La disuguaglianza socio-economica della salute come indicatore di benessere sociale

Obiettivo: Misurare il benessere sociale attraverso l’utilizzo della disuguaglianza socioeconomica della salute percepita dalle famiglie italiane e quantificare i contributi dei determinanti della salute alla disuguaglianza misurata. Materiali e metodi: Sono utilizzati i dati dell’indagine Istat sulle condizioni di vita (UDB IT-SILC), componente longitudinale. L’analisi è effettuata su un sotto-campione di 11.543 individui e 12 variabili, ottenuto dopo aver eliminato i dati mancanti per la variabile reddito e per le altre variabili rilevanti per la salute. E’ applicato il modello di regressione probit ordinale, per ottenere una misura continua della variabile salute, l’indice di concentrazione della salute, per misurare la disuguaglianza della salute, e infine la scomposizione della disuguaglianza, per calcolare il contributo di ciascun determinante. Le analisi sono a livello territoriale NUTS1. Risultati e conclusioni: La disuguaglianza di salute correlata al reddito è stimata pari all’1,18% a livello nazionale, mentre a livello territoriale il gradiente tra salute e reddito interviene solo al Sud. A livello territoriale, l’analisi rivela una disuguaglianza nella percezione della buona salute in tutte e cinque le ripartizioni territoriali, concentrata nel gruppo di individui avvantaggiati economicamente. La disuguaglianza nella salute è percepita maggiormente nel Nord Ovest (1,69%), seguita dal Nord Est (1,53%) e dal Sud (1,35%), Centro (1,21%); mentre la disuguaglianza della salute percepita non è significativa nelle Isole (-0,0012; IC95%=[-0,01; 0,01]). Emerge che in Italia nel 2010 si ha complessivamente una buona percezione della salute, che si concentra negli individui maschi, con una migliore posizione socioeconomica, istruzione più elevata, occupati; mentre esistono disuguaglianze nella malattia cronica e disabilità che penalizzano alcuni gruppi di popolazione svantaggiati economicamente con basso livello di istruzione e fuori dal mercato del lavoro

The Combination of Advanced Tools for Parameters Investigation and Tools Maintenance in Flow Forming Process

Abstract In this work, the authors present an investigation on technological parameters affecting the flow forming process of aluminum alloy 6060 tubular structures and to discuss about the tools maintenance. Flow forming tests were carried out by mounting a single roller on a lathe machine. A 3D thermo-mechanical finite element model was developed to analyze the interaction between the roller and the workpiece in terms of forces, strains and thermal distribution. The effects of friction conditions were investigated through the FE model results and comparing them with acquired thermal maps. The model was validated by comparing the geometrical characteristics of the workpieces, such as the axial elongation, the inner and outer tube diameter. Aluminum spring-back was taken into account with material model adopted in the numerical algorithm. Once collected a complete information on the process parameters, some thermal images were acquired on roller in order to find a parameters set able to reduce the stresses acting on it as far as to obtain the maximum elongation with the minimum number of passes

AN ADAPTIVE METHOD TO FOCUSING IN AN UNKNOWN SCENARIO

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Undetected patricide: Inaccuracy of cause of death determination without an autopsy

Patricide (killing the father) is uncommon form of homicide. Usually the assaults occur at home in the absence of witnesses and adult sons are frequently involved. Homicides in a domestic context usually do not tend to recurrence, because the motivation for the crime ends with the death of the parent. However, this is not what was observed in the present case study dealing with the death of a 70 years old white man originally misclassified as accident and discovered three years later only after an additional homicide in a family context of a 60 years old white lady. Multiple stab wounds to the neck and thorax were misinterpreted at the external male body examination as blunt trauma falling down stairs. No forensic autopsy was requested and no comparison of medical findings with the results from the death scene, such as a bloodstain analysis was performed by the police officers nor required by the judicial authority. This was quite surprising because an additional but preliminary post-mortem external examination performed by a general practitioner on the male body already raised the suspicion that the external lesions were stab wounds thus requiring a forensic autopsy. Only the exhumation of the elderly body, performed years later, confirmed the diagnostic hypothesis raised by the first physician. The present case is quite representative of a death investigation not run professionally and performed by individuals with no specific training where most of the medico-legal investigations (especially for traumatic and violent deaths) are restricted to an external body examination without subsequent autopsy. Although misinterpretation of external lesions is inevitable and significant discrepancies between external body examination and forensic autopsy are not rare, in the case of contradictory results of postmortem external examination or unclear/suspicious cause and manner of death, investigation should proceed necessarily with a forensic autopsy

Rac inhibits thrombin-induced Rho activation: evidence of a Pak-dependent GTPase crosstalk

The strict spatio-temporal control of Rho GTPases is critical for many cellular functions, including cell motility, contractility, and growth. In this regard, the prototypical Rho family GTPases, Rho, Rac, and Cdc42 regulate the activity of each other by a still poorly understood mechanism. Indeed, we found that constitutively active forms of Rac inhibit stress fiber formation and Rho stimulation by thrombin. Surprisingly, a mutant of Rac that is unable to activate Pak1 failed to inhibit thrombin signaling to Rho. To explore the underlying mechanism, we investigated whether Pak1 could regulate guanine nucleotide exchange factors (GEFs) for Rho. We found that Pak1 associates with P115-RhoGEF but not with PDZ-RhoGEF or LARG, and knock down experiments revealed that P115-RhoGEF plays a major role in signaling from thrombin receptors to Rho in HEK293T cells. Pak1 binds the DH-PH domain of P115-RhoGEF, thus suggesting a mechanism by which Rac stimulation of Pak1 may disrupt receptor-dependent Rho signaling. In agreement, expression of a dominant-negative Pak-Inhibitory Domain potentiated the activation of Rho by thrombin, and prevented the inhibition of Rho by Rac. These findings indicate that Rac interferes with receptor-dependent Rho stimulation through Pak1, thus providing a mechanism for cross-talk between these two small-GTPases

Radiation risks knowledge in resident and fellow in paediatrics: A questionnaire survey

Background: Analyse through a multi-choice anonymous questionnaire the knowledge's level in paediatric residents and fellows in two different main Italian hospital, looking mainly to the information to patients and relatives related to risks of ionizing radiation used in common radiological investigations in children. Methods: 65 multi choice questionnaires were distributed to paediatric residents and fellows of two different hospitals, an University Hospital (A.O.U.P. "P. Giaccone"- University of Palermo) and a national reference centre for paediatrics (Ospedale Pediatrico Bambino Gesù - Rome). The questionnaire included twelve multiple-choice questions with the aim of analyzing the knowledge about ionizing radiation related risks in infants and children who undergo common diagnostic radiology investigations. The data obtained were processed using software Stata/MP version 11.2. In order to measure the level of expertise of each interviewee a binary indicator was built. The value 1 was assigned if the percentage of correct answers exceeds the median of the distribution and 0 for values not exceeding the median. The association between the level of competence and demographic characteristics (gender, age) and training experience was measured by means of α2 test. Results: 51/65 questionnaires were completed, returned and analysed (87.7%). Only 18 surveyed (35%), (95% IC=[22%-48%]) can be defined as competent in radiation risk knowledge for common radiological investigations, considering the percentage of correct answers at least of 50% (sufficient knowledge was given with a minimum score of 8 correct answers out of 12). Conclusions: The study demonstrates an urgent need to implement the radiation protection knowledge in the training programme of paediatricians, that improve if just a short targeted training is performed

A Minor Modification of Lichtenstein Repair of Primary Inguinal Hernia: Postoperative Discomfort Evaluation.

The aim of this study was to evaluate the usefulness of a modification of the Lichtenstein hernioplasty procedure by evaluating its impact on postoperative discomfort. From December 1999 to May 2006, the Lichtenstein inguinal hernioplasty was performed in 406 patients with noncomplicated unilateral inguinal hernia. During reconstruction, the mesh was fixed to the inguinal canal floor without stitching its upper margin to the internal oblique muscle. Control of postoperative pain proved to be satisfactory; 72 hours after surgery, 26.1 per cent of patients no longer felt any pain, whereas 54.4 per cent had slight pain without the need for painkillers; on Day 7, 92.8 per cent felt no pain at all. After 10 days, 86.7 per cent of those with sedentary jobs were able to return to work, whereas 79.1 per cent of those with heavier jobs resumed work in 11 to 15 days. Our modification of the original Lichtenstein procedure permitted us to obtain satisfactory results with regard to the control of postoperative chronic pain and a rapid reprisal of normal working activity

GPR surveys for the characterization of foundation plinths within a seismic vulnerability analysis

We present the results of GPR surveys performed to identify the foundation plinths of 12 buildings of a school, whose presence is uncertain since the structural drawings were not available. Their effective characterization is an essential element within a study aimed at assessing the seismic vulnerability of the buildings, which are non-seismically designed structures, located in an area classified as a seismic zone after their construction. Through GPR profiles acquired by two 250 MHz antennas, both in reflection mode and in a WARR configuration, the actual geometry and depth of the building plinths were successfully identified, limiting the number of invasive tests necessary to validate the GPR data interpretation, thus enabling the choice of the most suitable sites that would not alter the serviceability of the structure. The collected data were also critically analysed with reference to local environmental noise that, if causing reflections superimposed on those of the subsoil, could undermine the success of the investigation. Due to the homogeneity of the ground, the processing and results relative to each pair of profiles carried out for all of these buildings is very similar, so the results concerning only two of them are reported

Ganymede's Surface Investigation in Support of the Radar for Icy Moon Exploration (RIME) Instrument

In order to support the JUICE mission and in particular RIME activities, we have initiated a research effort for understanding the geology of Ganymede