1,720,987 research outputs found
Curiositas. Studi di cultura classica e medievale in onore di Ubaldo Pizzani. A cura di Antonino Isola-Enrico Menestò-Alessandra Di Pilla
No full textRadiotherapy resources for the care of head and neck patients in Italy. A survey by the Head and neck Group of the Italian association for Radiation Oncology (AIRO)
No full textTumori. 2008 Jan-Feb;94(1):59-64.
Radiotherapy resources for the care of head and neck patients in Italy. A survey by the head and neck group of the Italian Association for Radiation Oncology (AIRO).
Frata P, Ponticelli P, Cosentino D, Buffoli A, Di Pilla A, Morrica B, Palazzi M.
Source
Department of Radiation Oncology Istituto del Radio O. Alberti, Brescia University Hospital, Brescia, Italy. [email protected]
Abstract
AIMS AND BACKGROUND:
In 2006 a survey was performed to define the resources available in Italy for the provision of radiotherapy services to head and neck cancer patients. This was the first initiative of the newly founded Head and Neck Group of the Italian Association for Radiation Oncology.
METHODS:
A questionnaire was sent to all 138 radiotherapy centers active in the country. Items investigated included total numbers of head and neck cancer patients treated per year, waiting time before the start of treatment, general technical issues, and integration with surgery and chemotherapy.
RESULTS:
Sixty-nine questionnaires were returned (50% response rate). The total number of patients treated was 4,670, averaging 68 cases per center. The larynx was the primary site most frequently involved. Average waiting time was 30 days and 47 days for nonresected and postoperative cases, respectively. The combination of chemotherapy and radiotherapy was delivered to nonresected and resected patients in 96% and 54% of centers, respectively. Survey response rates, waiting time, and the use of organ preservation protocols were the issues showing more variations across the country.
CONCLUSIONS:
This survey provides important data on radiotherapy resources available for head and neck cancer patients in Italy. The evidence of significant differences across the country concerning several relevant issues and the potential for cooperative clinical efforts in this relatively rare group of diseases urge the Group to plan further initiatives
Healthcare costs and outcomes: a value-based assessment tool for Clinical Governance [Pitch presentation]
No full textIssue/problem:
Health systems sustainability is a critical public health issue. A
value-based approach is essential to improve patient-centeredness,
appropriateness, quality and funding allocation in
healthcare.
Description of the problem:
This project was aimed to develop an innovative transferable
tool to assess value-based activities in Hospital by monitoring
care pathways costs and outcomes. Main questions were to:
assess cost and outcome variance in homogeneous groups of
patients; evaluate clinical activities contribution to the hospital
budget; identify and monitor critical points. In 2018 a Business
Intelligence system fed by different Hospital datasets was
developed and tested in a Teaching Hospital in Rome to
quantify and integrate data on pathways efficacy and costs. It
was based on an algorithm of 20 indicators related to Women
and Child Care Pathways.
Results:
Preliminary results showed a great variance for the same
intervention/procedure concerning length of stay (3-8 days),
waiting times (1-4 days), innovative technologies costs (2000-
6000E) and obsolete reimbursement rates (2000-5000E) that
do not guarantee adequate economic contribution margins.
Improvement actions were defined concerning pathways’
workflow and organizational appropriateness. The need for
negotiations with Ministry of Health was highlighted, aimed to
update reimbursement rates.
Lessons:
The tool, built on a value-based process view, allowed
analyzing online outcomes and costs data aggregated by
path, benchmarking results, identifying critical issues and
providing improvement solutions. It turned out to be an
innovative methodology - also applicable in other settings/
countries - to trigger changes in health management and
pursue quality and efficiency in healthcare.
Key messages:
Value-based healthcare is the new public health paradigm.
Assessing simultaneously Hospital costs and outcomes is a
valuable way to derive overall healthcare value, improve
quality and rationalize resources allocation
Continuità assistenziale: modelli e pilastri [Pitch]
No full textLa continuità assistenziale è definita come un insieme di azioni volte a garantire il passaggio tra differenti livelli di cura. L’incremento dell’età della popolazione e della prevalenza delle malattie croniche necessitano di strategie e programmi che permettano ai pazienti di affrontare con sicurezza le difficoltà dell’ospedalizzazione, dell’assistenza post-acuzie e del passaggio tra i due livelli. La transizione assistenziale in un sistema di cure frammentato può compromettere lo stato di salute dei pazienti. Lo scopo di questo studio è quello di analizzare i modelli di continuità di cura e gli approcci internazionali al continuum assistenziale identificando i loro pilastri principali.
Per la ricerca è stata eseguita una revisione narrativa della letteratura scientifica, all’interno del database Pubmed, tramite i termini a testo libero: chronic disease, continuum of care, primary care, secondary care, care models. Sono state incluse nello studio soltanto le revisioni sistematiche in lingua italiana e inglese incentrate sull’applicazione di modelli di continuum assistenziale, con particolare riferimento agli ambiti della cronicità, comorbidità, disabilità o fragilità.
La ricerca iniziale ha identificato 129 studi. Dopo la lettura del titolo e dell’abstract sono stati selezionati 33 articoli; dopo quella del full-text sono state scelte 22 pubblicazioni. Dalla revisione sono emersi 9 modelli di continuità assistenziale, tra i quali il maggiormente descritto è il ‘’modello assistenziale integrato’’, che mira ad un migliore coordinamento tra assistenza primaria e secondaria. Lo studio ha evidenziato dei pilastri comuni ai modelli analizzati: coinvolgimento e responsabilizzazione del paziente (86% degli studi), multidisciplinarietà (73% degli studi), coordinamento assistenziale (50% degli studi), case management (50% degli studi), integrazione di assistenza sanitaria e sociale, centralità del paziente, digital health, rapporto e comunicazione medico-paziente.
Il continuum assistenziale è un aspetto chiave di un sistema integrato avente lo scopo di guidare il paziente lungo il suo percorso assistenziale. I pilastri del continuum of care sono interdipendenti e parte di un processo atto a rispondere su più livelli ai complessi bisogni del paziente cronico e con multimorbilità. La ricerca infatti suggerisce come l’orientamento del sistema di erogazione verso la primary health care, con particolare attenzione alla centralità del paziente e all’approccio multidisciplinare e integrato dell’assistenza, siano necessari per far fronte ai molteplici bisogni di salute del paziente cronico e migliorarne il percorso di cura
Supportive care protocol and evaluation of side effects during radiotherapy concomitant to cetuximab in locally advanced head and neck cancer: a monoinstitutional experience.
No full textLa città e la legge. Echi ciceroniani nel libro I del De libero arbitrio di Agostino
No full textEsaminando il richiamo da parte di Agostino a una “legge che comanda di conservare l’ordine della natura e impedisce di sconvolgerlo”, di chiare ascendenze ciceroniane, si esamina un passo del De libero arbitrio (1,16,35), intorno alla funzione della legge civile, in cui viene scoperta una criptocitazione ciceroniana (De fin. bon. et mal. 3,8,29), non rilevata dalla critica, anche se inscritta in un quadro teorico nuovo
Paraphonia e paraphonista dalla lessicografia greca alla tarda antichità latina
No full textText of the Latin and Greek late antiquity provide the evidence of the existence of a performance praxis of liturgical chant featuring more than one voice
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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