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Copyright of Giornale Italiano di Medicina del Lavoro ed Ergonomia is the property of Giornale Italiano di Medicina del Lavoro ed Ergonomia Editorial Board and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The Covid-19 pandemic provided new challenges and opportunities for patients and healthcare providers while accelerating the trend of digital healthcare transformation. This study explores the perspectives of healthcare professionals and managers on (i) drivers to the implementation of telemedicine services and (ii) perceived benefits and challenges related to the use of telemedicine across the Italian National Health Service., Methods: An online cross-sectional survey was distributed to professionals working within 308 healthcare organisations in different Italian regions. Quantitative and qualitative data were collected through a self-administered questionnaire (June-September 2021). Responses were analysed using summary statistics and thematic analysis., Results: Key factors driving the adoption of telemedicine have been grouped into (i) organisational drivers (reduce the virus spread-80%; enhance care quality and efficiency-61%), (ii) technological drivers (ease of use-82%; efficacy and reliability-64%; compliance with data governance regulations-64%) and (iii) regulatory drivers (regulations' semplification-84%). Nearly all respondents perceive telemedicine as useful in improving patient care (96%). The main benefits reported by respondents are shorter waiting lists, reduced Emergency Department attendance, decreased patient and clinician travel, and more frequent patient-doctor interactions. However, only 7% of respondents believe that telemedicine services are more effective than traditional care and 66% of the healthcare professionals believe that telemedicine can't completely substitute in-person visits due to challenges with physical examination and patient-doctor relationships. Other reported challenges include poor quality and interoperability of telemedicine platforms and scarce integration of telemedicine with traditional care services. Moreover, healthcare professionals believe that some groups of patients experience difficulties in accessing and using the technologies due to socio-cultural factors, technological and linguistic challenges and the absence of caregivers., Conclusions: Respondents believe that telemedicine can be useful to complement and augment traditional care. However, many challenges still need to be overcome to fully consider telemedicine a standard of care. Strategies that could help address these challenges include additional regulations on data governance and reimbursements, evidence-based guidelines for the use of telemedicine, greater integration of tools and processes, patient-centred training for clinicians, patient-facing material to assist patients in navigating virtual sessions, different language options, and greater involvement of caregivers in the care process., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The study aims at defining the factors affecting the clinicians' decision of changing or confirming the treatment options for frail patients in polytherapy, supporting prescribing patterns, thus also figuring out if the inclination of the clinicians towards digital solutions (INTERCheckWEB) and specific guidelines, could play a role in their decision. A literature review was performed, revealing the main individual, organizational and decisional factors, impacting on the clinicians' propensity to change the current patients' therapy: the clinician perceptions of support in case of clinical guidelines use or INTERCheckWEB use were studied. A qualitative approach was implemented, and thirty-five clinicians completed a questionnaire, aimed at evaluating fifteen different clinical cases, defining if they would change the patient's current therapy depending on the level of information received. Three methodological approaches were implemented. (1) Bivariate correlations to test the relationships between variables. (2) Hierarchical sequential linear regression model to define the predictors of the clinician propensity to change therapy. (3) Fuzzy Qualitative Comparative Analysis-fsQCA, to figure out the combination of variables leading to the outcome. Patient's age and autonomy (p value = 0.000), as well as clinician's perception regarding IT ease of use (p value = 0.043) and seniority (p value = 0.009), number of drugs assumed by the patients (p value = 0.000) and number of concomitant diseases (p value = 0.000) are factors influencing a potential change in the current therapy. The fsQCA-crisp confirms that the clinical conditions of the patients are the driving factors that prompt the clinicians towards a therapy change., (© 2023. The Author(s).)

Background and Aims: INTERCheckWEB is one of the most outstanding digital technologies, that could be implemented at the hospital level, supporting the clinicians in the evaluation of the therapy appropriateness, reducing the potentially inappropriate prescriptions, for the improvement of the clinical decision-making process. The paper aims at investigating the relationship between clinicians' behaviors towards digital decision support system in therapy appropriateness for elderly patients in polytherapy in medical departments, defining the factors that could influence clinicians to use INTERCheckWEB, for supporting drugs' prescription., Methods: A questionnaire was administered to 70 clinicians referring to Internal Medicine wards, of four Italian hospitals. The authors assessed how perceived usefulness, perceived ease of use, image, and output quality, would affect INTERCheckWeb intention to use. Inferential statistics, by means of a regression analysis, were conducted to define the main aspects useful to understand the factors impacting on such digital technology adoption in clinical practice., Results: The regression analysis reported that image, perceived ease of use and perceived usefulness, as well as the moderator effect of the voluntary use between the perceived usefulness and the intention to use, are the factors that most influence the use of INTERCheckWEB (adjusted R 2  = 0.870)., Conclusions: Results demonstrated that clinicians would use INTERCheckWEB, when available, to identify all the information on situations that could be dangerous for the patients, thus limiting the drug-drug interactions, optimizing the overall patient's clinical pathway. Furthermore, the implementation of INTERCheckWEB could also contribute to the proper management of COVID-19 patients, since both hospitalized and symptomatic COVID-19 patients are frequently older, with comorbidities., Competing Interests: The authors declare no conflicts of interest., (© 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

The spontaneous alignment of dipoles in patterns tangential or transversal to the interface of molecular clusters is studied by molecular dynamics simulations throughout the entire aggregation process. Tangential ordering (TANGO) is found to rely on dispersion forces driven by dipolar fluctuations. Transversal ordering (TRANSO) results from the interplay of two conditions: the broken translational invariance at the cluster interface and the interactions of multipoles of opposite parity. In this case, the orientational order parameter at the interface follows a universal scaling law behavior. In the limiting case of strongly interacting particles, a sharp structural transition from a disordered into an ordered state is observed at a critical distance inside the cluster and at a critical magnitude of the dipole moment., Competing Interests: The authors declare no competing financial interest., (Copyright © 2019 American Chemical Society.)

Stochastic formation of a bi-polar state in three dimensional arrays of polar molecules with full Coulomb interactions is reproduced by Monte Carlo simulation. The size of the system is comparable to that of a real crystal seed. The spatial decay of the average order parameter is significantly slowed down by the long range interactions and the exact representation of correlation effects in terms of a single characteristic length becomes impossible. Finite size effects and possible scale invariance symmetry of the order parameter are extensively discussed.

Best care is not necessarily the most expensive, but the most appropriate, and prevention is the most powerful tool to promote health. A novel approach might envision the reduction of hospital admittance (thus meeting a requirement from long term condition patients: they would rather not being hospitalized!) and the enforcement of peripheral (both on the territory and at home) assistance. In this direction, experiences of reshaping new service deliveries towards an integrated disease management, namely clinical pathways, can be observed in Europe and in different parts of the world. Aim of this paper is to provide a methodological guideline to support the management in planning clinical pathways, also outlining the main barriers limiting the process. In particular, we present the results of planning a clinical pathway at the Centre for Hypertension of the Federico II University Hospital (Naples, Italy). The case study showed that the introduction of a similar service impacts on the organisation of the structure. An analysis of organizational processes "as are" and the re-design of processes "to be" are necessary to integrate the clinical pathway into the actual activities.

Within our Medical Unit of Competent Doctor, in the last years we have registered growing number of workers with psychic disorders, which affect, to various degrees, their normal working activity. This fact has required from us a thorough re-consideration of the psycho-social risks related to employment in general, but also of other issues such as the topic of third parties' healthcare assistance as well as the type of role that interested operators are supposed to play in managing people affected by this type of risks. The current work shows the outcome of the survey which was conducted, highlighting the main critical aspects which have emerged in managing workers with psychic disorders.

The performed study assesses the exposure to biological liquids among health operators of Hospitals belonging to the ASL Salerno/1 in the period 2006/2008. In the following case all work injuries announced in the mentioned period were considered. Overall, 633 injuries have been analysed. Of these, 323 had significant biological risk. Collected data highlighted that professional categories mostly affected are hospital nurses and doctors, and that most injuries happened during injecting therapy and also that the most frequent injury has been caused by the noodle injection.

It is demonstrated that the moments R(2k) of the end-to-end distance distribution function f(r) of charged wormlike chains with excluded volume effects in solution with added salt, in the Debye-Huckel approximation, obey a remarkably simple relation. It is shown that the R(2k) can be expressed as weighted sums of the corresponding moments of ideal wormlike chains. As an application of this method, we show that the Fourier transform of f(r) can also be represented by a superposition of distribution functions of ideal chains. The quantities so calculated are compared with the results of Monte Carlo simulations. Excellent agreement between them is observed., ((c) 2004 American Institute of Physics.)

We present a systematic Monte Carlo study of the scattering function S(q) of semiflexible polyelectrolytes at infinite dilution, in solutions with different concentrations of added salt. In the spirit of a theoretical description of polyelectrolytes in terms of the equivalent parameters, namely, persistence length and excluded volume interactions, we used a modified wormlike chain model, in which the monomers are represented by charged hard spheres placed at distance a. The electrostatic interactions are approximated by a Debye-Huckel potential. We show that the scattering function is quantitatively described by that of uncharged wormlike chains with excluded volume effects provided that an electrostatic contribution is added to the persistence length. In addition we have studied the expansion of the radius of gyration and of the end-to-end distance. The results are in agreement with the picture outlined in the Odijk-Skolnick-Fixman theory, in which the behavior of charged polymers is described only in terms of increasing local rigidity and excluded volume effects. Moreover, the Monte Carlo data are found to be in very good agreement with experimental scattering measurements with equilibrium polyelectrolytes, i.e., giant wormlike micelles formed in mixtures of nonionic and ionic surfactants in dilute aqueous solution, with added salt.

The relative stabilities of soluble and membrane proteins were examined in growing Escherichia coli cells. In contrast to mammalian cells, we found no correlations between the isoelectric points or molecular weights of E. coli proteins and their degradative rates. The soluble proteins with short half-lives tended to be degraded preferentially in vitro by trypsin or chymotrypsin. The stability of membrane proteins in vivo was correlated with in vitro sensitivity to chymotrypsin but not to trypsin. In the total membrane fraction, endogenous proteolytic activity varied with growth conditions. This activity was inhibited by o-phenanthroline, EDTA and dithiothreitol suggesting that one or more metallo-proteinases were present. Membrane proteinase activity was also inhibited by phenethyl alcohol, a membrane perturbant. The abundance of the membrane proteins that were most labile in vivo was dependent on growth conditions. The most labile protein accumulated in the outer membrane with an inverse relationship to growth rate.