Suchergebnisse

IntroduzioneL'elemento che piú di ogni altro ha caratterizzato la consultazione elettorale del 20 giugno 1976 è stato il forte aumento della polarizzazione dei suffragi intorno ai due partiti principali, DC e PCI, e, soprattutto, la forte avanzata del secondo che in una sola tornata elettorale ha registrato un incremento di poco inferiore alla somma di quelli registrati tra il 1946 e il 1972. Di conseguenza, l'attenzione dei commentatori che in questi ultimi tre anni si sono occupati dell'argomento è andata quasi esclusivamente a questi due protagonisti della vita politica italiana, e poco agli altri partiti.

IntroduzioneLe previsioni elettorali della primavera '76 davano per certo un grosso calo della DC e non escludevano il « sorpasso » dei comunisti. Confrontando a caldo i risultati con questo « scenario », è stata naturale la tendenza a sottovalutare i mutamenti introdotti dall'ultima tornata elettorale. Essa tuttavia costituisce, in un'ottica di lungo periodo, un momento di svolta. Quanto meno non si è confermata la stabilità che l'elettorato italiano aveva esibito dal '53 al '72. Stabilità che peraltro non escludeva che all'interno degli schieramenti si verificassero fenomeni dinamici importanti come la tendenza del PCI a prevalere all'interno della sinistra e quella del MSI a prevalere all'interno della destra. Gli incrementi comunisti però, come mostra la tabella 1, sono fino al '72 abbastanza limitati: 8,2 punti percentuali nell'arco di sette elezioni con un « gradino » massimo di 2,6 punti nel '63 rispetto al '58. Dal '72 al '76 invece il PCI aumenta di ben 7,3 punti, mentre l'incremento della sinistra non comunista nel suo insieme è in proporzione molto piccolo (0,7 punti percentuali). L'espansione dell'area di sinistra è quindi quasi totalmente attribuibile al PCI, che oltre a una grossa quota del voto giovanile ha probabilmente conquistato anche un certo numero diex-elettori del centro e della destra.

Patient quality of life (QoL) is a pivotal parameter, which is often used by clinicians to evaluate how treatments and therapies influence patients' functionality and emotional state, aiming to ameliorate interventions and their outcomes. Currently, the majority of questionnaires assessing the QoL are designed with the main contribution of clinicians and, therefore, include items that are cantered on the disease rather than on its multifaceted impact on people's life. The failure to truly grasp the patients' perspective, their needs, aspirations, perceptions and emotional state, is a major drawback that sets medical care on clinical parameters alone. We aimed to bridge this gap by establishing an innovative patient-designed QoL index to provide a new, unbiased tool considering the patients' perception of their own well-being. Based predominantly on patients' contribution, we defined specific areas (physical, emotional, social, functional, economical) and the respective characterizing features, and applied a pseudo-Delphi methodology combined with customer-satisfaction techniques. For each feature, the degree of agreement and the importance were assessed on a Likert scale. A synthetic QoL index was created by weighting the importance of each item. The methodology tested led to the development of a valid patient-designed QoL index, providing a way forward that could potentially be applied to many different conditions. The areas and the features included are indeed common to all patients, irrespective of their disease. We found that the process of methodology development enhanced the patients' awareness of their subjective experience with the disease, and enabled them to better present their situation to the clinicians. The patient-designed QoL index provides a descriptive model that can be helpful to patients, clinicians and third parties and that can be further integrated with clinical details to obtain an overall view of the course of treatment for each patient.

The Crimean-Congo hemorrhagic fever virus (CCHFV) is considered to be a major emerging infectious threat, according to the WHO R&D blueprint. A wide range of CCHFV molecular assays have been developed, employing varied primer/probe combinations. The high genetic variability of CCHFV often hampers the efficacy of available molecular tests and can affect their diagnostic potential. Recently, increasing numbers of complete CCHFV genomic sequences have become available, allowing a better appreciation of the genomic evolution of this virus. We summarized the current knowledge on molecular methods and developed a new bioinformatics tool to evaluate the existing assays for CCHFV detection, with a special focus on strains circulating in different geographical areas. Twenty-two molecular methods and 181 sequences of CCHFV were collected, respectively, from PubMed and GenBank databases. Up to 28 mismatches between primers and probes of each assay and CCHFV strains were detected through in-silico PCR analysis. Combinations of up to three molecular methods markedly decreased the number of mismatches within most geographic areas. These results supported the good practice of CCHFV detection of performing more than one assay, aimed for different sequence targets. The choice of the most appropriate tests must take into account patient's travel history and geographic distribution of the different CCHFV strains. ; Funding: This research was supported by the following funds: Italian Ministry of Health, grants Ricerca Corrente–Linea 1; European Union, Joint Action Consumers, Health, Agriculture, and Food Executive Agency for E cient response to highly dangerous and emerging pathogens at EU level no. 677066 (EMERGE); European Centre for Disease Prevention and Control (ECDC), EVD-LabNet Framework contract ECDC/2016/00; European Union, Horizon 2020 research and innovation program "European Virus Archive goes Global" no. 653316 (EVAg). ; Sí

BackgroundCrimean-Congo haemorrhagic fever virus (CCHFV) is considered an emerging infectious disease threat in the European Union. Since 2000, the incidence and geographic range of confirmed CCHF cases have markedly increased, following changes in the distribution of its main vector, Hyalomma ticks.AimsTo review scientific literature and collect experts' opinion to analyse relevant aspects of the laboratory management of human CCHF cases and any exposed contacts, as well as identify areas for advancement of international collaborative preparedness and laboratory response plans.MethodsWe conducted a literature review on CCHF molecular diagnostics through an online search. Further, we obtained expert opinions on the key laboratory aspects of CCHF diagnosis. Consulted experts were members of two European projects, EMERGE (Efficient response to highly dangerous and emerging pathogens at EU level) and EVD-LabNet (Emerging Viral Diseases-Expert Laboratory Network).ResultsConsensus was reached on relevant and controversial aspects of CCHF disease with implications for laboratory management of human CCHF cases, including biosafety, diagnostic algorithm and advice to improve lab capabilities. Knowledge on the diffusion of CCHF can be obtained by promoting syndromic approach to infectious diseases diagnosis and by including CCHFV infection in the diagnostic algorithm of severe fevers of unknown origin.ConclusionNo effective vaccine and/or therapeutics are available at present so outbreak response relies on rapid identification and appropriate infection control measures. Frontline hospitals and reference laboratories have a crucial role in the response to a CCHF outbreak, which should integrate laboratory, clinical and public health responses. ; This work was supported by the Health programme 2014–2020, from the European Commission; EMERGE Joint Action grant number: 677066. INMI received 'Ricerca Corrente, Linea 1, Patogeni ad alto impatto sociale, emergenti, tropicali, MDR, negletti' grants from the Italian Ministry of Health. This work was supported by the European Centre for Disease Prevention and Control (ECDC) under the EVD-LabNet Framework contract ECDC/2016/002. This work was supported by the CCHVaccine project 2 'the European Union's Horizon 2020 research and innovation program', grant agreement no. 732732. ; Sí

Background Crimean-Congo haemorrhagic fever virus (CCHFV) is considered an emerging infectious disease threat in the European Union. Since 2000, the incidence and geographic range of confirmed CCHF cases have markedly increased, following changes in the distribution of its main vector, Hyalomma ticks. Aims To review scientific literature and collect experts' opinion to analyse relevant aspects of the laboratory management of human CCHF cases and any exposed contacts, as well as identify areas for advancement of international collaborative preparedness and laboratory response plans. Methods We conducted a literature review on CCHF molecular diagnostics through an online search. Further, we obtained expert opinions on the key laboratory aspects of CCHF diagnosis. Consulted experts were members of two European projects, EMERGE (Efficient response to highly dangerous and emerging pathogens at EU level) and EVD-LabNet (Emerging Viral Diseases-Expert Laboratory Network). Results Consensus was reached on relevant and controversial aspects of CCHF disease with implications for laboratory management of human CCHF cases, including biosafety, diagnostic algorithm and advice to improve lab capabilities. Knowledge on the diffusion of CCHF can be obtained by promoting syndromic approach to infectious diseases diagnosis and by including CCHFV infection in the diagnostic algorithm of severe fevers of unknown origin. Conclusion No effective vaccine and/or therapeutics are available at present so outbreak response relies on rapid identification and appropriate infection control measures. Frontline hospitals and reference laboratories have a crucial role in the response to a CCHF outbreak, which should integrate laboratory, clinical and public health responses. ; Peer Reviewed