The European health services have well responded to the COVID-19 emerging crisis, especially if and where the intensive care unit (ICU) capacities were sufficient, were prepared and collectively cooperating, sharing knowledge and were able to protect from further spreading of the disease among the healthcare workforce and the patients. Today, only 47% of hospitals have the recommended coverage of intensive care specialists and they are unevenly distributed between centres and periphery. The Cyber-Physical System for Telemedicine and Intensive Care (CPS4TIC) enables existing or new ICU structures to transform and operate as one ICU Hub with one central ICU and connected ICUs in peripheral hospitals. CPS4TIC was used successfully in the first wave of COVID-19 to ensure efficient and effective diagnosis and treatment of COVID-19 patients, while reducing the risk of infection drastically. The CPS4TIC consists of a telemedicine cockpit, telemedicine consoles at each peripheral hospital, a connector platform and smart bedside hubs including robotic arm at the bedsides of both, the central telemonitoring clinics and the peripheral telemonitored hospitals. The ICU Hub operates telemedicine, continuous real-time telemonitoring and bedside smart care environment. The bedside smart care environment reduces the risk of infection for the health workforce significantly both for the central and the peripheral hospitals. ICU4Covid will deploy and test the CPS4TIC at large-scale, in 10 ICU Hubs in Europe, involving more than 30000 patients/year with a coverage of approximately 60 Million citizens.

"<< Background >>Families of people with mental health problems are not sufficiently supported by public or private services operating in this field.The stigma, the isolation and self-isolation of the person with mental troubles equally exclude the family members from social relationships. At the same time the recovery interventions are not only directed to the most fragile person, but also to the whole family. A study conducted in five European countries(Italy, United Kingdom, Germany, Greece and Portugal) shows that family members who care for schizophrenic adults spend an average of 6-9 hours a day in providing care and a survey carried out by Rethink in the United Kingdom found that 95% of operators are family members of users (WHO, User empowerment in mental health, 2010): they have to be valorized and supported (European Framework for Action on Mental Health and Well-being, 2016).The relevant role of the families is reaffirmed in ""The European Mental Health Action Plan 2013-2020"", which indicates: ""Identify and provide resources to support families who care for loved ones needing a long period of care, including training, support services and adequate benefits. ""But the interventions and methodologies that are adopted to support families are little known and widespread.FA.M.HE. is directed to sup-fulfills two of the 6 PRINCIPLES to be applied in action according to the ""European Framework for Action on Mental Health and Well being"" of the EU Joint Action on Mental Health and Well being (2016):A) Empowerment and involvement of patients, families and their organizations;B) Ensuring that policy and actions are supported by robust research evidence and knowledge of good practices, for contributing to the improvement of the dissemination of knowledge and the fight against the stigma associated with mental health problems, ensuring the participation of users and families.In this field, the psychoanalyst J.Garcia Badaracco had developed a innovative methodology , in the late 60s in the Borda psychiatric hospital of Buenos Aires, organizing the Multifamily Groups (MFGs) meetings with family members of several families at the same time. Since the end of the 90s his methodology has been spreading in Europe, particularly in Italy, Spain and Portugal, and in the last four years also in Belgium.Partners are working with this methodology but they are reporting many different elements in the organization and management in family meetings. Are different the therapeutic space, number of conductors / facilitators, timing of the group’s meetings, size of the groups, purpose (preventive or therapeutic), management of the group (by psychiatrists, psychologists, but also by nurses, social workers, educators). Even the role and the training of the conductors/facilitators are different.These interventions are insufficiently known both by the public and private institutions and are not supported by homogeneous and recognized methodologies and tools.There are several shortcomings related to multifamily groups, which can be summarized in two large groups:A) lack of research and information, by users and by institutions (stakeholders and policy makers)B) lack of training curriculum on the organization and the management of the MFGs, based on the sharing of tested methodologies, although the start-up and management of MFGs is a complex process that requires qualified interventions and the development of specific skills and competencies.<< Objectives >>Different objectives will be achieved that concern people, families, stakeholders and organizations working in the mental health field, but also all stakeholders and policy makers involved in social policies:A. Increase the knowledge about the Multifamily Groups (MFGs) existing in the field of mental health, and disseminate the collected information obtained trough a specific research on the types of existing models in different territories and at international level;B. Improve the operational methods adopted in GMF meetings, organized according to the theory of Garcia Badaracco, through the definition of standards for the organization and management of the groups, to support professionals, stakeholders and policy makers through a wealth of knowledge shared by experts from different countries and backgrounds;C. Strengthen the role and the figure of the conductor / facilitator of the MFGs in the labour marked and mental health sector, through the design of a European training curriculum based on his core skills and competencies, starting from partners experiences;D. Reinforce local communities for the development of new MFGs managed by conductors trained by an European curriculum, providing information, methodology and tools;E. Strengthen the Practice Community among MFGs key workers on mental health, through the organization of permanent sharing of know-how, of the training courses, of all documents offered as OER.About 1400 participants will be directly involved in the project: multi-family groups, conductors /facilitators, stakeholders and policy makers in the field of mental health. The realization of the intermediate objectives of FA.H.ME will be achieved also through territorial groups of experts and other participants not directly involved in the main activities. This will contribute to widen the number of participants, coming from Universities and public an private mental health services and social services.<< Implementation >>The activities are directly related to the objectives:A) A documentary and field research will analyze: territorial diffusion of the different MFGs models, their characteristics and presence in public/private entities in 4 countries and at international level, through a common survey tool and analysis of documentation, and via the web through a specific tool. A Guide of Multi-family Groups on mental health will be elaborated. These materials will be disseminated via the web platform and in the Universities and public and private organizations , through the partners social networks and the new elements involved by FA.H.ME.B) Each partner analyses the elements and characteristics of at least three MFGs meetings, taking into account the elements and results of the previous research. Areas to be explored : 1) constitution; 2) organization; 3) management; 4) review of results of the meeting.These 4 reports constitute the work materials of LTT activities, during three days of Job Shadowing. Partners:- analyze and compare the results;- identify the common elements of each area;- draw up a first version of a Vademecum.The coordinator of the LTT Activities organizes the final version of the Vademecum, the starting point for the analysis of the competencies.C) The coordinator of this tool set defines the methodology and the tools to identifies the competencies of the conductor/facilitator. The partners make suggestions and coordinator adopt them. A facilitator, expert in skills analysis:- organizes with each partner 1 virtual meetings with 9 conductors/facilitators of the MFGs (psychiatric, psychologist, nurses ...), to detect the competencies performed in four territories;- elaborates the results in a preliminary version.The coordinator shares this preliminary version, collects suggestions and elaborates the Competency Framework of the conductor/facilitator with the inputs received.The Training Curriculum (TC) of the conductor/facilitator includes the following activities:-The coordinator of this tool set defines the methodology and tools for developing the TC, organized into teaching units and modules.- The modules and units are distributed among the partners based on their experience. - Each partner produces learning content and develops the assigned modules, and tests them through a focus group with a local MFG.The coordinator collects the modules and proposes the preliminary version of the TC, which will be tested on the four territories through a focus group of 10 conductors / facilitators, realized with two main objectives: 1. to test and validate the TC and 2. its adequacy to transfer the contents of the program and the underlying skills of other conductors, following a model of training of trainers (ToT).D) Through the Communication and Dissemination Plan created at the beginning of FA.M.HE and the web platform the new products will be disseminated to numerous new users identified during the activities on the territories and by the web.. They are mainly networks of people and organizations, stakeholders and policy makers in the field of mental health who share the same interests and who will use the results of the project in their training activities and/or in their daily activities (therapeutic support , training, information and dissemination activities).The new website will facilitate the availability of materials which, like OER, will be innovative and highly useful tools for other stakeholders and policy makers across Europe.E) Organization of meetings, focus groups, researches and conferences in universities, in mental health services and through the web strengthens the community of practice on MFGs, already active among the partners, but also creates a wide social network of professionals who can collaborate , share and improve working methods and tools, facilitating the spread of MFGs in the field of mental healt<< Results >>The Results of FA.M.HE. are released sequentially:1. guide on “The Multi-family Groups in Mental Health "",2.the toolkit ""Competencies and training of the multifamily groups conductor / facilitator, according to the Garcia Badaracco theory"" which contains three tool sets:-the ""Vademecum on distinctive elements of MFG"", -the ""Competency Framework of professional and transversal of the conductors / facilitators, "" and -the ""Training Curriculum of the conductor / facilitator"".These results are included in the web platform, with all the working documents created during the project, in the partner language and in English. This web platform will be a space opened to health, social and training workers and families, that will access not only to improve their work and deepen their knowledge about MFGs , but also to exchange documents and information.The OER will be opened to a wide community of users, who will be able to:- get a personalized access to learning/training tools developed by the project, so that they can access and pick only those parts or sections of their interest:- develop and upload new contents, maximizing the impact of the project on large scale;;- be linked to web resources accredited on the topic.The features of the OER read as follows:- Various online support tools;- Free downloadable reading / training / activity material related to the outputs of project;- Links and documents to other OER;- Questionnaires / evaluations available to freely test knowledge;- Interaction with partners and institutions at European level.FA.M.HE. will produce other tangible outputs at the level of management (Work plan and its associated instruments, Evaluation strategy, Tools and Reports) as well as for the dissemination and valorization activities, during the project life and on its completions, brochures and presentation, web site, 4 newsletters, information leaflets and other dissemination tools as described in the Dissemination section.Through FA.M.HE., the realization of tangible products is accompanied by the development of equally important intangible products:* in relation to the participants responsible for the project actions:increased knowledge and competencies of all participants; adoption of common working methods and tools that will be used at the end of the project; greater formalization of MFGs experiences, taking into account the different contexts in which they develop and all the actors involved; strengthen and expand the community of practice, through the creation of networks based on the exchange of information and knowledge;* in relation to the participants in the dissemination and enhancement actions (other families, people with mental illness, stakeholders and policy makers):greater involvement of stakeholders and policy makers in mental health issues, taking into account the role of the family and the training of the conductor/facilitator of the MFGs,collaboration in the dissemination of these experiences and in the involvement of families, greater inclusion of families to strengthen their role in the adopted actions.At the end of the project- multifamily groups will have a recognized role in the interventions taken to improve mental health services and measures,- the web platform offers to draw on documents, information and e-learning modules to therapists, policy makers, university students and professors, families and all stakeholders interested on mental health issues;- the training course of the conductor / facilitator will be made available to all the institutions / bodies concerned;- the knowledge acquired through FA.M.HE. on MFGs and on group’s management will be available to any interested parties."

Patients with cardiovascular risk factors, e.g. hypertension and obesity are at risk of developing heart failure with preserved ejection fraction (HFpEF), a highly prevalent disease in the elderly, mostly women population. There is currently no specific, defined treatment for HFpEF, beyond control of risk factors. Activation of cardiac and vascular Beta3-adrenergic receptors (B3AR) represents a new concept and a novel target for structural cardiac disease. B3AR expression and coupling were demonstrated in human myocardium and vasculature. In pre-clinical models with expression of the human receptor, its activation attenuates myocardial remodelling, i.e. decreases hypertrophy and fibrosis in response to neurohormonal or hemodynamic stress. Mirabegron is a new agonist of B3AR available for human use, that was recently introduced for a non-cardiovascular indication (overactive bladder disease). The primary objective of the project is to design and implement a multi-centric, prospective, randomized, placebo-controlled clinical trial testing the additional beneficial effect of mirabegron, versus placebo over 12 months on top of standard treatment of patients carrying structural cardiac disease without overt heart failure (stage B of AHA classification); the co-primary end-point will be the quantitative change in myocardial hypertrophy measured by cardiac MRI; and in diastolic ventricular function, measured by Doppler echocardiography (E/E’); in addition, exercise tolerance (peak VO2) will be measured as well as circulating biomarkers reflecting both myocardial remodeling and function. In addition, we will test the effect of mirabegron on beige/brown fat activation and metabolism. Our proposal therefore combines a major conceptual advance and repurposing of an original drug to validate pre-clinical discoveries in the context of a major health problem.

GRIP on MASH will address the unmet public health need of reducing disease burden and comorbidities associated with Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD). Together with seven medical technology, pharmaceutical and biotechnology companies, we will devise a sustainable and scalable GRIP on MASH Platform that will enable access to at-risk patients developing or having MASLD through the early detection of this condition at the primary care level. This Platform will allow A) the early detection of patients with MASLD: distributed in 12 European Centers of Excellence (CoEs), 10,000 patients at high risk of MASLD - defined as patients with type-2 diabetes mellitus, metabolic syndrome, obesity or arterial hypertension - will be screened and characterized; B) better patients’ stratification: the Platform will comprise artificial intelligence-based decision support tools that will make use of existing and novel biomarkers/biomarker combinations. Their predictive accuracy will be tested at the primary care level; there we will perform multi-OMICs analysis (proteomics, lipidomics, metabolomics, genomics, metagenomics and fluxomics) in fasted blood samples and we will explore imaging biomarkers/organ-on-a-chip to find future non-invasive diagnostic alternatives for the current standard (liver biopsies); and C) personalized lifestyle advice, by exploring evidence-based lifestyle features and the effect of nutritional recommendations: among the cohorts at the CoEs, we will use validated questionnaires to assess physical activity, diet, sleep, smoking, alcohol consumption, and perception of stress. Integrating patients’ perspectives with the participation of two patient organizations, the trustworthiness and sustainability of our GRIP on MASH Platform will be assessed by investigating potential economic, ethical and regulatory barriers to its future adoption. GRIP on MASH will change healthcare practice in MASLD and reduce the disease burden for patients.