Towards a network around civic agriculture in the Province of Pisa

This paper aims at exploring the pathway towards the creation of a network around the principles of civic agriculture in the Province of Pisa (Tuscany, Italy). The research is part of the process towards a local Food Plan, aimed at coordinating public policies, civil society and private initiatives, to foster the access to a healthy and sustainable diet. In this context, the experiences of civic agriculture have played an important role, highlighting the centrality of agriculture in the animation of rural areas and in the rural-urban relationship and becoming a point of intersection amongst several vital areas for local communities. The research methods consisted in a first monitoring of civic agriculture experiences, a second round of in-depth interviews and in a more targeted focus group. The research has confirmed the presence of an expressed willingness to create a network of farms engaged on issues of sustainable food and sustainable local development. However, some critical points emerged with respect to the process of network building. Brokerage activities appear crucial to reinforce the relationships amongst the farmers and civil and institutional actors engaged in food related issues

Mindfulness and well-being: the relationship between various forms of awareness and psychological well-being

openPromuovere il benessere psicologico è il fine di questa ricerca e per questo motivo sono state studiate varie forme di consapevolezza come la mindfulness disposizionale, il non attaccamento, la self-compassion, l’interrelazione e il loro ruolo nel raggiungimento del benessere e nella soddisfazione di vita delle persone.Promuovere il benessere psicologico è lo scopo di questa ricerca, e per questo motivo varie forme di consapevolezza come la presenza mentale, il non attaccamento, l'auto-compatibilità e l'interrelazione e il loro ruolo nel raggiungere il benessere delle personeessere e soddisfazione di vita sono stati studiati

Opportunità commerciale e condivisione di valori: i Gruppi d'Acquisto Solidale in Toscana

A partire dagli anni ’90, in seguito a numerosi episodi controversi e a scandali alimentari, come la diffusione dell’Encefalopatia Spongiforme Bovina (BSE) o il ritrovamento di residui di diossina nel latte o nella carne di pollo, la fiducia che i consumatori riversavano nei confronti del mondo della produzione e dell’industria agroalimentare viene a mancare, spostando l’attenzione verso modalità giudicate più salubri, anche attraverso la riscoperta delle tradizioni culinarie e culturali locali. Allo stesso tempo, le difficoltà incontrate dai produttori spingono alla ricerca di nuove modalità di commercializzazione, che possono portare ad una maggiore valorizzazione dei propri prodotti, in termini economici e di percezione della qualità. Le esigenze espresse da consumatori e produttori trovano occasione di sintesi attraverso la riduzione della distanza che li divide e che i sistemi di distribuzione più comuni hanno contribuito ad aumentare. Queste nuove modalità sono diffuse in tutto il mondo e definite come circuiti brevi (Short Food Supply Chains o Alternative Food Networks), basano la loro azione sul potenziamento della relazione che si istaura tra consumatori e produttori, costruita sulla prossimità spaziale e sulla fiducia. Questi aspetti sono dovuti anche alla condivisione di valori, quali il rispetto per l’ambiente, la riscoperta delle culture locali, la volontà di preservare il mondo rurale dall’impatto con i meccanismi del mercato globale, l’equità nella distribuzione delle risorse. In Italia, tra le diverse modalità di avvicinamento e contrazione dei circuiti di produzione e consumo, si sono sviluppati i Gruppi d’Acquisto Solidale (GAS), nati alla metà degli anni ’90 e, attualmente, diffusi e in attiva crescita su tutto il territorio nazionale. Questi gruppi, nati da istanze diverse e con modalità molto varie, funzione del territorio in cui sono attivi, del percorso e delle sensibilità degli aderenti, effettuano gli acquisti in modo collettivo, scegliendo i propri fornitori sulla base di quattro criteri generali: la predilezioni per le produzioni locali, i piccoli produttori, che aderiscano ai metodi di produzione biologico o biodinamico e per le aziende che si dimostrano attente alle condizioni in cui operano i propri lavoratori. L’elaborato, partendo dai dati raccolti nel corso di un’indagine che ha coinvolto GAS e produttori attivi sul territorio toscano, si prefigge l’obiettivo di individuare gli elementi chiave della relazione che lega il mondo dei consumatori alla produzione, valutando la sostenibilità di questa esperienza e individuando alcuni possibili scenari futuri

The Food Council of Pisa

The need for a transition to more sustainable food systems has made the definition of more integrated and advanced forms of management of food-related issues increasingly urgent, especially in the urban contexts. As for many other cities around the world, also in the territory of Pisa (Tuscany, Italy), since 2010 a process aimed at developing an integrated food strategy has been promoted (the Food Plan of the province of Pisa). In the context of new reflexivity and mobilization created by the process for the definition and implementation of the Plan, in 2013 a group of citizens, researchers and professionals established the Food Council of Pisa, an organization aimed at stimulating a reflection on the food-related issues at urban level and at promoting an integrated approach to their management. The Council started to operate identifying some specific areas of action, establishing relationships with the various initiatives carried out by local civil society, and trying to interact with public administrations

Causes and Solutions for High Direct Care Staff Turnover

This quantitative research project explores the reasons and solutions for the high rates of direct care staff turnover. Emails were sent out to social service agency supervisors asking for their approval to allow their employees to participate in an online survey about direct care staff turnover. Agencies that agreed to participate were then emailed a script and a consent form with instructions to email both the script and the consent form to their employees. The ten question online survey explored the direct care staff\u27s opinions on topics such as compensation, support and training. Additionally, there was a qualitative question at the end of the survey asking for direct care staff\u27s input as to possible solutions to reduce direct care staff turnover. Twenty-six individuals participated in the survey. Answers were analyzed and entered into SPSS in order to find correlations in the data. Themes were identified amongst the responses to the qualitative question. A majority of the respondents did not feel they received adequate support from their supervisor or adequate compensation for the work that they do. Answers showed that direct care staff who participated in the survey attributed inadequate compensation as the largest contributor to the high rates of direct care staff turnover. The answers revealed no statistically significant data however, some correlations approached statistical significance. Results from this quantitative research project were consistent with pre-existing literature

In vivo kinematics of knee replacement during daily living activities: Condylar and post-cam contact assessment by three-dimensional fluoroscopy and finite element analyses

In total knee replacement, the investigation on the exact contact patterns at the post-cam in implanted patients from real in vivo data during daily living activities is fundamental for validating implant design concepts and assessing relevant performances. This study is aimed at verifying the restoration of natural tibio-femoral condylar kinematics by investigating the post-cam engagement at different motor tasks. An innovative validated technique, combining three-dimensional fluoroscopic and finite element analyses, was applied to measure joint kinematics during daily living activities in 15 patients implanted with guided motion posterior-stabilized total knee replacement. Motion results showed physiological antero-posterior translations of the tibio-femoral condyles for every motor task. However, high variability was observed in the position of the calculated pivot point among different patients and different motor tasks, as well as in the range of post-cam engagement. Physiological tibio-femoral joint rotations and contacts at the condyles were found restored in the present knee replacement. Articular contact patterns experienced at the post-cam were found compatible with this original prosthesis design. The present study reports replaced knee kinematics also in terms of articular surface contacts, both at the condyles and, for the first time, at the post-cam

What is known from the existing literature about the available interventions for pelvic floor dysfunction among female athletes? A scoping review

Background: Female athletes may be at higher risk of developing pelvic floor dysfunction (PFD). However, despite the great number of epidemiologic studies, the interventions have not been standardized. Aim: The present scoping review aimed to map and summarize the literature to identify the available interventions for PFD among female athletes. Methods: Seven databases were searched up to May 2021. Studies considering female athletes practising sports at any performance level with any type of PFD were eligible for inclusion. Any clinical intervention and any context were considered. No language, study design, and publication type restrictions were applied. Additional studies were identified through gray literature and the reference lists of articles included. The results were presented numerically and thematically. Results: From 2625 initial records, 35 studies met inclusion criteria. The majority of articles were narrative reviews, considering athletes with urinary incontinence practising multiple or high-impact sports. Authors discussed a wide range of interventions: preventive (n = 8); conservative (n = 35), pharmacological (n = 12), and surgical (n = 10). In particular, the Pelvic Floor Muscle Training was considered in 30 studies. Conclusions: This is the first scoping review to provide a comprehensive overview of the topic. Besides the great number of available interventions, specific programs and randomized controlled clinical trials for female athletes are still limited. Findings highlighted evident gaps in the primary research confirming that the current management is based on expert opinion. This review may be useful for the overall management, and it may represent a starting point for future research

In trials of physiotherapy for chronic low back pain, clinical relevance is rarely interpreted, with great heterogeneity in the frameworks and thresholds used:a meta-research study

QUESTIONS: How do authors of randomised controlled trials (RCTs) interpret the clinical relevance of the effects of physiotherapy interventions compared with no intervention on pain intensity, physical function and time to recovery in people with chronic low back pain (CLBP)? How can the clinical relevance be re-interpreted based on the available smallest worthwhile effect (SWE) threshold for this comparison? Are the studies in this field adequately powered?DESIGN: Cross-sectional meta-research study.PARTICIPANTS: People with CLBP.OUTCOME MEASURES: Pain intensity, physical function and time to recovery.RESULTS: This review included 23 RCTs with 1,645 participants. Twenty-two and 18 studies were included in the analysis of pain intensity and physical function, respectively. No studies investigated time to recovery. Sixteen studies reported varying thresholds to interpret clinical relevance for physical function and pain intensity. Discrepancies between interpretation using the minimal important difference and SWE values were observed in five studies. Study power ranged from 9% to 98%, with only four studies having a power &gt; 80%.CONCLUSION: Little attention is given to the interpretation of clinical relevance in RCTs comparing physiotherapy with no intervention in CLBP, with great heterogeneity in the frameworks and thresholds used. Future trials should inform patients and clinicians on whether the effect of an intervention is large enough to be worthwhile, using a reliable and comprehensive approach like available SWE estimates.REGISTRATION: medRxiv https://doi.org/10.1101/2022.12.14.22283454.</p

Obsessive compulsive disorder comorbidity in DBA

Diamond-Blackfan Anemia (DBA) is a congenital erythroid aplasia characterized as a normochromic macrocytic anemia with a selective deficiency in red blood cell precursors in otherwise normocelullar bone marrow. DBA is known to be associated with mental retardation and learning disabilities. Although comorbidities with other psychiatric conditions have not been reported in the existing literature, we report in this paper a case of a DBA patient with previously undiagnosed comorbidity of obsessive compulsive disorder (OCD), successfully treated with sertaline 200 mg/day and valproic acid 600 mg/day. This case of comorbid presentation has clinical, therapeutic and pathophysiological implications. Given the difficulty of distinguishing among mental retardation, learning disabilities and OCD and the importance of precocious diagnosis in treating OCD especially since there are treatment methods interfering with anemia symptoms, physicians should adapt an adequate screening tool treating a child with DBA and comorbid mental disorder

Invasive Pneumococcal Disease in Tuscany Region, Italy, 2016–2017: Integrating Multiple Data Sources to Investigate Underreporting

: Invasive pneumococcal disease (IPD) is a vaccine-preventable disease characterized by the presence of Streptococcus pneumoniae in normally sterile sites. Since 2007, Italy has implemented an IPD national surveillance system (IPD-NSS). This system suffers from high rates of underreporting. To estimate the level of underreporting of IPD in 2016-2017 in Tuscany (Italy), we integrated data from IPD-NSS and two other regional data sources, i.e., Tuscany regional microbiological surveillance (Microbiological Surveillance and Antibiotic Resistance in Tuscany, SMART) and hospitalization discharge records (HDRs). We collected (1) notifications to IPD-NSS, (2) SMART records positive for S. pneumoniae from normally sterile sites, and (3) hospitalization records with IPD-related International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9) codes in discharge diagnoses. We performed data linkage of the three sources to obtain a combined surveillance system (CSS). Using the CSS, we calculated the completeness of the three sources and performed a three-source log-linear capture-recapture analysis to estimate total IPD underreporting. In total, 127 IPD cases were identified from IPD-NSS, 320 were identified from SMART, and 658 were identified from HDRs. After data linkage, a total of 904 unique cases were detected. The average yearly CSS notification rate was 12.1/100,000 inhabitants. Completeness was 14.0% for IPD-NSS, 35.4% for SMART, and 72.8% for HDRs. The capture-recapture analysis suggested a total estimate of 3419 cases of IPD (95% confidence interval (CI): 1364-5474), corresponding to an underreporting rate of 73.7% (95% CI: 34.0-83.6) for CSS. This study shows substantial underreporting in the Tuscany IPD surveillance system. Integration of available data sources may be a useful approach to complement notification-based surveillance and provide decision-makers with better information to plan effective control strategies against IPD