347 research outputs found
Economic Impact of Rural Development Plan 2007 2013 in Tuscany
In 2007 in every European Union region, involved in the planning of Rural Development Plan (RDP), an independent evaluator should asses the impact of the plan in term of value added and productivity. Each region has adopted different methodologies but few of them have followed the indications of Common and Monitoring Evaluation Framework (CMEF) to evaluate the net value deriving by direct and indirect effect. IRPET, the Independent evaluator of Tuscany, utilising REMI-IRPET model has assed the impact of RDP on the main economic variables until 2020. Among 30 different measures it has been chosen only 5 of them that cover more than 54% of total amount of public and private investments. The economic impacts are also evaluated at provincial level.evaluation, regional model, rural development, Community/Rural/Urban Development,
La rappresentazione del rapporto tra utenti e sistema sanitario: I modelli culturali dei medici di medicina generale - The representation of the relationship between users and healthcare system: Cultural models of general practitioners
The present research study explores the emotional and symbolic representation of the Italian healthcare system and specifically of general medical services reported by a group of Italian general practitioners.
General medicine is recently affected by a structural change which could be sustained also by a cultural revolution, however this revolution seems to be oriented to expected values without a clear methodology which promotes and accompanies this cultural change. The present study deals with the lack of practices due to these unrealized expected values and assumes that for intervening it is necessary knowing the existing culture before thinking to change it. Interviews to 36 general practitioners were analyzed by Emotional Text Analysis (AET). Results highlight a factorial space characterized by five clusters. According to respondentsâ perspective, healthcare problems refer to two large issues characterized by powerlessness of general practitioners to intervene. On the one hand, there is health emergency, dealt with by first aid and emergency medicine. On the other hand, there is chronicity, especially affecting the elderly, which is dealt with by other workers (nurses, private family assistants, social workers) who care patients at home and replace physicians. The general practitionersâ work is difficult because of many different reasons; but the central theme is the lack of absolute power â based on morality and consciousness â which leads to the perception of catastrophic consequences for medical profession and the physician-patient relationship. Often, general practitioners are in their offices and are not able to go to patientsâ home, therefore they cannot create care relationships based on trust and dependence which allow useful and trustworthy interventions. In sum, the core theme emerging from data refers to the general practitionersâ perceived lack of personal and trust-based relationships with patients
La relazione che organizza il contesto sanitario: domanda dellâutenza e risposta dei servizi sanitari, nel territorio e nellâospedale - The relationship which organizes the healthcare context: usersâ demand and response of healthcare services, in the territory and the hospital
Our intent is to present citizensâ demand of health care services in Italy through a research structured in three studies. We used the Emotional Text Analysis (ETA) to lead the three s
tudies: the first study regarded the citizensâexpectations of the healthcare services, the second study regarded the point of view of the hospital personnel (medical doctors and nurses), the third regarded the point of view of the General Practitioners onthe health care services. These three studies are briefly presented. Data and outcome of an Assumed Similarity Test applied to all experimental subjects of the three studies in order to make a comparison among them, are also presented. The findings of the Emotional Text Analysis show that citizens, potential users of health services, center their requests on their individual subjectivity, and seek answers both to their suffering and to the feeling of alienation that characterizes the being sick feeling that makes them go to a medical doctor. For their part, general practitioners and hospital doctors immediately transform this subjective feeling in an objective medical diagnosis. Here a first gap emerges between patientâs demand and medical response, leavingthe possibility of an alliance on the diagnosis in order to jointly fight the disease. It has long been in place though a change that has expelled the patient also from sharing the diagnostic process, increasingly taken from self-centered dynamics within the healthcare system. This widens the gap between the request of the citizens and the response of the health services, that contributes to that conflictual growth to which defensive medicine gives a dysfunctional answer. The Assumed Similarity Test contributes to the interpretation of the health care dynamic identified in the Emotional Text Analysis; particularly in regard to the unfolding conflict, given by the hypothesis emerging from the data analysis, that a feeling of closeness for the hospital personnel goes along with an emotional stance of overpowering the othe
Locomotion performance for oscillatory swimming in free mode
Oscillatory swimming of a fishlike body, whose motion is essentially promoted by the flapping tail, has been studied almost exclusively in axial mode under an incoming uniform stream or, more recently, self-propelled under a virtual body resistance. Obviously, both approaches do not consider the unavoidable recoil motions of the real body which have to be necessarily accounted for in a design procedure for technological means. Actually, once combined with the prescribed kinematics of the tail, the recoil motions lead to a remarkable improvement on the resulting swimming performance. An inviscid impulse model, linear in both potential and vortical contributions, is a proper tool to obtain a deeper comprehension of the physical events with respect to more elaborated flow interaction models. In fact, at a first look, the numerical results seem to be quite entangled, since their trends in terms of the main flapping parameters are not easy to be identified and a fair interpretation is obtained by means of the model capability to separate the effects of added mass and vortex shedding. Specifically, a prevailing dependence of the potential contribution on the heave amplitude and of the vortical contribution on the pitch amplitude is instrumental to unravel their combined action. A further aid for a proper interpretation of the data is provided by accounting separately for a geometrical component of the recoil which is expected to follow from the annihilation of any spurious rigid motion in case no fluid interactions occur. The above detailed decomposition of the recoil motions shows, through the numerical results, how the single components are going to influence the main flapping parameters and the locomotion performance as a guide for the design of biomimetic swimmers
LâIslam e la sua rappresentazione nella cultura italiana
Different groups of citizens from Latium region, distributed by gender and age, and belonging to the medium-high socio-economic-cultural class, were asked in 2002, 2004 and 2005 to express what was coming to their mind, their associations and fantasies about Islam and islamic populations. The data were processed
with the Emotional Text Analysis. The results of these three research studies are presented, which show a progressive accentuation of the pejorative stereotypes towards the islamic populations
La cultura locale di Roma e delle sue periferie urbane nella rappresentazione dei resti archeologici - The local culture of Rome and its urban suburbs in the representation of the archaeological remains
Nel presente lavoro viene proposta lâanalisi della relazione come luogo del problema che caratterizza lâintervento psicologico clinico quale alternativa alla diagnosi. Tre esempi clinici aiutano a cogliere come la relazione sia il luogo del problema che sâintende affrontare; sia con il lavoro dâassistenza in ambito familiare, che scolastico o sociale. La funzione psicologica può cambiare radicalmente il lavoro assistenziale, mutando obiettivi inutili e obsoleti in interventi efficaci. Ciò è possibile se lâintervento cambia il proprio obiettivo, spostandolo dalla singola persona disabile o problematica, alla relazione entro la quale lâintervento si contestualizza.The research, carried out within a project research of national interest (PRIN) directed by archaeologist Professor Clementina Panella, has the purpose to detect the local culture of inhabitants of the center and the outskirts of Rome, paying attention to the archaeological remains and their cultural contribution. Three components of local culture emerged in this research; all of them are reported to a cultural context that people feel as organized by the pursuit of power and the enhancement of the mass media as factors that give notoriety and popularity then power. One of the three cultural repertoires, characterized by young participants and residents in the outskirts of Rome, enhances the archaeological remains as components of a fun culture. The fun, in combination with culture, is experienced as an effective alternative to the power and the pursuit of powe
Severe bleeding and absent ADP-induced platelet aggregation associated with inherited combined CalDAG-GEFI and P2Y12 deficiencies
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On-Treatment Platelet Reactivity is a Predictor of Adverse Events in Peripheral Artery Disease Patients Undergoing Percutaneous Angioplasty
Objectives: Few data are available on the association between a different entity of platelet inhibition on antiplatelet treatment and clinical outcomes in patients with peripheral artery disease (PAD). The aim of this study was to evaluate the degree of on-treatment platelet reactivity, and its association with ischaemic and haemorrhagic adverse events at follow up in PAD patients undergoing percutaneous transluminal angioplasty (PTA). Methods: In this observational, prospective, single centre study, 177 consecutive patients with PAD undergoing PTA were enrolled, and treated with dual antiplatelet therapy with aspirin and a P2Y12 inhibitor. Platelet function was assessed on blood samples obtained within 24 h from PTA by light transmission aggregometry (LTA) using arachidonic acid (AA) and adenosine diphosphate (ADP) as agonists of platelet aggregation. High on-treatment platelet reactivity (HPR) was defined by LTA ⼠20% if induced by AA, and LTA ⼠70% if induced by ADP. Follow up was performed to record outcomes (death, major amputation, target vessel re-intervention, acute myocardial infarction and/or myocardial revascularisation, stroke/TIA, and bleeding). Results: HPR by AA and HPR by ADP were found in 45% and 32% of patients, respectively. During follow up (median duration 23 months) 23 deaths (13%) were recorded; 27 patients (17.5%) underwent target limb revascularisation (TLR), two (1.3%) amputation, and six (3.9%) myocardial revascularisation. Twenty-four patients (15.6%) experienced minor bleeding. On multivariable analysis, HPR by AA and HPR by ADP were independent predictors of death [HR 3.8 (1.2â11.7), p =.023 and HR 4.8 (1.6â14.5), p =.006, respectively]. The median value of LTA by ADP was significantly lower in patients with bleeding complications than in those without [26.5% (22â39.2) vs. 62% (44.5â74), p <.001). LTA by ADP ⤠41% was independently associated with bleeding HR 14.6 (2.6â24.0), p =.001] on multivariable analysis. Conclusions: In this study a high prevalence of on-clopidogrel and aspirin high platelet reactivity was found, which was significantly associated with the risk of death. Conversely, a low on-clopidogrel platelet reactivity was associated with a higher risk of bleeding. These results document that the entity of platelet inhibition is associated with both thrombotic and bleeding complications in PAD patients
The optimal threshold of high post-treatment platelet reactivity could be defined by a point-of-care VerifyNow P2Y12 assay
Thromboelastography (platelet contribution to clot strength) for the assessment of platelet residual function
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