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To address the growing concerns over poor mental health experienced by adults with intellectual disabilities due to the COVID-19 pandemic, a national virtual mental health course was delivered and evaluated.This mixed methods study utilized both qualitative and quantitative assessments. Participants were 27 adults with intellectual disabilities who participated in the 6-week course. Participants completed measures of self-efficacy and well-being at three time points and qualitative satisfaction measures at post and follow-up.Attendance was high and the course was feasible and acceptable to participants. Positive changes related to mental health self-efficacy were detected (p = .01), though mental well-being did not improve.The study provided evidence for the feasibility and value of the course for this population. Future research should examine how virtual courses could support the population in terms of pandemic recovery and how courses may work for individuals who are less independent.

There is little research with people who experience intellectual/developmental disabilities and imprisonment.The study linked health and correctional data to examine prevalence of intellectual/developmental disabilities and health and correctional characteristics among adults experiencing their first federal incarceration between 1 January 2002 and 31 December 2011 (n = 9278) and two non-incarcerated groups (n = 10,086,802).The prevalence of intellectual/developmental disabilities was 2.1% in the incarcerated group and 0.9% in the non-incarcerated group. Before incarceration, those with, versus without, intellectual/developmental disabilities were at greater risk of traumatic brain injury, mental illness, and substance use disorders. While incarcerated, those with intellectual/developmental disabilities were more likely to incur serious institutional disciplinary charges. Post-incarceration, persons with intellectual/developmental disabilities were at greater risk of emergency department visits, and psychiatric and acute hospitalizations, than the non-incarcerated groups.People with intellectual/developmental disabilities are overrepresented in Canadian federal correctional institutions. The authors offer strategies to support people prior to, during, and post-incarceration.

Direct support professionals (DSP) are instrumental in supporting the health care of individuals with intellectual disabilities, yet receive little training and support for this role. We implemented a capacity building intervention for DSPs in a community agency in Ontario, Canada. This study evaluated the perceived value and feasibility of the intervention and the value of a structured implementation approach.The intervention included communication tools, a health resource toolkit, and training. A mixed methods evaluation was used to collect feedback from DSPs and people with intellectual disabilities.Participants generally found the intervention valuable and feasible. Although practice change is difficult, extensive engagement and being responsive to feedback were helpful strategies. The primary concern reported by DSPs was resistance from health care providers.An important next step is to engage health care providers to ensure the tools are valuable and feasible for everyone involved in the health encounter.

Introduction: COVID-19 has adversely impacted the health and wellbeing of people with intellectual and developmental disabilities (IDD). While there is emerging research examining how to support th...

BackgroundIntellectual and developmental disabilities (IDDs) and psychiatric disorders frequently co-occur. Although each has been associated with negative outcomes, their combined effect has rarely been studied.AimsTo examine the likelihood of five negative health and healthcare outcomes for adults with IDD and mental health/addiction disorders (MHAs), both separately and together. For each outcome, demographic, clinical and system-level factors were also examined.MethodLinked administrative data-sets were used to identify adults in Ontario, Canada, with IDD and MHA (n = 29 476), IDD-only (n = 35 223) and MHA-only (n = 727 591). Five outcomes (30-day readmission, 30-day repeat ED visit, delayed discharge, long-term care admission and premature mortality) were examined by logistic regression models with generalised estimating equation or survival analyses. For each outcome, crude (disorder groups only) and complete (adding biosocial covariates) models were run using a general population reference group.ResultsThe IDD and MHA group had the highest proportions across outcomes for both crude and complete models. They had the highest adjusted ratios for readmissions (aOR 1.93, 95%CI 1.88–1.99), repeat ED visit (aOR 2.00, 95%CI 1.98–2.02) and long-term care admission (aHR 12.19, 95%CI 10.84–13.71). For delayed discharge, the IDD and MHA and IDD-only groups had similar results (aOR 2.00 (95%CI 1.90–2.11) and 2.21 (95%CI 2.07–2.36). For premature mortality, the adjusted ratios were similar for all groups.ConclusionsPoorer outcomes for adults with IDD, particularly those with MHA, suggest a need for a comprehensive, system-wide approach spanning health, disability and social support.

Background Data on the prevalence of developmental disabilities in people who experience imprisonment and on their characteristics are lacking. Methods The present authors identified adults with developmental disabilities who were released from Ontario provincial prisons in 2010 and a general population comparator group using administrative data. The present authors examined demographic characteristics, morbidity and healthcare use. Results The prevalence of developmental disabilities was 2.2% in the prison group (N = 52,302) and 0.7% in the general population (N = 10,466,847). The prevalence of psychotic illness, substance-related disorder and self-harm was higher among people in the prison group with developmental disabilities. People with developmental disabilities were more likely to have emergency department visits and hospitalizations in prison and in the year after release. Conclusions People with developmental disabilities are overrepresented in provincial prisons and have a high burden of disease. Strategies are indicated to prevent incarceration and to improve health.

Adults with developmental disabilities have increased rates of mental illness and addiction, in addition to being more likely to experience physical health issues. This can lead to high rates of hospital and community-based healthcare. Population-based administrative health data can help in identifying the extent of problems experienced and target areas for policy and practice changes.

Family support is a core component of the Early Psychosis Intervention (EPI) model, yet it continues to have relatively low rates of implementation in practice. This paper reports results of a literature review on facilitators and barriers to delivering family interventions in EPI programmes. A search was conducted of 4 electronic databases, Medline, EMBASE, PsycINFO and Joanna Briggs, from 2000 to 2015 using terms related to early onset psychosis, family work and implementation. Four thousand four hundred and two unique studies were identified, 7 of which met inclusion criteria. Barriers and facilitators were coded and aggregated to higher-level themes using a consensus approach. Five of 7 studies examined structured multifamily psychoeducation. Uptake by families was affected by: family/client interest and readiness to participate; ability to access supports; and support needs/preferences. Implementation by programmes was affected by staff access to training and resources to provide family support. A key finding across the identified studies was that families have different needs and preferences regarding the timing, length, intensity and content of the intervention. One size does not fit all and many families do not require the intensive psychoeducational programmes typically provided. The reviewed literature suggests that flexible, tiered approaches to care may better meet family needs and increase rates of uptake of family support. However, more research is needed on the effectiveness of different models of family support in early psychosis and how they can be successfully implemented.

Seeking to understand factors affecting innovation diffusion, research has increasingly focused on process, actors and activities. After two decades of research, however, a systematisation of these three sets of studies is still lacking. Thus, this paper contributes to the existing literature providing a comprehensive framework of factors affecting innovation diffusion between organisations. Specifically it evidences phases of innovation diffusion process, clarifies the role of innovator, adopters and intermediaries and evidences actions that policy-makers can implement to support it.

The innovative activity of firms has been linked to the introduction of a new product or process associated with the development or application of new technological knowledge. New products generally contain innovative techniques that increase the quality of goods. New processes are based on the use of new technologies to increase the efficiency of production. However, the exclusive link between technology and innovation has been criticized for various reasons. It provides a restrictive vision considering innovation as part of the manufacturing and services sectors. Innovation in firms affects not only the development and application of new technologies but also the adoption and the reorganization of business processes, internal organization, external relations, and marketing. The literature in the field of management emphasizes the importance of integrating product, process, and organization to translate new ideas into market success. Thus, to obtain a complete picture of the innovative efforts of firms in the agrofood industry, the concept of innovation has been extended to both technological and nontechnological innovations. This analysis provided evidence of innovations used by agro-food firms. It also identified latent demand for future innovation.

As mental health (MH) care has shifted from institutional settings to the community, families and friends are responsible for providing the majority of the care at home. The substantial literature on the adverse effects experienced by caregivers has focused mainly on psychological morbidity. Less attention has been paid to how caregivers for persons with MH disorders interact with larger social systems and the impacts of factors such as financial strain, lost time from leisure activities, and the availability of health and social services. We conducted a scoping review of MH and other caregiver questionnaires published between 1990 and 2016 to determine whether they addressed four key domains: caregiver work demands, resource needs, resource utilisation and costs. A range of health and social care databases were searched, including MEDLINE and Health and Psychosocial Instruments. After screening for relevance and quality, our search identified 14 instruments addressing elements related to one or more of our domains. Because these instruments covered only a small portion of our domains, we conducted a second targeted search of the general care-giving literature and consulted with experts, identifying an additional 18 instruments. A total of 32 questionnaires were reviewed, 14 specific to care-giving for mental health problems and 18 for other health conditions. Our search identified instruments or items within instruments that assess constructs in each of our domains, but no one instrument covered them completely. Additionally, some constructs were evaluated in detail and others only addressed by single items. While these instruments are helpful for moving measurement beyond the psychological impacts of care-giving, our results serve only as an initial guide. Additional methodological work is needed to more comprehensively measure the impact of care-giving for individuals with MH disorders and to contribute to the development of more meaningful and effective policies and programmes.

Purpose – Italy is traditionally one of Egypt’s main trading partners, ranking first both as import and export partner. However, Italian firms face several cultural problems in Egypt. The purpose of this paper is to investigate the impact of cross-cultural differences faced by Italian firms’ operating in Egypt. The investigation of cross-cultural differences is facilitated by the examination of interaction between Italian and Egyptian culture using Hofstede and GLOBE’s cultural attributes and dimensions. Design/methodology/approach – The qualitative analysis has been conducted through face to face interviews of individuals working for Italian firms operating in Egypt. These interviews were structured to specifically identify the impact of cultural differences on the interaction between Italian and Egyptian firms. Findings – The results show that Italy is one of the most important commercial partners of Egypt. However, cultural diversity results in Italian small and medium enterprises facing risks when operating in Egypt. Cultural distance is a problem for Italian firms investing in Egypt. Thus, interaction between Italian and Egyptian firms requires a common understanding of cultural diversity. Italian firms must develop an understanding of Egyptian culture if they are to avoid cultural clash. Egyptian policy-makers must adopt policies that open national culture to international interactions. Research limitations/implications – The paper is based on a sub-set of the cultural attributes identified in Hofstede and GLOBE’s study. The results presented in this paper may be complimented through a future quantitative analysis, evaluating the relationship between religious values and other cultural dimensions. Originality/value – This paper provides an insight into the interaction between Italian and Egyptian culture. It contributes to the extant literature by filling a gap in the existing literature on cross-cultural diversity and interaction between Europe and Middle East.

Purpose – Existing work documents the role that institutional setting plays in the process of spin-off creation. However, despite decades of studies, scholars have not clearly explained why some regions are more involved in spin-off activity than others. Drawing from institutional theory, the purpose of this paper is to compare different institutional settings identifying factors affecting the general environment capability to support spin-off activity of a specific region. Design/methodology/approach – The authors utilize a cross-national analysis of American, Asian, and European areas identifying factors affecting their different rate of spin-off activity. This study contributes to the policy debate concerning entrepreneurship and how best to spur spin-off activities. Findings – In this paper, the authors identify the general and specific factors that explain the cross-national diversity in spin-off creation. The authors then perform an analysis of the impact of these factors in various regions of the USA, Asia, and Europe, providing evidence for the necessity of specific combinations of these factors. Originality/value – The paper offers a new perspective on the causes of spin-offs through a cross-national analysis of many areas around the world.

Purpose – The purpose of this paper is to offer a new perspective on innovation in agro-food industry. Innovations in the agro-food industry depend on multiple forces interacting with each other under specific rules to create new ways to deal with social or economic processes. The relevance of this topic for the whole economy leads the authors to investigate main drivers of innovation in agro-food system. Design/methodology/approach – The authors provide a framework that considers the role of policies, actors and activities for innovation in the agro-food industry and tests its validity on the Campanian tomato sub-system. Findings – The authors’ framework applied to Campanian tomato sub-system shows the role of institutions, actors and activities in promoting innovation in agro-food system. Originality/value – The paper offers a new perspective on innovation in agro-food industry.

Importance of the agro-food industry in Italy and in Campania led us to investigate industry structure and small and medium enterprises' (SMEs) strategies for competing in the global scenario. We first analyzed the relevance of the Campanian agro-food system. Then we presented the results of face-to-face interviews to some SMEs. Through the interviews, we highlighted the SME value chain structures and their strategies to face global challenges. Most of the Campanian SMEs internationalize their activity by exporting their products abroad. Firms export in markets oriented to a high level of product quality--the main factor of Campanian agro-food SMEs' competitive advantage

Purpose– There is evidence for major positive effects of knowledge transfer and innovation diffusion on economic growth. Much research has addressed schooling, training, and other aspects of human capital accumulation, but less emphasis has been placed on the interaction between firms and other organizations as a key driver of the development of new knowledge and its economic use. There is an extensive body of literature that discusses various aspects of knowledge transfer and innovation diffusion between firms, and this literature may serve as a microfoundation for understanding the role of knowledge in the growth process. However, we need to understand the role of the entrepreneur as a missing link between knowledge and innovation. The purpose of this paper is to outline some foundations of endogenous (externally driven) growth models, and uses the knowledge spillover theory of entrepreneurship to propose a new model of latent and emergent entrepreneurship.Design/methodology/approach– The paper uses the method of conceptual analysis to structure the literature and its assumptions. The authors review in broad terms what we know in the space of knowledge and growth, and what we still need to know. The authors curate informed views on the topic of knowledge and the way that entrepreneurs contribute to innovation diffusion.Findings– The paper develops a new perspective on knowledge. Starting from the role of knowledge as a core element in the microfoundations of endogenous growth models, it uses the knowledge spillover theory of entrepreneurship to propose a new model of latent and emergent entrepreneurship.Practical implications– The paper uses knowledge spillover theory to lay out a more complete and more realistic process through which knowledge gets converted into realized innovations, and as such, it makes the intervention points through which people management can facilitate organizational effectiveness through innovation more transparent.Originality/value– The paper provides guidance for future researchers on knowledge and innovation diffusion. It encourages innovation in our thinking about the role of knowledge, and allows scholars to combine perspectives more flexibly both across levels of analysis (macro and micro), and across disciplines (economy and management).

Aim: To identify factors that contribute to the initiation of alcohol and street drug use from the perspective of people who were enrolled in early intervention programmes for a first episode of psychosis. Method: Eight focus groups were conducted involving an average of four to six participants per group, with each group consisting of young people who met provincial inclusion criteria for early intervention programmes. Thematic analysis was used to systematically code transcripts from the focus groups for concepts, patterns and themes related to early use of illicit substances. Results: Participants included 45 young people diagnosed with affective psychosis or non-affective spectrum disorders. Seventy-three per cent were male, with a median age of 23 years. In general, substance use was an important topic that emerged across all focus groups. Participants talked about three main factors attracting them to initiate use of substances, most predominantly cannabis: (i) using within a social context; (ii) using as a self-medication strategy; and (iii) using to alter their perceptions. Conclusions: The need for social relationships, coping strategies and pleasurable experiences appear to be important reasons for initiating substance use. Additional research is needed to identify whether prodromal youth report the same factors that attract them to initiate use in order to develop more effective prevention strategies.

Aim: This paper aims to identify the ways in which youth at ultra high risk for psychosis access mental health services and the factors that advance or delay help seeking, using the Revised Network Episode Model (REV NEM) of mental health care. Methods: A case study approach documents help-seeking pathways, encompassing two qualitative interviews with 10 young people and 29 significant others. Theoretical propositions derived from the REV NEM are explored, consisting of the content, structure and function of the: (i) family; (ii) community and school; and (iii) treatment system. Results: Although the aspects of the REV NEM are supported and shape pathways to care, we consider rethinking the model for help seeking with youth at ultra high risk for psychosis.

Live interactive videoconferencing and other technologies offer innovative opportunities for effective delivery of specialized child and adolescent mental health services. In this article, an example of a comprehensive telepsychiatry program is presented to highlight a variety of capacity-building initiatives that are responsive to community needs and cultures; these initiatives are allowing children, youth and caregivers to access otherwise-distant specialist services within their home communities. Committed, enthusiastic champions, adequate funding and infrastructure, creativity and a positive attitude represent key elements in the adaptation of this demonstrated user-friendly modality.

Young people with psychological or psychiatric problems are managed largely by primary care practitioners, many of whom feel inadequately trained, ill equipped, and uncomfortable with this responsibility. Accessing specialist pediatric and psychological services, often located in and near large urban centers, is a particular challenge for rural and remote communities. Live interactive videoconferencing technology (telepsychiatry) presents innovative opportunities to bridge these service gaps. The TeleLink Mental Health Program at The Hospital for Sick Children in Toronto offers a comprehensive, collaborative model of enhancing local community systems of care in rural and remote Ontario using videoconferencing. With a focus on clinical consultation, collaborative care, education and training, evaluation, and research, ready access to pediatric psychiatrists and other specialist mental health service providers can effectively extend the boundaries of the medical home. Medical trainees in urban teaching centers are also expanding their knowledge of and comfort level with rural mental health issues, various complementary service models, and the potentials of videoconferencing in providing psychiatric and psychological services. Committed and enthusiastic champions, a positive attitude, creativity, and flexibility are a few of the necessary attributes ensuring viability and integration of telemental health programs.

This article provides a theoretical review of treatment adherence for children and youth with psychiatric disorders where pharmacological agents are first-line interventions. Four empirically based models of health behavior are reviewed and applied to the sparse literature about medication adherence for children with attention-deficit/hyperactivity disorder and young people with first-episode psychosis. Three qualitative studies of medication use are summarized, and details from the first-person narratives are used to illustrate the theoretical models. These studies indicate, when taken together, that the clinical approach to addressing poor medication adherence in children and youth with psychiatric disorders should be guided by more than one theoretical model. Mental health experts should clarify beliefs, address misconceptions, and support exploration of alternative treatment options unless contraindicated. Recognizing the larger context of the family, allowing time for parents and children to change their attitudes, and offering opportunities for easy access to medication in the future are important ways of respecting patient preferences, while steering them toward best-evidence interventions. Future research using qualitative methods of inquiry to investigate parent, child, and youth experiences of mental health interventions should identify effective ways to improve treatment adherence.

Primary data are rarely used explicitly as a source of data outside of the original research purpose for which they were collected. As a result, qualitative secondary analysis (QSA) has been described as an "invisible enterprise" for which there is a "notable silence" amongst the qualitative research community. In this paper, we report on the methodological implications of conducting a secondary analysis of qualitative data focusing on parents' narratives of help-seeking activities in the prodrome to psychosis. We review the literature on QSA, highlighting the main characteristics of the approach, and discuss issues and challenges encountered in conducting a secondary analysis. We conclude with some thoughts on the implications for conducting a QSA in children's mental health services and research.

Nel lavoro si analizza il rapporto tra l’efficacia dei progetti di Civic Crowdfunding e l’attrattivita del territorio. L’indagine, condotta attraverso lo studio di due importanti piattaforme di Civic Crowdfunding, e stata effettuata attraverso un’analisi statistica di regressione lineare e multivariata OLS. Si e cosi verificato, su un campione di 144 progetti di Civic Crowdfunding, la presenza di una correlazione positiva tra l’efficacia dei progetti e l’attrattivita del territorio, da un lato, ed il numero dei finanziatori, dall’altro. Sembra emergere, invece, una correlazione negativa con il numero dei progetti presentati. Il lavoro mostra l’importanza e la valenza del territorio attraverso la risposta data dai finanziatori aderendo ai progetti di Civic Crowdfuding, a dimostrazione dell’importanza che va assumendo questa particolare tipologia di investimento per lo sviluppo sostenibile del territorio, in linea con la tendenza, da parte dei cittadini, ad esprimere una maggiore volonta di partecipazione alla costruzione di citta e territori migliori.

Context: There is insuffi cient literature documenting the mental health experiences and needs of rural communities, and a lack of focus on children in particular. This is of concern given that up to 20% of children and youth suffer from a diagnosable mental health problem. Purpose: This study examines issues of access to mental health care for children and youth in rural communities from the family perspective. Methods: In-depth interviews were conducted in rural Ontario, Canada, with 30 parents of children aged 3-17 who had been diagnosed with emotional and behavioral disorders. Findings: Interview data indicate 3 overall thematic areas that describe the main barriers and facilitators to care. These include personal, systemic, and environmental factors. Family members are constantly negotiating ongoing tension, struggle, and contradiction vis-a-vis their attempts to access and provide mental health care. Most factors identifi ed as barriers are also, under different circumstances, facilitators. Analysis clustered around the contrasts, contradictions, and paradoxes present throughout the interviews. Conclusions: The route to mental health care for children in rural communities is complex, dynamic, and nonlinear, with multiple roadblocks. Although faced with multiple roadblocks, there are also several factors that help minimize these barriers.

Many recent grant initiatives have mandated coalition building as a key component of their health promotion efforts. Health service leaders are increasingly representing their organizations on coalitions and need to better understand the complexities involved in their creation and management. In this paper we focus on the implementation of a community–academic alliance using an ethnographic approach involving participant observation and in-depth interviews. Analysis of the data revealed five essential dimensions to be considered in the development of successful community–academic alliances: membership, structure, leadership, communication, and funding. Within each of these areas, facilitators and barriers to successful coalition building were identified. While these areas are not new, obtaining the perspective of coalition members directly adds to our understanding of the member experience in the process of implementing such initiatives. This example of a community–academic collaboration presents one model of how to minimize the distance between research and service and move toward a partnership between these two worlds. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 357–374, 2004.

BACKGROUND The concept of motivation involves a complex interplay of biopsychosocial and environmental determinants. For individuals diagnosed with schizophrenia, motivation has traditionally been approached from a neuro-biological standpoint, obscuring this complexity. The findings from this study underscore the importance of broadening our understanding of motivation and schizophrenia through an exploration of individual perspectives and identification of the psychosocial factors that clarify the experience of diminished motivation.

Background Young adolescents’ and their parents’ experiences with Attention-Deficit/Hyperactivity Disorder (ADHD) and its treatment were explored to investigate beliefs and attitudes regarding use of stimulant medication, and their influence on treatment decisions. Methods Using in-depth qualitative interviews, 12 adolescents with ADHD aged 12 – 15 years, and their parents described their experiences of ADHD and its treatment. Twenty four interviews, 12 with adolescents and 12 with their parents elicited detailed descriptions of beliefs about ADHD, attitudes about stimulant use and the circumstances surrounding treatment decisions. Verbatim transcripts were iteratively analyzed by a team of researchers following an interpretive interactionist framework. Results Young people offered three themes describing ADHD: 1) personality trait, 2) physical condition or disorder, and 3) minor issue or concern. Regarding medication use, youth described 1) benefits, 2) changes in sense of self, 3) adverse effects, and 4) desire to discontinue use. Parents’ beliefs were more homogeneous than youth beliefs, describing ADHD as a disorder requiring treatment. Most parents noted benefits from stimulant use. Themes were 1) medication as a last resort, 2) allowing the child to reach his or her potential; and 3) concerns about adverse and long-term effects. Families described how responsibility for treatment decisions is transferred from parent to adolescent over time. Conclusions Young adolescents can have different beliefs about ADHD and attitudes about medication use from their parents. These beliefs and attitudes influence treatment adherence. Incorporating input from young adolescents when making clinical decisions could potentially improve continuity of treatment for youth with ADHD.

Il presente rapporto ha lo scopo di delineare le caratteristiche strutturali, organizzative e di performance del sistema Agro-alimentare della Campania e di alcune delle principali filiere agro-alimentari che lo caratterizzano, al fine di individuare azioni che possano sfruttare appieno l'indiscussa immagine e riconoscibilità del Food Made In Italy nel mondo. In particolare, si è proceduto all'identificazione e all'analisi delle principali filiere Agroalimentari che connotano la Campania, attuando quindi, il passaggio da un'analisi condotta ad un livello territoriale aggregato (analisi di settore a livello regionale) ad un'analisi focalizzata su specifiche aree territoriali e pertanto spinta ad un livello di approfondimento e disaggregazione più elevato. Una filiera può essere infatti definita come insieme di agenti (imprese ed amministrazioni), di operazioni (di produzione, di distribuzione, di finanziamento) e di meccanismi di regolazione che concorrono alla formazione ed al trasferimento di un prodotto (o di un gruppo di prodotti) allo stadio finale di utilizzazione. Il concetto di filiera, nell'ambito alimentare, diventa una sorta di percorso dal campo alla tavola del prodotto alimentare: dalla produzione della materia prima, passando per la prima commercializzazione e la trasformazione, fino alla distribuzione all'ingrosso e al dettaglio. Dal punto di vista metodologico, l'analisi di filiera, si basa su un vero e proprio "sezionamento" verticale dei processi produttivi identificando, per ogni prodotto, tutte le attività tecniche ed economiche che intervengono nella fabbricazione di un prodotto alimentare fino alla sua commercializzazione. L'analisi delle operazioni realizzate lungo la catena di trasformazione del prodotto permette, altresì, di evidenziare l'aggregazione progressiva di valore che si forma ad ogni passaggio. Il quadro di riferimento e di studio delimitato dalla nozione di filiera diventa, di conseguenza, l'ambito privilegiato per l'analisi dei fenomeni d'interdipendenza e d'integrazione che caratterizzano tutta l'attività agroalimentare. La metodologia di analisi della filiera ha avuto l'obiettivo di evidenziare: 1. Rilevanza socioeconomica: peso economico, occupazionale e produttivo rivestito dalla filiera campana oggetto di studio (es. vitivinicolo campano), rispetto all'intera filiera italiana di riferimento e rispetto al complessivo agroalimentare campano, in termini di PIL, fatturato, occupazione, export e numero di imprese. 2. Struttura produttiva e mercato. In questa fase, è stata ricostruita e descritta la struttura produttiva che compone la filiera con dettaglio per singola fase. Nello specifico, per la fase agricola verranno considerati: numero di imprese attive, SAU/numero di capi, dimensione media delle imprese agricole, valore della produzione, valore aggiunto, scambi con l'estero (quota di produzione esportata, importazioni, esportazioni, saldo della bilancio commerciale, principali paesi di provenienza/sbocco). Per la parte industriale sono stai invece considerati: numero di imprese attive, dimensione media delle imprese, fatturato, valore aggiunto, numero di occupati, scambi con l'estero (quota di produzione esportata, esportazioni, saldo della bilancio commerciale, principali paesi di provenienza/ sbocco). 3. Relazioni di filiera. Sono state raccolte ed analizzate informazioni sul livello di integrazione verticale della stessa, mediante l'analisi delle modalità e dei canali di vendita delle aziende, la diffusione e la rilevanza della cooperazione regionale e di altre forme aggregative come le organizzazione di produttori. 4. Le innovazione di filiera. Non esistono dati statistici in grado di descrivere le innovazioni delle filiere agroalimentari in Campania, anche in conseguenza l'estrema polverizzazione dell'offerta produttiva e ridotta dimensione delle imprese. Pertanto, è stata realizzata una review dei principali contributi presenti in letteratura relativi all'innovazione di prodotto, processo, organizzativa e di marketing, per ciascuna filiera oggetto di studio. Numerose sono state le fonti statistiche necessarie per condurre la nostra indagine: Nomisma, Ismea, INEA, ISTAT, EUROSTAT, ICE, IPI, CNEL, Commissione Europea, l'Autorità Garante per la Concorrenza ed il Mercato, Ministero dello Sviluppo Economico, gli Assessorati regionali e provinciali alle Attività produttive e ai Trasporti, gli Enti camerali, le Associazioni di categoria e le Agenzie di sviluppo locale. I dati e le informazioni raccolte, sono stati rielaborati al fine di individuare in via preliminare punti in comune e differenze funzionali, operative e relazionali delle diverse filiere studiate. L'assenza di dati aggregati a livello regionale e di filiera sull'innovazione, ha richiesto la progettazione di una specifica indagine empirica a livello di supply chain che verrà condotta nell'attività 1.3 del progetto e sarà orientata allo studio dei rapporti collaborativi tra l'impresa focale, fornitori e clienti al fine di migliorare la sostenibilità, e la capacità di innovazione, dell'impresa e di tutta la catena. Nella parte finale, sono state definite alcune azione per il recupero di competitività delle filiere agroalimentari della Campania.

Purpose – The purpose of this study is to analyze Italian system of innovation and evidence factors that can affect its global competitiveness. Design/methodology/approach – The article provides a conceptual analysis of main factors of competitiveness of an innovation system and an empirical discussion of Italian case. Findings – The article evidences main factors affect Italian systems of innovation that both researchers and practitioners can use in their activities. Originality/value – The article offers a new perspective on innovation systems.

To examine the factors influencing medical students to choose child and adolescent psychiatry as a career specialty.Quantitative and qualitative methods were used. A web-based survey was distributed to child and adolescent psychiatrists at the University of Toronto. In-depth interviews were held with select child and adolescent psychiatrists as well as a focus group with psychiatry residents. Retrospective accounts of the factors that influenced their decision to choose psychiatry and/or child and adolescent psychiatry as a specialty were collected.Ninety-two percent of participants indicated that recruitment of child psychiatrists in Canada is a problem. The recent decision by the Royal College of Physicians and Surgeons to recognize child and adolescent psychiatry as a subspecialty and introduce an extra year of training was identified as a further challenge to recruitment efforts. Other deterrents included lower salary than other subspecialties, lack of exposure during training, stigma, and lack of interest in treating children. Recruitment into psychiatry was enhanced by good role modeling, early exposure in medical school, an interest in brain research, and career and lifestyle issues.A rebranding of the role and perception of psychiatry is needed to attract future psychiatrists. Early exposure to innovations in child and adolescent psychiatry and positive role models are critical in attracting medical students. Recruitment should begin in the first year of medical school and include an enriched paediatric curriculum.Examiner les facteurs qui influencent le choix des étudiants en médecine d’une carrière de spécialité en psychiatrie de l’enfant et de l’adolescent.Des méthodes quantitatives et qualitatives ont été utilisées. Un sondage en ligne a été distribué aux pédopsychiatres de l’Université de Toronto. Des entrevues de fond ont été menées avec des pédopsychiatres sélectionnés ainsi qu’avec un groupe de discussion formé de résidents en psychiatrie. Des comptes rendus rétrospectifs des facteurs qui ont influencé leur décision de choisir la psychiatrie et/ou la psychiatrie de l’enfant et de l’adolescent comme spécialité ont été recueillis.Quatre-vingt-douze pour cent des participants ont indiqué que le recrutement de pédopsychiatres au Canada est problématique. La décision récente du Collège royal des médecins et chirurgiens du Canada de reconnaître la pédopsychiatrie comme surspécialité et d’ajouter une autre année de formation a été identifiée comme étant un défi additionnel pour les initiatives de recrutement. D’autres éléments dissuasifs étaient notamment le salaire plus faible que celui des autres surspécialités, l’absence d’exposition durant la formation, les stigmates, et le manque d’intérêt à traiter des enfants. Le recrutement en psychiatrie bénéficiait de bons modèles de rôle, d’une exposition précoce à la faculté de médecine, d’un intérêt pour la recherche sur le cerveau, et d’enjeux de carrière et de mode de vie.Il faut redonner une nouvelle image du rôle et de la perception de la psychiatrie pour attirer de futurs psychiatres. L’exposition précoce aux innovations de la pédopsychiatrie et aux modèles de rôle positifs est essentielle pour attirer les étudiants en médecine. Le recrutement devrait débuter en première année de la faculté de médecine et comprendre un programme d’études enrichi.

To identify factors that contribute to the initiation of alcohol and street drug use from the perspective of people who were enrolled in early intervention programmes for a first episode of psychosis.Eight focus groups were conducted involving an average of four to six participants per group, with each group consisting of young people who met provincial inclusion criteria for early intervention programmes. Thematic analysis was used to systematically code transcripts from the focus groups for concepts, patterns and themes related to early use of illicit substances.Participants included 45 young people diagnosed with affective psychosis or non-affective spectrum disorders. Seventy-three percent were male, with a median age of 23 years. In general, substance use was an important topic that emerged across all focus groups. Participants talked about three main factors attracting them to initiate use of substances, most predominantly cannabis: (i) using within a social context; (ii) using as a self-medication strategy; and (iii) using to alter their perceptions.The need for social relationships, coping strategies and pleasurable experiences appear to be important reasons for initiating substance use. Additional research is needed to identify whether prodromal youth report the same factors that attract them to initiate use in order to develop more effective prevention strategies.

This paper aims to identify the ways in which youth at ultra high risk for psychosis access mental health services and the factors that advance or delay help seeking, using the Revised Network Episode Model (REV NEM) of mental health care.A case study approach documents help-seeking pathways, encompassing two qualitative interviews with 10 young people and 29 significant others. Theoretical propositions derived from the REV NEM are explored, consisting of the content, structure and function of the: (i) family; (ii) community and school; and (iii) treatment system.Although the aspects of the REV NEM are supported and shape pathways to care, we consider rethinking the model for help seeking with youth at ultra high risk for psychosis.The pathway concept is important to our understanding of how services and supports are received and experienced over time. Understanding this process and the strategies that support positive early intervention on the part of youth and significant others is critical.

Le organizzazioni sanitarie, per effetto del mutamento degli assetti competitivi e della accelerazione dell'evoluzione tecnologica, sono chiamate a confrontarsi con le problematiche di progettazione e di regolazione. Assumere come prospettiva di analisi delle condizioni di funzionamento dei sistemi e delle organizzazioni sanitarie quella fornita dall'Organizzazione aziendale, significa cogliere le specificità di funzionamento di queste strutture e proporre uno schema interpretativo utile a migliorare i processi di tutela della salute e a orientare l'azione di coloro che hanno la responsabilità di guidare sistemi e organizzazioni della sanità verso il conseguimento dei fini istituzionali.

Although a great deal has been written about the potential for telemedicine to increase access to care, applications in paediatrics are sparse. This chapter details how one paediatric telepsychiatry program has facilitated the creation of integrated healthcare solutions in patient psychiatric care for children and youth in remote and rural communities. It demonstrates how the telepsychiatry model of healthcare service delivery has improved access, enhanced capacity, and promoted knowledge exchange in rural communities. A case study is used to highlight theoretical and empirical research on the value of televideo information technology in mental healthcare and its impact on the healthcare stakeholders who utilize this technology. An overview of the clinical, education, and evaluation components of the program is outlined, with a focus on knowledge translation and exchange as the underpinning foundation to the success of the program.