Papers by Laura Policardo
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Italy is classified as a high-risk area for MS, with highest rates in the island of Sardinia, and... more Italy is classified as a high-risk area for MS, with highest rates in the island of Sardinia, and no evidence of the latitude gradient. The Italian MS patient society (AISM) estimates that in Italy there are 75,000 cases with an incidence of 2,000 cases per year. The latest rates published in Italy show a prevalence of 140 cases per 100,000 in 2009 [1] with the exception of Sardinia, where prevalence raised up to about 224 cases per 100,000 in 2009 [2]. The incidence was of about 5.5 cases per 100,000 in Continental Italy in 2009 [1] and 9.7 cases per 100,000 in Sardinia in 2011 [3]. In Tuscany (Central Italy), the latest estimates show a prevalence of 56 per 100,000 (1991) [4] and a mortality of 0.4 for males and 0.6 for females (2002-2006) [5]. Nowadays, in Italy, prevalence is absolutely higher than the above estimates. Indeed, prevalence is rising due to annual incidence that is higher than annual mortality [6]. In Tuscany a population MS register has been founded but, to date, it's not yet completed. To monitor disease epidemiology, comorbidities and care pathways, but also to describe the disease burden and to plan its prevention, treatment and management strategies and resource allocation, population-based studies are preferable. Administrative data offer a unique opportunity for population-based prevalence study of chronic diseases such as MS.
Economic Analysis and Policy, Sep 1, 2018
In past decades, a relevant strand of literature has found corruption to be an important determin... more In past decades, a relevant strand of literature has found corruption to be an important determinant of income inequality. In this paper, it is argued that a reverse causal relationship between corruption and income inequality might exist. We claim that income inequality could in fact be responsible for fostering corruption, which may be a reaction to a perceived unfair income distribution. Looking at a panel of 50 countries from 1995-2015, we show that the direction of causality between corruption and income inequality is country-specific and may be bidirectional. Using a dynamic GMM model, we robustly find that income inequality positively affects corruption, while corruption does not appear to be significant in the determination of income inequality, therefore contradicting the existing empirical literature on this topic.
Journal of Clinical Medicine, Apr 27, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Pharmacoepidemiology and Drug Safety, May 28, 2018
Purpose: To investigate whether the hospitalization rate for bacterial infections was modified by... more Purpose: To investigate whether the hospitalization rate for bacterial infections was modified by statin therapy in a population retrospectively followed up, over years 2011 to 2015. Methods: By using administrative databases, the 5-year hospitalization rate due to bacterial infections in population living in Tuscany, Italy exposed to statin therapy (n = 52,049) was stratified by 5 prescribed daily doses classes (0%-20%, 20%-50%, 50%-80%, 80%-100%, ≥100% of DDD) and subsequently compared with that of a population of untreated individuals (n = 3 300 ,675), matched through a propensity score accounting for all available covariates potentially able to modulate risk of infections such as age, gender, previous hospitalizations for infections, cardiovascular events, previous co-morbidities, diabetes, as well as general practitioners' proactive behaviour of care delivery according to current guidelines. Results: Unmatched individuals of each treatment-class had significantly more hospitalizations than controls, while matched treated people, apart from those in class 0% to 20%, had a decrease of hospitalizations, as large as the increase in prescribed drug. Statin effect in reducing hospitalizations translated into a number needed to treat (NNT) ranging across treatment strata from 102 to 54. Conclusions: Compliance to statin prescribed daily doses above the threshold 20% of DDD, along a 5-year follow-up, prevented hospitalizations due to infectious diseases in a large unselected population, after adjusting for covariates able to modulate baseline risk of infections. The NNTs to avoid 1 hospitalization for infections resulted on average not too dissimilar from a value lying between the 95% CI of NNTs previously found for primary prevention of 1 incident coronary ischemic event (72 to 119).
Journal of Diabetes and Its Complications, Apr 1, 2016
Incidental previously unrecognized diabetes Hospitalized patients Known diabetes Two-year mortali... more Incidental previously unrecognized diabetes Hospitalized patients Known diabetes Two-year mortality risk Administrative databases Chronic care model Aims: To identify incidental previously unrecognized diabetes (IPUD) among hospitalized patients and corresponding mortality risk in comparison with individuals with known diabetes (KDM). Methods: Out of 214,991 individuals discharged in year 2011 from all hospitals of Tuscany, Italy we retrospectively identified IPUD as individuals with no known diabetes and/or previous antidiabetic medication, receiving at least two prescriptions of glucose-lowering-drugs over the next 6 months after discharge. Two-year (2012-2013) adjusted mortality risk was tested by a Cox-regression-analysis, comparing IPUD and KDM patients with at least one hospital admission in 2011. Results: 974 patients with IPUD (375.6 × 100,000 hospitalized people) have been identified. IPUD risk was associated with aging, male gender and greater burden of co-morbidities, was higher in migrants of non-Italian ancestry and was reduced among patients of family physicians adhering to guidelines resulting in a proactive model of care delivery. In IPUD patients alive at 1st January 2012, (n = 865) the adjusted risk of two-year mortality was similar to that of KDM subjects (HR = 1.08; 95% CI: 0.92-1.26; p = NS). Conclusions: IPUD occurs more commonly in older male subjects, migrants of non-Italian ancestry, and among patients of physicians non-adhering to a shared diabetes care model. People with IPUD have similar two-year-mortality risk compared with KDM individuals.
Neurological Sciences, Jan 4, 2017
Overall prevalence of epilepsy ranges from 4 to 10 cases per 1000. Italy lacks recent epidemiolog... more Overall prevalence of epilepsy ranges from 4 to 10 cases per 1000. Italy lacks recent epidemiological studies on large populations. In the present study, prevalence of epilepsy has been assessed in Tuscany, an Italian Region with 3,750,000 habitants, implementing an algorithm based on administrative data from the Regional Information Health System. To identify patients with epilepsy, we used at least one the following criteria: (a) at least one EEG and at least two dispensations of any antiepileptic drug (AEDS) at a minimum distance of 12 months; (b) at least two dispensations of one ''specific'' AED (authorized for use only for patients with epilepsy) at a minimum distance of 12 months; and (c) hospital admission for epilepsy or recurrent relapses (cod. ICD-IX-345.*). This algorithm was validated through comparison with lists of true patients with epilepsy and subjects without neurological disorders (gold standard). 35,950 cases were identified. Total crude prevalence was 9.6/1000. Prevalence increased in older patients up to 16/1000 without gender differences. Overall sensitivity of the algorithm was 87.3%, and specificity was 99.9%. This algorithm identifies patients with epilepsy with acceptable sensitivity and specificity and can be used to assess the burden of disease and for monitoring health services.
Italian Journal of Medicine, Sep 22, 2015
Low birth-weight (BW) is related to rise in blood pressure (BP) later in life. Aim of this study ... more Low birth-weight (BW) is related to rise in blood pressure (BP) later in life. Aim of this study is investigating whether presence of overweight-obesity modifies this relationship, independently from any additional correlate of metabolic syndrome. We studied 535 (216 M/319 F) otherwise healthy overweight-obese people (body mass index≥25 kg/m 2), recording systolic, diastolic and pulse BP as well as plasma glucose and lipids, additionally interviewing them about BW and weight-change after age of 18 years. The reciprocal of BW was related only to pulse pressure (PP, r=0.14; P=0.04), uniquely in men and individuals with BW≤2500 g had a higher relative risk of having PP above upper quartile (>60 mmHg), independently of sex. After adjusting for confounders each 1 kg rise in BW was associated with 2.84±0.88 (standard error) mmHg decrease in PP; P=0.0042. Moreover, again only among males, the lower BW the higher was the risk of a PP>60 mmHg [odds ratio (95% confidence interval): 2.43 (1.39-4.24); P=0.0018]. In conclusion BW was inversely related only with PP in overweight-obese subjects, uniquely in men, being such effect independent from other correlates of metabolic syndrome. Since elevated PP can be considered a proxy of vascular damage, these findings further stress the importance of inquiring about BW to better stratify the risk of vascular damage, in adult overweight-obese individuals.
A Co-evolutionary Model for Human Capital and Innovative Firms
Springer eBooks, 2020
The paper aims to study the co-evolution dynamics of human capital and innovative firms by means ... more The paper aims to study the co-evolution dynamics of human capital and innovative firms by means of an evolutionary game theory model. We analyze the properties of the model, showing that if the demand for skilled labor is higher than its supply, then innovative firms may have an incentive to become non-innovative and stop hiring skilled workers. If, by contrast, the supply of skilled labor is higher than its demand, then there could be incentives for non-innovative firms to become innovative. Then, we introduce the dynamic extension of the model, applying a replicator dynamics equation for the fraction of innovative firms and the fraction of skilled workers. The steady states of the system are identified and as the most interesting one, the interior steady state, is discussed. Subsequently some simplified versions of the model are proposed and studied. By means of such analysis, we claim that a policy oriented to increasing the stock of skilled labor can set the economy on a positive path towards technological development.
Acta Diabetologica, Sep 6, 2016
Aims This study was designed to answer the question whether surgery due to newly diagnosed cancer... more Aims This study was designed to answer the question whether surgery due to newly diagnosed cancer may modify quality of diabetes' management, as suggested by current guidelines. Methods Adherence to guideline composite indicator (GCI), a process indicator including one annual assessment of HbA1c and at least two among eye examination, serum lipids measurement and microalbuminuria, was evaluated
Current Diabetes Reviews, Jul 1, 2022
Background: Diabetic Foot Disease (DFD) is more prevalent among males and is associated with an e... more Background: Diabetic Foot Disease (DFD) is more prevalent among males and is associated with an excess risk of cardiovascular events or mortality. Aims: This study aimed at exploring the risk of cardiovascular events, renal failure, and all-cause mortality after incident DFD hospitalizations, separately in males and females, to detect any gender difference in a cohort of 322,140 people with diabetes retrospectively followed up through administrative data sources in Tuscany, Italy, over the years 2011-2018. Methods: The Hazard Ratio (HR) for incident adverse outcomes after first hospitalizations for DFD, categorized as major/minor amputations (No.=449;3.89%), lower limbs' revascularizations (LLR: No.=2854;24.75%), and lower-extremity-arterial-disease (LEAD) with no procedures (LEAD-no proc: No.=6282;54.49%), was compared to the risk of patients having a background of DFD (ulcers, infections, Charcot-neuroarthropathy: No.=1,944;16.86%). Results: DFD incidence rate was higher among males compared to females (1.57(95% CI:1.54-1.61) vs. 0.97(0.94-1.00)/100,000p-years]. After DFD, the overall risk of coronary artery disease was significantly associated with the male gender and of stroke with the female gender. LEAD-no proc and LLR were associated with the risk of stroke only in females, whereas they were found to be associated with the risk of coronary artery disease among females to a significantly greater extent compared to males. The incident of renal failure was not associated with any DFD category. Amputations and LEAD-no proc significantly predicted high mortality risk only in females, while LLR showed reduced risk in both genders. Moreover, females had a greater risk of composite outcomes (death or cardiovascular events). Compared to the background of DFD, the risk was found to be 34% higher after amputations (HR: 1.34(1.04-1.72)) and 10% higher after LEAD-no proc (HR:1.10(1.03-1.18)), confirming that after incident DFD associated with vascular pathogenesis, females are at an increased risk of adverse events. Conclusion: After incident DFD hospitalizations, females with DFD associated with amputations or arterial disease are at a greater risk of subsequent adverse cardiovascular events than those with a DFD background.
Journal of Diabetes and Its Complications, Jul 1, 2015
To evaluate the effect of diabetes by gender on the peak-risk of first-ever-ischemic stroke and i... more To evaluate the effect of diabetes by gender on the peak-risk of first-ever-ischemic stroke and its recurrence. Methods: Administrative datasets including all hospital discharges for ischemic stroke (N = 43,332) in the diabetic (N = 207,568) and non-diabetic (N = 2,808,554) population of the Tuscany region, Italy were used to calculate Hazard ratios (HR) after Cox-regression, of first-ever and recurrent ischemic strokes, between 2005 and 2011. Results: Overall, diabetes increased the HR of first-ever ischemic stroke by about 50% in both genders. However, this risk significantly declined with age and was higher in women aged 55-74 yr than in men of the same age (HR; 95% CI: 1.392; 1.228-1.579 in age-class 55-64 yr and 1.203; 1.110-1.304 in age class 65-74 yr; p b 0.001). Diabetes also increased the adjusted risk of three-year-stroke recurrence (N = 5,998) in women, independently of age, whereas this was the case in men b70 yr. Conclusions: Diabetes is associated with increased risk of ischemic stroke although it declines with age though at lower rate among women than men. Moreover, diabetic women have greater risk of recurrence than in men N 70 yrs old, supporting a high-risk "time-window" in postmenopausal-elderly diabetic women.
RePEc: Research Papers in Economics, Mar 1, 2015
We look at two emerging economies, Brazil and China, and propose an evaluation of their recent de... more We look at two emerging economies, Brazil and China, and propose an evaluation of their recent development in terms of growth performance and the evolution of income inequality. Our analysis, therefore, is related to a recent vast growth literature but also to the much debated Kuznets-curve and theory. However, we claim that neither the growth approach nor Kuznets' capture recent relevant phenomena characterizing such countries' dynamics: namely, the presence of at least two distinct growth models. Cointegration analysis and empirical evidence seem to corroborate our interpretation. They also offer some further insights. We surmise that, while contributing to press for a re-examination (once again) of the issue of convergence in the light of the issue of income distribution, such findings have interpretative relevance and policy implications for other LDCs.
Journal of Economic Interaction and Coordination
In this article, the author name Sladana Pavlinović Mršić was incorrectly written as Sladana Pavl... more In this article, the author name Sladana Pavlinović Mršić was incorrectly written as Sladana Pavlinović Mršć. The original article has been corrected.
In this paper we look at two emerging economies, Brazil and China, and propose an evaluation of t... more In this paper we look at two emerging economies, Brazil and China, and propose an evaluation of their recent development in terms of growth performance and the evolution of income inequality. Our analysis therefore seems to be related to the well known Kuznets-curve and theory. The latter, however, populates an inequality-growth plane with countries’ average-valued coordinates and draws far fetching predictions that have been repeatedly questioned. In the same K-plane we introduce the dual notion (based upon coordinates that are bi-variate time series) of (a population of) growth models. Accordingly, we re-interpret the comparative histories of these two emerging economies to show how Kuznets’ traditional approach does not capture recent relevant phenomena characterizing such countries, and perhaps others as well: namely, the presence of at least two distinct growth models, one prevailing in China for most of its recent history, the other associated with Brazil. Descriptive statisti...
Annals of Operations Research
The paper analyzes the optimal lockdown policy using the SQAIRD model over a network with three p... more The paper analyzes the optimal lockdown policy using the SQAIRD model over a network with three population groups (young, adult, and old). We show that different lockdown policies may be justified by different socioeconomic structures (objective cost functions that are either convex or concave). We also show that a lockdown policy is always better than a laissez-faire policy, and a targeted policy specific to each group outperforms a uniform policy. In our benchmark example, we consider the case of Italy. Our simulations show that: (a) a lockdown policy is always better than the laissez-faire policy because it limits the costs generated by the pandemic in an uncontrolled situation; (b) a group-specific targeted lockout policy is more effective than a uniform policy to the extent that the groups differ. The latter is a less expensive targeted policy (as it optimally minimizes direct, indirect, and vaccination costs), and it is equally effective in controlling the pandemic. One findin...
Journal of Economic Interaction and Coordination
In this paper, we model an evolutionary noncooperative game between politicians and citizens that... more In this paper, we model an evolutionary noncooperative game between politicians and citizens that, given the level of infection, describes the observed variety of mitigation policies and citizens’ compliance during the COVID-19 pandemic period. Our results show that different stable equilibria exist and that different ways/paths exist to reach these equilibria may be present, depending on the choice of parameters. When the parameters are chosen opportunistically, in the short run, our model generates transitions between hard and soft policy measures to deal with the pandemic. In the long-run, convergence is achieved toward one of the possible stable steady states (obey or not obey lockdown rules) as functions of politicians’ and citizens’ incentives.
A predator-prey economic system of tax evasion and corrupt behavior
Journal of Dynamics and Games
Democratisation , Environmental and Income Inequality
Empirical economists commonly agree upon the fact that the demand for environmental goods is incr... more Empirical economists commonly agree upon the fact that the demand for environmental goods is increasing with income, so as long as democratisation shifts the decisive power from a rich individual (autocrat or dictator) to a poorer one (decisive voter), such a regime change should be associated to worse environmental conditions. Assuming that citizens' wealth does not depend on inherited endowments, but only on each individual's share on total production, I will show with a theoretical model that contrary to the expectations, democratisation may have mixed effects on the level of environmental quality, depending on the size of the price and income effects on the demand for environmental quality associated to a decrease in the decisive political actor's wealth. If indeed a poorer individual desires less environmental quality than a richer individual (income effect), he also desires less of the goods responsible for degradation (price effect) so the overall result on the environment is ambiguous. Assuming instead that society is composed by two classes of individuals, one supplying an embodied factor of production and one supplying capital, and assuming moreover that the decisive voter belongs to the first class of individuals while the autocrat does not, democratisation is shown to be beneficial for the environment, the better the effect on the environment, the bigger the difference in wealth between the two decisive political actors.
Dear readers, In this sixth issue of our quarterly newsletter 'Inequality Matters', we specifical... more Dear readers, In this sixth issue of our quarterly newsletter 'Inequality Matters', we specifically focus on Latin American countries (LACs) with many respects. First of all, LIS is excited about its longest data series for Latin America-Chile comes with 12 new micro datasets (CL90-CL15) added to the LIS Database. In a short data highlight, Louis Chauvel explores the Chilean data and exemplifies the quite unique structure of the Chilean income distribution.
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Papers by Laura Policardo