Carlos Chiatti - Academia.edu (original) (raw)

Research report by Carlos Chiatti

Report finale di un progetto finanziato dal Ministero del Lavoro e delle Politiche Sociali che ha... more Report finale di un progetto finanziato dal Ministero del Lavoro e delle Politiche Sociali che ha testato nella Regione Marche un nuovo modello di sostegno alla domiciliarità per le famiglie con Alzheimer

Papers by Carlos Chiatti

Geomatics, Dec 12, 2023

Previous research showed that living closer to bus stops could be a factor in promoting a healthy... more Previous research showed that living closer to bus stops could be a factor in promoting a healthy and active lifestyle. However, most of the studies relied on self-reported measures of distance, which might be affected by several confounders. In this study, self-reported distances among study participants were compared to actual ones, computed by the use of GIS (Geographic Information System) technology and routing algorithms. We tested whether distance to the bus stop is associated with health and socioeconomic conditions of the respondents, using data among 2398 older people (75-90 years) in three cities in Sweden. We found that several variables including older age, female gender, living alone, and worse health status are associated with an over-estimation of bus stop distance. People who use public transport daily or several times a week and are satisfied with the walking environment in the neighbourhood tend to underestimate bus stop distances. Evidence based on self-reported measures only should be treated cautiously. Considering the limitations still present in open-data-based routing algorithms, the best indication is to combine the subjective with the objective measure of distance. Having the possibility to combine the two measures appears as a sound strategy to overcome the limitations associated with each single measure.

International journal of engineering & technology, May 16, 2018

Dementia is one of the burdensome diseases in older age for which there is no cure known. The dem... more Dementia is one of the burdensome diseases in older age for which there is no cure known. The demand for carers of dementia patients is growing as the population ages. We analyse serious games as an approach to provide dementia carers with training on care related problem solving and modelling real-world cases. We present the behaviour model of improved care process by applying serious games, describe the design of the interactive serious game, its game mechanics, game environment, game actors and the motivation reinforcement mechanisms. The results of the initial evaluation performed by surveying the people caring for their elderly parents and elderly persons themselves, both healthy and showing early signs of dementia, and using the System Usability Score (SUS) questionnaire provided favourable response to the game. The use of an ICT-based gamification approach as part the training package for dementia care will be beneficial for direct care workers leading to long-term improvement of dementia care quality.

Journal of transport and health, Dec 1, 2017

Background: Little evidence is available on how public transport features can impact on older peo... more Background: Little evidence is available on how public transport features can impact on older people's health. The overarching aim of this paper is to evaluate socio-demographic, health and mobility-related factors correlated with health-related quality of life among people aged between 75 to 90 years old in three Swedish Municipalities. Methods: Within the SEBEM study, a cross-sectional survey using a self-administered postal questionnaire was conducted among 2398 older people aged between 75 and 90 years. Primary outcome of the study was health-related quality of life measured using the SF12 which distinguishes two dimensions of health, i.e. the Physical Composite Score (PCS) and the Mental Component Score (MCS). Descriptive statistics were used to analyze the variability study outcomes. Multilevel regression models were used to investigate factors independently correlated with health, controlling for the influence of potential confounders. Results: Higher physical and mental self-reported health is associated with walking more than 500 m on a daily basis, use of a private car and frequent engagement in social activities. Access to the car is only associated with physical health. Mental health scores are significantly lower among those living far from the closest bus stop and never using public transport. Discussion: We provide evidence of epidemiological associations between access to public mobility services and good health in older age. Given the cross-sectional design of our analyses, and the related limitations, the associations found should be investigated more thoroughly by future studies using longitudinal and/or experimental designs. 1. Background The acceleration of demographic ageing is one of the main challenges for European policy-making. As the baby-boom generation retires, the EU's active population will keep shrinking while the number of people aged over 60 will increase by about two million every year (European, 2010). Keeping this population active and healthy as long as possible should be the cornerstone of EU countries' policies and much research has been undertaken to promote older people's mobility and ability to actively participate in social life, in spite of functional or cognitive impairments (Risser et al., 2012; Risser et al., 2015; Lund et al., 2010). On a European level, barriers to mobility among the aging population have been highlighted (Risser et al., 2010) and previous research has pointed out that for increasing the possibility to maintain everyday life mobility among older people, supportive environments (

This report proposes a framework for Impact Assessment of ICT-enabled services to support informa... more This report proposes a framework for Impact Assessment of ICT-enabled services to support informal carers, at family, organisational and national levels, and applies this framework to assess the evidence for impact in 12 cases from Europe and North America.

Journal of Aging and Health, May 18, 2023

Objectives To synthesize the evidence on the relationships between physical housing characteristi... more Objectives To synthesize the evidence on the relationships between physical housing characteristics or housing accessibility and different aspects of health among community-dwelling people 60 years and older. Methods A systematic review of recent evidence with a narrative synthesis was conducted. Results We included 15 studies and found three themes covering physical housing characteristics or housing accessibility that are associated with aspects of health among community-dwelling older adults: (1) interventions by home modifications targeting housing features both at entrances and indoors; (2) non-interventions targeting indoor features; (3) non-interventions targeting entrance features, that is, the presence of an elevator or stairs at the entrance. The overall quality of evidence across studies was assessed as very low. Discussion The findings highlight the need for studies with a stronger research design and higher methodological quality that address the physical housing environment in relation to health among older adults to strengthen the body of evidence.

Annali di igiene : medicina preventiva e di comunità, Mar 1, 2010

Currently, more than one instrument has been found to be reliable and valid for the assessment of... more Currently, more than one instrument has been found to be reliable and valid for the assessment of hospital admission appropriateness. However; data on the level of agreement among these methodologies are extremely scarce. The study was aimed at evaluating whether the percentages of organizational (in)appropriateness resulting from some of the most diffused instruments (Italian Appropriateness Evaluation Protocol--AEP/PRUO; Disease Staging; Essential Levels of Care--LEA, version 2001 and 2008) are substantially concordant, or they largely depend upon the methodology. For each public hospital of Abruzzo, Italy, the amount of inappropriateness has been computed using six indicators: inappropriate days of care (PRUO1); totally inappropriate admissions (PRU02); early admissions DRGs according to the first Law on Italian LEA (LEA01); admissions assigned to one of the 108 potentially inappropriate DRGs according to the second Law on Italian LEA, currently inactive (LEA08). The sample was composed by all ordinary admissions made in 2006 in the Region, with the exception of PRUO indicators, which were based upon the manual revision of 2% of all admissions that could be assessed using PRUO methodology. We found a good correlation among most indicators based upon administrative discharge data (DS1, DS2 and LEA01), whereas the results obtained using PRUO and new LEA (LEA08) were discordant, and marked differences were observed also between the two PRUO indicators. Although the limitations of the study permit only preliminary conclusions, in future appropriateness evaluations it may be reasonable to use more than one indicator--allowing the creation of combined scores--and rank hospitals in large categories--avoiding excessively precise scores--as such rankings might relevantly differ depending upon the used instrument.

International Journal of Occupational Medicine and Environmental Health, Nov 18, 2016

Objectives: To investigate the prevalence of obesity among different types of employment status i... more Objectives: To investigate the prevalence of obesity among different types of employment status in the Italian working population, and to examine associated risk factors. Material and Methods: Cross-sectional survey of 36 814 people that declared to have been occupied with the same type of contract for at least 5 years was analyzed. Multivariable logistic regression models were built considering workers' sex, age, education, family body mass index (BMI) category, leisure time and occupational physical activity, weight control habits, smoking habit, use of drugs, number of working hours per week, and type of working contract. Results: After adjusting for covariates, the importance of temporary-employment was confirmed by multivariate analysis, with odds ratio (OR) = 1.32 for obesity (95% confidence interval (CI): 1.07-1.63) with respect to employed persons; the association was even more important in workers occupied for more than 40 h/week (OR = 1.69, 95% CI: 1.07-2.66); moreover, shiftwork was confirmed as a risk factor for obesity in workers (OR = 1.06, 95% CI: 0.94-1.2). Dealing with different occupational group, some categories were associated with obesity; in particular, this phenomenon involved people employed in agriculture (

Current Opinion in Pulmonary Medicine, Dec 1, 2011

Chronic obstructive pulmonary disease (COPD) is a high prevalence condition with a significant cl... more Chronic obstructive pulmonary disease (COPD) is a high prevalence condition with a significant clinical and economic burden. In elderly people, COPD is often associated with other chronic comorbidities (i.e. cardiovascular diseases), determining clinical complications and requiring frequent acute healthcare interventions. The aim of this article is to review the economic studies evaluating costs and healthcare resource utilization in elderly (≥ 65 years) COPD patients. Sixteen of the initial 359 articles retrieved through our research strategy were found to include relevant cost information on elderly COPD patients or to evaluate the effect of older age on healthcare expenditure. Most studies were carried out in the United States and used administrative database claims to determine resource consumption and direct costs (attributable and not). Very few studies focused exclusively on elderly patients. Results showed a certain variability of cost estimations, mainly due to the different methodologies and adopted cost approach. However, we found a trend of direct cost growth in the elderly population, which can be explained by a more frequent use of acute healthcare services, especially for managing COPD exacerbations. These results cannot be considered definitive and new studies, targeting elderly people, are required in order to confirm these preliminary findings.

The physical housing environment is important to facilitate activities of daily living (ADL) for ... more The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden.

Background: This contribution aims at illustrating the perspective of students attending the firs... more Background: This contribution aims at illustrating the perspective of students attending the first International Summer School on Ageing (ISSA), highlighting the midterm impact exerted by this init ...

Policy Press eBooks, Aug 21, 2013

This paper aims at pointing out the need for a more equitable, internationally driven approach to... more This paper aims at pointing out the need for a more equitable, internationally driven approach to solve elder care staff shortages, on the background of the implications deriving from the widespread phenomenon of employing migrant care workers in the Italian elder care sector. The paper describes at first how this form of care provision has become so popular in this country to face the long term care needs characterising its ageing population. Main reasons are identified, on the one hand, in the decreasing availability of informal care, due to the increasing female participation in the labor market, a longer working life and a reduction in the support provided by social networks. On the “formal” side, a major role has been played also by the lack of appropriate long term care services, such as residential and public home care, as well as by a chronic shortage of nursing staff and a shorter length of hospital stays. The traditionally “cash-oriented” profile of the Italian welfare system – more based on cash-for-care measures rather than in-kind services – has ended up with perpetuating familistic tendencies stimulating the employment of foreign migrant care workers, often on a live-in, undeclared basis. The paper’s conclusions focus on the analysis of the main opportunities and challenges raised by this phenomenon, trying to catch all involved parties’ perspectives: the older care recipients’ families; the migrant care workers; the receiving and the sending societies. This approach allows to identify core advantages of this solution in the possibility to increase ageing in place opportunities (thus reducing institutionalisation rates) and to provide a more personalised home care at reasonable costs. On the other hand, drawbacks can occur in terms of low quality of care, risk of widespread undeclared labour conditions, possible exploitation of foreign migrants and abuse of older people, as well as “brain and care drain” effects in sending countries. A more neutral, internationally driven governance is therefore suggested in order to minimize these risks and promote equitable solutions to solve care provision shortages in some countries without “plundering the future” of other nations.

Geomatics, Dec 12, 2023

International journal of engineering & technology, May 16, 2018

Journal of transport and health, Dec 1, 2017

Journal of Aging and Health, May 18, 2023

Annali di igiene : medicina preventiva e di comunità, Mar 1, 2010

International Journal of Occupational Medicine and Environmental Health, Nov 18, 2016

Current Opinion in Pulmonary Medicine, Dec 1, 2011

Policy Press eBooks, Aug 21, 2013

2022 IEEE International Symposium on Medical Measurements and Applications (MeMeA)

This chapter will focus on the role of family networks and other social support networks for well... more This chapter will focus on the role of family networks and other social support networks for well-being in older age, providing empirical data across European countries on different sources of support. The first section will illustrate how family care in this respect represents a relevant actor, not only in traditional familistic societies but also in more well-developed European welfare states.
Comparative data will be presented in particular on the role played by the family in granting assistance in case of increased dependency in older age. A related issue will be represented by the availability of supports to reconcile paid work and (unpaid) care tasks, especially in the light of the Europe-wide trends to a prolonged working life and increasing female participation in the labour market. Recent empirical evidence will be furthermore provided of the growing importance of migrant care work in households with dependent older people across the Continent, in particular when the formal care system is unable to tackle the challenge of very heavy care needs. The chapter will finally describe the effects of lacking family and support networks, which might take the form of elder abuse and neglect, identifying the main risk factors and possible strategies to prevent it.

L'assistenza agLi anziani non …, 2011

Centro, 2008

Quelli che di seguito si presentano in forma sintetica sono alcuni dati di una ricerca a campione... more Quelli che di seguito si presentano in forma sintetica sono alcuni dati di una ricerca a campione svolta sul movimento dei meet-up legati a Beppe Grillo. L'obiettivo di analisi alla radice dell'indagine è contribuire a tracciare il profilo sociale e culturale di questo movimento, nonché opinioni e motivazioni dei suoi aderenti. La finalità è approfondire la conoscenza di questo nuovo fenomeno di partecipazione rispetto alle analisi che hanno accompagnato a caldo il giudizio di molti opinion leader. La ricerca è stata realizzata senza finanziamenti da un gruppo di lavoro composto da ricercatori e dottorandi della Facoltà di Economia "G. Fuà" di Ancona, con l'ausilio tecnico e la collaborazione di liberi professionisti. La campagna di rilevazione si è svolta nel periodo Novembre-Dicembre 2007, attraverso la somministrazione di un questionario on line "postato" ai 142 meet-up di Beppe Grillo più numerosi sotto il profilo degli iscritti. Hanno aderito all'indagine 446 rispondenti.

NNA (Network Non Autosufficienza) è nato - da un’idea di Cristiano Gori - per promuovere riflessi... more NNA (Network Non Autosufficienza) è nato - da un’idea di Cristiano Gori - per promuovere riflessioni scientifiche sull’assistenza agli anziani non autosufficienti che siano utili all’operatività.
Lo compongono anche Anna Banchero, Enrico Brizioli, Antonio Guaita, Franco Pesaresi e Marco Trabucchi. Insieme ai componenti di NNA contribuiscono al volume Francesco Barbabella, Georgia Casanova, Fabio Cembrani, Carlos Chiatti, Renato Cogno, Mirko Di Rosa, Giovanni Lamura, Maria Gabriella Melchiorre, Sergio Pasquinelli, Laura Pelliccia, Fabio Ragaini, Giselda Rusmini e Rosemarie Tidoli.

Le indagini sul modello delle National Health Survey Interview (NHIS), quali la Multiscopo Istat ... more Le indagini sul modello delle National Health Survey Interview (NHIS), quali la Multiscopo Istat "Condizioni di Salute e Ricorso ai Servizi Sanitari", costituiscono un valido strumento nelle mani dei policy-makers per valutare lo stato di salute della popolazione ed i pattern di utilizzo del servizio sanitario. Utilizzando i dati della indagine Multiscopo condotta nel 2005, il progetto di ricerca si pone l'obiettivo di studiare caratteristiche e dimensioni delle disuguaglianze sociali di salute in Italia, contribuendo all'avanzamento delle evidenze scientifiche in questo ambito. Dopo aver introdotto nel primo capitolo il concetto di disuguaglianze sociali di salute e aver proposto nel secondo capitolo un modello analitico del fenomeno, il lavoro di tesi ha svolto due approfondimenti su altrettanti gruppi sociali a rischio. Nel terzo capitolo, utilizzando un campione di 5.812 donne, sono state confrontate le caratteristiche delle gravidanze e gli outcome del parto delle adolescenti madri con il resto delle madri italiane; nel quarto capitolo, invece, è stata indagata l'associazione tra status socioeconomico e ricorso al vaccino antinfluenzale in un campione di 25.183 soggetti anziani. I risultati ottenuti vanno in due direzioni opposte. Lo studio sulle adolescenti madri conferma la condizione di svantaggio in cui si trova questo gruppo della popolazione. L'analisi rivela anche che la natura dei problemi da loro affrontati è prettamente di natura sociale e non sanitaria: i loro outcome di salute non differiscono dalle altre donne, ma rispetto a queste, le adolescenti hanno un maggior rischio di esposizione a fattori ambientali nocivi (quali il fumo passivo) e a stili di vita insalubri (fumo attivo). Inoltre, lo studio mostra che le adolescenti possiedono un basso livello di controllo sull'evento del parto, avendo una scarsa conoscenza dei servizi disponibili nella fase pre-e post-natale. Diversamente, l'analisi sulla vaccinazione antinfluenzale degli anziani costituisce un esempio positivo di una politica di sanità pubblica in grado di attenuare l'impatto negativo dello status sociale sull'accesso ai servizi. I risultati ottenuti indicano che i ceti sociali svantaggiati non presentano tassi di vaccinazione inferiori ai ceti più abbienti, come accade in altri Paesi sviluppati quali gli Stati Uniti e la Gran Bretagna, e sono, al contrario, oggetto di una maggiore attenzione da parte dei Sistemi Sanitari Regionali.

Educational Gerontology, 2016

BioMed Research International, 2017

The Journals of Gerontology: Series B, 2016

L'assistenza agli anziani …, Jan 1, 2010

Voluntary work by older people in Europe, 2014

ABSTRACT This chapter informs on the main opportunities and restrictions for older volunteers in ... more ABSTRACT This chapter informs on the main opportunities and restrictions for older volunteers in Italy, through an examination across different levels (i.e. micro, meso, macro and structural). For example, the involvement, the preferences and the motivations of older volunteers have been scrutinised by considering interconnections with voluntary organisations, the welfare mix, the institutional level and cultural attitudes. Among other results, it has been argued that the dimension of older volunteering may be considerably under-estimated in Italy, due to a cultural propensity not to perceive self-expressive volunteer activities, as real “volunteering”. As a consequence of this, self-expressive volunteering among older people is not captured by the available data. The chapter also identifies main challenges on how to improve the match between supply of older candidates with the demand of voluntary organisations in the future, in Italy.