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Background. Quality improvement is an increasingly recognized approach to maximize service effectiveness and minimize costs in public health. However, the Italian law never provided for the institutional accreditation of vaccination services. Furthermore, a recently approved law added six more compulsory vaccinations to the original four, which has led to a considerable increase in vaccination efforts, without any previous resources evaluation. The aim of the study was to investigate structural, organizational and managerial characteristics of the Italian vaccination services, in order to suggest the adoption of adequate quality standards. Study design. A survey involving the representatives of the Italian Regions and Autonomous Provinces was performed between September 2017 and September 2018. Methods. An online questionnaire, including 26 items, designed to evaluate the structural, organizational and managerial characteristics of vaccination services was administered. The correlation between the number of vaccination centres and the coverage for each region was used to evaluate the performance of the vaccination services. Results. Respondents from seven Regions, totaling >15,000,000 inhabitants, answered the questionnaire. Overall, each vaccination service was potentially accessed by an average of 519 children aged zero to 24 months, with a β-coefficient of-0.87 (p = 0.01) for infant vaccination coverage in 2016. Eighty-five percent of vaccination services were provided with architectural features to accommodate the disabled but only 49% provided reserved parking lots. An average of 0.4 physicians and 0.6 other healthcare workers per 10,000 inhabitants were employed in vaccination services, with complete computerization in 74% of them. Conclusions. The inverse relation between vaccination services' spatial accessibility and vaccination coverage suggests that distance and accessibility of vaccination services should be considered in planning. This survey constitutes a baseline data for Italian vaccination services that could be useful for decision makers in establishing minimum requirements to provide high-quality preventive healthcare services.

In the diamond wire stone cutting process the objective is to remove a chip of material or a layer of uniform thickness from the entire length of the cut. The aim of this study is to correlate the cutting performance to the characteristics of the natural stone and subsequently to propose a method of classification strictly connected to stone workability. Hardness and micro-hardness tests are currently considered important methods for acquiring useful information about the workability of natural stones, but such gathered data alone do not give enough information to establish a satisfying classification. The concept of workability and stone machining has been, for the past thirty years, one of the main area of investigation in national and international researches. This study endorses a method for the prediction of stone-cutting tools interaction (mainly diamond wires) combining the micro-hardness and the UPV measurements, that better represent the mechanical, physical and petrographical stone properties. This paper studies eight different stones classified according to an “easy-to-cut” scale based on the historical company know-how (HIC - Historical Industrial Classification). This classification is based upon experience and not on explicit or really scientifically quantified parameters, nonetheless, it describes the stones workability completely. In previous works, however, criteria based on quantifiable parameters (SSC - Scientific Stone Classification) have been pursued and this led to a scientific correlation with the industrial classification. For each stone the following investigation techniques were performed: petrographic analysis, micro-hardness, Schmidt rebound, Ultrasound Pulse Velocity (UPV). Moreover UPV measures in indirect and direct method have been executed on stone blocks in the cutting plant and compared with those performed on slabs. The results of all the performed tests were analyzed and good correlations with the industrial classification were found. Introduction, International Conference on Stone and Concrete Machining (ICSCM), Vol 3 (2015)

Objective: We aimed to describe the pattern of nosocomial infections in an adult medical-surgical intensive care unit (ICU). Methods: A 2-year prospective cohort study of nosocomial infection surveillance in a 12 - bed adult medical and surgical ICU of the Federico II University Hospital in Naples, was carried out. Data were collected between January 2009 and December 2010 using the standard surveillance protocols and nosocomial infection site definitions of the National Healthcare Safety Network’s ICU surveillance component. Results: Out of 768 patients hospitalized during this period, 434 with an ICU stay longer than 48 h were included in the study. Fifty-three patients acquired a total of 71 nosocomial infections; 55 (77,5%) ventilatorassociated pneumonia (VAP), 10 (14,1%), central-line-associated bloodstream infection (CLA-BSI) and 6 (8,4%) catheter-associated urinary tract infection (CA-UTI). The overall patient day rate was 12,9 patient days. The patient infection rate was 16,3 patients at risk. The mean VAP rate was 15,0/1.000 ventilator days, the CLA-BSI rate 2,9/1.000 central line days and the CA-UTI rate 1,2/1.000 catheter days. Of the nosocomial infections, 65 were Gram-negative, 6 Gram-positive and 5 fungal. The most frequent organism was Acinetobacter baumannii (61,9%), followed by Pseudomonas aeruginosa (22,5%), Enterococcus fecalis (4,2%) and Candida albicans (4,2%). The crude mortality was 35% among ICU-infected patients. Conclusions: VAP was the most common nosocomial infection in our ICU. Gram-negative organisms were more commonly reported as etiologic agents of ICU infections.

Questa sezione, realizzata grazie alla collaborazione fra geologi ed ingegneri delle Università di Bologna e di Torino, tratta degli aspetti geologici e mineralogico-petrografici della Pietra di Firenzuola e fornisce nuovi dati sulla caratterizzazione fisico-meccanica di questo materiale lapideo. Viene trattata la genesi delle areniti facendo luce sui complessi fenomeni che, nel corso di milioni di anni, hanno dato origine alla Formazione geologica Marnoso-arenacea e viene compiuta una ricostruzione della successione degli eventi sedimentari, correlando le colonne stratigrafiche del bacino estrattivo di Firenzuola. Ciò permette di individuare con precisione la collocazione degli strati che vengono coltivati: lo strato Contessa, noto con il nome di “Pietra Forte Colombino”, lo strato Masso Grosso, chiamato “Pietra Serena di Firenzuola” e gli strati Filaretti, merceologicamente denominati in vario modo. I dati geologici e tecnici relativi alle cave ed agli strati coltivati, i risultati delle prove previste dalla marcatura CE per le specifiche destinazioni d’uso dei prodotti finiti costituiscono nel loro insieme il sistema di base per la tracciabilità e la rintracciabilità dei materiali lapidei prodotti nel comprensorio estrattivo di Firenzuola. Questo sistema di controllo è definito “aperto”, in quanto è sviluppabile nel tempo in funzione dell’incremento delle attività estrattive. Le informazioni fornite rappresentano il valore aggiunto dei materiali lapidei prodotti nel comprensorio estrattivo di Firenzuola e consentono, tramite un Regolamento attuativo, l’applicazione di un Disciplinare per la concessione del Marchio di origine e di controllo della “Pietra di Firenzuola”. La procedura per la concessione del Marchio prevede l’individuazione dell’area di provenienza della materia prima appurando la collocazione topografica e stratigrafica dello strato coltivato, e la realizzazione di una scheda tecnica con i risultati delle prove previste per la marcatura CE, obbligatoria nella Comunita’ Europea per i prodotti finiti di rocce ornamentali. Tale scheda deve riportare i riferimenti alla colonna stratigrafica ed all’ubicazione dello strato “filare” coltivato, la denominazione merceologica del prodotto lapideo ed i risultati dell’esame petrografico e modale che consente di classificare la roccia, identificare i costituenti mineralogici e determinare le caratteristiche strutturali come anisotropie, stato d’aggregazione e di cementazione dei granuli, porosità, fessurazioni e stato di alterazione. La scheda deve riportare inoltre, in funzione delle specifiche destinazioni d’uso, i dati fisico-meccanici eseguiti secondo la normativa CE. Questi parametri, assieme ai risultati dello studio petrografico e tenendo presenti le caratteristiche/difetti dei blocchi, delle lastre e dei prodotti finiti, forniscono tutti i termini di raffronto per poter scegliere la destinazione d’uso più appropriata ai fini della durata in opera di queste pietre.

The care-associated infections (HAI) are the most serious complication associated with medical care. They are the cause of diseases for patients and economic damage to public health. The University "Federico II" of Naples decided to monitor the HAI, repeating the prevalence survey conducted earlier in 2011 in order to analyze the phenomenon of infection and to evaluate the possible correlation with risk factors. The Survey was conducted according to ECDC criteria. Considered that the study carried out in 2011 was conducted following the same methodology, to compare the results of the year 2012 the prevalence rates of both years were standardized. For the year 2012, the number of patients enrolled in the study and stratification of patients by age and sex were similar to data collected in 2011. It was very interesting to find the prevalence of HAI standardized reduced in 2012 compared to 2011. As a matter of fact, in fact, that the standardized prevalence of HAI for the year 2012 was 3.1%, one percentage point lower than in 2011 (4.4%). The practical training and direct regarded as the most appropriate approach in order to make health professionals aware in the field of health care-associated infections, as well as the system of selfcontrol peripheral for the correct application of the procedures, as well as epidemiological surveillance active, measured through rates of incidence, at the same time allow the monitoring of the phenomenon is infectious and the application of corrective measures that prevent its onset. The choice to make again an epidemiological study of prevalence with the same methodology ensures, in fact, two advantages: the comparability of the data, both at intra-company both at regional, national and international evaluation of the effectiveness of corrective actions.