Steps towards collective sustainability in biomedical research

The optimism surrounding multistakeholder research initiatives does not match the clear view of policies that are needed to exploit the potential of these collaborations. Here we propose some action items that stem from the integration between research advancements with the perspectives of patient-advocacy organizations, academia, and industry

Comunità cooperative. Terzo rapporto sulla cooperazione sociale in Italia

Il terzo rapporto sulla cooperazione sociale fornisce vari elementi conoscitivi che consentono di definire meglio i modelli interpretativi a spiegazione del successo e della grande crescita della cooperazione sociale. Il focus del presente rapporto è pertanto rivolto sia a spiegare lo sviluppo della cooperazione sociale che il differenziarsi dei modelli organizzativi presenti al suo interno.- Indice #4- Prefazione #10- Cap.I I contenuti del terzo rapporto sulla cooperazione sociale, Carlo Borzaga e Flaviano Zandonai #18- Cap.II I dati ministeriali: una fotografia della cooperazione sociale, Gianfranco Marocchi #46- Cap.III Le cooperative sociali nel nonprofit italiano: convergenze e divergenze strutturali, Nereo Zamaro #74- Cap.IV L’inserimento lavorativo nelle cooperative sociali, Gianfranco Marocchi #98- Cap.V La cooperazione sociale a livello locale: il caso della Lombardia, Alessandro Ronchi #120- Cap.VI Peculiarità e modelli delle cooperative sociali, Carlo Borzaga e Sara Depedri #144- Cap.VII Le reti tra cooperative sociali: il fenomeno consortile, Emmanuele Pavolini #188- Cap.VIII Alcune riflessioni sulla natura imprenditoriale della cooperazione sociale, Michele Andreaus #222- Appendice #258- Dentro le regioni #260- Bibliografia #33

Collective health research assessment : developing a tool to measure the impact of multistakeholder research initiatives

Background: The need to more collaboratively measure the impact of health research and to do so from multidimensional perspectives has been acknowledged. A scorecard was developed as part of the Collective Research Impact Framework (CRIF), to engage stakeholders in the assessment of the impacts of health research and innovations. The purpose of this study was to describe the developmental process of the MULTI-ACT Master Scorecard (MSC) and how it can be used as a workable tool for collectively assessing future responsible research and innovation measures. Methods: An extensive review of the health research impact literature and of multistakeholder initiatives resulted in a database of 1556 impact indicators. The MSC was then cocreated by engaging key stakeholders and conducting semi-structured interviews of experts in the field. Results: The MSC consists of five accountability dimensions: excellence, efficacy, economic, social and patient-reported outcomes. The tool contains 125 potential indicators, classified into 53 impact measurement aspects that are considered the most relevant topics for multistakeholder research and innovation initiatives when assessing their impact on the basis of their mission and their stakeholders’ interests. The scorecard allows the strategic management of multistakeholder research initiatives to demonstrate their impact on people and society. The value of the tool is that it is comprehensive, customizable and easy to use. Conclusions: The MSC is an example of how the views of society can be taken into account when research impacts are assessed in a more sustainable and balanced way. The engagement of patients and other stakeholders is an integral part of the CRIF, facilitating collaborative decision-making in the design of policies and research agendas. In policy making, the collective approach allows the evaluation perspective to be extended to the needs of society and towards responsible research and innovation. Multidimensionality makes research and innovations more responsive to systemic challenges, and developing more equitable and sustainable health services.publishedVersionPeer reviewe

Beni comuni. Quarto rapporto sulla cooperazione sociale in Italia

A dieci anni dalla prima edizione, il quarto rapporto sulla cooperazione sociale aggiorna e amplia il quadro conoscitivo su uno dei più innovativi fenomeni imprenditoriali, che ha contribuito ad arricchire il panorama delle istituzioni sociali del paese.- Indice #5- Premessa di Marco Demarie #13- Presentazione di Corrado Passera #15- Prefazione di Vilma Mazzocco e Johnny Dotti #21- Cap.I La cooperazione sociale in Italia: tendenze evolutive e scenari di sviluppo, Flaviano Zandonai #33- Cap.II Un quadro teorico sull’impresa sociale, Carlo Borzaga #55- Cap.III Le traiettorie di sviluppo della cooperazione sociale, Gianfranco Marocchi #75- Cap.IV Imprenditorialità sociale tra innovazione e controllo dei mercati, Nereo Zamaro #107- Cap.V Cooperazione sociale e Mezzogiorno, Marco Musella #139- Cap.VI Le culture organizzative della cooperazione sociale: identità in movimento, Luca Fazzi e Sandro Stanzani #151- Cap.VII La cooperazione sociale nella rete del welfare locale, Sergio Pasquinelli #187- Cap.VIII I benefici individuali dei lavoratori svantaggiati nelle imprese sociali, Carlo Borzaga, Monica Loss e Domenico Zalla #207- Cap.IX Cooperazione sociale e qualità dei servizi, Giuseppe Scaratti #237- Cap.X La cooperazione sociale in una prospettiva di genere, Barbara Moreschi #265- Cap.XI Cooperativa sociale come impresa sociale? Le condizioni di imprenditorialità nel terzo settore, Michele Andreaus #285- Cap.XII Oltre il contracting out: nuove forme di relazione con le amministrazioni pubbliche, Franco Dalla Mura #319- Cap.XIII Finalità e organizzazione delle cooperative sociali: alcune indicazioni dal nuovo diritto societario, Antonio Fici #349- Cap.XIV L’impresa sociale in Italia: una quantificazione del fenomeno, Stefano Cima #377- Cap.XV Le condizioni di sviluppo delle imprese sociali nelle regioni del Centro-Nord, Carlo Borzaga e Mariangela Mongera #405- Cap.XVI Dal volontariato all’impresa sociale, Gabriella Bartolomeo e Flaviano Zandonai #439- Cap.XVII L’impresa sociale in Europa: alcuni spunti di comparazione, Paola Iamiceli #457- Cap.XVIII La nuova legge sull’impresa sociale, Felice Scalvini #485- Bibliografia #49

Le aziende non profit del settore socio-assistenziale in provincia di Trento: risultati di un'indagine

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Prediction of micromotion initiation of an implanted femur under physiological loads and constraints using the finite element method

In cementless total hip replacement surgery the conditions for micromotion initiation at the bone–stem interface and the role of stair climbing versus gait in promoting incipient slipping deserve attention. The goal of the present paper was to propose a finite element approach for analysing the structural behaviour of hip joint prostheses under physiological loadings and boundary conditions, which allows the prediction of micromotion initiation with low computational effort. In this paper, three-dimensional (3D) finite element analyses were performed of intact and implanted human femurs in order to address the above-mentioned problems. Accurate finite element models based on computed tomography images of a human femur were employed; tetrahedral elements were used to construct the models and the contact options of a full bond between the femoral bone and stem were also used. The shear strains at the contact between femoral bone and stem were evaluated. Two loading cases, namely walking and stair climbing, were applied to investigate the effect of different loading conditions on the shear strain patterns. Shear strains in the z direction can be reasonably considered a significant stimulus of slip initiation or fibrous tissue formation or both at the bone–stem interface, whereas shear strains in the x–y plane can be assumed to be a sensible measurement of the tendency to implant–bone micromotion under torsional loads. Comparisons with other studies are complicated by the difference in the methods and testing conditions used. If mobilization is to be initiated, rotational displacements at the interface should be sensible and significant parameters, i.e. the material, should be distorted to some extent. Thus, for a particular point on the bone–metal interface, the maximum shear strain in any direction within the interface plane will indicate the likelihood of slippage initiation at that point. The different femur states (intact and implanted) and loading conditions (walking and stair climbing) are compared. The stair-climbing loads resulted in the highest strains observed under any conditions, either intact or implanted

Analisi dello sforzo meccanico all'interfaccia osso corticale - stelo protesico della protesi d’anca mediante il Metodo degli Elementi Finiti.

Background. L’anca è, fra le articolazioni, quella che sopporta i carichi maggiori e che quindi più facilmente va incontro a cedimenti meccanici. Tali carichi inoltre sono ciclici e pertanto, mentre nelle strutture ossee possono indurre risposte favorevoli da parte del rimodellamento osseo, nelle protesi impiantate producono fenomeni di fatica. Obiettivi. Si vuole analizzare dal punto di vista strutturale l’impianto di una protesi d’anca non cementata, mettendone in risalto i criteri di progettazione e affrontando la soluzione del problema per via numerica. Metodi. L’indagine si è avvalsa del metodo degli elementi finiti e si è concentrata sulla simulazione numerica del comportamento meccanico dell’interfaccia osso corticale- stelo protesico, ipotizzando il raggiungimento della perfetta osteointegrazione. Il ricorso al metodo degli elementi finiti è giustificato dal fatto che le strategie analitiche o sperimentali non sempre sembrano facilmente percorribili nella trattazione di problemi complicati come l’analisi strutturale di una protesi impiantata. Risultati. Sono stati ottenuti la distribuzione degli sforzi tangenziali, di Mises, e principali nelle due situazioni di deformazione piana e di assial-simmetria sia nel caso di una lamina radiale sottile sia nel caso dell’intero sistema strutturale. Conclusioni. I risultati numerici nelle due situazioni prima citate sono molto vicini e rispecchiano le note conoscenze sperimentali. Background. Among skeletal joints, the hip bears the largest loads and it is likely to encounter mechanical risks. Such loads are cyclic and, while in the bone tissue they can induce favourable responses from the bone remodeling, in the hip implantable prostheses they produce fatigue damage. Objective. The aim of this study is to analyze stress and strain of an uncemented hip prosthesis by a numerical simulation. Methods. Under the hypothesis of perfect osteointegration, finite element model focuses on the analysis of the mechanical behaviour of the cortical bone-titanium stem interface. Results. Distribution of the shear, von Mises, first and third principal stresses are described in the two situations of plane strain (considering a thin radial lamina) and axial symmetry stress-strain (considering the whole structural system). Conclusions. Numerical results in the above mentioned two situations are very similar and they exhibit a good agreement with the experimental knowledges

Risk of failure at the cement-enamel junction of a human premolar tooth

Non-carious cervical lesions (NCCL) are characterized by the loss of dental hard tissue at the cement-enamel junction (CEJ). This type of cervical tooth loss, the so-called abfraction, can be associated with cuspal flexure, due to malocclusal loads causing the tooth to laterally bend. Exceeding stresses are therefore generated in the cervical region of the tooth that cause disruption of the bonds between the hydroxyapatite crystals, leading to crack formation and eventual loss of enamel and the underlying dentine. The aim of this study was to perform stress analyses of the first maxillary human premolar. An accurate model based on CT images of both the tooth and the periodontal ligament was employed. The threedimensional finite element model was used to investigate the stress distributions and to compare the changes occurring between normal and malocclusion. The risk of failure at the CEJ and to crack initiation at the dentin-enamel junction was also estimated

Optimal bone density distributions: Numerical analysis of the osteocyte spatial influence in bone remodeling

In this paper a control and optimization procedure for bone remodeling simulations was adopted to study the effect of the osteocyte influence range on the predicted density distribution. In order to reach this goal, the osteocyte network regulating bone remodeling process in a 2-D bone sample was numerically simulated. The assumed proportionalintegral-derivative (PID) bone remodeling rule was related to the error signal between the strain energy density and a selected target. Furthermore the control parameters and the target were optimally determined minimizing a suitable cost index: the goal was to minimize the final mass and the energy thus maximizing the stiffness. The continuum model results show that the developed and adapted trabecular structure was consistent with the applied loads and only depended on the external forces, the value of the cost index, the maximum attainable elastic modulus value (hence, the maximum density value) and the value of the energy target. The remodeling phenomenon determined the number and thickness of the trabeculae which are formed from a uniform distribution of mass density in the considered domain; this number and these thicknesses are controlled by the values assigned to the parameters of the model. In particular, the osteocyte decay distance (D) of the influence range affected the trabecular patterns formation, showing an important effect in the adaptive capacity of the optimization numerical model. 2013 Elsevier Ireland Ltd. All rights reserved