Does industry-sponsored education foster overdiagnosis and overtreatment of depression, osteoporosis and over-active bladder syndrome? An Australian cohort study

ObjectivesTo investigate patterns of industry-sponsored educational events that focus on specific health conditions for which there are concerns about overdiagnosis and overtreatment.Design and settingThis retrospective cohort study examines publicly reported industry-sponsored events in Australia from October 2011 to September 2015 for three conditions potentially subject to overdiagnosis and overtreatment: depression, osteoporosis and overactive bladder. We used a database of transparency reports to identify events with a focus on depression, osteoporosis and overactive bladder and compared these with other sponsored events. We hypothesised that companies marketing treatments for each condition would sponsor related events and that target audiences would mainly work in primary care, reflecting a broad patient population.Main outcome measuresEvent and attendee characteristics, sponsoring companies, related marketed treatments, cost-effectiveness ratings and dispensing rates.ResultsOver the study period, we identified 1567 events focusing on depression, 1375 on osteoporosis and 190 on overactive bladder (total n=3132, with 96 660 attendees). These events were attended by primary care doctors more often than sponsored events without a focus on these three conditions: relative risk (RR)=3.06 (95% CI 2.81 to 3.32) for depression, RR=1.48 (95% CI 1.41 to 1.55) for osteoporosis and RR=2.59 (95% CI 2.09 to 3.21) for overactive bladder. Servier, which markets agomelatine and AstraZeneca (quetiapine) sponsored 51.2% and 23.0% of depression events, respectively. Amgen and GlaxoSmithKline, which co-market denosumab, sponsored 49.5% of osteoporosis events and Astellas and Commonwealth Serum Laboratories (CSL) (mirabegron and solifenacin) sponsored 80.5% of overactive bladder events.ConclusionsThis 4-year overview of industry-sponsored events on three overdiagnosed and overtreated conditions found that primary care clinicians were often targeted, dinner was often provided and that a few companies sponsored most events. In most cases, sponsors’ products are not cost-effective choices for the specified condition. This pattern highlights the need for professional education to be free of commercial sponsorship.</jats:sec

The stressful implications of remote e-working: Evidence from Europe

Abstract This paper investigates the importance of different modes of spatial flexibility as well as of the distinction between autonomy and discretion to find plausible explanations of the so-called autonomy paradox, which maintains that the more the job autonomy that remote e-workers have the greater the effort they put into their work with adverse effects on work-related stress. Using multiple regressions, we test the hypotheses regarding the direct influence of autonomy, discretion and work intensification as well as their interaction effects on occupational stress in two subsamples of 1.380 home-based e-workers and 2.574 mobile ones drawn from the 2015 European Working Conditions Survey. The main findings are as follows. Home-based e-workers perceive that autonomy (namely over work goals) directly decreases occupational stress and buffers work intensification (i.e. autonomy over work goals and in the organizational choices of their department/company). In the context of remote e-work, discretion is more likely to boost the stressful impact of work intensification when work is mobile. At the same time, we do not find that autonomy increases work intensification, neither among mobile e-workers, nor among home-based e-workers (for whom it buffers the adverse impact of work intensification). In summary, this study does not confirm the existence of an autonomy paradox associated with remote e-work. Contrarily, it suggests that such a paradox is more likely to surface when research relies on conceptual frameworks that ambiguously define autonomy in terms of what should be more properly conceptualized as discretion

A cross-sectional analysis of pharmaceutical industry-funded events for health professionals in Australia

Objectives: To analyse patterns and characteristics of pharmaceutical industry sponsorship of events for Australian health professionals and to understand the implications of recent changes in transparency provisions that no longer require reporting of payments for food and beverages. Design: Cross-sectional analysis. Participants and setting: 301 publicly available company transparency reports downloaded from the website of Medicines Australia, the pharmaceutical industry trade association, covering the period from October 2011 to September 2015. Results: Forty-two companies sponsored 116 845 events for health professionals, on average 608 per week with 30 attendees per event. Events typically included a broad range of health professionals: 82.0% included medical doctors, including specialists and primary care doctors, and 38.3% trainees. Oncology, surgery and endocrinology were the most frequent clinical areas of focus. Most events (64.2%) were held in a clinical setting. The median cost per event was $A263 (IQR$A153–1195) and over 90% included food and beverages. Conclusions: Over this 4-year period, industry-sponsored events were widespread and pharmaceutical companies maintained a high frequency of contact with health professionals. Most events were held in clinical settings, suggesting a pervasive commercial presence in everyday clinical practice. Food and beverages, known to be associated with changes to prescribing practice, were almost always provided. New Australian transparency provisions explicitly exclude meals from the reporting requirements; thus, a large proportion of potentially influential payments from pharmaceutical companies to health professionals will disappear from public view

Eni Carbon Silicates as crystalline and mesoporous hybrids for gas sensing

Nowadays, in order to satisfy market demands, materials and devices for sensors production must be increasingly miniaturized, eco-friendly, energetically efficient, reliably multitasking, and low-cost. Then, the research in material and technological sciences has gained a huge development to reach the expectations. Moving towards these requirements, hybrid nanomaterials are a fundamental alternative choice with respect to well-established materials. The purpose of this work is to satisfy both sciences, on the one hand implementing innovative hybrid materials referred to as ECS (Eni Carbon Silicate) in gas sensors manufacturing, and on the other hand verifying their possible operation at room temperature as a technological progress. Concerning the research in materials science, it is obvious that the employment of hybrids has represented a new challenge, especially because in ECS powders, with respect to the most hybrid materials, organic and inorganic components are not only anchored but perfectly merged to each other in a complex structure. The novelty of these materials concerns in fact their structures, crystalline aluminosilicate scaffoldings with long-range 3D order, which distinguish them from the previously reported amorphous and ‘‘crystal-like’’ silica-based PMOs (periodic mesoporous organosilicas). Regarding the research in technological science, room temperature operation is an extremely valuable goal in gas sensing, due to intrinsic safety of sensors working in harsh or industrial environment; moreover it is interesting to reduce high power consumption that characterized the wide used sensors based on metal-oxides semiconductors and consequently the size of associated electronics. The research activity was divided in two parts: development of preliminary studies about the role of solvents and investigation on the suitability of ECS powders as suspensions for resulting film depositions. In the second part ECSs were used as functional material in screen-printable compositions. The samples were deposited by drop coating on glass, silicon and alumina substrates for morphological (optical and SEM microscopy), structural (XRD), and thermal (TG-DTA) or electrical (gas tests) characterizations, respectively. The measurements, carried out in a suitable test chamber with controlled atmosphere and standard electronic detection, allowed to study possible electrical and sensing properties. A significant response with sensors based on ECS 14 powders tested in humidity conditions and a calibration for an increasing RH% was obtained. Other powders showed an electrical activity, in particular ECS 13 gave a low response to acetaldehyde. The results were analyzed and compared with the literature to determine if ECSs represent an improvement in gas sensing field, and a possible interpretation of sensing mechanism was suggested. It was concluded that the electrically active films prepared with ECS powders by simple deposition technique can be employed as functional layers in gas sensors. The devices obtained with the ECS hybrids have the properties of speed, reversibility and selectivity fundamental for a good quality electrical response that makes them competitive with respect to systems currently in use. The technological advantage of room temperature operating and the selectivity are added to the novelty of the application of ECSs as active materials in gas sensing

Active Labor Market Policies and Transitions to Permanent Employment. The Potential of Administrative Data

This chapter aims at shedding some light on the effectiveness of existing Active Labor Market Policies. The main goal of this contribution is to show how it is possible to combine three sources of administrative data, namely the system of Compulsory Communications (Comunicazioni Obbligatorie CO), the archives of local agencies in charge of active labor market policies, and the equivalent economic/financial status indicator (EES) data drawn from fiscal assistance centers. We also discuss possible identification strategies to assess the effectiveness of active labor market programs which exploit discontinuity stemming from labor market reforms. Finally, we use event history analysis to model the time to exit to a permanent job as a function of individual characteristics previous labor experience and participation to programs

Insights into the Sensing Mechanism of a Metal-Oxide Solid Solution via Operando Diffuse Reflectance Infrared Fourier Transform Spectroscopy

Recently, the influence of Nb addition in the oxide solid solution of Sn and Ti was investigated with regard to the morphological, structural and electrical properties for the production of chemoresistive gas sensors. (Sn,Ti,Nb)xO2-based sensors showed promising features for ethanol monitoring in commercial or industrial settings characterized by frequent variation in relative humidity. Indeed, the three-metal solid solution highlighted a higher response level vs. ethanol than the most widely used SnO2 and a remarkably low effect of relative humidity on the film resistance. Nevertheless, lack of knowledge still persists on the mechanisms of gas reaction occurring at the surface of these nanostructures. In this work, operando Diffuse Reflectance Infrared Fourier Transform spectroscopy was used on SnO2- and on (Sn,Ti,Nb)xO2-based sensors to combine the investigations on the transduction function, i.e., the read-out of the device activity, with the investigations on the receptor function, i.e., compositional characterization of the active sensing element in real time and under operating conditions. The sensors performance was explained by probing the interaction of H2O and ethanol molecules with the material surface sites. This information is fundamental for fine-tuning of material characteristics for any specific gas sensing applications

Interactions with the pharmaceutical industry and the practice, knowledge and beliefs of medical oncologists and clinical haematologists: a systematic review

BACKGROUND: No previous review has assessed the extent and effect of industry interactions on medical oncologists and haematologists specifically. METHODS: A systematic review investigated interactions with the pharmaceutical industry and how these might affect the clinical practice, knowledge and beliefs of cancer physicians. MEDLINE, Embase, PsycINFO and Web of Science Core Collection databases were searched from inception to February 2021. RESULTS: Twenty-nine cross-sectional and two cohort studies met the inclusion criteria. These were classified into three categories of investigation: (1) extent of exposure to industry for cancer physicians as whole (n = 11); (2) financial ties among influential cancer physicians specifically (n = 11) and (3) associations between industry exposure and prescribing (n = 9). Cancer physicians frequently receive payments from or maintain financial ties with industry, at a prevalence of up to 63% in the United States (US) and 70.6% in Japan. Among influential clinicians, 86% of US and 78% of Japanese oncology guidelines authors receive payments. Payments were associated with either a neutral or negative influence on the quality of prescribing practice. Limited evidence suggests oncologists believe education by industry could lead to unconscious bias. CONCLUSIONS: There is substantial evidence of frequent relationships between cancer physicians and the pharmaceutical industry in a range of high-income countries. More research is needed on clinical implications for patients and better management of these relationships. REGISTRATION: PROSPERO identification number CRD42020143353

New Approach for the Detection of Sub-ppm Limonene: An Investigation through Chemoresistive Metal-Oxide Semiconductors

R-(+)-limonene, one of the major constituents of citrus oils, is a monoterpene that is widely used as a fragrance additive in cosmetics, foods, and industrial solvents. Nowadays, its detection mainly relies on bulky and expensive analytical methods and only a few research works proved its revelation through affordable and portable sensors, such as electrochemical and quartz crystal microbalance sensors. In response to the demand for effective miniaturized sensing devices to be integrated into Internet of Things systems, this study represents a pioneering investigation of chemoresistive gas sensor capabilities addressed to R-(+)-limonene detection. An array of seven metal-oxide sensors was exploited to perform a complete electrical characterization of the target analyte. The experimental evidence allowed us to identify the WO3-based sensor as the most promising candidate for R-(+)-limonene detection. The material was highly sensitive already at sub-ppm concentrations (response of 2.5 at 100 ppb), consistent with applicative parameters, and it resulted in selective vs. different gases at a lower operating temperature (200 ◦C) than the other sensors tested. Furthermore, it exhibited a humidity-independent behavior under real-life conditions (relative humidity &gt; 20%). Finally, the WO3 sensor also demonstrated a remarkable cross-selectivity, thus enabling its exploitation in cutting-edge applications

Late-time Light Curves of Type II Supernovae: Physical Properties of SNe and Their Environment

We present BVRIJHK band photometry of 6 core-collapse supernovae, SNe 1999bw, 2002hh, 2003gd, 2004et, 2005cs, and 2006bc measured at late epochs (>2 yrs) based on Hubble Space Telescope (HST), Gemini north, and WIYN telescopes. We also show the JHK lightcurves of a supernova impostor SN 2008S up to day 575. Of our 43 HST observations in total, 36 observations are successful in detecting the light from the SNe alone and measuring magnitudes of all the targets. HST observations show a resolved scattered light echo around SN 2003gd at day 1520 and around SN 2002hh at day 1717. Our Gemini and WIYN observations detected SNe 2002hh and 2004et, as well. Combining our data with previously published data, we show VRIJHK-band lightcurves and estimate decline magnitude rates at each band in 4 different phases. Our prior work on these lightcurves and other data indicate that dust is forming in our targets from day ~300-400, supporting SN dust formation theory. In this paper we focus on other physical properties derived from the late time light curves. We estimate 56Ni masses for our targets (0.5-14 x 10^{-2} Msun) from the bolometric lightcurve of each for days ~150-300 using SN 1987A as a standard (7.5 x 10^{-2} Msun). The flattening or sometimes increasing fluxes in the late time light curves of SNe 2002hh, 2003gd, 2004et and 2006bc indicate the presence of light echos. We estimate the circumstellar hydrogen density of the material causing the light echo and find that SN 2002hh is surrounded by relatively dense materials (n(H) >400 cm^{-3}) and SNe 2003gd and 2004et have densities more typical of the interstellar medium (~1 cm^{-3}). The 56Ni mass appears well correlated with progenitor mass with a slope of 0.31 x 10^{-2}, supporting the previous work by Maeda et al. (2010), who focus on more massive Type II SNe. The dust mass does not appear to be correlated with progenitor mass.Comment: We corrected the 56Ni mass of SN2005cs and Figures 8 (a) and 8 (c

Factors associated with work ability among employees of an Italian university hospital

Background: A growing body of evidence clearly documents the benefits of integrated systems approaches to protecting and promoting the safety, health and well-being of workers. The purpose of this study is to provide a holistic view of the work ability of employees of an Italian University Hospital measuring their resources in relation to job demands. In particular, it examines socio-demographics, family and organizational antecedents of health professionals' work ability. Methods: A survey was conducted to assess the work ability of healthcare professionals, including physicians, nurses and administrative staff, working at the University Hospital of Modena (Italy). The data collection allows us to get a sample of 443 workers, who correspond to 11% of the target population. The data were analyzed using preliminary statistics on the main characteristics of the sample in terms of work ability, socio-demographic variables, family and organizational characteristics. In addition, logit models of the likelihood of having high work ability were estimated using SPSS version 25. Results: Work ability decreases with increasing age, comorbidity, high body mass index, having at least one child under 5 and/or a dependent adult, having a poor work-life balance, and doing more than 20&nbsp;h of housework. Specific job resources can significantly promote work ability, including relationship-oriented leadership, autonomy in decision making and individuals' skill match. The nursing profession is associated with a low work ability. Finally, a significant gender gap has been documented. Women find it more difficult to reconcile life and work, especially when they have children of preschool age and work in professions with greater responsibilities, as in the case of women doctors, who experience lower work capacity. Conclusions: Our results suggest that it is necessary to consider other factors, in addition to age, that are equally relevant in influencing work ability. Consequently, organisational interventions could be implemented to improve the work ability of all workers. In addition, we propose targeted interventions for groups at risk of reduced work capacity, in particular older workers (45 years and over), nurses, women with children of preschool age and in the position of physician