The polarized infrared· spectrum of naphthalene single crystal has been studied between 800 and 1600 cm-1 . The dependence on temperature of the linewidth of eight Davydov components of internal modes has been studied in the 10-240 K temperature range. The deconvolution of the experimental line shapes allows us to extract a constant inhomogeneous contribution to the line broadening, due probably to crystal defects, over all the temperature range. The bandwidth data are interpreted on the basis of elementary relaxation mechanisms. In particular, at low temperature, the vibrational decay is dominated by three-phonon depopUlation processes. Above 80 K, higher order dephasing mechanisms generally contribute to the vibron dynamics. The calculated decay compares well with experimental results. The infrared results are compared with the relaxation data presented for the Raman modes in previous papers. 7938

Background: In recent years, the flow of patients to the Emergency Departments (ED) of Western countries has steadily increased, thus generating overcrowding and extended waiting times. Scholars have identified four main causes for this phenomenon, related to: continuity of primary care services; availability of specific clinical pathways for chronic patients; ED's personnel endowment; organization of the ED. This study aims at providing a logical diagnostic framework to support managers in investigating specific solutions to be applied to their EDs to cope with high ED waiting times. The framework is based on the ED waiting times and ED admission rate matrix. It was applied to the Tuscan EDs as illustrative example. Methods: To provide the factors to be analyzed once the EDs are positioned into the matrix, a list of issues has been identified. The matrix was applied to Tuscan EDs. Data were collected from the Tuscan performance evaluation system, integrated with specific data on Tuscan EDs' personnel. The Tuscan EDs matrix, the descriptive statistics for each quadrant and the Spearman's rank correlation analysis among waiting times, admission rates and a set of performance indicators were conducted to help managers to read the phenomena that they need to investigate. Results: The combined reading of the correlations and waiting times-admission rates matrix shows that there are no optimal rules for all the EDs in managing admission rates and waiting times, but solutions have to be found considering mixed and personalized strategies. Conclusions: The waiting times-admission rates matrix provides a tool able to support managers in detecting the problems related to the management of ED services. In particular, using this matrix, healthcare managers could be facilitated in the identification of possible solutions for their specific situation.

In recent years, the consumption of Over-The-Counter (OTC) drugs has increased. Previous studies have pointed out that the OTC medications are misused and abused by teenagers, who often show poor knowledge of the toxicity of these drugs.The paper aims to analyze the use of OTCs by teenagers and the factors that influence their consumption. This paper is based on quantitative data. A web-based survey was administered to the students of an Italian high school. The questionnaire included queries on the knowledge, attitudes and practices of the students with regard to OTCs. Since teenagers are influenced by their families, their approach to healthcare was also investigated.An exploratory factor analysis was conducted in order to determine the key factors influencing their attitudes toward the use of medications. Finally, a cluster analysis was run in order to identify different behavioral segments.Results show that four factors (tradition, social communication, self-management, and caution) influence the attitudes and behaviors of teenagers toward OTC medicines. The research also highlighted that attitudes toward the use of OTC medicines varied among the respondents, who were grouped into three different clusters: their presence implies the need for targeted educational programs, involving teenagers and their families.

Le opportunitÀ ed i vantaggi derivanti dall'esternalizzazione e dalla centralizzazione dei processi aziendali, evidenziati in letteratura nel contesto privato, sono riscontrabili anche nel contesto sanitario pubblico? L'articolo si propone di compiere una prima valutazione dei risultati raggiunti in Toscana con l'introduzione degli ESTAV, la cui istituzione č avvenuta per razionalizzare, a livello sovra-aziendale, le funzioni tecnicoamministrative ed in particolare gli approvvigionamenti. Valutando i risultati raggiunti in termini di efficienza e di efficacia, viene evidenziato come tale esperienza presenti, pur con ampi spazi di miglioramento, risultati indubbiamente positivi e assimilabili a quelli presenti nel contesto privato.

In molti contesti la standardizzazione dei processi e la personalizzazione dei servizi sono strategie considerate in buona misura antitctiche nella ricerca del vantaggio competitivo: la prima volta a conseguire economie di scala e di esperienza al fine di aumentare l'efficienza produttiva e ridurre i costi, la seconda finalizzata a ottenere una differenziazione rispetto alla concorrenza basata su servìzi "taylor made" per rispondere alle esigenze individuali del cliente a cui si rivolgono. Nell'ambito dei servizi sanitari il successo dipende dalla capacità di integrare queste due strategie. Non vi e servizio sanitario che riesca ad essere efficace se non è tagliato sui bisogni del singolo paziente. Al tempo stesso la qualità dei servizi dipende dalla capacità dei professionisti e delle organizzazioni sanitarie di offrire percorsi assistenziali in linea con le evidenze scientifiche internazionali, standardizzando quindi i processi in base ai protocolli cimici definiti dalle società scientifiche. L'offerta del servizio dovrà quindi essere personalizzata, per far si che il paziente diventi protagonista del proprio percorso di cura, ma dovrà anche garantire che la migliore assistenza (appropriatezza cllnica) sia fornita all'interno del setting più adeguato, per il migliore utilizzo delle risorse disponibili (appropriatezza organizzativa). 8.1 La sfida dei servizi sanitari tra qualità e sostenibilità finanziaria Le strategie adottate dalle aziende nel contesto privatistico del settore manifatturiero, ma anche nei servizi, possono essere suddivise in due tipologie1. Le imprese (Porter 1985) possono puntare o sulla leadership di costo, attraverso strategie che mirano a conseguire economie di scala e di esperienza al fine di essere vincenti sul mercato in termini di efficienza {il miglior prodotto al minor prezzo), oppure puntare sulla differenziazione, cercando di offrire un prodotto capace di rispondere alle esigenze