Il sistema del cibo torinese: risorsa economica e spazio delle politiche

Questo contributo presenta, sinteticamente, il sistema del cibo di Torino come oggetto di riflessione e spazio di azione da due punti di vista, strettamente interconnessi. In primo luogo, il sistema del cibo di Torino (inteso in una logica multiscalare che tiene insieme il livello urbano e quello territoriale metropolitano) viene analizzato in quanto filiera economica, costituita da un insieme complesso di attori, risorse, spazi, flussi e relazioni che attengono alla produzione, trasformazione, distribuzione, consumo e smaltimento di cibo. La filiera agro-alimentare intercetta la città e il territorio producendo molteplici economie urbane, molte delle quali capaci di migliorare la sostenibilità ambientale, la giustizia e l’inclusione sociale del sistema stesso. Inoltre, queste economie rappresentano sempre più una leva fondamentale nella costruzione simbolica e materiale della Torino post-industriale. In secondo luogo, il sistema alimentare di Torino viene letto come spazio di politiche (urbane e territoriali) che, negli ultimi anni, si muovono nella direzione di strategie integrate e partecipate, le quali rappresentano anche un’occasione preziosa di contaminazione e reciproca valorizzazione tra le economie del cibo e gli aspetti socioculturali ad esso sottesi. Le riflessioni qui presentate vanno lette all’interno del più ampio progetto di Atlante del cibo di Torino Metropolitana, strumento di analisi, rappresentazione e comunicazione del sistema del cibo urbani e territoriale

The impact of Nursing Homes staff education on end-of-life care in residents with advanced dementia: a quality improvement study

Context. End-of-life care in nursing homes (NHs) needs improvement. We carried out a study in 29 NHs in the Lombardy Region (Italy).Objectives. The objective of this study was to compare end-of-life care in NH residents with advanced dementia before and after an educational intervention aimed to improving palliative care.Methods. The intervention consisted of a seven-hour lecture, followed by two 3-hour meetings consisting of case discussions. The intervention was held in each NH and well attended by NH staff. This multicenter, comparative, observational study included up to 20 residents with advanced dementia from each NH: the last 10 who died before the intervention (preintervention group, 245 residents) and the first 10 who died at least three months after the intervention (postintervention group, 237 residents). Data for these residents were collected from records for 60 days and seven days before death.Results. The use of "comfort hydration" (< 1000 mL/day subcutaneously) tended to increase from 16.9% to 26.8% in the postintervention group. The number of residents receiving a palliative approach for nutrition and hydration increased, though not significantly, from 24% preintervention to 31.5% postintervention. On the other hand, the proportion of tube-fed residents and residents receiving intravenous hydration decreased from 15.5% to 10.5%, and from 52% to 42%, respectively. Cardiopulmonary resuscitations decreased also from 52/245 (21%) to 18/237 (7.6%) cases (P = 0.002).Conclusion. The short educational intervention modified some practices relevant to the quality of end-of-life care of advanced dementia patients in NHs, possibly raising and reinforcing beliefs and attitudes already largely present. (C) 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved

The last week of life of nursing home residents with advanced dementia: a retrospective study

Background Barriers to palliative care still exist in long-term care settings for older people, which can mean that people with advanced dementia may not receive of adequate palliative care in the last days of their life; instead, they may be exposed to aggressive and/or inappropriate treatments. The aim of this multicentre study was to assess the clinical interventions and care at end of life in a cohort of nursing home (NH) residents with advanced dementia in a large Italian region. Methods This retrospective study included a convenience sample of 29 NHs in the Lombardy Region. Data were collected from the clinical records of 482 residents with advanced dementia, who had resided in the NH for at least 6 months before death, mainly focusing on the 7 days before death. Results Most residents (97.1%) died in the NH. In the 7 days before death, 20% were fed and hydrated by mouth, and 13.4% were tube fed. A median of five, often inappropriate, drugs were prescribed. Fifty-seven percent of residents had an acknowledgement of worsening condition recorded in their clinical records, a median of 4 days before death. Conclusions Full implementation of palliative care was not achieved in our study, possibly due to insufficient acknowledgement of the appropriateness of some drugs and interventions, and health professionals' lack of implementation of palliative interventions. Future studies should focus on how to improve care for NH residents

Safety and efficacy of the feed additive consisting of protease produced by Bacillus licheniformis DSM 33099 (ProAct 360) for use in poultry species for fattening or reared for laying/breeding (DSM Nutritional Products Ltd)

Free PMC article:Following a request from the European Commission, EFSA was asked to deliver a scientific opinion on the safety and efficacy of a protease (ProAct 360) produced by a genetically modified strain of Bacillus licheniformis (DSM 33099) as a zootechnical feed additive for poultry species for fattening or reared for laying/breeding. The production strain and its recombinant DNA were not detected in an intermediate concentrated product representative of the final formulation. The final product did not trigger a safety concern with regard to the genetic modification. The Panel on Additives and Products or Substances used in Animal Feed (FEEDAP) concluded that ProAct 360 is considered safe for all growing poultry species at the recommended inclusion level of 30,000 NFP/kg complete feed. The use ProAct 360 as a feed additive did not give rise to concerns for the consumers or the environment. The additive is not an eye or a dermal irritant but should be considered a respiratory sensitiser. In the absence of data, no conclusions could be reached on the skin sensitisation potential of the additive. The FEEDAP Panel concluded that the additive has the potential to be efficacious at 30,000 NFP/kg complete feed for all poultry species for fattening or reared for laying/breeding.info:eu-repo/semantics/publishedVersio

Gesture and Symbolic Representation in Italian and English-Speaking Canadian 2-Year-Olds

Analyses of elicited pantomime, primarily of English-speaking children, show that preschool-aged children are more likely to symbolically represent an object with gestures depicting an object's form rather than its function. In contrast, anecdotal reports of spontaneous gesture production in younger children suggest that children use multiple representational techniques. This study examined the spontaneous gestures of sixty-four 2-year-old Italian children and English-speaking Canadian children, primarily from middle-class Caucasian families. The Italian children produced twice as many gestures as Canadian children in a picture-naming task but produced a similar range of representational techniques. Two-year-olds were equally likely to produce gestures depicting function as form. These data suggest young children's communicative skills are supported by a symbolic capacity that reflects contextual communicative demands