1,721,075 research outputs found
Indicatori di qualità dei servizi socio-sanitari. La definizione di un modello concettuale
No full textViene proposto un diverso approccio per la selezione di un insieme minimo di indicatori rivolti alla valutazione della performance dei sei servizi sanitari.Si presentano infatti i risultati di una ricerca condotta nel 2000-2001 con lo scopo principale di disegnare una cornice di riferimento concettuale per la valutazione di 'performance' dei servizi socio-sanitari: un modello che costituisca il prerequisito fondamentale per la successiva confrontabilità statistica. Il modello proposto adotta una chiave di lettura ancorata al concetto di organizzazione socio-sanitaria e intende essere applicabile ai vari livelli. L'efficacia del sistema (o della organizzazione) può essere misurata mediante la relazione tra risultati ottenuti e obiettivi misurabili, in un ciclo continuo che lega problemi di salute, mandato e risultati di salute, dove l'analisi possa basarsi sugli stessi indicator
“Surgical management of the spinal nerve in modified radical neck dissection” submitted chapter for the book titled “Neck dissection – clinical application and recent advances” .
No full textShoulder and neck pain associated with neck dissection are well recognized and closely related to the quality of life of patients undergoing surgical treatment for head and neck cancer. Shoulder pain and disfunction have been reduced using modified radical neck dissection that preserves cranial nerve XI
Perceived neighbouhood quality and adult health status : new statistical advice useful to answer old questions?
No full textInterest in the quantitative effects of neighbourhood characteristics on adult health has recently increased . Particularly, investigations concern the statistical influence on health of several individual demographic and socioeconomic characteristics and of neighbourhood characteristics as perceived by respondents. We analyze these issues within an original conceptual framework and employing statistical models unusual in this context. We use data collected in the Los Angeles Family and Neighbourhood Survey (L.A.FANS) to model the number of hospital admissions occurred to each individual as a function of some individual and neighbourhood characteristics, the latter being related to the individual perceptions about the neighbourhood he lives in. We
employ generalized additive models with different istributional assumptions: Poisson,Negative Biomial and Z ro Inflated Poisson (ZIP). Such models allow us to estimate (through spline functions) potential non linear effects of the covariates on the response. Moreover, non standard representations are used to overcome difficulties in interpreting the results for ZIP models. It turns out that perceived neighbourhood characteristics, and in particular the perception of social cohesion, have a significant effect after controlling for individual characteristics relevant to hospital admissions frequency. From a modeling point of view ZIP and Negative binomial models prove to be superior to standard Poisson
model. We have confirmed the role of the neighbourhood where an individual lives in determining his health status. A strength of this analysis is that, due to the choice of the neighbourhood characteristics to be included in the model, the results do t depend of a particular definition of neighbourhood (which is traditionally based on
administrative boundaries), since each individual refers his perceptions to his personal definition of it
Metodi statistici in epidemiologia ambientale: uno studio di associazione tra inquinamento urbano e ospedalizzazione
No full textPerceived neighbourhood quality and adult health status: new statistical advices useful to answer old questions?
Full text linkInterest in the quantitative effects of neighbourhood characteristics on adult health has recently increased in social epidemiology. Particularly, investigations concern the statistical influence on health of several individual demographic and socioeconomic characteristics and of neighbourhood characteristics as perceived by respondents. We analyze these issues within an original conceptual framework and employing statistical models unusual in this context. We use data collected in the Los Angeles Family and Neighbourhood Survey (L.A.FANS) to model the number of hospital admissions occurred to each individual as a function of some individual and neighbourhood characteristics, the latter being related to the individual perceptions about the neighbourhood he lives in. We employ generalized additive models with different distributional assumptions: Poisson, Negative Biomial and Zero Inflated Poisson (ZIP). Such models allow us to estimate (through spline functions) potential non linear effects of the covariates on the response. Moreover, non standard representations are used to overcome difficulties in interpreting the results for ZIP models. It turns out that perceived neighbourhood characteristics, and in particular the perception of social cohesion, have a significant effect after controlling for individual characteristics relevant to hospital admissions frequency. From a modeling point of view ZIP and Negative binomial models prove to be superior to standard Poisson model.
We have confirmed the role of the neighbourhood where an individual lives in determining his health status. A strength of this analysis is that, due to the choice of the neighbourhood characteristics to be included in the model, the results do not depend of a particular definition of neighbourhood (which is traditionally based on administrative boundaries), since each individual refers his perceptions to his personal definition of it
Statistical issues in choosing indicators to evaluate healthy cities projects (not only a political task)
No full textWe develop statistical considerations about methodologies that, at least in our opinion, are suitable to synthesize appropriately the impact on health of urban populations of socio-economic and environmental conditions and local policies.
In particular, we focus attention on the so called Health Impact Assessment (HIA) proposed by the European working group “Promoting and Supporting Integrated Approaches for Health and Sustainable Development at the Local Level across Europe” PHASE (2003-2005) within the World Health Organization (WHO) - Healthy Cities Project (HCP) (http://www.euro.who.int/healthy-cities/).
Among open issues about HCP in general and HIA in particular, we focus on statistical tools allowing for the multidimensionality of the phenomenon, the heterogeneity of its various aspects and the complexity of local urban realities involved. This will be done considering simultaneously both conceptual framework and data, measures and statistical models, trying to give policymakers and citizens relevant information in a suitable form as the HCP – Phase IV “Healthy Cities and Urban Governance” needs
MISA Metanalisi italiana degli studi sugli effetti a breve termine dell'inquinamento atmosferico 1996-2002Meta-analysis of the Italian studies on short-term effects of air pollution 1996-2002
No full textThe Italian Meta-analysis of short-term effects of air pollution for the period 1996-2002 (MISA-2) is a planned study on 15 Italian cities, among the larger country towns summing up 9 millions and one hundred thousand inhabitants at 2001 census. Mortality for all natural causes (362254 deaths), for respiratory causes (22317) and cardiovascular causes (146830), and hospital admissions for acute conditions, respiratory (278028 admissions), cardiac (455540) and cerebrovascular (60960), have been considered as HEALTH OUTCOMES DATA. . Mortality data came from Regional or Local Health Unit Registries, while hospital admissions data have been selected from Regional or Hospital Archives (exclusion percentages range for all admissions between 45% and 82%).As AIR POLLUTANTS DATA, daily pollutants concentration series (SO2, NO2, CO, PM10, O3) came from air quality monitoring networks of Regional Environmental Protection Agencies, of Environmental Offices of Provinces or Municipalities. Monitors' selection has been done by a working group composed by representatives of monitoring network Agencies. A generalized linear model on daily counts of health events has been fitted for each city. Linear pollutant effect has been specified and bi-pollutant models have been fitted for PM10+NO2 and PMO+O3. An age-specific natural cubic spline on season has been specified with 5 degree of freedom (on average) per year for mortality and 7 degree of freedom per year for hospital admission data. The base model is age-stratified (0-64, 65-74, 75+ years). Gender, age, season specific models have been fitted, too. Five sensitivity analyses have been done, varying the degree of freedom for the seasonality spline and specifying non parametric functions on temperature. Constrained distributed lag models have been fitted on mortality data to study potential harvesting effects. City-specific results have been meta-analyzed by random effects hierarchical Bayesian model. Four different models have been fitted in the sensitivity analyses, assuming different priors on heterogeneity variance and outlier-resistant prior on city-specific effects. Bayesian meta-regressions have been fitted on base model, bi-pollutant and season-specific city-specific results. Attributable deaths have been estimated by Monte Carlo methods using effect, pollutant, baseline rate distributions. Fourteen different scenarios have been considered for PM10 and ten for NO2 and CO, using meta-analitic and posterior city-specific effect estimates. Pollutants effects are reported as percent increase on mortality or hospital admissions for an increase of 10 microg/m3 of SO2, NO2 and PM10, and 1 mg/m3 of CO. We found an increase on mortality for all natural causes associated to increase of air pollutants concentration (for NO2 0.6% 95%CrI 0.3,0.9; CO 1.2% 0.6,1.7; PM10 0.31% -0.2,0.7). Similar findings were found for cardiorespiratory mortality and hospital admissions for respiratory and cardiac diseases
Adhesion and proliferation of human dental pulp stem cells on a laser micro textured implant surface: An in vitro study
Full text linkThe roughness of the implant surface and its chemistery and toporaphy were demonstrated to impact cells biological properties. A moderate roughness seems to allow better and faster adhesion and proliferation and to accelerate the biological processes. The different physical and chemical procedures used to obtain a certain microtopography modify the surface chemical composition and, in consequence of it, can affect the biological cell behavior. The ideal surface shuold be obtained through processes that do not modify the chemical composition maintaining a right roughness and microtopography. The aim of this investigation was to study the morphology, proliferation and pattern of distribution of human Dental Pulp Stem Cells (hDPSCs) after 5 days of growth on a laser micro-grooved implant surface (Laser-Lock, Bio Horizons IPH, Inc. Birmingham, AL 35244, USA) characterized by a micro geometric design obtained by computer-aided laser ablation without any chemical treatment. Data from SEM surface observation and XPS chemical analysis have highlighted the absence of contaminating chemical elements. The results from cell cultures indicated that the hDPSCs maintained a good morphology and well proliferated following the microgrooves direction
- …
