35 research outputs found

    Does institutional quality matter for multidimensional well-being inequalities? Insights from Italy

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    Our paper aims to shed light on regional multidimensional well-being inequalities in Italy. We first decompose the Theil index in its "within" and "between" components and we find that disparities in multidimensional well-being go beyond the historical GDP divide between the Centre-North and the South of Italy: "within" multidimensional well-being inequalities result to be as relevant as inequalities "between" these sub-national areas, suggesting that territorial-specific factors may be at work. Then, using a regional panel in the period 2004–2012, we analyse the relationship between multidimensional well-being disparities and regional institutional quality in terms of voice and accountability, government effectiveness, regulatory quality, rule of law, and corruption. We find that institutional quality matter in affecting regional multidimensional well-being inequalities and the effect varies heterogeneously accordingly to the level of public expenditure, institutional dimensions, and spatial spillovers. These findings indicate local policies could be better targeted to reduce gaps and increase expenditure efficiency, foremost among which are anti-corruption actions and measures to enhance the effectiveness of regulatory interventions, especially in regions which are lagging behind


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    Questo articolo studia la convergenza tra le regioni italiane considerando due indicatori compositi di progresso socio-economico che tengono conto della natura multidimensionale del benessere. Un primo indicatore composito viene costruito incorporando, oltre al reddito disponibile delle famiglie, altri due sotto-indicatori riguardanti gli aspetti della salute e dell’istruzione; il secondo indicatore composito viene ottenuto considerando, in aggiunta ai primi, altri tre sotto-indicatori che riguardano, rispettivamente, la qualità socio-istituzionale, le pari opportunità intergenerazionali e tra sessi sul mercato del lavoro, e la competitività regionale. La banca dati delle singole variabili o indici, complessivamente 17, che compongono i sei sotto-indicatori copre il periodo che va dal 1998 al 2008. Viene dunque valutata sia la convergenza sigma che la convergenza gamma, quest’ultima attraverso la costruzione dell’indice di Kendall. In coerenza con altri studi condotti per altri Paesi europei e che utilizzano indicatori compositi di reddito e di qualità della vita, i risultati mostrano l’esistenza di un processo di sigma convergenza tra le regioni in termini di benessere, anche se risultano assenti manifestazioni significative di mobilità intradistributiva: in altri termini, le differenze tra le regioni tendono a ridursi, ma la graduatoria in senso ordinale delle stesse non subisce variazioni di rilievo.

    Did the EU Airport Charges Directive Lead to Lower Aeronautical Charges? Empirical Evidence From a Diff-in-Diff Research Design

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    Abstract In this study we analyse the impact of the EU Airport Charges Directive on the level of aeronautical charges for EU airports serving between 2 and 20 million passengers, over the period 2008–2017, using a difference-in-differences research design. We find that the transposition of the Airport Charges Directive into national legislation has led to a statistically significant reduction in the level of airport charges, but only after a few years. We also find the existence of heterogeneous treatment effects that depend on the quality of transposition of the Directive

    High-Speed Railways and Firms Total Factor Productivity: Evidence from a Quasi-Natural Experiment

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    The focus of this study is to assess the causal impact of the connection of a local area to a high-speed rail network (HSR) on firms' total factor productivity (TFP). The quasi-random location of the HSR station in the Italian city of Reggio Emilia is exploited in a Difference-in Differences (DiD) research design applied to a large sample of firms, observed over the period 2010-2018. The results suggest that the opening of the HSR station improved treated firms' TFP of about 5%; in particular, such effect is larger for firms closer to the HSR station and slightly increases over the sample period. We also find that the impact of the connection to the HSR station is heterogeneous across industries and depends on firms' size and past productivity. Overall results are robust to a large number of sensitivity checks and falsification tests

    Assessing the impacts of Cohesion Policy on EU regions: A non-parametric analysis on interventions promoting research and innovation and transport accessibility

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    Traditionally, the effectiveness of European Cohesion Policy has been evaluated in terms of GDP growth rate. In this paper, we consider the effect of the regional policy in terms of its impacts on two specific fields of intervention, namely ‘research, technological development and innovation’, and ‘transport infrastructure’. Our econometric approach involves the use of a non-parametric regression discontinuity design technique to a uniquely-disaggregated Cohesion Policy dataset broken down according to the specific objectives of each stream of funding. The analysis considers different time intervals and sub-samples. Our results demonstrate a positive impact of Cohesion Policy interventions in these two specific fields of intervention

    "Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

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    Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 Âą 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

    Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

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    Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

    Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

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    : The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

    72nd Congress of the Italian Society of Pediatrics

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    Essays in regional economics: assessing cohesion policy effectiveness and measuring well-being for european regions

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    Dottorato di ricerca in Scienze economiche e aziendali, indirizzo economia applicata, XXVII ciclo. A.a. 2013-201