Accrual Accounting in Italian Local Governments in the Context of Public Sector Managerial Changes

This article focuses on the main reforms of accounting in Italian local governments within the context of international public management change. It traces the progressive introduction of accrual bookkeeping as a means of improving the decision-making process with the ultimate aim of improving efficiency, accountability and transparency. In Italy, local governments were the precursors of managerial changes in the public sector, and accounting innovations (starting in 1990) are still ongoing. A legislative decree of 1995 introduced accrual reporting in the traditional cash accounting as well as managerial control systems, whereas double-entry bookkeeping will be mandatory in 2014. Currently, budgetary accounting is still prepared on a cash and commitment basis, and the budget continues to play its central authorizing function in the accounting cycle in which accrual reporting has a marginal role. Accrual accounting is often considered a mere formal requirement; consequently, implementation of management by objectives is still largely elusive

Exploring virtual and augmented reality in the hospitality industry: A bibliometric analysis

Purpose – Virtual reality (VR) and augmented reality (AR) technologies are evolving, with scholars highlighting important roles and potential advantages for their use, particularly in the hospitality sector. This bibliometric study examined VR/AR research in the hospitality industry to take stock of the literature in this field and consider potential future directions. Methodology/Design/Approach – Using the Web of Science database, 213 relevant articles were selected and analyzed. Descriptive analysis was conducted using RStudio to identify the most productive countries, journals, authors, and institutions. The most influential topics were identified using keyword co-occurrence analysis in VOSviewer. Findings – The results revealed that VR/AR research in the hospitality sector has recently gained prominence, with China leading in contributions. Three major clusters of themes emerged: (i) the impact of VR on hospitality, tourism, and destinations; (ii) technology enhancing satisfaction and performance in hotels ; and (iii) user acceptance of AR in travel. Originality of the research – This study offers an overview of VR/AR research trends in the hospitality industry based on a bibliometric analysis of literature data from the Web of Science database. It provides research mapping to identify current developments in the VR/ AR literature within this industry and sheds light on areas for future research

EXPLORING VIRTUAL AND AUGMENTED REALITY IN THE HOSPITALITY INDUSTRY: A BIBLIOMETRIC ANALYSIS

Purpose – Virtual reality (VR) and augmented reality (AR) technologies are evolving, with scholars highlighting important roles and potential advantages for their use, particularly in the hospitality sector. This bibliometric study examined VR/AR research in the hospitality industry to take stock of the literature in this field and consider potential future directions. Methodology/Design/Approach – Using the Web of Science database, 213 relevant articles were selected and analyzed. Descriptive analysis was conducted using RStudio to identify the most productive countries, journals, authors, and institutions. The most influential topics were identified using keyword co-occurrence analysis in VOSviewer. Findings – The results revealed that VR/AR research in the hospitality sector has recently gained prominence, with China leading in contributions. Three major clusters of themes emerged: (i) the impact of VR on hospitality, tourism, and destinations; (ii) technology enhancing satisfaction and performance in hotels ; and (iii) user acceptance of AR in travel. Originality of the research – This study offers an overview of VR/AR research trends in the hospitality industry based on a bibliometric analysis of literature data from the Web of Science database. It provides research mapping to identify current developments in the VR/ AR literature within this industry and sheds light on areas for future research

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society