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Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

One of the challenges of providing healthcare services is to enhance its value (for patients, staff and the service) by integrating the informal caregivers into the care process, both concretely managing their patient's health conditions and treatment (co-executing) and participating in the whole healthcare process (co-planning). This study aims at exploring the co-production contribution to the healthcare process, analysing whether and how it is related to higher caregivers' satisfaction with service care and reduced staff burnout, in the eyes of the staff. It also investigated two possible factors supporting caregivers in their role of co-producers, namely relationship among staff and informal caregivers related to knowledge sharing (i.e. an ability determinant supporting co-production) and related to role social conflict (i.e. a willingness determinant reducing co-production). Results of a structural equation model on a sample of 119 healthcare providers employed by neurorehabilitation centers in Italy with severe acquired brain injury confirmed that knowledge sharing positively related with caregivers' co-executing and co-planning. Also, social role conflict was negatively related with co-executing but positively with co-planning. Furthermore, co-planning resulted in being unrelated to both outcomes, whereas co-executing was associated with caregivers' satisfaction, as measured by staff perceptions. Overall, our data provided initial empirical evidence supporting the ability of the determinant's contribution in allowing informal caregivers to assume an active role in both co-production domains. Furthermore, as expected, the role of conflict willingness determinant was found to be a hindering factor for co-executing but, conversely, a trigger for co-planning. This result should be considered more carefully in future studies., (© 2020 John Wiley & Sons Ltd.)

Pain is an important non-motor symptom in several neurological diseases, such as Parkinson's disease, cervical dystonia, amyotrophic lateral sclerosis, severe acquired brain injury, disorders of consciousness and dementia, as well as in oncology and neuroinfectivology. To overcome the lack of evidence-based data on pain management in these diseases, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) has defined criteria for good clinical practice among Italian neurorehabilitation professionals. Here a review of the literature (PubMed, EMBASE and gray literature) on pain characteristics, treatment and impact of pain in a neurorehabilitation setting is provided. Despite the heterogeneity of data, a consensus was reached on pain management for patients with these diseases: it is an approach originating from an analysis of the available data on pain characteristics in each disease, the evolution of pain in relation to the natural course of the disease and the impact of pain on the overall process of rehabilitation. There was unanimous consensus regarding the utility of a multidisciplinary approach to pain therapy, combining the benefits of pharmacological therapy with the techniques of physiotherapy and neurorehabilitation for all the conditions considered. While some treatments could be different depending on pathology, a progressive approach to the pharmacological treatment of pain is advisable, starting with non-opioid analgesics (paracetamol) and nonsteroidal anti-inflammatory drugs as a first-line treatment, and opioid analgesics as a second-line treatment. In cases of pain secondary to spasticity, botulinum neurotoxin, and, in some cases, intrathecal baclofen infusion should be considered. Randomized controlled trials and prospective multicenter studies aimed at documenting the efficacy of pain treatment and their risk-benefit profile are recommended for these conditions.

Hemispatial neglect due to right parieto-temporo-frontal lesions has a negative impact on the success of rehabilitation, resulting in poor functional gain. Recent research has shown that different types of neglect can impact in a different way on rehabilitation outcomes. The availability of a sensitive test, useful for distinguishing egocentric and allocentric forms of neglect, may be clinically important as all current clinical instruments fail to distinguish between these forms of disturbance, yet they differentially predict outcome. The Apples Test is a new instrument useful to evaluate both egocentric and allocentric forms of neglect. In order to establish Italian norms for this diagnostic instrument the test was administered to a sample of 412 healthy people of both genders (201 M and 211 F), aged from 20 to 80 years enrolled from 14 different rehabilitation centers in Italy. Based on the data, we established pathological performance cut-offs for the accuracy score (total omission errors), the asymmetry score for egocentric neglect (omission error difference), the asymmetry score for allocentric neglect (commission error difference) and execution time. The usefulness of the Apples Test for diagnostic purposes is illustrated by presenting three patients with different forms of neglect (egocentric, allocentric and mixed neglect).

The data's from National Statistic Institute referring to all Italians hospitalized during 1988 are: 37,312 patient due venous diseases, 2.03 p. cent of all hospitalized patients. Varicose veins diseases are more represented in female (10,948 f. and 4,476 m.). A regional study shows an increase in the north of Italy. The medium amount of days in hospital per patient is reduced in the last years at 11 day (from 18 d). The days in hospital in phlebophatic patients were 409,568 (20,522,122 d. for all diseases) during 1988. The expenses for hospital charges due to venous diseases were estimated in 163,827,000,000 of Italian liras, 136,522,500 US. dollar. Other report consider the factory working as the most important in the scale of job inducing phlebophaties. The first seems to be textile industries, at the second place the food factory, the last are builders. In 1974 were lost 2,300,000 working days. We suppose that increasing of private angiological assistance and having a poor public assistance in Italy the patients undergone to hospitals are reducing (81,599 with venous diseases in 1974 and 37,312 in 1988).

The mortality rate from cardiovascular diseases was analysed for Italy as a whole and for individual regions in a sample year (1975). A distinction was made between cardiac and vascular diseases in order to assess the real incidence of the latter. The absolute number of deaths, the percentage mortality and the specific mortality quotient were studied. Deaths were also divided into age groups. Cardiovascular diseases were found to be the primary cause of death, circulatory disease the second. Among the latter, diseases of the encephalic circulation took first place. The same parameters were applied to the 1965-1983 period. Mortality due to cardiovascular disease remained constant over the period since the decrease in deaths from cardiac conditions was offset by an increase in those due to vascular disease in the strict sense. Finally the specific standardised mortality quotients per age and sex were considered in the 1970-1979 period. Mortality trends in Italy and in the individual regions were identical to those described using non-standardised indices.