The patient at the center of the HTA evaluation process: research protocol

Background: HTA is a multidisciplinary evaluation process that examines the short and long term consequences of using new or existing health technologies. The subjects directly involved in the evaluation are the patients, the only ones who live with the disease and who know deeply treatments, undesirable effects and benefits of drugs and technologies. The evidence provided by patients (EBP) is based on direct experience and this makes it essential in the evaluation process, especially when comparing technologies that achieve the same clinical outcomes. Objectives: several studies have shown that the assessment by regional administrations is more oriented towards a rationalization and management of economic resources than all the introduction of new technologies that meet appropriateness criteria. Furthermore, the research highlighted a lack of interest in the impact of technology and a low level of involvement of patients and, more generally, of stakeholders in the evaluation process. The aim of the project is to develop, through the tools, a plan for involving patients, their associations and health professionals, to build hta reports. Methods/design: the methodology will mainly focus on the opinions of the patients and will refer to the "outcomes reported by the patient", ie structured questionnaires concerning the effects of a treatment and / or benefits and advantages of drugs and technologies, through targeted questions on the state of greeting, on the quality of life and on more specific aspects such as the perception of pain. Conclusion: the quantitative investigation of the structured questionnaires will be accompanied by the tools of the qualitative methodology such as interview, focus group and social media analysis which will constitute the completion of the feedback analysis of the three recipients identified for the purposes of the project

Technostress: how does it affect the productivity and life of an individual? Results of an observational study

Objectives: Technostress is an emergent phenomenon related to the pervasive use of technology and is associated with the increased computerisation and digitalisation seen over recent decades. This crosssectional observational study aims to investigate the impact that stress from the use of technologies (i.e. technostress) has on the productivity and life of an individual. Study design: Cross-sectional study. Methods: Data were collected using a previously proposed and validated questionnaire. The questionnaire was translated into Italian and transformed into an online format with a Google Docs form. The questionnaire was then associated with a link and QR code (also available in paper format) and disseminated manually and through the use of e-mail and social networks, such as Facebook and Twitter. Results: The study sample included 313 individuals, 54.6% of whom were women. The mean age of the sample participants was 34.7 years. The dependent variables were technstressors (i.e. techno-overload, techno-invasion, techno-complexity, techno-insecurity and techno-uncertainty), role stressors (i.e. role overload and role conflict) and productivity. In the multivariate analysis, techno-overload was significantly associated with female gender (b ¼ 0.128; P ¼ 0.018) and unemployment (b ¼ 0.303; P < 0.001); techno-invasion was significantly associated with female gender (b ¼ 0.098; P ¼ 0.081) and degree-level education (b ¼ 0.149; P ¼ 0.008); techno-complexity was significantly associated with female gender (b ¼ 0.107; P ¼ 0.057) and being married (b ¼ 0.113; P ¼ 0.046); techno-uncertainty was significantly associated with unemployment (b ¼ 0.337; P < 0.001); role overload was significantly associated with female gender (b ¼ 0.160; P ¼ 0.014) and productivity was significantly associated with degree-level education (b ¼ 0.125; P ¼ 0.057). Conclusions: This observational study evaluated the phenomenon of both work-related and noneworkrelated technostress of 313 individuals aged between 16 and 65 years. The present study investigated the impact of five techno-stressors, two role stressors and productivity. The results indicate that different techno-stressors are significantly associated with female gender, degree-level education and unemployment. Further research in this field is required to better understand and clarify the epid

Preventive medicine center and health care for students of medicine and health professions at the Sapienza University of Rome: a research protocol

This project aims to develop a Center of Preventive Medicine and Health Care for the students of Medicine and Health profession at Sapienza University of Rome. At the beginning of the university career students, both residents and nonresident s, have to face several difficulties such as: starting smoking or the increase in cigarette consumption ; the independent management of their own health (especially for non residents consequently to the distance of the family doctor) ; unhealthy diet; tuberculosis (TB) biological risk during their university training. These aspects , especially if present at the same time, act as a source stress and adversely affect the quality of life and the academic performance. Specific aims of the project will be: implementing an ambulatory of Preventive Medicine; implementing a virtual ambulatory of general medicine; creating a website on the problems mentioned above. Data collected will be computerized to keep an electronic health record (HER) and to use the information for the purposes of scientific research. The Centre will act in close relationship with the Central Administration, with the Headmasters of the Medical Faculties, and in close collaboration with the Center of Occupational Medicine of Sapienza University

Development and characterization of soluplus® nanomicelles associated to specific igg as an innovative strategy for the detection and neutralization of shiga toxin type 2

Shiga toxin type 2 (Stx2) is the main virulence factor of Shiga toxinproducing Escherichia coli and is responsible for triggering HemolyticUremic Syndrome (HUS). We aimed to develop and characterizepolymeric nanomicelles (PN) with the amphiphilic polymerSoluplus® coupled to anti-Stx2 IgG in order to introduce innovativeproposals for the detection of Stx2 and treatment of HUS. PN ofSoluplus® were formulated in PBS and coupled with IgG anti Stx2from hyperimmune (PN-IgG-Stx2) or control bovine colostrum (PNIgG-Ctrl). The hydrodynamic size of PN, PN-IgG-Stx2 and PN-IgGCtrlwas evaluated by Dynamic Light Scattering. Morphology of PNor PN-IgG-Stx2 was analyzed by Transmission Electron Microscopy(TEM). The PN toxicity was evaluated on both Vero and Human GlomerularEndothelial cells (HGEC) and cell viability was determinedby neutral red uptake. After coupling PN with IgG, Stx2 neutralizationcapacity of PN-IgG-Stx2 or PN-IgG-Ctrl was evaluated on Vero andHGEC cells and the percentage of cell viability was analyzed. Thehydrodynamic size of the PN of Soluplus® and IgG-Stx2 showed anaverage diameter of 70.2 ± 1.5 nm and 40.9 ± 2 nm, respectively.When both components were coupled, a single peak with a similarhydrodynamic size of the PN was observed (70.4 ± 0.2 nm). TEManalysis revealed circular particles with a diameter corresponding to100 nm either in PN and PN-IgG-Stx2 particles. PN-IgG-Stx2 wereable to neutralize Stx2 on Vero and HGEC cells in a dose dependentmanner. When comparing the neutralization capacity of Stx2 by IgGStx2vs PN-IgG-Stx2 a significant improvement in the cell viabilityof Vero and HGEC was observed with the PN-IgG-Stx2 (p<0.001).The association between anti-Stx2 IgG from bovine colostrum andSoluplus® PN was optimized and characterized. Encouraging resultsof antibody functionality coupled with PN were registered.These results may open the perspective of the design of new nanoplatformsfor neutralization and/or detection of Stx2.Fil: Girón Reyes, Claudio Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Gomez, Fernando Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Amaral, María Marta. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Chiappetta, Diego Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Tecnología Farmacéutica; ArgentinaFil: Moretton, Marcela Analía. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Tecnología Farmacéutica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ibarra, Cristina Adriana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaFil: Sacerdoti, Flavia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Fisiología y Biofísica Bernardo Houssay. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Fisiología y Biofísica Bernardo Houssay; ArgentinaLXVI Reunión Anual de la Sociedad Argentina de Investigación Clínica; LXIX Reunión Anual de la Sociedad Argentina de Inmunología; LIII Reunión Anual de la Asociación Argentina de Farmacología Experimental y XI Reunión Anual de la Asociación Argentina de NanomedicinasArgentinaSociedad Argentina de Investigación ClínicaSociedad Argentina de InmunologíaAsociación Argentina de Farmacología ExperimentalAsociación Argentina de Nanomedicina

How much do young Italians know about COVID-19 and what are their attitudes toward SARS-CoV-2? Results of a cross-sectional study

Objectives: At the end of 2019, an outbreak of novel coronavirus pneumonia, called severe acute respiratory syndrome coronavirus 1 (SARS-CoV-2), was first identified in Wuhan, Hubei Province, China. It subsequently spread throughout China and elsewhere, becoming a global health emergency. In February 2020, the World Health Organization (WHO) designated the disease coronavirus disease 2019 (COVID-19). The objective of this study was to investigate the degree of knowledge of young Italians about COVID-19 and their current attitudes toward the SARS-CoV-2 and to determine if there were prejudices emerging toward Chinese. Methods: An online survey was conducted on February 3, 4, 5, 2020, with the collaboration of Italian website “Skuola.net”. Young people had the opportunity to participate by answering an ad hoc questionnaire created to investigate knowledge and attitudes about the new coronavirus, using a link published on the homepage. Results: A total of 5234 responses were received, of which 3262 were females and 1972 were males. Most of the participants showed generally moderate knowledge about COVID-19. Male students, middle school students, and those who do not attend school, should increase awareness of the disease; less than half of responders say that their attitudes toward the Chinese population has worsened in the last period

Estrelas e Ases: o retrato fotográfico em Portugal (1916-1936)

Desde o final da década de 1910 e durante os anos 1920, a Fotografia Brasil, uma firma de retrato fotográfico de Lisboa, dirigida por Joaquim da Silva Nogueira, introduziu práticas modernas na fotografia portuguesa, praticamente dominada ainda por um gosto Oitocentista que tinha forte presença na maior parte dos estúdios fotográficos portugueses. Lisboa era escala frequente de artistas internacionais que itineravam a América do Sul e, em particular, o Brasil. O trabalho de Silva Nogueira beneficiou das sessões de pose com esses artistas que escalavam Lisboa durante as tournées artísticas. Desde 1920, a Fotografia Brasil tornou-se a principal fornecedora de retratos de artistas para a imprensa ilustrada portuguesa, sedenta de imagens do teatro. As origens da Fotografia Brasil podem justificar, por exemplo, as ousadas sessões com a bailarina e cantora de origem italiana, Adria Rodi, cujas poses audazes foram captadas pelo olhar moderno de Silva Nogueira, surpreendendo a conservadora sociedade portuguesa e introduzindo um novo padrão estético no retrato fotográfico. Muitos dos mais populares artistas de palco portugueses passaram a fotografar-se no seu estúdio e pontuaram as páginas das secções teatrais dos magazines ilustrados partilhadas com as estralas internacionais, que realçavam a modernidade das imagens de Silva Nogueira. Embora a maior parte dos artistas dos palcos portugueses tenham recorrido a Silva Nogueira durante os cinquenta anos de actividade do estúdio, foi durante os anos 1920 que ele se destacou em especiais cumplicidades com alguns desses artistas como Luísa Satanela que protagonizou um papel chave na transformação da cena teatral portuguesa. Satanela introduziu figurinos, cenários e coreografias modernistas nas representações da revista à portuguesa, um género teatral muito popular em Portugal. Silva Nogueira retratou Satanela de forma extensa em séries fotográficas de modernidade surpreendente, inovando sucessivamente num processo invulgar de cumplicidade, dando o mote para uma renovação decisiva da actividade do retrato fotográfico com ênfase no grande plano e na imagem do corpo. Os jovens artistas e intelectuais procuraram afirmar os valores modernistas na conservadora sociedade portuguesa. Destacou-se António Ferro. Como crítico teatral promoveu o modernismo nos palcos, em particular na revista. A campanha que pôs em 3 marcha nos jornais teve considerável sucesso. Mas Ferro usou a mesma abordagem ao intervir na propaganda, a se dedicou ainda antes de assumir a direcção do SPN. António Ferro teve um papel crucial na afirmação da visualidade em diversos âmbitos da sociedade portuguesa, da literatura ao jornalismo, do teatro à política. Na propaganda política nacional, Ferro suscitou a fotografia e o retrato fotográfico, entre outras áreas das artes para afirmar o novo regime, o Estado Novo, bem como os seus líderes, em particular o Presidente do Conselho, Oliveira Salazar. A afirmação visual do perfil discreto de Salazar representou um desafio particular para Ferro. Em última instância Ferro convocou a capacidade de um fotógrafo moderno, Silva Nogueira para conseguir capturar a imagem oficial de Salazar. Esse retrato esteve presente em todas as repartições públicas e escolas. Por fim, o modernismo, através do retrato fotográfico tinha conseguido assumir-se como a imagem institucional do país.From late 1910’s and throughout the 1920’s the Fotografia Brasil, a Lisbon commercial portraiture studio, led by Joaquim da Silva Nogueira, introduced modernist practices in Portuguese photography, still dominated by late 19th century taste that had a strong expression in most Portuguese photographic studios. Lisbon was then a frequent scale to South America, and especially to Brazilian ports. The work of Silva Nogueira benefited a lot from the posing sessions with foreign artists that scaled Lisbon during their artistic tours. Since 1920, Fotografia Brasil became the leading supplier of artist portraits to the Portuguese illustrated press eager of pictures from theatrical activity. The background of the Fotografia Brasil photographic portraits activity may justify, for instance, the daring photo sessions with the Italian born dancer and singer Adria Rodi, whose audacious poses captured by Silva Nogueira’s modern photographic look surprised the conservative Portuguese society and established a model to the changes in photographic portrait practice. Photographs of other popular artists soon started to be regularly published in special sections of illustrated magazine face to face with international stars highlighting Silva Nogueira’s modern portraits. Though most of Portuguese stage artists called upon the services of Silva Nogueira throughout fifty year of his studio’s activity, it was during the 1920’s that he stood out establishing a special relationship with the actress, singer and dancer Luísa Satanela who played a key role in the transformation of the Portuguese theatrical scene. Satanela introduced modernist design costumes, sceneries and dancing choreographies in the stage performances of revista, a theatrical genre quite popular in Portugal. Silva Nogueira extensively portrayed Satanela in surprisingly modern photographic series, innovating over and over in an unusual complicity process, setting the pace for the decisive renewal of the Portuguese photographic portrait activity with emphasis in close-up and body image. Portuguese young artists and intellectuals tried to assert modernism in Portuguese’s conservative society. António Ferro stood out in this role. As theatre critique he promoted modernist taste in theatrical productions, particularly in light theater. The campaign Ferro carried out in the press gave noticeable results. A transformation in theatre was noticed closing it to the cosmopolitan international productions. But Ferro also followed the same form of intervention in political propaganda, to which he started to devote himself even earlier of his nomination as director of the National Propaganda Secretariat. António Ferro had a crucial role in visuality’s assertion in different aspects of the Portuguese society, from literature to journalism, theater and particularly politics. In national political propaganda, Ferro called upon photography and photographic portrait among other areas of visual arts to disclose the new regime, the Estado Novo, as well as his leaders, particularly the Prime Minister Oliveira Salazar. The assertion of Salazar’s visual discreet profile represented a major challenge to Ferro. Ultimately Ferro called the skills of the modernist photographer Silva Nogueira to succeed in capturing the official image of Salazar. That portrait stood in every governmental office and school. Finally modernism, throughout photographic portrait stand out as Portuguese’s institucional image

Anosmia and ageusia as predictive signs of COVID-19 in healthcare workers in Italy. A prospective case-control study

The aim of this study was to investigate the diagnostic accuracy of symptoms and signs in healthcare workers (HCW) with Sars-CoV-2

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

The Technostress: definition, symptoms and risk prevention

With the advent of Web 2.0 and Social media, a radical change in the world of communication and information flows has occurred, that have crossed space and time limits. The new technology, with its rapid evolution marked by the access to the digital world through the Smartphone invention, resulted in a sharp acceleration of the rhythms of life and work. On the other hand a massive pervasiveness of digital technology in the professional and personal rhythms has been recorded. Technostress, defined for the first time in 1984, is a syndrome that occurs when the person, subjected to information overload and continuous contact with most digital devices, develops a state of stress, or an abnormal response characterized by specific symptoms at the cardiocirculatory, mental and neurological levels. The repercussions of Technostress invest business and relational sphere causing absenteeism, loss of professional effectiveness, conflict and isolation. In 2007, the syndrome has been recognized as an occupational disease: this requires that in all workplace where a frequently use of digital technologies (ICT, publishing etc.) does exist, there is the needto include Technostress in the document of work-related risk assessment. This application is essential to put in place adequate protection and prevention measures, such as increased training of employees on the harmful effect of Technostress and implementation of specific strategies for managing symptoms