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Intro -- Foreword -- Preface -- Contents -- Abbreviations -- 1 A New Challenge in Healthcare for India -- Abstract -- Rethinking the Healthcare in India -- The Indian Context -- The West Bengal Region -- References -- 2 The Current Indian Healthcare System and West Bengal's Health Status -- Abstract -- Indian National Health System -- Epidemiological Scenario and Health Criticisms -- Maternal and Child Health and Gender Issues -- Access to Improved Toilets and Wastewater -- Human Resources -- Health Status in West Bengal -- References -- 3 The Existing Indian NGOs' Scenario and the Local Actions in West Bengal -- Abstract -- The Indian NGOs' Scenario -- A Brief History Description of NGOs in India -- NGOs in West Bengal -- References -- 4 Design Approaches for a New Indian Healthcare -- Abstract -- Definition of the Factors Involved and Goals to be Achieved -- Environmental and Climatic Factors -- Social, Cultural and Typological Factors -- Construction-Technological Factors and Strategies -- Bamboo -- Mud -- Straw -- Steel -- Linoleum -- Lime -- Sum up -- References -- 5 Healthcare for All: A New Multidisciplinary Approach for Designing and Managing Hospital Layouts in India -- Abstract -- A Dimensional, Building Performance and Healthcare Services' Focus of IIMC' Healthcare Facilities for Understanding the Current Scenario -- Criteria of Settlement Development -- Identification of Main Flows and Paths -- Strategies for the Definition of the Urban Morphology -- The Module -- Functional Blocks and Aggregative Forms -- A First Level of Care: Urban/Receptive Block -- A Second Level of Care: The Outdoor Sanitary Block -- A Third Level of Care: Indoor Sanitary Block -- Energy Community Centre -- Development of a Masterplan Meta-Project for a New Healthcare Scenario -- Management Model -- Considerations and Perspectives -- References

Accessibility is often translated in design practice by means of a prescriptive approach, focusing on legislation's application, instead of understanding the real needs and wishes of users. On the contrary, the descriptive and performance-based approach of Design for All can help architects in designing inclusive environments. Therefore, it is fundamental to translate the existing theory into information that meets the architects' needs to link knowledge and practice. This study focuses on methods to inspire and support architects applying a Design for All strategy by gathering information and advice. In particular, the paper demonstrates a literature review to identify how to transfer design guidelines to architects. Based on the analysis of the included papers, four criteria were defined to translate Design for All information from users' needs into design indications for architects in a descriptive way. The current results will provide the basis for developing a tool to inspire and create awareness for architects on Design for All in architectural practice.

Accessibility is often translated in design practice by means of aprescriptive approach, focusing on legislation's application, instead of understanding the real needs and wishes of users. On the contrary, the descriptive and performance-based approach of Design for All can help architects in designing inclusive environments. Therefore, it is fundamental to translate the existing knowledge into information that meets the architects' needs to link knowledge and practice. This study focuses on methods to inspire and support architects applying a Design for All strategy by gathering information and advice. In particular, the paper demonstrates a literature review to identify how to transfer design information to architects. Based on the analysis of the included papers, four criteria were defined to translate Design for All information from users' needs into design strategies for architects in a descriptive way. The current results will provide the basis for developing a tool to inspire and create awareness for architects on Design for All in architectural practice. ; Peer Reviewed

Accessibility is often translated in design practice by means of a prescriptive approach, focusing on legislation's application, instead of understanding the real needs and wishes of users. On the contrary, the descriptive and performance-based approach of Design for All can help architects in designing inclusive environments. Therefore, it is fundamental to translate the existing theory into information that meets the architects' needs to link knowledge and practice. This study focuses on methods to inspire and support architects applying a Design for All strategy by gathering information and advice. In particular, the paper demonstrates a literature review to identify how to transfer design guidelines to architects. Based on the analysis of the included papers, four criteria were defined to translate Design for All information from users' needs into design indications for architects in a descriptive way. The current results will provide the basis for developing a tool to inspire and create awareness for architects on Design for All in architectural practice.

Accessibility is often translated in design practice by means of aprescriptive approach, focusing on legislation's application, instead of understanding the real needs and wishes of users. On the contrary, the descriptive and performance-based approach of Design for All can help architects in designing inclusive environments. Therefore, it is fundamental to translate the existing knowledge into information that meets the architects' needs to link knowledge and practice. This study focuses on methods to inspire and support architects applying a Design for All strategy by gathering information and advice. In particular, the paper demonstrates a literature review to identify how to transfer design information to architects. Based on the analysis of the included papers, four criteria were defined to translate Design for All information from users' needs into design strategies for architects in a descriptive way. The current results will provide the basis for developing a tool to inspire and create awareness for architects on Design for All in architectural practice. ; Peer Reviewed

AbstractIntroduction: WHO highlighted the need to strengthen the relationship between health and built environment; in particular, environmental factors and inadequate housing conditions are the most harmful risk factors for NCDs. Local Health Rules (LHRs) and Building Codes (BCs) are useful tools to provide safety and hygiene in building construction. The paper presents a survey on the adoption and updating of LHRs and BCs in Italian municipalities. Methodology: The survey analyses the state-of-the-art of LHRs, BCs and Municipal Development Plans (MDPs) on a sample of 553 cities, with different demographic and geographic characteristics from each other. Results: the survey highlights the serious shortage of updated LHRs, especially in small and medium municipalities. Instead, BCs and MDPs are much more current and updated, but only 30% of them are previously validated by Local Health Authorities. Conclusion: According to the analysis, it is necessary to introduce ever more performance guidelines, instead of prescriptive rules. The Government is taking steps to give rise to a National Building Code guidelines and this initiative could also be expanded to invest LHRs' issues.

Introduction. WHO has highlighted the need to strengthen the relationship between health and built environment factors, such as inappropriate housing conditions. Local Health Rules (LHRs) and Building Regulations (BRs) are tools which provide safety and building hygiene in construction practices. Currently the Italian Government is considering to establish a National Building Regulation and, related to the following purpose, this paper presents a survey on the status of adoption and updating of LHRs and BRs in Italian municipalities. Methodology. The current Italian state of LHRs, BRs and Municipal Development Plans (MDPs) have been examined by a survey considering a sample of about 550 cities, with different demographic and geographic features, starting from the previous research work by Signorelli et al. (1999). Results. The analysis underlines a serious shortage of updated LHRs, especially in small and medium-sized municipalities whereas BRs and MDPs are widespread. Only 30% of them are previously approved and validated by Local Health Authorities. Conclusion. Starting from a survey, the present scenario of Building Regulations requires the introduction of further performance guidelines instead of normative ones and, therefore, the current actions to give rise to a National Building Regulation could be integrated by building hygiene contents of LHRs.

Cross-sector, life-course, and setting approaches are identified in the 2015-2018 Regional Prevention Plan (PRP) of Lombardy Region (Northern Italy) as valuable strategies to ensure the efficacy and sustainable prevention of the non-communicable disease (NCDs). The involvement of non-health sectors in health promotion activities represents a suitable strategy to affect on social, economic, and political determinants and to change environmental factors that could cause NCDs. A dialogue among communities, urban planning, and prevention know-how is a prerequisite to develop a system of policies suitable to promote healthy lifestyle in general and, specifically, active lifestyles. The 2015-2018 Lombardy PRP pursues its aims of health promotion and behavioural risk factors for NCDs prevention through programmes that implement their own setting networks (Health Promoting Schools – SPS; Workplace Health Promotion – WHP) and develop new networks. Sedentary lifestyle prevention and active lifestyle promotion are performed through the approach promoted by the Healthy Cities Programme (WHO), encouraging two main processes: 1. creating integrated capacity-building among health and social prevention services, academic research, and local stakeholders on different urban planning and design issues; 2. promoting community empowerment through active citizens participation. Through this process, Lombardy Region aims to orient its services developing evidence-based programmes and enhancing advocacy and mediating capacity skills in order to create a profitable partnership with non-health sectors. This paper reports the main impact data: 26,000 children that reach school by foot thanks to walking buses, 57% of 145 companies joining WHP are involved in promoting physical activity, 18,891 citizens who attend local walking groups.

Recenti studi sulla salute pubblica si sono concentrati sulla determinazione delle influenze dell'ambiente costruito sullo stato di salute fisica e mentale della popolazione. Al fine di promuovere il trasporto attivo e l'attività fisica, considerati comportamenti favorevoli per la prevenzione delle malattie non trasmissibili (NCD) come l'obesità, è necessario ridurre gli effetti negativi dell'ambiente costruito e sviluppare quelli positivi, come, ad esempio, uno spazio urbano percorribile. Lo scopo della ricerca è definire un quadro di valutazione della percorribilità della città in grado di evidenziare punti di forza e debolezza nel suo ambiente urbano. Tutti gli aspetti che hanno un'influenza diretta (basata sull'evidenza) sulla promozione dell'adozione di stili di vita sani o sulla promozione del trasporto attivo come strategia per aumentare il livello di attività fisica a causa dell'esistenza del viaggio urbano quotidiano. Dopo aver condotto una revisione della letteratura volta a identificare tutti gli strumenti di valutazione esistenti, sono stati esaminati in dettaglio 20 studi di ricerca. Il nuovo metodo di valutazione nasce dal confronto e dalla selezione critica dei vari indicatori qualitativi-quantitativi trovati, integrati in una struttura di analisi multi-criterio di indagine a doppia scala, con riferimento alla calpestabilità e prestando attenzione a quegli indicatori che hanno implicazioni sulla promozione della salute . Il nuovo framework di valutazione, denominato MilanoWalkability Measurement (MWM), è applicabile in diversi contesti urbani ed è stato testato in due diverse aree di Milano. La dimensione Macro (vale a dire, densità, diversità e criteri di progettazione) si riferisce alla scala urbana ed esamina la città da una vista dall'alto. Descrive quantitativamente i fattori urbani complessivi (dimensione dell'area urbana pari a 1,5 Km2; tipologia di dati: archivio). La Micro dimensione (vale a dire criteri di Utilità, Sicurezza, Comfort ed Estetica) indaga la città a livello di scala stradale. Descrive qualitativamente le caratteristiche degli spazi esterni (lunghezza della strada di circa 500/700 mt; tipologia di dati: osservativa). Infine, il quadro è stato ponderato rispetto a un gruppo di esperti. I risultati attesi sono stati riflessi nelle raccomandazioni di progettazione basate sui dati qualitativi-quantitativi raccolti. Il metodo di valutazione sviluppato porta criteri innovativi come la fase di valutazione multi-scaling (Macro e Micro) e la capacità di prendere in considerazione aspetti che secondo la letteratura hanno relazioni con la promozione della salute legate al miglioramento di uno stile di vita sano, legate al quotidiano scelte di trasporto attive. Le raccomandazioni di progettazione sono utili sia per i responsabili politici, per fare scelte specifiche basate sull'evidenza, sia per i progettisti, per capire quali aspetti dell'ambiente urbano devono essere migliorati o implementati al fine di promuovere una città percorribile. ; Recent studies in public health have focused on determining the influences of the built environment on the population's physical and mental health status. In order to promote active transport and physical activity, considered favorable behavior for the prevention non-communicable diseases (NCDs) such as obesity, it is necessary to reduce the negative effects of the built environment and develop positive ones, such as, for example, a walkable urban space. The aim of the research is to define a city's walkability assessment framework capable of highlighting points of strength and weakness in its urban environment. All of the aspects that have a direct influence (evidence-based) on fostering the adoption of healthy lifestyles or promoting active transport as a strategy to increase the level of physical activity due to the existence of daily urban travel should be considered. After conducting a literature review aimed at identifying all of the existing assessment tools, 20 research studies were examined in detail. The new evaluation method arises from the comparison and critical selection of the various qualitative-quantitative indicators found, integrated into a multi-criteria analysis structure of dual-scale survey, with reference to walkability and paying attention to those indicators that have implications on health promotion. The new assessment framework, named MilanoWalkability Measurement (MWM), is applicable in different urban contexts and was tested in two different areas of Milan. The Macro dimension (i.e., Density, Diversity, and Design criteria) refers to the urban scale and examines the city from a top view. It describes quantitatively the overall urban factors (urban area size equal to 1.5 Km2; typology of data: archival). The Micro dimension (i.e., Usefulness, Safeness, Comfort, and Aesthetics criteria) investigates the city at the street scale level. It describes qualitatively features of the outdoor spaces (road length of about 500/700 mt; typology of data: observational). Finally, the framework was weighted by comparison with a panel of experts. The expected results were reflected in the design recommendations based on the collected qualitative-quantitative data. The developed assessment method brings innovative criteria such as the multi-scaling assessment phase (Macro and Micro) and the ability to take into consideration aspects that according to the literature have relationships with health promotion linked to the improvement of a healthy lifestyle, related to daily active transportation choices. The design recommendations are useful both to policy-makers, to make evidence-based specific choices, and to designers, to understand what aspects of the urban environment must be improved or implemented in order to promote a walkable city.

Nowadays, the majority of world population lives in urban areas and this portion is going to increase in the coming decades. The health impact of urban areas is well established and described in scientific literature. Italian health and hygiene legislation dealing with urban health is fragmented and not coordinated with the regulation about environment and city planning. The overlapping of legal competences between different authorities and the conflict of attribution between the Central State and Regional Governments deeply contributed to generate uncertainty. The authors here analyse the Italian regulatory framework and depict its lacks in terms of public health protection.

Oggi la maggior parte della popolazione mondiale vive nelle aree urbane e questa porzione aumenterà nei prossimi decenni. L'impatto sulla salute delle aree urbane è ben definito e descritto nella letteratura scientifica. La legislazione italiana in materia di salute e igiene relativa alla salute urbana è frammentata e non coordinata con la normativa in materia di ambiente e pianificazione urbana. La sovrapposizione di competenze giuridiche tra le diverse autorità e il conflitto di attribuzione tra lo Stato centrale e i governi regionali hanno contribuito notevolmente a generare incertezza. Gli autori qui analizzano il quadro normativo italiano e ne descrivono le carenze in termini di protezione della salute pubblica. ; Nowadays, the majority of world population lives in urban areas and this portion is going to increase in the coming decades. The health impact of urban areas is well established and described in scientific literature. Italian health and hygiene legislation dealing with urban health is fragmented and not coordinated with the regulation about environment and city planning. The overlapping of legal competences between different authorities and the conflict of attribution between the Central State and Regional Governments deeply contributed to generate uncertainty. The authors here analyse the Italian regulatory framework and depict its lacks in terms of public health protection.

INDOORS AND HEALTH: RESULTS OF A SYSTEMATIC LITERATURE REVIEW ASSESSING THE POTENTIAL HEALTH EFFECTS OF LIVING IN BASEMENTS A new law approved in March 2017 in the Lombardy Region makes it possible to live in basements. Basements are defined as buildings partly below curb level but with at least one-half of its height above the curb. Basements' features and structural characteristics might pose risks to human health. In this paper we adopt a multidisciplinary approach to assess the potential health effects of living in basements. In particular, we define a conceptual framework to describe basements' structural characteristics which are risk factors, as well as the mechanisms through which they impact on human health. We also conduct a systematic review on the scientific databases PubMed, Embase, DOAJ, Proquest and EBSCO to retrieve, pool and critically analyze all available research that quantified the risk of living in basements for different health outcomes. Available evidence suggests living in basements increases the risk of respiratory diseases (asthma and allergic disorders); more heterogeneous data are available for cancers and cardiovascular diseases. As more quantitative data need to be prospectively retrieved to assess and monitor the risk of living in basements for human health, clear minimum requirements for light, air, sanitation and egress are to be defined by technical experts and enforced by policy makers. (www.actabiomedica.it) BACKGROUND: Recentemente è stata approvata in Regione Lombardia la legge LR 10 Marzo 2017 "Recupero dei vani e locali seminterrati esistenti" che consente di utilizzare gli ambienti seminterrati a scopo abitativo. Questo ha dato origine a un interessante dibattito perché, se da un lato il legislatore si pone l'obiettivo di attivare processi virtuosi di riqualificazione urbana e di risparmio di suolo a fini edilizi, dall'altro le caratteristiche strutturali degli ambienti seminterrati possono costituire fattori di rischio per la salute umana. OBIETTIVI E METODI: Obiettivo ...

Partendo da una precedente esperienza del gruppo di lavoro "Igiene edilizia e ambientale" della Società Italiana di Igiene e Medicina Preventiva (SItI), l'obiettivo del presente lavoro è definire nuovi obiettivi strategici per il raggiungimento di una "Città sana e salutogenica" ", che sarà utile per i progettisti, i governi locali e gli enti pubblici, i responsabili politici e tutti i professionisti che lavorano presso le agenzie sanitarie locali. Dieci punti chiave sono stati formulati: 1. cambiamenti climatici e gestione degli eventi meteorologici avversi; 2. consumo di terra, espansione urbana e città in calo; 3. urbanismo tattico e resilienza urbana; 4. comfort urbano, sicurezza e percezione della sicurezza; 5. punti di forza e di debolezza delle aree verdi urbane e delle infrastrutture; 6. gestione dei rifiuti solidi urbani; 7. Emergenze abitative in relazione a cambiamenti socio-economici e ambientali; 8. aspetti energetici e pianificazione ambientale su scala urbana; 9. rete socio-assistenziale e assistenziale su scala urbana: importanza di un sistema razionale e diffuso; e 10. nuove forme di vita, consapevole dei modelli di copartecipazione e consapevole della condivisione degli obiettivi di qualità. Strategie, azioni e politiche di progettazione, identificate per migliorare la salute e il benessere della popolazione, sottolineano che la connessione tra caratteristiche morfologiche e funzionali del contesto urbano e della salute pubblica è cruciale per le città contemporanee e le società moderne. ; Starting from a previous experience carried out by the working group "Building and Environmental Hygiene" of the Italian Society of Hygiene and Preventive Medicine (SItI), the aim of the present work is to define new strategic goals for achieving a "Healthy and Salutogenic City", which will be useful to designers, local governments and public bodies, policy makers, and all professionals working at local health agencies. Ten key points have been formulated: 1. climate change and management of adverse weather events; 2. land consumption, sprawl, and shrinking cities; 3. tactical urbanism and urban resilience; 4. urban comfort, safety, and security perception; 5. strengths and weaknesses of urban green areas and infrastructures; 6. urban solid waste management; 7. housing emergencies in relation to socio-economic and environmental changes; 8. energy aspects and environmental planning at an urban scale; 9. socio-assistance and welfare network at an urban scale: importance of a rational and widespread system; and 10. new forms of living, conscious of coparticipation models and aware of sharing quality objectives. Design strategies, actions, and policies, identified to improve public health and wellbeing, underline that the connection between morphological and functional features of urban context and public health is crucial for contemporary cities and modern societies.

Starting from a previous experience carried out by the working group "Building and Environmental Hygiene" of the Italian Society of Hygiene and Preventive Medicine (SItI), the aim of the present work is to define new strategic goals for achieving a "Healthy and Salutogenic City", which will be useful to designers, local governments and public bodies, policy makers, and all professionals working at local health agencies. Ten key points have been formulated: 1. climate change and management of adverse weather events; 2. land consumption, sprawl, and shrinking cities; 3. tactical urbanism and urban resilience; 4. urban comfort, safety, and security perception; 5. strengths and weaknesses of urban green areas and infrastructures; 6. urban solid waste management; 7. housing emergencies in relation to socio-economic and environmental changes; 8. energy aspects and environmental planning at an urban scale; 9. socio-assistance and welfare network at an urban scale: importance of a rational and widespread system; and 10. new forms of living, conscious of coparticipation models and aware of sharing quality objectives. Design strategies, actions, and policies, identified to improve public health and wellbeing, underline that the connection between morphological and functional features of urban context and public health is crucial for contemporary cities and modern societies.

Starting from a previous experience carried out by the working group "Building and Environmental Hygiene" of the Italian Society of Hygiene and Preventive Medicine (SItI), the aim of the present work is to define new strategic goals for achieving a "Healthy and Salutogenic City", which will be useful to designers, local governments and public bodies, policy makers, and all professionals working at local health agencies. Ten key points have been formulated: 1. climate change and management of adverse weather events; 2. land consumption, sprawl, and shrinking cities; 3. tactical urbanism and urban resilience; 4. urban comfort, safety, and security perception; 5. strengths and weaknesses of urban green areas and infrastructures; 6. urban solid waste management; 7. housing emergencies in relation to socio-economic and environmental changes; 8. energy aspects and environmental planning at an urban scale; 9. socio-assistance and welfare network at an urban scale: importance of a rational and widespread system; and 10. new forms of living, conscious of coparticipation models and aware of sharing quality objectives. Design strategies, actions, and policies, identified to improve public health and wellbeing, underline that the connection between morphological and functional features of urban context and public health is crucial for contemporary cities and modern societies.