ALPHA: an eAsy inteLligent service Platform for Healthy Ageing

Dementia is one of the biggest global public health challenges facing our generation. Alzheimers disease (AD) is the most frequent cause of dementia in elderly people over 65 years of age. The typical characteristic of AD is impairment of memory. As the disease progresses, other cognitive domains such as language, praxis, visuo-spatial and executive functions become involved, eventually resulting in global cognitive decline. Behavioral Psychological Symptoms of Dementia (BPSD) problems are constant in AD and have highly negative impact on the quality of life of patients and their families. ALPHA project aims at developing an intelligent situation-aware system to collect and process information about Alzheimer Disease patients? life style. Starting from various data provided by caregivers and a set of non-invasive sensors and devices. ALPHA will provide clinicians with new quantitative and qualitative information about patients? abnormal behavior which, along with medical data, will enhance the accuracy and reliability of monitoring and assessing the patient?s health status. Clinicians will be supported by a suite of specifically designed tools and interfaces to analyze the metadata captured, improve management of personalized care plans and better interact with patients and caregivers. Studies of antique records of former psychiatric hospital will enable us towiden the knowledge of behavioral disorders thus allowing to compare the ancient ones and the curcurrent and to probabilistically determine relation between type of dementia and behavioral disorders

Percezione ed autorappresentazione della paternità ed esperienze detentive: Risultati di una ricerca negli Istituti Penitenziari della Puglia e della Emilia Romagna

L’esperienza della detenzione comporta spesso l'isolamento affettivo, relazionale, culturale, del soggetto ristretto, contribuendo a sgretolare le relazioni familiari e rendendo particolarmente difficile il mantenimento di rapporti affettivi, in un ambiente, quale quello detentivo, caratterizzato da grandi restrizioni. La letteratura non ha mancato di rilevare i riflessi della esecuzione della pena sui diritti fondamentali della personalità ed, in particolare, della genitorialità. Lo stato detentivo, infatti, impedendo l'esercizio, la pratica e l'esperienza sui quali la genitorialità si fonda, porta i genitori a sperimentare costantemente un sentimento di fallimento e di inadeguatezza. Sono estremamente complesse le interrelazioni che si creano tra dinamiche familiari e fasi della esecuzione penale del soggetto. L'esecuzione della pena detentiva rappresenta, infatti, un momento altamente critico per il detenuto, ma anche per la sua famiglia. Nel nostro contributo ci siamo soffermati solo sulla figura del padre detenuto, tentando con l’aiuto di uno strumento psicodiagnostico preciso e riconosciuto dalla letteratura scientifica in tema di percezione ed autopercezione della propria genitorialità, di misurare e verificare in qualche modo, la percezione e le rappresentazioni che hanno di sé come padri, soggetti ristretti E’ opinione degli autori, alla luce dei risultati della ricerca effettuata in istituti penitenziari di due regioni italiane e grazie alla disponibilità degli operatori e alla sensibilità dei loro dirigenti, che l’esercizio della genitorialità e la sua tutela, nei soggetti ristretti, rappresentino un valore aggiunto nei programmi e progetti di rieducazione e trattamento dei soggetti detenuti

Percezione ed autorappresentazione della paternità ed esperienze detentive: risultati di una ricerca negli istituti penitenziari della Puglia e della Emilia Romagna

The experience of detention often involves the affective, relational, cultural, narrow-minded isolation, contributing to eradicate family relationships, and making it particularly difficult to maintain affective relationships in an environment such as detention, characterized by great restrictions. Literature has not failed to detect the reflections of the execution of the punishment on fundamental rights of personality and, in particular, of parenting. In fact, detaining the state, preventing the exercise, practice and experience on which parenthood is based, leads parents to experience constantly a feeling of failure and inadequacy. Extremely complex relationships are created between family dynamics and phases of criminal execution of the subject. Execution of the prison sentence is, in fact, a very critical moment for the detainee, but also for his family. In our contribution we have focused only on the figure of inmate fathers, attempting with the help of a precise psychodynamic instrument recognized by the scientific literature on the perception and self-perception of parenthood, to measure and verify in some way the perception and representations that have themselves as fathers, narrow subjects. It is the opinion of the authors, in light of the results of the research carried out in prisons in two Italian regions, due to the availability of the operators and the sensibility of their leaders, that the exercise of parental care in the restricted subjects represents an added value in programs and projects for re-education and treatment of prisoner

Universal Access to Advanced Imaging and Healthcare Protection: UHC and Diagnostic Imaging

: Universal Health Coverage (UHC) is a set of principles adopted by the World Health Organization (WHO) aimed to guarantee access to primary care for the entire world population through a range of essential health services without neglecting the diagnostic aspect. Italy is one of the signatory states, which means that diagnostic services should be appropriated and exigible throughout the national territory equally. Our research analyzed and identified the main criticalities in terms of age, territorial distribution, and technological and health appropriateness of installed Computed Tomography (CT) needed to meet the principles of UHC. Data analyzed in our study were published by Assobiomedica at the end of 2016 and by COCIR, which included and investigated the installed fleet of diagnostic equipment in the Italian sanitary system and in various European countries. The 6th point of the Alma Ata Declaration defines the concept of "primary health care", which includes the importance of the diagnostic phase in the Italian health care system to provide Essential Levels of Assistance (LEA). It is clear from our studies that the technology at the national level is not adequate to satisfy the UHC principles or the European criteria, with negative effects on the diagnostic standards and on advanced screenings. This study conducted on the installed CTs in Italy at the end of 2016 confirms the persistence of progressive aging that has been recorded for several years in the health facilities of the country and suggests incentive policies for the replacement of obsolete equipment, which represent a form of investment rather than a cost, due to the nature of the expenditure itself, one-off and amortizable over time

Universal Access to Advanced Imaging and Healthcare Protection: UHC and Diagnostic Imaging

Universal Health Coverage (UHC) is a set of principles adopted by the World Health Organization (WHO) aimed to guarantee access to primary care for the entire world population through a range of essential health services without neglecting the diagnostic aspect. Italy is one of the signatory states, which means that diagnostic services should be appropriated and exigible throughout the national territory equally. Our research analyzed and identified the main criticalities in terms of age, territorial distribution, and technological and health appropriateness of installed Computed Tomography (CT) needed to meet the principles of UHC. Data analyzed in our study were published by Assobiomedica at the end of 2016 and by COCIR, which included and investigated the installed fleet of diagnostic equipment in the Italian sanitary system and in various European countries. The 6th point of the Alma Ata Declaration defines the concept of “primary health care”, which includes the importance of the diagnostic phase in the Italian health care system to provide Essential Levels of Assistance (LEA). It is clear from our studies that the technology at the national level is not adequate to satisfy the UHC principles or the European criteria, with negative effects on the diagnostic standards and on advanced screenings. This study conducted on the installed CTs in Italy at the end of 2016 confirms the persistence of progressive aging that has been recorded for several years in the health facilities of the country and suggests incentive policies for the replacement of obsolete equipment, which represent a form of investment rather than a cost, due to the nature of the expenditure itself, one-off and amortizable over time

Association of Laryngeal Cancer With Previous Gastric Resection

OBJECTIVE: To investigate the association between gastric surgery and cancer of the larynx. SUMMARY BACKGROUND DATA: Biliary reflux is frequent after gastric surgery and may reach the proximal segment of the esophagus and the larynx. It is possible that duodenal content (consisting in bile acids, trypsin), together with pepsin and acid residues when gastric resection is partial, may cause harmful action on the multistratified epithelium of the larynx. METHODS: A retrospective case-control study on subjects admitted between January 1987 and May 2002 in the same hospital in Rome was carried out. The study included 828 consecutive patients with laryngeal cancer (cases) and 825 controls with acute myocardial infarction. Controls were randomly sampled out of a total of 10,000 and matched with cases for age, sex, and year of admission. Logistic regression models were used to assess the role of gastric resection in determining laryngeal cancer risk while controlling for potential confounding factors. RESULTS: Previous gastrectomy was reported by 8.1% of cases and 1.8% of the controls (P < 0.0001). A 4-fold association emerged between gastric surgery and laryngeal cancer risk (adjusted OR = 4.3, 95% CI: 2.4–7.9). The risk appeared strongly increased 20 years after surgery (OR = 14.8, 95% CI: 3.4–64.6). Heavy alcohol drinking (OR = 2.5, 95% CI: 1.8–3.5), smoking (OR = 4.7, 95% CI: 3.3–6.7), and blue-collar occupation (OR = 4.6, 95% CI: 3.2–6.7) were all independently associated with the risk of laryngeal cancer. CONCLUSIONS: Previous gastric surgery is associated with an increased risk of laryngeal cancer. A periodic laryngeal examination should be considered in long-term follow-up of patients with gastric resection