Diseguaglianza, fiducia e capitale sociale nel Mezzogiorno

La carenza di capitale sociale del Mezzogiorno pu\uf2 essere spiegata, almeno in parte, con la maggiore incidenza delle diseguaglianz

Coping with cancer: A prospective psycho-social analysis of cancer patients and their non-medical caregivers (cg) – A goim study

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Treatment of pulmonary hypertension in patients undergoing cardiac surgery with cardiopulmonary bypass: a randomized, prospective, double-blind study.

OBJECTIVE: Pulmonary hypertension can already be present in patients undergoing cardiac surgery or can be exacerbated by cardiopulmonary bypass. Postoperative treatment is still a challenge for physicians. The aim of this study was to evaluate the effects of inhaled prostacyclin (iPGI2) and nitric oxide (iNO) compared with those of intravenous vasodilators. METHODS: This prospective, randomized, double-blind study included 58 patients affected by severe mitral valve stenosis and pulmonary hypertension with high pulmonary vascular resistance (> 250 dynes x s x cm(-5)) and a mean pulmonary artery pressure > 25 mmHg. All patients were monitored by central venous, radial arterial and Swan-Ganz catheters. Data were recorded at six different time points, before induction of anaesthesia, during and after surgery. Prostacyclin and nitric oxide were administered by inhalation 5 min before weaning from cardiopulmonary bypass and continued in the intensive care unit. Right ventricular function was evaluated by transoesophageal echocardiography. RESULTS: Hospital mortality was 3.4%. After drug administration, the mean pulmonary artery pressure and pulmonary vascular resistance were significantly decreased in the iNO and iPGI2 groups with respect to the baseline values (P < 0.05) and such a decrease was maintained throughout the study; this was not observed in the control group. In the iNO and iPGI2 groups we demonstrated a significant increase in cardiac indices and right ventricular ejection fraction after drug administration with respect to baseline. Furthermore, patients in the inhaled drug groups were weaned easily from cardiopulmonary bypass (P = 0.04) and had a shorter intubation time (P = 0.03) and intensive care unit stay (P = 0.02) than the control group. CONCLUSIONS: Our data suggest that both iNO and iPGI2 are effective in the treatment of pulmonary hypertension. iPGI2 has a number of advantages over iNO, including its easy administration and lower cost. Intravenous vasodilator treatment, on the other hand, is effective in terms of mortality but has a higher morbidity rate

Restoration practices in Mediterranean habitats using native woody species

Since the beginning of the XXI century, Legambiente (a national environmental association), supported by the University of Palermo, has launched several naturalization projects within three Sicilian nature reserves: 1)Isola di Lampedusa (Agrigento Province); 2)Macalube di Aragona (Agrigento Province); 3)Lago Sfondato (Caltanissetta Province). Interventions were carried out on bare lands and degraded sites where natural vegetation cover was almost completely disappeared. The main aim was to restore native habitats following the principles of ecological restoration. Accordingly, differently from the classical approach, consisting in the use of preparatory species, usually Pines, native shrubs and trees were selected and used in the field

Comparing the effect of STan (cardiotocographic electronic fetal monitoring (CTG) plus analysis of the ST segment of the fetal electrocardiogram) with CTG alone on emergency caesarean section rates: study protocol for the STan Australian Randomised controlled Trial (START).

BACKGROUND: Cardiotocography is almost ubiquitous in its use in intrapartum care. Although it has been demonstrated that there is some benefit from continuous intrapartum fetal monitoring using cardiotocography, there is also an increased risk of caesarean section which is accompanied by short-term and long-term risks to the mother and child. There is considerable potential to reduce unnecessary operative delivery with up to a 60% false positive diagnosis of fetal distress using cardiotocography alone. ST analysis of the fetal electrocardiogram is a promising adjunct to cardiotocography alone, and permits detection of metabolic acidosis of the fetus, potentially reducing false positive diagnosis of fetal distress. METHODS: This study will be a single-centre, parallel-group, randomised controlled trial, conducted over 3 years. The primary hypothesis will be that the proportion of women with an emergency caesarean section on ST analysis will not equal that for women on cardiotocography monitoring alone. Participants will be recruited at the Women's and Children's Hospital, a high-risk specialty facility with approximately 5000 deliveries per annum. A total of 1818 women will be randomised to the treatment or conventional arm with an allocation ratio of 1:1, stratified by parity. The primary outcome is emergency caesarean section (yes/no). Statistical analysis will follow standard methods for randomised trials and will be performed on an intention-to-treat basis. Secondary maternal and neonatal outcomes will also be analysed. Additional study outcomes include psychosocial outcomes, patient preferences and cost-effectiveness. DISCUSSION: Approximately 20% of Australian babies are delivered by emergency caesarean section. This will be the first Australian trial to examine ST analysis of the fetal electrocardiogram as an adjunct to cardiotocography as a potential method for reducing this proportion. The trial will be among the first to comprehensively examine ST analysis, taking into account the impact on psychosocial well-being as well as cost-effectiveness. This research will provide Australian evidence for clinical practice and guideline development as well as for policy-makers and consumers to make informed, evidence-based choices about care in labour. TRIAL REGISTRATION: ANZCTR, ACTRN1261800006268 . Registered on 19 January 2018

Risk Factors Associated with Adverse Fetal Outcomes in Pregnancies Affected by Coronavirus Disease 2019 (COVID-19): A Secondary Analysis of the WAPM study on COVID-19

To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Mean gestational age at diagnosis was 30.6\ub19.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09-1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3-7.9; p=0.001) were independently associated with composite adverse fetal outcome. Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible

L'uguale e il diverso. Come le diseguaglianza deprimono il capitale sociale

Come si creano e come si distruggono lo spirito di cooperazione, la solidariet\ue0, la lealt\ue0, la reciprocit\ue0, la fiducia? Quali sono le condizioni che favoriscono (o deprimono) la formazione di capitale sociale? La risposta a questa domanda pu\uf2 illuminare numerosi fenomeni contemporanei quali la crescita della propensione alla chiusura e all\u2019esclusione e il ritorno di manifestazioni discriminatorie, xenofobe e razziste. Anche le peggiori performance economiche del Mezzogiorno possono essere illuminate dalla risposta alla domanda su come si crea (e si distrugge) il capitale sociale

Capitale sociale pubblico e capitale sociale privato nel Sud

Se intendiamo per capitale sociale pubblico il senso civico, per capitale sociale privato dobbiamo intendere la rete di relazioni sociali dell'individuo. Le regioni meridionali hanno meno capitale sociale inteso come bene pubblico. Ma anche famiglia e amicizia che sarebbero i porti franchi della socialit\ue0 meridionale, mostrano nel tempo segni di deperimento

Minori stranieri non accompagnanti: abilità, risorse e competenze

L’apprendimento dell’italiano per i minori stranieri non accompagnati procede a passi relativamente rapidi anche se i ragazzi intervistati hanno una scarsa scolarità. L’età relativamente giovane, insieme a una esperienza di vita del tutto particolare, che li ha fatti crescere forzosamente, deve avere reso questi ragazzi particolarmente ricettivi nei confronti dell’apprendimento della lingua. D’altra parte, essa si presenta, ai loro occhi, come la porta principale di accesso a una condizione di vita che non può che essere migliore di quella che hanno lasciato e che, in ogni caso, offre loro la convinzione di avere più prospettive di vita e di riuscita di quelle che hanno lasciato nel paese di origine. Questa condizione dovrebbe indurre a prestare, sul piano delle policy, maggiore attenzione al ruolo di integrazione che può essere svolto da istituzioni deputate all’insegnamento dell’italiano, quali sono i CPIA.The learning of Italian for unaccompanied foreign minors proceeds at relatively rapid steps even if the children interviewed have poor schooling. The relatively young age, together with a very special life experience, which forced them to grow up, must have made these children particularly receptive to language learning. On the other hand, it presents itself, in their eyes, as the main gateway to a life condition that can only be better than the one they left and that, in any case, offers them the conviction of having more perspectives of life and success of those who left in their country of origin. This condition should lead to pay, in terms of policies, greater attention to the role of integration that can be played by institutions responsible for teaching Italian, such as the CPIA