Attivit\ue0 fisica adattata (APA) in anziani istituzionalizzati affetti da ritardo mentale: un possibile approccio con evidenza di efficacia

I benefici dell\u2019attivit\ue0 fisica sono notori ma l\u2019effettiva sistematica attuazione nella popolazione \ue8 la scommessa del futuro. E\u2019 necessario oggi verificare le metodologie e gli approcci per massimizzare l\u2019efficacia dei programmi di avvicinamento all\u2019attivit\ue0 fisica adattata mirati a segmenti particolari della popolazione con rilevanti comorbilit\ue0 e disabilit\ue0 relazionali. A tal fine lo scopo di questo studio \ue8 stato valutare alcuni indicatori funzionali per dimostrare l\u2019efficacia di un programma di APA (adapted physical activity) in gruppo di anziani disabili istituzionalizzati dell\u2019hinterland milanese nel migliorare la performance fisica, la massa muscolare e la mobilit\ue0 di alcuni distretti corporei. Vengono riportati i risultati di tre studi realizzati dal 2002 al 2011 nei quali sono stati reclutati complessivamente 58 soggetti disabili anziani affetti da ritardo mentale residenti presso la Fondazione Istituto Sacra Famiglia-ONLUS, omogenei per abitudini di vita. I soggetti reclutati sono stati sottoposti a diversi periodi di allenamento. Per ogni soggetto sono state misurate:la circonferenza brachiale, addominale, del quadricipite e del polpaccio; la mobilit\ue0 scapolo-omerale (test del bastone millimetrato, goniometro); e nell\u2019ultimo studio anche la forza dei flessori del braccio con dinamometro. Tutti gli anziani sono stati sottoposti inoltre a Walking Test (WT6\u2019) ed al Time Up and Go Test (TUG). Tutte le misure sono state eseguite garantendo il doppio cieco. I soggetti arruolati hanno svolto il programma motorio due/tre volte alla settimana per novanta/centoventi minuti. Per ciascun ospite \ue8 stata realizzata una scheda di lavoro personalizzata comprendente anche le indicazioni per l\u2019operatore. Per l\u2019analisi statistica \ue8 stato utilizzato il test T di Student. la compliance all\u2019APA \ue8 stata elevata, mai nessun soggetto \ue8 stato assente per tre volte consecutive. Tra i soggetti reclutati non si sono verificati decessi, cadute o eventi condizionanti ricoveri o giorni di immobilizzazione. I drop out sono stati determinati da motivi indipendenti dall\u2019attivit\ue0. Tutti i parametri sottoposti ad analisi hanno evidenziato una differenza statisticamente significativa tra il t0 e il t1 (p<0,05), con un miglioramento di tutti i parametri misurati. Questi studi evidenziano che l\u2019esercizio fisico continuativo risulta essere efficace nel migliorare i parametri di performance fisica dei partecipanti anche ma anche di essere un elemento fondamentale per garantire benessere psico-fisico all\u2019anziano istituzionalizzato. L\u2019APA pu\uf2 quindi essere adottata per soggetti anziani con disabilit\ue0 intellettivo-relazionale anche nelle residenze protette adattando il setting alla struttura

What matters in implementing the factory of the future: Insights from a survey in European manufacturing regions

Purpose: This paper aims to study the extent of the transformation of European manufacturing companies towards the factory of the future (FoF) and related concepts, e.g. Industry 4.0 and digitalisation. Design/methodology/approach: A qualitative survey design was used to investigate the areas, patterns and elements for implementing FoF. A total of 92 responses from manufacturing firms of Alpine regions were collected and analysed, followed by in-depth interviews with a subset of respondents to identify common challenges, drivers and opportunities for the transformation. Findings: Manufacturing companies are gaining awareness on their needs and gaps in the FoF path, the implications on business strategy and the rates of innovation and technology adoption. Nevertheless, they still need to shape their organisational structures (e.g. from highly centralised to more collaborative ones) and nurture their managerial capabilities in operations and supply chain management, and customer relationships, only partially based on FoF technologies. Research limitations/implications: This study aims to contribute to recent literature and practice of FoF (and related concepts) by depicting a picture of the possible areas of intervention, main issues and gaps (especially in terms of skills, supply chain and customer relationships) of manufacturing companies in their digital transformation. The qualitative research design and its scope represent the main limitations. Originality/value: This paper provides a systemic overview for FoF by encompassing the technological, strategic, managerial and organisational perspectives of digitalisation in manufacturing and integrating the insights from a multi-sectorial and multi-dimensional analysis

What matters in implementing the factory of the future: Insights from a survey in European manufacturing regions

Purpose: This paper aims to study the extent of the transformation of European manufacturing companies towards the factory of the future (FoF) and related concepts, e.g. Industry 4.0 and digitalisation. Design/methodology/approach: A qualitative survey design was used to investigate the areas, patterns and elements for implementing FoF. A total of 92 responses from manufacturing firms of Alpine regions were collected and analysed, followed by in-depth interviews with a subset of respondents to identify common challenges, drivers and opportunities for the transformation. Findings: Manufacturing companies are gaining awareness on their needs and gaps in the FoF path, the implications on business strategy and the rates of innovation and technology adoption. Nevertheless, they still need to shape their organisational structures (e.g. from highly centralised to more collaborative ones) and nurture their managerial capabilities in operations and supply chain management, and customer relationships, only partially based on FoF technologies. Research limitations/implications: This study aims to contribute to recent literature and practice of FoF (and related concepts) by depicting a picture of the possible areas of intervention, main issues and gaps (especially in terms of skills, supply chain and customer relationships) of manufacturing companies in their digital transformation. The qualitative research design and its scope represent the main limitations. Originality/value: This paper provides a systemic overview for FoF by encompassing the technological, strategic, managerial and organisational perspectives of digitalisation in manufacturing and integrating the insights from a multi-sectorial and multi-dimensional analysis

What causes obesity in children and adolescents?

Objective: To present the different aspects that may be involved in the genesis and maintenance of obesity in children and adolescents. Data source: Narrative review of articles published in the PubMed, Scielo, Lilacs, Scopus and Google Scholar databases, using the search terms: overweight, obesity, pre-conception, prenatal, infants, schoolchildren, children, and adolescents. The search was conducted in studies written in Portuguese, English and Spanish, including narrative, integrative or systematic reviews, meta-analyses, cross-sectional, case-control and cohort studies, published between 2003 and 2023. Data synthesis: A total of 598 studies were initially screened and 60 of them, which showed the main biopsychosocial aspects related to greater risks of excessive adiposity in the pediatric age, were included in the review. The data were presented taking into account the incidence of risk factors and their consequences in six periods: pre-conception, pre-natal, infant, preschool, school age, and adolescence. Conclusions: The causal factors described in the scientific literature that have been shown to be related to obesity in childhood and adolescence are presented

Development of an optimized closed and semi-automatic protocol for Good Manufacturing Practice manufacturing of tumor-infiltrating lymphocytes in a hospital environment.

Several studies report on Good Manufacturing Process (GMP)-compliant manufacturing protocols for the ex vivo expansion of tumor-infiltrating lymphocytes (TILs) for the treatment of patients with refractory melanoma and other solid malignancies. Further opportunities for improvements in terms of ergonomy and operating time have been identified. To enable GMP-compliant TILs production for adoptive cell therapy needs, a simple automated and reproducible protocol for TILs manufacturing with the use of a closed system was developed and implemented at the authors' institution. This protocol enabled significant operating time reduction during TILs expansion while allowing the generation of high-quality TILs products. A simplified and efficient method of TILs expansion will enable the broadening of individualized tumor therapy and will increase patients' access to state-of-the-art TILs adoptive cell therapy treatment