Massimo Aria

(Un)useful risk disclosure: explanations from the Italian banks

Purpose - – The purpose of this paper is to better understand how mandatory risk categories are disclosed and to provide a better understanding of the reasons why risk disclosure looks less useful than it ought to be. Design/methodology/approach - – We analyze how Italian banks provide risk information, by focusing on its characteristics to find out any differences between the notes to the financial statements and the public report, both prepared in compliance with the instructions of the Bank of Italy. We assess the risk-related reporting practices of 66 Italian banks, based on a content analysis of the two mandatory reports, and verify whether bank-specific factors explain any differences. Findings - – Italian banks formally comply with the Bank of Italy’s instructions, but there is discretion to choose the characteristics of the information provided. Despite different risk categories to disclose in each report, disclosure is quite uniform, although banks tend to provide denser information in the notes to the financial statements and the difference in the economic signs between the two reports decreases as the level of risk increases. Practical implications - – The significance of this study goes beyond the debate taking place in the academic arena, as it can be largely relevant for preparers, those responsible for setting international and national accounting standards, the Basel Committee on Banking Supervision and the domestic supervisory authorities, particularly concerning the possible introduction of requirements that are more explicit than the existing ones. Originality/value - – The Italian setting is very relevant because unlike other countries, Italy adopts “interventionist enforcements”, which are regarded as a critical tool for achieving the minimum disclosure requirements. Moreover, the two sets of disclosure required by the Bank of Italy have never been investigated in a single data set.

CEO performance evaluation systems: empirical findings from the Italian health service

This paper examines the way that the performance of chief executive officers of Italian healthcare organizations is evaluated. The aim is to analyse the extent of the use of New Public Management techniques in the highly regionalized and political Italian healthcare sector. A positive association was found between formal CEO performance evaluation systems and the quality of regional governance. There was no significant relationship between formal CEO performance evaluation and the duration of CEO tenure.

Management of reticular oral lichen planus patients with burning mouth syndrome-like oral symptoms: a pilot study

Abstract Objectives: We sought to determine the efficacy of psychotropic drug in the management of BMS-like oral symptoms in patients with reticular oral lichen planus (R-OLP) refractory to conventional therapies, and its impact on anxious and depressive symptoms. Materials and methods: We enrolled 28 cases of symptomatic R-OLP. The Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI), the Hamilton rating scales for Depression (HAM-D) and Anxiety (HAM-A) were performed at baseline (time 0), after 2u2009months of topical clonazepam (time 1) and after 6 months of benzodiazepine and antidepressant drugs (time 2). Results: R-OLP patients showed a statistically significant improvement in the NRS and T-PRI scores from time 0 [median: 9.0 (IQR: 7.2–10.0) and 10.5 (IQR: 7.0–13.0), respectively] to time 2 [(median: 2.0 (IQR: 2.0-3.0) (pu2009<u2009.001) and 3.0 (IQR: 2.0–4.7) (pu2009<u2009.001), respectively]. Similarly, the HAM-A and HAM-D scores showed an improvement from time 0 [(median: 15.0 (IQR: 10.2–17.8) and 13.0 (IQR: 12.0–15.0), respectively] to time 2 [median: 6.0 (IQR: 4.0–7.0) (pu2009<u2009.001) and 5.5 (IQR: 4.25–6.0) (pu2009<u2009.001), respectively]. Conclusions: Psychotropic drugs turned out to be effective in the management of BMS-like oral symptoms in R-OLP patients refractory to conventional immunosuppressive therapy, although in a long-term period.

Pain in Patients with Dystrophic Epidermolysis Bullosa: Association with Anxiety and Depression

Objective We investigate the presence and the quality of pain in patients with dystrophic epidermolysis bullosa (DEB), and its correlation with the level of anxiety and depression. Methods We collected data from 27 DEB patients and 26 healthy individuals. DEB patients and controls completed 1 scale for the quality of pain, and 1 scale for anxiety and depression. Pain was assessed with the short form of the McGill Pain Questionnaire, whereas anxiety and depression were assessed with the Hamilton rating scale for anxiety and depression. Results DEB patients and healthy control individuals were homogeneous for age and gender (p>0.05). A statistically significant difference in the two groups was seen for sensory pain rating scale (p<0.001), affective pain rating scale (p=0.029), total pain rating scale (p<0.001), visual analogue scale (p=0.012) and present pain intensity (p=0.001), but not for anxiety (p=0.169) and depression (p=0.530). The characteristics of pain that showed a significant difference between DEB patients and healthy controls were shooting, splitting, tender and throbbing (p<0.05). In DEB patients pain was not correlated with anxiety or depression (p>0.05), whereas a slight correlation between pain and anxiety was found in healthy controls (p<0.05). No difference was found between quality of pain and anxiety-depression in DEB patients (p>0.05), but was between the DEB dominant and the recessive form of DEB (p=0.025). Conclusion The perception of pain in DEB patients appears greater than in healthy individuals, with splitting and tender characteristics being the most significant ones, but was not associated with anxious and/or depressive symptoms.

Drug-induced oral lichenoid reactions: a real clinical entity? A systematic review

PurposeDrug-induced oral lichenoid reactions (DIOLRs) have been extensively reported in the literature, but the validity of the causality relationship between any drug and the oral lichenoid lesions (OLLs) still remains questionable. We sought to determine whether this causality relationship really exists, whether a resolution of the oral lesions upon withdrawal occurs, and what the most common alleged offending medications are.MethodsNine electronic databases from January 1966 to December 2016 were systematically searched to identify all relevant studies selected with specific inclusion criteria (a clinical and histopathological diagnosis of DIOLRs, and clearly statement on the systemic offending medication). Searched terms included but not limited to oral lichen planus/oral lichenoid lesions/oral lichenoid reactions, the adverse effects of medication, and drug-induced. Statistical analyses conducted.ResultsThe search retrieved a total of 817 articles, of which only 46 were included into a qualitative synthesis: 40 case reports/series and 6 studies. The causality assessment was done only in 14.8% of cases with the C-D-R protocol. The Naranjo algorithm was not reported in the majority of cases (98.2%). Culprit medication was withdrawn in 68.5% of the cases, obtaining a partial or complete resolution without treatment in 16.7% of cases and with treatment in 27.7% of cases. The median number of culprit medication(s) described was 1 with the most frequent ones being Methyldopa (20.37%), Interferon (IFN)-alpha (11.11%), and Imatinib and Infliximab (9.26%).ConclusionThis systematic review demonstrated that there is no strong scientific evidence to support the causal relationship between any drug and oral lichenoid lesions; therefore, in all reviewed cases, we must question whether the DIOLRs represent a real and separate clinical entity. Further and more thorough investigations using one of the available algorithms for adverse drug reaction are warranted.

Dynamic recursive tree-based partitioning for malignant melanoma identification in skin lesion dermoscopic images

In this paper, multivalued data or multiple values variables are defined. They are typical when there is some intrinsic uncertainty in data production, as the result of imprecise measuring instruments, such as in image recognition, in human judgments and so on. So far, contributions in symbolic data analysis literature provide data preprocessing criteria allowing for the use of standard methods such as factorial analysis, clustering, discriminant analysis, tree-based methods. As an alternative, this paper introduces a methodology for supervised classification, the so-called Dynamic CLASSification TREE (D-CLASS TREE), dealing simultaneously with both standard and multivalued data as well. For that, an innovative partitioning criterion with a tree-growing algorithm will be defined. Main result is a dynamic tree structure characterized by the simultaneous presence of binary and ternary partitions. A real world case study will be considered to show the advantages of the proposed methodology and main issues of the interpretation of the final results. A comparative study with other approaches dealing with the same types of data will be also shown. The comparison highlights that, even if the results are quite similar in terms of error rates, the proposed D-CLASS tree returns a more interpretable tree-based structure.