Oneiric stress and safety and security at work: the discovery of a new universal symbol

Cox and Griffiths define as psychosocial risks at work “those aspects of the planning, organization and management of work, which, along with their environmental and social contexts, may affect mental and physical health of the employees, directly or indirectly producing stress”. Therefore, a more effective approach to occupational safety and security should include integrated risk management through the identification of any work stress related problem. The purpose of this paper is to analyze the possible correlation of risk at work with the modification of sleep, and inside it, the specific function of dream activity

Self-selection effects in smokers attending lung cancer screening: a 9.5-year population-based cohort study in Varese, Italy.

BACKGROUND:: We hypothesize that mortality risk profile of participants and nonparticipants in nonrandomized lung cancer (LC) screening of smokers may be different. METHODS:: In 1997, a population-based cohort of 5815 smokers of Varese Province was invited to nonrandomized LC screening by annual chest x-ray examination for 4 years. LC risk factors and screening participation rate were recorded. Except for screening, the whole cohort received usual care. After 9.5-year observation, we compared mortality of participants versus nonparticipants by assessing age-standardized all-cause mortality rate ratio (MRR) and disease group-specific MRR with 95% confidence intervals (95% CI). RESULTS:: Self-selected screening participants were 21% of cohort. Participants were younger (p < 0.001), were more frequently current smokers (p = 0.019), had more pack-years of smoking (p < 0.0001), and had higher rate of LC family history (p < 0.0001) and of occupational LC risk (p < 0.0001) relative to nonparticipants. In logistic regression analysis familial LC, occupational risk and pack-years smoked were significant predictors of participation in screening and of developing LC. Participants displayed a healthy effect, as shown by all-cause MRR = 0.67 (95% CI, 0.53-0.84), all cancers except LC MRR = 0.61 (95% CI, 0.41-0.91), cardiovascular diseases MRR = 0.38 (95% CI, 0.22-0.63), and noncancer disease other than cardiovascular or respiratory MRR = 0.57 (95% CI, 0.34-0.92). The LC mortality (MRR = 1.40; 95% CI, 1.03-1.91) was higher in participants relative to nonparticipants (p = 0.031). CONCLUSION:: The selection effect in LC screening participants was dual: healthy effect and higher LC mortality. In assessing the overall effectiveness of LC screening on a population level, a higher LC mortality risk in participants should be considered

Cost of a population-based programme of chest x-ray screening for lung cancer.

Background. After the implementation of a population- based programme of chest x-ray (CXR) screening on smokers in Varese, Italy, lung cancer (LC) mortality was significantly reduced. Analysis of the incremental costs due to this type of screening programme is needed to evaluate its economic impact on the healthcare system. Methods. In July 1997 a population-based cohort, consisting of all high-risk smokers (n=5,815) identified among 60,000 adult residents from the Varese province, was invited to a LC screening programme (an annual CXR for five years) in a general practice setting, and was observed through 2006. Invitees received National Health Service (NHS) usual care, with the addition of CXRs in screening participants. At the end of observation, among the 245 LCs diagnosed in the entire screening-invited cohort the observed LC deaths were 38 fewer than expected. To estimate the incremental direct cost due to screening in the invited cohort for the period July 1997-2006, we compared the direct cost of screening administration, CXR screens and LC management in the invited cohort and in the uninvited and unscreened controls in NHS usual care setting. Results. Over the 9.5 years, the total incremental direct healthcare costs (including screening organization/administration, CXR screens, additional procedures prompted by false-positive tests, overdiagnosed LCs) were estimated to range from \u20ac 607,440 to \u20ac 618,370 (in euros as of 2012), equating to between \u20ac 15,985- \u20ac 16,273 per patient out of the 38 LC deaths averted. Conclusions. In a general practice setting, the incremental cost for a CXR screening programme targeted at all high-risk smokers in a population of 60,000 adults was estimated to be about \u20ac65,000 per annum, approx. \u20ac16,000 for each LC death averted

An experimental customer satisfaction index to evaluate the performance of city logistics services

© 2016 Vilnius Gediminas Technical University (VGTU) Press. Freight transport in urban areas entails benefits (i.e. free access to goods when needed), but also negative externalities (environmental, social and transportation impacts). In response to these problems, the concept of city logistics emerged, for the purpose of planning, organizing, coordinating and controlling physical and information flows in order to find a compromise between efficient freight distribution in urban areas and protection of the environment. A typical city logistics initiative is the Urban Freight Consolidation Centre (UFCC), the benefits of which are significant. Its financial issues though represent a huge problem for public administrations. However, a large customer network, comprising retailers participating in the initiative, could make the UFCC a self-financing scheme. The key to expanding the scheme is closely linked with marketing campaigns and customer care. Therefore, customer care analysis represents an important tool in developing UFCC schemes. In this paper, a new Customer Satisfaction Index (CSI) is proposed for evaluating UFCC service quality. The new index, named CSImod, is a modified version of the traditional CSI, but places greater emphasis on customer dissatisfaction, so as to analyse the most critical areas of the service with a view to improving them. The index has been tested using experimental data collected within the CIVITAS RENAISSANCE Project, in which the Bristol and Bath Freight Consolidation Centre (BBFCC) scheme was evaluated. The evaluation was done from a user perspective, i.e. the participating retailers. The CSImod places more importance on the most dissatisfied customers making it possible to understand why they are dissatisfied and with what. Thus, it is possible to intervene with the aim of improving those areas of the service that are perceived as the worst. In spite of the high level of satisfaction with the overall service provided by the BBFCC, thanks to the CSImod the analysis pointed out that some retailers are dissatisfied with the delivery time arrangements and also with deliveries that were getting wet, issues about which the BBFCC manager was totally unaware. The CSImod could be used by UFCC operators to extend the network of the retailers involved and could therefore provide an implicit solution for making the scheme self-financing

Cost of a population-based programme of chest x-ray screening for lung cancer

Background. After the implementation of a population- based programme of chest x-ray (CXR) screening on smokers in Varese, Italy, lung cancer (LC) mortality was significantly reduced. Analysis of the incremental costs due to this type of screening programme is needed to evaluate its economic impact on the healthcare system. Methods. In July 1997 a population-based cohort, consisting of all high-risk smokers (n=5,815) identified among 60,000 adult residents from the Varese province, was invited to a LC screening programme (an annual CXR for five years) in a general practice setting, and was observed through 2006. Invitees received National Health Service (NHS) usual care, with the addition of CXRs in screening participants. At the end of observation, among the 245 LCs diagnosed in the entire screening-invited cohort the observed LC deaths were 38 fewer than expected. To estimate the incremental direct cost due to screening in the invited cohort for the period July 1997-2006, we compared the direct cost of screening administration, CXR screens and LC management in the invited cohort and in the uninvited and unscreened controls in NHS usual care setting. Results. Over the 9.5 years, the total incremental direct healthcare costs (including screening organization/administration, CXR screens, additional procedures prompted by false-positive tests, overdiagnosed LCs) were estimated to range from € 607,440 to € 618,370 (in euros as of 2012), equating to between € 15,985- € 16,273 per patient out of the 38 LC deaths averted. Conclusions. In a general practice setting, the incremental cost for a CXR screening programme targeted at all high-risk smokers in a population of 60,000 adults was estimated to be about €65,000 per annum, approx. €16,000 for each LC death averted

Enzymes immobilized in Langmuir-Blodgett films: Why determining the surface properties in Langmuir monolayer is important?

ABSTRACT In this review we discuss about the immobilization of enzymes in Langmuir-Blodgett films in order to determine the catalytic properties of these biomacromolecules when adsorbed on solid supports. Usually, the conformation of enzymes depends on the environmental conditions imposed to them, including the chemical composition of the matrix, and the morphology and thickness of the film. In this review, we show an outline of manuscripts that report the immobilization of enzymes as LB films since the 1980’s, and also some examples of how the surface properties of the floating monolayer prepared previously to the transfer to the solid support are important to determine the efficiency of the resulting device

Cancro del polmone: \ue8 ora di cambiare strategia

Il Medico Ospedalier