Quality Assessment of Healthcare Databases

The assessment of data quality and suitability plays an important role in improving the validity and generalisability of the results of studies based on secondary use of health databases. The availability of more and more updated and valid information on data quality and suitability provides data users and researchers an useful tool to optimize their activities. In this paper, we have summarized and synthesized the main aspects of Data Quality Assessment (DQA) applied in the field of secondary use of healthcare databases, with the aim of drawing attention to the critical aspects having to be considered and developed for improving the correct and effective use of secondary sources. Four developing features are identified: standardizing DQA methods, reporting DQA methods and results, synergy between data managers and data users, role of Institutions. Interdisciplinarity, multi-professionality and connection between government institutions, regulatory bodies, universities and the scientific community will provide the "toolbox" for i) developing standardized and shared DQA methods for health databases, ii) defining the best strategies for disseminating DQA information and results

Ordenamiento urbanístico y diseño del edificio Administración Académica de la Facultad de Ciencias Económicas

Ordenamiento de la Facultad de Ciencias Económicas; diseño del edificio Administración Académic

Outpatient therapeutic chronic opioid consumption in Italy: a one-year survey.

BACKGROUND: In Italy since the 38/2010 law concerning Palliative Care and pain therapy has been promulgated, the consumption of opioids started increasing. However, despite the availability of a large amount of data regarding opioid prescription, a database including all patients on chronic opioid therapy does not yet exist. METHODS: Retrospective analysis of analgesic opioid consumption was performed between January 2013 and December 2013 using the data of national refunded medications for outpatients, collected by Italian Ministry of Health. We considered patients on chronic opioid therapy those patients with at least three opioids prescriptions in three consecutive months and/or six opioid prescriptions in six even not consecutive months in the observation period. We considered cancer patients those with neoplasm exemption code in the scheduled prescription and/or patients with at least one ROOs prescription (rapid onset opioids, approved in Italy for Break Through cancer Pain-BTcP- only). We also calculated the patient's morphine daily mean dose (MED) converting all prescribed opioids in equivalent of morphine using specific conversion tables. RESULTS: This census revealed a total of 422,542 patients in chronic therapy with opioids, of those 369.961 with chronic non-cancer pain and 52,581 with chronic cancer pain. This represents about 4% of the estimated requirement in Italy for both groups based on previous surveys regarding the prevalence of chronic pain. CONCLUSIONS: Relatively to MED, We found that in Italy chronic cancer pain patients receive doses similar to patients with cancer pain in other Literature reports, whereas patients with chronic non-cancer pain received lower dosages

Evidence That p-Cresol and IL-6 Are Adsorbed by the HFR Cartridge: Towards a New Strategy to Decrease Systemic Inflammation in Dialyzed Patients?

Introduction Hemodialysis (HD) and hemodiafiltration clear only with a low efficiency the plasma from interleukin-6 and p-cresol, two protein-bound uremic toxins associated with high cardiovascular risk in end stage renal disease. HFR Supra is a double-chamber hemodiafiltration system in which the ultrafiltrate returns to the patient after its regeneration through a resin cartridge that binds hydrophobic and protein-bound solutes. In the present study, we evaluated whether the HFR cartridge can also bind total p-cresol and IL-6 and remove them from the ultrafiltrate. Methods We compared the levels of IL-6 and p-cresol in ultrafiltrate samples collected at the inlet (UFin) and at the outlet (UFout) of the cartridge at the start or at the end of a 240 min HFR session in 12 inflamed chronic HD patients. The pro-inflammatory activity of the ultrafiltrate samples was also determined by evaluating the changes that they induced in IL-6 mRNA expression and protein release in peripheral blood mononuclear cells from 12 healthy volunteers. IL-6 and p-cresol circulating levels were also assessed in peripheral plasma blood samples collected before and after HFR and, for comparison, a control HD. Results p-Cresol and IL-6 were lower in UFout than in UFin both at the start and at the end of the HFR session, suggesting that they were retained by the cartridge. IL-6 mRNA expression and release were lower in PBMC incubated with UFout collected at the end than with UFin collected at the start of HFR, suggesting that passage through the cartridge reduced UF pro-inflammatory activity. Plasma total p-cresol decreased by about 53% after HFR, and 37% after HD. IL-6 circulating values were unmodified by either these dialysis procedures. Conclusions This study shows that the HFR-Supra cartridge retains total p-cresol and IL-6 in the ultrafiltrate and lowers plasma total p cresol but not IL-6 levels. Trial Registration ClinicalTrials.gov NCT0186577

L\u2019utilizzo dei farmaci analgesici oppiacei per il trattamento del dolore in Italia: un\u2019analisi empirica

The International association for the study of pain and the World medical association stated that receiving a fair treatment of pain is a right of each individual. Moderate or high intensity cases of pain are treated with opiates. In Italy, in 2010, a new legislation has been issued, one of the most advanced on the topic of the treatment of pain and the usage of opiates. Although the legislative progresses, the consumption of opiates is not so common and ranks far behind the other European countries. The analysis of the spread of opiates in the treatment of pain pointed out relevant differences in terms of gender, age, region, cancer, type of opioid prescribed. It should then take action to make consistent use of opiates in pain therapy, focusing in particular on cancer patients and territorial differences. The analysis of religiosity as a potential barrier to pain management and opiates usage allowed us to conclude, however, that it is a factor that influences the number of prescriptions of opiates, even if the moderate effect. Public policies should respect personal choices (also religious ones), but it is important broadcasting some appropriate information campaigns which allow to make independent and informed choices. Key words. Opioids, pain, religiosity. JEL classification. I18

EI Sistema de Clasificación de La National Library of Medicine Aplicado en la Biblioteca de la Facultad de Medicina de la UES

La finalidad principal del presente trabajo, tal como su nombre lo indica, es el análisis, investigación y aplicación practica del sistema de Clasificación de la National L1brary of Medicine (NLM), sistema utilizado en la Biblioteca de la Facultad de Medicina de la Un1versidad de El Salvador para la clas1ficacion del material bibliográfico que ella posee

Acuario en La Guardia, Pontevedra [Hojas Resumen]

Acuario en La Guardia, Pontevedr

Summer School “La rete, i cittadini e i diritti” Modulo J. Monnet (Fondi europei, Titolare avv. Sandro Di Minco).

La Summer School “La rete, i cittadini e i diritti” Modulo J. Monnet (Fondi europei, Titolare avv. Sandro Di Minco) è organizzata da Unicam in collaborazione con ITIS Divini di San Severino e Comune di San Severino, i giorni 16-31 luglio 2014. L'iniziativa gode del patrocinio della Commissione Europea, nel quadro dell'Azione Jean Monnet ed è articolata in due percorsi distinti, uno dedicato al Diritto del WEB e dei Social Network e l'altro alla Digitalizzazione dei servizi pubblici