Chapter The Financial Wellbeing Index: “Donne al quadrato” and the relevant impact measurement

How can we reduce economic violence? Can financial literacy and education enhance economic wellbeing? The present paper reports the results of a research conducted by ALTIS – Università Cattolica and Global Thinking Foundation for the evaluation of changes, improvements and consequences produced by the educational course in financial literacy ‘Donne al quadrato’, provided by the Foundation among the policies against economic violence implementation. In this study, impacts’ measurement refers to conceptual framework of financial wellbeing, a composite notion constructed of objective and subjective dimensions related to people’s financial behaviour. The expression ‘Financial Wellbeing’ highlights how economic issues are inextricably bound to individual and social wellness. Helping people enhancing their own financial wellbeing – in a broad sense – should then be the very first purpose of economic education activity. In the present research, financial wellbeing has been measured by the implementation of a synthetic index, based on studies of World Bank and University of Bristol. The index is intended to measure people’s self-sufficiency and independence about their financial situation, resources and capabilities. The indicator takes into account both micro and macro features, being the first ones specific of the sample analysed and latter territorial context variables employed for the removal of the macroeconomic changes affecting the entire population from the specific changes proceeding from the training. The trial, involving different Italian regions, has been fulfilled by the administration of a tailoredmade survey pre and post the “Donne al Quadrato” course, during academic year 2019/2020, in order to register the change occurred in the respondents’ perception of their knowledge, behaviour, personality and aptitudes. The results of the experimentation demonstrated that financial education could engender the modification not only of knowledge but also of awareness and proficiency in financial behaviours, as well as the increase of course participants’ financial wellbeing

Effective Neutralizing Antibody Response Against SARS-CoV-2 Virus and Its Omicron BA.1 Variant in Fully Vaccinated Hematological Patients

SARS-CoV-2 and its variants cause CoronaVIrus Disease 19 (COVID-19), a pandemic disease. Hematological malignancies increase susceptibility to severe COVID-19 due to immunosuppression. Anti-SARS-CoV-2 neutralizing antibodies protect against severe COVID-19. This retrospective real-life study aimed to evaluate seropositivity and neutralizing antibody rates against SARS-CoV-2 and its Omicron BA.1 variant in hematological patients. A total of 106 patients with different hematologic malignancies, who have mostly received three or more vaccine doses (73%), were included in this study. Serum was collected between May and June 2022. The primary endpoint was anti-SARS-CoV-2 antibody response against ancestral (wild type; wt) and Omicron BA.1 virus, defined as a neutralizing antibody titer ≥ 1:10. Adequate neutralizing antibody response was observed in 75 (71%) and 87 (82%) of patients for wt and Omicron BA.1 variants, respectively.However, patients with B-cell lymphoproliferative disorders and/or those treated with anti-CD20 monoclonal antibodies in the prior 12 months showed a lower seropositivity rate compared to other patients against both Omicron BA.1 variant (73% vs 91%; P = 0.02) and wt virus (64% vs 78%; P = 0.16). Our real-life experience confirmed that full vaccination against SARS-CoV-2 induces adequate neutralizing antibody protection for both the wt virus and Omicron BA.1 variants, even in hematological frail patients. However, protective measures should be maintained in hematological patients, especially those with B-cell lymphoproliferative diseases treated with anti-CD20 monoclonal antibodies, because these subjects could have a reduced neutralizing antibody production

ERS: A simple scoring system to predict early recurrence after surgical resection for hepatocellular carcinoma.

peer reviewed[en] BACKGROUND: Surgical resection (SR) is a potentially curative treatment of hepatocellular carcinoma (HCC) hampered by high rates of recurrence. New drugs are tested in the adjuvant setting, but standardised risk stratification tools of HCC recurrence are lacking. OBJECTIVES: To develop and validate a simple scoring system to predict 2-year recurrence after SR for HCC. METHODS: 2359 treatment-naïve patients who underwent SR for HCC in 17 centres in Europe and Asia between 2004 and 2017 were divided into a development (DS; n = 1558) and validation set (VS; n = 801) by random sampling of participating centres. The Early Recurrence Score (ERS) was generated using variables associated with 2-year recurrence in the DS and validated in the VS. RESULTS: Variables associated with 2-year recurrence in the DS were (with associated points) alpha-fetoprotein (100: 3), size of largest nodule (≥40 mm: 1), multifocality (yes: 2), satellite nodules (yes: 2), vascular invasion (yes: 1) and surgical margin (positive R1: 2). The sum of points provided a score ranging from 0 to 11, allowing stratification into four levels of 2-year recurrence risk (Wolbers' C-indices 66.8% DS and 68.4% VS), with excellent calibration according to risk categories. Wolber's and Harrell's C-indices apparent values were systematically higher for ERS when compared to Early Recurrence After Surgery for Liver tumour post-operative model to predict time to early recurrence or recurrence-free survival. CONCLUSIONS: ERS is a user-friendly staging system identifying four levels of early recurrence risk after SR and a robust tool to design personalised surveillance strategies and adjuvant therapy trials

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI

Chapter The Financial Wellbeing Index: “Donne al quadrato” and the relevant impact measurement

How can we reduce economic violence? Can financial literacy and education enhance economic wellbeing? The present paper reports the results of a research conducted by ALTIS – Università Cattolica and Global Thinking Foundation for the evaluation of changes, improvements and consequences produced by the educational course in financial literacy ‘Donne al quadrato’, provided by the Foundation among the policies against economic violence implementation. In this study, impacts’ measurement refers to conceptual framework of financial wellbeing, a composite notion constructed of objective and subjective dimensions related to people’s financial behaviour. The expression ‘Financial Wellbeing’ highlights how economic issues are inextricably bound to individual and social wellness. Helping people enhancing their own financial wellbeing – in a broad sense – should then be the very first purpose of economic education activity. In the present research, financial wellbeing has been measured by the implementation of a synthetic index, based on studies of World Bank and University of Bristol. The index is intended to measure people’s self-sufficiency and independence about their financial situation, resources and capabilities. The indicator takes into account both micro and macro features, being the first ones specific of the sample analysed and latter territorial context variables employed for the removal of the macroeconomic changes affecting the entire population from the specific changes proceeding from the training. The trial, involving different Italian regions, has been fulfilled by the administration of a tailoredmade survey pre and post the “Donne al Quadrato” course, during academic year 2019/2020, in order to register the change occurred in the respondents’ perception of their knowledge, behaviour, personality and aptitudes. The results of the experimentation demonstrated that financial education could engender the modification not only of knowledge but also of awareness and proficiency in financial behaviours, as well as the increase of course participants’ financial wellbeing