Epidemiological and Economic Evaluation of a Pilot Prostate Cancer Screening Program

Background. Prostate cancer (PCa) is the second most commonly diagnosed cancer, and the sixth most common killer among men worldwide (Aubry et al., 2013). This research was motivated by the fact that PCa screening continues to be a controversial topic in the Kazakh medical community. This study aimed at description of how newly diagnosed PCa patients are managed in Pavlodar region of the Kazakhstan Republic and at presentation of a budget impact analysis (BIA) for PCa screening program. Also, we aimed to provide a comparative analysis of pricing system on medical services applied in both private and public healthcare sectors of the Kazakhstan Republic. Methods. New cases of PCa have been retrospectively analyzed for the period from January 2013 to December 2017 based on the information obtained from information system "Policlinic" maintained by the Pavlodar regional branch of the Republican Center for Electronic Health and from Cancer Registry of Pavlodar Regional Oncology Center. All data were analyzed with the help of SPSS 20.0 software. Results. The mean age of PCa patients was 68.34 years (SD = 8.559). The government of Kazakhstan invested 20,437,000 KZT (Kazakhstani tenge) in 2017 equivalently 61,188 USD - to fund a pilot study for examination of 9638 men. From 2013 to 2017, out of 49,334 men residing in Pavlodar region of Kazakhstan 1,248 men were diagnosed with prostate diseases, including 130 PCa cases. The PCa detection rate was equal to two cases per month. Only 22.8% of all PCa cases identified in the region within specified time period were revealed as a result of the government-funded PCa screening program. The average prostate cancer detection rate among the target group of Pavlodar region within the period of 5 years was equal to 0.23%. Conclusion. Based on the fact that the PCa screening program failed to enable adequate detection of new PCa cases, we would not recommend to continue this type of screening unless it is undergone careful revision and replanning

Lactate detection in the brain of growth-restricted fetuses with magnetic resonance spectroscopy

OBJECTIVE: The objective of the study was to determine the feasibility of detecting fetal brain lactate, a marker of fetal metabolic acidemia, using a noninvasive technique, proton magnetic resonance spectroscopy (1H MRS), in intrauterine growth-restricted (IUGR) fetuses. STUDY DESIGN: In vivo human fetal brain lactate detection was determined by 1H MRS in 5 fetuses with IUGR. Oxygenation and acid-base balance data were obtained at birth. RESULTS: 1H MRS analysis showed the presence of a lactate peak in the brain of the most severely affected IUGR fetus, with abnormal umbilical artery Doppler and fetal heart rate tracing. This finding was consistent with the low oxygen content and high lactic acid concentration observed in umbilical blood obtained at delivery. CONCLUSION: 1H MRS allows the noninvasive detection of cerebral lactate in IUGR fetuses. Lactate detected by 1H MRS may represent a possible marker of in utero cerebral injury or underperfusion

The Early Royal Society and Visual Culture

Recent studies have fruitfully examined the intersection between early modern science and visual culture by elucidating the functions of images in shaping and disseminating scientific knowledge. Given its rich archival sources, it is possible to extend this line of research in the case of the Royal Society to an examination of attitudes towards images as artefacts –manufactured objects worth commissioning, collecting and studying. Drawing on existing scholarship and material from the Royal Society Archives, I discuss Fellows’ interests in prints, drawings, varnishes, colorants, images made out of unusual materials, and methods of identifying the painter from a painting. Knowledge of production processes of images was important to members of the Royal Society, not only as connoisseurs and collectors, but also as those interested in a Baconian mastery of material processes, including a “history of trades”. Their antiquarian interests led to discussion of painters’ styles, and they gradually developed a visual memorial to an institution through portraits and other visual records.AH/M001938/1 (AHRC

L'ufficio per le relazioni con il pubblico in sanit\ue0

L'aziendalizzazione del settore sanitario ha introdotto una fase di profondo cambiamento istituzionale, organizzativo e gestionale delle strutture preposte alla cura e alla tutela della salute sul territorio italiano. Il Legislatore con diversi interventi ha focalizzato l'attenzione sui problemi di efficacia, efficienza ed economicit\ue0 nelle attivit\ue0 di erogazione dei servizi sanitari, nonch\ue9, negli ultimi anni, anche sugli aspetti di carattere qualitativo dell'assistenza erogata attraverso la clinical governance . Lo studio, la progettazione e l'implementazione di nuovi processi gestionali rappresentano, in questo contesto, una direzione obbligata per riqualificare la spesa, migliorare la qualit\ue0 e la fruibilit\ue0 del servizio. Istituzioni, dirigenti di struttura e operatori sanitari sono chiamati cos\uec a conciliare obiettivi diversi (e talora contrapposti) come ridurre i costi, assicurare almeno lo stesso livello quantitativo di prestazioni migliorandone per\uf2 lo standard qualitativo. Il volume nasce dalla consapevolezza delle problematiche organizzative, gestionali e assistenziali che caratterizzano "l'universo salute", offrendo a quanti si occupano di sanit\ue0, una raccolta di contributi interdisciplinari, sviluppati nel comune ambito dell'economia e gestione delle aziende sanitarie

I sistemi di finanziamento delle aziende pubbliche

The volume maps out the alternatives available for the funding of public sector organizations, providing a framework suitable to bring order on a topic often dominated by technicalitie

\u201cIl sistema di reporting\u201d

The essay discusses the role of reporting in the performance cycle of healthcare organizations, and on the backdrop of the growing diffusion of management control systems discusses the requirements to make reporting effectiv