IRIS Università degli Studi dell'Aquila
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Integrated Hospital–Territory Organizational Models and the Role of Family and Community Nurses in the Management of Chronic Conditions: A Scoping Review
Full text linkBackground and Objectives: One of the challenges of modern healthcare systems, in terms of economic and organizational sustainability and the impact on patients’ quality of life, is the progressive increase in chronicity and care complexity. In this scenario, hospital–community integration models represent possible strategies to ensure the continuity of care, reduce readmission rates, and improve clinical outcomes. This study aims to map integrated care models for patients with chronic diseases, with active involvement of the family and community nurse, describing their functions and associated clinical, organizational, and economic outcomes, as well as barriers and facilitators to their implementation. Materials and Methods: The review was conducted using the JBI methodology and the PRISMA-ScR protocol and identified 26 studies with a publication range from 2000 to 2025. Results: The emerging results highlight the use of integrated and personalized organizational models in the post-discharge phases, with a leading role for the family and community nurse in the assessment, planning, and coordination of various steps. Conclusions: The interventions are associated with an increase in patient and caregiver satisfaction, a reduction in outcomes such as the rehospitalization rate, and greater continuity of care
Non-linear effects in seismic waves in high-energy earthquakes: A two-dimensional analysis for non-homogeneous isotropic media with a view towards the study of the 2009 L’Aquila earthquake
No full textIt is usually accepted in geophysics (and in civil engineering) that linear models can be used for describing an earthquake and the consequent seismic waves’ propagation. However, the large deformation experienced by the soil in these situations suggests that this paradigm requires more critical consideration. In fact, we claim that, in the vicinity of some discontinuities (that are common in all the geophysical applications of continuum models), the corresponding strain concentrations make the hypothesis of small deformation to be inadequate. In this paper, we verify the inappropriateness of the linear paradigm in a simple but reasonable case, with a view to a future application of this study to the effects of the 2009 L’Aquila earthquake. To this aim, we start with an analysis which is restricted to a two-dimensional body (i) with an inhomogeneity that resembles the Aterno River Valley, central Italy and (ii) with a non-linearity that is the most simple one, choosing the strain energy to be quadratic in the non-linear measures of deformation. More precisely, we consider a 2D piecewise homogeneous domain and a material that is viscoelastic isotropic and geometrically non-linear. We apply, to the bottom of such a domain, a seismic excitation and calculate the differences in the response between the linear and the geometrically non-linear cases. Using a suitably designed numerical model, we prove that, as conjectured, these differences not only originate near the pre-defined geometrical discontinuities but also propagate throughout the rest of the domain. Moreover, we find numerical predictions of the frequency ratios and ground acceleration time dependence and amplitude that produce, in the case of non-linear models, predictions which are closer to experimental evidence than those obtained using the corresponding linear model
Chlorhexidine 0.12% Mouthwash With or Without Bioflavonoids as an Adjunct to Non-Surgical Periodontal Therapy: A Randomized Clinical Trial
Full text link: This randomized clinical trial evaluated the adjunctive use of bioflavonoids in a 0.12% chlorhexidine mouthwash during non-surgical periodontal therapy. The addition of bioflavonoids resulted in clinical and patient-reported outcomes comparable to chlorhexidine alone, with both groups showing improvement over time and good overall treatment tolerance
Procedural and Clinical Outcome of Stroke after thrombectomy according to etiology: results from a nationwide registry
No full textBACKGROUND: The impact of stroke etiology on outcomes in patients who underwent endovascular thrombectomy (EVT) is still a matter of debate. We studied the effect of aterosclerotic versus cardioembolic etiology on the clinical and radiological outcome of patients with stroke due to large vessel occlusion (LVO) treated with EVT on a large sample of stroke patients enrolled in a nationwide registry. METHODS: The source of data was the Italian Registry of Endovascular Stroke Treatments, a national, prospective, observational internet-based registry including patients treated with EVT since 2011. We extracted and compared data of patients suffering from large atherosclerosis (LAA) or cardioembolic (CE) stroke. RESULTS: We included 5193 patients, 3899 CE, and 1294 LAA stroke. Patients with CE were significantly older (p < 0.001), and their stroke severity at admission was significantly higher (p < 0.001). Moreover, patients with LAA had significantly longer onset to end of procedure time, and procedure duration than CE patients. Good outcome at three months was reported in 45.2% of LAA and 45.4% of CE patients (p = 0.89). In the multivariable analysis, patients with CE had higher odds of achieving successful (OR = 1.61; 95% CI 1.35-1.92) or complete (OR = 1.40; 95% CI 1.21-1.62) recanalization Futile recanalization was detected more frequently in CE patients (OR = 1.35; 95% CI 1.18-1.61). There were no statistically significant differences in clinical outcomes (mRS 02: OR = 1.12; 95% CI 0.92-1.36). LAA patients had higher odds of sICH (OR = 0.65; 95% CI 0.49-0.85). The shift analysis showed a trend toward a better outcome in CE patients (OR = 1.19; 95% CI 0.99-1.35), which was statistically significant in subjects with anterior circulation stroke. (OR = 1.21; 95% CI 1.04-1.35). CONCLUSIONS: The study showed a better chance of successful recanalization in CE patients, a slightly better outcome in CE patients with anterior circulation stroke after adjusting for baseline confounders, despite their more unfavourable risk factor profile, and a higher chance of futile recanalization
No net land take by 2050? Quadro normativo, metodologie e scenari d'indagine nel contesto territoriale italiano.
No full textI suoli sono fondamentali per il sostegno degli ecosistemi, offrendo servizi vitali che
supportano la biodiversità, la regolazione del clima, la purificazione dell’acqua e la sicurezza
alimentare.
Tuttavia, pratiche insostenibili di uso del suolo, come l’urbanizzazione e l’agricoltura intensiva,
minacciano la salute del suolo e aggravano il cambiamento climatico. Questa
tesi esplora le sfide poste dal consumo di suolo in Europa, con particolare attenzione
all’Italia, dove l’espansione urbana e la conversione del territorio continuano a compromettere
gli sforzi di sostenibilità. Analizzando l’obiettivo dell’UE "No Net Land Take
by 2050" e valutando le normative nazionali e regionali, la ricerca esamina strategie per
mitigare il consumo di suolo. Inoltre, indaga il ruolo dei valori di soglia ("cut-off values")
nel determinare i limiti del consumo di suolo e presenta metodologie per valutare
le correlazioni socio-economico-ambientali con l’uso del territorio. Attraverso analisi
computazionali, lo studio mira a sviluppare criteri scientifici per ridurre il consumo di
suolo garantendo al contempo la sostenibilità a lungo termine degli ecosistemi del suolo.
I risultati contribuiscono alla comprensione delle politiche di gestione del territorio e
propongono soluzioni per raggiungere la sostenibilità del suolo nei contesti urbanizzati.
Questo lavoro è stato diffuso attraverso varie pubblicazioni e presentazioni a conferenze,
offrendo approfondimenti su approcci innovativi per la conservazione del suolo e l’uso
sostenibile del territorio
Influence of donor-recipient gender mismatch on renal function and on pharmacokinetics of tacrolimus after kidney transplantation: A 1-year single-center analysis
Full text linkThis study investigates whether donor-recipient gender mismatch influences the function of the
transplanted kidney and the pharmacokinetics of tacrolimus (TAC) in the first post-transplant year. We car
ried out a retrospective study on a cohort of 100 transplanted from deceased donors divided into 4 subgroups
of 25: subgroup M-M (man with male kidney), F-M (man with female kidney), M-F (woman with male
kidney), F-F (woman with female kidney). For each patient were calculated mean and standard deviation
of diuresis, eGFR (estimated Glomerular Filtration Rate), MAP (Mean Arterial Pressure), weight, BMI
(Body Mass Index), BSA (Body Surface Area), TAC blood concentrations/dose-TAC (C/D ratio) and cor
ticosteroid dose/kg between 0-3 months and between 3-12 months of follow up. Diuresis and MAP are not
affected by the mismatch. At 4-12 months the M-M subgroup shows higher eGFR than the other three
subgroups while the F-M subgroup has a significantly lower eGFR value than the other male M-M subgroup:
eGFRfM=44.46 mL/min/1,73m2 vs eGFRmM=58.11 mL/min/1.73m2. The C/D ratio of TAC identifies
the F-M subgroup as the subgroup with the slowest metabolism of TAC. Low eGFR values and TAC ‘slow
metabolizer’ status identify subjects with worse prognosis and greater risk of post-transplant complications.
T
his study demonstrates the influences of gender mismatch on renal clearance and pharmacokinetics of TAC
and identifies the F-M subgroup as a subgroup with worse prognosis. (www.actabiomedica.it
«Sodisfare a questi tempi, / a’ spettatori, a la materia nova»: la normalizzazione del tragico di Giovan Battista Giraldi Cinzio
No full textPur non volendosi presentare come riformatore del teatro, ma riconoscendo a sé stesso il ruolo di precursore nel genere, Giraldi Cinzio pone le basi, con la sua opera drammatica e la sua riflessione poetica, per la nascita della tragedia italiana moderna, che si ispira tanto alle sue scelte formali, quanto ai suoi temi e alla sua codificazione del tragico. L’innovativo finale lieto non risponde a un desiderio di contaminazione con il comico, ma deriva dalla consapevolezza dell’irrappresentabilità del macabro e dell’orrore. I nodi cruciali del tragico giraldiano si spostano nello spazio narrativo, in una contaminazione reciproca e continua con la scrittura novellistica
Simulating bone healing with bio-resorbable scaffolds in a three-dimensional system: insights into graft resorption and integration
Full text linkThis study introduces a three-dimensional (3D) model for investigating the interactions between trabecular bone tissue and bio-resorbable grafts, focusing on their role in bone remodelling processes. Using principles of poroelasticity, the model captures the mechanical behaviour of both bone and graft as porous continua, with their interaction influenced by time-varying mechanical loads and diffusive mechanical stimuli. The stimuli, originating from the strain energy density, propagate through the system, triggering bone formation and graft resorption across distant regions. Numerical simulations reveal the critical impact of load frequency and intensity on remodelling efficiency, with higher values promoting improved bone density and graft integration. This 3D approach provides information on optimizing scaffold design, offering valuable guidance to improve clinical outcomes in bone repair and regeneration procedures
Macroeconomic models for assessing the transition towards a circular economy: A systematic review
No full textIndirect Impact of Pandemic on the Diagnosis of New Primary Melanoma: A Retrospective, Multicenter Study
Full text linkBackground/Objectives: The indirect impact of the pandemic on the diagnosis and treatment of new primary melanoma has been carefully evaluated in recent years. The aim of the present study was to investigate if the indirect impact of the pandemic in Italy could be detectable also in the second year of the pandemic, as suggested by the characteristics of melanoma at diagnosis. Methods: Retrospective analysis of 1640 diagnoses of cutaneous melanoma in pre-pandemic period and 1292 diagnoses in the pandemic period from 10 centers (from 1 March 2019 to 28 February 2022). Results: Our findings confirmed an indirect impact of the pandemic on characteristics of incident melanoma, also in the second year of the pandemic in Italy (Breslow thickness p < 0.0001, tumor stage p = 0.002, ulceration p = 0.04, SNLB p = 0.03), without statistically significant differences between centers. A statistically significant reduction in the time interval from diagnosis to surgical treatment was observed, but only in centers that had to modify their case mix to address the needs of treating COVID-19 patients (p = 0.0002). Conclusions: Our study confirmed the indirect impact of the pandemic on melanoma characteristics at the diagnosis in the second year of the pandemic in Italy. We also found no differences in melanoma characteristics between hospitals with different organization. Diagnostic delays may be related to a delayed access of the patient to the entire diagnostic pathway, and therefore, especially in the case of a pandemic, policies to support early diagnosis are crucial