Mobile Apps are deeply entering in daily lives and could be also used for e-learning/e-training purpose. The realisation of a Mobile App, designed for iOS, would allow a wide spread of such tools, even among the medical community. However, several key points should be faced to build up a reliable product for this purpose, among which the implementation of accurate, reproducible methods to perform measurements on biomedical images. To this extent, a new approach for computing distances on biomedical images was developed and the results obtained with this approach were comparable to the ones achieved with more complex systems. Such result could foster the implementation of more complex functions and Apps devoted to healthcare professionals in various fields.

Congenital anomalies and their primary prevention are a crucial public health issue. This work aimedto estimate the prevalence of congenital anomalies in Brindisi, a city in southeastern Italy at high risk ofenvironmental crisis.Methods: This research concerned newborns up to 28 days of age, born between 2001 and 2010 to mothersresident in Brindisi and discharged with a diagnosis of congenital anomaly. We classified cases according to thecoding system adopted by the European Network for the Surveillance of Congenital Anomalies (EUROCAT).Prevalence rates of congenital anomalies in Brindisi were compared with those reported by EUROCAT. Logisticregression models were adapted to evaluate the association between congenital anomalies and municipality ofresidence of the mother during pregnancy.Results: Out of 8,503 newborns we recorded 194 subjects with congenital anomalies (228.2/10,000 total births), 1.2times higher than the one reported by the EUROCAT pool of registries. We observed 83 subjects with congenitalheart diseases with an excess of 49.1%. Odds Ratios for congenital heart diseases significantly increased fornewborns to mothers resident in Brindisi (OR 1.75 CI 95% 1.30-2.35).Conclusions: Our findings indicated an increased prevalence of Congenital Anomalies (especially congenital heartdiseases) in the city of Brindisi. More research is needed in order to analyze the role of factors potentially involvedin the causation of congenital anomalies.

La gestione delle identità digitali è un processo che interessa ogni organizzazione dotata di un sistema informativo. Pur non avendo procedure formali e/o sistemi dedicati, le identità digitali sono comunque gestite. Applicare delle best-practices nella gestione delle identità digitali riduce i costi per l'organizzazione e migliora l'efficenza della stessa, consentendo inoltre di limitare i rischi oltre che rispettare le normative legate alla privacy dei dati personali e/o sensibili.È noto che un'identità digitale possa essere rappresentata come un insieme di attributi e che tale insieme possa essere suddiviso in sottoinsiemi, ognuno dei quali rappresenta un'identità parziale dell'individuo [Borcea-Pfitzman et al. 2006].Nel tempo la gestione delle identità digitali si è evoluta ed è possibile infatti identificare in tale processo alcune fasi principali: una sorta di età della pietra vede le applicazioni gestire il nucleo minimo ed essenziale per l'autenticazione in maniera totalmente autonoma e indipendente; successivamente si sviluppano i primi sistemi per centralizzare le credenziali ed un nucleo di attributi sugli utenti (es. Kerberos, LDAP), anche se le applicazioni gestiscono autonomamente le informazioni necessarie per il processo di autorizzazione; infine le credenziali e l'insieme delle informazioni che caratterizzano l'identità digitale di un utente sono centralizzate (negli Identity Management System) e le applicazioni possono gestire solo gli "app-specific user data". L'Identity Manager, oltre che centralizzare il processo di autenticazione, diventa di supporto anche al processo di autorizzazione fornendo al SP gli attributi sui quali questo può decidere se, ed a quale livello, autorizzare l'accesso ai dati (Attribute/Role Based Access Control).Le architetture federate per l'autenticazione e l'autorizzazione portano questo concetto oltre i limiti dell'organizzazione e tramite le virtual organisation è possibile accedere a servizi sulla base di attributi aggregati in tempo reale forniti dalla propria e da organizzazioni esterne.Tali tecnologie introducono quindi dei significativi vantaggi per l'utente, che può disporre di numerosi servizi offerti dalla propria o da altre organizzazioni, utilizzando un unico meccanismo di autenticazione ed un'unica identità aggiornata allo stato corrente riguardo il rapporto con tali organizzazioni. Tale semplificazione favorisce a sua volta la creazione di sistemi informativi autonomi, sviluppati per specifici obiettivi o flussi di informazioni (es. presenze, gestione progetti, produzione scientifica, risorse assegnate ecc.), con l'effetto collaterale che tutte le informazioni che riguardano l'individuo (le identità parziali) vengono distribuite su sistemi diversi, con interfacce utente diverse, generando confusione nell'utente che a volte non è neppure consapevole dell'esistenza di particolari strumenti.IdeaManager si propone quindi come collettore di quell'insieme significativo (per l'utente

La riabilitazione respiratoria riveste un ruolo fondamentale nei pazienti con BPCO (evidenza A Linee Guida Gold 2010). La valutazione di programmi riabilitativi richiede attenzione alla dimensione clinica ed alla qualita? della vita del paziente anche attraverso la continuita? assistenziale territoriale. In tale ottica l'ASL Brindisi coordina un progetto CCM finanziato nel 2010 dal Ministero della Salute.

Best practice guidelines for clinical management have increasingly become useful tools for patients and health care professionals in several disease areas. This is the case not least in the area of rare diseases, where scarcity of expertise is a well known and far too common cause of late or wrong diagnosis and care. However, in order for clinical guidelines to be useful and trustworthy, they must adhere to principles of how they are developed and updated, including a basis of best available evidence. Because of the potential great importance of well made best practice guidelines for rare diseases, we here describe work within the RARE-bestpractices EU project aim to address this topic by i) delineate the current state of existing best practice guidelines, as well as processes and tools for developing, updating, and adapting guidelines in the field of rare diseases, ii) define and agree on methodological quality standards for best practice guidelines on rare diseases, iii) develop pilot best practice guidelines for a specific rare condition, implementing the agreed methodological quality standards and iv) to develop a graphical representation of the sequence of activities in best practice guidelines, which are useful for helping in understanding key steps, for allowing a faster development of information systems supporting the enactment of the modeled process, and for monitoring the effectiveness, efficiency and equity of the implemented guidelines.

Over the last decade the European Union (EU) has been coordinating actions addressing various aspects of rare diseases and has funded several cross-border research projects. Recently the EU has initiated the biggest rare disease interna- tional collaborative effort by launching the International Rare Diseases Research Consortium (IRDiRC).RARE-Bestpractices is one of the more than 100 collaborative research projects on rare diseases funded under the Seventh Framework Programme for Research and Technological Development (FP7/2007-2013) [1].As a wide, open and inclusive network, RARE-Bestpractices will build on the knowledge of the experts in rare disease

Purpose: The importance of working toward quality improvement in healthcare implies an increasing interest in analysing, understanding and optimizing process logic and sequences of activities embedded in healthcare processes. Their graphical representation promotes faster learning, higher retention and better compliance. The study identifies standardized graphical languages and notations applied to patient care processes and investigates their usefulness in the healthcare setting.Data sources: Peer-reviewed literature up to 19 May 2016. Information complemented by a questionnaire sent to the authors of selected studies.Study selection: Systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Data extraction: Five authors extracted results of selected studies.Results of data synthesis: Ten articles met the inclusion criteria. One notation and language for healthcare process modelling were identified with an application to patient care processes: Business Process Model and Notation and Unified Modeling LanguageTM. One of the authors of every selected study completed the questionnaire. Users' comprehensibility and facilitation of inter-professional analysis of processes have been recognized, in the filled in questionnaires, as major strengths for process modelling in healthcare.Conclusion: Both the notation and the language could increase the clarity of presentation thanks to their visual properties, the capacity of easily managing macro and micro scenarios, the possibility of clearly and precisely representing the process logic. Both could increase guidelines/path- ways applicability by representing complex scenarios through charts and algorithms hence contributing to reduce unjustified practice variations which negatively impact on quality of care and patient safety.