r = -0.042, p = 0.729, n = 68). It is generally understood that HI continues to increase with growth and remains constant after peak height is reached. Results of this survey show that symptom occurrence worsens with age (r = 0.27, p < 0.01, n = 97), as does body image concern (r = 0.22, p = 0.03, n = 98). Taken together, this suggests that PE symptoms occur more frequently even after HI becomes stable. CONCLUSION Although some authors have found correlations between HI and cardiopulmonary measures, our results suggest that the clinical presentation of PE may not be well defined by HI. In particular, using HI as criteria for surgery inclusion ignores the possibility of worsening medical and psychosocial symptoms even with a constant HI.

Thesis Chapters by Davide Ticchi

Doctor's Degree, 2019

In his dissertation, Ticchi specifically focuses on the life stories of shadows - youths with a c... more In his dissertation, Ticchi specifically focuses on the life stories of shadows - youths with a chest wall deformity (pectus excavatum, carinatum, etc.). Especially he focused on the congenital condition pectus excavatum, which is the most typical deformity of the upper body. The deformity causes shame and could evoke suffering, ridicule, and depression. ‘In fact, as a consequence of the societal and virtual preference for sexually objectified bodies with bare, muscular torsos, the social and self-stigma of living with a congenital anomaly of the chest wall plays an important role,’ Ticchi says. According to Ticchi, the youths and their families are often in a situation where they are unable to get professional help and where they lack knowledge about both the surgical and the psychosocial treatment options. Nowadays, most chest wall deformities can be surgically treated. However, Ticchi’s dissertation suggests that clinical social work practice with a narrative therapy approach could be used as a liberating and supportive method to surgical treatment. Telling stories would help youths with the deformity to better understand the problems associated with their body image and to learn to live with it. Ticchi says that the purpose of his dissertation is to find out how the narrative therapy approach in the treatment of physical anomalies could offer psychosocial support in a society that glorifies body perfection. ‘Trained clinical social workers could use accordingly their scientific knowledge and skills to support families to face the crises when a yes-or-no question about surgical repair significantly interferes with their optimal decision-making due to the family’s distress, in a continued emphasis on shadows being seen as diagnostic categories upon which a treatment plan is executed for the remediation of the problem,’ Ticchi finds. In addition, thanks to trained clinical social workers, the families would be more informed about the causes, nature, cost, treatment, and results of chest wall deformities. By using a narrative therapy approach, Ticchi’s dissertation opened a new focus for social work, which is more oriented to problems than disciplines, and which advocates the interdisciplinarity of thoracic surgery with clinical social work practice. In his dissertation, Ticchi uses data collected from both literature and different parties of the interviews (shadows themselves, their families, and so on).

The public defence of 'Slender shadows of youths: A narrative therapy approach to explore life stories about social and self-stigma of chest wall deformities for clinical social work practice', the dissertation of Davide Ticchi, doctoral student of the School of Governance, Law, and Society of the Tallinn University, took place on Monday, 2 September. The supervisor of the doctoral dissertation is Merike Sisask, Professor of Social Health Care at Tallinn University. Opponents are Professor Diana DiNitto (University of Texas at Austin) and Meyer Children's Hospital Professor Antonio Messineo (University of Florence). The doctoral thesis is available in Tallinn University Digital Library: https://www.etera.ee/s/2QrzDhxdMo

Interactive Cardiovascular and Thoracic Surgery, Sep 26, 2017

OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely c... more OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely clear-cut. Patients interested in treatment are referred for evaluation by numerous different specialists, but psychosocial counselling is currently not included in this process. Our objective was to assess whether PE patients would be interested in formal assistance with the decision-making process surrounding PE surgery using narrative therapy principles. METHODS: Ninety-seven untreated PE patients at 5 different institutions in 4 countries completed a questionnaire consisting of 13 questions, with 3 questions specifically evaluating interest in narrative therapy. RESULTS: Eighty-two percent of participants were interested in narrative therapy to assist with the decision-making process surrounding PE surgery. Individuals most interested in narrative therapy tend to be more interested in correction (P < 0.05) to improve the way they feel about their body (P < 0.05). CONCLUSIONS: The majority of PE patients are interested in narrative therapy to aid the decision-making process about treatment. We propose that narrative therapy should be offered to PE patients during the treatment evaluation process to address the psychosocial difficulties associated with PE and the surgical decision-making process overall. Future studies should assess the effectiveness of this interdisciplinary model.

OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely c... more OBJECTIVES: The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely clear-cut. Patients interested in treatment are referred for evaluation by numerous different specialists, but psychosocial counselling is currently not included in this process. Our objective was to assess whether PE patients would be interested in formal assistance with the decision-making process surrounding PE surgery using narrative therapy principles. METHODS: Ninety-seven untreated PE patients at 5 different institutions in 4 countries completed a questionnaire consisting of 13 questions , with 3 questions specifically evaluating interest in narrative therapy. RESULTS: Eighty-two percent of participants were interested in narrative therapy to assist with the decision-making process surrounding PE surgery. Individuals most interested in narrative therapy tend to be more interested in correction (P < 0.05) to improve the way they feel about their body (P < 0.05). CONCLUSIONS: The majority of PE patients are interested in narrative therapy to aid the decision-making process about treatment. We propose that narrative therapy should be offered to PE patients during the treatment evaluation process to address the psychosocial difficulties associated with PE and the surgical decision-making process overall. Future studies should assess the effectiveness of this interdisci-plinary model.

Artikkel annab ülevaate narratiivteraapia teoreetilistest alustest ja selle meetodi kasutamisest ... more Artikkel annab ülevaate narratiivteraapia teoreetilistest alustest ja selle meetodi kasutamisest seoses kehakuvandi kujunemisega teisme- ja noorukieas. See on kirjutatud sooviga aidata kaasa teooria ja praktika lõimimisele kliinilises ja rakenduslikus sotsiaaltöös. Ülevaade põhineb narratiivteraapia kasutamise juhistel ja kirjandusallikatel, ühtlasi on artiklis kirjeldatu ka minu doktoriõpingute teema.
Tutvustan analüüsi aluseks olevat teaduskirjandust ja materjale narratiivteraapia kohta, alustades selle poststrukturalistliku teraapiameetodi kõige üldisemast raamistikust ning liikudes kitsamate kehakuvandit puudutavate alateemadeni. Narratiivteraapia põhimõtteid saab kasutada nii töös inimestega, kellel on moonutatud arvamus oma välimusest (nn keha düsmorfiline häire) kui ka näiteks kaasasündinud rindkere moonutusega inimeste puhul: mõlemal juhul võib tulla kõne alla kas kirurgiline või mittekirurgiline korrektsioon. Jättes kõrvale meditsiinilised sekkumised, analüüsin oma uurimistöös nii kirjandusest pärinevaid kui ka teraapia eri osapooltelt (noorukid ise, nende pered, terapeudid ja arstid) kogutud andmeid selle kohta, kuidas narratiivteraapia soodustab positiivse kehakuvandi kujunemist teismelistel ja noorukitel, võttes arvesse ka teraapias osalevate noorte sotsiaalkultuurilist konteksti. Kuna narratiivteraapia põhimõtteid saab kasutada igasuguse nõustamise puhul, siis pakuvad artikli järeldused huvi lugejatele, kes soovivad rohkem teada saada sellest lähenemisviisist ja selle kasutamise võimalustest rakenduslikus sotsiaaltöös.

TERVIST! Tartu Tervishoiu Kõrgkooli Ajakiri, Sep 24, 2015

After three springs teaching medical anthropology to nursing and midwifery students at Tartu Terv... more After three springs teaching medical anthropology to nursing and midwifery students at Tartu Tervishoiu Kõrgkool, I can say that through our meetings we both learned something from each other. The reason why I also learned from the students is not only that I am a foreigner, and thus I have always some new meaning to put into context, but also the fact we often started from scratch to understand who nurses, midwifes and other health care professionals are today, in Estonia and abroad. It is no surprise that on the front cover of a book students reviewed and presented in class, the subtitle nursing reconsidered is a claim in capital letters that speaks to those persons who “didn’t know that angels flew this low!” before being patients for the first time, and also to professionals who reason about their function in post-modern societies.

Pain Without Boundaries: Inquiries Across Cultures, Jan 20, 2014

Nowadays, the concept of pain has been remodelled due to certain pathologies, such as chest wall ... more Nowadays, the concept of pain has been remodelled due to certain pathologies, such as chest wall deformities (CWDs), obesity, and other conditions that may lower one’s body-esteem. Thus, an increased number of surgeons propose new procedures to correct physical stigmas, positively influencing the self-confidence and wellbeing of patients. ‘Among the therapeutic armamentarium, nowadays classical techniques and new approaches make us able to choose the more appropriate for the single patient, according to the surgeon’s experience and preference but in particular tailoring the treatment on the individual clinical and psychological needs. A multidisciplinary approach is advisable in order to manage CWDs in all their complexity.’1 Thus, specialised medical anthropologists understand both patients who take their body’s look as a social deviation, and those who consider it an integrative aspect of their personhood. Because of the high stakes of surgery, throughout the preoperative phase specialists assess the motivations and expectations of deformed patients. In this chapter, I explore narratives of body image disturbance among teenagers, illustrating how the expertise of medical anthropologists may provide them with more insight into their own self-consciousness.

Normal Deformities - Those Who Make Me Feel Like Many others / Normaalsed moonutused: need, kes panevad mind tundma nagu paljud teised, May 30, 2014

This dissertation aims to make patients and therapists more aware of the psycho-social and anthro... more This dissertation aims to make patients and therapists more aware of the psycho-social and anthropological issues related to chest wall deformities (Pectus Excavatum, Pectus Carinatum, Poland syndrome and so on). Stories of 'normal deformities' were recorded at two children’s hospitals: Gaslini di Genova (in Italy) and Tallinna Lastehaigla (in Estonia). In both settings, many deformed youngsters wanted to rid themselves of their uncomfortable 'stigma' through corrective surgery. Such a scenario allowed the collaboration between a social scientist and two surgeons. It inspired a counselling psychology and medical anthropology meshwork which encompasses the asymmetries of lived experience when being conscious of chest wall deformities. Indeed, by listening, questioning and sharing with the accounts of patient participants, owing to Interpretative Phenomenological Analysis, we enter from this point forward into the kernel of a life-world for informants and the medical milieu of body image disturbance (Smith, Flowers & Larkin, 2009).
The first-hand narratives recounted also inform an assessment model described in the last chapter. This chronicles, perhaps even measures the degree of well-being for patients, both in their social and private surrounding. Moreover, a discourse on family resilience and resistance often appears throughout the dissertation. It assumes that how parents behave may strongly encourage or hinder the success of teenagers in coping with their own ‘stigma’, thus unfolding a lingering influence upon ‘normals’ who turn to those who do not feel like many others. Taking into account the works of Gelya Frank, Erving Goffman and Linda Finlay, ultimately this project aims to increase the attunement of therapists to patients – with their physical stigma, either medically diagnosed or imagined.

Pectus Excavatum Severity: Multicenter questionnaire demonstrates that symptoms progress after Haller index remains stable

BACKGROUND Pectus Excavatum (PE) accounts for 90% of chest wall deformities and has an estimated ... more BACKGROUND Pectus Excavatum (PE) accounts for 90% of chest wall deformities and has an estimated incidence of about 1 in 500. Some PE patients are asymptomatic while others may experience medical symptoms (e.g., dyspnea on exertion, chest pain, palpitations) or psychosocial symptoms (e.g., body image concerns, depression). There is a great deal of controversy surrounding the Haller index (HI), a measurement used to classify the severity of PE. It is defined as a ratio of the width to the depth at the deepest point of the deformity. Many leading health insurance companies rely on HI to determine if an individual qualifies for surgical treatment. Previous studies correlating HI with cardiopulmonary signs and symptoms have shown mixed results. For example, a recent study by Ewert et al., 2016 showed that HI does not correlate with subjective physical complaints in PE. HYPOTHESIS To demonstrate our idea that HI has poor utility in defining PE, we tested the hypothesis that PE symptoms worsen even after HI remains stable. METHODS Survey-data was collected from a total of N=98 PE patients at five different institutions in four countries: Costa Rica, Italy, Denmark, and Switzerland. The survey consisted of 13 questions and was only given to patients who have not yet had surgical or non-surgical treatment. RESULTS Pearson correlations were computed between HI and all 13 questions in our survey, of which none were statistically significant. Notably, HI does not correlate with symptom occurrence (Pearson correlation r = 0.09, p = 0.486, n = 68). It also does not correlate with interest in treatment (r = 0.014, p = 0.91, n = 68) or cosmetic dissatisfaction (r = -0.042, p = 0.729, n = 68). It is generally understood that HI continues to increase with growth and remains constant after peak height is reached. Results of this survey show that symptom occurrence worsens with age (r = 0.27, p < 0.01, n = 97), as does body image concern (r = 0.22, p = 0.03, n = 98). Taken together, this suggests that PE symptoms occur more frequently even after HI becomes stable. CONCLUSION Although some authors have found correlations between HI and cardiopulmonary measures, our results suggest that the clinical presentation of PE may not be well defined by HI. In particular, using HI as criteria for surgery inclusion ignores the possibility of worsening medical and psychosocial symptoms even with a constant HI.

Doctor's Degree, 2019

In his dissertation, Ticchi specifically focuses on the life stories of shadows - youths with a c... more In his dissertation, Ticchi specifically focuses on the life stories of shadows - youths with a chest wall deformity (pectus excavatum, carinatum, etc.). Especially he focused on the congenital condition pectus excavatum, which is the most typical deformity of the upper body. The deformity causes shame and could evoke suffering, ridicule, and depression. ‘In fact, as a consequence of the societal and virtual preference for sexually objectified bodies with bare, muscular torsos, the social and self-stigma of living with a congenital anomaly of the chest wall plays an important role,’ Ticchi says. According to Ticchi, the youths and their families are often in a situation where they are unable to get professional help and where they lack knowledge about both the surgical and the psychosocial treatment options. Nowadays, most chest wall deformities can be surgically treated. However, Ticchi’s dissertation suggests that clinical social work practice with a narrative therapy approach could be used as a liberating and supportive method to surgical treatment. Telling stories would help youths with the deformity to better understand the problems associated with their body image and to learn to live with it. Ticchi says that the purpose of his dissertation is to find out how the narrative therapy approach in the treatment of physical anomalies could offer psychosocial support in a society that glorifies body perfection. ‘Trained clinical social workers could use accordingly their scientific knowledge and skills to support families to face the crises when a yes-or-no question about surgical repair significantly interferes with their optimal decision-making due to the family’s distress, in a continued emphasis on shadows being seen as diagnostic categories upon which a treatment plan is executed for the remediation of the problem,’ Ticchi finds. In addition, thanks to trained clinical social workers, the families would be more informed about the causes, nature, cost, treatment, and results of chest wall deformities. By using a narrative therapy approach, Ticchi’s dissertation opened a new focus for social work, which is more oriented to problems than disciplines, and which advocates the interdisciplinarity of thoracic surgery with clinical social work practice. In his dissertation, Ticchi uses data collected from both literature and different parties of the interviews (shadows themselves, their families, and so on).

The public defence of 'Slender shadows of youths: A narrative therapy approach to explore life stories about social and self-stigma of chest wall deformities for clinical social work practice', the dissertation of Davide Ticchi, doctoral student of the School of Governance, Law, and Society of the Tallinn University, took place on Monday, 2 September. The supervisor of the doctoral dissertation is Merike Sisask, Professor of Social Health Care at Tallinn University. Opponents are Professor Diana DiNitto (University of Texas at Austin) and Meyer Children's Hospital Professor Antonio Messineo (University of Florence). The doctoral thesis is available in Tallinn University Digital Library: https://www.etera.ee/s/2QrzDhxdMo