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Ciullo A.,University of Bologna | Viglione A.,Vienna University of Technology | Castellarin A.,University of Bologna | Crisci M.,CNR Institute for Research on Population and Social Policies | Di Baldassarre G.,Uppsala University
Hydrological Sciences Journal | Year: 2017

This work aims to provide a dynamic assessment of flood risk and community resilience by explicitly accounting for variable human behaviour, e.g. risk-taking and awareness-raising attitudes. We consider two different types of socio-hydrological systems: green systems, whereby societies deal with risk only via non-structural measures, and technological systems, whereby risk is dealt with also by structural measures, such as levees. A stylized model of human–flood interactions is first compared to real-world data collected at two test sites (People’s Republic of Bangladesh and the city of Rome, Italy) and then used to explore plausible trajectories of flood risk. The results show that flood risk in technological systems tends to be significantly lower than in green systems. However, technological systems may undergo catastrophic events, which lead to much higher losses. Furthermore, green systems prove to be more resilient than technological ones, which makes them more capable of withstanding environmental and social changes. © 2017 IAHS

Nobile M.,CNR Institute for Research on Population and Social Policies | Pecoraro F.,CNR Institute for Research on Population and Social Policies
GL-Conference Series: Conference Proceedings | Year: 2013

This paper presents IRPPS Editoria Elettronica, an e-publishing service developed by the Institute for Research on Population and Social Policies (IRPPS) of the Italian National Research Council (CNR). Its aim is reorganize the Institute scientific editorial activity, manage its in-house publications and diffuse its scientific results. In particular this paper focuses on: the IRPPS editorial activities, the platform used to develop the service, the publishing process and the web portal developed.

Francisci S.,Instituto Superiore Of Sanita | Guzzinati S.,Instituto Oncologico Veneto IRCCS | Mezzetti M.,University of Rome Tor Vergata | Crocetti E.,Registro Tumori della Regione Toscana ISPO | And 4 more authors.
BMC Cancer | Year: 2013

Background: Due to changes in cancer-related risk factors, improvements in diagnostic procedures and treatments, and the aging of the population, in most developed countries cancer accounts for an increasing proportion of health care expenditures. The analysis of cancer-related costs is a topic of several economic and epidemiological studies and represents a research area of great interest to public health planners and policy makers. In Italy studies are limited either to some specific types of expenditures or to specific groups of cancer patients. Aim of the paper is to estimate the distribution of cancer survivors and associated health care expenditures according to a disease pathway which identifies three clinically relevant phases: initial (one year following diagnosis), continuing (between initial and final) and final (one year before death).Methods: The methodology proposed is based on the reconstruction of patterns of care at individual level by combining different data sources, surveillance data and administrative data, in areas covered by cancer registration.Results: A total colorectal cancer-related expenditure of 77.8 million Euros for 18012 patients (corresponding to about 4300 Euros per capita) is estimated in 2006 in two Italian areas located in Tuscany and Veneto regions, respectively. Cost of care varies according to the care pathway: 11% of patients were in the initial phase, and consumed 34% of total expenditure; patients in the final (6%) and in the continuing (83%) phase consumed 23% and 43% of the budget, respectively. There is an association between patterns of care/costs and patients characteristics such as stage and age at diagnosis.Conclusions: This paper represents the first attempt to attribute health care expenditures in Italy to specific phases of disease, according to varying treatment approaches, surveillance strategies and management of relapses, palliative care. The association between stage at diagnosis, profile of therapies and costs supports the idea that primary prevention and early detection play an important role in a public health perspective. Results from this pilot study encourage the use of such analyses in a public health perspective, to increase understanding of patient outcomes and economic consequences of differences in policies related to cancer screening, treatment, and programs of care. © 2013 Francisci et al.; licensee BioMed Central Ltd.

Francisci S.,Instituto Superiore Of Sanita | Robin Yabroff K.,U.S. National Cancer Institute | Gigli A.,CNR Institute for Research on Population and Social Policies | Mariotto A.,U.S. National Cancer Institute | And 2 more authors.
Annali dell'Istituto Superiore di Sanita | Year: 2013

Objectives: Cancer accounts for a major proportion of national health expenditures, which are expected to increase in the future. This paper aims to identify major challenges with estimating cancer related costs, and discuss international comparisons, and recommendations for future research. Methods: It starts from the experience of an international workshop aimed at comparing cancer burden evaluation methods, improving results comparability, discussing strengths and criticisms of different approaches. Results: Three methodological themes necessary to inform the analysis are identified and discussed: data availability; costs definition; epidemiological measures. Conclusions: Cost evaluation is applied to cancer control interventions and is relevant for public health planners. Despite their complexity, international comparisons are fundamental to improve, generalize and extend cost evaluation to different contexts.

D'Ulizia A.,CNR Institute for Research on Population and Social Policies | Ferri F.,CNR Institute for Research on Population and Social Policies | Grifoni P.,CNR Institute for Research on Population and Social Policies
Artificial Intelligence Review | Year: 2011

The high complexity of natural language and the huge amount of human and temporal resources necessary for producing the grammars lead several researchers in the area of Natural Language Processing to investigate various solutions for automating grammar generation and updating processes. Many algorithms for Context-Free Grammar inference have been developed in the literature. This paper provides a survey of the methodologies for inferring context-free grammars from examples, developed by researchers in the last decade. After introducing some preliminary definitions and notations concerning learning and inductive inference, some of the most relevant existing grammatical inference methods for Natural Language are described and classified according to the kind of presentation (if text or informant) and the type of information (if supervised, unsupervised, or semi-supervised). Moreover, the state of the art of the strategies for evaluation and comparison of different grammar inference methods is presented. The goal of the paper is to provide a reader with introduction to major concepts and current approaches in Natural Language Learning research. © 2011 Springer Science+Business Media B.V.

Caschera M.C.,CNR Institute for Research on Population and Social Policies | Ferri F.,CNR Institute for Research on Population and Social Policies | Grifoni P.,CNR Institute for Research on Population and Social Policies
IEEE Transactions on Systems, Man, and Cybernetics Part A:Systems and Humans | Year: 2013

The pervasiveness of ambiguity in communication processes suggests addressing the problem of semantic and syntactic ambiguities in multimodal interaction languages. This paper presents an integrated model based on layered, hierarchical, and hidden Markov models for dealing with the complex process of multimodal ambiguity resolution. The proposed model consists of different levels, from the terminals of a multimodal language (terminal elements) to the level of multimodal sentences. A software module implemented the model that has been evaluated in terms of accuracy and robustness. The experimental results show good levels of accuracy and robustness compared with other existing approaches. © 2013 IEEE.

PubMed | University of Rome La Sapienza, CNR Institute for Research on Population and Social Policies and University of Cagliari
Type: Journal Article | Journal: PloS one | Year: 2015

This study analyzes data sharing regarding mitochondrial, Y chromosomal and autosomal polymorphisms in a total of 162 papers on ancient human DNA published between 1988 and 2013. The estimated sharing rate was not far from totality (97.6% 2.1%) and substantially higher than observed in other fields of genetic research (evolutionary, medical and forensic genetics). Both a questionnaire-based survey and the examination of Journals editorial policies suggest that this high sharing rate cannot be simply explained by the need to comply with stakeholders requests. Most data were made available through body text, but the use of primary databases increased in coincidence with the introduction of complete mitochondrial and next-generation sequencing methods. Our study highlights three important aspects. First, our results imply that researchers awareness of the importance of openness and transparency for scientific progress may complement stakeholders policies in achieving very high sharing rates. Second, widespread data sharing does not necessarily coincide with a prevalent use of practices which maximize data findability, accessibility, useability and preservation. A detailed look at the different ways in which data are released can be very useful to detect failures to adopt the best sharing modalities and understand how to correct them. Third and finally, the case of human paleogenetics tells us that a widespread awareness of the importance of Open Science may be important to build reliable scientific practices even in the presence of complex experimental challenges.

PubMed | University of Piemonte Orientale, CNR Institute for Research on Population and Social Policies, Diabetology Center, University of Rome Tor Vergata and 2 more.
Type: Journal Article | Journal: BMJ open diabetes research & care | Year: 2016

Diabetes mellitus (DM) is a chronic-degenerative disease associated with a high risk of chronic complications and comorbidities. The aim of this study is to estimate the average annual cost incurred by the Italian National Health Service (NHS) for the treatment of DM stratified by patients comorbidities. Moreover, the model estimates the economic impact of implementing good clinical practice for the management of patients with DM.Data were extrapolated from administrative database of the Marche Region and specific inclusion and exclusion criteria were developed from a clinical board in order to estimate patients with DM only, DM+1, DM+2, DM+3 and DM+4 comorbidities (cardiovascular disease, neuropathy, nephropathy and retinopathy). Regional data were considered a good proxy for implementing a previously developed cost-of-illness (COI) model from Italian NHS perspective already published. A scenario analysis was considered to estimate the economic impact of good clinical practice implementation in the treatment of DM and its comorbidities in Italy.The model estimated an average number of patients with DM per year in the Marche region of 85.909 (5.5% of population) from 2008 to 2011. The mean costs per patients with DM only, DM+1, DM+2, DM+3 and DM+4 comorbidities were 341, 1,335, 2,287, 5,231 and 7,085 respectively. From the Italian NHS perspective, the total economic burden of DM in Italy amounted to 8.1. billion/year (22% for drugs, 74% for hospitalization and 4% for visits). Scenario analysis demonstrates that the implementation of good clinical practice could save over 700 million per year.This model is the first study that considers real world data and COI model to estimate the economic burden of DM and its comorbidities from the Italian NHS perspective. Integrated management of the patients with DM could be a good driver for the reduction of the costs of this disease in Italy.

PubMed | CNR Institute for Research on Population and Social Policies, University of Rome Tor Vergata, Janssen Cilag SpA Italia, University of Rome La Sapienza and University of Palermo
Type: Journal Article | Journal: Clinical drug investigation | Year: 2016

In Italy, the Italian Pharmaceutical Agency (AIFA) criteria used F3-F4 fibrosis stages as the threshold to prioritise the treatment with interferon (IFN)-free regimens, while in genotype 1 chronic hepatitis C (G1 CHC) patients with fibrosis of liver stage 2, an approach with pegylated interferon (PEG-IFN)-based triple therapy with simeprevir was suggested. The key clinical question is whether, in an era of financial constraints, the application of a universal IFN-free strategy in nave G1 CHC patients is feasible within a short time horizon. The aim of this study is to perform an economic analysis to estimate the cost-utility of the early innovative therapy in Italy for managing hepatitis C virus (HCV)-infected patients.The incremental cost-utility analysis was carried out to quantify the benefits of the early treatment approach in HCV subjects. A Markov simulation model including direct and indirect costs and health outcomes was developed from an Italian National Healthcare Service and societal perspective. A total of 5000 Monte Carlo simulations were performed on two distinct scenarios: standard of care (SoC) which includes 14,000 genotype 1 patients in Italy treated with innovative interferon-free regimens in the fibrosis of liver stages 3 and 4 (F3-F4) versus early-treatment scenario (ETS) where 2000 patients were additionally treated with simeprevir plus PEG-IFN and ribavirin in the fibrosis stage 2 (F2) (based on Italian Medicines Agency AIFA reimbursement criteria). A systematic literature review was carried out to identify epidemiological and economic data, which were subsequently used to inform the model. Furthermore, a one-way probabilistic sensitivity was performed to measure the relationship between the main parameters of the model and the cost-utility results.The model shows that, in terms of incremental cost-effectiveness ratio (ICER) per quality adjusted life year (QALY) gained, ETS appeared to be the most cost-utility option compared with both perspective societal (ICER=EUR11,396) and NHS (ICER=EUR14,733) over a time period of 10years. The cost-utility of ETS is more sustainable as it extends the time period analysis [ICER=EUR 6778 per QALY to 20years and EUR4474 per QALY to 30years]. From the societal perspective, the ETS represents the dominant option at a time horizon of 30years. If we consider the sub-group population of treated patients [16,000 patients of which 2000 not treated in the SoC, the ETS scenario was dominant after only 5years and the cost-utility at 2years of simulation. The one-way sensitivity analysis on the main variables confirmed the robustness of the model for the early-treatment approach.Our model represents a tool for policy makers and health-care professionals, and provided information on the cost-utility of the early-treatment approach in HCV-infected patients in Italy. Starting innovative treatment regimens earlier keeps HCV-infected patients in better health and reduces the incidence of HCV-related events; generating a gain both in terms of health of the patients and correct resource allocation.

PubMed | CNR Institute for Research on Population and Social Policies, Tufts Medical Center and CNR Institute of Clinical Physiology
Type: | Journal: Italian journal of pediatrics | Year: 2016

Congenital hearing loss is the most frequent birth defect. The American Academy of Pediatrics and the Joint Committee on Infant Hearing established quality of care process indicators for Universal Newborn Hearing Screening starting from 1999. In a previous systematic review of Universal Newborn Hearing Screening studies we highlighted substantial variability in program design and in reported performance data. In order to overcome these heterogeneous findings we think it is necessary to optimize the implementation of Universal Newborn Hearing Screening programs with an appropriate application of the planning, executing, and monitoring, verifications and reporting phases. For this reason we propose a conceptual framework that logically integrates these three phases and, consequently, a tool (a check-list) for their rationalization and standardization.Our paper intends to stimulate debate on how to ameliorate the routine application of high quality Universal Newborn Hearing Screening programs. The conceptual framework is proposed to optimize, rationalise and standardise their implementation. The checklist is intended to allow an inter-program comparison by removing heterogeneity in processes description and assessment.

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