1,721,045 research outputs found
Planning and control of medical device investments by Italian public health authorities: A means to improve the decision-making process
No full textWithin the context of increased health care spending in Italy and governmental cost-containment efforts,
attention has focused on the medical device sector also in light of the newly introduced centralized procurement
policy, of Health Technology Assessment, and of the Government’s call for a more managerial-type
approach by public health authorities. In this scenario, it became necessary to analyse investments in medical
devices and to assess their contribution not only to the health of patients, but also to – if any – the whole
economy and to the nation’s economic growth. Public health authorities must now also assess the effect of
investments on profitability by evaluating investment regenerations based on the diagnosis-related group
revenue for inpatients and on the Regional tariffs established by the Italian National Health Service for
outpatients. Knowledge of the medical device sector, and planning and control systems, will enable public
health authorities to improve their internal decision-making processes, which in turn will enable them to
reach their objectives of long-term economic balance and of quality of health care services to citizens
Impact of chemotherapy-induced nausea and vomiting on health-related quality of life and resource utilization: A systematic review
No full textBackground: Chemotherapy-induced nausea and vomiting (CINV) is a particularly distressing event for oncology patients. This review aims at analyzing the impact of CINV on Health-Related Quality of Life (QoL) and on the use of healthcare resources. Methods: A systematic search was conducted according to the PRISMA statement on MEDLINE, EMBASE and NHS EED. Results: Sixty-seven studies were included in the final selection. Despite the availability of numerous treatment options, CINV was found to have a strong impact on HRQoL of patients. Direct costs are particularly affected, but this result could be due to scarcity of studies assessing indirect costs. Conclusions: Evidence supports the notion that CINV continues to have a negative impact on HRQoL of patients, even for those receiving moderately emetic chemotherapy. Further studies need also to collect data on the cost of CINV, particularly indirect costs, to ensure that decisions on use of healthcare resources are better supported
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
A Probiotic-Based Sanitation System for the Reduction of Healthcare Associated Infections and Antimicrobial Resistances: A Budget Impact Analysis
No full textHealthcare Associated Infections (HAIs) and antibiotic resistance have high social and economic burdens. Healthcare environments play an important role in the transmission of HAIs. The Probiotic Cleaning Hygiene System (PCHS) showed to decrease hospital surface pathogens up to 90% vs. conventional chemical cleaning (CCC). This study compares PCHS to CCC as to reduction of HAIs and their severity, related antibiotic resistances, and costs. Incidence rates of HAIs/antibiotic resistances were estimated from a multicenter pre-post (6 months CCC + 6 months PCHS) intervention study after applying propensity score matching technique. A budget impact analysis compared the current scenario of use of CCC with future scenarios considering increasing utilization of PCHS, from 5% to 50% in the next five years, from the hospital perspective in Italy. The cumulative incidence of HAI was 4.6% and 2.4% (p <0.0001) for CCC (N=4,160) and PCHS (N=4,160) (OR = 0.47, CI 95% 0.37-0.60), with severe HAIs of 1.57% vs 1% and antibiotic resistances of 1.13% vs 0.53%, respectively. Increased use of PCHS over CCC in Italian internal medicine/geriatrics and neurology departments in the next 5 years is expected to avert at least about 31,000 HAIs and 8,500 antibiotic resistances, and save at least 14 million Euros, of which 11.6 for the treatment of resistant HAIs. Innovative, environmentally sustainable sanitation systems, like PCHS, might substantially reduce antibiotic resistance and increase protection of health worldwide
Pathological outcome of sonographically occult architectural distortions (AD) visible only on digital breast tomosynthesis, and comparison with AD visible also on 2D mammography
No full textPurpose: To evaluate the rates of malignant and of high-risk lesions among sonographically occult architectural distortions (AD) visible only on digital breast tomosynthesis (DBT) and compare them with AD visible on 2D mammography (2D) and DBT. Method: The records of 1104 DBT-vacuum assisted biopsies (DBT-VAB) were retrospectively reviewed and 218 cases of AD were identified. Complete radiologic examinations and pathologic results were available for 113 sonographically occult AD (1 clinically-detected, 112 clinically-occult). 2D and DBT images were reviewed and AD were divided into a “DBT-detected” group (visible on only DBT) and a “2D-detected” group (visible both in 2D and DBT). The rates of malignant and of high-risk lesions in the “DBT-detected” AD group were calculated and compared to those of the “2D-detected” AD group. Results: Thirty-five (31%) of 113 AD were assessed as “DBT-detected”, while 78 (69%) as “2D-detected”. DBT-VAB results were benign lesions in 63 (56%) AD, high-risk lesions in 32 (28%) AD and malignant lesions in 18 (16%) AD. Four (12.5%) high-risk lesions were upgraded to malignancy at surgery. Based on final pathology, the malignancy rate was significantly higher in the “DBT-detected” group than the “2D-detected” group (34% [12/35 cases] vs 13% [10/78]; p 0.05). Conclusions: AD visible on only DBT proved to be malignant in about one third of cases, which exceeded the malignancy rate of AD visible on also 2D. A similar proportion of DBT-only AD was represented by high-risk lesions
Health benefits and economic impact of implementing a pentavalent rotavirus vaccination program in Italy
No full textTowards a more competitive Italy in clinical research: The survey of attitudes towards trial sites in Europe (the SAT-EU studyTM)
No full textBackground: Italy is Europe’s third largest pharmaceutical market, yet it ranks only ninth in the number of NIH-registered clinical trials per capita. The aim of our study was to explore stakeholders’ perception of Italy as a place to undertake clinical trials, and to estimate the potential economic impact of selected reforms in terms of incremental trial activity. Methods: The Survey of Attitudes towards Trials in Europe (SAT-EU Study) was an anonymous, webbased survey, which systematically assessed factors impacting clinical trial site selection in Europe. Estimates of Italian economic impact were developed in collaboration with AICRO (Association of Italian Contract Research Organisations). Results: Responses were obtained from 485 professionals in 34 countries (15% residing in Italy) representing over 100 institutions, spanning BioPharma, Clinical Research Organizations (CROs), Medtech, and Academic Clinical Trial Units (CTUs). Italy ranked tenth of twelve in terms of accessibility and transparency of information required to run clinical trials, and last with respect to predictability and speed of Ethics Committees. Costs of running clinical trials were not considered critical, whereas, fragmented and slow approval process was. Streamlined centralized trial authorization would translate into an estimated 1.1 billion Euros of incremental trial investments over three years. ConclusionS: Clinical trial professionals consider Italy’s governance of clinical research suboptimal, among the worst in Europe, and indicate that much could be done to make Italy more attractive for clinical trial investments. The present study also provides evidence about stakeholders’ willingness to invest in trials and its economic consequences, provided effective reforms are put in place
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
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