Alpha-1-antitrypsin deficiency and bronchiectasis: A concomitance or a real association?

Alpha-1-antitrypsin deficiency (AATd) is a hereditary disease, mainly characterized by early onset and the lower lobes’ predominant emphysema. Bronchiectasis is characterized by dilatation of the bronchial wall and a clinical syndrome whose features are a cough, sputum production and frequent respiratory exacerbations. In the literature, there are many papers concerning these two clinical entities, but there is still a lot of debate about a possible association between them, in particular about the frequency of their association and causal links. The aim of this short communication is to show the literature reports about the association between AATd and bronchiectasis to establish the state of the art and possible future developments in this research field

Automation and Digitalisation: impact on the world of work

Warnings about technology displacing workers from their jobs are not new. In the early 19th century the luddites smashed up machines used in textile manufacturing. Although whether the origins of this protest were about working conditions or about the fear of machines deskilling their jobs in not clear. However, the speed and scope of changes today are unprecedented. Rapid advances in technology means that automation and digitalization are increasingly encroaching on jobs previously though as only suitable for humans, for example driverless cars. Such advances and possibilities are driven by advances in artificial intelligence (AI) and robotics and have the potential to radically alter the job market world-wide. The aim of this paper is to review the current research on automation in the workplace and examine the impact and the potential impact it is having and could have in the future

Defining Health Service Eco-System “Infection”: A Critical Analysis of Patient Surveys

Purpose – This paper focuses on the analysis of the most common tools that health care organizations use to assess the quality of the delivered services, the patient surveys. In line with the results of a systematic literature review on the issue, the study embraces service ecosystem perspective to understand why these surveys are unable to grasp actors’ disposition to co-create value for the health care system. Methodology – An in-depth literature review based on PRISMA framework explored 34 works on the topic of patient surveys in order to trace the evolution of the relationship users/providers and to highlight the criticalities related to the adoption of patient surveys in service-oriented era. The study discusses critically their efficacy to understand how they can affect (positively or negatively) the viability of a health care service eco-system. Findings – The literature review highlights patient surveys inability in grasping the real perception that patients have of experienced services and in involving them in value co-creation, through their engagement in service design and delivery. Moreover, the results reveal the need to adopt Service Dominant (S-D) Logic and service eco-system perspective to reread the traditional tools to measure quality in healthcare. For this reason, the metaphor of health service eco-system “infection” is launched, depicting the negative influence of patient satisfaction surveys on value co-creation and the subsequent service eco-system viability. Practical implications – The study shows that assuming a service eco-system perspective based on S-D logic, health care system should boost and preserve value co-creation processes. Moreover, institutions should foster those “rules of the game” that institutionalize the contribution of health providers to value co-creation, defining specific strategies to avoid the “infections” of health care service eco-system, e.g. investing and promoting non-detrimental tools. Originality – This study represents one of the first attempts to reread the tools used to assess patient embracing a service eco-system perspective. Interesting implications have been presented in terms of the negative effect that traditional assessment tools have on providers, patients and the whole society

Didactic "Harmonies" in a Bioeducational Perspective

While singling out the dialogue between biology and culture as a privileged site where musical language can be read as “complex phenomenon”, this essay moves from a bioeducational perspective in order to analyze learning as a fundamentally adaptive process i.e. the result of a synergic pathway, permeated by inter-active dynamics that involve subjects in their inseparableness of mind, body and organism. he relationship body, sounds and action promotes original didactic musicalities, which, hinging on a bioeducational perspective of the teaching-learning process, represent a simplexity, as an accessible variation of the didactic action

Putting Health 4.0 at the service of Society 5.0: Exploratory insights from a pilot study

The Health 4.0 paradigm is reshaping the attributes of health services' delivery. Alongside triggering institutional, structural, and cultural changes for health care organizations, it aims at achieving an increased patients and caregivers' participation in the value creation process. This is consistent with the transition towards Society 5.0 in health care. Drawing on the outcome of the research project “Health management system for managing bedsores in the home care setting”, which was financed by the Operative Regional Programme of Campania, Southern Italy (Regional decree no. 614 dated October 29th, 2018 - CUP: B53D18000120007 - POR FESR Campania 2014/2020, O.S. 1.1), this study advances a Health 4.0 solution embedded in a mobile clinical Decision Support System intended to merge the diverging purposes of increasing health services' efficiency and boosting the quality of care by enacting value co-creation. The solution has been tested in a delicate health care setting, i.e. bedsores’ treatment for home-care patients. The results of the pilot test suggest that Health 4.0 generates a twofold gain. On the one hand, it enables a more effective and timelier delivery of health services, curbing health exacerbations and tackling access to emergency care. On the other hand, it creates a digital-based empowering environment for patients and informal caregivers, activating them to perform as value co-creators. Health 4.0 should enter the socio-economic planning discourse in health care, being conceived of as a solution to enhance the economic viability and the social sustainability of health care systems

Analysis of Acinetobacter baumannii hospital infections in patients treated at the intensive care unit of the University Hospital, Wroclaw, Poland: a 6-year, single-center, retrospective study

Wieslawa Duszynska,1 Agnieszka Litwin,2 Stanislaw Rojek,1 Aleksander Szczesny,3 Alfonso Ciasullo,1 Waldemar Gozdzik1 1Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland; 2Microbiology Laboratory, Wroclaw University Hospital, Wroclaw, Poland; 3Students Scientific Society by Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland Background: Acinetobacter baumannii (AB) is one of the most frequently isolated strains of bacteria in intensive care unit (ICU) patients, which provides huge therapeutic problems due to its multidrug resistance (MDR).Patients and methods: The overall purpose of the study was analysis of health care-­associated infections in terms of the incidence of AB strain infections and the changing susceptibility of this strain within a 6-year observation (2011–2016). The study was carried out in an ICU of the University Hospital in Wroclaw (Poland).Results: Among 589 isolated strains responsible for 540 health care-associated infections (21.2%) in 2549 ICU patients, AB was the pathogen in 183 (31%) cases. The incidence of AB infection amounted to 6.4/1000 patient-days. An increase was noted in the total number of hospital infections caused by AB strain from 16.5% and 3.39/1000 patient-days in 2011 to 41% and 9.64/1000 in 2016 (p=0.0003 and p=0.000, respectively). AB infections most frequently concerned ventilator-associated pneumonia (73.8%). AB was susceptible to colistin, amikacin, imipenem, meropenem, and ciprofloxacin in 100%, 10.7%, 12.3%, 11.5%, and 2.4% respectively, and it was characterized by MDR in 98.36% of the strains.Conclusion: The study revealed a 3-fold increase in the incidence of AB strain infections, significant increase in the resistance to carbapenems in the observed period, and a very high MDR. The solution to this problem would be the implementation of a repair program aiming at inhibition of AB strain transmission, measures to prevent infections, and restricted use of antibiotics. Keywords: Acinetobacter baumannii, hospital infections, multiresistanc

Locally focused and digitally oriented: examining eco-museums' digitization in a service quality management perspective

Purpose Eco-museums safeguard the cultural authenticity and the historical identity of the place in which they operate. Conventional organizational models and management practices are generally employed to achieve this institutional aim. Conversely, innovative solutions - such as digitization - are overlooked. Adopting a service quality management perspective, the article intends to examine the role of managerialization and professionalization in triggering eco-museums' digitization. Design/methodology/approach An empirical analysis involving 126 eco-museums operating in Italy as of 2018 was designed to investigate the implications of managerialization and professionalization on the eco-museums' propensity to embark on a digitization process. Two different forms of digitization were examined: (1) the presence of eco-museums in the digital environment; and (2) the exploitation of digital tools for service delivery. The mediating role of two "soft" total quality management (TQM) practices, i.e. people centredness and strategic focus on visitors' experience, was contemplated in the empirical analysis. Findings The research findings suggest that managerialization and professionalization have ambiguous effects on eco-museums' digitization. Nevertheless, they indirectly contribute to a greater digital presence of eco-museums and to a larger use of digital tools for service delivery through an increased use of soft TQM practices. Research limitations/implications Managerialization and professionalization are likely to foster the digital transition of eco-museums, which advances their ability to protect and promote the local cultural heritage. Soft TQM practices intended to achieve people-centredness and to enhance the visitors' experience should be exploited to stimulate the eco-museums' digitization. Originality/value The article examines the triggers of eco-museums' digitization, providing some food for thought to scholars and practitioners

An integrated learning framework of corporate training system: a grounded theory approach

Purpose – Rooting in the literature on training and laying on Kirkpatrick model, this paper aims to explore key drivers of corporate training to identify how they can be combined into an integrated framework of learning for human capital development. Design/methodology/approach – By adopting the constructivist grounded theory, this contribution analyzes the experience carried out in the last ten years by Virvelle, an Italian corporate training firm. Findings – Results show the rise of five core categories, g1iving rise to an integrated model of Kirkpatrick. Their dynamic interplay led to a new orientation of Kirkpatrick model giving rise to a metalearning ecosystem. Research limitations/implications – Managerial implications have identified key factors on which building and implementing appropriate corporate training programmes capable of triggering co-generative processes of value creation. Particularly, the essential role of learning quality culture, digital technology and personalization are detected in integrating not only hard but furthermore soft shades of learning. Concerning theoretical implications, the emergence of key structural and systems enabling dimensions for learning, and contextual mechanisms involved in reshaping training effectiveness and achieving integrated learning outcomes are detected. The main limitation of this study lies in the need to generalize results: the conceptualized framework needs to be empirically tested. Originality/value – The value of this research is built along three main points. The first is the integration among the core categories that an integrated learning system can be built on, promoting learning quality culture through positive feedback loops. The second is represented by the chance to enhance an integrated mutual knowledge development among engaged actors, thereby shaping a more holistic and multidimensional learning model. The third is related to the transversal role that digital technology plays in all phases of the training process as it integrates and enriches them