Characteristics of the health districts in Italy and their implication in primary health care policies: an analysis of socio‐demographic trends

The Health District (HD) is a critical component of Italy’s National Health Service, responsible for ensuring Primary Health Care (PHC) services in response to community health needs. The Italian government established a national strategic reform program, the National Recovery and Resilience Plan (PNRR), with a series of health interventions to reorganize the PHC setting (Ministerial Decree 77/2022). Our study aimed to provide a description of socio-demographic data and to assess the correlation between HDs, in order to suggest health intervention priorities in PHC reforms. We conducted a retrospective analysis using a cross-sectional record linkage of data from multiple sources to compare organizational and socio-demographic variables. A dataset was created with each of the 21 Italian Regions’ HDs data of population, land area, mean age, ageing index, old-age dependency ratio, birth rate and death rate. We then linked the HD data with the Inland Areas Project in order to categorize them from a socio-economic point of view. Our study identified comparable groups of HDs, considering demographical, socio-economic and geographical aspects. The study provides a baseline understanding of the Italian situation prior to the implementation of DM77. It also highlights that inhabitants number cannot be the only variable to take into account for the definition of Italian HDs organisation and PHC reform, providing intercorrelated variables that take into account geographic location, demographic data, and socio-economic aspects

Novel MIPs-parabens based SPE stationary phases characterization and application

In this work, the synthesis, characterization, and application of novel parabens imprinted polymers as highly selective solid-phase extraction (SPE) sorbents have been reported. The imprinted polymers were created using sol–gel molecular imprinting process. All the seven parabens were considered herein in order to check the phase selectivity. By means of a validated HPLC-photodiode array detector (PDA) method all seven parabens were resolved in a single chromatographic run of 25 min. These SPE sorbents, in-house packed in SPE empty cartridges, were first characterized in terms of extraction capability, breakthrough volume, retention volume, hold-up volume, number of theoretical plates, and retention factor. Finally, the device was applied to a real urine sample to check the method feasibility on a very complex matrix. The new paraben imprinted SPE sorbents, not yet present in the literature, potentially encourage the development of novel molecularly imprinted polymers (MIPs) to enhance the extraction efficiency, and consequently the overall analytical performances, when the trace quantification is required

Novel MIPs-Parabens based SPE Stationary Phases Characterization and Application

In this work, the synthesis, characterization, and application of novel parabens imprinted polymers as highly selective solid-phase extraction (SPE) sorbents have been reported. The imprinted polymers were created using sol–gel molecular imprinting process. All the seven parabens were considered herein in order to check the phase selectivity. By means of a validated HPLC-photodiode array detector (PDA) method all seven parabens were resolved in a single chromatographic run of 25 min. These SPE sorbents, in-house packed in SPE empty cartridges, were first characterized in terms of extraction capability, breakthrough volume, retention volume, hold-up volume, number of theoretical plates, and retention factor. Finally, the device was applied to a real urine sample to check the method feasibility on a very complex matrix. The new paraben imprinted SPE sorbents, not yet present in the literature, potentially encourage the development of novel molecularly imprinted polymers (MIPs) to enhance the extraction efficiency, and consequently the overall analytical performances, when the trace quantification is required

Penerapan Metode Peer Teaching Untuk Meningkatkan Hasil Belajar Kognitif Siswa Pada Mata Pelajaran Pendidikan Agama Islam Materi Puasa Wajib dan Puasa Sunah : Penelitian Tindakan Kelas di Kelas VIII-G (Delapan) SMPN 31 Bandung

Masalah yang sangat menonjol yang di hadapi dalam pelajaran PAI yang bermula dari fenomena yang muncul di lapangan yaitu hasil belajar siswa yang masih rendah. Hal ini terlihat dari hasil belajar siswa dan hasil ulangan siswa masih banyak yang berada di bawah KKM 76 hampir 70%. Salah satu faktor yang mempengaruhi hasil belajar siswa adalah metode yang sesuai. Oleh karena itu, diperlukan metode yang baru dan interaktif, agar pemahaman siswa pada materi pelajaran menjadi optimal sehingga hasil belajar mereka pun dapat meningkat sesuai dengan yang diharapkan. Penelitian ini bertujuan untuk mengetahui (1) Hasil belajar kognitif siswa sebelum diterapkan metode Peer Teaching pada mata pelajaran PAI siswa kelas VIII-G; (2) Proses pembelajaran siswa kelas VIII-G dengan menggunakan metode Peer Teaching pada mata pelajaran PAI siswa kelas VIII-G; (3) Hasil belajar kognitif siswa kelas VIII-G pada mata pelajaran PAI setelah diterapkan metode Peer Teaching. Metode peer teaching dinilai dapat dimanfaatkan sebaik-baiknya dalam pelajaran Pendidikan Agama Islam. Kelebihan dari metode ini adalah (1) Meningkatkan motivasi belajar siswa; (2) Meningkatkan kualitas dan proses pembelajaran; (3) Meningkatkan hasil belajar. Penelitian ini merupakan Penelitian Tindakan Kelas yang dilakukan dalam 3 siklus. Setiap siklus terdiri dari 1 pertemuan dengan tahapan-tahapan (1) Perencanaan; (2) Tindakan; (3) Observasi; (4) Refleksi. Tahapan-tahapan ini dilakukan untuk meningkatkat hasil belajar kognitif siswa pada mata pelajaran PAI materi Puasa Wajib dan Puasa Sunah. Setelah melakukan penelitian, disimpulkan bahwa (1) hasil belajar kognitif siswa sebelum diterapkannya metode Peer Teaching masih banyak siswa yang mendapatkan nilai di bawah rata-rata KKM, (2) Proses pembelajaran dengan menggunakan metode Peer Teaching setiap siklusnya mengalami peningkatan yang sangat signifikan, dengan kegiatan intinya adalah siswa di bantu oleh temannya sendiri ketika belajar di kelas dan (3) Hasil belajar kognitif siswa setelah diterapkan metode Peer Teaching yaitu setiap siklusnya mengalami peningkatan, terlihat pada siklus I dengan rata-rata 72.37 termasuk kategori baik, ketuntasan belajar klasikal sebesar 36.84% dengan jumlah 14 siswa tuntas belajar, siklus II nilai rata-rata meningkat menjadi 80 termasuk kategori sangat baik, sehingga nilai rata-rata dari siklus I ke siklus II meningkat sebesar 7.63%, ketuntasan belajar klasikal sebesar 86.84% dengan jumlah 33 siswa tuntas belajar sehingga ketuntasan belajar klasikal dari siklus I dan II meningkat sebesar 50%, dan siklus III terjadi peningkatan nilai rata-rata yang signifikan menjadi 96.05 termasuk kategori sangat baik, sehingga nilai rata-rata dari siklus II ke siklus III meningkat sebesar 16.05% semua siswa masuk pada kategori tuntas sehingga persentasi kelulusan 100%. Dengan demikian, pembelajaran Pendidikan Agama Islam dengan menggunakan metode peer teaching dapat meningkatkan hasil belajar kognitif siswa

Dog filariosis in the Lazio region (Central Italy): first report on the presence of Dirofilaria repens

BACKGROUND: Epidemiological investigations were carried out in the Lazio Region to assess the status of canine filariosis and to evaluate the actual risk for veterinary and medical public health. METHODS: Since August 2001 to June 2003, a total of 972 canine blood samples, collected in public kennels and from private owners animals of the 5 Provinces of the Region, were tested. The presence of filarial parasites was evaluated by microscopy and bio-molecular techniques; the species identification was performed by means of the same diagnostic tools. RESULTS: A total of 17/972 (1.75%; 95%CI 1.06%–2.85%) blood samples were parasitized by D. repens,13 out them drawn by dogs resident in the Province of Roma, and 4 in the other provinces. Multivariate analysis was performed in order to evaluate the association between filariosis and risk factors. The origin from coastal territories seems to be a significant risk factor to acquire the infection. CONCLUSION: This is the first report of canine filariosis in the Lazio Region, where D. repens was before reported only in foxes. The risk of human zoonotic infection is stressed, and the absence of other filarial species is discusse

Fingolimod Limits Acute Aβ Neurotoxicity and Promotes Synaptic Versus Extrasynaptic NMDA Receptor Functionality in Hippocampal Neurons

Fingolimod, also known as FTY720, is an analogue of the sphingolipid sphingosine, which has been proved to be neuroprotective in rodent models of Alzheimer's disease (AD). Several cellular and molecular targets underlying the neuroprotective effects of FTY720 have been recently identified. However, whether the drug directly protects neurons from toxicity of amyloid-beta (A\u3b2) still remains poorly defined. Using a combination of biochemical assays, live imaging and electrophysiology we demonstrate that FTY720 induces a rapid increase in GLUN2A-containing neuroprotective NMDARs on the surface of dendritic spines in cultured hippocampal neurons. In addition, the drug mobilizes extrasynaptic GLUN2B-containing NMDARs, which are coupled to cell death, to the synapses. Altered ratio of synaptic/extrasynaptic NMDARs decreases calcium responsiveness of neurons to neurotoxic soluble A\u3b2 1-42 and renders neurons resistant to early alteration of calcium homeostasis. The fast defensive response of FTY720 occurs through a Sphingosine-1-phosphate receptor (S1P-R) -dependent mechanism, as it is lost in the presence of S1P-R1 and S1P-R3 antagonists. We propose that rapid synaptic relocation of NMDARs might have direct impact on amelioration of cognitive performance in transgenic APPswe/PS1dE9 AD mice upon sub-chronic treatment with FTY720

Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation

BACKGROUND: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape

What is the role of the placebo effect for pain relief in neurorehabilitation? Clinical implications from the Italian consensus conference on pain in neurorehabilitation

Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy