1,721,194 research outputs found
Complementary Strategy of Maternal Immunization with RSVpreF Vaccine and Monoclonal Antibodies for the Prevention of Respiratory Syncytial Virus Among Italian Infants: A Cost-Effectiveness Assessment
No full textIntroduction: Respiratory Syncytial Virus (RSV) is a leading cause of severe lower respiratory tract infections and is one of the primary causes of hospitalization in high income countries and death among children aged ≤ 1 year in lower income countries where the healthcare systems not always have the resources to provide appropriate intensive care to all infants with severe RSV infection. On the basis of the results of a large programme of clinical trials, the European Medicine Agency has recently approved a Bivalent Stabilized Prefusion F Subunit Vaccine (RSVpreFV) for maternal immunization, with a year-round administration between 24–36 weeks of gestation. The objective of the study is providing an estimation of the efficiency of complementary strategy RSVpreF and monoclonal antibodies for the prevention of RSV among Italian infants. Methods: Using a model (with a cohort framework and a Markov-type process) specifically adapted to the Italian context, the study provided cost-effectiveness and cost-utility assessment of prevention strategies adding the maternal vaccination to the existing immunization opportunities with palivizumab or nirsevimab administered to high risk and unprotected infants. Results: The complementary strategy RSVpreFV plus palivizumab demonstrates significative health benefits versus palivizumab alone: it would reduce annual hospitalizations by 4097 cases (−25.8%), Emergency Department (ED) admissions not followed by hospitalization by 534 (−18.8%), with 25 years of life recovered, and an increase of 90 Quality Adjusted Life Years (QALYs). The strategy results cost-saving: the complementary strategy saves € 6.0 mil and € 8.4 mil per year in the NHS and in the Societal perspective, respectively; the complementary strategies of maternal vaccination plus nirsevimab also prove to have significant benefits versus the monoclonal antibody alone, providing a decrease equal to 941 annual hospitalizations (−9.0%), 6 years of life recovered, and an increase of 20 QALYs. The strategy saves € 2.6 mil and € 3.1 mil per year in the NHS and in the Societal perspective, respectively. Conclusions: RSV is a leading cause of severe lower respiratory tract infections and is one of the primary causes of hospitalization in high income countries and death among children aged ≤ 1 year in lower income; bivalent Stabilized Prefusion F Subunit Vaccine (RSVpreFV) for maternal immunization proves to be effective in preventing RSV infections, avoiding severe disease. The modelling exercise shows that the complementary strategy of maternal vaccination with palivizumab or nirsevimab are both dominant (better health outcomes with lower costs) on monoclonal antibodies alone; the sensitivity analysis confirms that the complementary strategies in most of the simulation remain dominant or cost-effective adopting a low threshold for the willingness to pay; finally the complementary strategies are also sustainable, owing to a limited impact on the current national budget for vaccines
Regional Incentives and Patient Cross-Border Mobility: Evidence from the Italian Experience
Full text linkBackground: In recent years, accreditation of private hospitals followed by decentralisation of the Italian National
Health Service (NHS) into 21 regional health systems has provided a good empirical ground for investigating
the Tiebout principle of “voting with their feet”. We examine the infra-regional trade-off between greater patient
choice (due to an increase in hospital services supply) and financial equilibrium, and we relate it to the significant
phenomenon of Cross-Border Mobility (CBM) between Italian regions. Focusing on the rules supervising the
financial agreements between regional authorities and providers of hospital care, we find incentives for private
accredited providers in attracting patient inflows.
Methods:The analysis is undertaken from an institutional, regulatory and empirical perspective. We select a sample
of five regions with higher positive CBM balance and we examine regional regulations governing the contractual
agreements between purchasers and providers of hospital care. According to this sample, we provide a statistical
analysis of CBM and apply a Regional Attraction Ability Index (RAAI), aimed at testing patient preferences for
private/public accredited providers.
Results:We find that this index is systematically higher for private providers, both in the case of distance/boundary
patients and of excellence/general hospitals.
Conclusion:Conclusions address both financial issues regarding the coverage of regional healthcare systems and
equity issues on patient healthcare access. They also raise concerns on the new European Union (EU) directive
inherent to patient mobility across Europe
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
Modelli organizzativi per la cura della salute mentale e della schizofrenia in Lombardia, Lazio e Sicilia
No full textThe Basaglia law, enacted in 1978, decreed the closing down of mental hospitals in order to start a model of psychiatric care according to which patients would have been part of the society, without being relegated. Each Region reacted to this law by implementing its own model of mental health: some Regions invested in community-based services, while others increased the number of beds in the psychiatric departments of hospitals. The result is that the model of care for psychiatric patients in general, and schizophrenic ones in particular, is very heterogeneous at regional level, and seems to depend more on the services supplied than on the need of care. This paper focuses on three regional models – implemented respectively by Lombardy, Lazio and Sicily – and analyses the resource allocation for hospital admissions of schizophrenic patients. Results show disparities among regions in the provision of care and in the resource allocation between community-based and hospital services
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
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe 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
The general results of the RN4CAST survey in Italy
Full text linkThe issue of health workforce shortage and in particular of nurses, has been debated globally for almost three decades (Aiken & Mullinix 1987, Aiken et al. 1996, 2001, 2010), and has been exacerbated by the recent global financial crisis. The European RN4CAST project has shifted focus from considering only nursing workforce planning and workforce volumes to considering the impact of adequate nurse-patient ratios and work environment on patient safety and the quality of care (Sermeus et al. 2011)
RN4CAST@IT: Why is it important for Italy to take part in the RN4CAST project?
No full textstatus: Publishe
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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