A cost benefit analysis of in-vitro-fertilisation in italy.

This thesis presents a full cost-benefit analysis of In-Vitro-Fertilisation (IVF) from a societal perspective. It is based on a contingent valuation survey administered through internet to a sample of the Italian population. A referendum format and a payment scale were used to elicit willingness-to-pay (WTP) for a publicly funded program providing IVF to infertile couples. WTP was also elicited for a hypothetical situation in which the respondent was asked to imagine being infertile and willing to have a baby. Overall, results show the feasibility of using this new method of administration of contingent valuation questionnaires. Responses reveal consistent patterns and the number of inconsistent answers is limited. WTP for private use (in case of infertility) and for a public program are positively associated with income, education, being within the fertility age range and being informed about infertility and IVF. The take-it-or-leave-it format and a variant of the payment scale method result in different mean WTP estimates, but simulated and actual referendum WTP are very similar. There is evidence of an anchoring effect since the values presented in the take-it-or-leave-it question had an impact on the answers to the modified payment card questions that followed. Mean WTP estimated from the different questions are consistently above the mean cost of providing IVF, as estimated on the basis of a full costing methodology. The IVF program shows net welfare benefits under several assumptions. The study shows that the societal benefits of an IVF program mainly derives from the high WTP of a minority of citizens who tend to be the most affluent, educated and familiar with infertility and IVF

Propulsive strength training in wheelchair tennis to improve service response

In wheelchair tennis, the biomechanical-bioenergetic quantitative aspects involved are the fast force and maximum isometric propulsion force of the race medium. The problem encountered is to improve the propulsion force of the race medium, therefore the thrust force, to increase the strength of the upper limbs in the response to the service. The aim of the study is to verify the effects of a training with upper limb overloads on sports performance, in particular the response to the service. A sample of 30 paraplegic athletes, of an average age of 25 years, with a D8-D12 back injury, of the Open category, has been recruited. Athletes have been training with upper body overloads for 2 months with a frequency of 2 times a week. The 20m sprint test was executed after and before the two months. The T-test for dependent samples was used to detect the difference between the two groups (p < .05). Training with upper limb overloads showed a significant improvement (p < .05) of 42% in service response. According to the results, athletes from an average initial performance level of 5.2 have moved to an average level of 4.82, which corresponds to an almost excellent level. Overload training has proven effective in increasing fast strength in response to the technical gesture of the opponent's service

Regional Variations in Medical Device Diffusion

Despite established efficacy for cardiac implantable electrical devices (CIEDs), large differences in CIED implant rates have been documented across and within countries. The aim of this paper is to investigate the influence of socio‐economic, epidemiological and supply side factors on CIED implant rates across 57 Regions in 5 EU countries and to assess the feasibility of using administrative data for this purpose. A total of 1 330 098 hospitalizations for CIED procedures extracted from hospital discharge databases in Austria, England, Germany, Italy and Slovenia from 2008 to 2012 was used in the analysis. Higher levels of tertiary education among the labour force and percent of aged population are positively associated with implant rates of CIED. Regional per capita GDP and number of implanting centres appear to have no significant effect. Institutional factors are shown to be important for the diffusion of CIED. Wide variation in CIED implant rates across and within five EU countries is undeniable. However, regional factors play a limited part in explaining these differences with few exceptions. Administrative databases are a valuable source of data for investigating the diffusion of medical technologies, while the choice of appropriate modelling strategy is crucial in identifying the drivers for variation across countries. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd

Gli Ospedali di Comunità: quali prospettive alla luce del PNRR?

L’obiettivo del presente capitolo è quello di approfondire ulteriormente l’analisi rispetto a quanto emerso nel precedente capitolo sugli OdC pubblicato nel Rapporto OASI 2021 (ibid.), indagando l’evoluzione e le progettualità previste nel breve e medio periodo per queste strutture alla luce delle indicazioni di sviluppo contenute nel PNRR. In particolare, vengono analizzate le priorità strategiche, le vocazioni produttive e i modelli di servizio, il target di utenza e la tipologia di bisogni da soddisfare, la tipologia di personale clinico e amministrativo coinvolto, la dotazione tecnologica e i modelli di integrazione e interconnessione con gli altri servizi e setting di cura e assistenza, sia territoriali che ospedalieri

Reducing the burden of iron deficiency anemia in Cote D'Ivoire through fortification

Iron deficiency anemia (IDA) is highly prevalent in the Cote d'Ivoire and has severe health and economic consequences. In this paper, we apply a health economic model to quantify the burden of IDA, and the contribution of nationwide mandatory iron fortification of wheat flour and voluntary iron fortification of condiments to the reduction of this burden

‘Managing successful change in the public sector’: a view from the consultants’ world

Our paper presents the results of a survey on the perceptions of 680 Italian public-sector consultants on the drivers of successful organizational change according to Fernandez and Rainey’s model. The results show that the consultants mostly confirm the model, though recognizing that the various drivers have different degrees of relevance. A clear vision and plan for change and the top management’s commitment are seen as central in change processes, whereas interestingly, resource availability and a comprehensive approach to change appear to play a less relevant role

Gli ospedali di comunità in Italia: passato, presente e futuro

Il presente capitolo approfondisce il tema degli ospedali di comunità (OdC) attraverso un’analisi approfondita dell’esistente, concentrandosi prima sul contesto internazionale per poi analizzare quello nazionale, con una mappatura aggiornata degli OdC presenti nel nostro Paese e la presentazione di otto casi studio, condotti in sei regioni differenti

Italy: Health System Review

Presentazione e valutazione del sistema sanitario italiano commissionato al CERGAS e al Gemelli di Roma da parte della World Health Organization

L\u2019utilizzo dei farmaci analgesici oppiacei per il trattamento del dolore in Italia: un\u2019analisi empirica

The International association for the study of pain and the World medical association stated that receiving a fair treatment of pain is a right of each individual. Moderate or high intensity cases of pain are treated with opiates. In Italy, in 2010, a new legislation has been issued, one of the most advanced on the topic of the treatment of pain and the usage of opiates. Although the legislative progresses, the consumption of opiates is not so common and ranks far behind the other European countries. The analysis of the spread of opiates in the treatment of pain pointed out relevant differences in terms of gender, age, region, cancer, type of opioid prescribed. It should then take action to make consistent use of opiates in pain therapy, focusing in particular on cancer patients and territorial differences. The analysis of religiosity as a potential barrier to pain management and opiates usage allowed us to conclude, however, that it is a factor that influences the number of prescriptions of opiates, even if the moderate effect. Public policies should respect personal choices (also religious ones), but it is important broadcasting some appropriate information campaigns which allow to make independent and informed choices. Key words. Opioids, pain, religiosity. JEL classification. I18

Pharmacological targeting of the ephrin receptor kinase signalling by GLPG1790 in vitro and in vivo reverts oncophenotype, induces myogenic differentiation and radiosensitizes embryonal rhabdomyosarcoma cells

EPH (erythropoietin-producing hepatocellular) receptors are clinically relevant targets in several malignancies. This report describes the effects of GLPG1790, a new potent pan-EPH inhibitor, in human embryonal rhabdomyosarcoma (ERMS) cell lines