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The rise of the mean age incremented the occurrence of femur fractures with respect to the past, leading thus to serious consequences, as regards morbidity and socio-economic impact. The direction of the A.O.R.N. Cardarelli of Naples has introduced a DTAP whose aim was the reduction of LOS. The paper aims to discuss this issue.

The aim of this paper is to analyze the introduction of DTAP, employing Lean Thinking and Six Sigma methodology based on the DMAIC cycle. To evaluate the effectiveness of DTAP, two groups of patients have been observed for 14 months (before and after the implementation of DTAP).

Statistical tests were performed on the groups and graphics were provided to visualize the decrease of LOS (29.9 per cent). The overall population was also divided in subgroups according to six variables potentially influencing LOS.

Authors considered six variables of influences; yet, others could be taken into account in the future.

The decrease of costs due to the management of elderly patients with femur fracture, the optimization of care processes in hospitals and a faster recovery for patients is the tangible contribute of DTAP.

The implementation of DTAP allowed the hospital to obtain a significant reduction of LOS with a consequently decrease of costs alleviating the hospital and the society from the socio-economic burden and the morbidity of this pathology.

The best treatment for femur fractures is the surgical one within 48 h from the admission to the hospital. These fractures have serious consequences, both in terms of morbidity and socio-economic impact. In the hospital A.O.R.N. Cardarelli of Naples in Italy, the mean pre-operative length of hospital stay (LOS) was nine days and just 4 per cent of patients was operated within the suggested time. Therefore, a diagnostic-therapeutic-assistance path (DTAP) was implemented to improve the process.

This paper analyzes two groups of patients (534 and 562, respectively) before and after the introduction of DTAP, through six sigma (SS) based on define, measure, analyze, improve and control cycle. Age, gender, American Society of Anaesthesiologists (ASA) score, cardiovascular diseases, diabetes and allergies were used as independent subgrouping variables. The t-tests and chi-square were performed to compare the groups, tools of SS were used.

The analyses were conducted considering overall patients and some subgroups. The overall reduction in LOS was about 54 per cent, patients without cardiovascular diseases and with a low ASA score had the highest reduction, more than 60 per cent. All the p-values proved a high statistically significant difference between the two groups.

The influence of the Italian health-care system is a minor limitation while, unfortunately, the lack of a follow-up did not allow quantifying the real gain in health of patients. A lean thinking analysis would suit this context.

There are practical advantages for both hospital and patients: the hospital will have an increase in admissions and more beds available, while patients will benefit of a faster intervention and a shorter wait.

This is the first analysis through SS of DTAP showing its positive influences in terms of both socio-economic impact and patients’ outcome. Policy leaders could use this study as an example to evaluate the introduction of the same clinical pathway in other health facilities.

This paper aims to study the problem of the steady plane oblique stagnation-point flow of an electrically conducting Newtonian fluid impinging on a heated vertical sheet. The temperature of the plate varies linearly with the distance from the stagnation point.

The governing boundary layer equations are transformed into a system of ordinary differential equations using the similarity transformations. The system is then solved numerically using the “bvp4c” function in MATLAB.

An exact similarity solution of the magnetohydrodynamic (MHD) Navier–Stokes equations under the Boussinesq approximation is obtained. Numerical solutions of the relevant functions and the structure of the flow field are presented and discussed for several values of the parameters which influence the motion: the Hartmann number, the parameter describing the oblique part of the motion, the Prandtl number (Pr) and the Richardson numbers. Dual solutions exist for several values of the parameters.

The present results are original and new for the problem of MHD mixed convection oblique stagnation-point flow of a Newtonian fluid over a vertical flat plate, with the effect of induced magnetic field and temperature.

The purpose of this study is to describe the development of the 14-item reflective fostering fidelity rating (RFFR), an observational rating system to evaluate model fidelity of group facilitators in the Reflective Fostering Programme (RFP), a mentalisation-based psychoeducation programme to support foster carers. The authors assess usability, dimensionality, inter-rater reliability and discriminative ability of the RFFR.

Eighty video clip extracts documenting 20 RFP sessions were independently rated by four raters using the RFFR. The dimensionality of the RFFR was assessed using principal components analysis. Inter-rater agreement was assessed using the intra-class correlation coefficient.

The proportion of missing ratings was low at 2.8%. A single principal component summarised over 90% of the variation in ratings for each rater. The inter-rater reliability of individual item ratings was poor-to-moderate, but a summary score had acceptable inter-rater reliability. The authors present evidence that the RFFR can distinguish RFP sessions that differ in treatment fidelity.

To the best of the authors’ knowledge, this is the first investigation and report of the RFFR’s validity in assessing the programme fidelity of the RFP. The paper concludes that the RFFR is an appropriate rating measure for treatment fidelity of the RFP and useful for the purposes of both quality control and supervision.

The purpose of this paper is to provide a selected bibliography of recent resources on library instruction and information literacy.

Introduces and annotates periodical articles, monographs, and audiovisual material examining library instruction and information literacy.

Provides information about each source, discusses the characteristics of current scholarship, and describes sources that contain unique scholarly contributions and quality reproductions.

The information may be used by librarians and interested parties as a quick reference to literature on library instruction and information literacy.

The present study aims to trace out the science research output of top Indian universities from 2015 to 2019, as reflected in the Web of Science (WOS) database.

The present study has selected the Science Citation Index (SCI) of WOS core collection for selecting top Indian universities in terms of total publications in the last five years (2015–2019). The University of Delhi (DU), Banaras Hindu University (BHU), Anna University (AU), Jadavpur University (JU) and Punjab University (PU) have been selected. The study identified the most prolific authors, collaborating countries, collaborating institutions and the impact of their output in terms of citations per paper (CPP) and relative citation impact (RCI). For visualizing purposes, VOSviewer was used. The study also identified frequently used keywords and channels used for communicating research results.

The authors retrieved 26,173 documents consisting of journal articles, review papers and proceeding papers. The consistent growth of science research output has been observed. The University of Delhi (DU) has the maximum science publications. The study reflects that multi-authored papers have more research impact in terms of citation received. The USA, South Korea and Germany are the most collaborating countries. The top Indian Universities have a major collaboration with Anna University, Indian Institute of Technology, Center for Scientific and Industrial Research (CSIR) of India.

The present study reveals how the science research output of top Indian universities has grown in the last few years. The findings of the study can be used for identifying specific science research areas where special attention can be given.

The paper aims at enriching the knowledge of the application of lean management (LM) in emergency department (ED), structuring the methodology for implementing LM projects and summarizing the relevant dimensions of LM adoption in ED.

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic literature review has been performed, extracting a database of 34 papers. To answer the research purpose, a descriptive and content analyses have been carried out.

The descriptive analysis demonstrates that the dealt topic is worldwide emerging and multidisciplinary as it arouses interest by medical and engineering communities. Despite the heterogeneity in the adopted methodology, a framework can be grasped from the literature review. It points out the phases and activities, the tools and techniques and the enablers to be considered for guiding the developing of LM project in ED.

This paper provides a comprehensive overview on how to adopt LM in ED, contributing to fill in the gap emerged in the literature. From a practical perspective, this paper provides healthcare managers with a synthesis of the best managerial practices and guidelines in developing a LM project in ED.

The purpose of this paper is to combine studies that describe the spin-off creation process with studies that analyze spin-off determinants to understand the phenomenon of spin-off development.

This paper proposes a theoretical framework to improve our understanding of academic spin-off development in southern Italy. Following a systematic combining approach, the framework is constructed by iteratively matching the concepts derived by the literature on spin-off processes and spin-off determinants with the empirical findings obtained through a case study of 19 spin-offs in southern Italy.

The combination of empirical results and literature analysis helps us to identify a general model for spin-off creation that could be particularly useful to explain the criticalities of their development.

This paper provides implications for policy-makers in southern Italy regarding factors for which intervention would support the creation of new spin-offs. This study also provides useful implications for policy-makers in other contexts, such as areas that may or may not be at a disadvantage.

The resulting framework represents an original contribution to the literature because it: links two aspects – the stages of spin-off creation and determinants of spin-off development – which are often considered separately in existing studies; explores factors that either impede or facilitate the different stages of spin-off development; provides a series of findings that can be successively tested in other studies; and sheds more light on the context of southern Italy, which has been investigated in only a limited number of previous studies.