Cambiamenti della Corporate Governance nelle piccole e medie imprese familiari. I casi: Lanificio Luigi Ricceri e Lanificio Europa s.n.c

La conoscenza imprenditoriale della Family Business, ossia il sapere come gestire e far prosperare la propria azienda familiare è oggi uno dei principali temi trattati per comprendere l’importanza che queste realtà imprenditoriali hanno nel nostro Paese. Le imprese familiari in Italia si stima siano circa 784.000 - pari ad oltre l’85% del totale aziende - e pesino in termini di occupazione circa il 70%. Sotto il profilo dell’incidenza delle aziende familiari, il contesto italiano risulta essere in linea con quello delle principali economie europee quali Francia (80%), Germania (90%), Spagna (83%) e UK (80%), mentre l’elemento differenziante rispetto a questi paesi è rappresentato dal minor ricorso a manager esterni da parte delle famiglie imprenditoriali: il 66% delle aziende familiari italiane ha tutto il management composto da componenti della famiglia, mentre in Francia questa situazione si riscontra nel 26% delle aziende familiari ed in UK solo nel 10%. Questo progetto di tesi nasce, ed è stato sviluppato, per evidenziare come i cambiamenti generazionali nelle piccole e medie imprese familiari possono influenzare gli assetti della corporate governance, in uno scenario che oggi vede crescere e svilupparsi sempre più piccole e medie imprese familiari. Per rendere la trattazione non soltanto esplicativa a livello teorico, ma anche pratico, sono stati esaminati e riportati due casi di aziende familiari pratesi del settore tessile, che hanno raccontato la loro storia e la loro esperienza in tema di ricambio generazionale. Infine, confrontando le due imprese, vengono analizzati i cambiamenti che sono stati apportati alla governance aziendale e i motivi che hanno spinto gli imprenditori a procedere in quella direzione

Low dose aspirin and clinical outcomes in patients with SARS-CoV-2 pneumonia: a propensity score-matched cohort analysis from the National SIMI‑COVID‑19 Registry

Background: SARS- CoV-2 virus has had dramatic consequences worldwide being able to cause acute respiratory distress syndrome (ARDS), massive thrombosis and pulmonary embolism and, finally, patients' death. In COVID-19 infection, platelets have a procoagulant phenotype that can cause thrombosis in the pulmonary and systemic vascular network. Aspirin is a well-known anti-platelet drug widely used for the prevention of cardiovascular events and systematic reviews suggest a possible benefit of low-dose aspirin (LDA) use in the prevention and treatment of ARDS in patients with COVID-19 infection. However, several studies are available in the literature which do not support any benefits and no association with the patients' outcome. Therefore, currently available data are inconclusive. Materials and patients: Data from the nationwide cohort multicenter study of the Italian Society of Internal Medicine (SIMI) were analyzed. We conducted a propensity score-matched cohort analysis to investigate the impact of chronic assumption of LDA on mortality of adult COVID-19 patients admitted in Internal Medicine Units (IMU). Data from 3044 COVID-19 patients who referred to 41 Italian hospitals between February 3rd to May 8th 2020 were analyzed. A propensity score-matched analysis was conducted using the following variables: age, sex, hypertension, hyperlipidemia diabetes, atrial fibrillation, cerebrovascular disease, COPD, CKD and stratified upon LDA usage, excluding anticoagulant treatment. After matching, 380 patients were included in the final analysis (190 in LDA group and 190 in no-LDA group). Results: 66.2% were male, median age was 77 [70-83]. 34.8% of the population died during the hospitalization. Cardiovascular diseases were not significantly different between the groups. After comparison of LDA and no-LDA subgroups, we didn't record a significant difference in mortality rate (35.7% vs 33.7%) duration of hospital stay and ICU admission. In a logistic regression model, age (OR 1.05; 95% CI 1.01-1.09), FiO2 (OR 1.024; 95% CI 1.03-1.04) and days between symptoms onset and hospitalization (OR 0.93; 95% CI 0.87-0.99) were the only variables independently associated with death

Antihypertensive treatment changes and related clinical outcomes in older hospitalized patients

Background: Hypertension management in older patients represents a challenge, particularly when hospitalized. Objective: The objective of this study is to investigate the determinants and related outcomes of antihypertensive drug prescription in a cohort of older hospitalized patients. Methods: A total of 5671 patients from REPOSI (a prospective multicentre observational register of older Italian in-patients from internal medicine or geriatric wards) were considered; 4377 (77.2%) were hypertensive. Minimum treatment (MT) for hypertension was defined according to the 2018 ESC guidelines [an angiotensin-converting-enzyme-inhibitor (ACE-I) or an angiotensin-receptor-blocker (ARB) with a calcium-channel-blocker (CCB) and/or a thiazide diuretic; if >80 years old, an ACE-I or ARB or CCB or thiazide diuretic]. Determinants of MT discontinuation at discharge were assessed. Study outcomes were any cause rehospitalization/all cause death, all-cause death, cardiovascular (CV) hospitalization/death, CV death, non-CV death, evaluated according to the presence of MT at discharge. Results: Hypertensive patients were older than normotensives, with a more impaired functional status, higher burden of comorbidity and polypharmacy. A total of 2233 patients were on MT at admission, 1766 were on MT at discharge. Discontinuation of MT was associated with the presence of comorbidities (lower odds for diabetes, higher odds for chronic kidney disease and dementia). An adjusted multivariable logistic regression analysis showed that MT for hypertension at discharge was associated with lower risk of all-cause death, all-cause death/hospitalization, CV death, CV death/hospitalization and non-CV death. Conclusions: Guidelines-suggested MT for hypertension at discharge is associated with a lower risk of adverse clinical outcomes. Nevertheless, changes in antihypertensive treatment still occur in a significant proportion of older hospitalized patients