Assessing Different Histological Preparations for Reconstruction of Astrocyte Tridimensional Structure.

Astrocytes are ubiquitous in the brain and spinal cord and display a complex morphology important for the local interactions with neighboring cells, resulting in the modulation of circuit function. Thus, studies focusing on astrocyte physiology in the healthy and diseased brain generally present analyses of astrocytic structure. The labeling method used to visualize the astrocytic structure defines the morphological level to observe and may vary depending on the anatomical sub-regions.

Relation between pre-existing quality management measures and prevention and containment of COVID-19 outbreaks in 159 nursing homes in Tuscany: a mixed methods study.

Background: Nursing homes were often the focus of COVID-19 outbreaks. Many factors are known to influence the ability of a nursing home to prevent and contain a COVID-19 outbreak. The role of an organisation's quality management prior to the pandemic is not yet clear.

Detecting Massive Scalar Fields with Extreme Mass-Ratio Inspirals.

We study the imprint of light scalar fields on gravitational waves from extreme mass-ratio inspirals-binary systems with a very large mass asymmetry. We first show that, to leading order in the mass ratio, any effects of the scalar on the waveform are captured fully by two parameters: the mass of the scalar and the scalar charge of the secondary compact object. We then use this theory-agnostic framework to show that the future observations by LISA will be able to simultaneously measure both of these parameters with enough accuracy to detect ultralight scalars.

Astrocyte structural heterogeneity in the mouse hippocampus.

Astrocytes are integral components of brain circuits, where they sense, process, and respond to surrounding activity, maintaining homeostasis and regulating synaptic transmission, the sum of which results in behavior modulation. These interactions are possible due to their complex morphology, composed of a tree-like structure of processes to cover defined territories ramifying in a mesh-like system of fine leaflets unresolved by conventional optic microscopy. While recent reports devoted more attention to leaflets and their dynamic interactions with synapses, our knowledge about the tree-like "backbone" structure in physiological conditions is incomplete.

Managing community engagement initiatives in health and social care: lessons learned from Italy and the United Kingdom.

Background: Determining the different features and potential impacts of community initiatives aimed at health-related outcomes poses challenges for both researchers and policy makers.

Purpose: This article explores the nature of heterogeneous "community engagement initiatives" (CEIs) considering both their social and organizational features in order to understand the managerial and policy implications to maximize their potential local health and social care-related impacts.

Methodology: A threefold qualitative analysis was conducted: (a) Three frameworks were developed to classify and analyze different CEIs features, building upon the current literature debate; (b) primary data were collected from Italian CEIs; and (c) a comparative cross-case analysis of a total of 79 CEIs in Italy and the United Kingdom was implemented.

The Prescribing Practice for COPD: Relationship to Circadian Rhythm, Disease Severity, and Clinical Phenotype in the STORICO Observational Study.

Introduction: While selected clinical and laboratory findings are taken into account to find the best therapeutic strategies for chronic obstructive pulmonary disease (COPD), it is unknown whether the circadian rhythm of respiratory symptoms, a distinctive feature of COPD, affects the prescription pattern of pharmacological therapy. The main aim of this study was to verify whether the circadian rhythm of symptoms correlates with bronchodilating therapy prescribed to COPD patients as per clinical practice. A secondary objective was to assess the relationship between Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage and circadian rhythm of symptoms and health status.

Using co-creation to develop a cardiology online open course: an effective approach for implementing digital learning.

Aims: we developed a massive online open course (MOOC) through co-creation between medical students and academic staff on heart semeiotics and evaluated its teaching efficiency and user satisfaction.

Methods: "The Heart, Its Signs and Symptoms" was a MOOC aimed to teach medical students to collect clinical history and perform physical examination of patients presenting with chest pain, dyspnea, palpitations, or syncope. It consisted of 4 interactive cases with preliminary, interim and final evaluation tests.

Detecting Subsolar-Mass Primordial Black Holes in Extreme Mass-Ratio Inspirals with LISA and Einstein Telescope.

Primordial black holes possibly formed in the early Universe could provide a significant fraction of the dark matter and would be unique probes of inflation. A smoking gun for their discovery would be the detection of a subsolar mass compact object. We argue that extreme mass-ratio inspirals will be ideal to search for subsolar-mass black holes not only with LISA but also with third-generation ground-based detectors such as Cosmic Explorer and the Einstein Telescope.

What Counts in Nursing Homes' Quality and Efficiency? Results From Data Envelopment Analysis in Italy.

Purpose: Economic resource constrains in public spending budget in a country, such as Italy, with an ageing population with high incidence of chronic diseases calls for better strategies to improve measuring quality and efficiency in nursing homes (NHs). This paper analyses the efficiency of 40 NHs based in Tuscany considering not only structural characteristics but also quality of care, including residents, relatives and staff satisfaction.

Methodology: We run a classic data envelopment analysis (DEA) on data gathered by the NHs' regional performance evaluation system.

Trade union or trait d'union? Setting targets for general practitioners: A regional case study.

Aims: The Italian general practitioners (GPs) are not directly employed by the National Health Service but work as independent contractors. Their activity and their salary are managed at the national, regional, and local level. This paper analyses the Tuscany Region case study to investigate if primary care's target-setting styles are associated with different GP perceptions, by comparing nine different local agreements to a survey on 102 GPs.

Reported experience of patients with single or multiple chronic diseases: empirical evidence from Italy.

Background: More and more countries have been implementing chronic care programs, such as the Chronic Care Model (CCM) to manage non-acute conditions of diseases in a more effective and less expensive way. Often, these programs aim to provide care for single conditions instead of the sum of diseases. This paper analyzes the satisfaction and better management of single and multiple chronic patients with the core elements of chronic care programs in Siena, Italy.

Hospitalization among migrants in Italy: Access to health care as an opportunity for integration and inclusion.

This paper analyzes migrant access to health care by comparing hospitalizations of native and immigrant population with respect the Tuscany Region (Italy). In the analyses, a critical gap both for legal and undocumented migrant population is highlighted. Indeed, we found some key differences between the migrant and native populations related to the use of specific hospital services in Tuscany and, indirectly, of community and primary care services.

General practitioners: Between integration and co-location. The case of primary care centers in Tuscany, Italy.

Healthcare systems have followed several strategies aimed at integrating primary care services and professionals. Medical homes in the USA and Canada, and primary care centres across Europe have collocated general practitioners and other health and social professionals in the same building in order to boost coordination among services and the continuity of care for patients. However, in the literature, the impact of co-location on primary care has led to controversial results.

The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries.

Background: There is no clear evidence as to whether the co-location of primary care professionals in the same facility positively influences their way of working and the quality of healthcare as perceived by patients. The aim of this study was to identify the relationships between general practitioner (GP) co-location with other GPs and/or other professionals and the GP outcomes and patients' experiences.

Methods: We wanted to test whether GP co-location is related to a broader range of services provided, the use of clinical governance tools and inter-professional collaboration, and whether the patients of co-located GPs perceive a better quality of care in terms of accessibility, comprehensiveness and continuity of care with their GPs.

Strategies and governance to reduce health inequalities: evidences from a cross-European survey.

Background: The main objective of the paper is to identify the governance system related to policies to reduce health inequalities in the European regions. Considering the Action Spectrum of inequalities and the check list of health equity governance, we developed a survey in the framework of the AIR Project - Addressing Inequalities Intervention in Regions - was an European project funded by the Executive Agency of Health and Consumers.

Methods: A web-based qualitative questionnaire was developed that collected information about practiced strategies to reduce health inequalities.

Consistency of priorities for quality improvement for nursing homes in Italy and Canada: A comparison of optimization models of resident satisfaction.

The paper seeks to identify aspects of care that may be easily modified to yield a desired level of improvement in residents' overall satisfaction with nursing homes, comparing data across Canada and Italy. Using a structured questionnaire, 681 and 1116 nursing home residents were surveyed in Ontario in 2009 and in Tuscany in 2012, respectively. Fourteen items were common to the surveys, including willingness to recommend (WTR), which was used as the dependent variable and measure of global satisfaction.

Characterization of circadian COPD symptoms by phenotype: Methodology of the STORICO observational study.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality worldwide. The symptoms of COPD are troublesome, variable, can occur during all parts of the 24-h day and have a substantial impact on patients' health status, quality of life and healthcare resource utilization. Reducing symptoms, improving health status and increasing physical activity are major goals in the management of stable COPD.

Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy.

Background: Several countries have co-located General Practitioners (GPs) in Primary Care Centres (PCCs) with other health and social care professionals in order to improve integrated care. It is not clear whether the co-location of a multidisciplinary team actually facilitates a positive patient experience concerning GP care. The aim of this study was to verify whether the co-location of GPs in PCCs is associated positively with patient satisfaction with their GP when patients have experience of a multidisciplinary team.

Patient satisfaction, e-health and the evolution of the patient-general practitioner relationship: Evidence from an Italian survey.

Background: Scientific and public interest in the use of the Internet for health-related purposes has grown considerably. Concerns regarding its impact on patient-doctor relationship and risks for patients have inflamed the debate. Literature provides scarce evidence in this field.

Interventions addressing health inequalities in European regions: the AIR project.

Disparities in health between social groups have been documented all over Europe. We summarize the methods and results of the Addressing Inequalities in Regions (AIR) project, which identified illustrative interventions and policies developed in European regions to reduce inequalities at the primary health care level. The first phase was a systematic review of the published literature.

Criteria for implementing interventions to reduce health inequalities in primary care settings in European regions.

Background: The current social and political context is generating socio-economic inequalities between and within countries, causing and widening health inequalities. The development and implementation of interventions in primary health care (PHC) settings seem unavoidable. Attempts have been made to draw up adequate criteria to guide and evaluate interventions but none for the specific case of PHC.

The equity lens in the health care performance evaluation system.

The main objective of this paper is to describe how indicators of the equity of access to health care according to socioeconomic conditions may be included in a performance evaluation system (PES) in the regional context level and in the planning and strategic control system of healthcare organisations. In particular, the paper investigates how the PES adopted, in the experience of the Tuscany region in Italy, indicators of vertical equity over time. Studies that testify inequality of access to health services often remain just a research output and are not used as targets and measurements in planning and control systems.

Building China's municipal healthcare performance evaluation system: a Tuscan perspective.

Regional healthcare performance evaluation systems can help optimize healthcare resources on regional basis and improve the performance of healthcare services provided. The Tuscany region in Italy is a good example of an institution which meets these requirements. China has yet to build such a system based on international experience.

The effect of administering gonadotropin-releasing hormone agonist with recombinant-human growth hormone (GH) on the final height of girls with isolated GH deficiency: results from a controlled study.

To assess whether delaying puberty may improve final height in GH-deficient children with a poor height prediction at early puberty, we studied 24 girls with isolated GH deficiency until they reached their final height, in a controlled trial. Patients were taking recombinant human GH (r-hGH) substitutive therapy from 2.1 +/- 0.