Structural reforms in the european union after the global crisis: problems and prospects

In the perspective of a successful exit from the recent global crisis, the debate on the long-term programmes of structural reforms in the EU countries has gradually revived. However, similarly to the pre-crisis experience, the path of structural reforms continues to appear fraught with difficulties. On the basis of the extensive literature grounded on the political economy and public choice approaches, this paper analyses why the decision-making process of structural reforms is usually very difficult even though they lead to a more efficient allocation of resources and boost long-run growth. Finally, the paper points out how the progress of a country’s structural reforms may be strongly influenced by political, institutional and economic factors contributing to define the framework in which policy makers interact with the national community in its various forms, the lobbies and more in general the organized special interest groups

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

The difficult path of structural reforms in the European Union

In the expectation of a successful and definitive exit from the recent global crisis, the debate on the long-term programmes of structural reforms in the European Union has gradually revived. It is a widely shared view that the scant economic dynamism characterizing a number of member countries in recent decades is largely due to widespread structural weaknesses. However, similarly to the pre-crisis experience, the path of structural reforms continues to appear fraught with difficulties. On the basis of the extensive literature grounded on political economy and public choice approaches, this paper analyses why the decision-making process of structural reforms is usually very difficult even though, at least potentially, they lead to a more efficient allocation of resources and boost long-run growth. Finally, the paper points out how the path of a country’s structural reforms may be strongly influenced by political, institutional, and economic factors contributing to the definition of a framework in which policy makers interact with the national community in its various forms, lobbies and, more generally, organized special interest groups

The Law of One Price: further empirical evidence concerning Italy and the United Kingdom

Test disaggregato della ipotesi della 'legge del prezzo unico' nel settore manifatturiero per due paesi industrializzati, Italia e Regno Unito, nel corso degli anni settanta

Alcune riflessioni sull'approccio monetario alla determinazione del tasso di cambio

Analisi del contributo teorico dell' 'approccio monetario' alla comprensione dell'influenza che i mercati monetari e finanziari e le aspettative che su di essi si determinano esercitano sulla dinamica della bilancia deipagamenti e del tasso di cambi

The roots of the international monetary fund's difficulties: The pioneering contribution of Federico Caffè

The paper restates and evaluates Federico Caffè's sharp and accurate analysis of the major shortcomings that have prevented the international monetary fund from carrying out its mandate efectively. it argues that cafè explained the often disappointing performance of the fund, throughout its existence, in terms of policies that progressively drifted away from the inspiring principles of its founders, particularly Keynes. In particular, the paper suggests that Caffè's work is rich in insights and anticipations of subsequent developments due, above all, to his analysis of some severe weaknesses of the Fund's governance system, which have kept the Fund from accomplishing its goal of fostering international inancial cooperation