1,721,011 research outputs found
A neuroscientist-consumer alliance to transform mental health care
No full textThe field of mental health has long suffered from a lack of convergence of disciplines that deal with the mind, the brain, and behavior. This mind-brain dualism has been particularly detrimental for consumers and their families who daily face stigma and discrimination. The understanding of the brain and its dysfunctions has benefited from the study of the human genome and, in particular, of the mutations and variations in its code. This analysis permits a better understanding of the biological basis of mental disease and will soon inform a generation of new diagnostic tools and individualized pharmacological therapies. A biological perspective on mental illness will be complemented by the analysis of the social factors influencing people's behavior and their impact on brain biology and gene function. Neurobiology has progressed to a level for which the knowledge that is generated, even if still colored with uncertainty, could represent a catalyst for the creation of an alliance between neuroscientists and consumers. This partnership has the potential to benefit both parties but will require some concrete steps that might be outside of the usual courses of action for both consumers and scientists. It is by building collaborations based on personal contact and information sharing that a transformation of the mental health care system can occur. © 2006 National Council for Community Behavioral Healthcare
Pharmaceutical companies and Italian Regional Governments: Managing relationships in an increasing institutional complexity
No full textIn Italy, the process of power decentralization to Regional Governments has particularly affected pharmaceutical care policies.
Regions are experimenting with various strategies to govern drugs utilization and expenditure, and differentiating their
approaches, leading to an ever-changing and complex institutional scenario.
Pharmaceutical companies have created new professional roles, the Regional Affairs Managers (RAM), with the mandate
to monitor the different regional contexts and measures, and to establish relationships with the public actors in charge of
pharmaceutical policies.
This analysis shows how public affairs/lobbying actions at regional level and the creation of a solid political competence
within companies are still in an early phase. The activities carried out by RAMs remain limited to an exchange of information
and only rarely are perceived by Regional public servants (RRs) as giving support to their work or influence decisions.
The interaction with RAMs is often seen as little relevant and still too concentrated on products and a marketing/commercial
approach rather than on broader issues of interest to RRs who need to manage the pharmaceutical care system at large. The
level of acceptance of this type of activity is also variable and RRs’ attitudes alternate between diffidence, polite tolerance, and
openness to a constructive dialogue about pharmaceuticals and their management in a regional healthcare syste
Patient characteristics associated with the acceptability of teleconsultation: a retrospective study of osteoporotic patients post-COVID-19
Full text linkBackground: Due to the COVID-19 pandemic, teleconsultations (TCs) have become common practice for many chronic conditions, including osteoporosis. While satisfaction with TCs among patients increases in times of emergency, we have little knowledge of whether the acceptability of TCs persists once in-person visits return to being a feasible and safe option. In this study, we assess the acceptability of TCs across five dimensions for osteoporosis care among patients who started or continued with TCs after the COVID-19 pandemic had waned. We then explore the patient characteristics associated with these perceptions. Methods: Between January and April 2022, 80 osteoporotic patients treated at the Humanitas Hospital in Milan, Italy, were recruited to answer an online questionnaire about the acceptability of TCs for their care. The acceptability of TCs was measured using a modified version of the Service User Technology Acceptability Questionnaire (SUTAQ), which identifies five domains of acceptability: perceived benefits, satisfaction, substitution, privacy and discomfort, and care personnel concerns. Multivariable ordinary least squares (OLS) linear regression analysis was performed to assess which patient characteristics in terms of demographics, socio-economic conditions, digital skills, social support, clinical characteristics and pattern of TC use were correlated with the five domains of acceptability measured through the SUTAQ. Results: The degree of acceptability of TCs was overall good across the 80 respondents and the five domains. Some heterogeneity in perceptions emerged with respect to TCs substituting for in-person visits, negatively impacting continuity of care and reducing the length of consultations. For the most part, acceptability was not affected by patient characteristics with a few exceptions related to treatment time and familiarity with the TC service modality (i.e., length of osteoporosis treatment and number of TCs experienced by the patient). Conclusions: TCs appear to be an acceptable option for osteoporosis care in the aftermath of the COVID-19 pandemic. This study suggests that other characteristics besides age, digital skills and social support, which are traditionally relevant to TC acceptability, should be taken into account in order to better target this care delivery modality
The interplay between policy guidelines and local dynamics in shaping the scope of networks: the experience of the Italian Departments of Mental Health.
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Promozione Acido Folico
No full textL’acido folico (vitamina B9) è una vitamina idrosolubile del complesso B, che va introdotta nel nostro organismo con un’alimentazione adeguata. All’inizio della gravidanza il fabbisogno di questa importante vitamina aumenta. L’importanza dell'acido folico risiede nelle sue capacità di favorire la costruzione di nuove cellule: è dunque essenziale per la formazione del DNA e delle proteine, in particolare dell’emoglobina e delle cellule embrionali. La quantità (almeno 0,4 mg al giorno) necessaria all’embrione nei primissimi giorni di sviluppo non può essere assicurata solo dall’alimentazione. È dunque necessario assumere compresse di acido folico in aggiunta ad un’alimentazione adeguata già durante il periodo pre-concezionale, perché le eventuali malformazioni che intendiamo prevenire potrebbero essersi già verificate prima che la donna abbia scoperto di essere incinta.
L’acido folico diminuisce il rischio di insorgenza di difetti del tubo neurale. Pressochè tutti gli studi clinici dal 1981 ad oggi riportano una riduzione sia del rischio di occorrenza che di ricorrenza, pari al 30-70%.
La supplementazione periconcezionale potrebbe anche ridurre il rischio di altri difetti congeniti nel loro insieme, riduzione stimabile intorno al 10-20%, tra cui alcuni relativamente comuni come le cardiopatie congenite e le labio+/-palatoschisi, oltre a difetti del tratto urinario, ipo-agenesie degli arti, onfalocele e atresia anale. La quantità di acido folico sintetico assunto che si è dimostrata efficace nel ridurre il rischio di malformazioni è variabile, tra 0,4-0,8 mg e 4-5 mg al giorno. Una revisione sui dosaggi efficaci suggerisce un effetto dose-dipendente.
Nonostante anche nel nostro paese sia stata prodotta la “Raccomandazione per la riduzione del rischio di difetti congeniti” dal Network Italiano Promozione Acido Folico per la Prevenzione Primaria di Difetti Congeniti e siano state attivate negli anni campagne informative dirette alle donne in età fertile e agli operatori sanitari, la supplementazione periconcezionale rimane ancora oggi una buona pratica fortemente trascurata.
Per sostenere la diffusione nella pratica clinica di queste evidenze e contribuire a comprendere se gli altri vantaggi ipotizzati siano reali, è stato finanziato dall’Agenzia Italiana del Farmaco (AIFA), grazie ai bandi per la ricerca indipendente sui farmaci, lo “Studio Acido Folico” (www.folictrial.org).
L’ipotesi che l’assunzione di dosaggi più elevati di acido folico, rispetto a quelli attualmente raccomandati, riduca ulteriormente l’insorgenza di difetti del tubo neurale e di altre malformazioni congenite, rappresenta il razionale principale del progetto di ricerca.
Lo studio ha l’obiettivo primario di valutare se la supplementazione periconcezionale con acido folico alla dose di 4 mg al giorno, in confronto alla dose standard di 0,4 mg, riduca maggiormente l’insorgenza delle malformazioni congenite nel loro insieme. E’ oggetto di valutazione nei due bracci di trattamento anche la frequenza di ulteriori effetti benefici sugli esiti della gravidanza come il decremento di aborto spontaneo, di ritardo di crescita intrauterina, di pre-eclampsia, di distacco di placenta, di morte intrauterina, di parto pretermine, nonché la frequenza di comparsa di gravidanze gemellari.
Questa esperienza, condotta in collaborazione con i colleghi olandesi, rappresenta un’occasione unica in campo materno-infantile per diffondere un’attività che cerca di coniugare lo sviluppo di progetti diretti alla popolazione, con l’obiettivo di sostenere buone pratiche ancora oggi troppo trascurate e lo sforzo di dare una risposta a domande di ricerca cruciali per la salute della popolazione
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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