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This brief paper is intended to be a quick guide to prescribe biologics in severe asthma by following Global Initiative for Asthma (GINA) guidelines but also considering the author’s personal opinions. The paper starts with the identification of candidates for biologic therapy examining next the biological markers to be taken into account for the phenotyping of inflammation. Finally, it indicates the type of biologic to be chosen. This guide also points out the possible signals that can allow us to identify patients with severe asthma that would otherwise be ignored. Furthermore, it tries to give some directions on how to proceed in order to select the right biologic in the cases where the overlapping of different phenotypes can be found or in non-T2 asthma. [ABSTRACT FROM AUTHOR]

In this short document we propose an update on the latest AACC 2023 standards for the diagnosis and monitoring of diabetes at the laboratory level. In particular we will focus on some recommendations expressed in relation to the measurement of blood glucose, both with laboratory methods and through systems for continuous blood glucose monitoring, on the measurement of glycated hemoglobin and other glycated proteins, in particular glycated albumin. Some statements relating to the diagnosis of gestational diabetes, the measurement of ketone bodies, autoantibodies and C-peptide will also be considered. Particular attention is given to the quantitative measurement of albumin in urine. [ABSTRACT FROM AUTHOR]

The Consensus Conference on Psychological Therapies for Anxiety and Depression has concluded its work and published the final document. Clinicians, researchers, public health specialists and users met to formulate questions about efficacy, effectiveness, appropriateness of treatment and access to care for anxiety and depression, and to consider the role of psychological therapies. Four expert groups collected information on the role and efficacy of psychological therapies in common mental disorders (CMDs), guidelines, patient assessment according to levels of symptom severity matched to corresponding levels of treatment intensity, knowledge and skills to be provided by university psychological and medical courses, and on initiatives to raise awareness among potential users and decision-makers. On the basis of the experts' report, a jury chaired by Silvio Garattini formulated a set of recommendations: some models of psychological therapy are supported by research that demonstrates an efficacy at least equal to the drugs used in CMDs; these therapies are underrepresented in the Italian public health system, leading many people to resort to the private sector, resulting in unacceptable wealth discrimination; the difficulty of accessing psychological care often involves the use of pharmacological therapies in cases where they are not indicated, and very high social costs. Psychological treatments for depression and anxiety play a key role in the overall list of interventions aimed at reducing distress and impairment in psychosocial functioning of people with CMDs. Much needs to be done in Italy to improve timely access to these treatments, to ensure they are delivered correctly, and to guarantee the accountability of the healthcare professionals who provide them. The UK experience, Improving Access to Psychological Therapies, indicates compatibility with a containment of health care costs. To update recommendations over time and monitor the evolution, the Consensus has not dissolved, but has set up a permanent committee, some working groups and four thematic committees: (a) Editorial; (b) Training and updating of professionals; (c) Sensitization and monitoring; (d) Childhood and adolescence, whose work is illustrated in the article. [ABSTRACT FROM AUTHOR]

This study reviews current evidence and therapeutic approaches for treating Feeding and Eating Disorders (FEDs), focusing on Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED). Key therapeutic goals include increasing awareness of emotional and relational difficulties, improving specific psychopathological symptoms, normalizing eating behaviors and weight, and supporting families. Enhanced Cognitive Behavioral Therapy (CBT-E) emerges as the most researched and recommended treatment for AN and BN, with demonstrated effectiveness in BED as well. However, CBT-E has shown variable results regarding complete remission, with rates ranging from 37% to 55%. Other approaches, such as Dialectical Behavior Therapy (DBT) and Metacognitive Interpersonal Therapy (MIT-ED), show promising results, particularly for patients with emotional dysregulation and maladaptive interpersonal schemas. Pharmacological treatment, while useful, has limited efficacy and requires further research. In summary, an integrated approach that considers comorbidity and underlying psychopathological factors is crucial for improving adherence and treatment outcomes. [ABSTRACT FROM AUTHOR]

This paper was written based on the “National Institute of Health and Clinical Excellence (NICE) Guideline on Treatment and Management of Psychosis and Schizophrenia in Adults” (2014 edition, updated until 2020 in the online format), of which it represents a faithful summary of the parts dedicated to the role of psychotherapy in the treatment of psychosis and schizophrenia, with particular reference to cognitive-behavioral psychotherapy. [ABSTRACT FROM AUTHOR]

It has been almost 50 years since longterm studies in rodents have been recognised as a benchmark for assessing the chronic toxic effects of different chemicals, in particular their ability to induce cancer. After a so long time, both the European Food Safety Agency (EFSA) and the World Health Organisation (WHO) have affirmed that, internationally, the current methodological guidelines for testing the safety of chemical compounds or physical agents are not adequate. This is because when the guidelines were evaluated and produced the toxic agents were present mainly in the workplace, with exposure in confined environments and at high doses, starting from adulthood. This is no longer the case. In fact, toxic substances have come out of factories through consumer products, with inadequate processing for storage and treatment, and therefore with the accumulation of slag in the environment, that is, in practice, an environmental health policy not up to the pressure of industrial growth. Today we can talk about widespread toxicity in the general environment, air, water, soil. Doses are generally low, except in the case of accidents, but involve exposure of the entire population of the earth. Furthermore, the effects of the exposure to low doses of multiple chemical in mixtures are not yet adequately explored. Current guidelines, in general, do not include some tests necessary to assess adverse effects related to exposure at an early age (prenatal, neonatal, infancy) that occur only later in life. This is particularly true of complex chemicals such as pesticides. Based on our experience at the laboratories of the Ramazzini Institute, we proposed already in 2017 an integrated study project based on the existing guidelines. The proposed experimental design (Ramazzini Institute Design: RID) includes the objectives of the OECD and NTP guidelines to study carcinogenicity, chronic toxicity and developmental and reproductive toxicity (endocrine interference study). With the integration of a complete set of toxicological end-points in a single protocol, the use of animals is optimized in accordance with 3R (replacement, reduction and refinement); at the same time, including prenatal, neonatal exposures (lactation period) and by evaluating different parameters throughout life, the integrated experimental design has the potential to provide sufficient data on multiple windows of susceptibility (WOS) for each specific test, promoting good risk assessment and public health decision-making. The integrated RID allows, with the same generation cohort of rats used for the evaluation of long-term results, to monitor biomarkers and other parameters related to specific responses in parallel satellite groups, including metabolic changes, neurological and endocrine disorders. [ABSTRACT FROM AUTHOR]

Copyright of Rivista Italiana di Educazione Familiare is the property of Firenze University Press 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.)

The various guidelines for the management of bronchial asthma agree in considering the almost total control of symptoms as a primary objective, which is considered achievable in most asthmatics. The various documents do not provide a single definition of asthma control but agree that this assessment should be conducted in two areas: the control of current symptoms and the future risk of poor control of the disease, in terms of exacerbations and reduction of respiratory function. Some clinical studies have shown that satisfactory control of bronchial asthma is achievable in most patients. The GOAL study demonstrated that correct pharmacological management of bronchial asthma allows good control of bronchial asthma in approximately 76% of the study population. The guidelines also differ in the different therapeutic decision-making algorithms, as regards the indications for the use of short-acting β2-agonists as needed in the milder stages of the disease. The GINA document proposes the ICS/formoterol combination as needed as the first therapeutic approach (track 1) for mild asthma, suggesting as an alternative strategy (track 2) the assumption of an ICS every time a SABA is taken. The APPaRENT 2 study for the first time evaluated the prescribing habits of pulmonologists, and other internists and general practitioners, in five different countries. Physicians and patients continue to prioritize symptom control over exacerbation reduction, preferring regular ICS/LABA treatment (with or without as-needed SABA – track 2) in uncontrolled moderate-to-severe asthma. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. 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.)

La Regione Lazio, attraverso le 'Linee di indirizzo per la stesura dei Percorsi Diagnostico Terapeutico Assistenziali - PDTA nella cronicità -18/12/2020' ha recepito il 'Piano Nazionale per il Governo delle Liste d'Attesa 2012-2014'. Nel 2015 ha attivato tre PDTA (Percorsi Diagnostico-Terapeutici Assistenziali) riguardanti patologie croniche. Il dolore cronico è importante nella quotidianità del paziente, del medico e di riflesso nella società. Dal 2010 la valutazione del dolore è diventata obbligatoria (Art. 7 della legge 38/2010) ed è doveroso riportarne in cartella clinica le caratteristiche. Naturalmente deve essere registrata anche la terapia impostata in base ad una adeguata conoscenza della farmacocinetica e della farmacodinamica dei farmaci antidolorifici utilizzati, seguendo le linee guida a scale progressive (OMS). Dei farmaci è opportuno considerare anche le vie di somministrazione più adeguate e gli effetti collaterali, in particolare per gli oppioidi. [ABSTRACT FROM AUTHOR]

Introduction. Asthma is one of the most common chronic diseases in both pediatric age and adulthood, often underdiagnosed and undertreated. Over the past 20 years, numerous guidelines have been published with the aim of translating evidence into recommendations for good clinical practice; however, their impact was modest. The multilevel training program “Revolution in asthma” was created with the dual objective of improving the knowledge of the main guidelines on asthma and investigating the level of agreement of the participants with the recommendations of the guidelines, as well as their real-life application. Materials and methods. The survey was conducted from February to October 2021 on a representative sample of 400 Italian general practitioners, pulmonologists and algologists. Four guidelines (BTS/SIGN, NICE, AEPP-NHLBI-EPR and GINA) were compared and the concordances/ discrepancies between the recommendations of the guidelines relating to seven thematic areas were analyzed. Agreement/disagreement with the recommendations was measured with a Likert scale. The level of adherence in clinical practice was also assessed through questions aimed at estimating participants’ “opinions/beliefs” (as indicator of self-efficacy, i.e., confidence that the recommendations can be applied in daily practice). Results and conclusions. This e-learning project increased the participants’ guidelines knowledge (at the end of the course, 80% of the participants thought it was more useful to use several guidelines than one). The analysis highlighted the areas of agreement with the guidelines, and the “grey areas”, i.e. the areas with moderate agreement, such as patients monitoring and PEF use. Besides, barriers that interfere with the application of the recommendations into clinical practice were identified. In conclusion, the project allowed the participants to re-elaborate their own “mental guidelines” and to compare them with the published ones, thus driving a paradigm shift in everyday clinical practice. [ABSTRACT FROM AUTHOR]

Lead is a material used since ancient times to make pipes useful for water distribution, as it is ductile and resistant. Over time many European countries, including Italy, have widely adopted it to build aqueducts and domestic distribution systems. Due to associated health risk, lead concentration in water intended for human consumption has been limited since the '60s, making use of new regulations, new techniques, and materials. The Italian Ministry of Health issued Legislative Decree 31/2001 - applying both WHO and European Communities (EC) indications - which set the maximum levels for lead in water to 25 µg/liter for 15 years and 10 µg/liter starting from 25 December 2013. The new Directive (EU) 2020/2184, which entered into force on 12 January 2021, introduces a risk-based approach to water safety, which covers the entire supply chain, from the catchment area to the tap; the maximum levels for lead were further reduced to 5 μg/liter, establishing the new limit, at the latest, by 12 January 2036. The Italian Ministry of Health, together with a small group of experts from the National Institute of Health and other technical-scientific institutions, is finalizing the operational guidelines to apply the provisions of Directive (EU) 2020/2184. [ABSTRACT FROM AUTHOR]

Introduzione: L’evoluzione della formazione infermieristica ha di fatto portato ad un accrescimento di conoscenze e competenze che hanno reso gli infermieri dei veri e propri professionisti. Con l’introduzione del comma 566 della Legge di stabilità del 2015 e della Legge 24 del 2017, è stata posta una maggiore attenzione sull’utilizzo delle Linee Guida e su come esse, insieme alla buona pratica, possano ridurre il ricorso ad una medicina difensiva. Obiettivo: Indagine sulle conoscenze del personale infermieristico riguardanti i concetti di competenza avanzata e responsabilità professionale, in relazione al loro agire quotidiano, e ai nuovi assetti normativi. Materiali e Metodi: Uno studio cross-sectional è stato eseguito su un campione di 60 soggetti fra Giugno 2019 e Settembre 2019, presso l’ospedale Policlinico Umberto I di Roma. È stata condotta una survey, rivolta agli infermieri operanti nel setting dell’area critica e chirurgica, mediante l’utilizzo di un questionario non validato, in forma anonima in cui vengono analizzati e saggiati: a) dati anagrafici; b) analisi dell’attività lavorativa; c) analisi delle conoscenze. Risultati: Sono stati convalidati per lo studio 60 questionari correttamente compilati, con un tasso di risposta del 63.8%. Il 68.3% degli infermieri era di sesso femminile ed il 31.6% di sesso maschile. L’età media del campione è di 35.2 anni. Il 16.7% degli infermieri utilizza sempre le linee guida aziendali/ministeriali nella pratica clinica; il 36.7% le usa raramente; il 41.7% le utilizza abbastanza, mentre il 5% non le utilizza mai. In relazione alla conoscenza della normativa vigente, emerge che il 48.3% non conosce il comma 566 della Legge di stabilità, con il 48.3% del campione che asserisce di conoscere la Legge Gelli. Conclusione: Dai risultati ottenuti emerge la necessità del personale infermieristico di una maggiore formazione circa gli aspetti legali della professione mediante una formazione dedicata. Inoltre emerge l’importanza dell’aggiornamento professionale come mezzo per non incorrere in atti di medicina difensiva.

Generalized Anxiety Disorder and Panic Disorder are two psychopathological conditions often associated with a relevant subjective suffering for the individual as well as a significant impairment of general functioning. The need to care for who is suffering from these disorders led a number of clinicians to develop and/or perfectionate effective interventions. In parallel, the scientific community has been involved in the empirical test of the absolute and relative efficacy of most of these interventions. However, the clinician interested in the topic may often feel confused because of the vastness and the complexity of the specialized literature on this topic. This may be considered one of the motivations that underlined the attempt of some institutions to develop guidelines regarding the treatment of patients suffering from these two disorders. Despite the fact that the aim of these documents is not to dogmatically establish clinical practice standards, these are a valuable material that can help both the patient and the clinician to take informed decisions. In this current contribution, an overview of guidelines developed by the National Institute for Health and Clinical Excellence and by the American Psychiatric Association are provided. Then, some empirical contributions (systematic reviews and meta-analyses), retained especially relevant, are illustrated in order to familiarize the reader with the specialized literature on the topic. [ABSTRACT FROM AUTHOR]

In the last years, the dimensional classification of Personality Disorders and the development of manualized treatments have contributed to a new conceptualization of these disorders. Therefore, it is necessary to implement of evidence-based clinical treatments and good practices, through the application of international guidelines for the treatment of personality disorders. The aim of this paper is to analyse the main guidelines from recent literature regarding the treatment of Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD), to identify which are the recommended treatments with greater efficacy. For this reason, two of the most authoritative contributes to international guidelines were examined: National Institute for Health and Care Excellence (NICE) and the American Psychiatric Association (APA). Furthermore, given the need to provide updated scientific evidence, in addition to the guidelines, recent reviews and meta-analyses on the treatment of disorders in question were considered. In the last part of this work, the attention was placed on the current diagnostic classification of personality disorders, which aims at the functioning and personality traits rather than the nosographic diagnosis only, with a specific focus on Borderline Disorder and Antisocial Personality Disorder. In conclusion, literature seems to suggest the clinician a greater attention to the dimensional aspect of personality disorders within the psychotherapeutic intervention because it allows the use of specific traits and domains for setting up a more targeted intervention. [ABSTRACT FROM AUTHOR]

Psychopathological conditions related to the umbrella-term "depression" are various and often associated with significant impairments of the individual's quality of life. These also cause important costs from the individual, social and economic points of view. Fortunately, professionals operating in the field of mental health have been early involved in the development of interventions, psychological and not, that aim to treat these conditions. Moreover, the efficacy of these interventions has been a target of empirical investigations conducted by the scientific community. These efforts produced an important number of information that the clinician, that want to treat individual suffering from depression, should know and consider in order to provide an optimal intervention. In the attempt to divulgate the principal conclusions that can be drawn from a deepen examination of such material, different institutions developed guidelines with the aim to increase the capacity of clinicians to take informed clinical decisions. In our contribution, we present a summary, not exhaustive, of some relevant aspects of international guidelines related to the the clinical psychologist's practices. In addition, some scientific contributions are illustrated, that reported some empirical evidence recently produced that appear particularly relevant in order to formulate useful indications for clinical practice. [ABSTRACT FROM AUTHOR]

Obsessive Compulsive Disorder (OCD) is a debilitating condition that tends to be chronic. To date, a multiplicity of interventions aiming to treat this disorder exists. The vastness of literature and the difficulty for the clinician to orientate within this context drove several institutions to develop guidelines related to the treatment of OCD. Despite the aim of these guidelines is not to establish clinical standard for professional practice, these provide precious material that aim to take informed decisions. In this contribution, we offer a summary of the guidelines developed by the National Institute for Health and Clinical Excellence and by the American Psychiatric Association as well as a brief overview of their development process. Then, a selection of some relevant contributions is summed up - systematic reviews and meta-analyses-that sometimes supported the process of formulation of recommendations contained in the illustrated guidelines. [ABSTRACT FROM AUTHOR]

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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.)

Public health measures to cope with the Covid-19 pandemic, imposed also a shutdown of sports facilities and swimming pools. Safety issues related to recreational waters were emerging during the lockdown, rising concerns on how and when reopening pools and on how improve their management while SARS-CoV-2 is circulating in the population. The GSMS-SItI, Working Group on Movement Sciences for Health of the Italian Society of Hygiene Preventive Medicine and Public Health, discussed and summarized some indications for a suitable preventive approach. Several measures are highlighted, including social distancing, optimized water management, airflow and microclimatic parameters in the pool as well in the annexed rooms, verification of sanitation procedures. The GSMS-SItI underlines that prevention should be based on monitoring of the local epidemiological situation and on the constant collaboration with the local health authority and the national health service. [ABSTRACT FROM AUTHOR]

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Focused shock waves are a therapeutic technology now widely used for musculoskeletal disorders, with a proven efficacy, supported by solid evidence in the literature and with recommendations for use formulated in national and international guidelines. Radial shock waves are currently also used in this area. In the musculoskeletal field, by virtue of their analgesic and antiphlogistic effects, extracorporeal shock waves represent a valid therapeutic opportunity, together with physiotherapeutic treatment, for patients suffering from musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Copyright of La Medicina del Lavoro is the property of Mattioli 1885 SpA 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.)

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. 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.)

El presente trabajo analiza los cambios más importantes realizados en la responsabilidad penal por culpa del doctor de la reciente ley Balduzzi 2012, de la ley 2017 Gelli Bianco, ententando de establecer no sólo los aspectos positivos y negativos de estas reformas, pero también el camino del cambio en el sistema de responsabilidad penal del médico, a la luz de las observaciones surgieron en la legislación y doctrina, teniendo en cuenta nuevos y significativos desafíos a alianza terapéutica médico-paciente. Es así no sólo para equilibrar la protección del derecho a la salud con protección de profesionalismo y serenidad del médico, de hecho amenazado por el aumento de litigios penales, disminuyendo la difusión de la medicina defensiva, pero evaluar los cambios regulatorios más apropiados dados a promover (y reconstrucción) una positiva alianza terapéutica entre el médico y paciente, ahora cada vez más socavada por una contratación hyper y burocracia que lo hacen cada vez más frágil. [ABSTRACT FROM AUTHOR]

Copyright of Ri-vista: Ricerche per la progettazione del paesaggio is the property of Firenze University Press 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.)

Copyright of Italian Journal of Nursing (IJN) / Giornale Italiano di Infermieristica is the property of Collegio IPASVI MI-LO-MB - Ordine Professioni Infermieristiche MI-LO-MB 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.)

A recent paper by Dominguez and Lee (2017) discussed several methodological and statistical errors made by the American Psychological Association (APA) in defining Eye Movement Desensitisation and Reprocessing (EMDR) efficacy for PTSD as weaker than cognitive behavioural therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT) and exposure therapy. In this commentary, starting from the study of Dominguez and Lee (2017) we are going to express our position and state that the limits which make the results on EMDR treatment efficacy controversial are not merely methodological and statistical but, rather, theoretical. [ABSTRACT FROM AUTHOR]

La peritonite rappresenta la principale complicanza legata alla dialisi peritoneale. Sin dal 1983, l'International Society of Peirtoneal Dialysis (ISPD) ha elaborato delle linee guida, revisionate e aggiornate più volte sino al 2010, su prevenzione, diagnosi e trattamento delle infezioni correlate alla dialisi peritoneale. Tutti i pazienti in trattamento peritoneo-dialitico, che presentano un liquido di drenaggio torbido, devono iniziare una terapia antibiotica empirica, ad ampio spettro, per via intraperitoneale ed eseguire esami colturali. La prima scelta resta la vancomicina associata a cefalosporine di terza generazione o aminoglicosidi. In seguito la terapia deve essere modificata sulla base dell'anfibiogramma. La rimozione del catetere peritoneale è indicata in caso di peritoniti refrattarie e recidivanti, micotiche, infezioni croniche del tunnel e dell'exit-site. La terapia deve avere una durata non inferiore alle due settimane. I pazienti che rispondono lentamente, devono proseguire la terapia per almeno tre settimane. Le nuove linee guida, come quelle del 2005, non forniscono indicazioni precise sugli antibiotici da usare. Gli studi effettuati negli ultimi cinque anni hanno ampliato le possibilità terapeutiche nei casi di resistenza o intolleranza, pur non supportando con forte evidenza le opinioni presenti nelle precedenti linee guida.

According to United Nation human right council homeless people live in conditions of extreme poverty. Such condition can be considered as multidimensional, since it concerns issues as: health; job; social relationships. Furthermore, it damages the opportunity to "planning" their future and to enjoying their citizen rights. The Guidelines for night-shelters and emergency hostels are the outcome of a research project carried out for the City of Turin (I) in the 2016. The main purpose is to provide proper responses in order to build-up, renovate and managing the night shelters and other facilities available to them. [ABSTRACT FROM AUTHOR]

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HIV/AIDS surveillance data indicate that, in 2008, approximately one-fourth of all HIV infections in adults remain undiagnosed in Italy and that close to 60% of Aids diagnosed individuals discovered their seropositivity at the diagnosis of AIDS. Late diagnosis of HIV infection is associated with increased mortality and morbidity and increased cost to healthcare services. From a public health perspective, knowledge of HIV status is associated with a reduction in risk behaviour. Thus, a routine screening for HIV infection is important for both a better prognostic outcome, and control of HIV spreading in the population. In Italy there are not shared guidelines for the laboratory diagnosis. In this paper, we suggest two algorithms that can be adopted for the diagnosis of HIV infection in individuals undergoing HIV testing.

The purpose of this paper is to provide an account of my experience between 2013 and 2015 as a member of the Ministry of Cultural Heritage and Activities (MiBACT) working table formed to develop "Guidelines for improving energy efficiency in the cultural heritage of architecture and of urban and historical centres and cores." These guidelines currently make directives and solutions available in order to attempt to solve the problem of how to reconcile requirements of comfort and energy efficiency with the need to preserve structures whose original intended use was quite different; in other words, this is the problem of how to safeguard and capitalize on the historical and cultural characteristics typical of ancient settlements, while at the same time transforming them to be suited to the needs of an increasingly evolved society. [ABSTRACT FROM AUTHOR]

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.)