PROGETTARE LO SPORT. Teorie Ricerche Architetture

Il volume “Progettare lo sport” raccoglie un consistente numero di teorie, ricerche, architetture quali testimonianze del lavoro didattico svolto nell’ambito del laboratorio di tesi di laurea - a cura di Emilio Faroldi, Davide Allegri e Maria Pilar Vettori - elaborate e discusse presso la Scuola di Architettura Urbanistica Ingegneria delle Costruzioni del Politecnico di Milano, riguardante temi connessi all’architettura riferita allo sport nei suoi articolati profili. Il volume elegge la cultura dello sport e la gestione colta del tempo libero quale barometro interpretativo della definizione di modelli e strategie di rigenerazione urbana e sociale degli ambienti costruiti. Luoghi e spazi che lo sport trasforma in beni culturali da condividere e valorizzare, analizzando le ricadute che tale variabile esprime sulla trasformazione del tessuto urbano, in linea con le tendenze e i solchi di ricerca in atto negli scenari antropizzati e naturali più evoluti. La selezione dei lavori, all’interno del più ampio panel di tesi di laurea sviluppato sul tema, fonda le sue radici nell’interesse pedagogico della diffusione di esiti di eccellenza e nel loro porsi, per metodo e atteggiamento culturale, in modo innovativo nei confronti di dinamiche urbane spesso statiche e non più confacenti a una interpretazione aperta e inclusiva dello sport e delle sue declinazioni. Gli studi restituiscono esperienze progettuali consapevoli della complessità del fenomeno architettonico e costruttivo: in tale ambito, la ricerca storica, lo studio del contesto sociale e culturale, la sensibilità artistica, la verifica costruttiva e le istanze compositive si fondono in una competenza integrata di sintesi dalla quale, lo studente-progettista, attinge per configurare l’ipotesi trasformativa di un luogo attraverso la valorizzazione di una funzione primaria quale risulta essere lo sport, oggi riconosciuta come fondante per una rinnovata società. Nell’architettura contemporanea la progettazione delle infrastrutture sportive, anche nella loro declinazione di ambiti privilegiati atti a ospitare grandi eventi, offre un’occasione, spesso unica, di trasformazione e rivalutazione strategica della città e del territorio. Individuare nuove forme di sviluppo urbano polifunzionale, risulta imprescindibile all’interno della necessità di delineare, per mezzo di una paziente attività di analisi e ricerca, le caratteristiche e le potenzialità peculiari del tessuto territoriale nel quale si inseriscono. L’infrastruttura sportiva, perciò, interpretata come importante occasione di sperimentazione architettonica, progettuale e tecnologica: in tale logica il volume intende promuovere un’azione di sensibilizzazione e promozione volta alla valorizzazione progettuale dell’infrastrutturazione sportiva, interpretata quale bene culturale di una civiltà, per mezzo dell’analisi dei suoi fattori fisici, di quelli immateriali e delle figure atte alla loro progettazione, costruzione, gestione

Do community-based health insurance schemes fulfil the promise of equity? A study from Burkina Faso

Objective: To examine whether the community-based health insurance (CBHI) scheme in Burkina Faso has been effective in providing equitable healthcare access to poor individuals, women, children and those living far from health facilities. Methods: We used the Nouna Health District Household Survey to collect panel data on 990 households during 2004?08. By applying a series of random effects regressions and using concentration curves, we first studied determinants of CBHI enrolment and then assessed differences in healthcare utilization between members and non-members. We studied differences with regard to rich and poor, men and women, children and adults and those living far vs those living close to health facilities. Findings: With regard to enrolment, we found that poor (odds ratio [OR] = 0.274) and children (OR = 0.456) were less likely to enrol while gender and distance were not significantly correlated to enrolment. In terms of utilization, poor (coefficient = 0.349), women (coefficient = 0.131) and children (coefficient = 0.190) with CBHI had higher utilization than the group without CBHI. We also found that there was no significant difference in utilization between members and non-members if they were living far from health facilities. Conclusion: The CBHI scheme in this case was only partially successful in achieving the equity objectives. This study advises policy makers in Burkina Faso and elsewhere, who see CBHI schemes as a silver bullet to achieve universal health coverage, to be mindful of the chronically low enrolment rates and more importantly the lack of equity across the various groups that this study has highlighted

Effects of information, education, and communication campaign on a community-based health insurance scheme in Burkina Faso

Objective : The study analysed the effect of Information, Education, and Communication (IEC) campaign activities on the adoption of a community-based health insurance (CHI) scheme in Nouna, Burkina Faso. It also identified the factors that enhanced or limited the campaign's effectiveness. Design : Complementary data collection approaches were used. A survey was conducted with 250 randomly selected household heads, followed by in-depth interviews with 22 purposively selected community leaders, group discussions with the project management team, and field observations. Bivariate analysis and multivariate logistic regression models were used to assess the association between household exposure to campaign and acquisition of knowledge as well as household exposure to campaign and enrolment. Results : The IEC campaign had a positive effect on households’ knowledge about the CHI and to a lesser extent on household enrolment in the scheme. The effectiveness of the IEC strategy was mainly influenced by: 1 frequent and consistent IEC messages from multiple media channels (mass and interpersonal channels), including the radio, a mobile information van, and CHI team, and 2 community heads’ participation in the CHI scheme promotion. Education was the only significantly influential socio-demographic determinant of knowledge and enrolment among household heads. The relatively low effects of the IEC campaign on CHI enrolment are indicative of other important IEC mediating factors, which should be taken into account in future CHI campaign evaluation. Conclusion : The study concludes that an IEC campaign is crucial to improving the understanding of the CHI scheme concept, which is an enabler to enrolment, and should be integrated into scheme designs and evaluations

Studying complex interventions : reflections from the FEMHealth project on evaluating fee exemption policies in West Africa and Morocco

Peer reviewedPublisher PD

Plasma-Based Longitudinal Evaluation of ESR1 Epigenetic Status in Hormone Receptor-Positive HER2-Negative Metastatic Breast Cancer

Background: Endocrine therapy (ET) is the mainstay of treatment for hormone receptor-positive human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer; however, adaptive mechanisms emerge in about 25\u201330% of cases through alterations in the estrogen receptor ligand-binding domain, with a consequent ligand-independent estrogen receptor activity. Epigenetic-mediated events are less known and potentially involved in alternative mechanisms of resistance. The aim of this study was to test the feasibility of estrogen receptor 1 (ESR1) epigenetic characterization through liquid biopsy and to show its potential longitudinal application for an early ET sensitivity assessment. Methods: A cohort of 49 women with hormone receptor-positive HER2-negative MBC was prospectively enrolled and characterized through circulating tumor DNA using methylation-specific droplet digital PCR (MS-ddPCR) before treatment start (BL) and after 3 months concomitantly with computed tomography (CT) scan restaging (EV1). ESR1 epigenetic status was defined by assessing the methylation of its main promoters (promA and promB). The most established cell-free tumor DNA (ctDNA) factors associated with ET resistance [ESR1 and phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) mutations] were assessed through next-generation sequencing. Associations were tested through Mann\u2013Whitney U test, matched pairs variations through Wilcoxon signed rank test, and survival was analyzed by log-rank test. Results: The ET backbone was mainly based on aromatase inhibitors (AIs) (70.83%) in association with CDK4/6 inhibitors (93.75%). Significantly lower promA levels at baseline were observed in patients with liver metastases (P = 0.0212) and in patients with ESR1 mutations (P = 0.0091). No significant impact on PFS was observed for promA (P = 0.3777) and promB (P = 0.7455) dichotomized at the median while a 652-fold increase in promB or in either promA or promB at EV1 resulted in a significantly worse prognosis (respectively P = 0.0189, P = 0.0294). A significant increase at EV1 was observed for promB among patients with PIK3CA mutation (P = 0.0173). A trend was observed for promB in ESR1 wild-type patients and for promA in the ESR1 mutant subgroup. Conclusion: The study proofed the concept of an epigenetic characterization strategy based on ctDNA and is capable of being integrated in the current clinical workflow to give useful insights on treatment sensitivity

Renal outcome in patients with congenital anomalies of the kidney and urinary tract.

15openopenSanna-Cherchi S; Ravani P; Corbani V; Parodi S; Haupt R; Piaggio G; Innocenti ML; Somenzi D; Trivelli A; Caridi G; Izzi C; Scolari F; Mattioli G; Allegri L; Ghiggeri GM.Sanna Cherchi, S; Ravani, P; Corbani, V; Parodi, S; Haupt, R; Piaggio, G; Innocenti, Ml; Somenzi, D; Trivelli, A; Caridi, G; Izzi, C; Scolari, Francesco; Mattioli, G; Allegri, L; Ghiggeri, G. M

The Health and Demographic Surveillance System (HDSS) in Nouna, Burkina Faso, 1993–2007

The Nouna Health and Demographic Surveillance System (HDSS) is located in rural Burkina Faso and has existed since 1992. Currently, it has about 78,000 inhabitants. It is a member of the International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH), a global network of members who conducts longitudinal health and demographic evaluation of populations in low- and middle-income countries. The health facilities consist of one hospital and 13 basic health centres (locally known as CSPS). The Nouna HDSS has been used as a sampling frame for numerous studies in the fields of clinical research, epidemiology, health economics, and health systems research. In this paper we review some of the main findings, and we describe the effects that almost 20 years of health research activities have shown in the population in general and in terms of the perception, economic implications, and other indicators. Longitudinal data analyses show that childhood, as well as overall mortality, has significantly decreased over the observation period 1993–2007. The under-five mortality rate dropped from about 40 per 1,000 person-years in the mid-1990s to below 30 per 1,000 in 2007. Further efforts are needed to meet goal four of the Millennium Development Goals, which is to reduce the under-five mortality rate by two-thirds between 1990 and 2015