Forme della socialità, identità e differenza

I processi che producono relazioni interpersonali di riconoscimento si attivano all’interno di configurazioni strutturali (cioè a dire morfologiche) di rete, ma prendono forma a partire dalla capacità delle persone di mobilitare, in tutto o in parte, le risorse che hanno a disposizione. Se ci si concentra sugli elementi strutturali che caratterizzano tali processi e sul potere che essi esercitano nell’organizzare e vincolare la distribuzione degli attributi individuali, risulterà più agevole inferire i principi d’azione e di visione delle persone. Poiché si tratta di elementi che per il momento potremmo definire genericamente culturali e che, in quanto tali, vengono trasmessi e incorporati attraverso il processo di socializzazione, i gruppi socializzanti svolgono un ruolo decisivo. Questi gruppi, che nel nostro caso sono costituiti da nuclei familiari (genitori, fratelli,sorelle, parenti), gruppi di pari (amici, compagni di corsi o di sport) e figure guida (professori, guide spirituali, influencer) sono tutti portatori di principi di comportamento che possono essere fra di loro coerenti, discordanti e/o in conflitto, misti. La coesistenza e, spesso, la sovrapponibilità di reti nelle reti – ovvero di domini di rete in cui, a seconda delle situazioni, le persone si muovono transitando senza soluzione di continuità dall’uno all’altro – rappresenta un importante banco di prova teorico e metodologico per quegli elementi dei legami sociali che rendono agevole e immediata tale commutazione di ret

Remote Management of Hearth Failure the post discharge period: review of cost analysis and cost sustainability for Hospitals in the perspective of th National Health System

Heart Failure (HF) can be considered among the most expensive diseases for the National Health System in Italy (1,4% of the yearly expenditure); it is related to high levels of mortality and morbidity, and long hospitalization periods. This means that the largest part of costs is related to direct health assistance. Data on managing by telemedicine of post discharge periods in HF are scarce. A trial was conducted after a review on Health Care Management, and Health Technology Assessment literature, about telecardiology implications on cost accounting. For 12 months, forty patients affected by HF, implanted with ICD remote control just after discharge from the hospital were observed. The analysis showed, through an accurate cost accounting examination, that the use of telemedicine is cost effective because it allows hospitals to know the health condition of patients before they get worse. These information allow to predict and prevent relapses of HF and new hospitalization (reduced by more than 65%), with a consequent cost saving of about 65% for the same clinical outcome of alternative health treatments

Epigenetics and nutrition

In the last few years, the idea of food and nutrition has undergone radical changes. The paradigm defining food as a simple source of energy and body mass has evolved in a novel concept, in which nutrients can exert specific functions directly linked to human health. Several edibles contain biological active compounds that influence cellular, metabolic and physiologic processes. A variety of dietary compounds have been associated with specific effects and mechanisms of action, often involving epigenetic modifications and gene expression changes. DNA methylation, histone modifications and the activity of non-coding RNAs control chromatin condensation state, allowing the interaction of DNA with transcription factors required for transcriptional activation. Some metabolites act as substrates of key chromatin remodeling factors or compete with other substrates, influencing their catalytic activity. The quantity and quality of macronutrients assumed by diet offers a possible mechanism of interaction between the body and its environment. A number of biological compounds are known to interact with the epigenome. Folic acid, methionine, choline and other B group vitamins are an important source of one-carbon groups required for methylation of histone proteins and non-histone chromatin remodeling factors. Other compounds like polyphenols, including resveratrol, curcumin and quercetin exert a multitude of biological activities. Furthermore, these compounds can influence DNA methyltransferases, the enzymes responsible for DNA methylation. Dietary interventions aimed to maximize potential health benefits derived from nutrition have shown that dietary regimens can be very effective for prevention and treatment of several diseases. Calorie restriction, protein restriction, fast mimicking diets or time restricted feeding have shown to have significant effects on health. Food quality is crucial for the activity of biological compounds and their potential health benefits. Diets rich in animal-derived proteins are associated with higher rates of mortality compared to diets based on plant-derived proteins

How Information Availability Changes Healthcare Chronicity Management: Findings from a Pilot Case Study

Chronic diseases are a crucial matter for worldwide National Health Systems; they represent one of the first causes of disability, mortality and morbidity, due to their persistency and tendency to develop some degree of disability (WHO, 2013). To ensure the economic and social sustainability of such diseases, new healthcare business models development should be considered. Accordingly, Chronic Diseases Management shows how patients are enabled to actively take part of their healthcare by taking advantage of Internet of Things (IoT) (Batalden et al., 2018). This is particularly highlighted in cardiac chronicity: patients enhance their health status, by increasing the participation level (Osborne et al., 2016) on their care pathway, through telemedicine. Accordingly, the main purpose of this work is to explain how is possible to improve real time medical information exchange between patient and hospital, by using technological infrastructures. Just in time information allows the clinical staff to improve the chronicity management. This means: increasing quality of life for patients, optimisation of hospital workload, cost saving. Design/methodology/approach – It was adopted a pilot case study method (Yin, 2014), classified as “Extreme Case Sampling” (Patton, 2002). Study concerns with the observation of remote management of a group of heart failure (HF) patients that, at moment of discharge, are equipped with: i) electrocardiograph; ii) weight scale; iii) pulse- oximeter; iv) sphygmomanometer. All those medical devices are connected with a mobile transmitter. Thus, according with his/her own clinical protocol, each patient provides both the self-measurement and dispatch of his/her own clinical data. These data are sent on a website platform, where, on a daily basis, cardiology staff check them. Originality/value – The availability of these biomedical parameters allows medical staff to predict patient’s health status evolution. Before a patient’s health condition worsens, a predictive model, based on patients’ co- production and IoT, allows the medical staff to provide a TRIAGE aimed at promptly manage those troubled patients. Preliminary findings show that: i) patients were managed exclusive by telephone contact ii) no HF relapse, iii) no ER transit; iv) none hospitalization. Also a cost saving was observed. Practical implications – Empirical experience demonstrates that possibility to share clinical information might change the traditional paradigm (Cahn, 2000) of service providing. As complexity increases, information requirements increase; thus, managerial approaches to healthcare change. Patient’s participation and IoT technologies become critical drivers in chronicity management sustainability: operative inputs able to enhance also Social Value of services provided

Upregulation of the inhibitory receptor ILT4 in monocytes from septic patients

Sepsis-induced immune dysfunction is a complex phenomenon that involves both innate and adaptive responses. Upregulation of the inhibitor receptor named immunoglobulin like transcript 4 (ILT4) is crucial to the tolerogenic function of monocytes. Here, ILT4 expression, endotoxin-induced IL-12 and IL-10 production and CD86 expression were investigated in circulating monocytes from 16 patients with severe sepsis and 16 age and sex matched controls. We found that monocytes from patients with severe sepsis express significantly higher levels of ILT4 than monocytes from controls. Upregulation of ILT4 expression appeared to be induced by soluble factors present in the serum of septic patients and directly correlated with the degree of organ dysfunction. ILT4(+) monocytes from septic patients also displayed an alteration in the cytokine response to endotoxin stimulation characterized by reduced IL-12 production and increased IL-10 production, and a reduced expression of the costimulatory molecule CD86. In conclusion, the increased ILT4 expression and IL-10 production and the decreased CD86 expression and IL-12 production indicate that during sepsis monocytes undergo substantial modulation of the surface and cytokine phenotype. These phenotypic changes may interfere with the antigen presenting cell activity of monocytes, which may contribute to the impairment of adaptive immune responses that takes place during sepsi

L'abbazia di San Leone a Bitonto. Un monumento nel tempo

La storia documentaria e artistica di uno dei monumenti medievali più antichi di Bitonto, presso cui era attiva una fiera, nel Medioevo, talmente importante da meritare una citazione nel Decamerone di Boccaccio. Si ripercorre la sua evoluzione, analizzando le testimonianze archivistiche e materiale a noi giunte. Emerge un monumento unico nel suo genere, stratificato e ricco di tracce che esplicitano i passaggi a Ordini diversi nel corso dei secoli e il ruolo dell'abbazia nel contesto urbano e sociale di Bitonto e della intera Puglia