When Pandemic Strikes Hard: Digital Diversity Makes Difference

The Covid-19 pandemic, whose effects on the forms of social organi- zation are still far from being fully explored, has opened the door to forms of experimentation unprecedented in their speed and extent. The pandemic outbreak has required immediate responses from organizations that have drawn on both intentional and unintentional repertoires. In particular, the use of IT architectures was characterized by unintended responses that nevertheless allowed organiza- tions to respond to the demands of health systems and bureaucracy to document population protection activities. The work we present here confirms that in the case studied, the benefits manifested themselves most clearly when organizations were able to be flexibility-by-deviation by drawing on infrastructural projects considered by ordinary management to be non-strategic until the arrival of the pandemic

PPAR-γ regulates the effector function of human T helper 9 cells by promoting glycolysis.

T helper 9 (TH9) cells promote allergic tissue inflammation and express the type 2 cytokines, IL-9 and IL-13, as well as the transcription factor, PPAR-γ. However, the functional role of PPAR-γ in human TH9 cells remains unknown. Here, we demonstrate that PPAR-γ drives activation-induced glycolysis, which, in turn, promotes the expression of IL-9, but not IL-13, in an mTORC1-dependent manner. In vitro and ex vivo experiments show that the PPAR-γ-mTORC1-IL-9 pathway is active in TH9 cells in human skin inflammation. Additionally, we find dynamic regulation of tissue glucose levels in acute allergic skin inflammation, suggesting that in situ glucose availability is linked to distinct immunological functions in vivo. Furthermore, paracrine IL-9 induces expression of the lactate transporter, MCT1, in TH cells and promotes their aerobic glycolysis and proliferative capacity. Altogether, our findings uncover a hitherto unknown relationship between PPAR-γ-dependent glucose metabolism and pathogenic effector functions in human TH9 cells

Analisi dei modelli organizzativi di risposta al COVID-19 in Italia: evidenze da 2 anni di ISTANT REPORT Altems

Sistematizzazione e pubblicazione settimanalmente un report per analizzare in modo sistemico e comparativo i modelli di risposta adottati dalle Regioni in risposta all'emergenza da COVID- 1

Approcci innovativi per la valutazione dei Direttori Generali: evidenze preliminari per il SSN

With the Italian law 502/92, healthcare organizations are directly responsible for the achievement of an economic balance. With great expectations on a high degree of technical management, as opposed to the mainly political-driven management of the 90s, it becomes crucial to identify "the right people" to drive such complex organizations. This study defines the typical profile of innovative CEOs in the healthcare sector. The work arises from a previous study conducted by AGENAS that identified the 19 Italian most innovative healthcare organizations from a managerial point of view. A semi-structured interview has been administered to the CEOs, in order to capture information, usually not present in CVs. Dimensions such as leadership styles, Locus of control, optimism and cognitive styles, although rarely studied and difficult to measure, do indeed seem to affect behaviors and performances in a drastic way. A number of common traits among the most innovative CEOs have been identified. The study aims to test that not only educational and professional experiences matter in order for CEOs to achieve a high performance, but that there exist a number of other features, connected to their personality traits and leadership styles, that play a just as important role. The study has important implications in reference to Regions' responsibility in selecting CEOs in the healthcare sector

Exploring “patient-centered” hospitals: a systematic review to understand change

Abstract Background The healthcare scenario in developed countries is changing deeply: patients, who are frequently affected by multi-pathological chronic conditions, have risen their expectations. Simultaneously, there exist dramatic financial pressures which require healthcare organizations to provide more and better services with equal (or decreasing) resources. In response to these challenges, hospitals are facing radical transformations by bridging, redesigning and engaging their organization and staff. Methods This study has the ambitious aim to shed light and clearly label the trends of change hospitals are enhancing in developed economies, in order to fully understand the presence of common trends and which organizational models and features are inspiring the most innovative organizations. The purpose is to make stock of what is known in the field of hospital organization about how hospitals are changing, as well as of how such change may be implemented effectively through managerial tools. To do so the methodology adopted integrates a systematic literature review to a wider engaged research approach. Results Evidence suggests that the three main pillars of change of the system are given by the progressive patient care model, the patient-centered approach and the lean approach. However, there emerge a number of gaps in what is known about how to exploit drivers of change and their effects. Conclusions This study confirms that efforts in literature are concentrated in analyzing circumscribed experiences in the implementation of new models and approaches, failing therefore to extend the analysis at the organizational and inter-organizational level in order to legitimately draw consequences to be generalized. There seem to be a number of “gaps” in what is known about how to exploit drivers of change and their effects, suggesting that the research approach privileged till now fails in providing a clear guidance to policy makers and to organizations’ management on how to concretely and effectively implement new organizational models

I modelli organizzativi dipartimentali nel Ssn: risultati dell'indagine 2008-2010

Il modello organizzativo dipartimentale nasce e si diffonde quale soluzione organizzativa utile a fronteggiare il crescente fabbisogno di integrazione in ambito assistenziale

Approcci innovativi per la valutazione dei Direttori Generali: evidenze preliminari per il SSN

With the Italian law 502/92, healthcare organizations are directly responsible for the achievement of an economic balance. With great expectations on a high degree of technical management, as opposed to the mainly political-driven management setof the 90s, it becomes crucial to identify "the right people" to drive such complex organizations. This study defines the typical profile of innovative CEOs in the healthcare sector. The work arises from a previous study conducted by AGENAS that identified the 19 Italian most innovative healthcare organizations from a managerial point of view. A semi-structured interview has been administered to the CEOs, in order to capture information, usually not present in CVs. Dimensions such as leadership styles, Locus of control, optimism and cognitive styles, although rarely studied and difficult to measure, do indeed seem to affect behaviors and performances in a drastic way. A number of common traits among the most innovative CEOs have been identified. The study aims to test that not only educational and professional experiences matter in order for CEOs to achieve a high performance, but that there exist a number of other features, connected to their personality traits and leadership styles, that play a just as important role. The study has important implications in reference to Regions\u2019 responsibility in selecting CEOs in the healthcare sector

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Experts’ Opinion for Improving Pertussis Vaccination Rates in Adolescents and Adults: A Call to Action

This article highlights the importance of diphtheria-tetanus-acellular pertussis (with reduced antigen content, dTap) vaccination in preventing pertussis, a respiratory infection that is still widespread and easily transmitted. In particular, it highlights the need to receive a booster vaccination throughout life to maintain high antibody levels, which decrease through time. This document collects the opinions that emerged from the comparison between major Italian experts in the field of vaccination. This working group was created to promote a “call to action”, aimed at raising awareness among all institutions, public health authorities, and health workers involved in the vaccination process, about the importance of dTap vaccine administration and with the mindset of implementing the strategic vaccination plan provided by the National Vaccine Plan (NVP). In fact, despite this vaccine being included in the NVP, there are some issues attributable to the practice of vaccination (local health authorities, vaccination centers, occupational health services, gynecology centers, societies of work). Therefore, it is necessary that the Ministry defines the vaccination coverage objectives, identifies the groups of subjects who should receive the booster vaccine (subjects exposed to greater risk of infection, subjects over 60, pregnant women), and applies all the necessary measures to encourage the implementation of this practice