Green growth: regioni italiane a confronto

La ripresa economica e l'interesse verso le problematiche ambientali sono oggetto di studio da parte di molti paesi e organismi internazionali con l'obiettivo di definire un sentiero di sviluppo incentrato su una "crescita verde" (green growth). Economia, ambiente e società sono gli elementi di un sistema che deve necessariamente utilizzare le risorse in maniera efficiente e sostenibile, in modo da garantire che la crescita e il benessere non impoveriscano il patrimonio naturale e questo possa rinnovarsi continuando a fornire nel tempo risorse e servizi ambientali. Scopo del lavoro è quello di analizzare le condizioni regionali che possono favorire una crescita sostenibile. Un'analisi delle Componenti Principali è stata applicata su un set di variabili strutturali al fine di ottenere un indice composito in grado di sintetizzare i vari aspetti di una crescita che non deve più essere soltanto economica

Dealing with a potential bias in estimating the share of discriminated women

The Blinder-Oaxaca [1, 6] decomposition neglects any distributional issues of discrimination. Instead, Jenkins [5] has argued the importance of a distributional approach in evaluating wage discrimination, focusing on the entire distribution of discrimination experienced by each woman. In their distributional approach, Del Río et al. [3] have adapted the Foster, Greer and Thorbecke (FGT) [4] poverty indices in studying wage discrimination. These discrimination indices depend on a parameter which can be interpreted as a measure of aversion to discrimination. When the aversion parameter is zero, the index measures the share of discriminated women. In this paper we will demonstrate that the naïve approach to the estimation of the share of discriminated women – similar to that used by Del Río et al. [3] – could be considerably biased. We propose testing the significance of the discrimination experienced by each woman, using appropriate statistical tests

Measuring sustainable economic development through a multidimensional Gini index

This paper analyses the evolution of sustainable economic development inequality in Italy as regards the efforts made by each administrative Region, as a response to the main EU policies issued by the environmental and energy sector. For this purpose a multidimensional generalization of the Gini index has been performed, taking into account two different dimensions (energy and environment), in a time frame of six years (2008-2013). The multidimensional Gini results confirm the positive effect recorded by certain EU policies in determining a reduction in the inequality levels among the Italian Regions. A counterfactual analysis further underlined the relevant role played by the energetic dimension against the environmental one in strengthening Regional performance

Measuring wage discrimination according to an expected utility approach

Following on from the seminal works by Blinder (1973) and Oaxaca (1973), many methods have been proposed to measure wage discrimination against women. Some of these methods focus on the entire distribution of the discrimination experienced by each woman, underlining a common aspect of poverty and discrimination analysis: the latter two are both based on an idea of deprivation which originates from a poverty line (in the case of poverty) and from the expected wage in the absence of discrimination (in the case of wage discrimination) (Jenkins, 1994; Del Río et al., 2011). These approaches hinge on conditional-to-individual-characteristics expected wages, lacking in any focus regarding the entire conditional wage distribution faced by each woman. In this paper we will discuss an expected utility approach to the study of wage discrimination. Adjusted and unadjusted for discrimination conditional-to-individual-characteristic wage distributions are evaluated for each woman by means of a utility function. And, in order to evaluate the presence and the discrimination intensity, these distributions will be compared on the basis of the respective certainty equivalent wages. As the choice of the utility function affects the results of the analysis, we will also evaluate the share of women for which the adjusted for discrimination conditional wage distribution second-order stochastically dominates the un-adjusted distribution. Finally, an empirical analysis will be performed for the Italian labour market

A conservative treatment for eosinophilic cystitis

Introduction: Eosinophilic cystitis is a rare condition which causes common symptoms and may mimic other conditions. Eosinophilic cystitis has several causes such as hypereosinophilic syndrome, inflammatory diseases, neoplasia, parasites or fungal infection, IgE-related diseases, Drug Reaction and Eosinophilia and Systemic Symptoms (DRESS) syndrome, or Churg-Strauss syndrome. Therefore, differential diagnosis is difficult. Case presentation: We report the case of a middle-aged man affected by eosinophilic cystitis with persistent hematuria and other peculiar symptoms that may be brought back to hypereosinophilic crisis. Conclusion: Conservative approach is preferred, avoiding radical cystectomy rather than corticosteroid, antihistaminic and second line therapy. Hyperbaric therapy is an innovative approach for severe relapsing gross hematuria without specific literature and should be studied for further indications

Evaluating the effect of organization and context on technical efficiency: a second-stage DEA analysis of Italian hospitals

Objective: the purpose of this study was to compare the technical efficiency of Italian hospitals at a regional level and to examine if differences could be explained by organisational and contextual factors. Technical efficiency was defined as the ability of the operating units evaluated to use optimal resource levels for their level of output. Methods: the effect of external factors was explored through a second stage Data Envelopment Analysis (DEA). Efficiency scores were calculated for each hospital using the DEA method (Stage I). Through Tobit regression analysis, the estimated efficiency scores were regressed against a set of organisational and contextual characteristics beyond managerial control, which reflected differences in the population demographics and regional health expenditure (Stage II). Stage I and Stage II efficiency scores were compared in order to indirectly assess managerial contribution in relation to hospital efficiency. Results: the highest efficiency (M±SD) was observed in hospitals in the North-West (75.7±15.1), followed by those in the North-East (75.5±15.1), Central Italy (73.9±16.4) and then Southern Italy (70.6±17.9). Hospital Trusts (HTs) were shown to be more technically efficient than Local Public Hospitals (LPHs). Organisational and contextual indicators were statistically significantly different at Tobit regression analysis for HTs and LPHs. Emilia Romagna and Lombardia were the regions whose management contributed to increased efficiency. Conclusions: in our study, the distribution of regions according to technical efficiency only partly reflected the North-South gradient shown by other studies regarding the gap of expenditure. The important role of organisation and environment in establishing efficiency differences among hospitals was demonstrated

Preliminary Results of ERAS Protocol in a Single Surgeon Prospective Case Series

Background and Objectives: The aim was to compare the intra and postoperative outcomes between the Enhanced Recovery After Surgery (ERAS) protocol versus the standard of care protocol (SCP) in patients who underwent radical cystectomy performed by a single surgeon. Materials and Methods: A retrospective comparative study was conducted including patients who underwent radical cystectomy from 2017 to 2020. Length of stay (LOS), incidence of ileus, early postoperative complications, and number of re-hospitalizations within 30 days were considered as primary comparative outcomes of the study. Results: Data were collected for 91 patients who underwent cystectomy, and 70 and 21 patients followed the SCP and ERAS protocol, respectively. The mean age of the patients was 70.6 (SD 9.5) years. Although there was a statistically significant difference in time to flatus (TTF) [3 (2.7-3) vs. 1 (1-2 IQR) days, p < 0.001, in the SC hospital and in the ERAS center respectively], no difference was reported in time to first defecation (TTD) [5 (4-6) vs. 4 (3-5.8), p = 0.086 respectively]. The median LOS in the SCP group was 12 (IQR 11-13) days vs. 9 (IQR 8-13 p = 0.024). In the postoperative period, patients reported 22 complications (37% in SCP and 42.8% in ERAS group, p = 0.48). Conclusions: The study reveals how even partial adherence to the ERAS protocols leads to similar outcomes when compared to SCP. As a single surgeon series, our study confirmed the role of surgeons in reducing complications and improving surgical outcomes