Cooperazione interistituzionale nelle Pubbliche Amministrazioni: l'Ufficio intercomunale

Nell'ambito dello scenario istituzionale caratterizzato da profonde trasformazioni (si pensi ad esempio alla riforma del titolo V della Costituzione), l'innovazione nella pubblica amministrazione risulta assumere un importanza rilevante. Gli Enti Locali dovranno prepararsi ed adeguarsi a ricevere le funzioni e le responsabilita' derivanti dall'attuazione della riforma. In questo quadro di riferimento si inserisce il presente progetto che individua come idea forza la collaborazione inter-istituzionale come fattore decisivo nella valorizzazione e nell'uso strategico delle risorse turistico culturali del territorio preso in esame. L'area analizzata e' quella dell'alto Casertano, nello specifico i nove Comuni che hanno dimostrato una buona propensione alla collaborazione: Alife, Castello del Matese, Gallo Matese, Letino, Piedimonte Matese, San Gregorio Matese, San Potito Sannitico, Sant'Angelo d'Alife e Valle Agricola. L'idea progetto consiste nella stipulazione di una convenzione tra questi Comuni al fine di istituire un ufficio intercomunale per la gestione associata di diverse funzioni che risultano essere fondamentali per un maggiore coordinamento istituzionale. Il progetto e' strutturato secondo il seguente schema: analisi del cambiamento istituzionale risorse culturali come fattore di sviluppo analisi del quadro di riferimento territoriale analisi swot formulazione della strategia e degli obiettivi idea forza idea progetto aspetti tecnic

Infective Endocarditis in High-Income Countries

Infective endocarditis remains an illness that carries a significant burden to healthcare resources. In recent times, there has been a shift from Streptococcus sp. to Staphylococcus sp. as the primary organism of interest. This has significant consequences, given the virulence of Staphylococcus and its propensity to form a biofilm, rendering non-surgical therapy ineffective. In addition, antibiotic resistance has affected treatment of this organism. The cohorts at most risk for Staphylococcal endocarditis are elderly patients with multiple comorbidities. The innovation of transcatheter technologies alongside other cardiac interventions such as implantable devices has contributed to the increased risk attributable to this cohort. We examined the pathophysiology of infective endocarditis carefully. Inter alia, the determinants of Staphylococcus aureus virulence, interaction with host immunity, as well as the discovery and emergence of a potential vaccine, were investigated. Furthermore, the potential role of prophylactic antibiotics during dental procedures was also evaluated. As rates of transcatheter device implantation increase, endocarditis is expected to increase, especially in this high-risk group. A high level of suspicion is needed alongside early initiation of therapy and referral to the heart team to improve outcomes

Sensory Evaluation and Consumers’ Acceptance of a Low Glycemic and Gluten-Free Carob-Based Bakery Product

Carob pulp flour has antidiabetic and antioxidant activities, is naturally sweet, and is rich in fibers. It is obtained from carob pod pulp from the evergreen tree Ceratonia siliqua L., which is grown in Mediterranean areas and is known for locust bean gum production. Despite its valuable effects on health, such as the modulation of the glycemic index, this ingredient has a tremendous impact on technological and hedonic features, mainly on color, flavor, and texture. In this paper, the qualitative features and consumers’ acceptance of a carob-based gluten-free bakery product where rice flour was substituted at 40% with carob pulp flour were studied. A panel group of experts described the bread as dark, quite dense, sweet, aromatic, and with a limited bubble dispersion. On the other hand, the sensory assessment and the willingness to pay of consumers were assessed in two groups (a fully informed one about heathy attributes of the food and a blind one). The results indicated a moderate appreciation of the overall quality of the product (average score between 4 and 5 points on a 9-point Likert scale). The information about the food’s healthy properties and the ability to maintain a low glycemic index did not enhance the consumers’ perception of the product, while previous knowledge and involvement in the product consumption were perceived to have primary importance regarding the final consumers’ choice. Finally, an accelerated shelf-life test was run on the packaged snack to evaluate the general quality and stability. The protective packaging helped in limiting bread decay and maintaining the textural characteristics

Casing Contribution to Proteolytic Changes and Biogenic Amines Content in the Production of an Artisanal Naturally Fermented Dry Sausage

The effect of two kinds of casings on the production and characteristics of a dry fermented sausage was investigated. In detail, an Italian product, naturally fermented at low temperatures and normally wrapped in beef casing instead of the most diffused hog one, was selected. Two different productions (one traditionally in beef casing (MCB) and another in hog casing (MCH)) were investigated over time to determine the differences particularly regarding proteolytic changes during fermentation and ripening. First of all, the product in hog casing required a longer ripening time, up to 120 days, instead of 45–50 days, because of the lower drying rate, while the microbial dynamics were not significantly modified. Conversely, the proteolysis showed a different evolution, being more pronounced, together with the biogenic amines content up to 341 mg/Kg instead of 265 mg/Kg for the traditional products. The latter products were instead characterized by higher quantities of total free amino acids, 3-methyl butanoic acid, 3-Methyl-1-butanal, and 2-Methylpropanal, enriching the final taste and aroma. The traditional product MCB also showed lower hardness and chewiness than MCH. The results highlight how the choice of casing has a relevant impact on the development of the final characteristics of fermented sausages

Pathophysiology and Therapy of High-Altitude Sickness: Practical Approach in Emergency and Critical Care

High altitude can be a hostile environment and a paradigm of how environmental factors can determine illness when human biological adaptability is exceeded. This paper aims to provide a comprehensive review of high-altitude sickness, including its epidemiology, pathophysiology, and treatments. The first section of our work defines high altitude and considers the mechanisms of adaptation to it and the associated risk factors for low adaptability. The second section discusses the main high-altitude diseases, highlighting how environmental factors can lead to the loss of homeostasis, compromising important vital functions. Early recognition of clinical symptoms is important for the establishment of the correct therapy. The third section focuses on high-altitude pulmonary edema, which is one of the main high-altitude diseases. With a deeper understanding of the pathogenesis of high-altitude diseases, as well as a reasoned approach to environmental or physical factors, we examine the main high-altitude diseases. Such an approach is critical for the effective treatment of patients in a hostile environment, or treatment in the emergency room after exposure to extreme physical or environmental factors