117,572 research outputs found
Antonio Sacchini il melodista dimenticato
No full textProfilo biografico di Sacchini e analisi delle più celebri oper
The Equitable Benefit Approach to guide the assessment of medical and psychosocial factors in liver transplant candidacy
No full textLack of available organs poses a significant challenge in meeting the needs of patients with life-threatening liver disease who could benefit from liver transplantation (LT). Psychosocial vulnerability markers have been linked to post-transplant outcomes, raising questions about their use in patient selection. However, their incorporation into selection criteria raises concerns about health equity and potential discrimination. As a result, there is a pressing need to refine fair allocation systems that consider both clinical and psychosocial factors to ensure equitable access and optimize post-transplant outcomes. The Equitable Benefit Approach (EBA) proposed in this paper by the multidisciplinary group of clinical experts in LT from the Italian Society for the Study of the Liver seeks to address these concerns. It presents four procedural principles, the two allocative principles usually applied in transplantation (urgency and utility) and introduces a new one, the principle of health equity. The EBA aims to prioritize patients with the highest transplant benefit while addressing health inequalities. It emphasizes evidence-based decision-making and standardized assessment tools to reliably evaluate psychosocial risk factors. Implementing the EBA involves a multi-step process, including stakeholder engagement, prospective studies to validate its efficacy, development of institutional policies and algorithms, and ongoing monitoring and revision. By following these steps, health care providers can ensure that LT allocation decisions are transparent and responsive to evolving clinical and social contexts. Ultimately, the EBA should offer a comprehensive framework for fair patient selection in LT, considering both biomedical and psychosocial aspects
Il censimento delle gallerie-rifugio antiaereo come contributo alla geologia urbana di Genova
No full textCaratterizzazione geologico-ambientale preliminare delle gallerie antiaeree ad uso civile di Genova
No full textRelationships between precipitations and shallow landslides in the Municipality of Genoa (Italy)
No full textThe 4th October 2010 flash flood event in Genoa Sestri Ponente (Liguria, Italy)
No full textThe Mediterranean Sea and in particular the Liguria region have always been suffering from severe geohydrological events. Landform features and autumnal atmospheric circulation deeply influence the hazard in Genoa city, the capital of Liguria, crossed by many streams: heavy rainfall can trigger flash floods involving structures and infrastructures, often causing fatalities. The recent growth of events characterized by intense rainfall and floods has been amplified by the urban sprawl of flood-plain: these factors seem to be the most important causes in the increase of damage related to geo-hydrological events.
In this case, typical of the whole Genoan Metropolitan area, a severe event occurred in Sestri Ponente district on October 4th 2010: a critical rainfall, over 400 mm/6 hours, a peak of 125 mm/h, triggered shallow landslides and flash floods in the Molinassi and Chiaravagna catchments crossing Sestri Ponente, causing one fatality and damage of over 60 million euros. These watercourses show the typical features of Ligurian basins: small areas, steep slopes, proximity of watersheds to the coastline and intense urbanization of the plain. During this event, the hydrological response to rainfall was almost immediate, with times of concentration shorter than 25 minutes. The narrow plain on which Sestri Ponente rises was completely flooded
Integrating Patients’ Perspectives, Context, and Implementation in the Assessment of Complex Health Technologies.
No full textBackground: The rise in chronic diseases in ageing populations has led to the development of increasingly complex technologies. Current
Health technology assessment (HTA) methods do not sufficiently take into account the diversity in patient characteristics and patient
preferences, as well as context and implementation issues. A strategy is needed to integrate all these aspects into a comprehensive assessment.
Objectives: This EU-funded project aims at developing concepts and methods for a comprehensive, patient–centered, and integrated assessment of complex technologies.
Methods: Palliative care has been chosen as a case study as it is a highly complex health technology that deals with heterogeneous patients’
conditions, needs and objectives. Stakeholder advisory panels (SAPs) were established in 6 European countries to ensure public and
patient involvement (PPI) that informs the scope, research questions and outcomes. Logic models and a framework are used to conceptualize the intervention in its context. Literature searches, quantitative and qualitative methods are employed to assess effectiveness as well as
ethical, socio-cultural, economic, and legal issues.
Results: Interim results suggest SAPs are instrumental for including the patients’ perspective in the assessment of complex technologies.
Logic models have rarely been used in HTA but are helpful in understanding sources of complexity in the intervention and its implementation, in (un)desired outcomes and in the interactions between intervention and context. The integration of patients’ perspectives with medical, economic, ethical, socio-cultural, and legal issues needs to be undertaken from the outset of the HTA, not at the end.
Conclusions: For the assessment of complex technologies HTA-methodology
needs to be adapted at all stages. The patients’ perspective can be obtained through stakeholder panels. An integrated perspective will improve the relevance of the assessment for all stakeholders, including patients
Scoping as a Means to Systematically Involve Patients and Public in Health Technology Assessment (HTA).
No full textTo improve accountability and comprehensiveness, patient and public involvement (PPI) is crucial throughout the various
stages of HTA. However, little is known as to how this can be achieved in a systematic, culturally sensitive way
Health Technology Assessment of the anti HCV strategies in Italy: evidences from the WEF Project
No full textIn the last few years, HTA approach and its use in decision making has become one of the major concerns to be debated in Italy. In particular, physicians feel restricted in their budget spending, but they are often excluded from the decision making process. In addition, evaluations of new drugs are often based on studies which are conducted on different jurisdictions, regardless of the peculiarities of the Italian Health System. In this context the first national pharmacoeconomics workshop (WEF), aims for the first time in Italy to bring together all the stakeholders taking part in the decision making process, to develop concrete proposals and a consistent and holistic view. The WEF is intended to rationalize and to address the debate about qualitative standards for the assessment of health technologies, and to develop concrete an official reports, in line with the "Core" model, developed within the European network of health technology assessments (EUnetHTA). The assessment stage is based on the contribution of a scientific committee of clinicians, economists, pharmacologists, epidemiologists, payers and patients. The appraisal stage involves other
participants which are invited the day of the workshop. The first Workshop has treated issues in Hepatology (WEF-
E 2011), but the committee's mission is to expand the model to different areas of priority interest of medicine. The
first edition of the WEF was held on 27 and 28 April 2011 in Rome, at the Catholic University of the Sacred Heart,
Gemelli Hospital. The Scientific Committee of the WEF-E 2011 brought together different professionals: hepatologists, economists, experts HTA, infectious disease specialists, pharmacologists, representatives Institutions responsible for pharmaceutical expenditure, a representative of the patients, an epidemiologist and an expert in bioethics, allowing a 360-degree view of the anti HCV and anti HBV screenings in comparison with the treatment of chirrosis and HCC. Results underlined the high profitability of the screening programs in the area of hepatology from a clinical, economic, organitional and ethical perspectives. In conclusion, the project, which integrates research and dissemination results, aims to represent a new model of approaching the actual concerns of decision making in healthcare, to optimize the best use of resources in order to produce useful results to the scientific community, and to represent new standard applicable in other scopes
Antonio Sacchini / dessiné par L. Jay ; gravé par L.J. Cathelin
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