2,189 research outputs found
L'Armonizzazione della contabilitĂ degli Enti Locali: riflessi sul Bilancio Consolidato - il caso del Comune di Livorno
1. Le SocietĂ partecipate degli Enti Locali;
2. L’analisi delle società partecipate in una prospettiva economica;
3. Il Gruppo Pubblico Locale;
4. Il quadro normativo di riferimento;
5. L’Armonizzazione dei sistemi contabili;
6. Il sistema dei principi contabili;
7. L’area di consolidamento del Comune di Livorno;
8. Bibliografia
Uso especĂfico de ISCI durante a nutrição enteral noturna em criança com diabetes tipo 1, tireoidite de Hashimoto e sĂndrome de Down
The management of insulin therapy in diabetic patients who have comorbidities that involve nutritional aspects, is a major challenge for diabetes care teams. In diabetic patients with compromised nutritional status, artificial nutrition, both enteral or parenteral, may help in the treatment of chronic and acute diseases, leading to better and faster recover of the health status but, if not adequately associated with insulin therapy, it may negatively affect blood glucose levels and lead to poorer metabolic control. In particular, evidence-based recommendations for the treatment of diabetic patients during enteral nutrition therapy are not currently available and, therefore, medical practices are often based on case reports, rather than outcomes of research. We report our experience with a diabetic patient receiving nocturnal enteral feeding due to comorbidities and malnutrition, who was followed up at our centre and precociously treated with continuous subcutaneous insulin infusion after the onset of type 1 diabetes. There is great need for adequately powered randomized controlled trials to provide scientific evidence for the insulin treatment of diabetic patients undergoing enteral feeding
The Palliative Prognostic (PaP) Score without Clinical Evaluation Predicts Early Mortality among Advanced NSCLC Patients Treated with Immunotherapy
Background: An acceptable risk-benefit ratio may encourage the prescription of immune checkpoint inhibitors (ICI) near the late stage of life. The lung immune prognostic index (LIPI) was validated in advanced non-small cell lung cancer (NSCLC) patients treated with ICIs. The palliative prognostic (PaP) score without clinical prediction of survival (PaPwCPS) predicts early mortality probability in terminal cancer patients. Methods: We performed a retrospective study including 182 deceased advanced NSCLC patients, treated with single-agent ICI at our Institution. Two prognostic categories of high and low mortality risk were identified through ROC curve analysis for PaPwCPS and LIPI scores. Results: Most were >65 years of age (68.3%) and received second-line ICI (61.2%). A total of 29 (15.9%) and 131 (72.0%) patients died within 30 and 90 days from treatment start, respectively. A total of 81 patients (44.5%) received ICI during the last month of life. Baseline PaPwCPS and LIPI scores were assessable for 78 patients. The AUC of ROC curves was significantly increased for PaPwCPS as compared with LIPI score for both 30-day and 90-day mortality. A high PaPwCPS score was associated in multivariate analysis with increased 30-day (HR 2.69, p = 0.037) and 90-day (HR 4.01, p < 0.001) mortality risk. A high LIPI score was associated with increased 90-day mortality risk (p < 0.001). Conclusion: We found a tendency towards ICI prescription near the late stage of life. The PaPwCPS score was a reliable predictor of 30- and 90-day mortality
Justice, sustainability, and the diverse values of nature: why they matter for biodiversity conservation
Aiming at just and sustainable futures for biodiversity conservation requires clarity concerning how justice relates to the diverse values of nature. By drawing upon and expanding on the recent Values Assessment of Intergovernmental Platform on Biodiversity and Ecosystem Services, this article discusses the implications of the diverse values of nature for different dimensions of justice. It also addresses how achieving transformative change that protects biodiversity requires the inclusion of diverse values of nature into valuation and decision-making processes, and how this imperative is interconnected with different dimensions of justice
An inclusive typology of values for navigating transformations towards a just and sustainable future
Why nature matters:A systematic review of intrinsic, instrumental, and relational values
In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research.</p
The planetary commons:A new paradigm for safeguarding Earth-regulating systems in the Anthropocene
The Anthropocene signifies the start of a no-analogue trajectory of the Earth system that is fundamentally different from the Holocene. This new trajectory is characterized by rising risks of triggering irreversible and unmanageable shifts in Earth system functioning. We urgently need a new global approach to safeguard critical Earth system regulating functions more effectively and comprehensively. The global commons framework is the closest example of an existing approach with the aim of governing biophysical systems on Earth upon which the world collectively depends. Derived during stable Holocene conditions, the global commons framework must now evolve in the light of new Anthropocene dynamics. This requires a fundamental shift from a focus only on governing shared resources beyond national jurisdiction, to one that secures critical functions of the Earth system irrespective of national boundaries. We propose a new framework-the planetary commons-which differs from the global commons framework by including not only globally shared geographic regions but also critical biophysical systems that regulate the resilience and state, and therefore livability, on Earth. The new planetary commons should articulate and create comprehensive stewardship obligations through Earth system governance aimed at restoring and strengthening planetary resilience and justice.</p
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