Aligning Evaluation and Strategy With the Mission of a Community-Focused Foundation

Foundations are commonly recognized as having a comparative advantage in supporting forward-looking projects and programs. In this sense, the long term represents the natural horizon in which the foundations are called to fulfill their mission to plan and develop philanthropic activities and, therefore, the time reference for assessing results. When a mission is focused more on improving the quality of life in a specific community than on addressing a specific social problem, evaluation of outcomes becomes more challenging. While available methods can provide valuable support to measuring the impact of a foundation’s specific program, they are unlikely to provide an overview of the outcomes of a multitude of projects financed over time. This article presents the case of an Italian foundation committed to developing a tailored approach to evaluating the durable benefits of its local philanthropic activity

The Impact of Physical Disturbance and Increased Sand Burial on Clonal Growth and Spatial Colonization of Sporobolus virginicus in a Coastal Dune System

Dune plants are subjected to disturbance and environmental stresses, but little is known about the possible combined effects of such factors on growth and spatial colonization. We investigated how clones of Sporobolus virginicus, a widespread dune species, responded to the independent and interactive effects of breakage of rhizomes, breakage position and burial regime. Horizontal rhizomes were severed at three different internode positions relative to the apex to span the range of damage by disturbance naturally observed or left intact, and apical portions exposed to two burial scenarios (ambient vs. increased frequency) for three months in the field. The performance of both parts of severed rhizomes, the apical portion and the remaining basal portion connected to clone containing four consecutive ramets, was compared with that of equivalent parts in intact rhizomes. Apical portions severed proximal to the third internode did not survive and their removal did not enhance branching on their respective basal portions. Severing the sixth or twelfth internode did not affect survival and rhizome extension of apical portions, but suppressed ramet production and reduced total biomass and specific shoot length. Their removal enhanced branching and ramet production on basal portions and changed the original rhizome growth trajectory. However, the gain in number of ramets in basal portions never compensated for the reduction in ramet number in apical portions. Recurrent burial increased biomass allocation to root tissues. Burial also stimulated rhizome extension only in intact rhizomes, indicating that disturbance interacts with, and counteracts, the positive burial effect. These results suggest that disturbance and recurrent burial in combination reduces the regeneration success and spread capacity of S. virginucus. Since global change leads to increasingly severe or frequent storms, the impact of disturbance and burial on clones could be greater in future and possibly prevent colonization of mobile dunes by the species

First evidence of root morphological and architectural variations in young Posidonia oceanica plants colonizing different substrate typologies

Root morphology and root system architecture of young Posidonia oceanica plants established on two contrasting substrate types, sand and rock, were examined to provide insights into the strategy of adaptation of seagrasses to their environment. After germination, seedlings were planted on sandy patches and on rock within the same area, and survived plants were collected five years later for measurements of the size of the entire root complex and analysis of individual morphological and architectural root traits. Collected plants exhibited up to nine highly intermingled root systems and approx. 2.5 m of total root length. Maximum horizontal extension, total biomass and total length of roots were not significantly affected by substrate. However, on sand roots grew vertically reaching up to 13 cm, while on rock they extended more horizontally and did not penetrate deeper than 5e7 cm leading to the formation of a shallow, densely packed root complex. On rock, the number and the length of second order laterals on an individual root system were reduced and the topological index higher than on sand (0.8 vs. 0.7) reflecting a more simple (herringbone) branching pattern. Again, root diameter was greater than on sand. The results suggest that P. oceanica can adjust root traits early during plant development according to substrate typology to maximize anchorage and substrate exploration efficiency. This plasticity enables the species to establish and persist also on rocky bottoms which generally prevent establishment of the majority of seagrasses

New Bio-Composites Based on Polyhydroxyalkanoates and Posidonia oceanica Fibres for Applications in a Marine Environment

Bio-composites based on polyhydroxyalkanoates (PHAs) and fibres of Posidonia oceanica (PO) were investigated to assess their processability by extrusion, mechanical properties, and potential biodegradability in a natural marine environment. PHAs were successfully compounded with PO fibres up to 20 wt%while, at 30 wt%of fibres, the addition of 10 wt%of polyethylene glycol (PEG 400) was necessary to improve their processability. Thermal, rheological, mechanical, and morphological characterizations of the developed composites were conducted and the degradation of composite films in a natural marine habitat was evaluated in a mesocosm by weight loss measure during an incubation period of six months. The addition of PO fibres led to an increase in stiffness of the composites with tensile modulus values about 80% higher for composites with 30 wt % fibre (2.3 GPa) compared to unfilled material (1.24 GPa). Furthermore, the impact energy markedly increased with the addition of the PO fibres, from 1.63 (unfilled material) to 3.8 kJ/m2 for the composites with 30 wt % PO. The rate of degradation was markedly influenced by seawater temperature and significantly promoted by the presence of PO fibres leading to the total degradation of the film with 30 wt % PO in less than six months. The obtained results showed that the developed composites can be suitable to manufacture items usable in marine environments, for example, in natural engineering interventions, and represent an interesting valorisation of the PO fibrous wastes accumulated in large amounts on coastal beaches

Biocomposites based on PHBs and natural fibers for commodity applications in different environments: processing, performance in soil, compost and sea water

Composites based on poly(3-hydroxybutyrate) (PHB) and natural fibres such as fibres of Posidonia oceanica (PO), wood saw dust (WSD) and bran were produced by extrusion in presence of appropriate amounts of plasticizer (Acetyl Tri-n- Butyl Citrate, ATBC) and filler (calcium carbonate). Thermal, rheological, mechanical and morphological characterizations of the developed composites were conducted in order to optimize formulations in terms of processability and mechanical performance. The biodegradability of the optimized composites was investigated under controlled composting conditions in accordance with standard methods (ASTM D5338-98, ISO 20200-2004) and in soil for the PHB/WSD composites, because their expected fate is to be treated in composting plants or used for applications in agriculture; in simulated and natural marine sediments in mesocosms and dune habitat for the PHB/PO composites, because their potential applications are in marine environment, such as natural engineering interventions (restoration of seagrass habitats). The optimized PHB/WSD compounds were used for the production of pots for terrestrial plants, PHB/PO compounds for pots and other items usable in the sea and sand dunes, such as transplanting tools and structures for restoration or protection of coastal habitats, and the PHB/bran fibres for the production of food contact containers. The results showed that the industrial processing by extrusion of the composites did not show any difficulty up to 20 wt. % fibres and the presence of the fibres (PO or WSD) facilitated the disintegration of the PHB matrix and, consequently, accelerated its biodegradation both in compost, soil, sea water and dune. The PHB/WSD composites resulted no-phytotoxic by using cress (Lepidium sativum L.) germination test, compostable in accordance with EN 13427:2000, biodegradable in soil at controlled degradation rate. The PHB/PO composites showed a good controlled biodegradation rate in marine sediments and were suitable to manufacture items usable, for example, in natural engineering interventions and represent an interesting valorisation of the PO fibrous wastes accumulated in large amounts on coastal beaches

Virus contamination and infectivity in beach environment: Focus on sand and stranded material

To assess the exposure of beachgoers to viruses, a study on seawater, sand, and beach-stranded material was carried out, searching for human viruses, fecal indicator organisms, and total fungi. Moreover, for the first time, the genome persistence and infectivity of two model viruses was studied in laboratory-spiked sand and seawater samples during a one-week experiment. Viral genome was detected in 13.6 % of the environmental samples, but it was not infectious (Human Adenovirus – HAdV, and enterovirus). Norovirus and SARS-CoV-2 were not detected. The most contaminated samples were from sand and close to riverine discharges. In lab-scale experiments, the infectivity of HAdV5 decreased by ~1.5-Log10 in a week, the one of Human Coronavirus-229E disappeared in <3 h in sand. The genome of both viruses persisted throughout the experiment. Our results confirm viral contamination of the beach and suggest HAdV as an index pathogen for beach monitoring and quantitative risk assessment

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys