The Not Mini Adults Podcast - “Pioneers for Children’s Healthcare and Wellbeing”

Episode 5: SPACE with Dr Alberto Tozzi

July 17, 2020 Season 1 Episode 5
The Not Mini Adults Podcast - “Pioneers for Children’s Healthcare and Wellbeing”
Episode 5: SPACE with Dr Alberto Tozzi
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The Not Mini Adults Podcast - “Pioneers for Children’s Healthcare and Wellbeing”
Episode 5: SPACE with Dr Alberto Tozzi
Jul 17, 2020 Season 1 Episode 5

This week on The Not Mini Adults Podcast - "Pioneers for Children's Health and Wellbeing" we speak with Dr Alberto Tozzi, Chief Innovation Officer & Research Area Coordinator for Ospedale Pediatrico Bambino Gesu in Rome, Italy
 
We discuss 'Space' and how children need to be considered when organisations and governments are looking at colonisation on other planets in the next 20-30 years.
 
Given that Dr Tozzi is a paediatrician and an epidemiologist with experience in vaccines and transmissible diseases, we inevitably discussed the COVID-19 pandemic and what it has meant for children.
 
We also discuss how Dr Tozzi and his team are working with patients and their families to find solutions to unmet needs in hospital. 
 
Dr Tozzi has worked as a researcher with the Italian National Health Institute for more than 15 years, participating in and coordinating several projects concerning the prevention and surveillance of infectious diseases. In 2004 Dr Tozzi moved to the Bambino Gesù Children’s Hospital, where he continued to work in vaccine preventable diseases and started developing projects on eHealth and digital medicine.
 
Thinking of Oscar Website and Contact details can be found here.

Follow us on Twitter here.

Theme Music - ‘Mountain’

copyright Lisa Fitzgibbon 2000
Written & performed by Lisa Fitzgibbon,
Violin Jane Griffiths

Podcast artwork thanks to The Podcast Design Experts.

 


Show Notes Transcript

This week on The Not Mini Adults Podcast - "Pioneers for Children's Health and Wellbeing" we speak with Dr Alberto Tozzi, Chief Innovation Officer & Research Area Coordinator for Ospedale Pediatrico Bambino Gesu in Rome, Italy
 
We discuss 'Space' and how children need to be considered when organisations and governments are looking at colonisation on other planets in the next 20-30 years.
 
Given that Dr Tozzi is a paediatrician and an epidemiologist with experience in vaccines and transmissible diseases, we inevitably discussed the COVID-19 pandemic and what it has meant for children.
 
We also discuss how Dr Tozzi and his team are working with patients and their families to find solutions to unmet needs in hospital. 
 
Dr Tozzi has worked as a researcher with the Italian National Health Institute for more than 15 years, participating in and coordinating several projects concerning the prevention and surveillance of infectious diseases. In 2004 Dr Tozzi moved to the Bambino Gesù Children’s Hospital, where he continued to work in vaccine preventable diseases and started developing projects on eHealth and digital medicine.
 
Thinking of Oscar Website and Contact details can be found here.

Follow us on Twitter here.

Theme Music - ‘Mountain’

copyright Lisa Fitzgibbon 2000
Written & performed by Lisa Fitzgibbon,
Violin Jane Griffiths

Podcast artwork thanks to The Podcast Design Experts.

 


David:

Hello and welcome to the fifth episode of The Not Mini Adults podcast, Pioneers for Children's Health Care and Wellbeing. Once again, my name is David Cole, and I'm joined by my wife Hannah, together we are the co founders of children's charity thinking of Oscar. This week we speak with Dr. Alberto Tozzi. Dr Tozzi is the Chief Innovation Officer and research area coordinator for the Bambino Gesu Paediatric Hospital in Rome, Italy. Dr. Tozzi is a paediatrician and an epidemiologist with experiences in vaccines and epidemiology of transmissible diseases. He has worked as a researcher for the Italian National Health Institute for more than 15 years, participating and coordinating several projects concerning the prevention and surveillance of infectious diseases. In 2004, Dr Tozzi moved to the Bambino Gesu Children's Hospital, where he continued to work in vaccine preventable diseases and started developing projects on eHealth and digital medicine. As you will hear, he is now bringing Research and Innovation together within the hospital and leading a broad range of initiatives. So Hannah, unfortunately, you weren't able to join us on this conversation. I know it was one that you really wanted to, to be a part of.

Hannah:

Yeah, I really enjoyed listening to it afterwards. I think were the same as lots of other families at the moment just juggling to fit in unusual schedules.

David:

Absolutely.

Hannah:

But yeah, so you gave me a sneaky preview, while I did a quick morning run and Alberto talks in a really different way than other conversations we've had to date and the obvious one that jumped out was the heading that you've given this conversation, which was all about space. You know, you start off listening, wondering what could Child Health possibly, or how could Child Health possibly connect to space, and I'll leave Alberto to tell his own story. But the point I took from it was something that translates in many other spaces, which is that you can think big and think small at the same time. What I heard him saying was, one of the parts of that story was to do with him. He's got short term things that he can accomplish in the here and now. But he's also always got one eye absolutely on the horizon, to see what the art of the possible is. Thats not just because he's curious about what might come around the corner in the future. But if you don't put certain measures in place early on then,when the future becomes the now then you're not prepared for it. So I thought it was really interesting that he was preparing for such a long term.

David:

Absolutely. And he's such a lovely man, you know, a real pleasure to speak with and I hope others will, you know, take a lot out of the conversations or as much out of the conversations as we did. There's so much that we could discuss with him as we kind of allude to, during the conversation.

Hannah:

Then the last section that really resonated with me personally, was the one to do with, you know, he said, if there's well I kind of I don't want to ruin the punchline of the story. But he was talking about the importance of involving kids, whether they're the young ones or the older end of the spectrum, in their treatment process and how you communicate with them. He talked about the power of patients and their families and that resonated so strongly, because, as you will remember, on the Wednesday morning, when we were in hospital with Oscar, and he died on the Thursday, on the Wednesday morning, we were with the consultants. I remember I've always remembered asking, what's the difference between being sleepy and losing consciousness and we were given an answer, which was absolutely plausible. It's not at all that we weren't listened to. Oscar had really great care when he was in hospital. But what probably none of us, including the clinicians understood was how important that observation was, I never understood that, my opinion and what I could see was that important and it turned out that it was completely vital. I guess I had perceived my observation and what I could see was just a mother's instinct, whereas looking back on it, it was data. And there isn't a mechanism at the moment to collect those types of data points.

Dr Alberto Tozzi:

Good morning.

David:

Good morning.

Dr Alberto Tozzi:

Thank you for inviting me.

David:

Oh, no, it's it's an absolute pleasure. Sadly, I guess we won't be seeing each other in person this year. I think last time we saw each other was in Rome last year during your Future of Paediatrics Conference. I wanted to start by just maybe talking a little about you and how you got to be doing what what you're doing currently?

Dr Alberto Tozzi:

Well, I hope that we will meet in person very soon and I bet so. About my role, I must say that I'm a paediatrician. But actually, the interest that I had since I was very young in technology in computer science and in the technicalities that can make health a little bit better, changed a little bit, my initial attitude that was simply being a paediatrician. I was very soon involved in research activities simply because it was in the 80s, I must say, I was able to programme a computer and I was experienced in actually dealing with statistical packages, software's like these. There were absolutely strange things in the 80s, I must say. And then my career, went on, on research activities. I have been involved in several research activities in the National Health Institute, in Rome, Italy. We did a lot of international activities, including a big clinical trial on vaccines, because my interest is still today is vaccine preventable diseases. But still, technology played a role and when I moved to the Bambino Gesu hospital, this was very helpful in shaping a new area of activity, starting from research, very slowly, but well, in a few years, we went in a new area that was innovation. We were able to form a new group that was including people from different profiles. I was appointed Chief Innovation Officer in this hospital, which is a very strange thing for an Italian hospital. More recently, we grouped together the research activities and innovation activities, and we try to explore all the things that might be useful to improve the quality of care, especially looking at outside. I think technologies, plus other profiles, other disciplines. Multidisciplinarity is one of the rules that we follow.

David:

Wonderful. We're going to have to come back to the vaccine side of things because obviously, that's very topical at this point in time, especially given that you are currently in Italy. But if we could just touch a little bit on Bambino Gesu, so that the hospital in itself is a special place. Yes?

Dr Alberto Tozzi:

It is and I did not expect this because this is a hospital, but the very first feeling that I had when I came in was that this is a big team, everybody's working for one single reason, which is the wellness and the goodness of children. This is, simply you can touch this because people are so patient in their daily work and this is very uncommon. This enthusiasm is one of the good things of our daily routine, because you can't hear anybody complaining of anything, simply because we're working with passion. This makes this place a very special place. At the same time, we're also very involved in activities, we collaborate with other hospitals especially. Well, I would say, hospitals in Africa and in poor countries. I must say that one of the big things of this hospital is that the boss is the Pope, which is very uncommon as well.

David:

That's what I was gonna say. Yeah, I mean as you say the the pope is kind of the head of the hospital and what have you and tell us about the story how that all kind of came about.

Dr Alberto Tozzi:

Well, this is a hospital owned by the Vatican actually. But at the same time, the Pope decided that this should be the place where children are taken care of in the best way. That's why he has a lot of expectations about us, this puts a lot of pressure, which is fine. But at the same time, it's also one of the things that make us improve everyday. It's not common, living such a routine, because most of the times, when you work in every place, including a hospital, you think about a daily routine. We always expect something new every day, which is very special. That's why this is valid for me and my group, we never get tired. At least by now.

David:

I think probably lots of people around the world would say that they, you know, they see the Pope as their boss as it where. But he really is your boss, right? Let's talk about given where, you know, given the global pandemic that we're in at the minute, and I know that you got drafted in by, by the Italian health system to actually look at some of the, the vaccine side of things and what have you. Can you tell me a little bit about that?

Dr Alberto Tozzi:

Well, speaking about the pandemic, we have a long story behind, simply because I have been living during the years when we were trying to prepare for a new pandemic. Actually, this was a very big lesson. Unfortunately, it was too long ago, many of the people involved in that, actually activities forgot that. But actually, we learn a couple of things. One is that prevention is everything. and tracing the contactst, for example, which is one of the focuses that we have today is crucial. Several years ago, we also made a couple of experiments. When we had the H1N1 pandemic, that was several years ago, we tried, for example, to make an experiment in the hospital, tagging every single person in the world with an active RFID tag. That was very instrumental to understanding the pattern of contacts within the hospital, which is very important because you learn, for example, that the nurses are one of the categories, most likely to spread the infection simply because they spend a lot of time with children. They have a lot of children to take care of. But you'll have also other people like for example, people in charge of distributing food, they touch every single bed. Actually this is also very important for understanding how an infection can spread. All this information instead of being simple feelings were translated into numbers. This was very important for putting in place policies and this is what we learned. We should also keep in mind when we cope with this pandemic today, because measuring things is absolutely crucial for putting in place real policies and working policies, most of the times. I must say that, about contact tracing, there are a lot of stories to be told and including the last days in which every single European countries, but also other countries are trying to promote the use of apps for contact tracing. On one hand, you have a very powerful tool, which is absolutely supporting some of the policies that you can do with contact trace. You can't contact people that you don't know simply and this is one of the basic rules. At the same time, we discovered the big concern that people have about privacy, and we were not used to that. We thought that actually we simply asked for information and people are fine. This is not the case. So this is a new area in which we should be more cashflow more sensitive and try to work together with patients and with general people. This is a an area for collaborative activity. Absolutely.

David:

I think you know at the beginning, certainly from a European point of view, Italy was obviously at the forefront you're in Rome and mostly in the southern part of Italy. But and we as we know, it was the northern part that got hit the most but how are things how are things now and are you you know, what are you still playing a role? Are you still kind of assisting in terms of what what they're trying to do?

Dr Alberto Tozzi:

Yeah, well, we are trying to monitor everything. This happens at local level, including the hospital, we have a very strict policy for screening, for example. Every single patient and caregivers are tested. First with a set of questions and if we have any suspicion that something is happening, we go with a lab diagnostic test for understanding if we have to take care of this kind of patients. Same thing is happening for personal health, we have a lot of activity and continuous screening more on the diagnostic test site. This was enough for limiting diffusion inside the hospital. You know that Italy had a very unfortunate setting that was especially happening in the northern Italy, where many hospitals didn't realise that this new infection was coming. So they were not trying to limit the contacts and also they were not able to screen them. We were much more lucky, because in Rome, the circulation of this virus happened very late. We had all the opportunities to set up all these systems for screening. But this is still in place. So we screen every single person. You know that, for example, we had two or three different clusters coming especially from abroad, people from Bangladesh and things like that. One of the first cases in these new clusters were coming from to the hospital simply because there was one child with fever, he was sick. We then discovered all the rest of the cases. But it'sa hard game, because it's tough, because you should be very fast. Once you discover a single case, you must be as fast as possible in trying to find out the others. That that's one of the big things.

David:

No, absolutely. But I guess, you know, in terms of lots of conversations that I've been having and you and I had a few weeks ago. Fortunately, it's not affecting children in the same way that it has adults.

Dr Alberto Tozzi:

Yeah. This is something that is a big question mark. I don't think that children play a major role in driving infection. At the same time. I'm amazed by the, you know, we don't have that much information about the epidemiology in children. One of the discussions that we are having is, why don't we try to promote an epidemiologic study on children, because we should learn much more than we know today. For example, we will learn that possibly school closure may not have a major impact on circulation of the infection. This is extremely important, because if this is true, we want our children participating in community activities and going to school. But at the same time, we have a certain level of uncertainty, which is a very usual when we have new infections and new situations like this. I think that in in two or three months, we will discover new things, we will discover new therapies, and we will be even more ready than we are right now. We're progressing in our knowledge. And we're getting better, I think, until we will have a vaccine,

David:

Fingers crossed. One of the things that I have been, I guess, kind of mulling over and thinking about is, given the podcast that we you know, that we've launched during the pandemic is just what can we learn from, as you say, you know, the physiological side of children, which we can then bring into adult medicine.

Dr Alberto Tozzi:

Yeah.

David:

To help in the future with any other future pandemics that may come along. You know, I think that's that's going to be a fascinating thing to, to look at.

Dr Alberto Tozzi:

Yeah, it is, and I think we're still learning.

David:

Still to come on the Not Mini Adults podcast, we talk about culture and diversity of thinking, as well as how Alberto is using patients and their families in the innovation process and of course, we're going to be talking about space. I want to pick up on one of the things that you said at the beginning. So you talked about, obviously, the Bambino Gesu Hospital. You said, it's very rare for an Italian hospital to do the innovative programmes and research and what have you that you do. Just expand on that a little bit, if you don't mind.

Dr Alberto Tozzi:

Yeah, this is strange, but I'm trying to play this role, since I was very young. One of the things tha most of the times I enc untered was you know, some Most certainly and so how do you work with the senior executives cepticism about the possibility that disciplines, different f om medicine can help improve in he health of children an our patients, that's a general rule. So and this is very com on in every single hospital. Even if you go abroad, you reco nise that this is a common barr er and this has to do with cu ture simply because we're no educated to learn from other th ngs. At least for my generati n, you know, when you think of being a doctor, this means simp y having a educational pat , which is only medicine, noth ng else. Since since it is a ver heavy, you know, and long, eve ybody feels like this should b the highest profile possible Then you discover that explo ing other disciplines, you l arn other things, or have differ nt points of view. You must go back and understand that y u can learn even more than you id and this is the difficult thing. For example, one of t e big lessons that I learned, several years ago, when I att nded one of my first artificial intelligence in medicine confer nces. This was mostly lect res by data scientists, few med cal doctors, very few medical do tors, a lot of engineers or data scientists. But after four days of this conference, I came out a d my question was, she says I have to start back again, have to study things in a dif erent way. Otherwise, I will n t be at the same level that I ca try to imagine because I can i prove. This kind of thing is very difficult to accept by pe ple that, for example, have a ong career, they did a lot of efforts to be in a position th t that is now consolidated, f r example. They don't want to g back and learn something agai . So culture is a problem. But t the same time, it's also problem of the system, because we don't have room for innovati n in the system. Commonly, we do 't have investments. T ere's a lot of confusion betw en innovation and resea ch. Everybody is crazy for res arch, but nobody cares about in ovation. There's a strong link between the two things. But so etimes it's very difficult o invest in innovation simply because of this confusion. I hink this will be one of the dis ases we must take care of, i the near future. within your hospital to make ure innovation is on a, you now, is on a level playing ield and seen in the right way? This was very difficul and it is very difficult because you can do whatever you want, but the system outside does not care for innovation. So for example, if we go for investing in an activity, which is creating a new product with a startup for telemedicine or whatever. You must find out a way to support all these activities with existing tools and means. This is crazy, because most of the times, we try to translate innovation into research simply because funding and support are available for research and much less for innovation. In our environment, one of the tricks that worked was that we had, we were lucky enough to have a group of people with very different profiles. We have writers, we have data scientists, we have journalists, we have architects, we have whatever, nurses, medical doctors, absolutely. But this group with so many different profiles was one of the big things that convinced people that we deserved some attention, because we were trying to address problems in a different way.

David:

So I'm going to be slightly provocative here and ask you the question, if you were doing some of the things that you're looking at, which are classed innovation at Bambino Gesu, in a an adult centric hospital, would they be called innovation?

Dr Alberto Tozzi:

Uh, well, I think so. Absolutely, we have an advantage, because, you know, when you work in a innovation area with children, this is a very big push. Having children as partners and working with patients is absolutely powerful. Children, they have some fresh ideas, and they come out with some solutions that you never think about. This is something that we usually recognise and is really amazing. I'm not sure that this happens in the adult hospitals as well.

David:

No, I think what I meant by the question was, you know, they would just see a lot of the things that you would look at doing as businesses as normal in adult hospital

Dr Alberto Tozzi:

Yeah

David:

It wouldn't be something innovative, it wouldn't be something, you know that either they haven't tried before, or they were trying to do something different, because either they've already done it, or they wouldn't be trying it at all.

Dr Alberto Tozzi:

Yeah, you know, on the definition of innovation, everybody discusses it a lot, but simply we're trying to find out a solution to a problem. This solution does not exist yet. This is innovation simply.

David:

Absolutely. So let's talk about some of the work that you're currently doing. You touched on one of the and I think this is a common theme across anyone that's trying to, you know, do similar things within a children's hospital setting or a children's care setting, whatever it might be, which is the fantastic ability to actually work with patients,and use the creativity of youngsters in order to move things forward. So you have a project, which, think you call Science Shops. Can you talk to us a little bit about that, because they're really exciting.

Dr Alberto Tozzi:

Well by now we have just a project. Hopefully this will be funded by the European Commission, because it's a collaborative project with other hospitals. We have another three hospitals together. One is in Barcelona, the other one is the Helsinki hospital. The third one is in Toronto, actually. Sick children in Toronto are participating as well. The idea behind this project is, we are passionate, involving children in common activities and we always discuss with them about potential solutions. But we don't have any structure, which is set up for this purpose. We mostly meet them and discuss with them that there's nothing which is a real infrastructure. So the idea behind the project was, why don't we try to think of a case study and we decided to focus on rare diseases, which is problematic because you have several problems, several patient with different problems and complex things that are not addressed yet. Several of these problems are not only therapies, but are practical problems of daily life. So how to get involved in sports, while having a lot of disabilities and other things. So the idea was, why don't we try to imagine an infrastructure which is open to patients for proposing some of the other problems of the issues, but at the same time, also offering some expertise and involvement for addressing these issues. So we decided to divide the activities in three different fields. One is innovation. The other one is therapy and the third one is service design. We imagined that we can make these categories because we have for example, how to invent new devices for getting better during the daily life. This is innovation, for example. How to be more involved in research activities, when, for example, designing a new clinical trial for a new therapy, and this is therapy, how can we improve the access to health structures, which is the patient journey and this is service design. And we divided this three categories into three different sides. These shops not only then respond to, and actually listen to the patients just because they propose an issue, but they also select some of these issues and develop a solution in I would say, 6 to 12 months to offer a response to

David:

I think it's absolutely fascinating and as you say, you them. So if this works, this might be an experiment that might translate into something real, because I expect that each single hospital should have an interest in infrastructure and a service like this. Someplace where the patients go and find out somebody who listens to them and also help them to make something real together with them. For doing this, it's not only thinking of, you know, you have a group of researchers dealing with some innovation, it's involving them, and providing them with some information with some educational activities. Bri g them on board for setting up new solution for innovation or or research or for service des gn. That was the idea behind the project. know, if this proves to be successful, then having these kinds of shops in all healthcare settings would be essential. There's a couple of questions that springs to mind. The first is, how did you go about getting engagement from from the patient as it were? Because they wouldn't ordinarily, you know, that as a patient, or as a paren , you go into hospital a d you think, Well, they've go all the answers, not they're g ing to be asking me to help to d sign the answers.

Dr Alberto Tozzi:

Oh, good. There are two questions, I would say. Because one is that, especially when you deal with this, patients that are so complex, and sometime sometimes their disabilities do not allow, to move, actually should say it all. Sometimes they can't move really. On the other hand we also started working in this project during COVID-19, which is an additional barrier to actually connection between people. So the solution we tried to find out was trying to point to virtual solutions and web connections all the time. This is pretty easy, because we, you know, we are still in one of the biggest experiments, digital experiments in the world, because of COVID-19. This is something that we learned at the same time. Actually, the patient associations, especially in the domain of rare diseases are extremely active and they have a strong background in active participation in research and innovation. Also in connecting with hospitals and other groups. They're very powerful. There are many, because rare diseases are rare, but the Federation of rare diseases, patient associations are so many people. That's why we decided to focus on them also, because we have plenty of issues to address. It's not just one disease, and one single problem and one vertical approach.

David:

So the the other question, I think you've kind of touched on it a little bit, but given that you're looking at rare diseases by kind of default, you're working with hospitals that are more tertiary settings, they're larger hospitals, they're specialists in this area. I think what sometimes gets overlooked is if you move into other areas, how do you bring that down to the more localised hospitals.

Dr Alberto Tozzi:

Thats a very good point and I think that virtualizing the connection between the associations and the patients and the B hospitals will help in actually bringing to the local setting some of t e innovations and the appr ach.The strange thing is that the area where we made this appl cation was citizen science, whic is actually a little bit unus al for medical science. But this is exactly why we decided to g for that, because we thou ht that participation is the ey word in this project. And lso, we always don't reco nise the power of patients and heir families that and you know very well, you're one of the ig demonstration that fami ies can make the diff rence. We always don't reco nise that. So if I can try to d anything that can unde line this, this obse vation, I will do that.

David:

First of all, thank you for for saying that. You know, obviously, we couldn't agree more in terms of, but you know, I don't think everybody feels that they have a have an ability or a say, to actually change or make change or make suggestions or whatever it might be. So I think, you know, we've we've talked about it quite a bit on on other podcasts, but the empowerment of the child, but also, I guess, of the parents of the carers to feel part of the process. I think is, you know, is really important and something that this, you know, will hopefully bring with it,

Dr Alberto Tozzi:

Yeah, you may recognise I've been discussing a lot of times this issue with several friends. One of them is Anthony Chang, for example, you know, always tell him my frustration in waiting for things that never happened. He always says, it takes time. Don't worry it will happen, but it takes time.

David:

So for for any listeners that don't know, Anthony, so Anthony Chang is probably the reason why you and I know each other not yet I knew either of you at that point in time, but he started Ispy the International Society for paediatric innovation. You and I first met him at a gathering of Ispy. We've kind of gone from there, and hopefully we will speak to Anthony at some point in the future around what he's doing. I was, you know, to one of the points that you brought, originally one of the things that I was found fascinated about Anthony that, again, he's a paediatrician and a surgeon, but also he's gone back and studied, he's got a data science degree as well. So he's bringing both of those elements together.I think if you listen to the conversation that we had with Neil, Sebire at, GOSH, last week, you know, it kind of put it all into context in terms of the importance of data and understanding all of the multitude of data that we're discovering moving forward.

Dr Alberto Tozzi:

Very good.

David:

So, there's a couple of other points now I think, as we've discussed previous there's so many things that we could discuss and I think one of the the wonderful things that you are doing at Bambino Gesu and I guess across other hospitals as well. First of all, you collaborate with many other hospitals, which I think is fantastic. The other thing is that there's a lot of diversity as you've kind of picked up on it in terms of your team and the way that you look at things. I think that's an opportunity for us to have a longer discussion at another time, but one of the things that you and I have spoken about, which I'd really like to touch on, and again, I think this epitomises some of the aspects of the Not Mini Adults podcast is space is a word, it's a big frontier, right? Give give me a view, your view and how you're starting to think about it.

Dr Alberto Tozzi:

Well, space is fascinating. And when you get in touch with people involved in space science, you understand that you can learn a lot of things that you never imagined. This is one thing and actually I learned that several innovations came simply because they were in a lab of science space, they had nothing to do with medicine. They were just experiments that came into use just because by coincidence, I would say. But besides that, there's a perspective that I think we should very simply keep in consideration because we're getting better and better in travelling into space. We saw that for example, SpaceX took less than one day to bring two people to the space station like it was in air flight, it was more or less like that. So what happens if in 20 or 30 years, we'll be living with families in space. That's my point. If we should think of that, we should think of children, because children might be one of the subjects with a lot of problems when travelling to space, because they're very young, they would be exposed to radiations and to physical forces, that might be a problem for their health. So the point is, before saying that they should not travel to space, maybe we should sit down and start thinking if there's any chance that we can study the possibility that they can do that in the future, and which kind of effect we should expect from travelling in space. Since it's completely unethical to make experiments on children and what we have been dealing with so far is just animal models, we have a couple of things that we can do. One is laboratory experiments, we can grow up cells and make experiments that might be very useful to understand what a child can suffer. For example, from a travelling space. The second thing that we have today is artificial intelligence. One of the big things might be visualising a model that may resemble a child and understand what happens if he would travel to space. Being prepared for that might be important. I think, we were not that anxious about sending people to space. But I think this deserves some thought. Because together with experiments, I would say we should reflect also, about the ethics. We learned that several technologies, may have problems with ethics simply because we don't think of ethics at the very beginning. So we have this big opportunity to start thinking of this progress, which is travelling to space, thinking at the same time about technologies and ethics. This is an opportunity that I think is absolutely crucial and important. I hope that we will open up the doors to that. So who should be involved in this study of these processes and these new things. I think paediatricians should be involved, because I think that, well, they take care of the health of children and they can address many of the issues that we can encounter together with another list of other disciplines. But my interest is because I think it's time to switch this idea on before it's too late. And then possibly, the progress and the science will be conducted not in the right way. So this is the right time to put together ethics and technology. I think

David:

It's a great vision. I think, given the amount of effort and money that is going into space travel at this point in time, you know, if it's not looked at, then then we're missing a trick. But also, if we can, if there wasn't the ability to start to do those kinds of studies, you would think surely there are the abilities to do some of the other studies that need to start happening with children who are on Earth, who are suffering from other diseases, or whatever it might be. Just because it's not travelling to space, and it's not such a, you know hot topic of conversation. Hopefully it will open up other doors, I guess, is my kind of correlation and thought process around that.

Dr Alberto Tozzi:

Hope so

David:

Alberto, I'm going to finish with with one question that we've been, we've been asking our other guests, and that is, if you could change anything within child health, what would that be?

Dr Alberto Tozzi:

That's a big question. Well, one thing that I would change is letting them participate more actively to the healthcare process, because we're still very paternalistic. What what we do all the time says, just ask him, what do you think about that? This is different from involving directly families, caregivers, and children. I expect that they can give a lot of support simply because they know their disease. They have a very fresh mind. So this is one of the things that will change immediately.

David:

Fantastic. Thank you. Alberto thank you so much for your time. I'm very conscious that it's precious. I think it's been a fascinating conversation and I hope that people will listen and learn some of the aspects that you've taken into the work that you've done from an innovation perspective. I also hope that we can have another conversation in the future and hopefully, Hannah will be able to join us that time as well.

Dr Alberto Tozzi:

Absolutely. Thank you to you David. Thank you so much

David:

Ciao Alberto, Speak to you soon

Dr Alberto Tozzi:

Ciao, will speak to you soon

David:

Thank you for joining us on Not Mini Adults Podcast. It's always a pleasure to talk to Alberto and I hope you enjoyed the conversation as much as I did. As ever details of today's show can be found in the show notes. And of course, if you think that we should be speaking to someone, then please do get in touch and let us know. Next week will we be speaking to Christian Koerner from th Copenhagen Children's Hospita and the exciting topic o conversation is all about play We hope you can join us then