Migration and the neoliberal state: accounting ethics in the Italian response to the refugee crisis

This research adds to sparse accounting literature on immigration by problematizing the intertwined relationship between accounting and ethics in the neoliberal era. It explains ethical paradoxes inherent in the neoliberal project and how these unfold in the accounting practices deployed by the Italian state to handle the ongoing refugee crisis. Our analysis shows how the State’s proclaimed conviction to the human right cause turned out to be neoliberal in nature. On the one hand, the use of accounting was indeed partially dictated by the State’s mission of constructing the neoliberal citizen. On the other hand, accounting practices mainly prioritized efficiency over care and reflected the unwillingness of the State to enact responsibility for immigrants' human rights. We conclude that the use of accounting epitomizes complementary rather than opposing forms of neoliberalism and ultimately unveils the inability of the State to offer a humanitarian response to the immigration crisis

Inclusion of Platinum Agents in Neoadjuvant Chemotherapy Regimens for Triple-Negative Breast Cancer Patients: Development of GRADE (Grades of Recommendation, Assessment, Development and Evaluation) Recommendation by the Italian Association of Medical Oncology (AIOM)

In the absence of identified therapeutic targets, chemotherapy is the main systemic treatment option for triple-negative breast cancer (TNBC). The achievement of a pathological complete response (pCR) after neoadjuvant chemotherapy leads to good outcome, whereas patients not achieving a pCR are at high risk of relapse. Various trials have evaluated the inclusion of platinum in neoadjuvant chemotherapy regimens for TNBC, leading to non-univocal results. The panel of the Italian Association of Medical Oncology (AIOM) Guidelines on Breast Cancer developed a clinical recommendation on the addition of platinum to anthracycline/taxane-based neoadjuvant chemotherapy for TNBC by using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology and the Evidence to Decision framework (EtD). Five studies were eligible. The panel identified the following outcomes of benefit: pCR (critical), disease/event-free survival (DFS/EFS, critical), and overall survival (OS, critical). The panel identified febrile neutropenia (critical), serious adverse events (critical), anemia grade 3-4 (important), thrombocytopenia grade 3-4 (important) as outcomes of harms. The probability of pCR was higher in the platinum-based chemotherapy group versus control group (RR = 1.45, 95%CI 1.28-1.64); however, no impact on long-term outcome was observed. Neoadjuvant treatment regimens containing platinum resulted in a non-significant increase in the risk of febrile neutropenia and in a significant increase in the risk serious adverse events, G3-G4 anemia and G3-G4 thrombocytopenia: 11.3% versus 0.8%, RR = 15.66 (95%CI 6.38-38.44). The panel judged uncertain/favorable the benefit/harms balance. The panel's final recommendation was conditional in favor of the inclusion of platinum in anthracycline/taxane-based neoadjuvant regimens for TNBC

PARP-inhibitors for BRCA1/2-related advanced HER2-negative breast cancer: A meta-analysis and GRADE recommendations by the Italian Association of Medical Oncology

Background: Approximately 5-10% of unselected breast cancer (BC) patients retain a hereditary predisposition related to a germline mutation in BRCA1/2 genes. The poly-ADP ribose polymerase (PARP)-inhibitors olaparib and talazoparib have been granted marketing authorization by both FDA and EMA for adults with BRCA1/2 germline mutations and HER2-negative (HER2-) advanced BC based on the results from the phase III OlympiAd and EMBRACA trials. Methods: The panel of the Italian Association of Medical Oncology (AIOM) Clinical Practice Guidelines on Breast Cancer addressed two critical clinical questions, adopting the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach and the Evidence to Decision framework (EtD), to develop recommendations on the use of PARP-inhibitors, with respect to single-agent chemotherapy, in patients with BRCA-related triple-negative (clinical question 1) and hormone receptor-positive (HR+)/HER2- (clinical question 2) advanced BC. Results: Two studies were eligible (OlympiAd and EMBRACA). For both clinical questions, the Panel judged the benefit/harm balance probably in favor of the intervention, given the favorable impact in terms of PFS, ORR, and QoL at an acceptable cost in terms of toxicity; the overall certainty of the evidence was low. The panel's final recommendations were conditional in favor of PARP-inhibitors over single-agent chemotherapy in both HR+/HER2-and triple-negative BC. Finally, the Panel identified and discussed areas of uncertainty calling for further exploration. Conclusions: The Panel of AIOM BC Clinical Practice Guideline provided clinical recommendations on the use of PARP-inhibitors, with respect to single-agent chemotherapy, in patients with BRCA-related HER2-advanced BC by adopting the GRADE methodology

Implementing an evidence-based computerized decision support system linked to electronic health records to improve care for cancer patients: the ONCO-CODES study protocol for a randomized controlled trial.

BACKGROUND: Computerized decision support systems (CDSSs) are computer programs that provide doctors with person-specific, actionable recommendations, or management options that are intelligently filtered or presented at appropriate times to enhance health care. CDSSs might be integrated with patient electronic health records (EHRs) and evidence-based knowledge. METHODS/DESIGN: The Computerized DEcision Support in ONCOlogy (ONCO-CODES) trial is a pragmatic, parallel group, randomized controlled study with 1:1 allocation ratio. The trial is designed to evaluate the effectiveness on clinical practice and quality of care of a multi-specialty collection of patient-specific reminders generated by a CDSS in the IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) hospital. We hypothesize that the intervention can increase clinician adherence to guidelines and, eventually, improve the quality of care offered to cancer patients. The primary outcome is the rate at which the issues reported by the reminders are resolved, aggregating specialty and primary care reminders. We will include all the patients admitted to hospital services. All analyses will follow the intention-to-treat principle. DISCUSSION: The results of our study will contribute to the current understanding of the effectiveness of CDSSs in cancer hospitals, thereby informing healthcare policy about the potential role of CDSS use. Furthermore, the study will inform whether CDSS may facilitate the integration of primary care in cancer settings, known to be usually limited. The increasing use of and familiarity with advanced technology among new generations of physicians may support integrated approaches to be tested in pragmatic studies determining the optimal interface between primary and oncology care. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02645357

Chronic Cough and Eosinophilic Esophagitis: An Uncommon Association

An increasing number of children, usually with gastrointestinal symptoms, is diagnosed with eosinophilic esophagitis (EE), and a particular subset of these patients complains of airway manifestations. We present the case of a 2-year-old child with chronic dry cough in whom EE was found after a first diagnosis of gastroesophageal reflux disease (GERD) due to pathological 24-hour esophageal pH monitoring. Traditional allergologic tests were negative, while patch tests were diagnostic for cow's milk allergy. We discuss the intriguing relationship between GERD and EE and the use of patch test for the allergologic screening of patients

Il caso studio del "Parco Marino del Piceno"

Il caso studio del "Parco Marino del Piceno

Schema Generale di assetto alla Variante Generale al PRG di Pineto

Lo Schema Generale d'Assetto corrisponde al primo momento della costruzione del PRG. E' caratterizzato dai seguenti contenuti e finalità: - conoscere criticamente e valutare lo stato di fatto del territorio comunale in tutte le sue dimensioni (ambientali, fisico‐spaziali, funzionali, infrastrutturali, produttive, sociali, culturali, economiche); - tratteggiare, a partire dalla conoscenza e valutazione, l’idea complessiva di sviluppo socioeconomico e spaziale da porre a base del PRG; - illustrare la struttura territoriale e le scelte strategiche di assetto sottese all’idea complessiva di sviluppo; - fornire, di conseguenza, il quadro degli obiettivi e delle azioni da perseguire e da attivare tramite il PRG; - avviare la partecipazione degli attori del territorio e dei cittadini al processo di pianificazione; - avviare la copianificazione con gli altri enti e soggetti pubblici competenti per il governo - del territorio. Il percorso intrapreso ha consentito la predisposizione degli elaborati che compongono il Documento Programmatico Preliminare: - Relazione - Elaborati Grafici: 1. Invarianti Strutturali (scala 1:10.000) 2. Problemi e Questioni Emergenti nello Spazio Urbano scala (1:8.000) 3. Schema Preliminare scala (1:8000) 4. All. Repertorio dei Progetti Strategici

Reti ecologiche e Siti Natura 2000

Le questioni ambientali rivestono un rilievo sempre maggiore nelle politiche comunitarie, e i temi del paesaggio e delle reti ecologiche rappresentano il cuore del dibattito proprio in virtù della loro pervasività e del ruolo che assumono nel determinare caratteri identitari e specificità territoriali dell'Europa. Se abbiamo spesso descritto il continente europeo come un coacervo di tradizioni, costumi e lingue, depositato in un'area geografica composta da tanti, irriducibilmente diversi paesaggi, dovremmo anche evidenziarne il layout di fondo costituito da una vasta matrice ambientale, punteggiata da pregiati e variegati ecosistemi. Come le diverse visioni delle molteplici tradizioni culturali sembrano in fiduciosa attesa di consolidare processi di integrazione, anche attraverso forme di reciproco accoglimento, basate sul dialogo e non sul semplice accostamento di etnie separate (o peggio prevaricazione di una cultura sulle altre ), così pure i tanti paesaggi europei attendono di rafforzare e di evidenziare occasioni di contatto e quindi di profonda interazione. Le reti ecologiche che, alla scala locale, utilizzano il supporto delle politiche paesistiche per orientare il governo degli spazi esterni ai territori protetti e guidare la gestione di ambiti relazionali tra aree tutelate, alla scala europea, potrebbero costituire quella trama di fondo in cui s'incastonano grandi paesaggi e infinitesimi ecosistemi naturali. Senza disconoscere ruoli e caratteri gestionali particolari che mantengono obbiettivi specifici e tra loro diversi, è evidente che l'infrastrutturazione paesistico-ambientale sviluppata alla scala europea coglie la profonda interazione tra le componenti della natura e della cultura, scoprendone ed esaltandone valori e contenuti comuni, chiamati a costruire la carta d'identità dell'Europa