Services In Italy Research Articles

Towards a sociomaterial approach to inter-organizational boundaries: How information systems elicit relevant knowledge in government outsourcing

This article furthers a sociomaterial framework to examine inter-organizational boundaries in government IT projects. It engages in a dialogue with the practice theory-based approach to boundary spanning and utilizes analytical tools and epistemologies drawn from the social studies of technology. It aims to contribute to a situated, material understanding of inter-organizational boundaries. We argue that boundaries in outsourcing relationships can be de facto enacted through definitions of what counts as relevant knowledge. Information systems have a key role in eliciting such definitions, thus establishing knowledge asymmetries and regimes of inclusion and exclusion. The article responds to the call to value the role of artefacts in IT research. Furthermore, it eventually shows that understanding knowledge asymmetries triggered at the micro-level of information systems can help to examine macro-scale transformations between the public and the private sectors. To illustrate the framework, two ethnographic case studies of governmental IT projects are discussed. The first case concerns a permit and licence submission service in Italy. The second case analyses a 20-year-long database integration carried on at the Dutch land registry. In the first case, information systems made relevant a form of knowledge developed by contractors; in the second case, the integration process valued knowledge developed in-house. Three sets of implications are drawn for the theory and practice of inter-organizational IT projects. To conclude, the article focuses on inter-organizational boundaries involving the public and the private sectors and foresees a novel interdisciplinary research direction at the confluence of information systems and political studies.

Pandemic: Presentation of non‐Covid cases – Delay in emergencies in children

<scp>Pandemic</scp>: Presentation of non‐Covid cases – Delay in emergencies in children

Aggression and Violence Toward Healthcare Workers in a Psychiatric Service in Italy: A Retrospective Questionnaire-Based Survey: Erratum.

Aggression and Violence Toward Healthcare Workers in a Psychiatric Service in Italy: A Retrospective Questionnaire-Based Survey: Erratum.

The Interplay between States and Movements on Violence Against Women. Comparative Perspectives in Sociology and Policy Analysis

In the last 25 years, women’s movements, governments and international bodies have been active in awareness-raising on and reduction of violence against women (VAW). The main aim of this issue is to providean overview of comparative perspectivesof policies and services, which offer an innovative point of view to evaluate action. A comparative outlook on VAW initiatives can show acceleration or deceleration in decision-making, proliferation or scarcity of regulations, high or low effectiveness of plans and services in reaching set goals, and reasons why this is the case. The four articles of this issue present original research conducted on firearm policy on a global scale, comparative analysis of services in Italy, accessibility of VAW services in Israel and perceptions of VAW after film screening in Tunisia. The articles illustrate the level of interest that elicited by VAW, the complexities of the analysis and the local and global actors that play a role in action against this global problem.

Towards food platforms? An analysis of online food provisioning services in Italy

This paper makes use of a unique dataset on the population of online food provisioning services to shed light on the organization of the food e-commerce in the Italian context. Building on the opposition between pipelines and platforms, we propose a categorization of the different forms of organization within each business model and examine how they differ. Hence, we concentrate on food platforms to discuss the implications this new business model may have for both producers and consumers. We highlight three critical areas that warrant further attention. First, in view of the EU regulatory framework, we discuss the potential implications for consumer protection; second, we reflect on the ways the potential success of the platform model could change labour market relations between producers and platform owners; third, we point out the differences and similarities platforms have with alternative food networks (AFNs). In the conclusion, we reflect on future research developments and on the possible trajectories that online grocery shopping could take in light of the disruption caused by COVID19.

Public, private or hybrid? Providing care services under austerity: the case of Italy

PurposeThe paper examines the different trajectories of externalisation and the development of different kinds of welfare mix in three different sub-sectors of socio-educational services: long-term care for the elderly, early childhood services and kindergartens. By integrating the industrial relations and comparative public administration literatures, it analyses the different rationales underpinning contracting-out decisions of Italian local governments.Design/methodology/approachThe paper adopts a multi-method, multi-level approach: quantitative data on the provision of socio-educational services and the nature of the providers are combined with the analysis of 12 case studies of municipalities through 80 semi-structured interviews and documentary analysis.FindingsThe paper argues that differentials in labour regulation across the public/private divide and the consequent possibility to access labour markets characterised by cheaper labour and higher organisational flexibility are a key explanation in local governments' decisions to outsource. Despite labour market factors playing a prominent role, their relevance is significantly tempered by political and social factors and particularly by the strong opposition of citizens, personnel and trade unions to pure market solutions in the provision of such services. However, the centrality of these factors depends on the nature of the services: political sensibility against privatisation proved to be stronger in kindergartens, while services for the elderly were more frequently and less contentiously privatised.Originality/valueThe main contribution is the integration of the two research traditions to analyse patterns of outsourcing in the socio-educational services in Italy, showing that neither of them is able, alone, to explain the different private/public mix characterising different social and educational services.

Folic acid supplementation in Italian women during pregnancy: A cross-sectional study conducted in general practice.

The association between folate insufficiency and congenital neural tube defects has been extensively investigated since the 1990s. To reach an adequate intake of folic acid (FA), improving folate status through periconceptional supplementation with FA, promotion of the consumption of foods rich in natural folates, and appropriate use of fortified foods is recommended. The aim of the present study was to investigate the supplementation of FA in a sample of pregnant women referred to general practice services in Italy, with a focus on the quality of information received by fertile women. Participants were recruited from patients admitted to 44 general practice offices enrolled in the Italian Society of Preventive Medicine and Lifestyle study and located in Italy throughout the national territory. A questionnaire for the evaluation of FA supplementation was administered by the general practitioners (GPs). The interviewed subjects were asked to provide information about pregnancy characteristics, nutritional habits, lifestyle and risk factors, information sources, and knowledge about FA. This study included 328 participants. The percentage of women who did not take any FA supplements was 16.8%, and 66.4% of women started FA supplementation only after finding out they were pregnant. Only 16.8% of women started FA supplementation 12 wk before the beginning of pregnancy. The lack of supplementation with FA, as well as the incorrect adherence to the existing FA supplementation protocol, is attributable to different social (e.g., immigration, place of residence, job employment) and cultural (e.g., educational level, knowledge about FA) factors, the relatively poor planning of pregnancies, and the lack of information concerning the need for FA supplementation in the prepregnancy period. Finally, GPs and gynecologists are the only sources of information on the importance of FA supplementation. The adherence of women to FA supplementation before pregnancy is still insufficient. The GP role in preconception care, and the promotion of FA supplementation, needs to be emphasized and further promoted.

Obesity treatment within the Italian national healthcare system tertiary care centers: what can we learn?

The prevalence of obesity is soaring all over the world, and Italy is reaching the same pace. Similar to other countries, the Italian healthcare system counts on a three-tier model for obesity care, and each region has freedom in the implementation of guidelines. No national record is currently available to monitor the actual situation throughout the country. To provide a report of the current status on the availability of specialized public obesity care services in Italy. Regional prevalence of obesity was extrapolated from publicly available data. Data on facilities for the management of obesity were retrieved from records provided by national scientific societies. Whenever possible, data was verified through online research and direct contact. We report a north-south and east-west gradient regarding the presence of obesity focused facilities, with an inverse correlation with the regional prevalence of obesity (R = 0.25, p = 0.03). Medical-oriented centers appear homogeneous in the multidisciplinary approach, the presence of a bariatric surgery division, the availability of support materials and groups, with no major difference on follow-up frequency. Surgery-oriented centers have a more capillary territorial distribution than the medically oriented, but not enough data was retrieved to provide a thorough description of their characteristics. Obtaining a clear picture of the situation and providing consistent care across the country is a challenging task due to the decentralized organization of regions. We provide a first sketch, reporting that the model is applied unevenly, and we suggest feasible actions to improve the situation in our country and elsewhere. Level V, narrative review.

The use of discretion in decision-making by social workers at child protection services in Italy

ABSTRACT Child protection social workers in Italy operate within a context apparently lacking reference laws on procedures to be implemented in selecting the most appropriate intervention measures for a child's welfare. The result is a situation leaving significant operational discretion up to each professional who, although able to choose the best possible intervention based on each specific case and on local resources, also risks creating profound inequalities. The objective of this research was to identify the criteria according to which decisions are taken by child protection services social workers in Italy. Three focus groups were formed of 22 social workers operating in protection services in three cities of the Veneto region, in north-eastern Italy. The results highlight certain significant convergences on the social worker's decision-making criteria, together with the lack of both shared practices, also within individual services, and the use of standardised methods. Moreover, there is a strong shift of decision-making toward the individual rather than the institution and based on experiential-intuitive methods, rather than scientific-analytical ones.

Aggression and Violence Toward Healthcare Workers in a Psychiatric Service in Italy: A Retrospective Questionnaire-Based Survey.

Workplace violence and aggression are receiving increasing attention, especially when perpetrated in at-risk services such as psychiatric and emergency departments. Many healthcare providers have been victims of verbal aggressions (VAs) and physical aggressions (PAs), as well as injuries (INs), at the hands of patients. We conducted a 1-year retrospective questionnaire-based survey to assess workplace violence and aggression experienced by staff working at the Psychiatric Service of the Health District of Bolzano-Bozen (Italy). We performed parametric statistics. Logistic regression estimated the size of the association between PA occurrence and staff characteristics. Our psychiatric service's employees were frequent victims (91.5%) of 1 or more aggression/injury in the previous year. VAs and INs showed comparable frequencies among the three sites of our service, that is, the inpatient (INP), the outpatient (OUTP), and the rehabilitation (REHAB) units, differently from PAs, which were more common at INP (p < 0.001). The logistic regression model showed that female sex, working at INP, and a shorter psychiatry work experience predicted PAs occurrence. Most of the staff felt they could benefit from aggression management. Findings show that VAs, PAs, and INs are common among our psychiatric service's employees and point to the need to provide staff training on de-escalation.

Reflections on Doctor Question – Patient Answer Sequences and on Lay Perceptions of Close Translation

ABSTRACT The lay perception of those who work with interpreters in their professional conversations (and sometimes of interpreters themselves) is that translation of what they and their patients/clients say should be as close as possible. The very idea of close translation may seem simple, but the practice of rendering spontaneous talk-in-interaction as close as possible is quite complex, and requires much more from the mediator than textually close renditions. In this paper, we discuss what is involved in the accomplishment of close rendering in talk. We focus on question-answer sequences with clinicians and patients, when details about the patients’ history and their symptoms are collected. We show that meaning is achieved and rendered through processes that may go rather beyond the single words and utterances and that involve the contribution of all the interlocutors. We show three types of sequences taken from a collection of authentic data audio-recorded in health care services in Italy and transcribed to allow for analysis. The sequences show three different forms of talk, found in the data, where participants pursue close, precise rendition of medical details. The analysis highlights that the Italian intercultural mediators (just like those trained and assigned as public service interpreters in other countries), even in these cases which are peculiarly focused on precise details, do need to take responsibility not only for translating the textual items but also for coordinating turns at talk. It is responsible turn-coordination which leads to rendering meaning closely.

The Ambivalence of Law: Some Observations on the Denial of Access to Abortion Services in Italy

The Ambivalence of Law: Some Observations on the Denial of Access to Abortion Services in Italy

Territorial Energy Decentralisation and Ecosystem Services in Italy: Limits and Potential

This article focuses on the complex relationships between energy processes and ecosystem services. It highlights the conflicts between them due to the anthropocentric value that characterizes their interrelationship. The article reports the initial results of ongoing research on energy decentralization processes in Italy, examining the Italian districts heating performance, concerning ecosystem provisioning and regulating services. The analysis is based on a sample of more than 150 Italian district-heating systems. Contrary to studies that positively evaluate processes of energy decentralization, the results of the research show some critical factors and impacts. An efficiency gap between districts heating and traditional energy systems emerged. The data processed show a critical situation in the development of local networks, highlighting that the decentralized energy model is not deeply rooted in the local area and is poorly characterized by shared governance, which instead would benefit from the integration of ecosystem services. The significant presence of large energy groups and the considerable use of fossil sources in Italy reduces the effectiveness of the decentralization of energy systems. The article presents some conclusive considerations, which outline some general guidelines for proceeding towards a more correct relationship with ecosystem services and greater integration with the territories.

Survey on centres and procedures for the diagnosis and treatment of adult ADHD in public services in Italy.

Attention deficit/hyperactivity disorder (ADHD) often persists into adulthood. Although its persistence and relative high prevalence, ADHD in adults is often underdiagnosed and undertreated in Italy, leading to poor clinical and functional outcomes, and higher costs of illness. The aims of the study were to identify the Italian mental health services for ADHD in adults, describe the diagnostic and treatment procedures they follow, and compare this offer with the recommendations of the German and English guidelines. The centres, that adopt a clinical and assessment protocol for adult ADHD diagnosis (carried out by specifically trained personnel) and prescribe pharmacological treatment for adult ADHD, were selected from the list of accredited services provided by the Appendix B.2 of the ISTISAN 16/37 Reports of the ISS. An ad-hoc survey including open-ended and close-ended questions was sent to each selected centre in February 2020. The overall picture resulting from the data analysis was compared with the recommendations of the German and English guidelines. The present survey shows that only a few centres are specialised in the diagnosis and treatment of ADHD in adults in Italy. Furthermore, there are no national guidelines for adult ADHD in Italy. The collected data also suggest that there is no a unified practice shared by the Centres both for the patient's transition from child and adolescent to adult mental health services and for the diagnostic-therapeutic process. It is therefore crucial to create specific protocols and develop national guidelines to better identify and diagnose ADHD in adults and provide targeted and more efficient multimodal treatments.

Parental alienation (syndrome) in child custody cases: survivors’ experiences and the logic of psychosocial and legal services in Italy

ABSTRACTParental alienation (syndrome) is a controversial issue, criticized by experts in different fields. However, this concept is often used by professionals and is frequently cited in courtrooms. This qualitative study focuses on parental alienation and explores women’s experiences as well as legal and social services’ practices in child custody cases. Semi-structured interviews were conducted with separated mothers who were victims of intimate partner violence, and with social workers and psychologists/psychiatrists designated by courts to evaluate parenting skills. Expert reports, psychological assessments and legal documents were also analysed. Results show that professionals endorsed parental alienation and considered it a ‘feminine problem’. Women were often blamed and labeled as ‘engaging in parental alienation’ when they were trying to ensure their children’s safety. Children’s accounts were interpreted as being a result of their mothers’ manipulation. In contrast, fathers were treated as victims of vindictive women who want to keep children to themselves. Men’s violent behaviours were not considered, and their role as fathers was seen as ‘inviolable’. These practices seem to reflect the ‘good-enough father’ approach, according to which the presence of the father is essential for children’s development, regardless of his violent behaviours.

Future psychiatric services in Italy: lesson from the COVID-19 pandemic.

During the COVID-19 epidemic, home care and remote working showed important technological innovations, leading to review all public mental health policies. In this article, some considerations based on the Italian COVID-19 experience in order to plan post-COVID psychiatric interventions are reported. (www.actabiomedica.it)

The influence of COVID-19 on regional railway services in Italy and Poland

The aim of the paper is to compare the scale of regional train cancellation in Italy and Poland in the aftermath of COVID-19 pandemic and to answer the question whether different approaches to public transport limitation can be observed at national and regional scales in different European countries. The article is a preliminary study and as such contains the first observations and initial conclusions. From the analysis it results that the influence of COVID-19 on regional railway transport in both Italy and Poland is strong but much different. In Italy the scale of cancellation is generally larger and so are the differences between the regions. In both analysed countries the lines which have turned out to be mostly affected by suspension are urban and suburban connections with dense train traffic. It would seem that in Italy exactly as in Poland the train cancellations are more the result of the character of the operated rail system, the different approaches to regional rail transport and of the tendency to cut costs than of the actual epidemic situation in the regions.

The design of the tenders for natural gas distribution in Italy: How much are territorial districts really contestable?

This article is aimed at checking the degree of contestability of the tenders to allocate the right to deliver the natural gas distribution service in Italy. This check is based on the analysis of the general rules provided by the D.M. 12 novembre 2011, n. 226 and subsequent modification. The degree of contestability is evaluated by estimating the presumable number of ‘noncaptive’ points (out of 100) related to the different criteria. For this purpose, two representative scenarios of the possible calls for tenders are simulated. The paper concludes that this number is relatively limited. Around 15% only (or just above) of the total score would be really non-captive.

Healthcare digital services in Italy: good practices across Regions

Abstract Background In Europe, digital transformation of healthcare is one of the agenda priorities. Institutional websites and mobile applications (APPs) have been increasingly adopted by healthcare organizations for communication and service delivery. This study aims at describing the state of art and the variability of healthcare digitalization in Italy. Methods The study focuses on 144 active websites of public healthcare organizations (i.e. Local Health Authorities and Teaching Hospitals) of 11 out of the 21 Regional healthcare systems in Italy. The research investigates whether the healthcare organizations provide e-booking and e-paying for outpatient visits through their website/APP and whether citizens are informed of this opportunity. Researchers independently analyze the websites taking the user’s perspective, by adopting a common grid. Data refers to December 2018. Results The majority of items analyzed show a high variability within and among Regions. The provision of online services patients can benefit of change across the same territory. Almost 76% of the LHAs/hospitals allow for e-booking of outpatient visits and e-paying is available for 84% of them. The adoption of APPs for healthcare is not homogenous. Some Regions develop a specific regional tool (e.g. Apulia, Lombardy) providing uniform access to digital services to their resident population while in other Regions, public healthcare providers can implement their own APP (e.g. Liguria, Veneto). Conclusions Our findings suggest that centralizing digital services - at least at regional level - can enhance healthcare digitalization in Italy, avoiding jeopardized and unequal provision of digital services. Further research should investigate the actual use of these services by citizens and the reasons of variability. Key messages Italy is in delay in digital transformation of healthcare. Our study supports the identification of good regional practices, which could endorse the implementation of future actions.

The quasi-market of employment services in Italy

This paper aims to study pros and cons of the first experiment of quasi-market in the provision of employment services in Italy: the Lombardy DUL (Dote Unica Lavoro). The program, which has inspired the 2015 national reform within the Jobs Act and lines towards the recent experience of several Anglo-Saxon countries, has revitalized the sector by providing important job opportunities to jobless workers. We find the typical problems of quasi-markets (lion’s share of private organizations; cherry picking; gaming and asymmetric information). However, different expedients were devised in the program to minimize these shortcomings. The empirical analysis suggest that such phenomena are at a physiological level. Analysis of the determinants of completing successfully the program provides non-trivial results as to, among others, the role of organizations of different ownership type and of the type of services provided. On these we base our policy advice.