The performance of mHealth in cancer supportive care:A research agenda

Background: Since the advent of smartphones, mhealth has risen to the attention of all actors in the health care system as something that could radically change the way health care has been thought of, managed, and delivered to date. This is particularly relevant for cancer, as it is one of the leading causes of death worldwide, and for cancer supportive care (CSC) since patients and care givers have a key role in managing side effects: given adequate knowledge, they are able to expect appropriate assessments and interventions. In this scenario, mhealth has great potential for linking patients, care givers, and health care professionals, for enabling early detection and intervention, for lowering costs and achieving better quality of life. Given its great potential, it is important to evaluate the performance of mhealth. This can be considered from several perspectives, of which organizational performance is a particularly relevant dimension, since mhealth may increase the productivity of health care providers and as a result even the productivity of health care systems. Objective: This paper aims to review studies on the evaluation of the performance of mhealth, with particular focus on cancer care and cancer supportive care processes, concentrating on its contribution to organizational performance, and identifying some indications for a further research agenda. Methods: We carried out a review of literature, aimed at identifying studies related to the performance of mhealth in general or focusing on cancer care and cancer supportive care. Results: Our analysis revealed that studies are almost always based on a single dimension of performance. Any evaluations of the performance of mhealth are based on very different methods and measures, with a prevailing focus on issues linked to efficiency. This fails to consider the real contribution that mhealth can offer for improving the performance of health care providers, health care systems, and the quality of life in general

The role of mobile technologies in health care processes:The case of cancer supportive care

Background: Health care systems are gradually moving towards new models of care based on integrated care processes, shared by different care givers, and on an empowered role of the patient. Mobile technologies are assuming an emerging role in this scenario. This is particularly true in care processes where the patient has a particularly enhanced role, as is the case of cancer supportive care. Objective: This paper aims to review existing studies on the actual role and use of mobile technology during the different stages of care processes, with particular reference to cancer supportive care. Methods: We carried out a review of literature with the aim of identifying studies related to the use of mhealth in cancer care and cancer supportive care. The final sample size consists in 106 records. Results: There is scant literature concerning the use of mhealth in cancer supportive care. Looking more generally at cancer care, we found that mhealth is mainly used for self management activities carried out by patients. The main tools used are mobile devices like smartphones and tablets, but remote monitoring devices also play an important role. SMS technologies have a minor role with the exception of middle income-countries where SMS plays a major role. Tele-health technologies are still rarely used in cancer care processes. If we look at the different stages of health care processes, we can see that mhealth is mainly used during the treatment of patients, especially for self management activities. It is also used for prevention and diagnosis, although to a lesser extent, whereas it appears rarely used for decision-making and follow-up activities. Conclusions: Since mhealth only seems to be employed for limited uses and during limited phases of the care process, it is unlikely that it can really contribute to the creation of new care models. This under-utilization may depend on many issues, including the need for it to be embedded into broader information systems. If the purpose of introducing mhealth is to promote the adoption of integrated care models, using mhealth should not be limited to some activities or to some phases of the health care process. Instead, there should be a higher degree of pervasiveness at all stages and in all health care delivery activities

From Wage Rigidity to Labour Market Institution Rigidity: A Turning-Point in Explaining Unemployment?

In this paper we offer a critical discussion about the concept of labour market rigidity in the light of recent theoretical approaches that have aimed to provide sound micro-foundations to the presence of unemployment in market economies. We point out that the concept of labour market rigidity usually referred to in such theories has changed over time, involving in succession the rigidity of wages, contracts and labour market institutions. We also appraise the factors that lead labour market institutions rigidity, stressed by the search literature, to challenge the more widespread explanation of unemployment grounded on wage rigidity. Moreover, we analyse some theoretical and empirical issues that cast doubt on the ability to deal with unemployment, disentangling the role of institutional rigidities from that of wage stickiness

E-government e innovazione nei servizi pubblici

Dall’inizio di questo secolo si è assistito alla definizione di politiche di e-government da parte di molti governi Occidentali, tra cui l’Italia. Data la sempre maggiore rilevanza del tema, il capitolo ha l’obiettivo di analizzare il tema dell’e-government, contestualizzandolo nel panorama italiano. Partendo da un’analisi del ruolo dell’ICT nell’innovazione della pubblica amministrazione, si è posto in evidenza come, trattando di e-government, progressivamente, il focus si stia spostando dalle tecnologie al loro ruolo in un più ampio processo di cambiamento. Successivamente, si è andati ad analizzare come l’e-government risponde a due macro-obiettivi: l’informatizzazione del back-office, volta a garantire una maggiore efficienza della PA, e l’informatizzazione del front-office, in grado di garantire una maggior efficacia nell’erogazione dei servizi pubblici. Infine sono stati analizzati alcuni dei trend emergenti rispetto al tema dell’e-government, quali la gestione delle relazioni con i cittadini e la trasparenza, anche relativamente all’utilizzo di strumenti di open data government

Technological barriers of biomass gasification

This work deals with the main technological barriers which limit the commercial diffusion of biomass gasifiers. Five technological barriers have been identified. 1) The properties of biomass are variable so gasifiers require flexibility to process different kinds of feed. 2) The high moisture content of biomass limits the energetic efficiency of the process. 3) Problems arising from solid handling and management. 4) Biomass ash can form particulates and alkaline vapours. 5) The presence of tar in the gas can lead to fouling and plugging of the plant pipelines. Each barrier is discussed with concern on different gasifier configuration and end-use of the gas. In addition, since the tar abatement is a specific problem related to biomass gasification, a preliminary experimental study of tar thermal cracking is described. The tar and gas yields as well as the gas composition are reported as functions of temperature. The experimental results are then used to estimate kinetic parameters for the thermal cracking of gasification tars