The Impact of Covid-19 Pandemic on Italian Nature-Based Programs in the Educational, Therapeutic, Training and Leisure Areas

In these times of global crisis caused by Covid-19, there is an urgent need to address the topic of nature-based experiences in education: the pandemic has strongly highlighted both the interdependence between human beings and nature, and the need for mending the dichotomic vision that keeps them separate. Experiential education in natural contexts within an ecological framework might have a strategic role in this crucial period to develop anthropologic, civic, and dialogic conscience (Morin, 2001). Through this study, CEFEO Research Center had the objective of investigating the socio-economic impact of Covid-19 on Italian nature-based programs in the educational, therapeutic, training, and leisure areas. From 28 May to 19 June 2020, an online questionnaire was distributed with the purpose of understanding the socio-economic impact of the pandemic on nature-based programs during the lockdown period and during the period of first reopening, and the related needs and new opportunities for the future. The results highlight a paradox: the Covid-19 crisis has caused more problems for a sector which was already suffering from a lack of funding and of social and institutional acknowledgment. Many agencies working in the field lost months of income and numerous working days, and they are uncertain about the future: they are having difficulties surviving in a moment when we need them more

Phyto-progestins for the treatment of abnormal uterine bleeding without organic cause in women at high risk for breast cancer and breast cancer survivors: a prospective, pilot study

Objectives: Some plants, such as Dioscorea Villosa (DV), Vitex Agnus Castus (VAC) and Turnera diffusa (D) have some 'progesterone-like' properties. We have investigated their simultaneous administration in breast cancer (BC) survivors or carriers of specific genetic mutations that can increase the risk of developing BC suffering from abnormal uterine bleeding without organic cause. Methods: Women with irregular cycles in terms of length (interval between ≤ 24 or ≥ 38 days) without a uterine organic disease (polyps, adenomyosis, fibroids, hyperplasia/malignancy) were included. A daily diary of bleeding, questionnaires about health-related quality of life (Short Form 36) and menstrual psychophysical well-being (PGWB-1) and the Greene Climacteric Scale (GCS) (in women older than 40 years old) questionnaire were used. The presence of some premenstrual syndrome (PMS) symptoms was also evaluated. Results: In the analyzed group of women (n = 15), all experienced a regularization of the menstrual cycles, with a mean duration in the three months of use of 27.1 ± 3.2 days, with a significant reduction of menstrual pain (p = 0.02) and flow (p = 0.02) intensity. Women with PMS (7/15) reported an impovement in depression, headache and abdominal pain scores (p < 0.05). No specific deterioration of different questionnaires evaluated during treatment were observed. General satisfaction with the treatment was 6.8 ± 0.3/10 on a 10 point. Conclusions: A combination of DV, VAC and D could be a promising candidate to treat menstrual irregularities without an organic cause, with a significant reduction of menstrual pain and flow intensity and possible additional benefits in PMS symptoms treatment in women at genetic risk for BC and BC survivors

Lo stato dell’arte dei progetti nature-based in ambito educativo, formativo, terapeutico e ricreativo in Italia: quadro concettuale e una possibile categorizzazione dei settori/contesti

National and international literature on nature-based programs in the educational,training, therapeutic and leisure areas reveals a lack of homogeneityin using the different terminologies: the various terms are used with differentmeanings, both by practitioners and by scholars. The present work is theconceptual premise of a research which outlined a quantitative and qualitativemapping of the Italian organizations that use nature-based approachesand methodologies. This paper provides both a literature review of the theoreticalroots which support nature-based experiences, and a reconnaissanceof the national situation regarding the use of terminology and thedifferentiation in the various specific practical fields. In order to properly introducethe mapping research, this work proposes a conceptual organizationdefining four macro-areas of the nature-based sector. This categorization,which is organized around some indicators, aims to be flexible and to havepermeable borders; and it has the goal to help orienting in the complexframework of the numerous nature-based proposals in Italy.Dall’analisi della letteratura nazionale e internazionale sulle pratiche naturebasedin ambito educativo, formativo, terapeutico e ricreativo, emerge disomogeneitànell’utilizzo delle diverse terminologie, utilizzate con significatitalvolta molto diversi sia dagli stessi soggetti che se ne occupano, sia daglistudiosi che ne teorizzano e concettualizzano le pratiche. Il presente contributoè la premessa concettuale di una ricerca* effettuata per disegnare unamappa quantitativa e qualitativa delle realtà che operano in Italia utilizzandometodologie e approcci nature-based e propone sia una rassegna delle radiciteoriche che sostengono le esperienze nature-based, sia una ricostruzionedel panorama nazionale in merito all’utilizzo della terminologia e alla differenziazionenei diversi ambiti specifici di operatività. Ai fini della suddetta rilevazione,inoltre, il lavoro propone un’organizzazione concettuale chedelinea quattro macro-aree del settore nature-based; la categorizzazione proposta,organizzata intorno ad alcuni indicatori, intende essere fluida e daiconfini permeabili ed è finalizzata a facilitare l’orientamento nel complessoquadro delle numerose proposte nature-based presenti sul territorio italiano

Lo stato dell’arte dei progetti nature-based in ambito educativo, formativo, terapeutico e ricreativo in Italia: i dati di una ricerca di mappatura

The main purpose of this study is to outline a quantitative and qualitative map of the Italian organizations working in the socio-educational, training,therapeutic, and leisure areas, that use nature-based methodologies. The second goal is to understand the professional identities of these organizations,through an analysis of their history, practical proposals, practitioners’ qualifications, evaluation practices. 99 participants, selected through nonprobabilitysampling, answered a questionnaire that was partly developed with the collaboration of stakeholders’ representatives. The conclusions focus on a reflection on the findings and on the perspectives for further research. This paper follows another one named “The state of art of naturebased programs in the educational, training, therapeutic, and leisure areas in Italy: conceptual framework and possible categorization of sectors/contexts.”, which had the aim to outline the Italian state of art regarding the terminology and the differentiation of the various nature-based areas.La ricerca che qui presentiamo è stata finalizzata principalmente a disegnare una mappa quantitativa e qualitativa delle realtà che operano in Italia utilizzando metodologie e approcci nature-based negli ambiti socio-educativo, formativo, didattico (extrascuola), terapeutico e per il tempo libero. Il secondo obiettivo è stato quello di comprendere le identità professionali di tali soggetti analizzando la loro storia, le loro proposte operative, la preparazione professionale e i titoli di studio, la prassi di effettuare valutazioni delle proposte realizzate. La ricerca ha coinvolto un campione non-probabilistico formato da 99 soggetti coinvolti nella compilazione di un questionario ideato anche con la collaborazione di stakeholdher, rappresentanti del comparto nature-based. Le conclusioni esplicitano le riflessioni scaturite dai dati raccolti e disegnano le prospettive di sviluppo di ulteriori fasi e studi futuri. Il presente contributo è il seguito di una prima parte dal titolo “Lo stato dell’arte dei progetti nature-based in ambito educativo, formativo, terapeutico e ricreativo in Italia: quadro concettuale e una possibile categorizzazione dei settori/contesti.”, in cui viene ricostruito il quadro del panorama nazionale in merito all’utilizzo della terminologia e alla differenziazione nei diversi ambiti specifici di operatività

Impaired CFTR function in mild cystic fibrosis associated with the S977F/T5TG12complex allele in trans with F508del mutation

AbstractBackgroundThe S977F mutation (c.2930C>T) in the CFTR gene (CFTR/ABCC7) is extremely rare. We describe the case of an adult patient carrying the complex allele S977F/T5TG12 in trans with the F508del mutation. Mild respiratory manifestations arose in adulthood associated with azoospermia, acute pancreatitis, minor hemoptysis and Cl− levels ranging from 40 to 42mEq/L.MethodDiagnosis was confirmed by repeated NPD measurements, genetic DHPLC analysis and a recently described functional assay measuring cAMP-dependent cell depolarization in peripheral blood monocytes.ResultsNPD measurements, DHPLC and monocyte functional assay (CF index=−18). Results were consistent with a CF phenotype.ConclusionsThe combined application of DHPLC and NPD analysis in the algorithm for CF diagnosis appears useful for the management of similar cases. In addition, the novel monocyte functional assay might contribute to improve our diagnostic capability, counseling and better treatment of these challenging clinical cases

Challenging the diagnosis of Cystic Fibrosis in a patient carrying the 186-8T/C allelic variant in the CF Transmembrane Conductance Regulator gene

BACKGROUND: This report describe for the first time a clinical case with a CFTR allelic variant 186-8T/C (c.54-8 T/C) in intron 1 of CFTR and underline the importance of applying a combination of genetic and functional tests to establish or exclude a diagnosis of Cystic Fibrosis. In this case the diagnostic algorithm proposed for CF has been successfully applied at our Center and previous CF diagnosis assigned in a different Center was not confirmed.Case report: A 38 year-old Italian woman had been treated as affected by CF since 2010, following diagnosis based on sweat tests (reported values of 73 and 57 mEq/L) and a clinical history consistent with CF. No mutations were identified by first level of genetic analysis. Afterwards the patient referred to our center for assessing the relevance of these findings. The genetic variant 186-8T/C (c.54-8 T/C) in intron 1 of the CFTR gene was detected by sequencing. Low-level interstitial-alveolar infiltration was recorded by high-resolution computerized tomography. Lung function was normal and sputum and Broncho Alveolar Lavage cultures resulted bacteriologically negative. Sweat chloride levels was re-assessed and resulted with values of 57 and 35 mEq/L, with a borderline range between 40 and 60 mEq/L. Nasal Potential Difference measurements resulted in three reliable measurements consistent with a non-CF phenotype. Differential diagnosis with ciliary dyskinesia was excluded, as was exon 2 skipping of CFTR gene that might have caused a CFTR functional defect. Furthermore, single cell fluorescence analysis in response to cAMP agonists performed in patient's monocytes overlapped those obtained in healthy donors. CONCLUSION: We concluded that this patient was not affected by CF. This case highlights the need for referrals to highly specialized centers and the importance of combined functional and genetic tests in making a correct diagnosis. Moreover, we confirmed a correlation between NPD tracings and cell depolarization in monocytes providing a rationale for proposing the use of leukocytes as a potential support for CF diagnosis

Position Paper of the Italian Association of Medical Oncology on Early Palliative Care in Oncology Practice (Simultaneous Care)

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Defective CFTR Expression and Function Are Detectable in Blood Monocytes: Development of a New Blood Test for Cystic Fibrosis

BACKGROUND: Evaluation of cystic fibrosis transmembrane conductance regulator (CFTR) functional activity to assess new therapies and define diagnosis of cystic fibrosis (CF) is cumbersome. It is known that leukocytes express detectable levels of CFTR but the molecule has not been characterized in these cells. In this study we aim at setting up and validating a blood test to evaluate CFTR expression and function in leukocytes. DESCRIPTION: Western blot, PCR, immunofluorescence and cell membrane depolarization analysis by single-cell fluorescence imaging, using the potential-sensitive DiSBAC(2)(3) probe were utilized. Expression of PKA phosphorylated, cell membrane-localized CFTR was detected in non-CF monocytes, being undetectable or present in truncated form in monocytes derived from CF patients presenting with nonsense mutations. CFTR agonist administration induced membrane depolarization in monocytes isolated from non-CF donors (31 subjects) and, to a lesser extent, obligate CFTR heterozygous carriers (HTZ: 15 subjects), but it failed in monocytes from CF patients (44 subjects). We propose an index, which values in CF patients are significantly (p<0.001) lower than in the other two groups. Nasal Potential Difference, measured in selected subjects had concordant results with monocytes assay (Kappa statistic 0.93, 95%CI: 0.80-1.00). RESULTS AND SIGNIFICANCE: CFTR is detectable and is functional in human monocytes. We also showed that CFTR-associated activity can be evaluated in 5 ml of peripheral blood and devise an index potentially applicable for diagnostic purposes and both basic and translational research: from drug development to evaluation of functional outcomes in clinical trials