ENERGETIC CONSUMPTION PREDICTION ON CONSTRUCTION SITE

The paper presents some ongoing results of a research still carried on by the authors concerning the design and management of a ‘green’ construction site. The study is born from the exigency that every design discipline has to deal with the importance of making the building process more sustainable. So, it’s necessary not only to proceed with an Integrated Design, but also to achieve sustainability by a focused construction site design. Starting from the well‐known definition of sustainability ‐ sustainable development for future generations ‐ the research has identified three basic issues in order to save the necessary resources: (i) the energetic consumption of construction site, (ii) the wastes production, (iii) the environmental impact on the around human activities. Some results of the analysis of the first basic issue are presented here. The method used follows two different approaches. The first concerns the collection and setting of data about ended construction sites. In particular these data regard the urban parameters of the building construction, the significant works realized, the electrical consumption of the construction process and its costs. These data have been collected thanks to the involvement of a number of building firms, that were interested in understanding the impact of the electricity charges on their business. The second analysis concerns yard equipments. Data about their electrical consumptions have been collected and organized into critical schedules. In different sections are contained information about the equipment typology, the kind of supply and the start up power. Equipments data have been collected using existing publication, technical sheets and interviewing manufacturers. The final aim of the research will be the definition of innovative construction site design in order to optimize its sustainability, by orienting its designers choices

Yard energy data collection

The aim of the research is to develop methods and tools to predict, during the design phase, the construction site need of energy, so to orient technological and operating choices in order to reduce, at the same time, energy consumptions and construction costs. In recent years, following the expectations and deadlines set by the European and International Community, the attention of the construction industry to a more sustainable use of resources has been directed mainly towards the energetic optimization and energy savings during the life cycle of a building, involving every design discipline. However, to date, sustainability isn’t a permanent requirement of the construction site discipline. The current situation of the building sector, by contrast, may act as a fruitful phase in the development of new construction equipment that combine both the goal of energy savings and of energetic self-sufficiency of a yard using semi-industrial systems for the production of renewable energy. The first phase of the research consisted in the data collection of the main European energy distributor (TERNA), of the users (construction companies) and of the producers of construction site equipment. The collection has allowed the identification of a series of building descriptors useful to correlate the operational design with the possibility to save energy during construction. In order to validate the method, the data collection is now going on in the field, by direct observation of consumptions associated with specific works. At the same time the group of research is studying some new construction site equipment sustainability oriented

Severe community onset healthcare-associated Clostridium difficile infection complicated by carbapenemase producing Klebsiella pneumoniae bloodstream infection.

BACKGROUND: Clostridium difficile infection (CDI) and Klebsiella pneumoniae carbapenemase producing-Klebsiella pneumoniae (KPC-Kp) bloodstream infection (BSI) are emerging health-care associated (HCA) diseases of public health concern, in terms of morbidity, mortality, and insufficient response to antibiotic therapy. Both agents can be acquired in the hospital but clinical disease can develop in a community setting, after discharge. We report here a putative link between the above-mentioned healthcare associated infections that appeared as a dramatic community onset disease with a fulminant fatal outcome. CASE PRESENTATION: We describe the case of a 63 year old man affected by severe CDI. Even though the patient underwent 72 hours of standard CDI antibiotic treatment, the clinical course was complicated by toxic megacolon and KPC-Kp BSI. The patient died 24 hours after total colectomy. CONCLUSION: The impact of HCA-BSIs in complicating CDI is still unknown. Intestinal inflammatory injury and disruption of intestinal flora by standard antibiotic treatment could be responsible for promoting difficult-to-treat infections in CDI. By preserving intestinal flora, Fidaxomicin could have a crucial role in preventing BSIs complicating severe CDI

Candidemia Subsequent to Severe Infection Due to Clostridium difficile: Is There a Link?

[No abstract available

A cluster of fulminant Clostridium difficile colitis in an intensive care unit in Italy

We describe, for the first time, a cluster of lethal fulminant health-care associated Clostridium difficile (CD) colitis in Italy, observed in the intensive care unit (ICU) of an Italian tertiary care hospital in Rome. For all cases the cause of ICU admission was CD-related septic shock. Three out of seven patients were residents in a long-term care facility in Rome, and the others had been transferred to the ICU from different medical wards of the same hospital. Five patients died within 96 h of ICU admission. Because of a clinical deterioration after 4 days of adequate antibiotic therapy, two patients underwent subtotal colectomy: both of them died within 30 days of surgical intervention. In four cases, ribotyping assay was performed and ribotype 027 was recognized. This high mortality rate could be attributable to three findings: the extent of disease severity induced by the strain 027, the delay in antimicrobial therapy administration, and the lack of efficacy of the standard antibiotic treatment for fulminant CD colitis compared to an earlier surgical approach. In order to contain a CD infection epidemic, control and surveillance measures should be implemented, and empirical therapy should be administered. Because of potential 027 ribotype CD spread in Italy, CDI should be regarded with a high index of suspicion in all patients presenting with shock and signs or symptoms suggesting abdominal disease, and an early surgical approach should be considered