[Strategies for the development of the quality of integrated home care]. / Strategie di sviluppo della qualità dell'assistenza domiciliare integrata.

Home Health Care (HHC) is a strategy to provide holistic care for elderly, chronic and terminal patients and for patients early discharged from hospitals. The aim of this article is to give some advice to ensure social and health integration, coordination of procedures and family participation in HCC. Moreover a framework to ensure organization of a HHC service is required and a guideline to define functions and responsibilities, human and physical resources and procedures to deliver health care is provided. The first stage of a HHC project must be an educational programme for the multidisciplinary team involved in home care. The common education is the strategy to improve Quality of a HHC service, involving medical and social workers in the definition of their own "criteria and standards" for organization, resources and procedures.

[Multidimensional diagnosis in general medicine. Comparative study of the use of various instruments]. / La diagnosi multidimensionale in medicina generale. Studio comparativo sull'uso di alcuni strumenti.

This study was performed to test three instruments for functional status assessment in General Practice: the Dartmouth Coop Charts (COOP Charts), the Functional Status Questionnaire (FSQ) and the Duke University Health Profile (DUHP). All the instruments covered a score of functional aspects in physical, mental and social areas, providing a multidimensional measure of health status. We used these three instruments, validated by international studies, to acquire information concerning their feasibility and acceptability among patients from rural communities needing primary care and to test their validity in differentiating between patient subgroups. The COOP Charts, the FSQ and the DUHP were administered by physicians respectively to 98, 100 and 97 patients, waiting for a visit in the ambulatories of their General Practitioner. Answers relating to each instrument were analyzed according to sex, age and education of patients. All the instruments seemed to be feasible and acceptable, but only the COOP Charts and the FSQ were able to discriminate between different sex, age and scolarity groups. Taking into account the need to elaborate answers according to a formula when using the FSQ, we concluded that the best instrument for General Practice to provide a multidimensional measure of health status seems to be the COOP Charts.

[Health education through sports. Proposal for an intervention in the formative years]. / Educazione sanitaria allo sport. Proposta di intervento nell'eta' evolutiva.

The authors present the program: "Physical fitness and health education", direct to childhood of secondary school. The goal is to encourage physical activity and behaviors linked with exercise (caloric intakes and weight control, no smoking ...) to improve health and fitness. The accomplishments of the program need collaboration between physicians and gym teachers to determine methods of realizations and verifications of the program. The educational program has been based on the operative pattern introduced by Guilbert. It is developed through four stages: 1) Definition of pedagogical objectives. The authors point three intermediate objectives a) acquisition of theoretical and practical elements characterizing training exercises wealthy for growth and health; acquisition of the right attitudes not be lose the aforesaid educational contents. b) acquisition of theoretical and practical elements characterizing a diet wealthy for growth and efficiency in sports; acquisition of the right attitudes not be lose the aforesaid educational contents. c) acquisition of theoretical and practical elements for a correct way of life allowing growth and efficiency in sports; acquisition of the right attitudes not be lost the aforesaid educational contents. 2) Definition of methods of verification. The authors point out the following: a) written and oral test, questionnaires for the valuation of the "know" level b) practical tests for valuation of the "know how to do" level c) reports from the teachers of valuation of the "know how to be" level. 3) Organization and realization of the program. The authors point out educational contents to get the three intermediate objectives, together with the times for realization of the program. The fixed program is introduced to the young people at the beginning of secondary school in physical education periods all over the three years of the first grade course. 4) The authors point out the moments of verifications: beginning and end of each or the three years of course.

Kinetic studies of cytoplasmic and mitochondrial aconitate hydratases from rat liver.

The kinetic properties of the cytoplasmic and mitochondrial aconitate hydratases of rat liver have been studied by measuring the formation of the two products from each of the three tricarboxylic acids used as substrate. The kinetic properties of the two enzymes are very similar; the similarity of the Km values for each of the three substrates is particularly remarkable. The results are discussed with particular reference to a possible role of the cytoplasmic aconitate hydratase in the process of gluconeogenesis. With both aconitate hydratases, substrate activation by citrate and D-isocitrate has been observed.