177,425 research outputs found
The impact of health policy and technology on hospital productivity growth: evidence from Italy
No full textThe rapid increase in healthcare costs has drawn the attention of managers and policymakers towards regu-lating health expenditures: many countries have implemented deep reforms to improve efficiency and produc-tivity in the provision of health services. In Italy, the central government has introduced austerity measures,called recovery plans, to force the administrative regions to reduce healthcare deficits. In this study, we firstevaluate the impact of these recovery plans on hospitals’ productivity by calculating the Malmquist pro-ductivity index using data envelopment analysis. Next, we regress the obtained productivity index and itscomponents on a set of explanatory variables to capture the impact of the austerity measures, the moder-ating role of the regional organisational models, the variation in hospitals’ size and management autonomyand the capital intensity. The data used to estimate productivity were for an extensive period – from 2006 to2018. The results could contribute to assessing the increase in the productivity of hospitals and the influenceof government policies on the same
Information and communication technology and labour productivity growth: a production‐frontier approach
No full textThis work provides evidence of the positive impact of Information and Communication Technology (ICT) on the labour productivity growth of 24 countries, members of the OECD, from 1995 to 2019. Using a non-parametric production-frontier approach, we decompose labour productivity growth into components attributable to technological change (shifts in the world production frontier), efficiency change (movements toward or away from the frontier), physical (non-ICT) capital change and ICT capital change (movements along the frontier). We find that, on average, the most significant improvement in worldwide labour productivity is attributable to technological change, non-ICT, and ICT capital change over 1995-2019. In addition, we confirm the role of ICT as a general-purpose technology that needs to implement complementary changes in business organisations to exploit its growth opportunities fully. Finally, we conclude that ICT capital contributes to convergence
Anatomical Distribution and Autopsy Features of Gunshot Injuries to Discriminate Between Homicides and Suicides: A Five-Year Retrospective Study From the Onondaga County Medical Examiner’s Office
No full textLearning Overview: After attending this presentation, attendees will better understand the most common features of fatal gunshot wounds encountered in homicides and suicides. Impact on the Forensic Science Community: This presentation will impact the forensic science community by illustrating the most common body regions affected by gunshot wounds and the relevant autopsy features, showing their relationship with the manner of death. Firearm-related injuries are commonly encountered by forensic pathologists worldwide. In these fatalities, a careful evaluation of all the evidence is mandatory to prevent wrong conclusions concerning the manner of death. The analysis of the location of the gunshot wounds can be useful to understand the circumstances of death. This study will provide data to support an association between a specific wound location and the manner of death. The files of the Onondaga County Medical Examiner’s Office were searched for deaths due to gunshot wounds between January 2012 and December 2016. Only cases in which gunshot wounds were the primary cause of death and in which a clear and reliable manner of death was reported were included in the study. Undetermined deaths were not considered as part of study population. The investigative report, the autopsy report, and postmortem toxicological studies were reviewed in each case. The following parameters were recorded from the files: manner of death, gender, race and age, firearms and bullets type (if available), number and sites of entrance and exit wounds, shooting distance, internal bullet pathway, blood drugs and/or alcohol concentration, and investigative narratives. The obtained data were then subcategorized as to the manner of death (suicide, homicide, and accident). The information detected on the autopsy report was used to create a graphic reconstruction of the anatomical distribution of the gunshot wounds on the body surface. A total of 5,231 accepted cases in the studied period were found in the Onondaga County Medical Examiner’s Office database, including 626 suicides, 208 homicides, and 2,275 accidents. Of these, 347 deaths due to gunshot wounds were identified and were then subcategorized based on the manner of death, showing: 238 suicides (~69%), 108 homicides (~31%), and 1 accident (<1%). A thorough discussion of the results, including graphical models showing the most common location of the injuries, and demographic data will be presented. This study will illustrate distinct differences in suicidal and homicidal wounds that should be considered while investigating gunshot wounds related deaths. The autopsy findings, together with the scene findings, the investigative report, and the medical history of the victim, can help determine a reliable manner of death
A Case of Sudden Death Due to Persistent Severe Pulmonary Arterial Hypertension After Late Atrial Septal Defect Closure.
No full textAtrial septal defects (ASDs) are one of the most prevalent congenital cardiac anomalies in adults. These interatrial communications can produce changes in the right heart (remodeling and failure) and the lungs (pulmonary hypertension). Most adults with ASDs are surgically treated with excellent results. However, a small fraction of patients is at risk for postoperative complications, particularly the persistence of pulmonary hypertension. A case of a 47-year-old woman who was found unresponsive in the bathroom of her house and died despite resuscitative efforts is described. According to medical records, the woman underwent a surgical repair of an atrial septal defect at the age of 37. At the autopsy, macroscopic and microscopic signs of advanced pulmonary hypertension were detected, highlighting the importance for the forensic pathologists to recognize pulmonary hypertension as a cause of sudden death in adults with a history of late surgical closure of an atrial septal defect
ICT capital accumulation and economic growth: a nonparametric approach
No full textThis work provides evidence of the positive impact of Information and Communication Technology (ICT) on the labour productivity growth of 24 countries, members of the OECD, from 1995 to 2019. Using a non-parametric production‐frontier approach, we decompose labour productivity growth into components attributable to technological change (shifts in the world production frontier), efficiency change (movements toward or away from the frontier), physical (non-ICT) capital change and ICT capital change (movements along the frontier). We find that, on average, the most significant improvement in worldwide labour productivity is attributable to technological change, non-ICT, and ICT capital change over 1995–2019. In addition, we confirm the role of ICT as a general-purpose technology that needs to implement complementary changes in business organisations to exploit its growth opportunities fully. Finally, we conclude that ICT capital contributes to convergence
A Macroeconomic analysis of institutional assets and their impact in modelling pharmaceutical market in Italy
No full textRationale Since its institution in 1978, the National Health Service in Italy has undergone two major reforms: the first one occurred in 1992/1993 and the second one in 1999/2000. The reform process has seen the increase of the degree of decentralization and the shift in the financial responsibility for health expenditures - from the central level of government to the local level of government -). The legislative measures implemented according to the health care reforms have modified the initial scenario, leading pharmaceutical firms to adapt their strategies to the arising challenges. Objectives The aim of this study is that of analysing how the Italian pharmaceutical market has been evolving across the last decades. The strategy selection process for pharmaceutical firms, in order to adapt to changes, might depend on some structural "exogenous" factors, such as regulatory issues, concentration in the market, etc., likely to influence firms' performances. Methodology In this paper, a sample of Italian pharmaceutical firms, representing the 75% of total sales, has been observed from 1978 on, when the National Health System was set out in Italy. Estimations have been carried out through a Fully Modified-LS (Phillips-Hansen) regression, given the presence of unit roots for the variables that have been employed. Moreover, structural changes occurred in the years immediately following the reforms in the health sector have been tested. Among variables included in the analysis there are level of revenues, dummies related to institutional change, health, R&S and pharmaceutical expenditure. Results Results of this paper explain trends in pharmaceutical industry in Italy from the institution of National Health Service till 2005: first of all, structural changes have been observed few years after the main reform of 1992/93; a minor impact on firms' revenues has been observed after the reform of 1999. Even if there has been an increase in number of products and level of R&S expenditure, the latter is still influenced by the high level of regulation and pricing policies. Qualified employment in the pharmaceutical sector do exert a positive impact on firms' revenues as well as mergers and acquisitions that, along time, have led to a more concentrated market. It still needs to be clarified the sustainability of the whole system in the next years, because of the aging population and the consequent increase in health expenditure demand. A positive impact of the openned towards foreigna markets is signalled by the value of the export/import ratio. Conclusions Strategies and performances of pharmaceutical firms have to be analysed looking at macro variables instead of micro and behavioural factors only. Institutional assets do have a role in determining variations in their economic results
Appropriate Similarity Measures for Author Cocitation Analysis
No full textWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Familial intrahepatic cholestasis: New and wide perspectives
No full textBackground: Progressive familial intrahepatic cholestasis (PFIC) includes autosomal recessive cholestatic rare diseases of childhood. Aims: To update the panel of single genes mutations involved in familial cholestasis. Methods: PubMed search for “familial intrahepatic cholestasis” alone as well as in combination with other key words was performed considering primarily original studies and meta-analyses. Results: PFIC1 involves ATP8B1 gene encoding for aminophospholipid flippase FIC1. PFIC2 includes ABCB11 gene, encoding for protein functioning as bile salt export pump. PFIC3 is due to mutations of ABCB4 gene responsible for the synthesis of class III multidrug resistance P-glycoprotein flippase. PFIC4 and PFIC5 involve tight junction protein-2 gene and NR1H4 gene encoding for farnesoid X receptor. Benign Intrahepatic Cholestasis, Intrahepatic Cholestasis of Pregnancy and Low-phospholipid-associated cholelithiasis involve the same genes and are characterized by intermittent attacks of cholestasis, no progression to cirrhosis, reversible pregnancy-specific cholestasis and cholelithiasis in young people. Blood and liver tissue levels of bile-excreted drugs can be influenced by the presence of mutations in PFIC genes, causing drug-induced cholestasis. Mutations in PFIC genes might increase the risk of liver cancer. Conclusion: There is a high proportion of unexplained cholestasis potentially caused by specific genetic pathophysiologic pathways. The use of next generation sequencing and whole-exome sequencing could improve the diagnostic process in this setting
Solid-phase Friedel-Crafts acylation on polystyrene resins-synthesis of antiepiletic 1-aryl-3,5-dihydro-4H-2,3-benzodiazepin-4-ones
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