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Sapountzaki K.,Harokopio University | Wanczura S.,Institute of Fire Service and Rescue Technologies | Casertano G.,Regione Lazio | Greiving S.,TU Dortmund | And 2 more authors.
Natural Hazards | Year: 2011

The present work addresses the problem of lack of coordination between policies and actors with joint competence for risk management, i. e., civil protection, spatial planning, and sectoral planning (e. g., forest policy in the case of forest fire risk). Spatial planning in particular is assigned a minor or no role at all though it might perfectly operate as the coordinating policy platform; the reason is that spatially relevant analysis and policy guidance is an omnipresent component of the risk management cycle. However, disconnected risk relevant policies turning a blind eye to spatial planning might cause several adverse repercussions: Breaks in the response-preparedness-prevention-remediation chain (which should function as a continuum), minimal attention to prevention, risk expansion and growth instead of mitigation, lack of synergies between involved actors as well as duplicated or even diverging measures and funding. The authors bear witness to the above suggestions by examining three cases of European (regional and local) risk management systems faced with failures when confronting natural hazards (floods and forest fires). These three systems are embedded in different types of political-administrative structures, namely those of the city of Dortmund (Germany) facing floods, Eastern Attica region (Greece), and Lazio Region (Italy) facing forest fires. © 2011 Springer Science+Business Media B.V.


Zorzi M.,Registro Tumori del Veneto | Senore C.,University of Turin | Da Re F.,Settore Promozione e Sviluppo Igiene e Sanita Pubblica | Barca A.,Regione Lazio | And 11 more authors.
Gut | Year: 2015

Objectives: To assess variation in the main colonoscopy quality indicators in organised colorectal cancer (CRC) screening programmes based on faecal immunochemical test (FIT). Design: Data from a case-series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected. The adenoma detection rate (ADR) and caecal intubation rate (CIR) were assessed for the whole population and the individual endoscopists. To explore variation in the quality indicators, multilevel analyses were performed according to patient/centre/endoscopist characteristics. Results: We analysed 75 569 (mean age: 61.3 years; men: 57%) colonoscopies for positive FIT performed by 479 endoscopists in 79 centres. ADR ranged from 13.5% to 75% among endoscopists (mean: 44.8%). ADR was associated with gastroenterology specialty (OR: 0.87 for others, 95% CI 0.76 to 0.96) and, at the endoscopy centre level, with the routine use of sedation (OR: 0.80 if occasional (<33%); 95% CI 0.64 to 1.00) and availability of screening-dedicated sessions (OR: 1.35; 95% CI 1.11 to 1.66). CIR ranged between 58.8% and 100% (mean: 93.1%). Independent predictors of CIR at the endoscopist level were the yearly number of screening colonoscopies performed (OR: 1.51 for endoscopists with >600 colonoscopies; 95% CI 1.11 to 2.04) and, at the endoscopy centre level, screeningdedicated sessions (OR: 2.18; 95% CI 1.24 to 3.83) and higher rates of sedation (OR: 0.47 if occasional; 95% CI 0.24 to 0.92). Conclusions: The quality of colonoscopy was affected by patient-related, endoscopist-related and centre-related characteristics. Policies addressing organisational issues should improve the quality of colonoscopy in our programme and similar programmes.


Grant
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: PHC-06-2014 | Award Amount: 2.99M | Year: 2015

Very preterm birth is a principal determinant of motor and cognitive impairment in later life. About 50 000 infants in the EU survive very preterm birth annually and are at much higher risk of cerebral palsy, visual and auditory deficits, impaired cognitive ability, psychiatric disorders and behavioural problems than infants born at term. However, the long term prognosis at initial discharge from hospital for each individual infant is unknown. Follow-up screening and prevention programmes aim to identify health problems early, enable interventions to improve outcome and to allow optimal management of health care. Despite the recognised importance of these programmes, little is known about their actual application and impact. These programmes consume significant resources because of the multidisciplinary staff required for clinical and developmental assessments and interventions, the coordination required to maintain contact with children after discharge and the time input from families. This project uses a unique resource the EPICE cohort of 6675 babies born before 32 weeks of gestational age and surviving to discharge home in 18 geographically diverse regions in 2011/2012 to assess the impact of these screening programmes on health, care and quality of life for very preterm infants and their families as well as on coverage, ability to meet needs, health equity and costs at the population-level. It will also generate new knowledge about assessment tools and methods. Four inter-related studies will be carried out in 11 EU countries by a multi-disciplinary consortium of clinicians (in obstetrics, paediatrics, and child development), researchers (in epidemiology, health services research and health economics) and a user organisation. Partners have the expertise to implement this project and the national and international renown to translate its result into better programmes and policies.


Grant
Agency: Cordis | Branch: FP7 | Program: CP-FP | Phase: HEALTH.2010.3.1-1 | Award Amount: 3.97M | Year: 2011

Context: Very preterm infants face high risks of mortality and long-term neuro-developmental impairment. Rates of mortality and morbidity vary by a factor greater than two between European regions. This projects overriding aim is to improve these infants survival and long-term health and development by ensuring that available medical knowledge is translated into effective perinatal care. Objectives: (1) Build an empirical knowledge base concerning how scientific evidence is translated into health service provision in maternity and neonatal units by measuring the use of key medical interventions in clinical settings, identifying the factors associated with adoption of evidence-based practices and providing updated information on the effectiveness of medical practices; (2) Assess decision-making and knowledge implementation processes within units and regions to identify catalysts for evidence-based practice; and (3) Propose intervention strategies to achieve behavioural change. Study design: This project combines quantitative and qualitative approaches to assess the use of evidence-based medical interventions and determinants of use on the regional, unit and patient level in 19 European regions (550 units, 10,500 births). The project includes a population-based cohort study of very preterm infants with follow-up to 2 years of age, a survey of all maternity and neonatal units caring for these infants, semi-structured narrative interviews and focus groups in selected units and case studies on regional governance. Impact: The project will produce empirical data about the uptake of medical interventions in European maternity and neonatal units and new knowledge about catalysts for the adoption of medical knowledge. Its results will provide a methodological and conceptual basis for future scientific work on the effectiveness of intervention strategies. The project enhances cooperation and excellence in Europe by bringing together national research initiatives.


Grant
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: MG-7.1-2014 | Award Amount: 5.95M | Year: 2015

SocialCar is an Intelligent Transport System based on an innovative approach to transport demand management, and more specifically to carpooling in urban and peri-urban areas. SocialCars main objective is devopping a new communication network for intelligent mobility, sharing information of car-pooling integrated with existing transport and mobility systems. It will be achieved by means of powerful planning algorithms and integration in a liveable environment of big data related to public transport, carpooling and crowdsourcing in order to provide the final user with a simplified travel experience allowing comparison and choice between multiple options/services. SocialCar will take advantage Social Media to communicate, share information and provide the best just-in-time notifications to the travellers. SocialCar will take advantage of the ever growing connectivity of people and objects and the propagation of Internet services, the potential of Future Internet and the availability of GNSS based location and social media to create an integrated mobility service with the potential to sensibly reduce mobility problems of European citizens. SocialCar will capitalise on a strong pan European team with a solid background in social, psychological and economic sciences, the involvement of 10 European urban sites will prove the concepts validity and business case. SocialCar General Objectives are to: contribute to the EU2020 targets on energy efficiency and renewable energy sources reducing congestion by improving and maximising connectivity and information in real-time overcoming the limitations of current carpooling practices moving from long trips to effective urban and peri-urban use validate green driving support systems, active management based on European GNSS identify a suitable big data management architecture for integrating mobility data produce a city-based open integrated mobility repository of public transport and traffic city-based data


PubMed | SS Prevenzione Secondaria e Screening, Settore promozione e sviluppo igiene e sanita pubblica, Assessorato alle politiche per la salute, Italian National Cancer Institute and 10 more.
Type: | Journal: Gut | Year: 2016

To assess detection rate and predictive factors of sessile serrated polyps (SSPs) in organised colorectal cancer (CRC) screening programmes based on the faecal immunochemical test (FIT).Data from a case series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected, including the age-standardised and sex-standardised adenoma detection rate (ADR) of the individual endoscopists. The SSP detection rate (SSP-DR) was assessed for the study population. To identify SSP-predictive factors, multilevel analyses were performed according to patient/centre/endoscopist characteristics.We analysed 72021 colonoscopies, of which 1295 presented with at least one SSP (SSP-DR 1.8%; 95% CI 1.7% to 1.9%). At the per-patient level, SSP-DR was associated with males (OR 1.35; 95% CI 1.17 to 1.54) and caecal intubation (OR 3.75; 95% CI 2.22 to 6.34), but not with the FIT round. The presence of at least one advanced adenoma was more frequent among subjects with SSPs than those without (OR 2.08; 95% CI 1.86 to 2.33). At the per-endoscopist level, SSP-DR was associated with ADR (third vs first ADR quartile: OR 1.55; 95% CI 1.03 to 2.35; fourth vs first quartile: OR 1.89; 95% CI 1.24 to 2.90).The low prevalence of SSPs and the lack of association with the FIT round argue against SSP as a suitable target for FIT-based organised programmes. Strict association of SSP-DR with the key colonoscopy quality indicators, namely caecal intubation rate and high ADR further marginalises the need for SSP-specific quality indicators in FIT-based programmes.


Grant
Agency: Cordis | Branch: H2020 | Program: CSA | Phase: CIRC-03-2016 | Award Amount: 1.77M | Year: 2016

SCREEN aims at the definition of a replicable systemic approach towards a transition to Circular Economy in EU regions within the context of the Smart Specialization Strategy, through the identification and implementation of operational synergies between R&I investments from H2020 and the European Structural and Investment Funds, thus contributing to novel future eco-innovative and horizontal business models across different value chains. The concept of the action is to develop a EU reference framework for establish operational synergies between Horizon 2020 and the European Structural and Investment Funds related to Circular Economy by: a) Sustaining the regional actors participation at H2020 The mechanism of the vouchers, already adopted in the past, will be reinforced an harmonized, in order to ensure common rules in EU regions and therefore encouraging to composition of international Consortia applying for circular economy projects related to the regional Smart Specialisation. b) Encouraging the entrepreneurial initiatives based on H2020 projects results The participating Regions will agree about a specific rule in their Structural Funds giving an advantage for those initiatives targeted to the exploitation of the H2020 project results with a circular economy approach. c) Investigating the possibility of maximizing the H2020 investment through a recovery(fully or partial) of well ranked unfinanced proposals dealing with circular economy Even if there is a clear presence of several bureaucratic and operational barriers, a possible solution could have an impressive multiplier effect on the H2020 results. The approach of the action is to leverage on growing industry sectors in EU regions to act as a driver also for the less performing ones, through a circular economy approach, and to support the emergence of new actors in the regional economies leading to new or redesigned value chains.


Pace A.,Regina Elena Cancer Institute | Di Lorenzo C.,Don Carlo Gnocchi Onlus Foundation | Capon A.,Regional Public Health Agency | Villani V.,Regina Elena Cancer Institute | And 7 more authors.
Journal of Palliative Medicine | Year: 2012

Despite aggressive multimodality treatment the prognosis of patients with primary brain tumors (BT) remains poor. At present, there are no data about the role of palliative home-care services and their impact on quality of care. We report the results of a pilot project of palliative home care for BT patients started in 2000 in the National Cancer Institute Regina Elena of Rome. We report also the result of a cost/effectiveness analysis utilizing administrative data on re-hospitalization rate in the last two months of life. Methods: Since October 2000 until December 2009, 572 patients have been followed by our home care staff. Among 394 patients who died, 276 (70%) were followed at home until death. A cost/effectiveness analysis was carried out evaluating the rehospitalization rate in the last 2 months of life in a subgroup of patients (group 1 assisted at home, 72 patients; group 2 not assisted at home, 71). The number of hospital readmission in the last 2 months of life, and length and cost of hospitalization were retrospectively analyzed from hospital discharge records. Results: Hospitalization rate of group 1 (16.7%) was lower than group 2 (38%) (95% CI: 0.18-0.65, p=0.001). Costs of hospitalization also differed substantially: 517 £ (95% CI: 512-522) in represent an alternative to in-hospital care for the management of brain tumor patients and may improve the end-of-life quality of care. © 2012, Mary Ann Liebert, Inc.


Grant
Agency: Cordis | Branch: FP7 | Program: JTI-CP-FCH | Phase: SP1-JTI-FCH.2013.1.1 | Award Amount: 41.89M | Year: 2015

The 3EMOTION project will provide policymakers and financing institutions with the necessary arguments to invest in Fuel Cell Buses (FCB) as a cost effective strategy to accelerate the reduction of harmful local emissions while offering attractive co-modality options for commuters. By leveraging the experiences of earlier FCB demonstrations in overcoming the last technical and economic barriers, as well as significantly increasing the number of bus operators involved with FCBs, the project will support the achievements anticipated in the upcoming FCH-JU Bus Commercialisation Study, 2014. More specifically, the project will: Lower H2 consumption for FCBs to less than 9kg/100km (a 30% improvement over the FCH JU targets) Integrate latest drive train, fuel cells & battery technologies to lower the TCO and increase their actual lifetime Ensure Availability >90% without the need of permanent technical support, a major advance compared to that achieved under current FCH-JU projects Increase warranties (>15,000 hours) and improved delivery times of key components Reduce bus investment costs to 850K for a 13m bus (a reduction of 35% over the current generation of vehicles) A pan-European consortium of public & private actors will achieve these challenging targets and objectives by: Operating 27 FCB in 5 leading EU cities: London, Rome, Flanders, Rotterdam, Cherbourg (6 already existing) Developing 3 new Hydrogen Refuelling Station (HRS) Conducting an evaluation assessment of the use of FCB & HRS (environment, economic, social) using the existing MAF Identifying the transferability model for accelerating the commercialisation of FCBs in the EU by comparing their latest performances with conventional/alternative technologies Consolidating and extending the network of H2 Bus Centres of Excellence to the project sites, in collaboration with the H2 Bus Alliance Global H2 Bus Platform and UITP.


PubMed | Regina Elena Cancer Institute, National Institute for Health and Regione Lazio
Type: Journal Article | Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer | Year: 2016

Although previous studies have demonstrated the efficacy of rehabilitation programs for brain tumor (BT) patients and the positive impact on quality of life of functional gain, there are few studies focusing on specific rehabilitation management of brain tumor patients.With the aim to evaluate the pattern of rehabilitation care and health services utilization in patients with brain tumor, we retrospectively analyzed administrative data on a large cohort of brain tumor patients diagnosed during the period 2008-2009 in the Lazio Region. Pattern of rehabilitation care was analyzed during a follow-up of 12months after diagnosis. Data for this study were gathered and linked from two sources: (1) hospital discharge records stored into the Lazio Regional Health System database and (2) rehabilitation pathways database including inpatient and outpatient interventions files.We identified 789 patients with an ICD-9-CM code of 191.** in the Regional Health System databases in the study period. Among 719 patients included in this study, 92 (12.8%) were treated with inpatient rehabilitation program, 22 (3.1%) received an outpatient personalized program with intensive rehabilitation plan, and 85 (11.8%) received outpatients rehabilitation interventions.Our retrospective analysis on the rehabilitation service utilization in a large cohort of BT patients shows that a limited number of patients received rehabilitation interventions during the first year after diagnosis. Nevertheless, the rehabilitation needs in BT patients are largely unmet and the lack of defined physical and cognitive rehabilitation strategies may negatively affect the functional independence and the short- and long-term quality of life.

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