Papers by virginia recchia
The International Journal of Health Planning and Management
The International Journal of Health Planning and Management
Mutation Research/Genetic Toxicology and Environmental Mutagenesis
Vaccines
The SARS-CoV-2 pandemic led to the development of various vaccines. The BNT162b2 mRNA vaccine was... more The SARS-CoV-2 pandemic led to the development of various vaccines. The BNT162b2 mRNA vaccine was the first approved due to its efficacy in eliciting a humoral immunity response after the second dose. However, a decrease in the antibody concentration was observed over time. Therefore, the administration of a third dose was scheduled, primarily for frail people and workers of essential public activities. The aim of this study was to assess the level of antibodies against the spike (S) RBD of SARS-CoV-2 in healthcare workers before and after the third dose of BNT162b2 vaccine, according to sex, age, and the time interval between vaccine doses and tests. All 37 (12 males, 25 females, 19 < 50 years old, 18 ≥ 50 years old) healthcare workers recruited showed a consistent antibody titer increase after the third dose. Data analysis showed that the antibody concentration before the third dose significantly decreased as the time interval up to the test increased, and a significantly highe...
Nowadays, patient-centred practice represents the key for quality and successful outcomes in heal... more Nowadays, patient-centred practice represents the key for quality and successful outcomes in healthcare. At the same time, shared decision-making is acknowledged as the highlight of patient-centred care. Informed consent, whenever derives appropriately from a two-way communication between doctor and patient, follows a negotiation process that leads to appropriate and shared decisions. This article aims to show how the typical negotiating styles can lead or not to effective informed consent and conflict mediation processes. To this end, the three negotiating styles currently theorized (sharks, saints, and samurai) are integrated into the three clinical models of doctor-patient interaction (paternalistic, interpretative and autonomist). Currently, being any paternalistic attitude disapproved both ethically and legally, the model of autonomy is the only suitable one to communicate effectively. A concrete case from cardiology is reported to show the different negotiation styles within a...
International Journal of Environmental Research and Public Health, 2022
The application of in silico medicine is constantly growing in the prevention, diagnosis, and tre... more The application of in silico medicine is constantly growing in the prevention, diagnosis, and treatment of diseases. These technologies allow us to support medical decisions and self-management and reduce, refine, and partially replace real studies of medical technologies. In silico medicine may challenge some key principles: transparency and fairness of data usage; data privacy and protection across platforms and systems; data availability and quality; data integration and interoperability; intellectual property; data sharing; equal accessibility for persons and populations. Several social, ethical, and legal issues may consequently arise from its adoption. In this work, we provide an overview of these issues along with some practical suggestions for their assessment from a health technology assessment perspective. We performed a narrative review with a search on MEDLINE/Pubmed, ISI Web of Knowledge, Scopus, and Google Scholar. The following key aspects emerge as general reflection...
Journal of Preventive Medicine and Hygiene, 2021
Summary SARS-CoV-2, responsible for the current pandemic, is a novel strain of the Coronaviridae ... more Summary SARS-CoV-2, responsible for the current pandemic, is a novel strain of the Coronaviridae family, which has infected humans as a result of the leap to a new species. It causes an atypical pneumonia similar to that caused by SARS-CoV in 2003. SARS-CoV-2 has currently infected more than 9,200,000 people and caused almost 480,000 deaths worldwide. Although SARS-CoV-2 and SARS-CoV have similar phylogenetic and pathogenetic characteristics, they show important differences in clinical manifestations. We have reviewed the recent literature comparing the characteristics of the two epidemics and highlight their peculiar aspects. An analysis of all signs and symptoms of 3,365 SARS patients and 23,280 COVID-19 patients as well as of the comorbidities has been carried out. A total of 17 and 75 studies regarding patients with SARS and COVID-19, respectively, were included in the analysis. The analysis revealed an overlap of some symptoms between the two infections. Unlike SARS patients, C...
The key word patient engagement is worldwide becoming a “must do” for academics, industries and p... more The key word patient engagement is worldwide becoming a “must do” for academics, industries and policy makers in the healthcare arena. The academic and managerial “buzz” on patient engagement is growing at a dizzying pace. In 2015, 665,300 new web indices were found on Google.com with the key words “patient engagement,” including 1,230 news pages and 6,200 dedicated blogs. During this same period, over 3,500 new academic papers focused on patient engagement (see Figure 1) The idea of patient engagement moves from the assumption that making patients co-producer of their health can enhance their satisfaction towards the healthcare system, as well as their responsibility in care, cure and prevention. A previous Book entitled Promoting Patient Engagement and Participation for Effective Healthcare Reform (Graffigna, 2016) has been dedicated to discuss the clinical and pragmatic value of favoring the active role of patients along their care journey. The different chapters of that Book wel...
Jacc-cardiovascular Imaging, 2012
International Journal of Environmental Research and Public Health, 2021
Sexually transmitted diseases (STDs) among adolescents and young people represent a significant p... more Sexually transmitted diseases (STDs) among adolescents and young people represent a significant public health problem that generates a pressing requirement of effective evidence-based education to promote primary and secondary prevention. The objective of the study is to evaluate how knowledge, information needs, and risk perception about HIV and STDs can change after targeted education interventions for students. A total of 436 subjects aged 15–24 attending high school (134 biomedical and 96 non-biomedical fields) and university courses (104 scientific and 102 non-scientific disciplines) were enrolled to respond to a questionnaire before and after the intervention. An improvement in knowledge was found in all groups, with statistically significant knowledge score differences between the four groups in 60% of the items. More than 94% of the students consider it useful to promote information on these issues. Receiving this information generated awareness and safety in more than 85% o...
Pratica Medica & Aspetti Legali, 2018
[Transformative mediation in the era of the patient revolution. A model for the management of cli... more [Transformative mediation in the era of the patient revolution. A model for the management of clinical and legal risk in Italian health facilities]Nowadays, too many patients do not perceive that their doctors are exclusively dedicated to care them. This is probably because current health systems are too focused on physicians and diseases, rather than on patients. Such systems are also expensive, fragmented, inefficient and often cynical, generating not only the anger but also the willingness to bring legal claims from many patients. Many scholars, in fact, claim that &amp;amp;amp;amp;amp;amp;amp;quot;too much medicine&amp;amp;amp;amp;amp;amp;amp;quot; can bring more harm than good to the patients and to the health systems themselves, therefore promoting a more sober and respectful medicine. This is the vision of the &amp;amp;amp;amp;amp;amp;amp;quot;patient revolution&amp;amp;amp;amp;amp;amp;amp;quot; and the idea that inspires some other movements that aim to break the vicious circle of greed and cynicism that damages not only patients but also health professionals. Within the same vicious circle, an exponential increase in litigations takes place, as an additional negative effect of the system focused on the disease and on the doctors instead of on the patient.In the present article, we assume that a greater participation of the patient in the choices concerning his/her own health is the fertile ground in which concrete solutions can be found to many problems arising from the current medicine. We therefore analyze the main advantages of active patient participation, which in turn generate a reduction in health conflicts. Based on this analysis, we propose a model in which through various approaches, tools and methods - starting from the upstream prevention of the conflicts - we can also manage them downstream, for the benefit of both patients and health professionals. Finally, we show that within this framework, transformative mediation is an essential approach for weakening many legal disputes and repairing the relational damage generated upstream, where communication has failed or is completely lacking in the clinical practice.
Transformative Healthcare Practice through Patient Engagement
The World Health Organization has estimated that chronic obstructive pulmonary disease (COPD) is ... more The World Health Organization has estimated that chronic obstructive pulmonary disease (COPD) is the fourth most common cause of death worldwide. Due to the economic and social extent of the problem, patient engagement must be comprised as a new resource for the achievement of higher health outcomes and lower costs. As many key processes involved in the COPD patient engagement consist of communication and education processes, modelling those processes in a whole framework, including actors and content needs, is a requirement. The main scope of this chapter is contributing to design such a framework within the Italian Health System. Final recommendations suggest to create a synergy among patient engagement and a set of legal tools, namely informed consent, integrated care and advance care planning. The synergy is based on the fact that both patient engagement and those legal tools have a common deep root in the universal principle of patient autonomy.
Recenti Progressi in Medicina, Nov 1, 2011
Background. Knowledge and learning processes are nowadays renowned both in the literature and in ... more Background. Knowledge and learning processes are nowadays renowned both in the literature and in practice as key assets for competitive advantage in the business world. This is due to the fact that those processes are strictly related to innovation and, consequently, to value creation. And this is even more true in sectors – such as advanced medical imaging – in which innovation and education play a key role in building and maintaining leadership as well as in attracting patients. Nevertheless, in healthcare organisations as well as in business companies, many initiatives to develop organizational knowledge are not explicitly linked to business strategy and technological innovation. Actually, Knowledge Management (KM) approaches mostly attempt to capture existing knowledge within formal configurations, such as information systems. This constitutes a relevant research and applicative gap. Methods. The main research question regards the role of knowledge strategy within innovation pro...
Although knowledge processes are nowadays recognised as key assets for competitive advantage, man... more Although knowledge processes are nowadays recognised as key assets for competitive advantage, many initiatives to develop Knowledge Management (KM) do not explicitly link processes, knowledge, organisation and innovation. They mostly attempt to capture existing knowledge within formal configurations, such as information systems. This research project, through a multiple embedded case study from ten excellence Echocardiography Laboratories (EchoLabs), provides a framework which connects all those aspects in the medical field, to improve KM processes within the real setting of an EchoLab. The whole framework is grounded on the integration of two approaches: a process-oriented view of KM, to develop a knowledge-based analysis of the three basic processes – that is, research, education and patient-care; the Theory of Planned Behaviour, in order to comprehensively address the social, organisational and technological (KM tools) issues of KM within a seminal theory. As a result, the knowle...
L'e-Learning, cioè l'insieme dei processi di formazione interattiva a distanza erogata me... more L'e-Learning, cioè l'insieme dei processi di formazione interattiva a distanza erogata mediante l'impiego di strumenti e metodi basati sulla rete Internet, sta prendendo piede in modo crescente in questi ultimi anni, diffondendosi un po’ in tutti i settori, ed in particolare – grazie all’introduzione delle FAD (Formazione A Distanza) nel programma nazionale ECM – nei settori medici. Le applicazioni di e-learning, learning management ed ECM online sono in una fase iniziale di sviluppo, ma nei prossimi anni sono destinate a diffondersi ulteriormente. L’e-learning dischiude delle potenzialità estremamente interessanti per la formazione e l’aggiornamento professionale dei medici, ma queste discendono sia dalle caratteristiche progettuali che dalle modalità di implementazione. Tra i molteplici fattori che ne favoriranno lo sviluppo e la diffusione sono certamente rilevanti quelli relativi all’adattabilità ai tempi dei professionisti medici ed alla facilità di accesso consenti...
Knowledge processes are nowadays recognised as key assets for competitive advantage, due to the f... more Knowledge processes are nowadays recognised as key assets for competitive advantage, due to the fact that they are strictly related to innovation and, consequently, to value creation. Nevertheless, many initiatives to develop Knowledge Management (KM) do not explicitly link processes, knowledge, organisation and innovation. They mostly attempt to capture existing knowledge within formal configurations, such as information systems. This research project, through a multiple embedded case study from twenty medical imaging departments, provides a framework which connects work processes, knowledge processes, socio-organisational issues, and technological innovation in the medical field. The final objective is optimising KM processes within an ideal-type Department for Advanced Medical Diagnostics. The whole framework is grounded on the integration of two approaches: a process-oriented view of KM, in order to develop a knowledge-based analysis of the three basic processes – that is, resea...
Knowledge strategy is nowadays recognised as strongly related to competitive advantage, since kno... more Knowledge strategy is nowadays recognised as strongly related to competitive advantage, since knowledge and learning processes are strictly related to innovation and, consequently, to value creation. By using two comparative qualitative case studies from echocardiography laboratories, we provide a framework for clarifying the link between knowledge, strategy and technological innovation. The framework is built upon a deductive study - which has been developed through a literature review - and an exploratory inductive research - which has been tested by an empirical investigation. We argue that, within a knowledge-based competition, a “system strategy” is relevant for sustaining innovation, while a “human strategy” is more appropriate for disruptive innovation.
This paper is aimed at describing three processes belonging to the knowledge creation process (kn... more This paper is aimed at describing three processes belonging to the knowledge creation process (knowledge transfer, sharing and integration) and their applicability in different working contexts. For each of them, the following issues have been analyzed: directionality (with respect to the involved actors), who is prevalently asked to work for the process to be realized, the kind of cooperation and the synchronicity. The different results in terms of output stability of the generated knowledge, process efficacy and velocity are pointed out
Inappropriate use of ionizing tests in medicine represents an increasing trend, which causes note... more Inappropriate use of ionizing tests in medicine represents an increasing trend, which causes noteworthy damages to health, as well as a huge increment of health expenditures, waiting lists, organizational conflicts, judicial disputes, and insurance compensations. This phenomenon is strictly related to the key bioethical and legal issue of patient’s autonomy, which is protectable by means of a correct implementation of informed consent. The current practice of the passive signature on incomplete and unreadable informed consent templates belongs to the so-called “event-based” approach. This practice mortifies the patient’s right to decide freely and deliberately, being him unaware of the biological consequences of diagnostic-therapeutic interventions on himself and on his progeny’s health. On the other hand, physicians themselves are not protected, since they can generate arbitrary clinical acts more frequently, with heavy deontological and legal consequences. Conversely, a “process-b...
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Papers by virginia recchia