The nature and dynamics of internet pornography exposure for youth.

Abstract We examined exposure to Internet pornography before the age of 18, as reported by college students (n = 563), via an online survey. Ninety-three percent of boys and 62% of girls were exposed to online pornography during adolescence. Exposure prior to age 13 was relatively uncommon. Boys were more likely to be exposed at an earlier age, to see more images, to see more extreme images (e.g., rape, child pornography), and to view pornography more often, while girls reported more involuntary exposure. If participants in this study are typical of young people, exposure to pornography on the Internet can be described as a normative experience, and more study of its impact is clearly warranted

Index of Problematic Online Experiences: Item Characteristics and Correlation with Negative Symptomatology

This exploratory study aimed to develop and test a quick, easily administered instrument, the Index of Problematic Online Experiences (I-POE). The goal of the I-POE extends beyond assessing for Internet overuse to broadly assess problematic Internet use across several domains and activities. Data was collected from 563 college students from a Northern New England university using an online survey methodology. Results indicated the I-POE has adequate construct validity and is highly correlated with a variety of relevant constructs: depression, anger=irritability, tension-reduction behavior, sexual concerns, and dysfunctional sexual behavior as measured by the Trauma Symptom Inventory; as well as amount of Internet use and permissive attitudes toward engaging in a variety of sexual activities. Early flagging of online experiences could mitigate the negative effects associated with problematic use. The I-POE, as an easy-to-administer, short screening index, holds promise in this regard. Initial testing of the instrument points to its utility in identifying persons who are experiencing a broad range of Internet-related problems

Developing a combined quantitative benchmarking system for the performance of local health authorities: The case of the Tuscany Region in Italy

This paper proposes an integrated quantitative benchmarking approach for the measurement of the performance of Local Health Authorities (LHAs). It is based on a sound balanced scorecard approach developed and implemented in the Tuscany Region by the Management and Health Laboratory of Sant’Anna School combined with a bias corrected measure of technical efficiency, estimated using a bootstrap based Data Envelopment Analysis. The empirical results show that the typical LHA in Tuscany experienced 14% bias-corrected inefficiency in 2007. Using correlation analysis and mapping quadrants, the paper shows the relationships among technical efficiency and quality and appropriateness as well as analyses the impact of organizational factors on the performance of LHAs. Finally, this combined benchmarking approach is illustrated as a useful and important managerial tool both for regional and local authorities.appropriateness, bias correction, data envelopment analysis, local health authorities, performance evaluation system

Basic ICT adoption and use by general practitioners: an analysis of primary care systems in 31 European countries

There is general consensus that appropriate development and use of information and communication technologies (ICT) are crucial in the delivery of effective primary care (PC). Several countries are defining policies to support and promote a structural change of the health care system through the introduction of ICT. This study analyses the state of development of basic ICT in PC systems of 31 European countries with the aim to describe the extent of, and main purposes for, computer use by General Practitioners (GPs) across Europe. Additionally, trends over time have been analysed

Organizational climate: Comparing private and public hospitals within professional roles

AbstractThis study compares the organizational climate differences within professional roles in private and public hospitals. We focused on how physicians, administrative, healthcare and non-healthcare staff either in the public or in the private perceived their work environment and each organizational climate dimension. Data came from organizational-climate questionnaires administered in 2010 and 2012 to 19616 and 1276 health employees in public and private hospitals in the Tuscany Region respectively. We applied exploratory factoranalysis to verify the validity and internal consistency between items in the questionnaire and t-test, one-way analysis of variance to compare mean perceptions regarding to the dimensions across different groups of respondents. We measured four dimensions: “training opportunities”, “managerial tools”, “organization” and “management & leadership style” and overall job satisfaction. Hospital status in the professional roles was found significant in the staff's perceptions (p≤0.05)

Women's choices of hospital for breast cancer surgery in Italy: Quality and equity implications

: This paper employs mixed logit regression to investigate the effects of providers characteristics on women's choice of hospital for breast surgery. Patient level data are used to model choices in Tuscany region, Italy. In particular, we focus on the effects of travel time and hospital quality indicators including quality standard (volumes of breast surgery), measurement of process (waiting times) and quality of surgical procedures. Variation in preferences related to individual characteristics such as age, education and travel distance from the hospital are also considered. Findings show that, on average, women prefer closer hospital with longer waiting times and higher quality (high volumes of interventions). We found preference heterogeneity associated to education: travel distance affects choice especially among less educated women (regardless of age), while among younger women (<65 years), less educated ones prefer shorter waiting times. These results could be used to optimize the allocation of resources toward breast cancer units that meet quality and efficacy standards to increase the efficiency and responsiveness of breast cancer care

Heterogeneity in Preferences for Primary Care Consultations: Results from a Discrete Choice Experiment

Abstract: Purpose: The increasing importance of flexibility in the general practitioner (GP) -patient consultation approach in primary care requires healthcare managers and physicians to find a balance among all the potentially important characteristics of consultation. This study used a discrete choice experiment (DCE) to assess patients' preferences for different attributes of GP consultation and how the rate at which they traded between different attributes is affected by socio-demographic characteristics and past experiences with primary care services . Methods: A survey was conducted to a sample of 6970 residents in Tuscany region, Italy. Besides socio-demographic characteristics the survey collected information about participants' past experience with GP consultation in the last 12 months. Moreover, participants were asked to select their preferred option in a series of pairwise choices, defined by the following attributes: level of involvement in decision making, amount of information received from the GP and waiting time for the visit. Results: Results revealed that receiving information from the GP was more important than being involved in the decisions and that, approximately, a complete involvement had the same importance as a partial involvement. Participants' past experience with GP's consultation appeared to have the greatest influence on the involvement level. The amount of information required by the respondents was also influenced by a complex interplay of personal and contextual factors. Conclusions: This large-scale study extends the body of literature on DCE applications for different GP consultation approaches, providing new information about the influence that patients' socio-demographic characteristics and past experiences could have on consultation preferences.

Breaking the Cycle of Homelessness

With funding from Department of Health and Human Services secured by United Power for Action and Justice, CURL partnered with United Power for  Chicago Health Outreach, Deborah's Place and Lakefront SRO to evaluate their systems integration demonstration project. The overall goal of the demonstration project was to break the cycle of homelessness by providing services in a coordinated fashion.

Excess economic burden of multimorbidity: a population-based study in Italy.

t In Italy the increasing incidence of chronic disease and multimorbidity are major challenges for health systems. When a patient suffers from more than one chronic condition, the conditions can interact causing a significant increase in patients’ care needs. Using healthcare administrative databases of Tuscany region to identify cohorts of chronic prevalent patients and their total direct healthcare expenses, in this paper we aim to study the economic burden of multiple chronic conditions and calculate the excess cost when comorbidities occur in order to assess how combinations of chronic conditions in adults affect total direct health expenditure