scholarly journals Malnutrizione associata a patologie, una problematica da risolvere

2002 ◽  
Vol 3 (3) ◽  
pp. 147-160
Author(s):  
Mario Eandi ◽  
Lorenzo Pradelli ◽  
Augusta Palmo
Keyword(s):  
Clinical Outcomes ◽  
Health Professionals ◽  
Tube Feeding ◽  
General Medicine ◽  
Cost Benefit ◽  
Industrialized Countries ◽  
Nutritional Interventions ◽  
Hospital Stays ◽  
Prolonged Hospital ◽  
The Cost

Disease-related malnutrition, the most frequent cause of undernourishment in industrialized countries, appears to be highly prevalent among western patient populations, interesting up to 60% of the hospitalized and almost one fifth of the persons attending to the general medicine service. There are several reasons for this high prevalence, among which pathology-related causes, inadequate presentation of the meals in hospitals and institutions, and low recognition of nutritional problems by health professionals. Several studies have shown that undernourished patients have higher morbidity and mortality rates than the general population and suffer of more and more severe complications, leading to prolonged hospital stays and worse clinical outcomes. This determines a much higher Health costs, estimated in an English study as a yearly additional burden of over 7 billion £ for the National Heath Service. Nutritional interventions, such as the administration of oral supplements or enteral tube feeding, are capable to increase body mass index (BMI), that is considered the most reliable indicator of the nutritional status, muscle strength and overall psycho-physical performance, determining an improved quality of life and a reduced need for medical assistance. These functional improvements go alongside with better clinical outcomes, as shown by a reduced mortality rate, shorter hospital stays and lower incidence of complications observed after supplementation. Studies that have analyzed the economical impact of nutritional supplementation in terms of cost-benefit have shown that the cost of enteral nutritional interventions is almost negligible when compared to the associated savings in the production of the health service, mainly determined by lower hospitalization rates, shorter hospital stays, reduced costs for the treatment of complications and for the consultation of specialists. Greater awareness of the health professionals and more encouraging health policies toward nutritional interventions are required to reduce the clinical and economical impact of this unnecessarily wide-spread condition.

scholarly journals Optimizing foods for special dietary use in Canada: key outcomes and recommendations from a tripartite workshop

2019 ◽  
Vol 44 (11) ◽  
pp. 1258-1265
Author(s):  
Ashleigh K.A. Wiggins ◽  
Andrea Grantham ◽  
G. Harvey Anderson
Keyword(s):  
Tube Feeding ◽  
Infant Food ◽  
Nutritional Recommendations ◽  
Hospital Patients ◽  
Drug Regulations ◽  
Stakeholder Workshop ◽  
Nutritional Needs ◽  
Hospital Stays ◽  
Multi Stakeholder ◽  
Prolonged Hospital

Many health conditions result in unique nutritional requirements (e.g., protein restriction, low energy, fortification) and the need to consume foods in nontraditional formats (e.g., liquid diets, supplements, tube feeding). In Canada, 45% of hospital patients are malnourished upon admission, resulting in prolonged hospital stays, increased health care costs, and higher mortality rates. Fortunately, advances in nutrition and food science enabled the development of products that provide nutritional support for individuals in hospital and at home. In Canada, these products are defined as Foods for Special Dietary Use (FSDUs). Canada’s regulation of FSDUs (Division 24 of the Food and Drug Regulations) is particularly stringent and outdated, which results in products that do not meet current nutritional recommendations or allow application of current technologies, and lack harmonization with other countries. Many of these issues also apply to the Infant Food regulations in Canada. To provide vulnerable populations with optimal nutrition, experts have suggested modernization of Canadian FSDU regulations. A multi-stakeholder workshop established several recommendations and goals toward that end while ensuring the safety of consumers. These include (i) assessing other jurisdictions’ regulations; (ii) tracking products currently on the market; (iii) temporary marketing authorizations to permit products on the market and collect data; (iv) use of incorporation by reference for compositional requirements; (v) support for research of FSDU and nutritional needs of special population; and (vi) better understanding accessibility to these products. Overall, the proposed vision is for a modern, safe, flexible, innovative, and health-driven regulatory framework for FSDU in Canada.

scholarly journals Scope and limits of the obligations of health workers during a pandemic

2021 ◽  
Vol 5 (2) ◽  
pp. 39-43
Author(s):  
Jennifer Hincapie Sanchez
Keyword(s):  
Risk Factors ◽  
Health Professionals ◽  
Health Personnel ◽  
Health Workers ◽  
Cost Benefit ◽  
The Cost

The obligation to provide services, by health professionals, in a pandemic such as that caused by the SARS-Cov-2 virus is not unlimited; it is essential to take into account the risk factors of health personnel, in the event of absence and / or death, the cost benefit, the consideration of their vulnerability as being human and social being susceptible to being infected and infecting their family nucleus. That’s why it’s important to know that medicine is a humanitarian profession with deontological demands that transcend the moral plane.

How Do We Know What Is Normal?

2020 ◽  
pp. 161-172
Author(s):  
Joel Paris
Keyword(s):  
Early Intervention ◽  
Early Diagnosis ◽  
General Medicine ◽  
Cost Benefit ◽  
Normal Range ◽  
Benefit Ratio ◽  
Negative Side ◽  
Cost Benefit Ratio ◽  
The Cost

Establishing the boundaries of disease with normality is somewhat easier in general medicine than in psychiatry. This chapter reviews the various definitions of normality and examines their strengths and weaknesses. It will reflect the concerns of many observers that the medicalization of human experiences can pathologize normality. It will also present a critique of an emphasis on early diagnosis, which extends the boundaries of psychiatry by treating people who are functioning within a normal range, and for whom the cost-benefit ratio of early intervention may weigh more on the negative side. Examples from general medicine are presented in which this scenario has also been played out.

Developing a Quality Improvement Feeding Program for NICU Patients

NeoReviews ◽  
2022 ◽  
Vol 23 (1) ◽  
pp. e23-e35
Author(s):  
Erika K. Osborn ◽  
Sudarshan R. Jadcherla
Keyword(s):  
Quality Improvement ◽  
Clinical Outcomes ◽  
Preterm Infants ◽  
Tube Feeding ◽  
Practice Variation ◽  
Oral Feeding ◽  
Evidence Based ◽  
Feeding Difficulties ◽  
Feeding Program ◽  
Hospital Stays

Practices in NICUs vary widely, particularly when clinical decisions involve complex tasks and multiple disciplines, which occurs with feeding preterm infants. Neonatal feeding difficulties in preterm infants often lead to prolonged tube feeding and therefore lengthened hospital stays. Education and compliance with evidence-based protocols and guidelines are needed on the initiation of feedings and feeding advancement to transform enteral and oral feeding practices and thus reduce practice variation and improve clinical outcomes.

scholarly journals Consideration of climate change-induced corrosion by structural codes

2021 ◽  
Author(s):  
Maria Nogal ◽  
Emilio Bastidas-Arteaga ◽  
Helena Maria dos Santos Gervásio
Keyword(s):  
Climate Change ◽  
Service Life ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
Industrialized Countries ◽  
Problem Design ◽  
The Cost ◽  
New Generation ◽  
The Impact

<p>The impact of climate change on ambient temperature and relative humidity along with the present CO2 levels are speeding the corrosion process of reinforced concrete structures. The alarming cost of the associated reduction of the service life of structures, which is estimated to cost 3% to 4% of the Gross Domestic Product (GDP) of industrialized countries, has put the spotlight on the importance of introducing the issue of climate change on the new generation of Eurocodes. Amongst the strategies to tackle the problem, design-phase measures seem not to be always cost- effective, nevertheless, measures during service-life are generally the most expensive. This paper discusses the potential strategies to be addressed by structural codes to tackle the problem of climate change-induced corrosion, considering aspects such as the cost-benefit analysis, viability, and the large uncertainty involved in climate change evolution.</p>

Plasma Exchange: The Cost/benefit Ratio and the Critical Revision of Indications

1993 ◽  
Vol 16 (5_suppl) ◽  
pp. 173-176 ◽  
Author(s):  
M. Valbonesi ◽  
G. Florio ◽  
G. Lercari ◽  
P. Carlier ◽  
M.R. Ruzzenenti ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Cost Benefit ◽  
Therapeutic Modality ◽  
Benefit Ratio ◽  
Therapeutic Procedures ◽  
Acute Renal Insufficiency ◽  
Cost Benefit Ratio ◽  
Hospital Stays ◽  
Critical Revision ◽  
The Cost

The number of conditions that can benefit from Plasma-Exchange (PE) continues to grow. We have recently added to the list the Cyclosporin-A induced hypertrygliceridemia and myoglobinuric acute renal insufficiency. Such as any therapeutic measure for PE, four evolutive phases can be recognized: the discovery and research, the confirmation of indications, the routine applications and the decline, when new more powerful tools are offered by culture or technology. We have participated in the first three phases during the last 20 years. Not necessarily all experiences were favourable. Nonetheless, we feel that, for the time being, a hemapheresis unit is an absolute necessity for a medium - sized hospital even if only therapeutic procedures are carried out. The phase four, decline of interest and applications, cannot be foreseen. Finally the ability of PE to shorten substantially the length of hospital stays along with the ease with which procedure can be performed on ambulatory patients, substantiate a favourable cost/benefit ratio for this therapeutic modality.

Economic Evaluation of Pharmacologic Therapy

1986 ◽  
Vol 20 (7-8) ◽  
pp. 594-596 ◽  
Author(s):  
Walter L. Hill
Keyword(s):  
Cost Effectiveness ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
National Average ◽  
Economic Effects ◽  
Pharmacologic Therapy ◽  
Benefit Analysis ◽  
Average Hospital ◽  
Hospital Stays ◽  
The Cost

Cost-benefit and cost-effectiveness analyses are defined and described, particularly as they apply to evaluating costs in pharmacologic therapy. The cost-benefit analysis (CBA) approach is used to compare dissimilar alternatives, whereas the cost-effectiveness (CEA) approach compares similar alternatives with similar objectives. A CBA, for instance, will demonstrate the economic effects of a program and can thus be used as a tool to compare the outcomes of several programs. A CEA, on the other hand, can help determine which of several alternatives is the least costly in achieving a stated objective. A CEA approach was used to examine results of clinical trials with cefoxitin or piperacillin in 86 patients undergoing intraabdominal surgery at two institutions. Results of multivariate analysis showed that patients who had received piperacillin had significantly shorter hospital stays (1.59 days) than those who had received cefoxitin. Based on national average hospital per diem rates, piperacillin patients were said to have saved $680 compared with patients treated with cefoxitin. Moreover, piperacillin was less expensive than cefoxitin.

scholarly journals Testing as an approach to control the Corona epidemic dynamics and avoid lockdowns

2021 ◽  
Vol 18 (1) ◽  
pp. 1-24
Author(s):  
Thomas Gries ◽  
Paul J. J. Welfens
Keyword(s):  
Crucial Role ◽  
Cost Benefit Analysis ◽  
National Income ◽  
Cost Benefit ◽  
Industrialized Countries ◽  
Testing Strategy ◽  
Epidemic Dynamics ◽  
Standard Cost ◽  
Testing Approach ◽  
The Cost

AbstractVaccinations, lockdowns and testing strategies are three potential elements of an effective anti-coronavirus, and in particular Covid-19, health policy. The following analysis considers - within a simple model - the potentially crucial role of a Corona testing approach in combination with a quarantine approach which is shown herein to be a substitute for broad lockdown measures. The cost of lockdowns/shutdowns are rather high so that – beyond progress in terms of a broad vaccination program – a rational testing strategy should also be carefully considered. Testing has to be organized on the basis of an adequate testing infrastructure which could largely be implemented in firms, schools, universities and public administration settings. As regards the cost of a systematic broad Covid-19 testing strategy, these could come close to 0.5% of national income if there are no vaccinations. The Testing & Quarantine approach suggested here – with tests for symptomatic as well as asymptomatic people - is based on a random sampling and would require rather broad and frequent testing; possibly one test per person every 7–10 days. At the same time, one should consider that the cost of further lockdowns/shutdowns of a duration of 1 month could be very high, such that a standard cost benefit analysis supports the testing approach suggested herein. Also, an optimal policy mix could be designed where both vaccinations and testing play a crucial role. As of late January 2021, no further lockdowns in Germany and other OECD countries would be necessary if a broad testing infrastructure can be established rather quickly. This in turn will reinforce economic optimism and help to jumpstart economic growth in Europe, the US and Asia in a solid way. The basic logic of the testing approach pointed out here for industrialized countries could also be applied in developing countries. The approach presented is complementary to the IMF analysis of Cherif/Hasanov.

Hostile Takeovers and Anti-takeover Defenses in the Russian Corporate Market

2007 ◽  
pp. 70-84 ◽  
Author(s):  
E. Demidova
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Hostile Takeovers ◽  
Russian Market ◽  
Takeover Defenses ◽  
The Cost ◽  
European Markets

This article analyzes definitions and the role of hostile takeovers at the Russian and European markets for corporate control. It develops the methodology of assessing the efficiency of anti-takeover defenses adapted to the conditions of the Russian market. The paper uses the cost-benefit analysis, where the costs and benefits of the pre-bid and post-bid defenses are compared.

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