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Abstract Background Simulation has been recognized as a shift in healthcare education that can improve skills and patient safety and outcomes. High-fidelity simulation of critical medical situations can be a source of stress among participants that can interfere with students' abilities leading to unexpected emotional responses. The aim of this study is to determine if two simulation methods, high-fidelity (HF) and procedural simulation (PS), may be associated with stress responses at a self-perceived and biological level (salivary cortisol variations), and to compare stress levels of the two different simulation method. We also wanted to find independent variables associated with cortisol total hormonal output. Methods A quasi-experimental before-after study was used including the administration of questionnaires, and biomarkers evaluation by salivary cortisol samples before and after simulation. A total of 148 students were eligible and agreed to participate in the study. We used paired T-test for mean comparison regarding State-trait anxiety for both HF and PT simulations. For NASA-TLX we performed a T-test mean comparison between groups. We used paired T-test mean comparison for cortisol analysis. Multivariable linear regression has been used to assess variables associated with AUCg values and perceived stress. Results values of STAI-Y scores were relatively higher at the end of the HF and PS sessions. NASA-TLX was significantly higher at baseline for the HF simulations, with respect to the PS simulation. Cortisol fold increase was significantly different in the two groups. Linear regression showed that cortisol AUCg was related to the STAI-Y score in both groups. Conclusion Participating students developed a stress response both after in the HF and PS training, testified by psychological and biological outputs. According to our results, stress levels were increased for simply being in a simulation scenario than to the intrinsic complexity of the task required. More studies are needed to confirm this trend and to clarify the role of simulated stress response in a long-term learning scenario.

Refrigeration applications is responsible for approximately 17% of the total electricity and around 8% of greenhouse gas emissions. This study presents a comparative life cycle assessment between two refrigeration systems, the first operating with a traditional fluid and the second with a natural refrigerant. The analysis was performed in accordance with international standards ISO 14040/14044 and adopted the attributional life cycle assessment approach. The functional unit was: ‘the storage of meat products, at the temperature of 0°C for a lifetime of 10 years, in refrigerating cells of a medium city supermarket’. Three different scenarios were analysed to investigate the effect of the energy mix in relation to the use of the machines. Results highlight how the choice of the refrigerating fluid has a higher effect on the environmental performances of the machine with a reduction of approximately 10% in a whole life cycle. Scenario analysis shows how the use of such machines in different countries allows a significant reduction of environmental impacts mostly related to the use phase. Eco-design actions were listed and connected with environmental hot spots specifying the life cycle phases and the environmental indicators involved.

The fashion industry is responsible for a significant contribution to environmental pressure in the European Union. The present study aims to quantify the environmental impacts of a leather shoe production chain and identify the most criticalities in terms of companies, processes, and materials. The Life Cycle Assessment (LCA) methodology was used to assess the impacts related to the production of a pair of classic man leather shoes. Slaughtering and tanning resulted in the less environmentally sustainable stages for almost all the analysed impact categories, except water resource depletion and ozone layer depletion. Such outcomes are mainly due to the high distance from animals’ skin suppliers to slaughterhouses and tanneries, the use of lorries transport, and the large use of unsustainable chemicals to treat the leather. Going downstream, the main hot spot refers to the use of cotton during upper manufacturing and shoe assembly and finishing. Three alternative realistic production scenarios were simulated to find the best sustainable mix. They focused on alternative means of transport, the substitution of cotton, and green purchasing of upper and lining. An environmental impact reduction of about 30% can be obtained if all the suggested scenarios are implemented.

By using a functional requirement analysis, through Design for Manufacture and Assembly and Design for Environment principles, this paper aims at showing a new design method to improve the overall assembly features and environmental sustainability of a packaging solution. This method provides to rank functional requirements according to three different design specifications and also to the number of relationships they have with each other. At the same time, a ranked order of importance for the packaging parts has been realised, considering the number of performed functions. The purpose of this method is to support the designers in focusing their attention on the most important packaging parts and, at the same time, giving them a clear idea of which are the most important functional requirements to be satisfied. This study has been focused on domestic household packaging, but the provided method can be extended to any particular packaging solution and its findings are still valid. According to the Design for Environmental perspective, the actual and the new resulting packaging solutions have been then compared through Life Cycle Assessment method. The results have shown the new packaging solution being able to cut down the environmental impacts, on average, of approximately 30%.

The growing attention to environmental sustainability is not reflected in the effective implementation of ecodesign principles in the industrial context. The main barriers are related to the propensity of companies to optimise only specific aspects directly affected by legislation and to the higher priority given to other drivers such as performance, cost and aesthetics. The present paper faces this issue by proposing an approach to support designers to concurrently deal with environmental, economic and technical performance in all the key phases of the product development process (selection of drivers, evaluation of design alternatives, preservation, sharing and reuse of knowledge, etc.). The approach is grounded on a multi-criteria index, called Product Impact Index (PII), which allows weighting different drivers, verifying the satisfaction of the company’s goals, and comparing different design solutions. The method has been successfully applied in two case studies to support the redesign of a cooker hood and a freestanding cooker. Results confirmed its usefulness and effectiveness in overcoming the common barriers to ecodesign implementation in the industrial context.

Demand for automated processes in the manufacturing industry is now shifting toward flexible, human-centered systems that combine productivity and high product quality, thus combining the advantages of automated and robotic systems with the high-value-added skills of operators and craftsmen. This trend is even more crucial for small and medium-sized enterprises operating in the “Made in Italy” fashion industry. The paper presents the study, simulation, and preliminary testing of a collaborative robotic system for shoe polishing that can reduce manual labor by limiting it to the finishing stage of the process, where the aesthetic result is fully achieved, with a benefit also in terms of ergonomics for the operator. The influence of process parameters and design solutions are discussed by presenting preliminary test results and providing hints for future developments.