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The research analyzes good practices in health care “management experimentation models,” which fall within the broader range of the integrative public–private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the “management experimentation models” are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations.

In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC – Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies.

The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable.

The recognition of ISMETT’s good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

To examine how clinicians navigate providing treatment to Borderline Personality Disorder (BPD) in the context of the DSM 5, deinstitutionalization, and the biomedical model.

We conducted 39 interviews with mental health providers in the United States in a two-year period preceding and following the release of the DSM 5. Using Constructivist Grounded Theory, we analyzed the data for themes that emerged.

Clinicians faced pressures from insurance companies, the DSM categories, and their professional training to focus on biomedical treatments. These treatments, which emphasized pharmaceuticals and short courses of care, were ill-suited to BPD, which has a strong evidence base recommending long-term therapeutic interventions. We term this contradiction a “biomedical mismatch” and use Gidden’s concept of structuration to better understand how clinicians navigate the system of care. Providers ranged in their responses to the mismatch: some championed biomedicine, others were complicit, and a final group behaved as activists, challenging the paradigm. The sum of the strategies had downstream effects which included crisis reinstitutionalization and a discourse of untreatability. Ultimately, we discuss how social factors such as gender bias, stigma, and trauma are insufficiently represented in the biomedical model of care for BPD.

BPD fits poorly within the biomedical underpinnings of the current system. Accordingly, it illuminates the structuration of health care and where the rules of care break down. More precisely, deinstitutionalization was designed to remove patients from long courses of inpatient care. Many patients with BPD have failed to experience this outcome, with some patients now cycling through long courses of short-term crisis reinstitutionalization instead of having effective outpatient care over long periods. This unintended consequence of deinstitutionalization calls for a more biopsychosocial response to BPD.

The purpose of this paper is to provide a comprehensive overview of the current knowledge regarding chronic hepatitis C (CHC) infection, antiviral therapy, depression, and gender.

CHC and its treatment options were reviewed examining their relationship with depression and gender.

CHC is a high prevalent chronic infection worldwide, being similar in men and women. However, the infection shows many gender differences in terms of innate response, genetic variability (i.e. IL-28B), route of transmission (i.e. intravenous drug use), disease progression (i.e. fibrosis), lifetime period (i.e. pregnancy), and risk factors (i.e. HIV). Both the hepatitis C infection and antiviral treatment (especially when using the pro-inflammatory cytokine interferon α), are highly associated with depression, where female gender constitutes a risk factor. It seems that the new direct-acting antiviral combinations produce fewer neuropsychiatric side effects. In fact, the presence of depression at baseline is no longer a limitation for the initiation of antiviral treatment. Antidepressant drugs have been recommended as current depression and prophylactic treatment in risk subgroups. However, caution should be exercised due to the risk of drug-drug interactions with some antiviral drugs. Women should be counselled prenatal, during and after pregnancy, taking into account the clinical situation, and the available evidence of the risks and benefits of antiviral and antidepressant treatments. Multidisciplinary approach shows cost-efficacy results.

The paper clarifies the complex management of CHC therapy and the importance of individualizing treatment. The results also underline the need for an integrated multidisciplinary approach.

The study described here aims to set forth an analysis approach for a specific biomedical therapeutic device principally involving fluid mechanics and resulting sound generation. The function of the therapeutic device is to clear mucus from the airways of the lungs. Clearance of the airways is a primary means of relief for cystic fibrosis and is also effective in less profound dysfunctions such as asthma. The complete system consists of a device to periodically pulse air pressure and a vest that girdles the abdomen of the patient and receives and discharges the pulsating airflow. The source of pulsed air can be tuned both with respect to the amplitude and frequency of the pressure pulsations.

The key design tools used here are computational fluid dynamics and the theory of turbulence-based sound generation. The fluid flow inside of the device is multidimensional, unsteady and turbulent.

Results provided by the fluid mechanic study include the rates of fluid flow between the device and the inflatable vest, the rates of air supplied to and extracted from the device, the fluid velocity magnitudes and directions that result from the geometry of the device and the magnitude of the turbulence generated by the fluid motion and the rotating component of the device. Both the velocity magnitudes and the strength of the turbulence contribute to the quantitative evaluation of the sound generation.

A comprehensive literature search on this type of therapeutic device to clear mucus from the airways of the lungs revealed no previous analysis of the fluid flow and sound generation inside of the device producing the pulsed airflow. The results presented in this paper pinpoint the locations and causes of sound generation that can cause audible discomfort for patients.

This chapter examines the role of pharmaceutical patents in the on-going support of pharmaceutical innovation. The social value of pharmaceutical innovation and the importance of its sustained growth are explained. The government buy-outs of patents to reduce drug prices for all American consumers while preserving vital drug innovation are proposed.

The main objective of this paper is to illustrate an analytical view of different methods of 3D bioprinting, variations, formulations and characteristics of biomaterials. This review also aims to discover all the areas of applications and scopes of further improvement of 3D bioprinters in this era of the Fourth Industrial Revolution.

This paper reviewed a number of papers that carried evaluations of different 3D bioprinting methods with different biomaterials, using different pumps to print 3D scaffolds, living cells, tissue and organs. All the papers and articles are collected from different journals and conference papers from 2014 to 2022.

This paper briefly explains how the concept of a 3D bioprinter was developed from a 3D printer and how it affects the biomedical field and helps to recover the lack of organ donors. It also gives a clear explanation of three basic processes and different strategies of these processes and the criteria of biomaterial selection. This paper gives insights into how 3D bioprinters can be assisted with machine learning to increase their scope of application.

The chosen research approach may limit the generalizability of the research findings. As a result, researchers are encouraged to test the proposed hypotheses further.

This paper includes implications for developing 3D bioprinters, developing biomaterials and increasing the printability of 3D bioprinters.

This paper addresses an identified need by investigating how to enable 3D bioprinting performance.

The politics of intimate relationships structure innovation for sexual and reproductive health technologies. In this chapter I present three case studies that explore how national political concerns surrounding maternal intentions and the race of sexual women shape the production of sexual and reproductive health technologies. The products I examine are: GONAL-F, a subcutaneous injection of follitropin alpha for ovulation induction; Evra, a transdermal patch containing norelgestromin (NGM) and ethinyl estradiol (EE) for hormonal contraception; and zidovudine (ZDV) for HIV therapy, including the prevention of mother-to-child transmission. Together, these case studies illustrate how the politics of intimate relationships, which are deeply engrained in societies, structure clinical innovation, through conditions of inclusion, exclusion and anticipation.

Institutional theorists treat law and regulations as external factors that is part of the organization’s environment. While institutional theory has been criticized for its inability to recognize the role of agents and to theorize agency, the growing literature on institutional work and institutional entrepreneurship, partially informed by and co-produced with practice theory, advances a more dynamic view of processes of institutionalization. In order to cope with legal and regulatory frameworks, constituting the legal environment of the organization, there are evidence of organizational responses in the form of bargaining, political negotiations, and decoupling of organizational units and processes. The purpose of this paper is to report how legal and regulatory frameworks both shape clinical practices while at the same time they are also informed by the activities and interests of professional communities and commercial clinics.

This paper reports an empirical study of the Swedish-assisted conception industry and is based on a case study methodology including the use of interviews and formal documents and reports issues by governmental agencies.

The empirical material demonstrates how scientists in reproductive medicine and clinicians regard the legal and regulatory framework as what ensures and reinforces the quality of the therapies. At the same time, they actively engage to modify the legal and regulatory framework in the case when they believe it would benefit the patients. The data reported presents one successful case of how PGD/PGS can be used to develop the efficacy of the therapy, and one unsuccessful case of regulatory change in the case of patient interest groups advocating a legalization of commercial gestational surrogacy. In the former case, scientific know-how and medicinal benefits served to “push” the new clinical practice, while in the latter case, the “demand-pull” of patient interest groups fails to get recognition in regulatory and policy-making quarters.

The study contributes to the literature on agency in institutional theory (e.g. the emerging literature on institutional work) by emphasizing how legal and regulatory frameworks are in a constant process of being modified and negotiated in the face of novel technoscientific practices and social demands. More specifically, this process include many scientific, technological, economic, political and social relations and resources, making the legal environment of organizations what is the outcome from joint negotiations and agreements across organizational and professional boundaries.

Tissue engineering (TE) offers treatments for chronic, life threatening, degenerative illnesses and possibilities for restoring cellular or organ functions that have been lost due to injuries or hereditary conditions. However, a prerequisite for the use of TE products as part of future therapies is the development of strategies for safe and efficient supply chain management and versatile services spanning from product development to a follow‐up period of possibly decades. The present study aims to explore the future needs for services and extended supply chains for safe delivery of health care, procurement, distribution and long‐term follow‐up of TE products and therapies.

Studies in operational disciplines and coordination systems for different types of supply chains and service networks are used to formulate a framework for developing services throughout product lifecycle. Case examples of TE products are presented to demonstrate complexity, microbial risks, services and long‐term follow‐up. The role of logistics and the necessary services are identified for products classified into experimental, therapy and standard products.

The paper finds that, through the stages, the importance of logistics increases from an enabler to becoming a strategic tool, emphasizing logistics requirements in establishing a viable TE supply chain. New dimensions to existing service operations frameworks are needed where proactive tissue sourcing, long follow‐up periods, short shelf life and biological risks call for enforcing flexible services with tissue banks, detailed tracing, authorization and regulation.

The paper presents the discovery of the logistics services and service institutions that will become imperatives for the future success of TE products and therapies.

The aim of this paper is to present results of a foresight study on identifying priorities for health-related research and development (R&D) in Russia for the period until 2030.

Research priorities were identified through consistent integrated expert analysis and evaluation of the subject area, i.e. biomedical research preceding development of medical technologies.

Key global and national trends in the biomedical R&D sector and related areas (medicine and health) were identified. According to the experts, the following markets have the best prospects for Russia: regenerative medicine, biodegradable and other biocompatible materials, diagnostic systems, implants, surgical equipment, targeted delivery systems and non-invasive visualisation systems. Entering these markets requires providing support to R&D in the following areas: promising drug candidates, molecular diagnostics, molecular profiling and mechanisms of human diseases, cell technologies (therapies), new materials (biomimetics and other), bioelectronic, bioimaging and biosensors and human genome databases.

Regularly updating research priorities is a necessary prerequisite of successful science and technology development of countries, innovative companies and academic institutions. Allocation of (always limited) financial resources on the basis of such priority-setting exercises’ results is evidence of adherence to scientific planning principles. Combined with monitoring and evaluation tools, priority setting for biomedical R&D must become an integral component of Russia’s innovation policy.

This is a first-ever presentation of Russian experience in setting research priorities for the health-related sphere. Global and national contexts for development of biomedical R&D are described; markets and research areas with the biggest potential for Russian companies are identified.