[A system for collecting historical professional exposures in the workplace in Piedmont (ESP ALP).] / Un sistema per la catalogazione delle esposizioni storiche professionali negli ambienti di lavoro in Piemonte (ESP ALP).

SUMMARY: Background. ARPA Piemonte carries out occupational exposure measurements of chemical agents in workplace environment to support the Occupatonal Health and Safety Units of Local Health Boards for the assessment of the exposure level of dangerous chemical. Data are reported in internal documents, but are not available for other purposes. Objectives. Organize the occupational exposure measures collected by ARPA Piemonte, in order to facilitate their availability, in accordance with the indications of the European Foundation for the Improvement of Living and Working Conditions. Methods. An application in a relational database environment was defined and developed to collect and structure information relating to companies, interventions, tasks and / or monitored sampling points, samples and measurements performed. Results. Data on chemical exposure related to interventions carried out by ARPA Piemonte in the period from 2005 to part of 2020 have been collected in the ESP ALP application. ESP ALP contains information about 161 companies, 193 interventions, 815 sampling points, 3.490 samples and 18.576 measurements and information on companies obtained from the 2011 Census of Economic Activities and the archives of the National Institute for Insurance against Accidents at Work (INAIL). Discussion. We verified the feasibility of retrieving and organizing the information collected in past years in an integrated environment that facilitates its processing and use. Finally, we confirm the usefulness of collaboration between multidisciplinary professionals.

[The family and community nurse-led proactive management of COPD patients: experience of an Italian health district]. / La gestione proattiva dei pazienti BPCO a cura degli infermieridi famiglia e comunità: l'esperienza di un Distretto del Piemonte.

. The family and community nurse-led proactive management of COPD patients: experience of an Italian health district. INTRODUCTION: Integrated care management for COPD may reduce healthcare utilisation, improving cost-efficiency. AIM: To assess the primary outcomes of a family and community nurse-led proactive management of COPD patients of an Italian health district. METHODS: Target population comprised men and women >60 years, resident in the municipalities of Collegno and Grugliasco (metropolitan area of Turin). Administrative databases (hospital discharge records, drug prescriptions, legal exemptions) were first used to identify patients with diagnosis of COPD; the cases were validated by the General Practitioners (GPs). The 335 patients were enrolled from July 1, 2015 to November 30, 2016. Family and community nurses were responsible for anamnesis, spirometry, assessment of adherence to therapy, counselling and healthy lifestyles education. GPs were responsible for the clinical staging and revision of therapy. Patients were followed-up to 12 months. RESULTS: Improvements were observed in smoking cessation (prevalence of smokers from 23.9% to 20%), BMI normalization (in 13.4% of patients out of standard), physical activity (from 32.5% to 64.5% of patients), and pneumococcal vaccinations (from 14.9% to 58%). The last two outcomes were statistically significant. Patients showed high levels of satisfaction; 12-months compliance was 62.1%. CONCLUSION: A family and community nurse-led proactive management of COPD patients in primary care is feasible and effective. Interventions should be structured, personalised and multi-component, oriented at motivating, engaging and supporting the patients. Positive results led to continue and extend the programme.

Analysis of Site Formation and Assemblage Integrity Does Not Support Attribution of the Uluzzian to Modern Humans at Grotta del Cavallo.

Based on the morphology of two deciduous molars and radiocarbon ages from layers D and E of the Grotta del Cavallo (Lecce, Italy), assigned to the Uluzzian, it has been proposed that modern humans were the makers of this Early Upper Paleolithic culture and that this finding considerably weakens the case for an independent emergence of symbolism among western European Neandertals. Reappraisal of the new dating evidence, of the finds curated in the Taranto Antiquities depot, and of coeval publications detailing the site's 1963-66 excavations shows that (a) Protoaurignacian, Aurignacian and Early Epigravettian lithics exist in the assemblages from layers D and E, (b) even though it contains both inherited and intrusive items, the formation of layer D began during Protoaurignacian times, and (c) the composition of the extant Cavallo assemblages is influenced in a non-negligible manner by the post-hoc assignment of items to stratigraphic units distinct from that of original discovery. In addition, a major disturbance feature affected the 1960s excavation trench down to Mousterian layer F, this feature went unrecognized until 1964, the human remains assigned to the Uluzzian were discovered that year and/or the previous year, and there are contradictions between field reports and the primary anthropological description of the remains as to their morphology and level of provenience. Given these major contextual uncertainties, the Cavallo teeth cannot be used to establish the authorship of the Uluzzian. Since this technocomplex's start date is ca. 45,000 calendar years ago, a number of Neandertal fossils are dated to this period, and the oldest diagnostic European modern human fossil is the <41,400 year-old Oase 1 mandible, Neandertal authorship of the Uluzzian remains the parsimonious reading of the evidence.