Innovative Approaches to Active and Healthy Ageing: Campania Experience to Improve the Adoption of Innovative Good Practices.

The demographic projections on the European population predict that people aged over 60 will increase by about two million/year in the next decades. Since 2012, the Campania Reference Site of the European Innovation Partnership on Active and Healthy Ageing supports the innovation of the Regional Health System, to face up demographic changes and sustainability. Campania Reference Site provides the opportunity to connect loco-regional stakeholders in social and health care services (universities, healthcare providers, social services, local communities and municipalities), with international organizations, in order to adopt and scale up innovative solutions and approaches. This paper describes the building process of Campania Reference Site and the main results achieved, that have been allowing it to become a hub for open innovation in the field of active and healthy aging at regional, national and international level.

Health tourism: an opportunity for sustainable development.

In February 2017, the "Programma Mattone Internazionale Salute" (ProMis), that is the Italian Program for Internationalization of Regional Health Systems of the Ministry of Health (MoH), presented the first version of its Position Paper on Health Tourism, which embeds a first shared approach to the recommendations expressed by the European Committee of Regions (CoR) on "Age-Friendly" tourism. The CoR stresses the importance of local and regional authorities in the coordination of multi-sectoral policies such as healthcare, social assistance, transport, urban planning and rural development in relation to the promotion of mobility, security, accessibility of services, including health care and social services. "Age-friendly" tourism is an example of an innovative tourist offer that strives to meet the health needs of the entire "traveling" population, with an integrated and cross-sector approach that involves various organizations operating in sectors such as healthcare, accessibility and transport. The aim of the workshop was to explore the interest of the stakeholders to participate in a systemic action in the field of "health" tourism, and to identify priority implementation areas that offer opportunities to take advantage of validated, innovative experiences that strengthen the accessibility to health and social services in regional, national and international contexts. This effort provides the opportunity to take advantage of aligning the European Structural and Investment Funds (ESIF) to the development of tourism, coherently with the needs and resources of local and regional health authorities.

Implementing an ICT-Based Polypharmacy Management Program in Italy.

Although there is evidence of a growing awareness of the problem, no official policy statements or regulatory guidelines on polypharmacy have been released up to date by Italian Health Authorities. Medication review, application of appropriateness criteria and computerized prescription support systems are all possible approaches in order to improve the quality of prescribing in older persons. More focused training courses on multimorbidity and polytherapy management are encouraged. Furthermore a multidisciplinary approach integrating different health care professionals (physicians, pharmacists, and nurses) may positively impact on reducing the sense of fear related to discontinue or substitute drugs prescribed by others; the fragmentation of therapy among different specialists; reducing costs; and improving adverse drug reaction detection and reporting. Aiming at achieving the individualized pharmacotherapy, a multidisciplinary approach starting with identification of patients and risk for drug-related problems, followed by medication review overtime and use of inappropriateness criteria, supported by computerized systems has been proposed.

[Normal value of the tracheal bifurcation angle and correlation with left atrial volume]. / Valore normale dell'angolo della biforcazione tracheale e correlazione con il volume dell'atrio sinistro.

PURPOSE: We evaluated the mean value and the variability range of the tracheal bifurcation angle by patient gender, age, height, weight, build, body area and max transverse diameter of the chest under normal conditions. We also evaluated tracheal bifurcation angle changes in orthostatism and recumbency, as well as in the different respiratory phases. Finally, we investigated the statistical correlation between the tracheal bifurcation angle value and the left atrial volume, to eventually derive either value from the other. MATERIAL AND METHODS: We reviewed 700 high-voltage radiographs of the chest performed in 500 patients with normal echocardiographic findings from 1986 to 1990. To analyze the relationships with the left atrium, 100 patients with echocardiographically enlarged atrium were submitted to high-voltage radiography. The tracheal bifurcation angle was measured directly. RESULTS: Mediastinal radiographs nearly always depict the trachea and extraparenchymal bronchi adequately. The tracheal bifurcation angle should be measured continuing and joining the upper and lower parabronchial contours. A 4-degree deviation is accepted between the upper or interbronchial and lower or carinal angles since the angles formed by parallel segments have the same value. Under normal conditions the absolute mean value of the tracheal bifurcation angle was 79.7 degrees and the range 37-105 degrees. DISCUSSION AND CONCLUSIONS: In normal patients the mean value of the tracheal bifurcation angle: is independent of age and gender; depends on build; is related to the max transverse diameter of the chest and to body area; exhibits no major radiographic changes in orthostatism versus recumbency; exhibits no major radiographic changes in expiration versus inspiration; is correlated with left atrial volume, but the value is not statistically significant.