La rappresentazione del rapporto tra utenti e sistema sanitario: I modelli culturali dei medici di medicina generale - The representation of the relationship between users and healthcare system: Cultural models of general practitioners

The present research study explores the emotional and symbolic representation of the Italian healthcare system and specifically of general medical services reported by a group of Italian general practitioners. General medicine is recently affected by a structural change which could be sustained also by a cultural revolution, however this revolution seems to be oriented to expected values without a clear methodology which promotes and accompanies this cultural change. The present study deals with the lack of practices due to these unrealized expected values and assumes that for intervening it is necessary knowing the existing culture before thinking to change it. Interviews to 36 general practitioners were analyzed by Emotional Text Analysis (AET). Results highlight a factorial space characterized by five clusters. According to respondents’ perspective, healthcare problems refer to two large issues characterized by powerlessness of general practitioners to intervene. On the one hand, there is health emergency, dealt with by first aid and emergency medicine. On the other hand, there is chronicity, especially affecting the elderly, which is dealt with by other workers (nurses, private family assistants, social workers) who care patients at home and replace physicians. The general practitioners’ work is difficult because of many different reasons; but the central theme is the lack of absolute power – based on morality and consciousness – which leads to the perception of catastrophic consequences for medical profession and the physician-patient relationship. Often, general practitioners are in their offices and are not able to go to patients’ home, therefore they cannot create care relationships based on trust and dependence which allow useful and trustworthy interventions. In sum, the core theme emerging from data refers to the general practitioners’ perceived lack of personal and trust-based relationships with patients

La relazione che organizza il contesto sanitario: domanda dell’utenza e risposta dei servizi sanitari, nel territorio e nell’ospedale - The relationship which organizes the healthcare context: users’ demand and response of healthcare services, in the territory and the hospital

Our intent is to present citizens’ demand of health care services in Italy through a research structured in three studies. We used the Emotional Text Analysis (ETA) to lead the three s tudies: the first study regarded the citizens’expectations of the healthcare services, the second study regarded the point of view of the hospital personnel (medical doctors and nurses), the third regarded the point of view of the General Practitioners onthe health care services. These three studies are briefly presented. Data and outcome of an Assumed Similarity Test applied to all experimental subjects of the three studies in order to make a comparison among them, are also presented. The findings of the Emotional Text Analysis show that citizens, potential users of health services, center their requests on their individual subjectivity, and seek answers both to their suffering and to the feeling of alienation that characterizes the being sick feeling that makes them go to a medical doctor. For their part, general practitioners and hospital doctors immediately transform this subjective feeling in an objective medical diagnosis. Here a first gap emerges between patient’s demand and medical response, leavingthe possibility of an alliance on the diagnosis in order to jointly fight the disease. It has long been in place though a change that has expelled the patient also from sharing the diagnostic process, increasingly taken from self-centered dynamics within the healthcare system. This widens the gap between the request of the citizens and the response of the health services, that contributes to that conflictual growth to which defensive medicine gives a dysfunctional answer. The Assumed Similarity Test contributes to the interpretation of the health care dynamic identified in the Emotional Text Analysis; particularly in regard to the unfolding conflict, given by the hypothesis emerging from the data analysis, that a feeling of closeness for the hospital personnel goes along with an emotional stance of overpowering the othe

Market-Driven Management and Intangible Assets in Global Television Set Manufacturers

The television set industry is a global sector where the most competitive companies are market-driven. Their competitive advantage is based not only on their ability to innovate products but also on their capability to develop and strengthen intangible assets, such as corporate culture, brand image and relationships between organisations.Television set industry, Market Driven Management, Competitiveness, Intangible Assets DOI:http://dx.doi.org/10.4468/2010.2.07silvestrelli

Entrepreneurship for sustainable development: co-evolutionary evidence from the tourism sector

Purpose – This paper aims to enhance understanding of how sustainable entrepreneurship (SE) contributes to sustainable development in the tourism sector. To do so, specific factors that act as enablers or inhibitors of SE are identified according to a co-evolutionary lens. Design/methodology/approach – A co-evolutionary explanation of the firm? Environment relationship is adopted to undertake a qualitative empirical study of the Castelli Romani tourism destination (Italy), via 23 semi-structured interviews according to a narrative approach. Findings – The paper demonstrates that entrepreneurs play a crucial role in sustainable development but cannot act in isolation. In fact, according to the co-evolutionary approach, they influence and are influenced by 20 factors. Accordingly, SE can be conceptualised as resulting from effective co-evolutionary interactions between micro (i.e. entrepreneurs and their firm), meso (i.e. the destination where tourism firms are based) and macro (i.e. the wider socio-economic and natural system) levels. Practical implications – Several actions are suggested to entrepreneurs and policymakers to help achieve specific sustainable development goals. These actions focus on: (1) training courses, (2) investments in technologies, (3) creation of innovative business models, (4) exploitation of cultural and natural resources, (5) community involvement and (6) multi-level partnerships. Originality/value – This is the first study that adopts a co-evolutionary lens to investigate the influencing factors of SE in tourism, shedding light on the effects of their dynamic interdependence. Thus, it provides a more nuanced SE conceptualisation that takes a holistic and dynamic view of sustainability

Imprese agricole, territorio e turismo in sinergia per lo sviluppo sostenibile

The aim of this paper is to understand the role played by Italian farms in the local sustainable development processes, through the analysis of the agritourism phenomenon. In order to do so, the study proposes an integrated and dynamic vision of the three sustainability dimensions, focusing on the relationship between farms, territories and tourists in a co-evolutionary perspective. The proposed framework is tested through the analysis of ten case studies localized in the Lazio region. Findings show that farms, through the strategic choice of agritourism, activate sustainability-oriented synergies based on effective co-evolutionary adaptations between multiple actors, improving the territories competitiveness with positive effects on the social wellbeing. Common vision and both ethical and moral values are the fundamental pre-requisites to realize these synergies. Overall, the study adds new elements on the sustainability literature. Thus, both theoretical and managerial implications emerge, together with suggestions for future research

A Single Wearable Sensor for Gait Analysis in Parkinson’s Disease: A Preliminary Study

Movement monitoring in patients with Parkinson’s disease (PD) is critical for quantifying disease progression and assessing how a subject responds to medication administration over time. In this work, we propose a continuous monitoring system based on a single wearable sensor placed on the lower back and an algorithm for gait parameters evaluation. In order to preliminarily validate the proposed system, seven PD subjects took part in an experimental protocol in preparation for a larger randomized controlled study. We validated the feasibility of our algorithm in a constrained environment through a laboratory scenario. Successively, it was tested in an unsupervised environment, such as the home scenario, for a total of almost 12 h of daily living activity data. During all phases of the experimental protocol, videos were shot to document the tasks. The obtained results showed a good accuracy of the proposed algorithm. For all PD subjects in the laboratory scenario, the algorithm for step identification reached a percentage error low of 2%, 99.13% of sensitivity and 100% of specificity. In the home scenario the Bland–Altman plot showed a mean difference of −3.29 and −1 between the algorithm and the video recording for walking bout detection and steps identification, respectively

Un estudio sobre la percepción del estigma asociado al consumo de drogas en una muestra de italianos y no italianos

The goal of the present study has been to exploratorily analyse the possible differences in perceived stigma on drug use between a sample of students and health services workers from Italy and Belgium. The Perceived Stigma of Addiction Scale (PSAS) (Luoma, Hair, Kohlenberg, Hayes, and Fletcher, 2010) was used. A total of 277 participants took part in this study. Outcomes\ud showed that the perceived stigma among Italians was signifi- cantly higher (M= 23.68) than that reported by Belgians (M = 20.26). Authors argued that many factors (e.g., social, cultural, etc.) may explain the differences obtained. On the other hand, the existence of a stigma circuit (Scioli and Paniccia), which would\ud share some similarities with the anxiety circuit, seems to trap the person in a vicious cycle of events that would make the relapse from addiction harder. The limitations and scope of the obtained results in the frame of this ex- ploratory study is discussed

Penetrating particle ANalyzer (PAN)

PAN is a scientific instrument suitable for deep space and interplanetary missions. It can precisely measure and monitor the flux, composition, and direction of highly penetrating particles ($> \sim$100 MeV/nucleon) in deep space, over at least one full solar cycle (~11 years). The science program of PAN is multi- and cross-disciplinary, covering cosmic ray physics, solar physics, space weather and space travel. PAN will fill an observation gap of galactic cosmic rays in the GeV region, and provide precise information of the spectrum, composition and emission time of energetic particle originated from the Sun. The precise measurement and monitoring of the energetic particles is also a unique contribution to space weather studies. PAN will map the flux and composition of penetrating particles, which cannot be shielded effectively, precisely and continuously, providing valuable input for the assessment of the related health risk, and for the development of an adequate mitigation strategy. PAN has the potential to become a standard on-board instrument for deep space human travel. PAN is based on the proven detection principle of a magnetic spectrometer, but with novel layout and detection concept. It will adopt advanced particle detection technologies and industrial processes optimized for deep space application. The device will require limited mass (~20 kg) and power (~20 W) budget. Dipole magnet sectors built from high field permanent magnet Halbach arrays, instrumented in a modular fashion with high resolution silicon strip detectors, allow to reach an energy resolution better than 10\% for nuclei from H to Fe at 1 GeV/n

Severe bleeding and absent ADP-induced platelet aggregation associated with inherited combined CalDAG-GEFI and P2Y12 deficiencies

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