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Abstract Background This paper describes a study protocol for co-producing and co-assessing a new sustainable and scalable service solution that enhances health and social integration by involving providers and volunteers delivering services for elderly people in the province of Cremona (Italy), where the elderly population will reach 27% in 2023. Methods This upcoming study involves mixed-method participatory research and is structured in three study phases and related objectives. First, it will co-produce a new, accessible and sustainable service solution using an iterative design and management method, Plan-Do-Check-Act by involving professionals and volunteers of a heterogeneous group of health, social and third sector organizations located in the city of Cremona (Italy). Second, the study protocol will co-assess the outcomes of the new service solution using a mixed-method approach for measuring the outcomes on: professionals and volunteers (micro level) and their health, social and third sector organizations (meso level). Third, this study will co-investigate the scalability of the new solution promoting health and social integration in other similar urban areas of the Province of Cremona via the Intervention Scalability Assessment Tool (macro level). The data will be collected through the analysis of official documents, websites, policies and participatory workshops. Discussion This protocol proposes an innovative intervention, a novel participatory approach, and an unexplored scalability assessment tool in the context of health and social care integration. This study aims to support professionals from health and social care service providers and volunteers from third-sector organizations to collaborate and integrate each other’s resources. In doing so, the participatory approach will facilitate the co-creation of an effective response to the need of health and social integration, and the development of trustful relationships between health and social care service providers. Moreover, the adoption of Plan-Do-Check-Act and Intervention Scalability Assessment Tool will ensure the quality, scalability and sustainability of the new service solution in other settings.

Leptospirosis has a complex transmission, involving rodents and many species of domestic and wild animals. Carrier animals spread leptospires, contaminating soil and water, the main sources of human infection. The risk of infection is modulated by socio-economic factors, environment and host animals and has changed, historically linked to agriculture but now prevalent in recreational environments. Leptospirosis also reveal gender-specific exposure patterns that determine infection risks. Emphasizing the interconnectedness of humans, animals, and the environment, the One Health approach highlights the ecosystem dynamics through which leptospires interact with hosts and abiotic factors, ensuring their survival and transmission.We advocate for integrating gender considerations into the ecosystem dynamics of complex zoonoses, such as leptospirosis, through a One Health perspective. This approach, yet to be fully explored, may enhance our understanding of the infection and its modulating factors. A scoping review of the literature was conducted across Embase and Pubmed databases to collect information on sex and gender-specific drivers, sources of infections, environmental drivers, and related risks of leptospirosis. Quantitative data were extracted from the articles selected according to a list of criteria, and analyzed to discern sex and gender disparities and identify primary drivers of leptospirosis. We confirmed that the excess of male leptospirosis cases described in many parts of the world is also present in Europe. Furthermore, we identified environmental and sociocultural drivers and hypothesized their interactions between and within human, animal, and environmental sectors. These interactions modulate direct and indirect exposure to Leptospira, heightening infection risks across the ecosystem. Based on our findings, utilizing leptospirosis as a model, we advocate for integrating One Health and gender approaches in public health practices to better plan and implement more effective and timely intervention measures.

Flax (Linum usitatissimum L.) can be grown both as an oil crop and as a fiber crop, and this offers new opportunities when included in the framework of a whole-crop biorefinery, a system in which a range of products are made from portions of grain and straw and in which both of these should be satisfactorily produced. In the present experiment, the effect of flax genotypes (7 varieties), cultivation sites (two locations) and seasons (two years) were tested with a standard randomized complete block design, in search of a compromise for the production performance for both grain and straw, with the aim of reintroducing flax back into the northern Italian environment. Overall, grain yield reaches an average value of about 1.4 t ha−1 (dw), while straw yield reaches 2.77 t ha−1 (dw). The former is strictly dependent on the environmental effects of the growing site and season, while the effect of genotype was not significant. The straw yield also depends on the second-order interaction of the factors analyzed, although the performance of three varieties, Festival, Solal and Linoal, was noteworthy and seemed to respond well in both environments. Overall, it was found that flax can be conveniently grown for both grain and straw production.

Le développement de l’éthique de la recherche dans le milieu collégial soulève des préoccupations spécifiques, compte tenu des particularités de ce milieu. Cette étude s’intéresse à trois enjeux prioritaires de la communauté d’éthique de la recherche du collégial : 1) la question des ressources pour l’évaluation éthique par les comités d’éthique de la recherche du réseau collégial; 2) l’évaluation de projets de recherche relevant de plusieurs autorités; et 3) l’évaluation des activités de recherche conduite dans le cadre de cours par des étudiantes et étudiants. Afin de sonder cette communauté sur ses réalités concrètes face à ces enjeux, nous avons réalisé une étude mixte de type Delphi en temps réel grâce à la plateforme Surveylet, au cours de laquelle nous avons mis en dialogue 31 panélistes durant une période totale de cinq semaines. Cet article présente les résultats de notre analyse statistique et thématique des réponses obtenues, les principaux consensus et dissensus identifiés au sujet des trois enjeux, ainsi que des pistes de solutions pour surmonter ces enjeux inspirés par les propositions des panélistes.

This paper describes a procedure for settlement prediction of shallow foundations on carbonate sands, but it is fully applicable and valid for siliceous sands. For practical purposes, the design of shallow foundations resting on medium dense and dense granular soils is typically governed by limiting settlement to tolerable values. Predicting foundation settlement is therefore important, but in standard practice it is necessarily based on indirect (and therefore often conservative) determinations of soil compressibility (or modulus), due to the intrinsic difficulties in obtaining direct measurements.While numerical analyses incorporating non-linear soil behaviour may be a preferred method for computing expected total and differential settlement of shallow foundations of given geometry and stiffness on sand under static loading, the method described in this paper consists of a simplified and expeditious method based on equivalent linear elasticity. The method uses: i) the elastic soil stiffness profile at small strain, E0(z) obtained from the shear wave velocity as the primary measurement of deformability and ii) the reduction in modulus as a function of strain magnitude, E(ε) to account for stiffness non-linearity. The beneficial effect on the soil initial stiffness of the applied footing load is also considered. The method was developed as an on-site tool for checking the compaction of hydraulic fills made of carbonate sand to form artificial islands, but its application can be extended to other natural and anthropogenic coarse-grained materials.

The present research had two aims. The first was to evaluate the effect of height and exposure on the vegetative response of olive canopies’ vertical axis studied through a multispectral sensor and on the qualitative and quantitative product characteristics. The second was to examine the relationship between multispectral data and productive characteristics. Six olive plants were sampled, and their canopy’s vertical axis was subdivided into four sectors based on two heights (Top and Low) and two exposures (West and East). A ground-vehicle-mounted multispectral proximal sensor (OptRx from AgLeader®) was used to investigate the different behaviours of the olive canopy vegetation index (VI) responses in each sector. A selective harvest was performed, in which each plant and sector were harvested separately. Product characterisation was conducted to investigate the response of the products (both olives and oils) in each sector. The results of Tukey’s test (p > 0.05) showed a significant effect of height for the VI responses, with the Low sector obtaining higher values than the Top sector. The olive product showed some height and exposure effect, particularly for the olives’ dimension and resistance to detachment, which was statistically higher in the upper part of the canopies. The regression studies highlighted some relationships between the VIs and product characteristics, particularly for resistance to detachments (R2 = 0.44–0.63), which can affect harvest management. In conclusion, the results showed the complexity of the olive canopies’ response to multispectral data collection, highlighting the need to study the vertical axis to assess the variability of the canopy itself. The relationship between multispectral data and product characteristics must be further investigated.

Introduction: Social Prescribing has an established recognition regarding the benefits provided to the health-related social needs of adults, but little is known about how the intervention addresses young people’s needs. There is optimism regarding the central role of two core mechanisms that allows social prescribing to be effective, such as the empathetic role of Link Workers and the connection with community resources. This paper aims to describe the role played by Link Workers working a Social Prescribing intervention targeting young people. Description: This paper adopts a case study methodology to describe the role of Link Workers addressing young people’s needs and implementing Social Prescribing scheme in Sheffield (UK). Data were collected through semi-structured interviews with four of the seven link workers of one organisation based in Sheffield. Data were analysed through an inductive approach for emerging themes. Discussion: We provided a description of the profiles and background of Link Workers and described the three models of referral pathways into the intervention. The paper also shows how Link Workers identify young people’s needs and how they connect with the community. Conclusion: Based on the insights and the internationally accepted definition of Social Prescribing, we provide a visual representation of the Social Prescribing model and discuss challenges. The paper highlights lessons learned and future directions regarding the role of Link Workers from the case study.

The human-animal-environment interface is where the emergence of new infectious diseases can occur as a result of many complex reasons, including its alteration due to intensive farming and agriculture, increased human encroachment into wildlife habitats, international travel networks, and urbanization. The One Health approach to zoonoses is a holistic approach that considers environmental sustainability, animal health, and human health together. Gender-specific social and domestic roles can modulate (increase or decrease) an individual's risk of exposure to various hazards, including infectious diseases and zoonoses. The two scenarios presented here, one on avian influenza and the other on leptospirosis, clearly highlight the influence of gender, demonstrating that women's roles at the human-animal-environment interface are not the same as men's.Integrating the gender aspect into cross-sectoral interventions defined according to the One Health perspective could help reduce the risks of exposure to infections for humans and animals and the possible consequent economic losses. We suggest supplementing the One Health perspective with a gender analysis to study the influence of social norms, activities and risk behavior on exposure to infections, chemical pollution and the consequences of climate change.

Several factors including gender, age groups, cultures and social conditions may affect significantly the risk of diseases and their clinical evolution. Unfortunately, little research has been carried out on these aspects and, consequently few guidelines or interventions have been implemented. In particular, gender is considered a main determinant of inequalities in living conditions, access to health services and, thus, in health protection.Focusing on the gender gap, we propose an ecological approach to find relationships between quantitative indicators of the gender gap dimension, the environmental performance index and the life expectancy at birth as summary of human health index in 155 countries. We speculated on the consequences of wider gender gaps to the population and environmental health. We further explore these relationships considering gender gap and environmental aspect subindexes, to identify determinants that should be addressed to maximize the One Health effect. We found that the gender gap in educational attainment followed by the political empowerment were strongly correlated with life expectancy, environmental health, and ecosystem vitality.Addressing gender issues, particularly the education attainment and political empowerment, can provide positive impact beyond the social dimension and the population health, and gender should be component of the One Health approach. We recommend gender targeted interventions that integrate these aspects into One Health national policies.

Interacting bosons in one or two dimensions are expected to be in either a superfluid or an insulating ground state. Here, the authors show numerically that an experimentally relevant 1D model of disordered bosons with dipolar couplings supports an unusual metallic phase that does not fit into existing descriptions.

Wild-type p53 cancer therapy-induced senescent cells frequently engulf and degrade neighboring ones inside a massive vacuole in their cytoplasm. After clearance of the internalized cell, the vacuole persists, seemingly empty, for several hours. Despite large vacuoles being associated with cell death, this process is known to confer a survival advantage to cancer engulfing cells, leading to therapy resistance and tumor relapse. Previous attempts to resolve the vacuolar structure and visualize their content using dyes were unsatisfying for lack of known targets and ineffective dye penetration and/or retention. Here, we overcame this problem by applying optical diffraction tomography and Raman spectroscopy to MCF7 doxorubicin-induced engulfing cells. We demonstrated a real ability of cell tomography and Raman to phenotype complex microstructures, such as cell-in-cells and vacuoles, and detect chemical species in extremely low concentrations within live cells in a completely label-free fashion. We show that vacuoles had a density indistinguishable to the medium, but were not empty, instead contained diluted cell-derived macromolecules, and we could discern vacuoles from medium and cells using their Raman fingerprint. Our approach is useful for the noninvasive investigation of senescent engulfing (and other peculiar) cells in unperturbed conditions, crucial for a better understanding of complex biological processes.

Chickpeas are one of the most widely consumed legumes in the world. Nevertheless, the literature is lacking studies on the effect of drying and milling processes on chickpea flour characteristics, thus motivating this work. The first aim of this work is to improve chickpea drying process through an in-depth evaluation of drying kinetics; the second aim is to assess the effects of three different moisture contents (8, 10, and 12%) and three milling speeds (120, 220, and 320 RPM) on operative milling parameters, particle size distribution, and flour composition. Our results highlight that moisture content and stone rotational speed have statistically significant effects on milling operative parameters, flour particle size, and chickpea flour composition. As stone rotational speed increases, flour temperature (∆T), average power, and damaged starch content significantly increases. On the other hand, as moisture content increases, energy consumption and specific milling energy increases, while starch and protein content significantly decrease. The results of this study recommend, for the first time in the literature, optimal values of moisture content and milling speed of chickpea. In conclusion, milling chickpeas with 10% moisture content at 320 RPM (milling speed) seems to be the best compromise between milling operative parameters, particle size, and chickpea flour composition.

This study focuses on the development of a reliable coding scheme (CP-CODER) for studying interaction dynamics during the co-production of a public service involving priority communities. CP-CODER addresses the need to involve priority populations in the development of public services, an approach that has been recognized as difficult because of the high possibility of their experiencing negative health, social, and economic outcomes. The coding scheme was designed to capture group dynamics and forms of public engagement by adopting and integrating existing theoretical frameworks in the public service management and qualitative method literature. Coding was conducted on the transcripts of four co-production workshops, which included 26 family caregivers, three local health and social care service provider representatives, and five researchers involved in the co-production of new community-based services. One category was added to the two theoretical frameworks. The kappa ranged from 0.70–1.00 for the eight variables and the 26 individual items. The overall kappa was 0.91, while the overall percentage of agreement was 91.16%. The results of the pilot test showed the importance of integrating and managing three dimensions in co-producing with a priority population: the turn-taking, the content, and the level of abstraction of the discussion. The findings of this study have enhanced and supported both practitioners and researchers in co-producing services, ensuring the equal contribution of all participants, even those whose voices are rarely heard.

Though many data on the experience of care of patients and caregivers are collected, they are rarely used to improve the quality of health care delivery. One of the main causes is the widespread struggle in interpreting and enhancing these data, requiring the introduction of new techniques to extract intelligible, meaningful, and actionable information. This research explores the potentiality of the latent class analysis (LCA) statistical model in studying experience data. A cross-sectional survey was administered to 482 parents of infants hospitalized in several Italian neonatal intensive care units. Through a 3-step LCA, four subgroups of parents with specific experience profiles, sociodemographic characteristics, and levels of satisfaction were identified. These were composed of parents who reported (1) a positive experience (36%), (2) problematic communication with unit staff (30%), (3) limited access to the unit and poor participation in their baby's care (26%), and (4) a negative experience (8%). Through its explorative segmentation, LCA can provide valuable information to design quality improvement interventions tailored to the specific needs and concerns of each subgroup.

Abstract Background Family caregivers are key actors in the ageing society. They are mediators between practitioners and patients and usually provide also essential daily services for the elders. However, till now, few services have been deployed to help caregivers in their care tasks as in improving their mental health which can experience sever burden due to caregiving duties. The purpose of the study is to implement a community-based participatory research project to co-design an innovative organizational model of social services for family caregivers of elderly health consumers living in remote rural areas in Italy. Methods This is a community-based participatory research project in the remote area of Vallecamonica involving four main phases. These included a quantitative analysis of caregiver needs, a scoping review on existing services for caregivers, co-design workshops with local stakeholders and caregivers to create a novel service the piloting and a first implementation of the service and the assessment of project transferability to other contexts. Results As the hours dedicated to elder care increases, both objective and developmental caregiver’s burden significantly increases. Conversely, higher levels of engagement were associated with lower physical and emotional burden, and caregiver engagement was positively correlated with their perceived self-efficacy in managing disruptive patient behaviours. Based on these preliminary results, four co-design workshops with caregivers were conducted and led to the definition of the SOS caregivers service, built on four pillars structured upon the previous need analysis: a citizens’ management board, training courses, peer-to-peer meetings, and project and service information. We found that co-design is an effective means of creating new services for family caregivers, whose experiential knowledge proved to be a key resource for the project team in delivering and managing services. Less positively, the transferability analysis indicated that local municipalities remain reluctant to acknowledge caregivers’ pivotal role. Conclusions A dedicated support service for caregivers can ameliorate caregiving conditions and engagement levels. The service has resulted a successful co-productive initiative for a psycho-social intervention for family caregivers. For the future, we suggest that family caregiver should be considered an active partner in the process of designing novel psycho-social services and not just as recipients to enhance a better aging-in-place process.

The osteological investigation of archived and historic skeletal collections can often provide clues to how they were organised and managed, offering key osteobiographical insight into past populations. A small, yet significant, collection of skulls housed at the Museum “Giuseppe Sergi” of the Sapienza University of Rome, remained anonymous prior to a recent reassessment protocol started in 2018. This collection was excavated from a funerary area discovered during the 19th century from the site of Castel Trosino (Ascoli Piceno, Italy). The cemetery was part of an important community during the Longobard domination of Italy, as testified by the richness of the cultural artefacts reported with the burials. The 19 skulls presented in this paper are the only ones available for assessment; all the others were lost shortly after the first excavation. Their importance is related to providing a better understanding of biological evidence of a community that lived in Italy during the Early Middle Ages.

Abstract Background Patient-reported data—satisfaction, preferences, outcomes and experience—are increasingly studied to provide excellent patient-centred care. In particular, healthcare professionals need to understand whether and how patient experience data can more pertinently inform the design of service delivery from a patient-centred perspective when compared with other indicators. This study aims to explore whether timely patient-reported data could capture relevant issues to improve the hospital patient journey. Methods Between January and February 2019, a longitudinal survey was conducted in the orthopaedics department of a 250-bed Italian university hospital with patients admitted for surgery; the aim was to analyse the patient journey from the first outpatient visit to discharge. The same patients completed a paper-and-pencil questionnaire, which was created to collect timely preference, experience and main outcomes data, and the hospital patient satisfaction questionnaire. The first was completed at the time of admission to the hospital and at the end of hospitalisation, and the second questionnaire was completed at the end of hospitalisation. Results A total of 254 patients completed the three questionnaires. The results show the specific value of patient-reported data. Greater or less negative satisfaction may not reveal pathology-related needs, but patient experience data can detect important areas of improvement along the hospital journey. As clinical conditions and the context of care change rapidly within a single hospital stay for surgery, collecting data at two different moments of the patient journey enables researchers to capture areas of potential improvement in the patient journey that are linked to the context, clinical conditions and emotions experienced by the patient. Conclusion By contributing to the literature on how patient-reported data could be collected and used in hospital quality improvement, this study opens the debate about the use of real-time focused data. Further studies should explore how to use patient-reported data effectively (including what the patient reports are working well) and how to improve hospital processes by profiling patients’ needs and defining the appropriate methodologies to capture the experiences of vulnerable patients. These topics may offer new frontiers of research to achieve a patient-centred healthcare system.

Abstract Background Co-production has been widely recognised as a potential means to reduce the dissatisfaction of citizens, the inefficacy of service providers, and conflicts in relations between the former and the latter. However, the benefits of co-production has begun to be questioned: co-production has often been taken for granted, and its effects may not be effective. To understand and prevent unsuccessful citizen and provider collaboration, the recent literature has begun to focus on the causes of co-destruction. This paper investigates how the barriers that may arise during the co-production of a new social service with family carers can be identified and interpreted. Methods To investigate this topic, we undertook a single case study - a longitudinal project (Place4Carers (Graffigna et al., BMJ Open 10:e037570, 2020)) intended to co-produce a new social care service with and for the family carers of elderly patients living in rural and remote areas. We organised collaborative co-assessment workshops and semi-structured interviews to collect the views of family carers and service providers on the co-production process. A reflexive approach was used in the analysis for collecting the opinions of the research team that participated in the co-production process. Results The analysis revealed four main co-production barriers: lack of trust, lack of effectiveness of engagement, participants’ inability (or impossibility) to change and the lack of a cohesive partnership among partners. Despite these findings, the project increases carers’ satisfaction, competence and trust in service providers by demonstrating the positive effects of co-production. Conclusions Our article confirms that co-creation and co-destruction processes may coexist. The role of researchers and service providers is to prevent or remedy co-destruction effects. To this end, we suggest that in co-production projects, more time should be spent co-assessing the project before, during and after the co-production process. This approach would facilitate the adoption of adjustment actions such as creating mutual trust through conviviality among participants and fostering collaborative research between academia and organisations that are not used to working together.

BackgroundIt is extremely common to need to select a subset of reads from a BAM file based on their specific properties. Typically, a user unpacks the BAM file to a text stream using SAMtools, parses and filters the lines using AWK, then repacks them using SAMtools. This process is tedious and error-prone. In particular, when working with many columns of data, mix-ups are common and the bit field containing the flags is unintuitive. There are several libraries for reading BAM files, such as Bio-SamTools for Perl and pysam for Python. Both allow access to the BAM's read information and can filter reads, but require substantial boilerplate code; this is high overhead for mostly ad hoc filtering.ResultsWe have created a query language that gathers reads using a collection of predicates and common logical connectives. Queries run faster than equivalents and can be compiled to native code for embedding in larger programs.ConclusionsBAMQL provides a user-friendly, powerful and performant way to extract subsets of BAM files for ad hoc analyses or integration into applications. The query language provides a collection of predicates beyond those in SAMtools, and more flexible connectives.

Aux États-Unis, le bioéthicien Arthur L. Caplan, ainsi que trois collègues ont affirmé dans un texte publié dans le PennLive Patriot-News, en mai 2020, que toute personne atteinte de la COVID-19 qui n’aurait pas suivi les consignes de la santé publique concernant le port du masque ou la distanciation sociale ou qui serait responsable d’une éclosion de COVID-19 devrait se porter volontaire pour être soignée en dernier. Pour se faire, ils s’appuient sur le principe du philosophe John Stuart Mill voulant que l’expression de la liberté ne peut pas causer du tort à autrui. Bien que l’on puisse comprendre les arguments évoqués par Caplan et ses collègues, cette position ne peut pas s’appliquer en contexte québécois, et ce, tant pour des motifs philosophiques (éthiques) et de santé publique.