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The aim of this paper is to investigate some elements that might influence the choice of PPP as a managerial form for the provision of social services at the local government level, given the contribution of this type of services to social sustainability. To this end, we apply the GLS method to a sample consisting of all 116 Italian provincial capitals over a three years period (no. 2,088 observations). The analysis highlights that: 1) the financial commitment of the municipality is not correlated with the use of PPPs; 2) the rightwing and Star Movement political orientation of local government shows a negative correlation with the use of PPPs; 3) a larger population to be assisted does not lead to a higher use of PPPs. Finally, we suggest some desirable lines of future research some thoughts in support of public management.

This chapter describes the evolution of social services in Europe, setting the picture in the frame of the changing profile of European societies and demographics, on one hand; and the changed configuration and role of public administration, on the other hand. Changes to welfare systems in Europe have occurred at different levels, including the mission and goals of welfare institutions, the actors providing social services, the arrangements for the delivery of social services, and the funding of services. In terms of mission and goals, the trend has been away from social assistance and toward emphasizing social inclusion. In terms of governance and actors within the welfare system, the tendency has been from public entities to an emphasis on hybrid organizations and public–private partnerships. In terms of the arrangements for service provision, the trend has been from cash allowances toward forms of user involvement, co-design, and co-production. Finally, in terms of funding, we observe a trend from “generous” public funding to a mixing of public and private sources, a general fragmentation, and, often, an overall reduction in the funding of welfare.

Background: in the field of rare diseases (RDs) most of the European studies on budget impact analysis of drugs that have been conducted often lay on theoretical assumptions and focus only on Orphan drugs (ODs). Objectives: we aimed to estimate the budget impact of specific drugs for non-oncological RDs, both ODs and non-ODs, using real-world data about patients residing in Veneto Region (Italy) and to describe its expenditure structure and dynamics. Methods: a population-based multi-source observational study was conducted using data from Regional administrative databases; an ad-hoc drugs’ list specific for RDs including both ODs and non-ODs and classifying them by ATC codes has been created. Results: In 2019, the total expenditure for drugs specific for RDs was EUR 97.2 million (6.6% of the total Regional budget). The RD drug list included 58 ATC codes, of which 15 ATC had an annual budget impact over EUR 1 million (“blockbuster drugs”). The most expensive treatment was a non-OD drug (Coagulation factor VIII). The two most represented therapeutical areas were the metabolic and the hematological ones. Conclusions: Cost analyses on RD high-cost drugs expenditure should consider any specific RD drug, not only ODs. Expenditure dynamics for RD drugs are peculiar showing “blockbuster drugs”. Some therapeutical areas seem to be lacking in the drug research field.

Although the scientific debate in the field of business economics is rich in contributions to the subject of sustainability, they mainly focus on a specific aspect represented by sustainability reporting. Consistent with this bibliographic evidence, the aim of this study was to investigate a sustainability management model in local authorities, which, by examining the dimensions of sustainability, goes beyond the focus of reporting highlighted in the literature to consider the entire sustainability cycle (from planning to measurement). To this end, the methodology of the single case study with multiple units of analysis is used, examining the case of an Italian local authority that has experimented with the sustainability management model described in this paper. The analysis of the case leads to some concluding remarks on the strengths and weaknesses of the model, contributing to the scientific debate on sustainability management and providing useful indications for public managers and political decision-makers.

Personalized medicine (PM) moves at the same pace of data and technology and calls for important changes in healthcare. New players are participating, providing impulse to PM. We review the conceptual foundations for PM and personalized healthcare and their evolution through scientific publications where a clear definition and the features of the different formulations are identifiable. We then examined PM policy documents of the International Consortium for Personalised Medicine and related initiatives to understand how PM stakeholders have been changing. Regional authorities and stakeholders have joined the race to deliver personalized care and are driving toward what could be termed as the next personalized healthcare. Their role as a key stakeholder in PM is expected to be pivotal., The Coordination and Support Action Regions4PerMed has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 825812.

Dopo la Rivoluzione industriale e soprattutto nel XX Secolo si sono affermati e sempre piA¹ consolidati il principio e la logica della specializzazione e della divisione del lavoro all’interno di istituti economici e sociali, nonchA© delle funzioni tra i diversi istituti nella societA . In particolare si A¨ imposta la separazione, diventata progressivamente separatezza e divaricazione, tra economia e societA , tra produttivitA ed equitA , tra produzione della ricchezza e sua distribuzione, tra scambi/relazioni di mercato e scambi/relazioni non di mercato, tra economia e cultura, tra valore economico e valore estetico, tra ricerca dell’efficienza e ricerca del bello, tra ciA² che ingentilisce gli animi e ciA² che risponde a bisogni materiali, di status sociale, di stima e autostima, tra approccio scientifico e approccio umanistico, tra tecnica e arte. … to be continued

Business management and, more generally, decision makers, are increasingly aware of the importance of corporate social responsibility and ethical choices within the strategic business vision. The number of tools (e.g., board of directors, organization actions), levers (e.g., cultural, social example of direct boss) and rules (e.g., protocols, certifications, law decrees) available, however, makes it difficult for management to identify the set of best practices to be adopted within its own organization. Further, the task is even more difficult when management is called upon to choose these tools for life-long learning programs intended for company staff as well as for new hires. The Italian Association for Managerial Training has promoted a survey that pays particular attention to the «ethical choices» and «behaviors» to be adopted in the organization’s management and their training programs. The results of the survey have been modelled through «Carroll’s conceptual framework» that, as known, is made of two parts: the most cited CSR pyramid and the least mentioned, but equally important, descriptive types of management. In this work, it has been employed a two steps multivariate analysis, employing an Exploratory Factor Analysis (EFA) and a Structural Equation Modelling (SEM). EFA has been used to identify Carroll’s descriptive types (or profiles), while SEMs were employed to verify the plausibility of the causal models that represent, in turn, thought experiments simulating «ethical dilemmas» useful for the company’s management during its decision making. The models identified, readable in the form of simple «heuristics», are interpreted in the light of Carroll’s «descriptive types» of management (i.e., moral, immoral and amoral). Thereby, any organization, even of a small size, interested in adopting «sustainable policies», can make use of the identified models to establish which guidelines can be adopted by the management during her/his decision making, and, according to Carroll, «to isolate the ethical or moral component of CSR and relate it to perspectives that reflect the three major ethical approaches to management», with the overall objective of managing with «stakeholders in an ethical or moral fashion».

The editors of this symposium hope that this collection of articles can help advance the public administration literature stream across the multiple organizational and cultural settings in which these performance management studies were conducted. However, this symposium also focused on articles that can help advance the practice of performance management, where specific recommendations are needed to help public officials collect, analyze, and use meaningful outcome measures specifically for the benefits for making better management and policy decisions.

Low efficiency of public administrations is considered an obstacle towards overcoming the effects of the financial crisis and recovering growth. Why does this happen? It is for sure because principles, criteria, techniques of good management are not tailored to the peculiarity of public interest organizations, but also because public integrity distortions orient people to use it as an instrument to exercise power. New Public Management has not been sufficient to break the vicious circle of inefficient public administration and a new anti-corruption law has been introduced in Italy. Its main objective is to prevent and control “the negative corruption effect” attempts towards the common good – also characterized by capital rationing – which can compromise the present and future wealth of communities.

The term surgery derives from the Greek words χέρι (hand) and ἔργον (work). However, it is likely that surgical techniques first appeared before other medical practices. Indeed, there are archeological findings dating back to the Paleolithic which suggest that some sort of surgical activity was already being carried out, such as trepanning. Furthermore, there is evidence that the Egyptians were capable of performing highly specialized surgical techniques, with doctors benefiting from the anatomical knowledge of embalmers. The first regulation of the medical profession dates back to the Old Kingdom, whereas the world’s oldest depiction of a surgical procedure—a circumcision—can be found at the entrance to the temple in Memphis. The first example of regulating the practice of physicians and surgeons can be attributed to some of the laws found in the Code of Hammurabi (1792–1759 BC), which provided for both monetary sanctions and corporal punishment in the event of medical errors.

The purpose of this symposium is to contribute to the ongoing debate on this topic in the public administration literature by exploring the contribution of performance management in the implementation of effective governance systems that may foster community resilience, especially to social “wicked” problems. The set of articles hosted in this issue provides a variegated mix of ideas and experiences in this field, encompassing different countries (from Northern to Southern Europe, and Canada), sectors (including labor, healthcare, tourism, and public utilities), and methodological approaches. An empirical perspective is adopted by the authors, involving case studies, interviews, and field research. Both the variety of explored fields and the practical viewpoints from which investigated issues are framed provide useful insights to highlight a research field that is still relatively unexplored, especially if considered under the perspective of performance management.

The contributions contained in this book have shed light on some trends and challenges for the future of abdominal wall surgery. First and foremost, the professionalism of surgeons is evolving. Indeed, surgeons must acknowledge that surgical outcomes will not depend so much on their knowledge and skills alone but rather on the contributions of many professionals working together in harmony. Thus, while developing new surgical techniques will continue to be important, so will building close-knit teams of people who are motivated to work together to meet the real needs of patients in the best possible way. Members of these teams will have to accept the principle that they can no longer be good at what they do “individually”, but rather “together”. Thus, the type of leadership required will have to shift from technical/professional leadership to organizational and motivational leadership.

The environmental dimension of sustainability implies the role of cities, considering their institutional vocation to territorial management and their proximity to the needs expressed by the community. This paper aims to investigate the implementation of a sustainable approach by cities in the realization of environmental policies. The methodology followed is regression (GLS method) that relates the expenses for the environmental policy of a sample of Italian cities (116) to some environmental indicators for the same municipalities (considering 2003–2011). Furthermore, t-test methodology is applied to compare the sample average values to the Italian average values of the selected environmental indicators. The paper takes into account not only a specific phase of sustainability, but it also considers the whole sustainability approach. In fact, the research connects the financial starting point of environmental policy (city's environmental financial commitment) to its environmental impacts (environmental indicators). The results obtained show that the investigated cities, on the one hand, direct environmental expenses to critical factors affecting environmental sustainability but, on the other hand, their environmental policies are not very effective. The research output gives useful information to city managers and politicians in order to focus their environmental policy on a sustainability approach that is effectiveness oriented.