Sustainable Agriculture for Environment Protection: Results of Six Years of Cooperation between China and Italy

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Prospettive del negoziato globale sui cambiamenti climatici

Dopo che il senato USA aveva respinto la proposta di ratifica del Protocollo di Kyoto, e dopo che, nel dicembre 2000, vi era stata la rottura tra USA e Europa in occasione della COP 6, sarebbe stato necessario prendere atto che senza la partecipazione della più grande economia mondiale la dimensione globale del Protocollo veniva notevolmente ridimensionata. Nel 2003 l’Italia aveva invano cercato di aprire una riflessione critica sull’efficacia del Protocollo e sull’esigenza di avviare un dialogo su basi nuove con USA e Cina. Ma la UE ha insistito con un approccio unilaterale, ha convinto la Russia nel 2004 a ratificare il Protocollo senza però alcun impegno effettivo per l’economia russa. Intanto tra il 1997 e il 2005 l’economia mondiale era cambiata, le emissioni continuavano a crescere nei paesi non coinvolti gli impegni di riduzione delle emissioni di CO2. Nel 2007 il IV rapporto IPPC e Word Energy Outlook dell’IEA avevano chiarito il ruolo marginale del Protocollo mentre a Bali si stabiliva una road map per arrivare a Copenaghen con un nuovo trattato includente USA e Cina. Ma nonostante il fallimento il modello di negoziato del Protocollo è stato mantenuto. Invece di concentrarsi su complesse architetture legali e burocratiche, l’UE dovrebbe dedicarsi alla promozione di progetti internazionali per affrontare la sfida tecnologica globale valorizzando tutte le potenzialità di una grande economia integrata.Protocollo di Kyoto, C02, cambiamenti climatici

Esame clinico in Riabilitazione Respiratoria.

Trattato aggiornato sulle le valutazioni e le misure di outcome all'interno dei programmi di riabilitazione dedicati ai pazienti con patologie respiratorie a evoluzione disabilitante

Sustainable agriculture for environment protection: results of eight years of cooperation between China and Italy

In China most of the population (about 60%) lives in rural areas, in poor conditions and still relies on agriculture as the main source of income. Several environmental problems have been caused by shifting to more intensive and polluting agriculture in order to address the increasing demand for food and the need of higher incomes of rural communities. With the present Chinese economic growth, urbanization and increased leisure time, tourism and recreation activities in rural areas are also increasing. Additionally, in the restructuring process of economy in rural areas, one of the most obvious effects is the necessity to create job opportunities alternative to agricultural sector. The role of sustainable agriculture fro environment protection in a country such as China is highlihted. The experience gained in the framework of the Sino-Italian Cooperation Program for Environment Protection jointly launched by the Italian Ministry for the Environment, Land and Sea (IMELS) and the State Environment Protection Administration of China (SEPA) in the year 2000, through the implementation of several cooperation projects in different rural areas of China is critically discusse

Insufficienza Respiratoria acuta e cronica

Trattazione della fisiopatologia eclinica della insufficienza respiratoria acuta ecronica; guida alle terapie correnti (razionale, obiettivi, indicazioni, efficacia

The Italian multicentre study on noninvasive ventilation in chronic obstructive pulmonary disease patients

Chronic obstructive pulmonary disease (COPD) patients with chronic ventilatory failure (CVF) are more likely to develop exacerbations, which are an important determinant of health-related quality of life (HRQL). Long-term noninvasive positive-pressure ventilation (NPPV) has been proposed in addition to long-term oxygen therapy (LTOT) to treat CVF but little information is available on its effects on HRQL and resource consumption. Therefore, the current authors undertook a 2-yr multicentric, prospective, randomised, controlled trial to assess the effect of NPPV+ LTOT on: 1) severity of hypercapnia; 2) use of healthcare resources, and 3) HRQL, in comparison with LTOT alone. One hundred and twenty-two stable hypercapnic COPD patients on LTOT for > or = 6 months were consecutively enrolled. After inclusion and 1-month run-in, 90 patients were randomly assigned to NPPV+LTOT (n=43) or to LTOT alone (n=47). Arterial blood gases, hospital and intensive care unit (ICU) admissions, total hospital and ICU length of stay and HRQL were primary outcome measures; survival and drop-out rates, symptoms (dyspnoea and sleep quality) and exercise tolerance were secondary outcome measures. Follow-up was performed at 3-month intervals up to 2 yrs. Lung function, inspiratory muscle function, exercise tolerance and sleep quality score did not change over time in either group. By contrast the carbon dioxide tension in arterial blood on usual oxygen, resting dyspnoea and HRQL, as assessed by the Maugeri Foundation Respiratory Failure Questionnaire, changed differently over time in the two groups in favour of NPPV+LTOT. Hospital admissions were not different between groups during the follow-up. Nevertheless, overall hospital admissions showed a different trend to change in the NPPV+LTOT (decreasing by 45\%) as compared with the LTOT group (increasing by 27\%) when comparing the follow-up with the follow-back periods. ICU stay decreased over time by 75\% and 20\% in the NPPV+LTOT and LTOT groups, respectively. Survival was similar. Compared with long-term oxygen therapy alone, the addition of noninvasive positive-pressure ventilation to long-term oxygen therapy in stable chronic obstructive pulmonary disease patients with chronic ventilatory failure: 1) slightly decreased the trend to carbon dioxide retention in patients receiving oxygen at home and 2) improved dyspnoea and health-related quality of life. The results of this study show some significant benefits with the use of nocturnal, home noninvasive positive-pressure ventilation in patients with chronic ventilatory failure due to advanced chronic obstructive pulmonary disease patients. Further work is required to evaluate the effect of noninvasive positive-pressure ventilation on reducing the frequency and severity of chronic obstructive pulmonary disease exacerbation