1,242 research outputs found

    Scoping review and bibliometric analysis of Big Data applications for Medication adherence: An explorative methodological study to enhance consistency in literature

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    Background: Medication adherence has been studied in different settings, with different approaches, and applying different methodologies. Nevertheless, our knowledge and efficacy are quite limited in terms of measuring and evaluating all the variables and components that affect the management of medication adherence regimes as a complex phenomenon. The study aim is mapping the state-of-the-art of medication adherence measurement and assessment methods applied in chronic conditions. Specifically, we are interested in what methods and assessment procedures are currently used to tackle medication adherence. We explore whether Big Data techniques are adopted to improve decision-making procedures regarding patients' adherence, and the possible role of digital technologies in supporting interventions for improving patient adherence and avoiding waste or harm. Methods: A scoping literature review and bibliometric analysis were used. Arksey and O'Malley's framework was adopted to scope the review process, and a bibliometric analysis was applied to observe the evolution of the scientific literature and identify specific characteristics of the related knowledge domain. Results: A total of 533 articles were retrieved from the Scopus academic database and selected for the bibliometric analysis. Sixty-one studies were identified and included in the final analysis. The Morisky medication adherence scale (36%) was the most frequently adopted baseline measurement tool, and cardiovascular/hypertension disease, the most investigated illness (38%). Heterogeneous findings emerged from the types of study design and the statistical methodologies used to assess and compare the results. Conclusions: Our findings reveal a lack of Big Data applications currently deployed to address or measure medication adherence in chronic conditions. Our study proposes a general framework to select the methods, measurements and the corpus of variables in which the treatment regime can be analyzed

    Anchor entrepreneurship and industry catalysis: The rise of the Italian Biomedical Valley

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    Accounting for the rise of the medical device industry in the Emilia-Romagna town of Mirandola from a once depressed agricultural area in 1962 to a world-manufacturing center for dialysis equipment and disposable plastic medical devices, requires in large measure mapping the methods of the local entrepreneur who spearheaded its development. Reworking Agrawal and Cockburn's anchor-tenant hypothesis highlighting the role of large organizations in fostering agglomerations, this paper privileges the Schumpeterian entrepreneur as the dynamic force driving new industrial formations. This anchor-entrepreneur with no prior experience in manufacturing medical devices and without any public financing or large private backers founded six firms. Each of these would be sold off fairly quickly to a different large multinational corporation. Placing the anchor-entrepreneur at the center stage advances understanding of early industry evolution, spelling out how first-mover pioneers shape the environment to establish the first markets needed to attract new resources and capabilities. Underpinning our argument are 61 fine-grain interviews with key medical device industry informants in addition to extensive secondary sources and historical records. We draw on this material to induce a stylized model of anchor-entrepreneurship and industry catalysis that rests on three generative processes: bricolage, second-hand imprinting and beaconing

    Topic modeling and user network analysis on twitter during world lupus awareness day

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    Twitter is increasingly used by individuals and organizations to broadcast their feelings and practices, providing access to samples of spontaneously expressed opinions on all sorts of themes. Social media offers an additional source of data to unlock information supporting new insights disclosures, particularly for public health purposes. Systemic lupus erythematosus (SLE) is a complex, systemic autoimmune disease that remains a major challenge in therapeutic diagnostic and treatment management. When supporting patients with such a complex disease, sharing information through social media can play an important role in creating better healthcare services. This study explores the nature of topics posted by users and organizations on Twitter during world Lupus day to extract latent topics that occur in tweet texts and to identify what information is most commonly discussed among users. We identified online influencers and opinion leaders who discussed different topics. During this analysis, we found two different types of influencers that employed different narratives about the communities they belong to. Therefore, this study identifies hidden information for healthcare decision-makers and provides a detailed model of the implications for healthcare organizations to detect, understand, and define hidden content behind large collections of text

    Drug-eluting Microspheres Compared to Conventional Transarterial Chemoembolization as First Line Treatment for Unresectable Hepatocellular Carcinoma: A Single-center Retrospective Cost-utility Analysis

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    Purpose: To assess the cost-utility of initial treatment with drug-eluting microspheres (DEM) transarterial chemoembolization (TACE) versus conventional (C)-TACE in patients with hepatocellular carcinoma considering the perspective of a Local Healthcare Authority in Italy. Materials and methods: The economic evaluation is based on a retrospective single-center study and individual patients' data whose details have been previously reported. The impact of initial treatment with DEM-TACE or C-TACE on disease progression, mortality, and direct health costs over a lifetime horizon were simulated and compared in terms of incremental cost-utility ratio expressed as costs per quality adjusted life years (QALY). Costs included direct health costs related to the first chemoembolization procedure and all subsequent follow-up costs associated with health care resources used for disease management. Probabilistic (PSA) sensitivity analysis was used to assess the robustness of the results. Results: A total of 101 patients in each treatment group were considered. All over the time-horizon median costs were €3,145.14 and €2,158.32 in the DEM-TACE and C-TACE group, respectively (p < 0.001); while mean costs were € 24,619 and € 17,001, respectively (p < 0.001). The ICUR was 6,461.86 €/QALY when using median costs derived from the study population as input for the health-economic evaluation and 49,932.15 €/QALY when the mean costs were considered. Results from PSA highlighted that using median costs DEM-TACE was always cost-effective, while using mean costs, it was preferable only 24.7% of times. Conclusions: The higher prices of DEMs are counterbalanced by the positive impact on QALY

    Ecological effects of the European barbel Barbus barbus (L., 1758) (Cyprinidae) invasion on native barbel populations in the Tiber River basin (Italy)

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    The purpose of this study was to investigate the effects of the European barbel Barbus barbus (L., 1758) invasion in the Tiber River basin (Italy) on the native Tiber barbel Barbus tyberinus Bonaparte, 1839, verifying whether the co-occurrence played a negative impact on growth rate and relative weight. Fish census data were collected during three periods (2000–2005, 2006–2010, 2011–2015) at 158 sampling sites. Since its first record in 1998, European barbel rapidly spread in the study area: it was present in more than 20% of the monitoring sites, where it is leading to the gradual replacement of Tiber barbel by widening its distribution in the Tiber River and in the downstream reaches of the main tributaries. By contrast, Tiber barbel has suffered from this competition, as demonstrated by the fact that the mean value of the relative weight was significantly higher where European barbel was absent. The results obtained suggested that this non-native species could be a serious threat to the conservation status of endemic Tiber barbel, and constitute the premise to underpin conservation strategies aiming to preserve native freshwater biodiversity

    L'importanza delle vegetazioni relitte e delle siepi nell\'agroecosistema della Pianura Padana e nella ricostruzione dinamica della vegetazione

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    ItDi fronte alla continua degradazione dell’ambiente e all’esigenza di ricercare nuovi equilibri tra ambiente ed agricoltura, acquista sempre maggiore importanza la conoscenza dei relitti di vegetazione forestale e delle siepi che costituiscono attualmente un punto di aggregazione di specie relitte, sparse nel territorio. Alle situazioni relitte ed alle siepi si lega tutta la problematica non solo vegetale ma anche animale che deve essere tenuta presente nella ipotizzazione di nuovi agroecosistemi a basso impatto ambientale.EnBecause of continuos environment degradation and in view of the necessity of searching new equilibria between environment and agriculture, it becames more and more important to have knowledge of forest relicts and hedges, that represent, at present, a point of aggregation for the relict species spread in the area. Relict vegetation and hedges are in tight connection with all of those problems regarding plants and animals, which must be kept in mind in planning new agro-ecosystems having low envirommental impact
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