Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products

__Abstract__ Osteoporosis has become a major health concern, carrying a substantial burden in terms of health outcomes and costs. We constructed a model to quantify the potential effect of an additional intake of calcium from dairy foods on the risk of osteoporotic fracture, taking a health economics perspective. Introduction: This study seeks, first, to estimate the impact of an increased dairy consumption on reducing the burden of osteoporosis in terms of health outcomes and costs, and, second, to contribute to a generic methodology for assessing the health-economic outcomes of food products. Methods: We constructed a model that generated the number of hip fractures that potentially can be prevented with dairy foods intakes, and then calculated costs avoided, considering the healthcare costs of hip fractures and the costs of additional dairy foods, as well as the number of disability-adjusted life years (DALYs) lost due to hip fractures associated with low nutritional calcium intake. Separate analyses were done for The Netherlands, France, and Sweden, three countries with different levels of dairy products consumption. Results: The number of hip fractures that may potentially be prevented each year with additional dairy products was highest in France (2,023), followed by Sweden (455) and The Netherlands (132). The yearly number of DALYs lost was 6,263 for France, 1,246 for Sweden, and 374 for The Netherlands. The corresponding total costs that might potentially be avoided are about 129 million, 34 million, and 6 million Euros, in these countries, respectively. Conclusions: This study quantified the potential nutrition economic impact of increased dairy consumption on osteoporotic fractures, building connections between the fields of nutrition and health economics. Future research should further collect longitudinal population data for documenting the net benefits of increasing dairy consumption on bone health and on the related utilization of healthcare resources

Methods and tools to evaluate the availability of renewable energy sources

The recent statements of both the European Union and the US Presidency pushed in the direction of using renewable forms of energy, in order to act against climate changes induced by the growing concentration of carbon dioxide in the atmosphere. In this paper, a survey regarding methods and tools presently available to determine potential and exploitable energy in the most important renewable sectors (i.e., solar, wind, wave, biomass and geothermal energy) is presented. Moreover, challenges for each renewable resource are highlighted as well as the available tools that can help in evaluating the use of a mix of different sources

Economia di territorio e area integrata

Proposta del tavolo di discussione sul tema del rapporto tra economia, insediamento, paesaggio e infrastruttura per il Libro Bianco per la città di Parm

Is there a role for menopausal hormone therapy in the management of post-menopausal osteoporosis?

We provide an evidence base and guidance for the use of menopausal hormone therapy (MHT) for the maintenance of skeletal health and prevention of future fractures in recently menopausal women. Despite controversy over associated side effects, which has limited its use in recent decades, the potential role for MHT soon after menopause in the management of postmenopausal osteoporosis is increasingly recognized. We present a narrative review of the benefits versus risks of using MHT in the management of postmenopausal osteoporosis. Current literature suggests robust anti-fracture efficacy of MHT in patients unselected for low BMD, regardless of concomitant use with progestogens, but with limited evidence of persisting skeletal benefits following cessation of therapy. Side effects include cardiovascular events, thromboembolic disease, stroke and breast cancer, but the benefit-risk profile differs according to the use of opposed versus unopposed oestrogens, type of oestrogen/progestogen, dose and route of delivery and, for cardiovascular events, timing of MHT use. Overall, the benefit-risk profile supports MHT treatment in women who have recently (< 10 years) become menopausal, who have menopausal symptoms and who are less than 60 years old, with a low baseline risk for adverse events. MHT should be considered as an option for the maintenance of skeletal health in women, specifically as an additional benefit in the context of treatment of menopausal symptoms, when commenced at the menopause, or shortly thereafter, in the context of a personalized benefit-risk evaluation

PARMA CITTÀ FUTURA VOLUME II Il libro bianco

Secondo volume di Parma Città Futura Il libro bianco raccoglie il lavoro di riflessione strategica organizzato in dieci tavoli di discussione che si sono spontaneamente attivati grazie all’impegno di docenti di vari Dipartimenti dell’Università di Parma che si sono dedicati a elaborare proposte collegate all’attuazione del Progetto Urbano Strategico documentato nel primo volume. Come le varie politiche urbane possono orientarsi e svilupparsi nella prospettiva di concretizzare una idea di città verde accessibile ed accogliente come quella prefigurata? Cultura con la proposta di realizzare un museo/laboratorio della città, Sport e tempo libero orientato all’uso consapevole e condiviso dello spazio pubblico, cittadi- nanza attiva, comunicazione scientifica come nuovo cromosoma nel DNA della città, musica come identità e risorsa, economia di territorio ed area integrata, mobilità sostenibile, tecnologie innovative per la casa e la città, salute e benessere, strategie di attuazione, sono i temi affrontati da oltre 130 persone provenienti da 66 enti, fondazioni, istituzioni e associazioni per elaborare progettualità di settore mirate e complementari. Oltre alle proposte dei vari tavoli offerte alla città ed alla sua amministrazione comunale, l’esperienza di un network flessibile di lavoro collettivo come quello coagulatosi nel 2016 viene presentato come strumento di riflessione operativa e di confronto permanente da mantenere in vita e rilanciare per stimolare un processo prezioso quanto raro di democrazia deliberativa

Effects of pre‐operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or >= 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care