Assessing the Social and Environmental Impact of Healthcare Technologies: Towards an Extended Social Return on Investment

Stroke is the third leading cause of death and disability overall worldwide. Upper limb impairment is a common consequence for stroke survivors, having negative impact on their quality of life. Robotic rehabilitation, through repetitive and monitored movements, can improve their status. Developed by a team of researchers at Politecnico di Milano, AGREE is an exoskeleton for upper limb rehabilitation at the stage gate between translational research and clinical validation. Since the cost of this device is particularly high, the present study aimed to provide a framework for assessing its value. The Social Return on Investment (SROI) method, able to grasp the economic, social and environmental impact of an activity, was applied, using expert opinions of a pool of clinical engineers and healthcare professionals from different Italian hospitals to obtain information. Environmental impacts were estimated through Life Cycle Assessment in terms of CO2 emissions and incorporated in the analysis. Considering a 5-year period, the SROI for a single exoskeleton was 3.75:1, and the SROI for the number of exoskeletons projected to be sold was 2.868:1, thus resulting largely in value for money. This study provides a model for combining economic, social and environmental outcomes that, besides contributing to theory, could be useful for decision-making

Is it prosody that settles the syntactic issue? An analysis of italian cleft sentences

The present study aims at investigating the prosodic realization of Italian cleft sentences, in order to provide some new cues for their still debated syntactic interpretation. A monoclausal approach to the analysis of cleft sentences (a.o. Frascarelli & Ramaglia 2013) parallels them to left focalization constructions, while a biclausal approach (a.o. Belletti 2008) considers them composed of a main copular clause and an embedded pseudo-relative clause. A systematic comparison between cleft sentences and left focalizations \u2013 carried out through an experimental study and an analysis of pitch accent distribution, scaling, and prosodic phrasing \u2013 leads to conclude that their prosodic realization is very similar. Prosody would thus suggest a monoclausal interpretation of cleft sentences, if we assume a direct matching between prosodic and syntactic phrases.The present study aims at investigating the prosodic realization of Italian cleft sentences, in order to provide some new cues for their still debated syntactic interpretation. A monoclausal approach to the analysis of cleft sentences (a.o. Frascarelli & Ramaglia 2013) parallels them to left focalization constructions, while a biclausal approach (a.o. Belletti 2008) considers them composed of a main copular clause and an embedded pseudo-relative clause. A systematic comparison between cleft sentences and left focalizations \u2013 carried out through an experimental study and an analysis of pitch accent distribution, scaling, and prosodic phrasing \u2013 leads to conclude that their prosodic realization is very similar. Prosody would thus suggest a monoclausal interpretation of cleft sentences, if we assume a direct matching between prosodic and syntactic phrases

Does prosody meet syntax? A case study on standard Italian cleft sentences and left peripheral focus.

In this work we deal with two structures that have a very similar pragmatic function in Italian and have been claimed to have similar semantic and syntactic properties, namely clefts and left peripheral focus. Since Chomsky (1977. On wh-movement. In Peter W. Culicover, Thomas Wasow & Adrian Akmajian (eds.), Formal Syntax, 71\u2013132. New York: Academic Press.) they have been both considered as instances of A\u2019-movement and should therefore behave alike. Here we investigate their prosody and their syntax on the basis of three experimental studies and show that while the prosodic patterns found are indeed very similar, their syntax is less homogenous than expected if we apply general tests that have been traditionally used to distinguish A- from A\u2019- movement. In particular, we will discuss three of these tests, namely parasitic gaps, weak crossover and anaphoric binding and show that the two constructions yield quite different results. We analyse the differences within the framework of featural relativized minimality originally proposed in Rizzi (2004. Locality and the left periphery. In Adriana Belletti (ed.), Structures and Beyond: The Cartography of Syntactic Structures 3, 223\u2013251. Oxford: Oxford University Press.) and subsequent work. On this basis, we conclude that there is no one to one match between prosodic and syntactic properties, since we observe differences in the syntactic behaviour of the two constructions that do not surface in the prosodic patterns. Indirectly, this study sheds new light on the interface between prosody and syntax and is a confirmation of a modular theory of the components of grammar: some specific syntactic properties have no reflex in other components of grammar and can only be detected through purely syntactic tests

Allergy and parasites

It is estimated that at least one-fifth of the world’s population suffers from allergic diseases (atopic asthma and allergic rhinitis are the most common). Different factors contribute to the development of allergies; a predisposing genetic background is needed; however, environmental factors play an important role, among them is the exposure to infectious agents

Impact Investing: an Overview

Impact Investing is a very promising phenomenon which is gaining always more popularity and importance, drawing the attention of both academics and practitioners. This practice was crucial in the recovery process after the 2008 financial crisis, and it has all the potential to be considered as a critical element to respond to the emergency situation generated by Covid-19 pandemic. However, since a lot of organisations and investors are now approaching the industry, this risks to incur the “impact washing” phenomenon. In order to avoid this threat, it is important to define the specific characteristics of impact investing, distinguishing it from other forms of sustainable finance, and this is the primary objective of this paper. Subsequently, this work describes in detail the impact investing ecosystem, composed of supply-side, demand- side, intermediaries and the enabling environment, in order to provide a complete view of the phenomenon. Finally, the main challenges of impact investing are identified, in order to direct the attention of research to them, enabling the phenomenon not to lose its transformative potential

Towards a More Inclusive Society: The Social Return on Investment (SROI) of an Innovative Ankle–Foot Orthosis for Hemiplegic Children

Hemiplegia is a form of disability that affects one side of the body and has a prevalence of 0.5–0.7 per 1000 live births. It has consequences not only at the medical level but also on psychological, cognitive, and social aspects, and it prevents children from social participation, especially in sports settings. The studies demonstrating the social impact of sports on the hemiplegic population and, in particular, children, are limited. In addition, previous evaluations of healthcare sports initiatives in the hemiplegic population are not available, and traditional methods of evaluation, which are mostly focused on economic outcomes, are not applicable. Thus, this article employs the social return on investment (SROI) methodology, which is able to determine the socio-economic impacts of an initiative, to evaluate the impact of an innovative ankle–foot orthosis (AFO) for hemiplegic children that was created to promote the possibility of “sports for all”. The model was designed with the involvement of stakeholders in all the phases and with mixed methods to assess the input, outcomes, and impact indicators. The final SROI, computed for a time horizon of three years and with a focus on the Lombardy Region, was equal to 3.265:1. Based on this result, the initiative turned out to be worthy of investment

Glucometer Usability for 65+ Type 2 Diabetes Patients: Insights on Physical and Cognitive Issues

Background: Self-monitoring of blood glucose (SMBG) is of paramount relevance for type 2 diabetes mellitus (T2DM) patients. However, past evidence shows that there are physical and cognitive issues that might limit the usage of glucometers by T2DM patients aged 65 years and over. Objective: Our aim was to investigate the physical and cognitive issues related to the usage of glucometers by T2DM patients aged 65 years and over. Materials and Methods: The extant literature was analysed to define an original framework showing the logical nexus between physical and cognitive issues and quality of life. Then we collected evidence addressing the specific case of the Accu-Chek® Instant glucometer produced by Roche Diabetes Care GmbH, which implements new features claiming to improve usability. We conducted 30 interviews with T2DM patients aged 65 years and over, three interviews with senior nurses, and a focus group with three senior physicians and three senior nurses. Results: From the interviews, both patients and nurses declared that they were generally satisfied with the Accu-Chek® Instant glucometer’s characteristics. In the focus group, the results were commented on and, in the light of some diverging answers, improvements have been set up for future implementation. Conclusions: Our study produces evidence and future suggestions about the usage of glucometers by type 2 diabetes patients aged 65 years and over

Problemi di valutazione della qualità di un corso universitario Uno studio esplorativo

Il contributo discute il problema generale della valutazione dell’efficacia didattica a livello universitario, con il supporto dei datiricavati in due anni accademici successivi (2010/11 e 2011/12) monitorando il corso di Teoria e pratica della formazione (Università di Bologna, Facoltà di Lettere) a partire dal giudizio dei frequentanti, per verificare la percezione degli studenti degli obiettivi formativi e delle scelte metodologiche e organizzativedel corso stesso. A chi aveva completato l’esame nei primi tre appelli (43 studenti nel 2010/11 e 37 nel 2011/12) sono state rivolte due domande ee è stato somministrato un breve questionario (nei due anni il questionario è stato modificato). Questi elementi sono stati messi a confronto con i dati della scheda personale dello studente (che registra il percorso di scuola secondaria, quello accademico, il giudizio sull’esercitazione svolta all’interno del corso e il voto finale conseguito). I dati ricavati, che sono indicativi del riconoscimento, da parte degli studenti, degli obiettivi del corso e delle scelte metodologiche in esso operate, forniscono almeno alcune suggestioni e indicazioni per future ipotesi di lavoro in questa direzione

Transition temperature range of thermally activated nickel-titanium archwires

Objectives: The shape memory resulting from the superelasticity and thermoelastic effect is the main characteristic of thermally activated NiTi archwires and is closely related to the transition temperature range (TTR). The aim of this study was to evaluate the TTR of thermally activated NiTi archwires commercially available. Material and Methods: Seven different brands of 0.019"x0.025" thermally activated nickel-titanium archwires were tested as received by differential scanning calorimetry (DSC) over the temperature range from -100°C to 150°C at 10°C/min. Results: All thermally activated NiTi archwires analyzed presented stage transformation during thermal scanning with final austenitic temperature (Af) ranging from 20.39°C to 45.42°C. Three brands of NiTi archwires presented Af close to the room temperature and, this way, do not present properties of shape memory and pseudoelasticity that are desirable in clinical applications. Conclusions: The thermally activated NiTi archwires present great variability in the TTR and the elastic parameters of each NiTi archwire should be provided by the manufacturers, to allow achievement of the best clinical performance possible