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This study explores the application of Universal Design (UD) principles to university environments, aiming to improve the experiences of students and staff by fostering inclusivity in educational and social spaces. The research began with a literature review and employed the 'Design for All A.U.D.I.T.' tool, developed by Politecnico di Milano. This tool was adapted to evaluate six buildings across two universities in Milan:Politecnico di Milano and Statale University. The buildings ranged from the most recent to medium-aged and the oldest on each campus. The assessment focused on three main categories-physical, social, and sensory-cognitive quality-across eight key areas, including outdoor environments, entrances, halls, horizontal and vertical circulation, restrooms, classrooms, and study/leisure spaces. A binary scoring system was used to calculate the satisfaction of requirements, previously weighted by experts. The evaluation revealed that newer buildings generally scored higher on average (77%) compared to those from the 1960s (62%) and historical ones (67%). Despite higher scores, newer constructions often prioritized educational spaces over social and leisure areas, resulting in a lack of student gathering spaces. Significant issues included poor entrance design, inadequate wayfinding strategies, and a lack of inclusive classroom features, although restroom facilities consistently demonstrated good accessibility. The most recent building atPolitecnico di Milano scored highest overall but struggled in leisure and study rooms, as did the new building at Statale University. This research highlights both the current state and potential for improvement in university architecture through the lens of UD. The study underscores that innovative design does not always equate to user satisfaction and provides an objective tool to aid decision-makers in enhancing the accessibility and inclusivity of university spaces, ultimately improving the well-being of all users.

Background: Patient‐centredness has been targeted by the Italian government as a key theme for the future development of health services. Objective: Measuring patient‐centred health services in partnership with citizens, health professionals and decision makers. Design: National participatory survey in a large test set of hospitals at national level. Setting and participants: A total of 387 hospital visits conducted in 16 Italian regions by over 1,500 citizens and health professionals during 2017‐2018. Main variables and outcome measures: An ad hoc checklist was used to assess person‐centredness in hospital care through 243 items, grouped in 4 main areas, 12 sub‐areas and 29 person‐centred criteria (scored 0‐10). GEE linear multivariate regression was used to explore the relation between hospital characteristics and person‐centredness. Results: Person‐centred scores were moderately high, with substantial variation overall (median score: 7.0, range: 3.2‐9.5) and by area (Care Processes: 6.8, 2.0‐9.8; Access: 7.4, 2.7‐9.7; Transparency: 6.7, 3.4‐9.5 and Relationship: 7.3, 0.8‐10.0). Multivariate regression found higher scores for increasing volumes of activity (quartile increase: +0.21; 95% CI: 0.13, 0.29) and lower scores in the south and islands (−1.03; −1.62,‐0.45). Discussion: The checklist has been applied successfully by over 1,500 collaborators who assessed hospitals in 16 distinct Regions and Autonomous Provinces of Italy. Despite an overall positive mark, all scores were highly variable by location and hospital characteristics. Conclusion and patient or public contribution: A national participatory programme to improve patient‐centredness in Italian hospitals highlighted critical areas with the direct input of citizens. [ABSTRACT FROM AUTHOR]

• External operational variables are associated with efficiency estimation. • Efficiency is higher in municipalities with lower levels of income per capita. • Efficiency is lower for municipalities with higher undifferentiated waste produced. • Adoption of zero waste strategy is related to higher efficiency in MSW service. • Privatization is not associated with significant improvement in performance results. This paper assesses the performance of waste services in the region of Tuscany in Italy. It adopts non-parametric techniques for this purpose. Furthermore, it investigates the influence of the operational environment on the estimated performance by using the robust order-m technique. Meaningful levels of inefficiency were found in the Italian waste services. A specification of the ownership of the operator entrusted with waste management by municipalities and the formal adoption of the zero-waste strategy are included as environmental variables. The study concludes that the influence of the operational environment is a determinant of performance. The income per capita is negatively associated with efficiency, while population density is positively associated. Furthermore, efficiency levels are lower for municipalities with higher mixed waste per capita produced. Improving good pro-environmental behaviours is likely to improve efficiency and, thus, tariffs. The empirical results support the idea that it is necessary to make relevant organizational decisions that imply higher costs to increase the refuse collection rate. An increase in the separate collection rate beyond 50% is associated with the reduction of the efficiency level reached. Efficiency analysis does not consider the additional costs and the opportunities for municipalities to get revenues by selling them as secondary raw materials. Besides, the adoption of a zero-waste strategy is related to higher efficiency in MSW service provision. Finally, results about the ownership issue support the idea that privatization is not necessarily associated with the performance improvement of the waste services. [ABSTRACT FROM AUTHOR]

Protected designations of origin (PDOs) and protected geographical indications (PGIs) for food products are used by the European Union with the goal of achieving several policy objectives. We build a multi-criteria analysis framework for ex post assessment of the performance of PDOs. The performance criteria are based on five policy objectives, as defined by European policy makers in regulations, with each criterion measured by a set of indicators. We apply the framework to analyze the performance of all Italian PDO cheeses and olive oils from 2004 to 2008. The results show that for the PDOs studied it is feasible, in general, to perform on all five objectives at the same time, although partial tradeoffs are present between the bargaining power and local development objectives on one side and the market performance objective on the other. A ranking of PDOs in the two sectors on all objectives using multi-criteria analysis and equal weights on all objectives shows overall higher performance for smaller PDOs that are well rooted in the territory of origin and targeted to niche market segments. Lower ranked PDOs under this scenario tend to be bigger, older, and better established in wider markets. Alternative weighting scenarios that emphasize niche/local market PDOs or market performing PDOs yield different relative rankings. The results provide insights for both policy makers and stakeholders into the evaluation of PDO policy, as well as into the performance of individual PDO products. [ABSTRACT FROM AUTHOR]

Abstract: The availability of solar radiation in phase with the seasonal as well as hourly cooling load profiles in most of the office buildings in the Mediterranean region, in addition to the large share of primary energy consumed for air- conditioning applications in office buildings create a high motivation for the utilization of solar cooling technology for such type of buildings. A solar heating and cooling system for an office building in Italy has been designed, installed and monitored within the framework of the EC co-funded project SOLERA aiming at developing highly integrated solar thermal heating and cooling system that is able to achieve a high solar fraction both for the heating and cooling seasons. The analysis of the system performance during 2011 is presented in this paper, with main focus on electricity consumption during summer. The analysis has been carried out according to the monitoring procedure developed within the frame of the IEA SHC Task 38. [Copyright &y& Elsevier]

Abstract: Introduction: The main objective of this study was to compare clinical and functional outcomes of patients with schizophrenia in Italy and Sweden with a special focus on daily functioning performance and real life milestones. Also, to study if outcome is to be regarded as a consequence of premorbid function, the level of symptom control and functional capacity or if other influences, such as cultural differences, must parallel be considered. Method: Ninety-five patients from three centres, Milan and Naples in Italy and Trollhattan in Sweden were investigated. The Positive and Negative Syndrome Scale and the UCSD Performance-Based Skills Assessment - Brief version were used together with patients’ school history and their status of accommodation and occupation. Results: Patients in Trollhattan were more likely to live independently and patients in Naples to have a work or take part in education. Differences in symptoms and the performance test were present but subtle. Discussion: Differences in real life milestones were not explained by corresponding differences in symptoms, premorbid function or the performance-based test. It is therefore not appropriate only to present functional outcome as an expression of how successful treatment has been. [Copyright &y& Elsevier]

The seismic vulnerability and inadequate behaviour of existing school buildings observed during past earthquakes in Italy have raised awareness of the need to upgrade their performance. This paper examines different retrofit strategies for three case study school buildings, representing the main typologies found within the Italian school building stock. The three building typologies investigated in this study are representative of reinforced concrete (RC), precast concrete (PC) and unreinforced masonry (URM) school buildings. A seismic performance assessment was carried out using detailed numerical models that consider the main structural deficiencies documented for older buildings in Italy, generally designed and built before the 1970s. The retrofit interventions were specifically aimed at mitigating these main structural deficiencies in order to meet current building code limit state requirements. These requirements are set to limit the damage to non-structural elements and prevent non-ductile failure mechanisms in the structural system, following a typical building code and practitioner-oriented process. The retrofit alternatives were then evaluated through increasing ground shaking intensities to quantify risk-based decision variables, such as the expected annual loss and mean annual frequency of collapse. The results highlight the level of adequacy of each retrofit option in reducing both the economic losses and collapse vulnerability. To predict the economic feasibility of these interventions, a cost-benefit analysis was also conducted using estimated implementation costs of each retrofit alternative. Lastly, the results were also compared with the outcome of the seismic risk classification guidelines, recently proposed in Italy. [ABSTRACT FROM AUTHOR]

Background: Demographic changes and chronicity are posing new challenges to health care systems. Our study aimed to examine how effectively the three different types of proactive primary care models adopted by three different regional health care systems in Italy were improving the quality of diabetes management by general practitioners., Methods: A coordinated Italian nationwide project to compare systematically the new proactive organizational models implemented at regional and local level (the MEDINA Project) involved several regions and their local health units (LHUs). A quasi-experimental study was conducted on a large dataset obtained by processing administrative databases. A combined indicator was developed to assess the quality of care delivered by primary care physicians, based on adherence to recommendations concerning patient monitoring and treatment., Result: The study concerned 602 Italian general practitioners (GPs), 174 of them female, who were caring for a total of 753,366 patients (47,575 of them diabetic). Analyzing a total score, representing global adherence to a quality management of patients with diabetes, confirmed that GPs who had adopted the new model of care for their diabetic patients obtained better results than those who had not, so the new policy was generally effective., Conclusion: Our study showed that introducing new, proactive primary care models could sustain efforts made around the world to guarantee good-quality chronic disease management in the primary care setting., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Healthcare-Associated Infections are a great concern for worldwide healthcare systems and represent a considerable threat to patient safety, leading to adverse clinical outcomes. A defined panel of indicators represents a key element to guide Healthcare Organizations towards identification of main gaps, implementation of effective actions and continuous improvements on Healthcare-Associated Infections prevention and control activities. A review on accreditation systems conducted by the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene Preventive Medicine and Public Health revealed a substantial heterogeneity of implemented standards and led to the development of a core set of indicators and requirements for Healthcare-Associated Infections' prevention and control within the hospital setting. The main aim of the study was to test the feasibility of the Healthcare-Associated Infections' prevention and control within the hospital setting tool to calculate performance scores on a sample of Italian Healthcare Organizations and to identify major critical issues. The potential benefits of the possibility of future implementation of the tool within Institutional Accreditation Programs is discussed., Study Design: Cross sectional pilot survey., Methods: The Healthcare-Associated Infections' prevention and control within the hospital setting included 96 criteria and 20 key areas including an area for outcomes indicators. For applicable criteria, standards fulfilment was evaluated according to a 4 point Likert scale. A composite score was calculated for each Healthcare Organization and five performance levels were identified. Data were further analysed by computing performance scores at the level of each area and requirement., Results: 20 Healthcare Organizations agreed to take part in this pilot study including two rehabilitative Healthcare Organizations. Among the whole sample a mean of 12.20% of requirements resulted not fulfilled, leaving space for further improvements. Critical areas were easily identified and the instrument was able to capture substantial differences between Healthcare Organizations. Only a few number of standards resulted "Not Applicable" (Mean = 4.71%) and most of them regarded Rehabilitative Healthcare Organizations. Mean composite performance index resulted 74.06% (SD = 16.96, range 36.30 - 94.27%); area of outcome indicators obtained a mean score of 56.17., Conclusion: The Healthcare-Associated Infections' prevention and control within the hospital setting resulted an useful tool to assess Healthcare Organizations' performance in the field of Healthcare-Associated Infections prevention and control and to identify necessary actions for further improvements. The distribution of total scores by Healthcare Organizations showed a high heterogeneity. Implementation of the Healthcare-Associated Infections' prevention and control within the hospital setting tool as an institutional accreditation tool may help to drive the required harmonization at a national level of Healthcare-Associated Infections management and control strategies and overcome current substantial regional differences.