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In the Lombardy Region, as in many other contexts all over the world, hazard maps do not have a precise legislative confirmation. Despite this, they are necessary to support several institutional activities, and among these, local urban planning. An approach to hazard analysis and mapping that fits the Lombardy Region legislative framework is presented here that introduces a level of experimental modelling, making use of SOBEK 1-D--2-D as a tool for hydrodynamic simulations. A stretch of 17 km of the Adda river in Valtellina has been modelled, referring to twelve scenarios characterised by different temporal probabilities, and comprising the main sources of uncertainty. The results were compared with available local hydraulic studies, and combined to obtain two complementary flood hazard maps which could usefully support urban planning. Advantages and drawbacks of this modelling approach, together with considerations related to flood hazard mapping are discussed. [ABSTRACT FROM AUTHOR]

During September and October 1997 a seismic sequence of moderate magnitude struck the Umbria and Marche regions, central Italy. As a consequence of the main shocks several rock falls were triggered along the flanks of the Valnerina valley, an important canyon formed by the erosion of the Nera river on limestone formations. This landslide data set was used to explore the correlation existing among rock falls and several causal factors, like slope angle, geology and strong ground motion parameters. All the data have been digitised and georeferenced with the aid of a Geographic Information System in the form of digital thematic layers. The landslide inventory has been overlaid to the maps of causal factors, and the result arranged in order to create a data structure suitable to perform a multivariate statistics. A multiple regression allowed to formulate a predictive rule that can be used to produce a rock fall susceptibility map in case of an earthquake, in regions with similar geologic and geomorphologic characteristics. [Copyright &y& Elsevier]

This paper seeks to identify those areas that proved socially vulnerable to the earthquake that struck central Italy on 24 August 2016. The study involved four key steps. First, six relevant social vulnerability indicators were selected, based on previous conclusions in the literature. Second, the indicators were mapped using the inverse distance weighted interpolation method. Third, social vulnerability was assessed according to a spatial combination of the indicators. Fourth, in order to build a heterogeneity map, another approach was employed to represent the spatial variability of social vulnerability and to provide additional information on the synergistic contributions of the indicators. The results indicate that age and accessibility indicators affect the entire region under review, with highly vulnerable zones being close to small historical centres. These findings will be useful to governments, policymakers, and stakeholders with regard to implementing vulnerability mitigation strategies in Italian territories that are highly susceptible to earthquake hazards., (© 2019 The Authors Disasters © 2019 Overseas Development Institute.)

Objectives: To describe clinical characteristics and outcome of Clostridium difficile infection (CDI) patients in Internal Medicine, to identify ribotypes (RTs); to evaluate the association between RT and patient clinical characteristics and report outcome., Methods: One year prospective cohort study. Clinical data, Barthel Index (BI) and outcomes were collected for all inpatients suffering from CDI (n = 148) in hospital wards in Northern Italy. 84 fecal samples were analysed for molecular typing., Results: 12 RTs were identified, predominantly RT018 (42.9%, n = 36/84) and RT356/607 (40.5%, n = 34/84). Patients with dementia were more frequent among those infected by RT018 [55.6% (n = 20/36) vs. 32.4% (n = 11/34), p = 0.05]. The median BI score of patients with RT018 was lower than BI score of patients with RT356/607 [10 (IQR 0-32) vs. 15 (IQR 5-50), p = 0.06]. RT018 infection was associated to higher levels of C-reactive protein [7.2 mg/dl (IQR 4.1-14.7) vs. 4.0 mg/dl (IQR 2.2-6.8), p = 0.01] and white blood cells ≥15,000/dl [33.3% (n = 12/36) vs. 14.7% (n = 5/34) of patients, p = 0.07]. Higher mortality was noted among RT018 infected patients. We found a continuous mortality increase according to the ATLAS score., Conclusions: Our results confirm that RT018 and RT356/607 are the two major RTs causing CDI in older patients with a high degree of disability in Northern Italy and RT018 is associated with more serious outcomes., (Copyright © 2018. Published by Elsevier B.V.)

Background: Clostridium difficile-associated disease (CDAD) is the most common infectious antibiotic-associated diarrhea and is a growing health care problem. Prevention of Clostridium difficile infection focuses on clinical and epidemiologic infection control measures., Methods: Between 2008 and 2009, we conducted a retrospective study that showed an incidence of CDAD among the highest reported in the literature. Subsequently, we developed a preventive protocol that was adopted in our hospital in 2010. We then conducted a prospective study to investigate prevalence, incidence, and mortality of CDAD and to compare the results with those of the retrospective study, evaluating adherence to preventive measures and their efficacy., Results: In both studies, prevalence and incidence significantly increased in older patients. Crude prevalence was similar in the 2 studies. The incidence rate increased by 36%, with a significant increase only in the C and D wards. In-hospital mortality rose in both prevalent and incident cases. Regarding adhesion to hospital protocol, 77% of prevalent cases were treated with the required procedure. The highest percentage of isolated patients was achieved in C and D wards. In these wards we detected lower training hours per nurse. However, in 2013, we observed a significant decrease in incidence of CDAD and found a hospital prevalence of 0.33%., Conclusions: Health care personnel education could be more important than the possibility of isolating infected patients in single rooms., (Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)