VALUE-BASED EVIDENCES TO FACE THE NEW CHALLENGES OF HEALTH PROMOTION IN A SUSTAINABLE HEALTHCARE SYSTEM

Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population\u201f health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP) as \u201cthe process of enabling people to increase control over and to improve their health and well-being\u201d. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society\u201fs sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics

Night-time shift work and related stress responses: A study on security guards

Work-related stress can induce a break in homeostasis by placing demands on the body that are met by the activation of two different systems, the hypothalamic\u2013pituitary\u2013adrenal axis and the sympathetic nervous system. Night-shift work alters the body\u2019s exposure to the natural light\u2013 dark schedule and disrupts circadian (daily) rhythms. The greatest effect of night-shift work is the disruption of circadian rhythms. The impact that these disruptions may have on the pathogenesis of many diseases, including cancer, is unknown. This study aims to discover the relationship among three different job activities of security guards and their stress-related responses by evaluating salivary cortisol levels and blood pressure. Methods: Ninety security guards, including night-time workers and night-time and daily-shift workers, were recruited for this study. Each security guard provided two saliva samples before and after three scheduled time points: (i) at 22:00, (ii) at 06:30, and (iii) at 14:00. Results: The results of the study showed a significant alteration in cortisol levels. Night-time shift cortisol levels significantly increased before and after the work shifts. A physiological prevalence of the vagal tone on the cardiocirculatory activity was found during night-shift work. Conclusions: This study indicates that cortisol levels and blood pressure are sensitive markers of biological responses to severe work stress. Shift-change consequences may occur at the end of the night shift when there is a significant increase in the cortisol level and a significant variation in cardiovascular parameters

Contact-damage coupled modelling of FRP reinforcements under variable loading times

In the last years FRP (Fiber Reinforced Polymer) technology has been developed to repair damaged concrete structures. In this work it is proposed to investigate the complex mechanism of stress-strain evolution at the FRP interface, during different loading programs (short or long-time loadings), until complete debonding. This study has been performed by means of a fully threedimensional approach within the context of damage mechanics, to appropriately catch transversal effects as well as normal stresses, developing a realistic and comprehensive study of the delamination process. The adhesion properties have been reconstructed through a contact model incorporating an elastic-damage constitutive law, relating inter-laminar stresses acting in the sliding direction. A F.E. research code (FRPCON) has been developed, including a numerical procedure accounting for Mazars’s damage law inside the contact algorithm. The code is able to describe the delamination process considering the different surface preparation of the concrete part as well. The long-time behaviour of these composite structures has been studied by means of two visco-elastic formulations: i) Bazant’s B3 law has been considered for the concrete component, where creep effect is composed by three different terms, i.e. the elastic part, basic creep and drying creep; ii) for FRP’s fibres and matrix a micromechanical approach has been implemented. The experimental results of long-time bending tests have been used to calibrate and validate the numerical models

Aggregate behaviour in concrete materials under high temperature conditions

Concrete under high temperature conditions is a topic of wide interest for applications in several engineering fields, from nuclear to civil as well as building engineering

EUROMEDITERRANEAN BIOMEDICAL JOURNAL: THE RENEWED MANUSCRIPT LAYOUT AND WEB RENDERING FORESHADOW FURTHER JOURNAL IMPROVEMENT

In January 2006, a new journal, Capsula Eburnea, was born into the Italian scientific publishing scene with the initial goal of creating, at the same time, \u201can open scientific forum and a blog\u201d, based on the premise that \u201cin medicine, nothing should be considered stable, immutable or unsusceptible to critical review at any time, by any scientist\u201d. The Editorial Team progressively sought to improve the quality of the manuscripts published, introducing the requirement for all articles to be written in English, and changed the Journal\u2019s name to EuroMediterranean Biomedical Journal in 2012. Over the last five years, approximately 125 articles by young doctors (including original articles, reviews, commentaries, notes, and abstract books) have been published. The editorial board are confident that the new publishing layout and the renewed web-portal of the journal, introduced in this editorial, represent an essential upgrade after over 10 years of editorial activity, and that these improvements will be appreciated by our authors and, especially, our readers

Numerical modelling of ellipsoidal inclusions

Within the framework of numerical algorithms for the threedimensional random packing of granular materials this work presents an innovative formulation for polydispersed ellipsoidal particles, including an overlapping detection algorithm for an optimized simulation of the mesostructure of geomaterials, particularly concrete. Granular composite cement-based materials can be so reconstructed with adequate precision in terms of grain size distribution. Specifically, the algorithm performance towards the assumed inclusion shape (ellipsoidal or spheric) and degree of regularity (round or irregular) is here discussed. Examples on real grading curves prove that this approach is effective. The advantages of the proposed method for computational mechanics purposes are also disclosed when properly interfaced with visualization CAD (Computer Aided Design) tools

Autoerotic accidental death by Self-inflicted asphyxia by Body-wrapping in a plastic curtain

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Perceived need for an International Elective Experience among Italian Medical Residents.

In the contemporary society an International Health Elective (IHE) represents a strategic tool in order to implement future medical doctor\u2019s education. In Italy, in the last decade, an increasing interest of trainees and residents to IHE and opportunities was documented and supported by the reorganization of the Italian residency programs, provided by the Ministry for Education, University and Research (MIUR). Aim of the present study was to collect data on perceived need of medical residents for an IHE. A structured questionnaire was developed and administered to medical residents of Palermo\u2019s University who underwent their annual visit to the Occupational Health Physician Ambulatory (OHPA) of Palermo\u2019s University Hospital, in the period between March and October 2011. Medical residents more prone to undergo an IHE were, younger than 29 years old (p <0.01), attending the new educational system (p 0.02) and surgical residents (p= 0.0001). A negative opinion about the formative quality performances of the residency program was significantly associated with surgical residencies (p= 0.002). Future Italian surgeons are more prone to undergo an IHE and this statement is probably related to the not satisfying residency program. Residents attending the old educational system consider the IHE as a way to implement their professional perspectives possibly for their more realistic professional perspective facing an approaching future full of work uncertainties. Considering the future competition between medical professionals working in different EU contexts, the Italian Government should implement future medical education policy in order to provide for a Healthcare \u201cwithout Border\u201d in the EU

Investigation of stress-strain behaviour in concrete materials through the aid of 3D advanced measurement techniques

This work deals with the investigation of the mechanical behaviour of cementitious materials, following a mesoscopic approach where aggregates, grains and cement paste are explicitly represented, and the strict comparison between the numerical results and the experimental results from uniaxial tests is carried out. For this purpose, solid models are created with the support of advanced techniques of measurement and detection, such as laser scanners or computer tomography (CT). The 3D laser- scanning technique in fact allows to acquire the exact shape of the grains added to the concrete mix design while, through the adoption of an ad-hoc random distribution algorithm, a realistic disposition of the inclusions is guaranteed. The industrial CT instead, is able to reproduce exactly the tested specimens; the geometry of the inclusions and their placement. Once reconstructed realistic geometries for the models, the mechanical behaviour of concrete under uniaxial compression tests is numerically studied. A specific constitutive behaviour is assigned to each component; an elasto-plastic law with damage is assumed for the cement matrix while the aggregates are conceived to behave elastically. The implemented damage-plasticity model consists in the combination of the non-associated plasticity model by Men\ue9trey-Willam, where the yield surface is described in function of the second and the third invariant of the deviatoric stress tensor and the scalar isotropic damage model by Mazars. Comparisons between numerical and experimental results fairly prove the correctness of the suggested approach