Ferric carboxymaltose for patients with heart failure and iron deficiency in Italy: cost-effectiveness and budget impact.

Aim: To evaluate the cost–effectiveness of intravenous ferric carboxymaltose (FCM) versus placebo for the management of iron deficiency in patients with chronic heart failure in the Italian healthcare system and to estimate its impact on the national healthcare budget. Materials & methods: A Markov model was developed to project costs and health outcomes over 1 year, based on data from literature. Healthcare resources consumption was derived from an e-survey administered to clinicians. Costs were obtained from official tariffs. Results: Treatment with FCM represents a dominant strategy compared with placebo, leading to national budget annual savings of 20–97 million Euros, according to different increasing utilization rates. Conclusion: FCM is a cost-saving option for the treatment of chronic heart failure patients with iron deficiency in Italy

Informative Sources for the Evaluation of the University Education Effectiveness in Italy

Summary. The evaluation of the effectiveness of a study programme refers to its outcomes, and may be measured with the level of satisfaction of the programme objectives. In an educational programme, we can recognize three macro objectives referred to students: i) the formation of specific competences; ii) general competences and individual cultural development; iii) capability in finding a suitable job. The measurement of these components is based on the construction and analysis of several indicators from surveys on teaching assessment, or on placement, or on teachers and employers, and, too, on linkage between databases

introduction to social costs of diseases

Quando si parla di valutazioni economiche in sanità si intendono tipicamente delle analisi comparative, in termini di costi e di conseguenze, di programmi sanitari alternativi come l'introduzione di un nuovo farmaco, di una nuova apparecchiatura diagnostica o di una nuova terapia, confrontata con una situazione precedente o con un'altra alternativa (un altro farmaco, un'altra apparecchiatura diagnostica, un'altra terapia). Come si può evincere dalla tabella I (Gold et al., 1996), in realtà, esistono diverse tecniche di valutazione economica e solo alcune di esse corrispondono pienamente alla definizione appena fornita..

Abruzzo

In Abruzzo region 55,4% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 29 cases of cervicocarcinoma and 12 related deaths and thus results to be cost-effective (20.836 €/QALY). When the vaccination programme is extended to 16-year-old girls a further 28 cancer cases and 12 deaths could be prevented, with a very similar cost-effectiveness ratio. In Abruzzo region, the net cost for woman vaccinated is 199 € for the single cohort and 202 € for the multiple cohort

L'introduzione del vaccino anti-HPV bivalente adiuvato con AS04 nelle regioni italiane: impatto economico ed effetti sulla salute delle donne

Introduction: the impact of cervical cancer prevention, in particular through HPV female vaccination, has been published for many countries at the national level. However, to our knowledge no attempt has been made to address the impact at a regional level. Since the Italian health reforms of the early 1990s, introducing "managerialism", decentralization and quasi-market mechanisms, regional authorities have consequently been experimenting with different organizational and funding models to achieve an acceptable combination of equity, efficiency, freedom of choice and cost-containment. Methods: a Markov model, previously described and successfully adapted to the national scenario [La Torre, 2007], has been used to explore the impact of preventive cervical cancer vaccination with Cervarix™ at a regional level in Italy. Resource use was based on a standard therapeutic path applied to all regions. However we quantified the impact of the so-called "decentralization progress" by collecting regional data on: pap-test coverage, tariffs for treatments and cost of the vaccination course. We performed for each Italian region a cost-effectiveness analysis combined with a regional budget impact analysis. The regional analyses compared HPV vaccination, both of a single female cohort (12 years old) and a multiple female cohort (12+16 years old), plus screening to screening only. Results: 21 regional reports were produced presenting regional results on screening coverage, treatments costs, ICER and ICUR, net cost per subject vaccinated etc. Conclusions: national and regional analyses have two different aims: the former wants to address national regulatory agencies and needs to be representative of the national population whereas the latter deals with the real budget-holders, accountable in the eyes of patients. Furthermore in the Italian scenario, characterized by decentralization and local autonomy, a further level of detail is essential in order to describe the specific local settings and implications of a new health intervention

Puglia

In Apulia region 43,9% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 127 cases of cervicocarcinoma and 52 related deaths and thus results to be cost-effective (13.471€/QALY). When the vaccination programme is extended to 16-year-old girls a further 133 cancer cases and 54 deaths could be prevented, with a very similar cost-effectiveness ratio. In Apulia region, the net cost for woman vaccinated is 137€ for the single cohort and 141€ for the multiple cohort

A trajetória do movimento feminista e das conquistas jurídicas até a paridade de gênero na Convención Constitucional chilena

En este artículo analizamos el proceso de interpelación de las mujeres a la Asamblea Constituyente de Chile como resultado de la movilización y la formación política durante años de lucha por los derechos. El punto de partida de este estudio es la primera movilización de estudiantes de secundaria, en 2006, finalizando con los hechos del Mayo Feminista, en 2018, cuando se aprobó un proceso constituyente. Se destaca en este trabajo la centralidad del pensamiento, la acción y la lucha de las mujeres y del feminismo chileno, pues aquí demostramos cuánto tuvo un impacto concreto la lucha permanente de las mujeres contra las estructuras patriarcales de la sociedad y, principalmente, contra las instituciones del Estado. El resultado fue la participación de las mujeres en la Convención Constituyente en términos paritarios con los hombres. Las premisas de este trabajo se sustentan en una revisión de las principales leyes para la equidad en las relaciones de género, editadas a partir de 2015. Además del análisis de la legislación y normas, finalmente realizamos una consulta bibliográfica sobre el movimiento de mujeres y feministas en perspectiva histórica. Se concluye que el modelo paritario de la Asamblea constituyente es parte de un proyecto de construcción colectiva feminista de la sociedad, luego de la politización de la violencia vivida contra las mujeres.Neste artigo analisamos o processo de interpelação das mulheres à Assembleia Constituinte chilena como resultado da mobilização e da formação política ao longo de anos de luta por direitos. O marco inicial deste estudo é a primeira mobilização dos estudantes secundaristas, em 2006, findando nos acontecimentos do Mayo Feminista, em 2018, quando da aprovação de um processo constituinte. Destaca-se neste trabalho a centralidade do pensamento, ação e luta das mulheres e do feminismo chileno, pois aqui demonstramos o quanto a luta permanente das mulheres contra as estruturas patriarcais da sociedade e, principalmente, contra as instituições estatais. O resultado foi a participação das mulheres na Convenção Constituinte em termos paritários com os homens. As premissas deste trabalho se sustentam numa revisão das principais leis para a equidade nas relações de gênero, editadas a partir de 2015. Além da análise da legislação e de normas, realizamos, finalmente, uma consulta bibliográfica sobre o movimento de mulheres e feministas numa perspectiva histórica. Conclui-se que o modelo paritário da Assembleia constituinte é parte de um projeto de construção coletiva feminista da sociedade, após a politização da violência vivenciada contra as mulheres.This article looks back on recent events in Chile's political and social history that would have created a suitable environment for the formation of an unprecedented model of Constituent Assembly, marked by the centrality of the feminist thought and movement that became more radically present since the “MayoFeminista”, which took place in May 2018, when university and high school students rose denouncing the patriarchal violence that lived within the walls of educational institutions. A review of the laws for gender equality in political participation that were edited in the country from 2015 onwards and consultation of the bibliography that critically analyzes the social movements of contemporary women and feminists were the tools used for the analysis presented here. In the end, it is concluded by the importance of the presence of feminists for the construction of a broadly egalitarian Chilean society

Contribuições do novo constitucionalismo latino-americano para o debate do Marco Temporal para a demarcação de terras indígenas no Brasil

A discussão sobre o marco temporal para a demarcação de terras indígenas está atualmente aguardando votação no Supremo Tribunal Federal (STF). O tema envolve, dentre outras questões, a discussão sobre a relação entre comunidades indígenas e a natureza. Identificam-se duas abordagens contrapostas pelas quais se pode vislumbrar a questão: uma centrada na ideia de natureza como algo a ser utilizado, usufruído, se alinhando a construção colonial e a outra (dos indígenas) que tem na terra a conexão com a antepassados, a manutenção da própria cultura e a sobrevivência . O presente estudo expõe este conflito e aprofunda o debate a partir da perspectiva dos Estudos Decoloniais, sobretudo por meio dos temas da colonialidade do poder e do saber (QUIJANO, 2005); (GROSFOGUEL, 2018); (MIGNOLO, 2001). Neste sentido, emprega-se, além da  pesquisa bibliográfica, a pesquisa documental para analisar como o novo constitucionalismo latino-americano e, em especial, a Constituição do Equador de 2008 propõe a relação entre seres humanos e a natureza. Espera-se que os resultados possam agregar mais uma perspectiva para a discussão do marco temporal no Brasil.The discussion on the “time frame” for the demarcation of indigenous lands in Brazil is currently awaiting a vote in the Federal Supreme Court. The theme involves, among other issues, the discussion about the relationship between indigenous communities and nature. Two opposing approaches to the issue can be identified: one centered on the idea of nature as something to be used, enjoyed, aligning with the colonial construction, and the other (supported by indigenous people) that is concerned with the ancestors of the land, the maintenance of one's own culture and survival. The present study exposes this conflict and deepens the debate from the perspective of Decolonial Studies, especially through the concepts of coloniality of power and knowledge (QUIJANO, 2005); (GROSFOGUEL, 2018); (MIGNOLO, 2001). In addition to bibliographic research, documentary research is used to analyze how the “new Latin American constitutionalism” and, in particular, the 2008 Constitution of Ecuador addresses the relationship between human beings and nature. Hopefully, the results can add another perspective to the discussion of the “time frame” in Brazil.La discusión sobre el “marco temporal” indígena en Brasil actualmente se encuentra pendiente de votación en la Suprema Corte de Justicia  (STF). La cuestión involucra, entre otros temas, la discusión sobre la relación entre las comunidades indígenas y la naturaleza. Se identifican dos enfoques contrapuestos por medio de los cuales se puede vislumbrar el tema: uno centrado en la idea de la naturaleza como algo a ser utilizado, disfrutado, adherente con la construcción colonial, y el otro (de los pueblos indígenas) que tiene otra conexión con la naturaleza, viendo en la tierra una conexión con los ancestrales, el mantenimiento de la cultura y de la supervivencia. El presente estudio expone este conflicto y profundiza el debate desde la perspectiva de los Estudios Decoloniales, especialmente por medio de los temas de la colonialidad del poder y del saber (QUIJANO, 2005); (GROSFOGUEL, 2018); (MIGNOLO, 2001). En este sentido, además de la investigación bibliográfica, se utiliza la investigación documental para analizar cómo el nuevo constitucionalismo latinoamericano y, en particular, la Constitución de Ecuador de 2008 propone la relación entre el ser humano y la naturaleza. Se espera que los resultados puedan agregar una perspectiva más a la discusión del marco temporal en Brasil

The Rectal Gland in Relation to the Osmoregulatory Mechanisms of Marine and Freshwater Elasmobranchs

The rectal gland of elasmobranchs secretes large quantities of electrolytes and is of primary importance in the osmoregulatory mechanisms of these animals (Burger and Hess, 1960; Burger, 1962). Analogously, various organs of other vertebrates are also known to be involved in salt secretion (Schmidt-Nielsen, 1965; Bonting, 1970; Bentley, 1971). In general, active ion transport is the basis of this phenomenon; in any case, it requires the presence of structural devices, morphologically and chemically well defined, and of metabolic capabilities which, taken singly, are not specific, but collectively are consistent with active ion transport and salt secretion

Sicilia

In Sicily region 39,6% of women (aged 25-64) are screened regularly, meaning every 3 years. Considering regional tariffs and vaccine acquisition cost, the vaccination of 12-year-old girls with a 90% coverage could prevent 169 cases of cervicocarcinoma and 68 related deaths and thus results to be cost-effective (15.534 €/QALY). When the vaccination programme is extended to 16-year-old girls a further 181 cancer cases and 75 deaths could be prevented, with a very similar cost-effectiveness ratio. In Sicily region, the net cost for woman vaccinated is 171 € for the single cohort and 176 € for the multiple cohort