Methods and tools for analysis and management of risks and regulatory compliance in the healthcare sector: the hospital at home – HaH

Changing or creating an organisation means creating a new process. Each process involves many risks that need to be identified and managed. The main risks considered here are procedural and legal risks. The former are related to the risks of errors that may occur during processes, while the latter are related to the compliance of processes with regulations. Managing the risks implies proposing changes to the processes that allow the desired result: an optimised process. In order to manage a company and optimise it in the best possible way, not only should the organisational aspect, risk management and legal compliance be taken into account, but it is important that they are all analysed simultaneously with the aim of finding the right balance that satisfies them all. This is the aim of this thesis, to provide methods and tools to balance these three characteristics, and to enable this type of optimisation, ICT support is used. This work isn’t a thesis in computer science or law, but rather an interdisciplinary thesis. Most of the work done so far is vertical and in a specific domain. The particularity and aim of this thesis is not to carry out an in-depth analysis of a particular aspect, but rather to combine several important aspects, normally analysed separately, which however have an impact and influence each other. In order to carry out this kind of interdisciplinary analysis, the knowledge base of both areas was involved and the combination and collaboration of different experts in the various fields was necessary. Although the methodology described is generic and can be applied to all sectors, the case study considered is a new type of healthcare service that allows patients in acute disease to be hospitalised to their home. This provide the possibility to perform experiments using real hospital database.

The Allocation of Asylum Responsibilities in the EU: a Law & Economics Analysis

This dissertation focuses on how the design of the EU asylum allocation system, the system that allocates the EU’s asylum duties to its member states, relates to the development of asylum crises. The current EU asylum allocation system, the Dublin system, has in the literature frequently been blamed as an important factor that contributed to the events that occurred during the 2015/2016 EU Asylum Crisis. In the first part of this dissertation, I use a Law & Economics methodology based on rational choice theory to study how the Dublin system creates behavioural incentives for both asylum seekers and member states and how this relates to the events during the 2015/2016 EU Asylum Crisis. In the second part, I analyse how behavioural incentives for asylum seekers and member states would change if the EU would replace the Dublin system with a so-called (tradable) quota system. By comparing the outcomes of the first and the second part of the dissertation I make some normative recommendations on desirable features for an EU asylum allocation system that provides better incentives for asylum seekers and member states.

Theoretical and experimental study of novel hybrid composite and metal-composites interfaces

The growing demand for lightweight solutions in every field of engineering is driving the industry to seek new technological solutions to exploit the full potential of different materials. The combination of dissimilar materials with distinct property ranges embodies a transparent allocation of component functions while allowing an optimal mix of their characteristics. From both technological and design perspectives, the interaction between dissimilar materials can lead to severe defects that compromise a multi-material hybrid component's performance and its structural integrity. This thesis aims to develop methodologies for designing, manufacturing, and monitoring of hybrid metal-composite joints and hybrid composite components. In Chapter 1, a methodology for designing and manufacturing hybrid aluminum/composite co-cured tubes is assessed. In Chapter 2, a full-field methodology for fiber misalignment detection and stiffness prediction for hybrid, long fiber reinforced composite systems is shown and demonstrated. Chapter 3 reports the development of a novel technology for joining short fiber systems and metals in a one-step co-curing process using lattice structures. Chapter 4 is dedicated to a novel analytical framework for the design optimization of two lattice architectures.

Association between pre-treatment indicators and compliance to neoadjuvant/perioperative chemotherapy in operable gastric cancer

Background and aims: perioperative treatment is currently the gold standard approach for locally advanced gastric cancer (GC). Unfortunately, the phenomenon of patients dropping out of treatment has been frequently observed. The primary aims of this study were to verify if routine blood parameters, the inflammatory response markers, sarcopenia, and the depletion of adipose tissues were associated with compliance with neoadjuvant/perioperative chemotherapy. Methods and study design: sarcopenia and adipose indices were calculated with a CT scan before starting chemotherapy and before surgery. Blood samples were considered before the first and second cycles of chemotherapy. Results: A total of 84 patients with localized operable GC, were identified between September 2010 and January 2021. Forty-four patients (52.4%) did not complete the treatment according to the number of cycles planned/performed. Eight patients (9.5%) decided to suspend chemotherapy, seven patients (8.3%) discontinued because of clinical decision-making, 14 patients (16.7%) because of toxicity, and 15 patients (17.9%) for miscellaneous causes. Sarcopenia before starting chemotherapy was found to be present in 38 patients (50.7%) while it was in 47 patients (60%) at the CT scan before the gastrectomy. In multivariable analysis, both for changes tending to have a value of PLR at basal and in the second control a higher one than the cut-off (OR = 5.03, 95% CI: 1.34 - 18.89, p-value = 0.017), and for PLR which increased from a lower to a higher value in second control with respect to the cut off (OR = 4.64, 95% CI: 1.02 -21.02, p-value = 0.047) resulted associated with incomplete compliance. Conclusions: among the biological indicators, changes in the value of PLR with a tendency towards increasing compared to the cut-off appear to be an immediate indicator of incomplete compliance with neoadjuvant/perioperative treatment. More information is needed to reduce the causes of interruption.