Entropy production for velocity-dependent macroscopic forces: the problem of dissipation without fluctuations

In macroscopic systems, velocity-dependent phenomenological forces $F(v)$ are used to model friction, feedback devices or self-propulsion. Such forces usually include a dissipative component which conceals the fast energy exchanges with a thermostat at the environment temperature $T$, ruled by a microscopic Hamiltonian $H$. The mapping $(H,T) \to F(v)$ - even if effective for many purposes - may lead to applications of stochastic thermodynamics where an $incomplete$ fluctuating entropy production (FEP) is derived. An enlightening example is offered by recent macroscopic experiments where dissipation is dominated by solid-on-solid friction, typically modelled through a deterministic Coulomb force $F(v)$. Through an adaptation of the microscopic Prandtl-Tomlinson model for friction, we show how the FEP is dominated by the heat released to the $T$-thermostat, ignored by the macroscopic Coulomb model. This problem, which haunts several studies in the literature, cannot be cured by weighing the time-reversed trajectories with a different auxiliary dynamics: it is only solved by a more accurate stochastic modelling of the thermostat underlying dissipation.Comment: 6 pages, 3 figure

Socio-demographic aspects and therapeutic pathways in patients with rheumatoid arthritis in Italy

The research carried out by Censis Foundation, in collaboration with SIR (Italian Society of Rheumatology) and ANMAR (National Association of Rheumatic patients), with the sponsorship of Roche S.p.A., involved more than 600 patients, diagnosed with arthritis by a rheumatologist according to ACR criteria. The patients were recruited through a representative sample of 300 general practitioners. A number of different research and survey tools were used to collect data, helping to identify several of the problems that affect Italian patients: a survey form to be filled by the GPs, in order to verify the diagnosis and the comorbidity level; a questionnaire for the self-assessment of the disease activity, Rheumatoid Arthritis Disease Activity Index (RADAI), and a sociological questionnaire set up for the analysis of the main aspects of the patients' path. Among the most serious criticalities found, the difficulties and the time needed for the patients to get a clear AR diagnosis, the problems in interacting with health structures, and the differences in accessing pharmaceutical therapies (only a slight majority of patients use DMARDs drugs, a small amount takes biological drugs, while a large number of patients is treated exclusively with symptomatic drugs) stand out. The differences in patients' condition appear then to be exaggerated, regarding the chances to get an early diagnosis, the access path to specialised centres, and in receiving the most appropriate treatments. Moreover, these differences appear to be strongly dependent on both the social characteristics of the patients and the supply arrangement in their area

Health-related quality of life in patients with rheumatoid arthritis: assessment by a Italian version of the Arthritis Impact Measurement Scales, Version 2 (AIMS2)

The research carried out by Censis Foundation, in collaboration with SIR (Italian Society of Rheumatology) and ANMAR (National association of rheumatic patients) involved 646 patients, diagnosed with rheumatoid arthritis (RA) by a rheumatologist according to ACR criteria. The patients were recruited through a representative sample of 300 general practitioners (GP). A cross-sectional survey was conducted to study the current status of health-related quality of life (HRQL) of patients using a revised Italian version of a revised version of the Arthritis Impact Measurement Scales 2 (AIMS2). The AIMS2 was administered to the 646 patients with (RA) attending arthritis clinics at various hospitals across the country. Self-report functional disability scores were calculated for all 12 specific scales, summary components, and overall impact measures. The AIMS2 has been validated for the Italian language. Ranging from 0 (perfect health) to 10 (poor health), the mean scores of the AIMS2 showed an important impact of the disease on the 4 components of the health status of these patients: walking and bending, mean score = 5.1; nervous tension = 5.0, arthritis pain = 5.0, and social activity = 4.6. Among other dimensions, the impact of RA was moderate for mood, work, hand and finger function and mobility (mean score: 3.7, 3.7, 3.5 and 3.4, respectively) and low for household tasks, arm function, self-care tasks and family support (3.0, 2.9, 2.5 and 2.1, respectively). There was a tendency for the scores of younger patients to be better than those of olders patients. In conclusion, RA have a clearly detrimental effect on the HRQL in both physical and mental components. Prevention and management of physical disability should be seriously planned in consideration of the changes in these conditions in RA patients. Use of the AIMS2 makes it easier and less costly to collect data and reduces the burden on RA patients

Meeting the governance challenges of integrated health and social care

Background Many countries are experimenting with novel ways of organising and delivering more integrated health and social care. Governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration. Methods Cross-country case analysis involving document review and semi-structured interviews with 27 local, regional and national level stakeholders in Italy, the Netherlands and Scotland. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to structure our analytical enquiry to explore factors that influence the governance arrangements in each system. Results Governance arrangements ranged from informal agreements in the Netherlands to mandated integration in Scotland. Novel service models were generally participative involving a wide range of stakeholders, including the public, although integration was seen to be driven, largely, from a health perspective. In Italy and Scotland some reversion to ‘command & control’ was reported in response to the imperatives of the Covid-19 pandemic. Policies, budgets, auditing and reporting systems that are clearly aligned at all levels were seen to help with implementing innovations in service organisation. Where alignment was lacking, cooperation and integration was suboptimal, regardless of whether governance arrangements were statutory or not. There was wide recognition of the importance of buy-in. Enablers of greater engagement included visible leadership, time and long-standing working relationships. Lack of suitable indicators and openness to data sharing to measure integration hindered working relationships and thus the successful delivery of integrated services. Conclusions Our study provides important insights into how to more effectively and efficiently govern service delivery structures within care systems. We will discuss approaches to governance that help support more resilient integrated care systems. Key messages • Different governance arrangements face common challenges to greater integration of care. Enablers include strong leadership, inclusivity and openness to work across traditional boundaries. • Meeting the governance challenges of integrated health and social care requires clear lines of accountability, aligned policies, budgets and reporting systems

Play and the exhibition:the problematic fun of showcasing of videogames in informal and formal contexts

Video games are inherently problematic as cultural artefacts, presenting issues of stability, currency, interaction and participation (to name but a few) in their curation. These issues are not necessarily unique to video games in an exhibition context, but their combination with the on-going debate about the status of video games as an art form inspire discussion and debate. Despite the issues presented by video games, there have been countless video game exhibitions in formal and informal contexts, typically focussing upon the historical narrative around games or their position as artefacts with cultural value. It is only in the last few years that artistic and academic study of this problematic field has developed traction, through both an emerging body of literature looking to formalise video games exhibitions practices and practitioner debate. 2019 sees the inaugural Game Arts International Assembly “a think tank for the international games arts ecosystem” bringing together leading curators and makers working at the forefront of public display of interactive arts and playful media.This paper contributes to the developing body of knowledge which analyses video games exhibition methods by formalising and evaluating the methods utilised within informal and formal contexts of video games exhibition from the perspective of reception theory. The study of both large scale exhibition such as those orchestrated by the Victoria and Albert museum and the Smithsonian American Art Museum alongside the one night indie game night or play party is a unique contribution to the field, with studies typically focussing on approaches within one given context. Reception theory provides a lens through which the active participative role of the attendee or visitor in meaning making can be evaluated and allows consideration of the connection between selected methods of exhibition and the resulting meaning making opportunities possible for a range of potential audiences

The Role of Openness in the Effect of ICT on Governance

The study investigates how openness influences information and communication technology (ICT) penetration for improved government quality in sub-Saharan Africa for the period 2000–2012. Openness is measured in terms of trade and financial globalization whereas ICT is proxied with mobile phone and internet penetration rates. Ten bundled and unbundled governance indicators are used. The empirical evidence is based on Generalised Method of Moments with forward orthogonal deviations. The main findings are First, financial openness has an edge over trade openness when combined with ICT to affect both economic and institutional governance. Second, mobile phones have an edge over internet penetration in complementing (i) trade openness for economic governance and (ii) financial openness for institutional governance. Third, net effects on political governance are consistently negative. Taken together, in the short-run, openness-driven ICT policies are more rewarding in terms of economic and institutional governance than political governance. Fourth, catch-up in governance is facilitated by the interaction between openness and ICT. Contributions of these findings to literature are discussed

Determinants and consequences of international migration

This chapter provides a simple overview of the canonical model of international migration, discusses the consequences of migration on both sending and receiving countries and draws some considerations on future research prospects for the international migration literature