Efficiency of Italian universities: a comparative analysis of public, private, and online institutions

TPS272 Background: Treatment of metastatic castration-resistant prostate cancer (mCRPC) has been steadily evolving during the last decade, but access remains a significant issue in low- and middle-income countries (LMICs). As novel therapies emerge and translate into clinical practice, the gap in treatment patterns between patients who do or do not have access to these therapies is expected to increase. The resulting disparities in outcomes are likely to be more noticeable in countries with pronounced inequality, such as Brazil. In Brazil, while a minority of patients have private insurance and have access to nearly all available treatment options, approximately 75% of patients depend on the public health system, which is unable to afford most of the recent treatment innovations for mCRPC, such as novel hormonal agents (NHA) or PARP inhibitors. LACOG 1818 was developed to investigate and compare outcomes of patients with mCRPC treated at private and public hospitals in Brazil. Methods: LACOG 1818 (NCT04962919) is a retrospective multicentric study investigating disparities in cancer treatment and survival among public and private institutions in Brazil. Patients with mCRPC diagnosed within January 2014 and December 2017 will be included and their data will be abstracted from medical records. Primary endpoint is cause-specific survival, comparing patients from private and public institutions. We estimate that 299 events are needed to detect a hazard ratio of 0.75 indicating a lower risk of prostate cancer-related death for patients treated at private institutions with a power of 80% and a bicaudate significance level of 10%. Considering a follow up of 24 months and a median cause-specific survival of 20 months in patients from public institutions, 590 patients are planned to be included. Secondary endpoints include describing comorbidities, sociodemographic and clinicopathological characteristics of patients with mCRPC; comparing overall survival of patients with mCRPC treated at public and private institutions; comparing treatments patterns of patients with mCRPC treated at public and private institutions; and describing skeleton-related complications, bone-directed treatments, and admission rates. From January 2020 to August 2022, 244 of planned 590 patients have been enrolled in 7 Brazilian centers. Additional 12 centers are still planned to open before 2023. Results are expected in the first semester of 2023. Clinical trial information: NCT04962919 .

The aim of this research paper is to compare the quality of education delivered at the undergraduate level in the public and private institutions of the Twin Cities (Islamabad and Rawalpindi) in Pakistan. Data is collected with the help of questionnaires from 246 students. The data was collected from three public and three private educational institutions of the Twin Cities, and the age of students ranged from 18 to 27 years. The research instrument used in this paper is the independent sample t-test to find the difference between the three private and three public educational institutions selected in Rawalpindi and Islamabad in terms of different variables that are very important in measuring the quality of education. For analysis, Levene’s test was adopted, which reflects the variations in educational quality with respect to academic staff availability in the twin cities. The differences in close supervision of students by academic staff between public and private sector educational institutions were also analysed, and the results reflected a difference between private and public educational institutions with respect to close supervision of students. The results also highlighted the factors that are involved in higher performance of students in private institutes as compared to that of students in public institutes. These factors can be implemented in the public sector to increase student performance.

e19569 Background: Non-Hodgkin lymphoma (NHL) is the most frequent hematological malignancy. B-cell (BCL) and T-cell (TCL) NHL subtypes differs in high income and low-and middle-income countries. In Peru, the healthcare system is divided mainly into public and private institutions. We aimed to describe the subtypes of NHL seen according to healthcare facilities. Methods: We reviewed medical records at National Cancer Institute and Oncosalud, both the leading public and private cancer centers in Peru, respectively. All patients diagnosed with NHL from 2015-2018 according to the 2016 WHO classification were included. Baseline characteristics were compared between public and private institutions using Student’s t test and Chi-square as appropriate. Results: A total of 2,317 NHL were included from both institutions. The median age was 61 years (range 15-99), 49.7% were male. Most patients NHL cases were encountered at the public institution (88.9%, n = 2,059); 84.4% (n = 1,957) were BCL and 15.5% (n = 360) TCL. Differences of BCL and TCL frequencies were seen among institutions. More BCL cases were seen at the private institution (96.6%, n = 230 versus 83.9%, n = 1,727, respectively) whereas TCL were common in the public institution (16.1%, n = 332 versus 11.8%, n = 28, respectively) (p < 0.035). The most frequent BCL was DLBCL with 70.0% (n = 1209) and 49.6% (n = 114) seen in public and private institutions, respectively (p < 0.001). The second most frequent BCL was follicular lymphoma (FL) with 10.8% (n = 187) and 20.4% (n = 47) seen in the public and private institutions, respectively (p < 0.001). Chronic lymphocytic lymphoma (CLL) and Burkitt lymphoma (BL) were most frequent in private institution (CLL 7%, n = 16 vs. 3.5%, n = 60, p = 0.017; BL 3.9%, n = 9 vs. 1.2%, n = 21, p = 0.004). The most frequent TCL was peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) (27.7%, n = 92) for the public institution and mycosis fungoides (MF) (39.3%, n = 11) for the private institution. The second most frequent TCL was natural killer/TCL (NKTCL) (22.6%, n = 75) for the public institution, and PTCL, NOS (17.9%, n = 5) for the private institution. There was significant difference in the number of NKTCL and MF cases seen during the study period among institutions (NKTCL public 22.6%, n = 75 vs. private 3.6%, n = 1, p = 0.033; MF public 15.1%, n = 50 vs. private 39.3%, n = 11, p = 0.003). The presence of extranodal involvement was more frequent in the public institution (52.3%, n = 1,049 vs. 35.3%, n = 84, p < 0.001). Conclusions: The distribution of NHL differs according to the type of healthcare system in Peru. Extranodal involvement, TCL, DLBCL and NKTCL are more frequent in patients treated at the public cancer center than in private center. On the contrary BCL, FL, CLL, BL and MF are more frequent in private cancer center. Our institutions are currently building the largest registry of NHL patients diagnosed and treated in Peru.

Differences in the Distribution of Non-Hodgkin Lymphoma in Public Versus Private Institution in a Latin American Country: A Cohort of 5,807 Cases

The COVID-19 pandemic has brought massive online activities and increased cybersecurity incidents and cybercrime. As a result of this, the cyber reputation of organisations has also received increased scrutiny and global attention. Due to increased cybercrime, reputation displaying a more important role within risk management frameworks both within public and private institutions is vital. This study identifies key factors in determining reputational damage to public and private sector institutions through cyberattacks. Researchers conducted an extensive review of the literature, which addresses factors relating to risk management of reputation post-cyber breach. The study identified 42 potential factors, which were then classified using the STAR model. This model is an organisational design framework and was suitable due to its alignment with organisations. A qualitative study using semi-structured and structured questions was conducted with purposively selected cybersecurity experts in both public and private sector institutions. Data obtained from the expert forum were analysed using thematic analysis, which revealed that a commonly accepted definition for cyber reputation was lacking despite the growing use of the term “online reputation”. In addition, the structured questions data were analysed using relative importance index rankings. The analysis results revealed significant factors in determining reputational damage due to cyberattacks, as well as highlighting reputation factor discrepancies between private and public institutions. Theoretically, this study contributes to the body of knowledge relating to cybersecurity of organisations. Practically, this research is expected to aid organisations to properly position themselves to meet cyber incidents and become more competitive in the post-COVID-19 era.

BackgroundAlthough the prognosis for survival in people with severe functional disabilities is a serious concern for their families and health care practitioners, there have been few reports on survival rates for this population. Every year, the Japanese Association of Welfare for Persons with Severe Motor and Intellectual Disability collects anonymous records of individual registrations and deaths from all private and public institutions, excepting national institutions. We used these data to estimate the prognosis for survival.MethodsWe reviewed the records of 3221 people with severe motor and intellectual disabilities (SMID); all subjects had lived in one of 119 public or private institutions in Japan between 1961 and 2003. Kaplan–Meier survival estimates were calculated according to disability type and birth year range.ResultsOf the 3221 persons, 2645 were alive and 576 had died. The survival rate at the age of 20 for all subjects was 79% (95% confidence interval, 78%–81%). Among people who were unable to sit, those with lower intelligence quotients had lower survival rates.ConclusionsThe survival rate among people with SMID housed in public and private institutions in Japan was much worse than that of the general population, and has not improved since the 1960s.

The authors examine the 1910, 1920, 1930, and 1940 US censuses to identify demographic characteristics of children who resided in public and private institutions for minors, with special attention to patterns of racial segregation and exclusion. The article focuses on public and private institutions founded exclusively to serve children and youth and also on correctional institutions for children and adults. The authors found racial segregation in private institutions, underrepresentation of children of color in both private and public institutions, and overrepresentation of boys of color in correctional institutions for minors and adults. They also identified a historical pattern, with few exceptions, of excluding girls of color from all types of public and private institutions.

This research investigation delves into the classroom management routines and protocols implemented by English educators within two educational institutions, one public and the other private, over the course of a senior academic year. The primary objective of this inquiry is to dissect the commonalities and disparities between these institutions concerning their methodologies for classroom management. The researchers strive to identify the challenges encountered by instructors when implementing classroom management routines and protocols, alongside assessing students' comprehension of and adherence to these established procedures. The research employs a blend of three data collection methodologies: observation checklists, surveys, and interviews, which collectively employ triangulation to offer comprehensive insights. The findings divulge substantial disparities and limitations in the application of routines and procedures between the public and private institutions, notably concerning behavioral control and the diversity of pedagogical activities integrated into lessons. The public institution demonstrates a heightened degree of instructor authority in overseeing student behavior, while the private institution incorporates a more intricate range of activities during instructional sessions. Drawing from the conclusions derived from this research, the authors proffer tailored recommendations to English instructors in both educational settings. These recommendations are meticulously formulated to address the identified challenges and proffer potential resolutions for augmenting classroom management, thereby ultimately facilitating the pedagogical trajectory of teaching and learning.

1629 Background: Exercise offers significant benefit for patients with cancer, improving physical function, quality of life, and treatment-related outcomes. However, barriers such as limited referral practices and insufficient knowledge hinder its integration into care. This study compared referral practices, exercise assessment, and physicians’ perceptions in public (PUB) and private institutions (PRI). Methods: A cross-sectional survey of 454 physicians from 21 Latin American countries was conducted using a 25-item questionnaire on referral practices, patients’ exercise habits, and perceived barriers and facilitators to implementing exercise programs. Descriptive statistics summarized respondent characteristics and adherence to exercise-related practices. Chi-square tests were used to compare differences in referral practices and perceived barriers/facilitators between physicians working in PUB versus PRI institutions. Results: Out of 454 participants, most were from PUB (52%), mainly from Mexico (17%), Brazil (12%), and Colombia (10%). In the PRI (48%), Brazil led with 51%, followed by Argentina (18%), and Peru (8%). Female representation was higher in PUB compared to PRI (57% vs. 43%, P = 0.01). Physicians in PUB were less likely than those in PRI to assess exercise habits (53% vs. 18%, P = 0.001), refer patients (72% vs. 36%, P = 0.001), or provide guidance (56% vs. 12%, P = 0.001). Resource limitations were more common in PUB (e.g., no referral location: 86% vs. 70%, P = 0.04). Barriers included treatment side effects (PUB: 66% vs. PRI: 40%, P = 0.001) and lack of knowledge on prescribing exercise (PUB: 63% vs. PRI: 27%, P = 0.001). Physicians in PUB emphasized facilitators like access to qualified professionals (90% vs. 66%, P = 0.001) and personal experience (90% vs. 80%, P = 0.01). Conclusions: This study reveals significant disparities in cancer exercise practices between oncologists in public and private institutions across Latin America. Oncologists in public institutions were less likely to assess exercise, refer patients to exercise programs, and provide guidance. They also reported greater barriers, such as treatment side effects and lack of knowledge on exercise prescription and resources. Facilitators such as access to qualified professionals were less prominent in public institutions. These findings highlight the need for targeted interventions to improve exercise integration in cancer care, particularly in resource-limited settings.

Trade and...Problems, Cost-Benefit Analysis and Subsidiarity

Health care systems as determinants of outcomes in multiple myeloma: final results from the Latin American MYLACRE study.

Various studies have shown differences in detection rates of CHD between tertiary and non-tertiary institutions. The aim of this study was to investigate and compare the prenatal detection rates of five major congenital cardiac malformations over a ten-year period from 1995 to 2004 between private and public institutions in Singapore. Data on major cardiac malformation cases born in the period from 1995 to 2004 were retrieved from the National Birth Defect Registry and analyzed in two 5-year periods, 1995–1999 and 2000–2004. Between the periods 1995–1999 and 2000–2004, detection rates improved significantly (P < 0.05) from 9.2% to 47.3% for Fallot's tetralogy (overall 24.1%), 16.4% to 45.2% for transposition of great vessels (overall 29.6%), 12.7% to 44.9% for coarctation of aorta (overall 31.6%), 43.9% to 70.1% for hypoplastic left heart (overall 58.8%) and 44.2% to 70.0% for atrioventricular septal defect (overall 59.2%). This improvement in detection rates occurred uniformly in both private and public institutions. Detection rates for all five cardiac malformations, however, were significantly higher in the public institutions compared to private hospitals for both time periods (P < 0.05). The improvement in overall detection rates reflects greater awareness and better diagnostic skills due to a concerted educational and awareness program amongst Singaporean obstetricians, as well as improvements in diagnostic equipment. The gap in detection rates between public and private institutions reflects possible differences in operator training, skill and experience. To this end, a comprehensive national training program is proposed as the key healthcare implementation for detection and prevention of CHD. The ideal training center should be one with a high throughput of abnormal cases and demonstrated good detection rates.

The topic of risk factors for posture pathology in Polish children is relevant at present, as it is insufficiently studied and reflects the need to investigate the relationship between family socioeconomic status and the occurrence of posture defects, to develop relevant prevention and treatment strategies in the context of current socioeconomic conditions in Poland. The research aims to study posture defects in children depending on their socioeconomic status in the example of private and public schools. A comparison of the prevalence of deformities and posture disorders of participants in private and public educational institutions from 2017 to 2020 is presented. Theoretical research methods (literature analysis, generalisation); empirical methods (study of other researchers' experience), statistical analysis, and graphical presentation of data were used. More than 1300 Polish schoolchildren from private and public schools took part in this cross-sectional study. The most common problems were flat feet (54.73%), calf muscle contracture (44.30%), and valgus deformity (21.22%). The least common problems were funnel chest (0.37%), cavus foot (0.10%), and hammer toe deformity (0.04%). The general trend shows that problems with flat feet and calf muscle contracture were more common among participants in both types of educational institutions. There was a general trend of increasing the number of nosological forms per patient in both private and public institutions over a period of three years. Private institutions had significantly fewer cases of one patient having more than one nosological form as compared to public institutions.

This study examines institutional differences in library resources, student library use, and graduation rates at U.S. Association of Research Libraries (ARL) universities from 2018 to 2023. By comparing public and private institutions, it explores trends in library resource allocation and their relationship to student success, measured through graduation rates. Findings reveal that private institutions allocate significantly more funding per student, maintain lower student-to-staff ratios, and demonstrate higher levels of library use compared to their public counterparts. However, the gap in library usage between the two sectors is less pronounced than the disparity in resource allocation. Correlation analyses show that both private and public institutions exhibit strong positive relationships between library funding, staffing, and graduation rates. Notably, public institutions demonstrate a unique correlation between resource use—such as circulation, interlibrary loans, and database searches—and student success, a pattern not observed in private institutions. These findings highlight the critical role of library investments in supporting student outcomes and suggest that public institutions should prioritize expanding access to research resources, while private institutions should enhance engagement strategies. The study underscores the importance of sustained funding and strategic resource allocation to maximize the impact of academic libraries in higher education.

Orthopaedic and trauma surgery in France: Do patterns differ across healthcare institution types (public community, public university, private not-for-profit, and private for-profit)?