Pregnancy-associated osteoporosis with seven vertebral compression fractures, a case treated with strontium ranelate

This paper shows a case of pregnancy-associated osteoporosis (PAO) with seven vertebral compression fractures treated with strontium ranelate and supplementation of calcium and cholecalciferol. Clinical evaluation, laboratory and radiological results are analyzed in the case-report to demonstrate that strontium ranelate is a good option to restore quickly the value of bone mineral density in the treatment of a case of PAO. KEYWORDS

Addressing decisions about new hospitals’ siting: a multidimensional evaluation approach

Background. Site selection for urban facilities is a crucial topic in planning decision processes for the several side effects they produce and the multiple criteria involved, especially for healthcare facilities. Nevertheless, the location problem has been ignored by most of the existing evaluation systems. Methods. Starting from a deep literature review and the analysis of hospitals in 10 European cities, the paper proposes an evaluation system divided into four macro-areas (Functional quality, Location quality, Environmental quality, Economical aspects), each in turn composed by criteria and sub-criteria. Results. The evaluation system has been applied for the site selection of “La Città della alute” in Milan, Italy. Furthermore, the ShOS (Selection hospitals’ Site) Evaluation Tool has been defined, with the aim of assessing the land suitability for new healthcare structures. Conclusion. The ShOS evaluation tool improves the transparency and robustness of the decision-making process and it could be broadly applied

Measuring the expected increase in cycling in the city of Milan and evaluating the positive effects on the population’s health status: a Community-Based Urban Planning experience

BACKGROUND: It's scientifically known that inactivity is one of the major risk factors for Non-Communicable Diseases. One of the elements affecting the choice of transport mode, regarding circulation in the city, is the cities' urban morphology, i.e. the infrastructural facilities for the slow mobility service. Cyclability, in fact, can help to increase daily physical activity level, therefore becoming a protective factor for individual health. METHODS: After a literature review about the state of the art regarding the correlation between built environment, active transport and quantification of the physical activity level, we have developed a specific questionnaire to collect information about current and forecast use of bicycle, in case of improvement and implementation of the cycling network. The questionnaire also investigated social and health aspects concerning the anamnesis of the interviewees (age, gender, health status, sport activity performed, etc) and users' opinions about existing infrastructure and planned interventions, designed to promote cycling mobility. Aim of the research was to quantify the increase of physical activity people would have realized in front of an improvement of the specific infrastructures, and the expected positive effects in terms of health. RESULTS: The collected data (343 interviewed in a district of Milan, named "Zona 7") demonstrate that through the implementation of the cycle network, there would be more cyclists to practice the 150 minutes weekly of physical activity recommended by WHO: time spent in cycling, indeed, would increases by 34.4% compared to the current level of cyclability, as detected by our survey. CONCLUSIONS: The investigation confirmed that urban interventions, especially those in small-scale, could play a key role in the promotion of healthy lifestyles, inducing therefore important positive effects on the population health. It was also carried out an application of the WHO "Health Economic Assessment Tool" to evaluate the benefits in terms of Non-Communicable Diseases' reduction, specifically a provisional quantification of deaths saved

TRASPORTO ATTIVO E SALUTE: MISURAZIONE DELL’INCREMENTO PREVISIONALE DI CICLABILITA’ NELLA CITTA’ DI MILANO E VALUTAZIONE DELLE RICADUTE POSITIVE SULLO STATO DI SALUTE DELLA POPOLAZIONE

INTRODUZIONE: È scientificamente noto come l’inattività fisica sia tra i principali fattori di rischio per l’incremento delle malattie cronico-degenerative. L’emergenza è particolarmente rilevante nei contesti urbani, dove, tuttavia, la maggior parte degli spostamenti copre una distanza inferiore ai 5km, facilmente percorribile a piedi o in bicicletta. Questi spostamenti garantirebbero una sufficiente attività fisica giornaliera. Risulta pertanto necessario indagare quali caratteristiche delle infrastrutture ciclopedonali incentivino o scoraggino l’adozione di corretti stili di vita. METODI: Dopo un confronto con lo stato dell’arte relativo alle correlazione tra trasporto attivo, Physical Activity e salute, è stato redatto un questionario per raccogliere dati sul livello attuale della ciclabilità urbana e quantificare l’incremento previsionale in caso di miglioramento ed implementazione della rete ciclabile. Il questionario è stato somministrato digitalmente e in forma cartacea, per un periodo di 3 mesi nella città di Milano. RISULTATI: I dati raccolti (1675 compilazioni) dimostrano che la scelta della bicicletta come mezzo di trasporto aumenterebbe: nella situazione previsionale il 76,5% del campione (oltre il 21% in più rispetto alla situazione attuale) raggiungerebbe i 150 minuti settimanali di attività fisica raccomandata dall’OMS. È stata condotta inoltre una valutazione dei benefici sulla salute, in termini di riduzione della mortalità causata da malattie cronico-degenerative tramite l’applicazione dello strumento HEAT dell’OMS ha individuato un incremento dei benefici protettivi pari al 5%. CONCLUSIONI: L’indagine condotta ha perseguito lo scopo di individuare gli aspetti da migliorare dal punto di vista del progetto urbano. Scopo principale è quello di sensibilizzare i Policy Makers, evidenziando come gli interventi urbani, soprattutto quelli a piccola scala, potrebbero avere un ruolo chiave nella riduzione dell’inattività fisica e quindi di una maggior salute

Humanisation and soft qualities in emergency rooms

Scenario. Currently, there are few evaluation methods that analyse social aspects in healthcare issues, especially humanisation and well-being, as perceived by users in emergency departments which are places in which patients’ psycho-physical well-being is decisive. For this reason, research was conducted to create a tool to improve the quality of these areas. Methodology. In order to conduct the research, the work was structured in three phases: the first, based on the analysis of State-of-the-Art and the current studies on the interactions established between the physical and emotional conditions of the structure and the users; the second, through the definition of a questionnaire which explores humanisation and comfort aspects; the third, through the application of the instrument. Results. The paper presents and analyses data collected from the application on a case study in Milan, analysing the responses and proposing design suggestions for increasing the quality of emergency environments. Conclusions. In anticipation of future works, the application of such a tool can provide the opportunity to improve and enhance quality and staff efficiency in emergency department spaces

IL VERDE PER MIGLIORARE LA QUALITÀ DELL’ARIA OUTDOOR NEI CONTESTI URBANI

Introduzione: I contesti urbani presentano elevati livelli di inquinamento atmosferico, responsabili di patologie acute e di malattie cronico-degenerative. La vegetazione è in grado di assorbire e trattenere alcune sostanze, tuttavia nelle aree densamente costruite è spesso difficile creare nuovi spazi verdi, se non ipotizzando di utilizzare le coperture. Scopo della ricerca è stato l’elaborazione di un modello di calcolo per la quantificazione delle possibili superfici trasformabili a verde e la relativa capacità di assorbimento degli inquinanti di uno specifico contesto urbano. Metodologia: Il confronto con la letteratura scientifica ha consentito da definizione di correlazioni tra patologie, inquinanti atmosferici e specie arboree in grado di abbatterli. In seguito, è stato sviluppato un modello di calcolo in grado di quantificare gli inquinanti abbattuti in relazione ad uno specifico aumento di verde di un’area urbana. Nella terza parte, il modello di calcolo, è stato sperimentato e validato in un quartiere di Milano. Risultati: L’applicazione dello strumento è avvenuta nel quartiere città studi, a Milano. Le ipotetiche trasformazioni di coperture piane in tetti verdi, porterebbero ad una riduzione degli inquinanti fino a 3,9 μg/m³ di PM10, 2,92 μg/m³ di PM2. 5 e 1,57 μg/m³ di O3 ogni giorno in tutto il quartiere. Se tale ipotesi fosse estesa a tutta la città di Milano si arriverebbe ad un abbattimento di circa 18,09 μg/m³ di PM10, 13,56 μg/m³ di PM2. 5 e 7,24 μg/m³ di O3. Lo strumento ipotizza anche una stima dei costi di realizzazione e i benefici sanitari in termini di riduzione del n. di ricoveri. Conclusioni: Considerando un progetto di riqualificazione urbana la possibilità di recuperare spazi verdi dalle coperture diviene una strategia fondamentale non solo per i benefici psicologici-percettivi, energetici e climatico-ambientali ma anche per la riduzione dell’inquinamento atmosferico urbano, con ricadute positive sulla salute della popolazione

Open building and flexibility in healthcare: strategies for shaping spaces for social aspects

Introduction. The fast development of technology and medicine influences the functioning of healthcare facilities as health promoter for the society, making the flexibility a fundamental requirement. Among the many ways to ensure adaptability, one that allows change without increasing the building’s overall size is the Open Building approach. Methodology. Starting from the analysis of the State-of-the-Art and many case-studies, eight parameters of evaluation were defined, appraising their relative importance through a weighting system defined with several experts. The resulting evaluation tool establishes in what measure healthcare facilities follow the Open Building principles. Results and discussion. The tool is tested to ten case-studies, chosen for their flexible features, in order to determine his effectiveness and to identify projects’ weaknesses and strengths. Conclusions. The results suggest that many Open Building’s principles are already in use but, only through a good design thinking, it will be possible to guarantee architectures for health adaptable for future social challenges

Social sustainability in healthcare facilities: a rating tool for analysing and improving social aspects in environments of care

Introduction. Nowadays several rating systems exist for the evaluation of the sustainability of buildings, but often their focus is limited to environmental and efficiency aspects. Hospitals are complex constructions in which many variables affect hospital processes. Therefore, a research group has developed a tool for the evaluation of sustainability in healthcare facilities. Methodology. The paper analyses social sustainability issues through a tool which evaluates users’ perception from a the quality and well-being perspective. It presents a hierarchical structure composed of a criteria and indicators system which is organised through a weighing system calculated by using the Analytic Network Process. Results and discussion. The output is the definition of a tool which evaluates how Humanisation, Comfort and Distribution criteria can affect the social sustainability of a building. Conclusion. Starting from its application, it is evident that the instrument enables the improvement of healthcare facilities through several design and organisational suggestions for achieving healing and sustainable architectures

PENGARUH DOSIS PUPUK KOMPOS DAN NPK TERHADAP PERTUMBUHAN DAN HASIL BAWANG MERAH (ALLIUM ASCOLANICUM L.) VARIETAS BREBES

Penelitian ini bertujuan untuk mengetahui pengaruh kompos dan NPK pupuk terhadap pertumbuhan dan produksi tanaman bawang Brebes dan interaksi antara kedua faktor. Percobaan ini menggunakan Faktorial Rancangan Acak Pola. Faktor-faktor yang mempengaruhi dosis diuji kompos terdiri dari 4 tingkatan, yaitu: kontrol, 10, 20 dan 30 faktor ton / ha dan NPK dosis pupuk yang terdiri dari 4 tingkatan, yaitu: kontrol, 100, 200 dan 300 kg / ha, sehingga bahwa ada 16kombinasi perlakuan dengan 3 ulangan dan 48 unit percobaan, setiap unit terdiri dari 5 tanaman sampel percobaan.Hasil penelitian menunjukkan bahwa dosis kompos cenderung lebih baik pada dosis pengobatan 30 ton / ha untuk pertumbuhan dan hasil bawang. Sementara itu, NPK dosis pupuk untuk pertumbuhan dan hasil tanaman bawang merah cenderung lebih baik pada dosis pengobatan 200 kg NPK / ha. Tidak ada interaksi yang nyata antara perlakuan dosis pupuk NPK untuk kompos dengan semua variabel yang diamati pada pertumbuhan dan hasil bawang.Kata kunci: bawang, kompos, NPKBanda Ace

Social sustainability in healthcare facilities: a rating tool for analysing and improving social aspects in environments of care

Introduction. Nowadays several rating systems exist for the evaluation of the sustainability of buildings, but often their focus is limited to environmental and efficiency aspects. Hospitals are complex constructions in which many variables affect hospital processes. Therefore, a research group has developed a tool for the evaluation of sustainability in healthcare facilities. Methodology. The paper analyses social sustainability issues through a tool which evaluates users’ perception from a the quality and well-being perspective. It presents a hierarchical structure composed of a criteria and indicators system which is organised through a weighing system calculated by using the Analytic Network Process. Results and discussion. The output is the definition of a tool which evaluates how Humanisation, Comfort and Distribution criteria can affect the social sustainability of a building. Conclusion. Starting from its application, it is evident that the instrument enables the improvement of healthcare facilities through several design and organisational suggestions for achieving healing and sustainable architectures