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Objectives. Poor adherence to medication treatment can have devastating consequences for patients with mental illness. The goal of this project was to develop recommendations for addressing adherence problems to improve patient outcomes. Methods. The editors identified important topics and questions concerning medication adherence problems in serious mental illness that are not fully addressed in the literature. A survey was developed containing 39 questions (521 options) asking about defining nonadherence, extent of adherence problems in schizophrenia and bipolar disorder, risk factors for nonadherence, assessment methods, and interventions for specific types of adherence problems. The survey was completed by 41(85%) of the 48 experts to whom it was sent. Results of the literature review and survey were used to develop recommendations for assessing and improving adherence in patients with serious mental illness. Results. ASSESSING ADHERENCE: The experts endorsed percentage of medication not taken as the preferred method of defining adherence, with 80% or more of medication taken endorsed as an appropriate cut-off for adherence in bipolar disorder and schizophrenia. Although self- and physician report are the most common methods used to assess adherence in clinical settings, they are often inaccurate and may underestimate nonadherence. The experts recommend that, if possible, clinicians also use more objective measures (e.g., pill counts, pharmacy records, and, when appropriate, serum levels such as are used for lithium). Use of a validated self-report scale may help improve accuracy. SCOPE OF THE PROBLEM: The majority of the experts believed the average patient with schizophrenia or bipolar disorder in their practices takes only 51%-70% of prescribed medication. FACTORS ASSOCIATED WITH NONADHERENCE: The experts endorsed poor insight and lack of illness awareness, distress associated with specific side effects or a general fear of side effects, inadequate efficacy with persistent symptoms, and believing medications are no longer needed as the most important factors leading to adherence problems in schizophrenia and bipolar disorder. The experts considered weight gain a side effect that is very likely to lead to adherence problems in patients with schizophrenia and bipolar disorder; sedation was considered a more important contributor to adherence problems in bipolar disorder than schizophrenia. The experts rated persistent positive or negative symptoms in schizophrenia and persistent grandiosity and manic symptoms in bipolar disorder as the most important symptomatic contributors to adherence problems in these illnesses. INTERVENTIONS: It is important to identify the specific factors that may be contributing to a patient's adherence problems in order to customize interventions to target those problems. Multiple problems may be involved, requiring a combination of interventions. Conclusions. Adherence problems are complex and multi-determined. The experts recommended customized interventions focused on the underlying causes. Copyright © of content 2009 owned by Comprehensive Neuroscience, Inc.

This paper provides a comparative overview of different types of (temporary) shelters that have recently been used in various field locations in response to a forced displacement due to disastrous events. In particular, possible strategies useful to increase the sustainability of the humanitarian response and reduce the carbon footprint, while ensuring the adequacy and suitability of the shelters themselves, are here explored. This study investigates a systematic design framework that is often constrained by many obstacles such as the limited availability of low-cost materials, and a lack of local labour experience. To reduce the negative impact of a disaster, especially in the developing countries, the possibility of exploiting alternative materials, such as the regenerated, recycled, reused, and semi-finished materials, is extremely important. Some examples of emergency shelters are deeply discussed in terms of technological and architectural features; among those the Italian case of the tent-cities and the design projects of the Architect Shigeru Ban. Moreover, the choice of the used materials for the shelters’ construction will be deeply analysed as an essential element particularly sensible to certification and characterised by suitable properties in order to offer the maximum performance. The large number of disasters that have occurred in the recent years, deeply showed that despite the best intentions to coordinate and manage the operations, the executive reality is often quite chaotic and full of conflicting interests that hinder the relief efforts. Indeed, providing shelter implies temporary settlements that, on the other hand, gradually become almost permanent. Therefore, the need for socially sustainable solutions - based on green and sustainable design adapted to local conditions - must become a prerequisite. For the next designs it will be necessary to translate architectural solutions, whether for temporary emergency or reconstruction phases, into quality choices, with innovative materials that look to tradition but provide also the minimum comfort for communities.

The maintenance of the façade(s) is one of the most common solutions – in countries where this intervention is allowed – which can also guarantee the “preservation” of the existing built herit- age, as well as the construction of new “zero land consumption buildings”. The English term used to identify this area of work is Façadism. The paper analyses a perfect example attributable to this area of work that is being implement- ed on the former Chelsea and Fulham Power Station in London. The refurbishment project, in the construction phase, was instructed to Midgard Design Service Ltd (Design Department of the Irish construction company JRL Group Limited) which will transform the entire area into a luxurious complex of blocks with apartments, amenities and commercial units. A new ten-floors residential building with a reinforced concrete frame will be built behind the historic facades of the Lots Road power station and connected to them with mechanical connections. The paper is divided into three parts: the first, dedicated to an analysis of the phenomenon of “Façadism”, as a refurbishment option for historic buildings in purely Anglo-Saxon contexts, analyzing their advantages and highlighting the considerations from which derived the analyzed various interventions; the second, which examines the former Lots Road Power Station of Chel- sea and Fulham in London and the project for its recovery; the third, which reports the results of the analysis of an alternative mechanical connection system to the one developed by the multidis- ciplinary consulting firm for engineering design Meinhardt (www.meinhardt.co.uk) – and wanted by the client (Cheung Kong Property Holdings, and Hutchkinson, www.ckh.com.hk)- which will be used for the construction of the new building within the original “shell” of the former Lots Road Power Station.

This study describes construction features typical of masonry buildings in the historic centre of Alcamo, Sicily. This local context is significant for the extent of the historic building stock and for the large use of travertine as traditional masonry material. The local availability of this rock is a peculiarity of Alcamo, in comparison with the rest of Sicily, and its use explains the originality of several construction details. The analysis exposed in this study is part of a wider research, aimed at developing a Sicilian database of mechanical and hygrothermal data for masonry tipologies. The historic tonewalls of Alcamo have been described by means of four masonry categories, whose main construction features are discussed. Furthermore, the results of laboratory tests of compressive strength and thermal conductivity, carried out on travertine samples, are reported. Finally, a focus on the structure of balconies, and the solutions related to the use of travertine, is described. The outcomes of this study are preliminary and will be extended to a more detailed thermal and hygrometric analysis of travertine and its stonewalls in Alcamo.

This study proposes the reuse of spent coffee ground and biomass fly ash in the development of green geopolymeric thermo-plastering for innovative building applications. The former waste is the major residue of the brewing process, that is usually used as fertilisers or disposed of in landfill with extreme harmfulness for the natural environment. The latter is an industrial waste generated during the Kraft paper-pulp process, that is usually landfilled. The mortar is produced with a combination of metakaolin (30 wt.%) and biomass fly ash (70 wt.%), and natural siliceous sand filled with spent coffee ground (up to 17.5 wt.%). The high amount of reused waste makes the material an optimum candidate for the Environmental Minimum Criteria (CAM) assessment as ruled by the National Action Plan on Green Public Procurement. The overall manufacturing process occurred at ambient conditions (20 °C, 65% RH) contributing to the materials sustainability. 28-days cured specimens were analysed to assess the material engineering properties and delineate the possible applications in construction. Finally, virtual energy simulations were implemented to study the possible energetic performance benefits in a simplified building model. The major results are that the used wastes considerably improve the technological material performance making it suitable for effective use in construction. While the slurry workability is significantly affected by the waste introduction, and the mechanical resistance is still high, the thermal conductivity outlines a possible energy application. All considering, coffee waste can be effectively reused to manufacture green bio-composite materials with satisfactory performance considering the main requirements of a building making them exploitable in various applications in construction, especially in energy-saving functions, in line with the European directives towards zero-energy building.

The need to respond to global missions about the containment of energy losses has generated the promotion, at national level, of numerous tax incentives for the recovery of the built heritage. The race for funding has encouraged a sudden innovation of materials and new technological solutions for energy retrofit interventions that sometimes are invasive for the application on those historic buildings, even if not punctually constrained, which characterize most of the curtains of the historical centers of the big cities. With the support of bibliographical data and through simplified quantitative checks, the paper highlights the limit of the application of prescriptive regulations for energy efficiency and the critical issues about the compatibility and durability of retrofit solutions applied to traditional wall supports. With the contribution, the authors intend to open a discussion among the representatives of the scientific sector, about the regulatory conflict that exists between the demands for energy efficiency and the demands of the conservation of the built heritage highlighting the need to overcome the diachrony between the productive world and the academic one so that the latter can implement the technological and cultural transfer activities aimed, on the one hand, at the development of clear paths for test and certification of materials and technologies for the recovery and redevelopment of the built heritage and, on the other hand, to the revision of energy regulations structure, in those cases where the waiting of theoretical parameters determine a damage to the preservation of the physical characteristics of the building.

A large part of the Italian territory is characterized by a spatial organization structured in small towns, with natural and cultural resources, vast material and immaterial heritage, and economic potential. All features often mirrored by a limited accessibility to essential services (transportation, health, and education systems), depopulation and high building vulnerability and inefficiency. The aim of this paper is to propose a methodology for the systemic definition of intervention strategies for building recovery and valorization, as part of a more complex strategy of inner areas’ revitalization, to be achieved in accordance with the cultural landscape, local construction techniques and materials, and the specific characteristics of considered buildings. The chosen case study has been the small town of Conza della Campania, whose historic center was almost destroyed by the 1980’s Irpinia earthquake; although abandoned since, the damaged building stock still preserves acknowledged architectural and constructive qualities, and the area has many potentials linked to its natural and productive vocations. Applying the methodology, seismic and energy retrofitting strategies resulted in the definition of adaptive abacuses describing the most efficient interventions for each considered building, derived by detailed analysis related to their construction techniques, architectural features, historical evolution, and artistic/cultural values. In terms of urban regeneration, these abacuses, as basis for seismic and energy building recovery, act as adaptive tools to support the definition of compatible operational choices and ensure the development of sustainable strategies leading to holistic results.

The research herein presented was carried out within the issues of the Adriseismic project, funded by the Interreg Adrion program, to address seismic vulnerability through a multidisciplinary approach. The project aims at developing new integrated approaches to innovate and harmonise the normative, technical and training frameworks in the ADRION area, providing ready-to-use methods, tools and procedures that will be integrated into the existing policies and practices, thus strengthening local responses and reducing vulnerability to natural hazards. The starting point of the activities was to deepen the knowledge of the built heritage in each country involved in the project, especially the local building techniques in the historic centres of the Adriatic-Ionian area, then qualitatively correlate them to possible seismic weaknesses. The typical construction characteristics of the buildings present in these Countries, both traditional and more recent ones, were analysed. In the first phase, the investigations were conducted by collecting all possible data in the six countries involved in the project: Italy, Croatia, Albania, Serbia, Slovenia and Greece. Then, the building techniques were divided according to their structural function, defining four macro-categories: vertical masonry structures, vertical reinforced concrete structures, horizontal structures and foundation structures. In the last phase, the results collected for each country were compared, highlighting a common general framework with substantial similarities between the various countries’ construction characteristics, despite different historical-cultural events and distant regulatory practices. This result demonstrates how the availability of the same building material governs construction solutions, even though human events are very different.

Circular economy (CE), focused on closing the material loops, turns out to be relevant in the building industry to improve the construction process and reduce waste. Assessing the circular performance of buildings reveals the current level of achievement and future areas of improvement, hence aiding in transitioning from a linear to a CE based construction industry. However, this can be very complex, especially due to absence of a universally accepted Circularity Assessment Framework. Bearing that, a comprehensive CE assessment tool called Whole-Building Circularity Indicator (WBCI) is being developed at Engineering Department of University of Campania. This study tests and validates the first version of the freshly released WBCI using an existing apartment building in Southern Italy as a case study. The data is collected through building documents (detailed drawings, specifications) and site visits, and then modelled in BIM to perform a rigorous analysis. The results show that the apartment building does not perform well in circularity and scores very low (0.274). Excessive use of virgin materials, linear design approach, poor adaptability and disassembly potential after the end of life are the leading causes for this low score. The space plan turns out to be the most circular system among different building layers. The validation also uncovers the positives and negatives of the tested model. Finally, the study recommends practical strategies to improve the circular performance of residential buildings. With these advantages, this paper contributes to the much-anticipated debate on the measurement of CE in the building industry and can help construction practitioners estimate how advanced they are in the process of transition from linear to circular

Con el enfoque creciente para reducir el contenido de sulfurados y aromáticos en los combustibles, el proceso de hidrotratamiento de destilados medios se hace cada día más importante en las refinerías. Existen diferentes tecnologías para la remoción de sulfurados y aromáticos, y una de las más usadas es el proceso donde se le agrega hidrógeno al combustible para su remoción. Estas tendencias son: la mejora de la actividad del catalizador, a través de la formulación de nuevos catalizadores; adaptación de la reacción y de las condiciones del proceso; diseño de nuevas configuraciones de reactores y desarrollo de nuevos procesos. En la parte de diseño de configuraciones de reactores nuevos, se tiene diferentes propuestas para el diseño de nuevos reactores industriales. Una de estas propuestas es colocar en un único reactor, diferentes tipos de catalizadores, el cual puede ser operado en flujo en equicorriente y en flujo en contra-corriente. En función de lo antes expuesto, el objetivo principal del presente trabajo fue desarrollar una metodología que permita obtener una propuesta de la mejor configuración de lechos catalíticos con dos tipos de catalizadores diferentes para un reactor de hidrodesulfuracion de gasóleo, a través de la propuesta de un modelo que permita obtener la mejor distribución de dos tipos de lechos catalíticos el reactor, tal que estudie la existencia o no y la selección de un tipo de catalizador, y genere como resultado la mejor combinación de catalizadores en el reactor y el tamaño del equipo, minimizando el costo total anual. La metodología general propuesta consta de diferentes etapas. La primera fue el desarrollo de un modelo de simulación detallado para un reactor del proceso de hidrotratamiento de gasóleo con reacciones químicas en las fases líquida y gaseosa, considerando el efecto de la transferencia de masa gas-líquido, la eficiencia de mojado y un factor de efectividad global en el sistema. Luego se evaluó los coeficientes de las velocidades de reacción en base a datos experimentales modificando los que aparecen en la bibliografía, y se simplificó el modelo sin detrimento de la bondad de los resultados. El modelo anterior permite obtener los datos de entrada al modelo de optimización de la red de reactores. Como paso previo al modelo de optimización estocástica se desarrolló un modelo de optimización determinista y finalmente se desarrolló el modelo de optimización bajo incertidumbre basado en programación matemática estocástica no lineal entera mixta, el cual proporciona el mejor diseño del reactor, tipos de catalizadores incluidos, de manera que minimice el consumo de hidrógeno, los costos del catalizador y maximice el tiempo de vida del catalizador. Entre los resultados obtenidos se tiene que se desarrolló el modelo matemático detallado del reactor de hidrotratamiento de destilados medios, el cual, se representó a través de un modelo pseudohomogéneo, que es la característica de los modelos que incorporan el factor de efectividad global El sistema reactivo estudiado fue la reacción de eliminación del sulfurados en compuestos aromáticos y las reacciones de hidrogenación de los compuestos diaromáticos y monoaromáticos a naftenos. Se realizó una simulación isotérmica y adiabática a nivel de planta piloto y una a nivel de planta comercial. Los datos utilizados pertenecen a un experimento a nivel de planta piloto y fueron escalados a nivel de planta comercial. La simulación a nivel de planta piloto se realizó considerando el uso de inertes no porosos, para así lograr un comportamiento similar al de la planta comercial, con respecto a mojado pobre, efecto de pared, retro mezclado de líquido, efectos de transferencia de masa y efectos de la temperatura. En esta etapa se determinó, la composición de la corriente de salida y las velocidades de operación del reactor. Asumiendo que se mantiene la velocidad espacial igual para cada nivel, se realizó el escalamiento a nivel comercial, lo que permitió obtener las nuevas velocidades de operación del reactor. Los datos obtenidos en la simulación en escala de planta comercial, fueron utilizados como datos de entrada a los modelos de optimización determinista y la optimización estocástica. Adicionalmente, se desarrolló la optimización determinista y estocástica del reactor, donde se propuso una metodología para desarrollar optimización no lineal en el reactor de hidrotratamiento de gasóleo con el objetivo de proponer el diseño óptimo para la síntesis de un reactor de hidrotratamiento de gasóleo indicando la distribución del tipo de catalizador, longitud y diámetro del lecho catalítico y conversión de los reactivos, mediante el uso de la química básica a través de propuesta de las reacciones que ocurren en el sistema en función del tipo de catalizador. Se trabajó con dos casos de operación, para obtener el diseño conceptual del reactor en cada uno de los casos y poder establecer así, las tendencias de los resultados obtenidos. La condición de operación que se varió fue el flujo de alimentación del gasóleo. En el caso determinista, el flujo de alimentación seleccionado es único, y para el caso estocástico, es la esperanza matemática de los flujos de alimentación de gasóleos seleccionados. Al comparar los resultados del modelo determinista con los resultados del modelo estocástico se observa, que los resultados del modelo estocástico son más robustos que los del modelo determinista. En el caso del modelo estocástico se pueden observar las tendencias de las opciones de configuración de distribución de uno o dos tipos de catalizadores en el lecho catalítico del reactor, desde dos criterios: uno de calidad y el otro de operación. El primero es la conversión de aromáticos sulfurados y la segunda es el consumo de hidrógeno, este último permite proyectar las tendencias de los costes de operación con respecto al consumo de hidrógeno. En el caso del modelo determinista solo se pudo establecer un único criterio para observar las tendencias, el cual fue el criterio de calidad del gasóleo, medido en conversión del aromático azufrado. En ambos modelos los resultados de las tendencias con respecto al criterio de calidad fue mismo, se obtiene mejor conversión cuando el resultado factible es la opción de trabajar con un reactor con una combinación de dos tipos de catalizadores. SUMMARY With the increasing approach to reduce the sulfated and aromatic content in fuels, the process of hydrotreating the average distillates is gaining a mayor importance everyday in refineries. There are different technologies for the removal of sulfated and aromatic one of the most used processes is when hydrogen is added to fuel. These tendencies are: the improvement of the activity of the catalyst through the formulation of new catalysts; adaptation of the reaction and the conditions of the process; design of new configurations of reactors and development of new processes. In the area of design of configurations of new reactors, there are different proposals for the design from new industrial reactors. One of these proposals is to place in a unique reactor, different types from catalysts which can be operated against the cocurrent flow and crosscurrent flow. Based on the previously exposed, the primary target of the present work was to develop a methodology that that will allow us to obtain a proposal of the best configuration of catalytic beds, with two types of different catalysts for a reactor of hydrodesulfurization of gasoil, through the proposal of a model that allows to obtain the best distribution of two types of catalytic beds the reactor, that will study the existence or not and the selection of a type of catalyst, and as a result will generate the best combination of catalysts in the reactor and the size of the equipment, diminishing the annual total cost. The general methodology proposed consists of different stages. First was the development of a detailed model of simulation for a reactor of the process of gasoil hydrotreating with chemical reactions in the liquid phases and gaseous, considering the effect of the gas-liquid mass transfer, the efficiency of wet and a factor of global effectiveness in the system. The coefficients of the reaction rates where evaluated on the basis of experimental data modifying those that appear in the bibliography, and the model without damage to the kindness of the results was simplified. The previous model allows to obtain the input data to the model of optimization of the network of reactors. As previous step to the model of stochastic optimization a model of determinist optimization was developed and finally the model of optimization under uncertainty was developed based on nonlinear mixed stochastic mathematical programming, which provides the best reactor design, including types catalysts, so that it diminishes the hydrogen consumption, the costs of the catalyst and maximize the time of life of the catalyst. According to the obtained results, a detailed mathematical model of the reactor of hydrotreating of average distillates, has to be developed, which, imagined through a pseudohomogenous model, that is the characteristic of the models that incorporate the factor of global effectiveness. The studied reactive system was the reaction of elimination of sulfur in aromatic compounds and the reaction of hydrogenation of diaromatic and monoaromatic compounds to naftenos. An isothermal and adiabatic plant. The used data belong to an experiment concerning pilot plant and were scaled concerning commercial plant. The simulation concerning pilot plant was realized considering the use of inert nonporous, thus to obtain a behavior similar to the one of the commercial plant, concerning wet poor, wall effect, retro mixed of liquid, effects of mass transfer and temperature effects. In this stage it was determined, the composition of the exiting stream and the speeds of operation of the reactor. Assuming the space speed is stays equal for each level, the scale at a commercial level was realized, which allowed to obtain the new speeds of operation of the reactor. The data collected in the simulation in scale of commercial plant, were used like input data to the models of determinist optimization and the stochastic optimization. Additionally, the determinist optimization and stochastic of the reactor was developed, where a methodology to develop nonlinear optimization in the reactor of hydrotreating gasoil was proposed, with the aim of proposing the optimal design for the synthesis of a reactor of gasoil hydrotreating indicating the distribution of the type of catalyst, length and diameter of catalytic bed and conversion of the reagents, by means of the use of basic chemistry through proposal of the reactions that happen in the system based on the type of catalyst. Two cases of operation were worked with, to obtain the conceptual design of the reactor in each one of the cases and power thus of establishing, the tendencies of the obtained results. The condition of operation that varied was the flow of feeding of the gasoil. In the determinist case, the selected flow of feeding is unique, and for the stochastic case, it is the mathematical hope of the flows of selected gasoil feeding. When comparing the results of the determinist model with the results of the stochastic model we can observe, that the results of the stochastic model are more robust than those of the determinist model. In the case of the stochastic model the tendencies of the options of configuration of distribution of one can be observed or two types of catalysts in the catalytic bed of the reactor, from two criteria: one of quality and the other of operation. First it is the conversion of aromatic sulfurated and second it is the hydrogen consumption, this last one allows to project the tendencies of the costs of operation with respect to the hydrogen consumption. In the case of the determinist model a unique criteria could only be established to observe the tendencies, which were the criteria of quality of the gasoil, measured in aromatic conversion of the sulfured one. In both models the results of the tendencies with respect to the quality criteria were the same, a better conversion was obtained when the feasible result is the option to work with a reactor with a combination of two types of catalysts.

El hidrotratamiento de gasóleo es uno de los procesos de refinación,sometido a mejora continuas, en el ámbito de la creciente demanda del diesel y el incremento de las restricciones ambientales. En este marco, las nuevas tendencias de este proceso se dirigen a proponer nuevos esquemas de procesamiento, cuyo desarrollo requieren disponer de modelos que coadyuven a predecir la aracterización de las corrientes involucradas. En el desarrollo de modelos de procesos que traten fracciones pesadas, como el gasóleo, la limitante es la falta de detalle molecular, que ofrecen las técnicas de análisis de mayor aplicación, como la cromatografía de gases o espectrometría de masa. Una solución alternativa es reconstruir el detalle molecular aplicando estrategias de agrupamiento continuo, que consisten en definir a priori una función de distribución continua, que refleje la composición de un grupo de moléculas respecto a una variable de interés fácilmente cuantificable. En tal sentido en este trabajo se desarrollo una metodología para la caracterización de un fracción pesada del petróleo, desde el enfoque del agrupamiento continuo, que ha sido aplicada a un modelo cinético predictivo del proceso de hidrotratamiento de gasóleo, mediante el desarrollo de tres módulos, i) el desagrupamiento de la alimentación de acuerdo a la estrategia continua, ii) la evaluación de la transformación de las reacciones principales con un balance molar discreto-continuo, iii) la predicción de las propiedades importantes para la caracterización del gasóleo hidrotratado. En este orden, se abordan los objetivos que persiguieron estos módulos, separadamente.