Conseil et prescription de l'activité physique au cabinet médical

[Table des matières] 1. Introduction. 2. Validité thérapeutique de l'activité physique. 3. Prédisposition des médecins tessinois à conseiller et prescrire l'activité physique. 4. Conclusion générale et proposition. Bibliographie. Annexes. Glossaire

IL BINGE EATING DISORDER: UN MODELLO DI TRATTAMENTO AMBULATORIALE

In questa Tesi viene discusso il Disturbo della condotta alimentare: il Binge Eating Disorder(BED). Si analizza dapprima l’epidemiologia, il quadro clinico, la comorbidtà psichiatrica e le complicanze organiche di questo disturbo. Nella seconda parte vengono illustrate le terapie fino ad oggi impiegate nel trattamento del BED:la terapia cognitivo comportamentale, la terapia interpersonale, la terapia farmacologica, i programmi di riduzione del peso e la terapia chirurgica. Viene poi discusso il nuovo modello di trattamento ambulatoriale da noi proposto. Esso si basa su una prima fase di terapia cognitivo comportamentale e di educazione nutrizionale seguito da una seconda fase di psicoterapia interpersonale associata ad un intervento nutrizionale mirato alla riduzione del peso. Un campione di 17 soggetti reclutati consecutivamente sono stati valutati, con consenso informato, periodicamente tramite la verifica dell’indice di massa corporeo e l’applicazione di scale di valutazione psicopatologiche(SCIDI, SCIDII, BEDCI, EDI-2). Le valutazioni sono state fatte all’inizio del trattamento, alla fine del trattamento e dal folllow-up di 18 mesi. Nonostante l’esiguità del campione, dall’analisi statistica delle scale sono emersi risultati promettenti al termine del trattamento ed in special modo al follow-up di 18 mesi

How patients' experiences help institutions to improve care in oncological pathway.

To improve services, institutions need to listen the patients voice. The patient experience through the health care pathway can help institutions to point out the problems and to learn to design the organization putting the patient at the center of the service. Methods. Focus groups were performed on a group of patients affected by colon rectum neoplasia who had an operation during June-September 2003 in the hospitals located in three geographical districts. It was performed a focus group per district in the period between June and July 2004. Results. Overall patient were interviewed in district A, B and C, respectively. District C included a Universtiy Hospital and a Community Hospital. We choose the focus group technics because of the peculiarity of the studied disease. By a crossed reading of patients' experience we obtained two type of informations: how CORD is working (CORD is the structure which has the role of coordination of oncological pathway, according to the regional guidelines) and which are the strength ness and the weakness of the services delivered by each healthcare unit participating at the study. The patient experience in benchmarking through out different institutions, has been useful for managers to start an internal process of reviewing critical points regarding above all humanization and care coordination along the heath care pathway. Particularly interesting is the case of the University Hospital of Pisa, where the patients indications allowed the institution to reengineering the process, to improve services and empower the communication skills of the physicians and nurses involved in the clinical pathway . Conclusions. Patient point of view in oncological care was an easy tool for improving the health care pathway. It gives to health managers a simple method that allows the organization to evaluate services through the patients eyes .Focus group, Oncological pathway, Patients’ point of view

IOSCO: The World Standard Setter for Globalized Financial Markets

As the current endless crisis clearly proves, world financial markets are closely interconnected. In order to provide a legal backdrop, a soft-law body, named the International Organisation of Securities Commissions (IOSCO), was established and tasked with encouraging an efficient flow of capital. Funded as a Pan-American, and subsequently worldwide, forum more than thirty years ago, IOSCO is a multilateral regulatory network whose members are the public regulators of more than ninety percent of the world’s securities and futures markets. It is devoted to promoting common and efficient regulations, setting the floor for the exchange of information between its members, improving the effective surveillance of international securities transactions, and increasing the mutual assistance necessary for the integrity of global financial markets, valued at over $800 trillion. IOSCO is now the primary institution through which international standards, memoranda, and guidelines concerning the securities markets are promulgated. This paper examines the way this relatively hidden organisation works by trying to figure out its regulatory role in the international financial arena

Using abm in managing territorial health services: the “home-care”.

In recent years in Italy, as in other European countries, profound changes have been introduced in health care at both the central and the regional levels. Most of them were oriented towards a shift from “hospital-centred” healthcare to healthcare based more on territorial services. This transition pursues two objectives: giving more effective responses to citizens’ needs and reducing public health expenditure. Changes that involve organizational structure must also be carried out with the introduction of measurement tools that can help in planning and can control the changes. Starting from the experiences of the healthcare system of the Tuscan Region of Italy, the paper aims to provide an experience of the ABM approach to measure both output and efficiency of territorial health services. Activity Based Management provides an appropriate method to examine territorial activities and to meet the fact-finding needs of national and regional policy, by considering the issues indicated by the territorial managers of the Tuscan healthcare system and the regional and national experiences in recent years. ABM focuses on managing activities as the route to improving value for users and for the local healthcare unit; this is accomplished by the measurement of activities and resources that determine the costs and performance of territorial services. This approach requires organization and integration of sets of data belonging to different systems such as financial and operational systems. The ABM model is complex but it can be used by policy makers for strategic perspective and for continuous improvement. Moreover, ABM meets managers’ demands, as the Tuscan territorial managers have confirmed in interviews. On the basis of experience obtained in territorial long term homecare , the paper underscores the principal issues arising from the process of conducting an ABM project in territorial health services through strong involvement of healthcare workers. The paper also presents the main outputs achieved.Home care, performance measurement, ABM.

Influence of Living Plant Roots and Mycorrhizal Hyphae on Soil Hydraulic Properties

The interrelationships between vegetation, soil, and water are fundamental in evaluating the projected impacts of global climate change. Many predictive models require soil hydraulic parameters as inputs. As most hydraulic parameter datasets are for repacked soil, the influence of vegetation on hydraulic parameters is not thoroughly understood. Living roots and mycorrhizal fungi cause physicochemical alterations in soils. Quantifying how vegetation influences soil hydraulic parameters is necessary to more accurately simulate soil water dynamics in climate models. Laboratory experiments were conducted to test if the presence of roots and roots inoculated with mycorrhizal fungi have a significant effect on the saturated and unsaturated hydraulic conductivity, and water retention properties of two soils with contrasting textures: Flint sand and Hamblen silt loam soil. Cores were seeded with Switchgrass (Panicum virgatum) and grown in a greenhouse over three separate growth periods. Serendipita indica was injected as liquid inoculant into designated mycorrhizal cores. In both soil types, the presence of roots with mycorrhizal fungi increased total biomass. Saturated hydraulic conductivity measurements were obtained with a soil permeameter using the constant head method. Analysis of variance (ANOVA) found that saturated hydraulic conductivity was reduced (due to pore clogging) by the presence of plant roots when grown under nutrient-deficient conditions in comparison to bare soil. In contrast, no significant differences were found between treatments for unsaturated hydraulic conductivity curve parameters obtained using the evaporation method. Soil water retention curves were also obtained using the evaporation method, and supplemented at the dry end for the Hamblen silt loam by water activity meter data. Retention curve parameters were obtained by fitting the van Genuchten equation to the resulting measurements. ANOVA indicated the presence of roots changed the shape of the water retention curve in two ways: (i) by increasing water content at saturation, and (ii) and by reducing the slope of the curve. These changes suggested roots created additional porosity and broadened the pore size distribution. The presence of mycorrhizal fungi further accentuated these effects. Future research should investigate the effect of root-mycorrhizal interactions on soil hydraulic parameters for more soil types, plant-fungal associates, and time periods

Scientia petita, Theologia manifesta: scientific rationality and theological proposals in the pandemic

The urgency of understanding the pandemic has exponentially increased the circulation of information. The main directions of information transfer have been internal, that is within scholarly communities, and external, that is towards the public. The very manner in which scientific communication is produced has also changed. While the difficulty of finding practical solutions has often created a sense of mistrust, it has also led to the emergence of an image of scientific rationality as progressive, collective and capable of growth. This image of Science makes it possible to understand and distinguish the epistemic and ontological dimensions of scientific analysis. Theology can identify an attitude of epistemic humility that is conducive to a better understanding of the role of the human being in relation to nature and as the protagonist of history in collaboration with God

Senior Recital: Mary Catherine Davis

A Senior Recital featuring Mary Catherine Davis and Dan Marcacci.https://digitalcommons.kennesaw.edu/musicprograms/2426/thumbnail.jp