Online and offline integration in marketing communication. Delving into the business perspective

Literature about Integrated Marketing Communication (IMC) is still evolving, but lacks a systematic focus on online and offline integration approaches. This research aims to identify the key managerial issues related to online and offline integration within IMC and explore the existence of clusters of firms with consistent conducts and results. We carried out a survey with 124 large firms operating in Italy, running first exploratory factor analyses and then a non-hierarchical cluster analysis. The former highlight the nature of the implementation modalities of online and offline integration in IMC, the main types of advantages, and the different categories of barriers to such implementation. The latter results in two clusters of firms. Academic and managerial implications are presented along with future research directions

Presbyphagia and dysphagia in old age

Although presbyphagia is a clinically relevant problem among elderly population, possibly leading to dysphagia in old age, it remains a still underestimated health condi-tion. The present review analyzes swallow-ing related anatomical and functional changes during aging, both in healthy peo-ple and in those affected by dysphagia. First of all, dysphagia in old people must not be confused with presbyphagia. To distinguish these two different conditions, a correct def-inition of both should be considered. Subsequently, a comprehensive evaluation including instrumental analysis should be carried out. The aim of this narrative review is to analyze the current knowledge of this clinical condition and to provide the state of art to clinicians. A systematic PubMed research on dysphagia in the elderly was conducted and most relevant and most recent references were manually screened and selected. The aim of a correct diagnosis is to enable the choice of a correct interven-tion in order to prevent and treat complica-tions of dysphagia, such as ab ingestis pneumonia and malnutrition. Moreover, the assessment, diagnosis and therapy of dys-phagia/presbyphagia should include the intervention of different specialists

Three-dimensional (3D) versus two-dimensional (2D) laparoscopic adrenalectomy: A case-control study

Laparoscopic adrenalectomy is today considered the gold standard of treatment for adrenal tumors. The development of high definition cameras does not eliminate the major limitation of two-dimensional (2D) laparoscopy: lack of depth perception and loss of spatial orientation. Tree-dimensional (3D) HD laparoscopy was developed as an alternative to conventional 2D laparoscopy

Verbal Fluency in Mild Alzheimer's Disease: Transcranial Direct Current Stimulation over the Dorsolateral Prefrontal Cortex

Background: Recent studies showed that in healthy controls and in aphasic patients inhibitory trains of repetitive transcranial magnetic stimulation (rTMS) over the right prefrontal cortex can improve phonemic fluency performance, while anodal transcranial direct current stimulation (tDCS) over the left prefrontal cortex can improve performance in naming and semantic fluency tasks. Objective: This study aimed at investigating the effects of cathodal tDCS over the left or the right dorsolateral prefrontal cortex (DLPFC) on verbal fluency tasks (VFT) in patients with mild Alzheimer’s Disease (AD). Methods: Forty mild AD patients participated in the study (mean age 73.17 ± 5.61 years). All participants underwent cognitive baseline tasks and a VFT twice. Twenty patients randomly received cathodal tDCS to the left or the right DLPFC, and twenty patients were assigned to a control group in which only the two measures of VFT were taken, without the administration of the tDCS. Results: A significant improvement of performance on the VFT in AD patients was present after tDCS over the right DLPFC (p=.001). Instead, no difference was detected between the two VFTs sessions after tDCS over the left DLPFC (p=.42). Furthermore, these results cannot be related to task learning effects, since no significant difference was found between the two VFT sessions in the control group (p= .73). Conclusions: These data suggest that tDCS over DLPFC can improve VFT performance in AD patients. A hypothesis is that tDCS enhances adaptive patterns of brain activity between functionally connected areas

Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) for uterine fibroids: our experience on patients’ eligibility

Learning objectives The aim of our work is to discuss the clinical and technical eligibility for MRgFUS of women with symptomatic uterine fibroids emphasizing the lack of knowledge of this technique among both patients and physicians. Background MRgFUS represents a feasible, effective, and completely noninvasive thermal ablation procedure that may be alternatively used as a fertility-preserving technique in selected cases. To date, no absolute inclusion criteria have been defined to establish treatment indications and most cases are referred for MRgFUS treatment after many clinical and imaging examinations. Findings and procedure details From June 2012 to August 2013, 29 outpatients women (mean age 43.14±5.96 years) with uterine fibroids were considered clinically eligible for MRgFUS by a general practitioner or a gynecologist and underwent pretreatment pelvic imaging to determine candidacy for the procedure. 13 patients were technical eligible: 11 were treated and 1 of the treated patients underwent myomectomy anyway. Most frequent reasons for ineligibility were: thickness of subcutaneous fat layer, not avoidable bowel interposition, extensive cutaneous scars, fibroid size/structure/location, severe adenomyosis, uterine size, poor compliance and patients’ decision of alternative treatments. In 11 of the 29 patients the pelvic MR could be avoided since the reason of ineligibility could be detected through an accurate clinical examination and/or by ultrasound imaging. Conclusion In our experience MRgFUS treatment is technically possible in less than a half (44,8%) of outpatients women with symptomatic fibroids. However, we can speculate that this result is partially due to the lack of knowledge about of MRgFUS technique among both patients and physicians

Adrenal cavernous hemangioma: which correct decision making process?

Introduction: Cavernous hemangioma of the adrenal gland is a rare benign tumor characterized by the presence of blood-fil- led, dilated vascular spaces. These adrenal masses are usually non-functioning and the patients have no symptoms so the diagnosis is incidental. Methods: We performed a systematic literature review for all articles published until April 2015. The initial search identified 98 publications. We considered some characteristics: the mean age of the patients at diagnosis was 59 years (range 19 - 84); there were approximately 1.7 times more female patients than male patients; mean diameter of the lesions was 10.3 cm (range 2 - 25). Surgical treatment was more often open with midline or subcostal incision. Results: From literature analysis we know that small adrenal hemangiomas are usually asymptomatic. Only four patients in our literature review show endocrinologic disturbances with three cases of subclinical Cushing’s syndrome and a case of hyperaldo- steronism. The pre-operative radiologic features play a fundamental role for correct surgical approach. On enhanced Computed Tomography (CT) scan adrenal hemangiomas tend to be heterogeneous, hypodense lesions with high-density rim of tissue at the periphery. On Magnetic Resonance Imaging (MRI) common findings associated with adrenal hemangiomas are hypointense inhomo- geneous masses with central hyperintensity on T1 images and a high intensity peripheral rim on T2 images due to hemorrhage or necrosis. Conclusion: Laparoscopic adrenalectomy is considered the standard treatment in case of benign lesions. Some authors sugge- st that the main limitation during laparoscopic dissection for large and potentially malign adrenal tumors is incomplete resection and capsular disruption with increased risk of local recurrence and intra-abdominal neoplastic dissemination. We recommend for these patients an integrated multidisciplinary approach that considers endocrine studies, preoperative radiologic findings and the expe- rience of surgical team

Patients perception of ionising radiation risks in CT ionising exposure. Does dose bill works?

Communicating to patients the magnitude of risk related to ionizing radiation exposure is problematic because of the uncertainty in estimates derived principally from epidemiological studies of large populations [1-6]. Euratom directive 59/2013 requires that dose bill will be part of the radiological report in European Countries [7]. However, how a risk is framed has a profound effect on risk perception. To date, no previous studies evaluated which could be the best way to make patient friendly dose bill. Our aim was to evaluate patients' perception of radiation exposure related to routine CT and their understanding after dose bill

PATIENTS' KNOWLEDGE AND AWARENESS OF RADIATION DOSE AND RISKS FROM CT: DO PATIENTS NEED A PERSONALIZED COMMUNICATION OF DOSE BILL?

In the last decades exposure to ionizing radiations in computed tomography (CT) has constantly increased. Only a few years ago it was quite difficult to assess how much radiation had been delivered to a patient during a CT examination. Nowadays, the technical challenges of dose data reporting between CT scanners from different vendors have been met, making dose tracking a reality since these dose data are automatically stored in the picture achieving system of the radiology department. Most authors affirm communication of CT risk to patients should be personalized, but no studies investigate if a tailored communication is needed. Aim of our study is to understand how patients' characteristics may condition the comprehension of this information

SHOT-DEAD CT-VIRTOPSY: OUR EXPERIENCE

To illustrate the potential of CT-virtopsy (CT-v) as a valid help in post-mortem evaluation in gunshot-dead people. To explain as it can support, complete and, in some special cases, be a substitute of body-opening autopsy. To stress its role in establishing cause of death, in dating the succession of lethal events occurred in the body and, possibly, in identifying the corpse

EFFICACY OF RAW IMPLEMENTATION AND REDUCTION DOSE PROTOCOLS IN CT COLONOSCOPY: A SINGLE CENTRE 4 YEARS RETROSPECTIVE REVIEW.

CT Colonoscopy, or Virtual Colonoscopy, is well known as an effective alternative in patients that cannot sustain classic colonoscopy. Otherwise as all radiological procedure concerns arise for radiation exposure related to the examination. If CT colonoscopy is considered necessary the radiation dose, according to ALARA principle should be the lowest. For this reason we examined retrospectively our dose performance in CT colonoscopy in terms of CTDIvol and DLP considering the efficacy of different dose reduction factors