228 research outputs found

    The organizational effectiveness of third sector organizations: A dialogic-participatory action research in a regional food bank

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    The study of organizational effectiveness (OE) within nonprofit organizations is a well-established area of inquiry in international scholarly literature. This focus is particularly crucial in organizations where internal relational dynamics may sometimes be overshadowed by a strong mission- and values-driven identity. This article proposes a relational analysis of OE, employing this interpretive framework to examine the specific organizational context of food banks, complex entities operating at multiple levels with a specialized role in food recovery for charities addressing food poverty. Drawing on evidence from a dialogic-participatory action research conducted within an Italian regional food bank, the study pursued a dual objective. Firstly, it aimed to facilitate the collective construction of knowledge, promoting a cohesive environment for sharing and integrating knowledge to address real-world challenges effectively. Secondly, it sought to empower participants by providing them with opportunities for active engagement in effecting changes and improvements through participatory reflection, thus devising actionable strategies to enhance organizational effectiveness

    Oltre il welfare mix: approcci al welfare plurale tra convergenza e differenziazione

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    The overcoming of the "welfare mix" model opens the way for the development of a plural welfare which is realized by expanding and promoting independent intermediate social spheres, recognizing their public function when oriented to act for the common good. In this path, the importance (at least nominal) of subsidiarity – understood here as a regulatory mechanism and method of coordination between the actors - has been strengthened. The hypothesis of the paper is that in Italy the prospects of the welfare system innovation go through a process of differentiation, which can be described by an ideal-typical typology emerging as a result of abstraction. In particular, the paper suggests the presence of four ideal-typical models of subsidiarity emerging from the "cultures of welfare" existing in Italy

    Extracorporeal membrane oxygenation for COVID-19 and influenza H1N1 associated acute respiratory distress syndrome: a multicenter retrospective cohort study

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    BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has become an established rescue therapy for severe acute respiratory distress syndrome (ARDS) in several etiologies including influenza A H1N1 pneumonia. The benefit of receiving ECMO in coronavirus disease 2019 (COVID-19) is still uncertain. The aim of this analysis was to compare the outcome of patients who received veno-venous ECMO for COVID-19 and Influenza A H1N1 associated ARDS. METHODS: This was a multicenter retrospective cohort study including adults with ARDS, receiving ECMO for COVID-19 and influenza A H1N1 pneumonia between 2009 and 2021 in seven Italian ICU. The primary outcome was any-cause mortality at 60 days after ECMO initiation. We used a multivariable Cox model to estimate the difference in mortality accounting for patients’ characteristics and treatment factors before ECMO was started. Secondary outcomes were mortality at 90 days, ICU and hospital length of stay and ECMO associated complications. RESULTS: Data from 308 patients with COVID-19 (N = 146) and H1N1 (N = 162) associated ARDS who had received ECMO support were included. The estimated cumulative mortality at 60 days after initiating ECMO was higher in COVID-19 (46%) than H1N1 (27%) patients (hazard ratio 1.76, 95% CI 1.17–2.46). When adjusting for confounders, specifically age and hospital length of stay before ECMO support, the hazard ratio decreased to 1.39, 95% CI 0.78–2.47. ICU and hospital length of stay, duration of ECMO and invasive mechanical ventilation and ECMO-associated hemorrhagic complications were higher in COVID-19 than H1N1 patients. CONCLUSION: In patients with ARDS who received ECMO, the observed unadjusted 60-day mortality was higher in cases of COVID-19 than H1N1 pneumonia. This difference in mortality was not significant after multivariable adjustment; older age and longer hospital length of stay before ECMO emerged as important covariates that could explain the observed difference. Trial registration number: NCT05080933, retrospectively registered. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-03906-4

    Number magnitude to finger mapping is disembodied and topological

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    It has been shown that humans associate fingers with numbers because finger counting strategies interact with numerical judgements. At the same time, there is evidence that there is a relation between number magnitude and space as small to large numbers seem to be represented from left to right. In the present study, we investigated whether number magnitude to finger mapping is embodied (related to the order of fingers on the hand) or disembodied (spatial). We let healthy human volunteers name random numbers between 1 and 30, while simultaneously tapping a random finger. Either the hands were placed directly next to each other, 30 cm apart, or the hands were crossed such that the left hand was on the right side of the body mid-line. The results show that naming a smaller number than the previous one was associated with tapping a finger to the left of the previously tapped finger. This shows that there is a spatial (disembodied) mapping between number magnitude and fingers. Furthermore, we show that this mapping is topological rather than metrically scaled

    Segregation of Virulent Influenza A(H1N1) Variants in the Lower Respiratory Tract of Critically Ill Patients during the 2010–2011 Seasonal Epidemic

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    BACKGROUND: Since its appearance in 2009, the pandemic influenza A(H1N1) virus circulated worldwide causing several severe infections. METHODS: Respiratory samples from patients with 2009 influenza A(H1N1) and acute respiratory distress attending 24 intensive care units (ICUs) as well as from patients with lower respiratory tract infections not requiring ICU admission and community upper respiratory tract infections in the Lombardy region (10 million inhabitants) of Italy during the 2010-2011 winter-spring season, were analyzed. RESULTS: In patients with severe ILI, the viral load was higher in bronchoalveolar lavage (BAL) with respect to nasal swab (NS), (p<0.001) suggesting a higher virus replication in the lower respiratory tract. Four distinct virus clusters (referred to as cluster A to D) circulated simultaneously. Most (72.7%, n = 48) of the 66 patients infected with viruses belonging to cluster A had a severe (n = 26) or moderate ILI (n = 22). Amino acid mutations (V26I, I116M, A186T, D187Y, D222G/N, M257I, S263F, I286L/M, and N473D) were observed only in patients with severe ILI. D222G/N variants were detected exclusively in BAL samples. CONCLUSIONS: Multiple virus clusters co-circulated during the 2010-2011 winter-spring season. Severe or moderate ILI were associated with specific 2009 influenza A(H1N1) variants, which replicated preferentially in the lower respiratory tract

    Time course of risk factors associated with mortality of 1260 critically ill patients with COVID-19 admitted to 24 Italian intensive care units

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    Purpose: To evaluate the daily values and trends over time of relevant clinical, ventilatory and laboratory parameters during the intensive care unit (ICU) stay and their association with outcome in critically ill patients with coronavirus disease 19 (COVID-19). Methods: In this retrospective–prospective multicentric study, we enrolled COVID-19 patients admitted to Italian ICUs from February 22 to May 31, 2020. Clinical data were daily recorded. The time course of 18 clinical parameters was evaluated by a polynomial maximum likelihood multilevel linear regression model, while a full joint modeling was fit to study the association with ICU outcome. Results: 1260 consecutive critically ill patients with COVID-19 admitted in 24 ICUs were enrolled. 78% were male with a median age of 63 [55–69] years. At ICU admission, the median ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) was 122 [89–175] mmHg. 79% of patients underwent invasive mechanical ventilation. The overall mortality was 34%. Both the daily values and trends of respiratory system compliance, PaO2/FiO2, driving pressure, arterial carbon dioxide partial pressure, creatinine, C-reactive protein, ferritin, neutrophil, neutrophil–lymphocyte ratio, and platelets were associated with survival, while for lactate, pH, bilirubin, lymphocyte, and urea only the daily values were associated with survival. The trends of PaO2/FiO2, respiratory system compliance, driving pressure, creatinine, ferritin, and C-reactive protein showed a higher association with survival compared to the daily values. Conclusion: Daily values or trends over time of parameters associated with acute organ dysfunction, acid–base derangement, coagulation impairment, or systemic inflammation were associated with patient survival
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