Value based Healthcare as a solution for the future of publicly funded healthcare systems

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Simulating Brown hare (Lepus europaeus Pallas) dispersion: a tool for wildlife management of wide areas

The second half of the 20th century was characterised by intense processes of urbanisation, industrialisation and agricultural mechanisation, leading to a fragmentation of the agricultural and forest landscape. This, in turn, reduced the bio-permeability of the territory and affected the dispersion of many wild species. Brown hare (Lepus europeus) dispersion is dramatically affected by habitat fragmentation, presence of predators, intense tillage and elevated hunting pressure. Consequently, the only stable populations of hare are often in no-hunting areas where wildlife management is efficient. It is necessary, therefore, to identify not only additional areas suitable for reproduction, but also the most suitable dispersion pathways for hares, in order to optimise management. In the present study, by means of a Geographic Information System (GIS), a deterministic hare suitability model was developed on the basis of a multicriterial approach and fuzzy logic. Subsequently, a fiction surface was derived from the suitability map in order to describe the land bio-permeability. Finally, on the basis of species potential, the spread of hares from stable population areas (source areas) to the remaining territory was simulated. The area of study was the province of Viterbo (central Italy). The suitability map showed good discrimination ability (ROC=0.705). The hare dispersion simulation map allowed the potential spreading of this species throughout the provincial territory to be analysed. Isolated or less connected zones were highlighted, allowing the distribution of habitat enhancements, and/or the institution of new no-hunting areas devoted to the reproduction and consequent spread of hares throughout the territory, to be localised. The presented flexible and reiterable methodology could prove useful for wildlife management and hunting planning over a wide area. It would thus provide an important contribution to reducing the importance of animal translocation and favouring an increase in native resources spontaneously spreading throughout a territory. In a more general sense, this study is in accordance with the sustainable land management perspective, meeting the requirements of environmental protection, without compromising the anthropic development of non-urban areas

Optimal Control Problems with Mixed and Pure State Constraints

This paper provides necessary conditions of optimality for optimal control problems, in which the pathwise constraints comprise both “pure” constraints on the state variable and “mixed” constraints on control and state variables. The proofs are along the lines of earlier analysis for mixed constraint problems, according to which Clarke's theory of “stratified” necessary conditions is applied to a modified optimal control problem resulting from absorbing the mixed constraint into the dynamics; the difference here is that necessary conditions which now take into account the presence of pure state constraints are applied to the modified problem. Necessary conditions are given for a rather general formulation of the problem containing both forms of the constraints, and then these are specialized to problems having special structure. While combined pure state and mixed control/state problems have been previously treated in the literature, the necessary conditions in this paper are proved under less restrictive hypotheses and for novel formulations of the constraints

The Impact of School and After-School Friendship Networks on Adolescent Vaccination Behavior

Psychological and social characteristics of individuals are important determinants of their health choices and behaviors. Social networks represent "pipes" through which information and opinions circulate and spread out in the social circle surrounding individuals, influencing their propensity toward important health care interventions. This paper aims to explore the relationship between students' vaccination health choices and their social networks. We administered a questionnaire to students to collect data on individual students' demographics, knowledge, and attitudes about vaccinations, as well as their social networks. Forty-nine pupils belonging to 4 classrooms in an Italian secondary school were enrolled in the study. We applied a logistic regression quadratic assignment procedure (LR-QAP) by regressing students' positive responsive behavior similarity as a dependent variable. LRQAP findings indicate that students' vaccination behavior similarity is significantly associated with after-school social ties and related social mechanisms, suggesting that pupils are more likely to share information and knowledge about health behaviors through social relationships maintained after school hours rather than through those established during the school day. Moreover, we found that vaccination behaviors are more similar for those students having the same ethnicity as well as for those belonging to the same class. Our findings may help policymakers in implementing effective vaccination strategies

The value based approach to treat diabetes. The case of Puglia Region

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Modulation of the electrochemical properties of SBS-based anionic membranes by the amine molecular structure

Abstract In this work, different amines (bifunctional, as diazabicyclo[2.2.2]octane (Dabco) and monofunctional, as N-methylimidazole or trimethylamine) were utilized for the amination of benzyl chloride-grafted polystyrene-b-poly(butadiene)-bpolystyrene triblock copolymers (SBS-g-VBC). The use of Dabco solutions in mixture with variable amounts of monoamine or at different concentration allowed to modulate the degree of crosslinking of the SBS-based membranes and their electrochemical parameters. More specifically, tuning Dabco concentration permitted the reduction of water uptake without significantly affecting ionic conductivity

Photoemission study of ferrocenes: insights into the electronic structure of Si-based hybrid materials

We present here the results of synchrotron radiation-excited UV-photoemission investigation and DFT calculations on vinylferrocene (VFC), a redox molecule suitable for applications in molecular electronics. A detailed assignment is discussed of the valence photoelectron spectra (UPS), which provides new data on the electronic structure and offers a partial re-interpretation of previous assignments on VFC based on theoretical and experimental evidences. Furthermore, the present results can allow for a meaningful comparison of photoemission results from the corresponding hybrid obtained by covalently attaching VFC to Si oriented surfaces. © 2008 IOP Publishing Ltd

The Daily Mile:15 minutes running improves the physical fitness of italian primary school children

The Daily Mile™ is an innovative school-based intervention that requires children to run or jog outside for 15 min at a self-selected pace during class time. Today, only one study has investigated the efficacy of The Daily Mile on physical fitness, which was conducted with Scottish children. Thus, we aimed to evaluate the feasibility and effectiveness of The Daily Mile in Italian primary schools. A total of 486 children participated in The Daily Mile for 3 months (experimental group), whereas 309 children continued their daily school routine (control group). The 6-min run test, standing long jump, body mass index, and waist-to-height ratio were assessed. Their teachers completed surveys for assessing the intervention acceptability. After correction for age and gender, significant group × time interactions were observed in the 6-min run test and standing long jump results. In the post-test period, the experimental group showed improvement in the 6-min run test and standing long jump results. Overall, the teachers were satisfied with the program and found it suitable for their school context and easy to implement. The Daily Mile was successfully implemented and smoothly accepted in the day routine of Italian primary schools