La disponibilità a pagare per la copertura del rischio di non autosufficienza: analisi econometrica e valutazione di policy

In response to the increasing demand for elderly care, Italy has experienced an intense debate on what should be the most appropriate way to extend coverage for long-term care (LTC). This paper bridges a gap into existing literature by analysing household preferences for LTC coverage in light of an ad hoc survey. We present evidence on household stated willingness to pay (WTP) both for tax financed and private LTC insurance schemes. The distribution of WTP across different socio-economic groups provides insights on the political sustainability of the different institutional solutions. Moreover, estimates of the determinants of demand highlights the importance of income levels and opinion indicators in turning consumer preferences either to public or private schemes. We interpret the different patterns of WTP as evidence of the influence of the redistributive effects inherent to public insurance

Double-ended Pseudocomedones in Hidradenitis Suppurativa: Clinical, Dermoscopic, and Histopatho­logical Correlation

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Evaluating impact of possible transgenic poplar cultivation on protected areas

Plant biodiversity studies have been performed in the Migliarino-San Rossore-Massaciuccoli Regional Park in Tuscany (Italy) within the framework of the European project LIFE08 NAT/IT/342.This project aims at developing a quick monitoring index (QMI) to rapidly assess the potential risk generated by transgenic plants in characterized ecosystems or biotopes. For this reason test areas have been selected inside the protected area to evaluate plant (weeds and trees), animal, and soil microoganisms biodiversity. The proximity of the selected test area to cropped surfaces where Genetically Modified Plants (GMPs) might be cultivated has been taken into account. GMPs could spread pollen and contaminate natural populations. To avoid this risk, an efficient monitoring system is required taking into account genetic diversity and breeding study. As far as tree biodiversity concern, Populus species were identified in the test areas. Two populations of Populus present into two different ecosystems (forest and wetland areas) were examined together with two cultivated varieties. The two ecosystems were characterized for the vegetation. Nuclear microsatellites were used to evaluate genetic diversity of poplar populations and level of breeding between natural and cultivated Populus. In addition the insect populations present on male and female poplars during flowering period have been studied

Disease management in diabetes care: when involving GPs improves patient compliance and health outcomes

Although the study of the association between interventions in primary care and health outcomes continues to produce mixed findings, programs designed to promote the greater compliance of General Practitioners and their diabetic patients with treatment guidelines have been increasingly introduced worldwide, in an attempt to achieve better quality diabetes care through the enhanced standardisation of patient supervision. In this study we use clinical data taken from the Diabetes Register of one Local Health Authority (LHAs) in Italy’s Emilia-Romagna Region for the period 2014-2015. Firstly, we test to see whether the monitoring activities prescribed for diabetics by regional diabetes guidelines, actually have a positive impact on patients’ health outcomes and increase appropriateness in health care utilization. Secondly, we investigate whether GPs’ participation in the local Diabetes Management Program (DMP) leads to improved patient compliance with regional guidelines. Our results show that such a program, which aims to increase GPs’ involvement and cooperation in following regional guidelines for best practices, achieves its goal of improved patient compliance with the prescribed actions. In turn, through the implementation of the DMP and the greater involvement of physicians, regional policies have succeeded in promoting better health outcomes and the improved appropriateness of health care utilization

SMARCE1-related meningiomas: A clear example of cancer predisposing syndrome

We report the case of a 16-year-old girl presenting with spinal clear-cell multiple meningiomas (CCMs). In view of this presentation, we sequenced a bioinformatic panel of genes associated with susceptibility to meningioma, identifying a germline heterozygous variant in SMARCE1. Somatic DNA investigations in the CCM demonstrated the deletion of the wild-type allele (loss of heterozygosity, LOH), supporting the causative role of this variant. Family segregation study detected the SMARCE1 variant in the asymptomatic father and in the asymptomatic sister who, nevertheless, presents 2 spinal lesions. Germline heterozygous loss-of-function (LoF) variants in SMARCE1, encoding a protein of the chromatin-remodeling complex SWI/SNF, have been described in few fa-milial cases of susceptibility to meningioma, in particular the CCM subtype. Our case confirms the role of NGS in investigating predisposing genes for meningiomas (multiple or recurrent), with specific regard to SMARCE1 in case of pediatric CCM. In addition to the age of onset, the presence of familial clustering or the coexistence of multiple synchronous meningiomas also supports the role of a genetic predisposition that deserves a molecular assessment. Additionally, given the incomplete penetrance, it is of great importance to follow a specific screening or follow-up program for symptomatic and asymptomatic carriers of pathogenic variants in SMARCE1

Opposite Effects of HIV-1 p17 Variants on PTEN Activation and Cell Growth in B Cells

The HIV-1 matrix protein p17 is a structural protein that can act in the extracellular environment to deregulate several functions of immune cells, through the interaction of its NH2-terminal region with a cellular surface receptor (p17R). The intracellular events triggered by p17/p17R interaction have been not completely characterized yet. In this study we analyze the signal transduction pathways induced by p17/p17R interaction and show that in Raji cells, a human B cell line stably expressing p17R on its surface, p17 induces a transient activation of the transcriptional factor AP-1. Moreover, it was found to upregulate pERK1/2 and downregulate pAkt, which are the major intracellular signalling components involved in AP-1 activation. These effects are mediated by the COOH-terminal region of p17, which displays the capability of keeping PTEN, a phosphatase that regulates the PI3K/Akt pathway, in an active state through the serin/threonin (Ser/Thr) kinase ROCK. Indeed, the COOH-terminal truncated form of p17 (p17Δ36) induced activation of the PI3K/Akt pathway by maintaining PTEN in an inactive phosphorylated form. Interestingly, we show that among different p17s, a variant derived from a Ugandan HIV-1 strain, named S75X, triggers an activation of PI3K/Akt signalling pathway, and leads to an increased B cell proliferation and malignant transformation. In summary, this study shows the role of the COOH-terminal region in modulating the p17 signalling pathways so highlighting the complexity of p17 binding to and signalling through its receptor(s). Moreover, it provides the first evidence on the presence of a p17 natural variant mimicking the p17Δ36-induced signalling in B cells and displaying the capacity of promoting B cell growth and tumorigenesis

Vacuum oscillation solution to the solar neutrino problem in standard and non-standard pictures

The neutrino long wavelength (just-so) oscillation is revisited as a solution to the solar neutrino problem. We consider just-so scenario in various cases: in the framework of the solar models with relaxed prediction of the boron neutrino flux, as well as in the presence of the non-standard weak range interactions between neutrino and matter constituents. We show that the fit of the experimental data in the just-so scenario is not very good for any reasonable value of the $^8B$ neutrino flux, but it substantially improves if the non-standard $\tau$-neutrino--electron interaction is included. These new interactions could also remove the conflict of the just-so picture with the shape of the SN 1987A neutrino spectrum. Special attention is devoted to the potential of the future real-time solar neutrino detectors as are Super-Kamiokande, SNO and BOREXINO, which could provide the model independent tests for the just-so scenario. In particular, these imply specific deformation of the original solar neutrino energy spectra, and time variation of the intermediate energy monochromatic neutrino ($^7Be$ and $pep$) signals.Comment: Latex, 14 pages, 9 figures (avalilable by fax or postscript files requested to [email protected]) -- some textual and Latex errors are corrected and few references adde