Waiting times in emergency departments: A resource allocation or an efficiency issue?

Background: In recent years, the flow of patients to the Emergency Departments (ED) of Western countries has steadily increased, thus generating overcrowding and extended waiting times. Scholars have identified four main causes for this phenomenon, related to: continuity of primary care services; availability of specific clinical pathways for chronic patients; ED's personnel endowment; organization of the ED. This study aims at providing a logical diagnostic framework to support managers in investigating specific solutions to be applied to their EDs to cope with high ED waiting times. The framework is based on the ED waiting times and ED admission rate matrix. It was applied to the Tuscan EDs as illustrative example. Methods: To provide the factors to be analyzed once the EDs are positioned into the matrix, a list of issues has been identified. The matrix was applied to Tuscan EDs. Data were collected from the Tuscan performance evaluation system, integrated with specific data on Tuscan EDs' personnel. The Tuscan EDs matrix, the descriptive statistics for each quadrant and the Spearman's rank correlation analysis among waiting times, admission rates and a set of performance indicators were conducted to help managers to read the phenomena that they need to investigate. Results: The combined reading of the correlations and waiting times-admission rates matrix shows that there are no optimal rules for all the EDs in managing admission rates and waiting times, but solutions have to be found considering mixed and personalized strategies. Conclusions: The waiting times-admission rates matrix provides a tool able to support managers in detecting the problems related to the management of ED services. In particular, using this matrix, healthcare managers could be facilitated in the identification of possible solutions for their specific situation

INTERNAL SEGMENTATION, RESIDENTIAL PATTERNS AND JOB-RELATED SPATIAL MOBILITY FOR INDEPENDENT PROFESSIONALS. AN ORIGINAL ANALYSIS ON PRIMARY DATA.

This study challenges the traditions of the sociology of work and industrial relations by taking into consideration a new emergent category of workers: the Independent Professionals (IPros). Recent data (Labour Statistics) provide some hints on the relevance of the phenomenon: self-employed workers in advanced services (finance, counselling, producing-distributing information, auditing and so on) have increased their share in employment in most countries. As a recent survey (Edelman Berland 2014) pointed out, 53 million Americans are doing freelance work (53 percent of the entire workforce) Despite these figures, the phenomenon is still overlooked by the academic literature. The aim is to provide a first description of this phenomenon not only from a mere labour perspective, but considering spatial practices and lifestyles too. Indeed labour studies and economic sociology should not avoid considering space and time as two main dimensions shaping their object of study: workers are not abstract entities, they are fully part of the material environment they move in. Labour markets, Welfare regimes, and spatial processes play together. Mobility-related literature traditionally identifies two different forms of moving to get a job: mobility of less skilled people for whom becoming mobile is the only way to get a job, and mobility of highly qualified people, looking for career opportunities. What is missing in this binary analysis is a new intermediate workforce, the self-employed independent professionals (Ipros) who often experience long distance interregional commuting patterns. Among them there are young high-skilled people with low income who are likely to undergo phenomena of spatial exclusion at the regional level. Where do they live? Where do they work? What are the explaining micro and macro variables? These questions will be discussed in the contribution which has firstly a descriptive and investigative aim. The method of study is based on quantitative analysis mainly performed on web survey data, due to the lack of available offical data sources in Italy. Specifically we provide a detailed description of survey design and data collection process, with a focus on methodological strategies applied for data cleaning, coding and editing in order to better highlight first descriptive results related to research questions. GIS (Geographical Information System) tools have been applied to survey data in order to provide a full extensive spatial description of social phenomena investigated: the core analysis is based on GIS and spatial statistics techniques by using data collected at micro and macro levels

FROM ARCHIVE DOCUMENTATION TO ONLINE 3D MODEL VISUALIZATION OF NO LONGER EXISTING STRUCTURES: THE TURIN 1911 PROJECT

Rebuilding the past of cultural heritage through digitization, archiving and visualization by means of digital technology is becoming an emerging issue to ensure the transmission of physical and digital documentation to future generations as evidence of culture, but also to enable present generation to enlarge, facilitate and cross relate data and information in new ways. In this global effort, the digital 3D documentation of no longer existing cultural heritage can be essential for the understanding of past events and nowadays, various digital techniques and tools are developing for multiple purposes. In the present research the entire workflow, starting from archive documentation collection and digitization to the 3D models metrically controlled creation and online sharing, is considered. The technical issues to obtain a detail 3D model are examined stressing limits and potentiality of 3D reconstruction of disappeared heritage and its visualization exploiting three complexes belonging to 1911 Turin World’s Fair

An efficient and stereoselective dearylation of asarinin and sesamin tetrahydrofurofuran lignans to acuminatolide by methyltrioxorhenium/H2O2 and UHP systems

The synthesis of stereoisomers of acuminatolide is rare and requires complex and time-consuming multistep procedures. Asarinin (1) and sesamin (2), two diasteromeric tetrahydrofurofuran lignans, are efficiently mono-dearylated by methyltrioxorhenium (MTO, I) and hydrogen peroxide (H2O2) or urea hydrogen peroxide adduct (UHP) as primary oxidant to give (-)-(7R,8'R,8R)-acuminatolide (3A) and (+)-(7S,8R,8'R)-acuminatolide (3B), respectively, in high yield and diastereoselectivity (de > 98%). The oxidation of 1 was also performed with novel heterogeneous catalysts based on the heterogenation of MTO on poly(4-vinylpyridine) and polystyrene resins. In these latter cases 3A was obtained with a different yield and selectivity depending on the physical-chemical properties of the support. Cytotoxic effects of 3A and 3B in mammalian cell lines in vitro are also reported

Current surgical concepts and indications in the management of the short bowel state: A call for the use of multidisciplinary intestinal rehabilitation programs

The mainstay of management for short bowel syndrome (SBS) is to promote access to the best quality of care provided by the intestinal rehabilitation program (IRP) in specialized centres. When treating SBS patients, the main goal is to minimize disease-associated complications, as well as achieve enteral autonomy. Surgical strategies should be selected cautiously upon the actual state of the bowel with respect to what it is clinically relevant for that specific patient. To this aim, a personalized and multidisciplinary approach for such a complex syndrome is needed

A rapid spectroscopic method to detect the fraudulent treatment of tuna fish with carbon monoxide

Carbon monoxide (CO) can be used to treat fresh meat and fish in order to retain its 'fresh' red colour appearance for a longer period of time. In fact, upon aging, myoglobin is oxidized to met-myoglobin with the concomitant blue-shift and broadening of the Soret maximum, which brings about a change in the colour of the fish, revealing that it is no longer fresh. The use of carbon monoxide, which reacts with the oxy-myoglobin to form a fairly stable cherry red carboxy-myoglobin complex may mask spoilage, because the CO-complex can be stable beyond the microbiological shelf life of the meat. The presence of CO in tuna fish has been investigated by optical spectroscopy as the formation of the CO adduct can be easily detected by the combined analysis of electronic absorption spectra in their normal and second derivative modes, monitoring the intense Soret band at 420 nm. The presence of met- and oxy-myoglobin can obscure the presence of small amounts of the CO adduct; however, it can be revealed by chemically reducing the met- and oxy-forms to the deoxy-form in an anaerobic environment. This spectroscopic method provides a qualitatively rapid laboratory screening procedure for food control to unmask the presence of CO in frozen or fresh fish. (c) 2006 Elsevier Ltd. All rights reserved

"TORINO 1911" project: A contribution of a SLAM-based survey to extensive 3D heritage modeling

In the framework of the digital documentation of complex environments the advanced Geomatics researches offers integrated solution and multi-sensor strategies for the 3D accurate reconstruction of stratified structures and articulated volumes in the heritage domain. The use of handheld devices for rapid mapping, both image- and range-based, can help the production of suitable easy-to use and easy-navigable 3D model for documentation projects. These types of reality-based modelling could support, with their tailored integrated geometric and radiometric aspects, valorisation and communication projects including virtual reconstructions, interactive navigation settings, immersive reality for dissemination purposes and evoking past places and atmospheres. The aim of this research is localized within the “Torino 1911” project, led by the University of San Diego (California) in cooperation with the PoliTo. The entire project is conceived for multi-scale reconstruction of the real and no longer existing structures in the whole park space of more than 400,000 m², for a virtual and immersive visualization of the Turin 1911 International “Fabulous Exposition” event, settled in the Valentino Park. Particularly, in the presented research, a 3D metric documentation workflow is proposed and validated in order to integrate the potentialities of LiDAR mapping by handheld SLAM-based device, the ZEB REVO Real Time instrument by GeoSLAM (2017 release), instead of TLS consolidated systems. Starting from these kind of models, the crucial aspects of the trajectories performances in the 3D reconstruction and the radiometric content from imaging approaches are considered, specifically by means of compared use of common DSLR cameras and portable sensors

Survey and Trend of Some Zoometric Parameters Correlated to the Growth of Male Subjects of Mediterranean Italian Buffalo for Meat Production

In this study was evaluated the presence of hereditary disposition to meat production in Mediterranean Italian buffaloes through the analysis of variation of certain important parameters related to the production of meat, in 40 young subjects having the same age. The parameters studied were: live weight, daily weight gain (DWG), withers height, thoracic circumference and trunk length. These values were investigated by controls every 21 days during the period ofmajor growth of the animals, that is from the 240th day of life up to the attainment of slaughter weight. This work has pointed out that there are significant differences in growth between animals of the same age. The data suggested that hasn't yet been made any selection about the presence of hereditary disposition to meat production in Mediterranean Italian Buffalo