A Literature Review of Business/IT Alignment Strategies

AbstractIn the last years, the alignment issue was addressed in several researches and numerous methods, techniques and tools were proposed. Indeed, the business and IT performance are tightly coupled, and enterprises cannot be competitive if their business and IT strategies are not aligned. This paper proposes a literature review useful for evaluating different alignment approaches, with the aim of discovering similarity, maturity, capability to measure, model, asses and evolve the alignment level existing among business and technological assets of an enterprise. The proposed framework is applied to analyse the alignment research published in the Information & Management journal and the Journal of Strategic Information Systems, that are the ones that more published on this topic. The achieved evaluation results are presented

Otolarylogical features in a cohort of patients affected with 22q11.2 deletion syndrome: a monocentric survey

Otorhinolaryngologic manifestations are common in 22q11.2 deletion syndrome (22q11.2DS), but poorly described. This study aimed to better define the ear-nose-throat (ENT) phenotype of 22q11.2DS patients, in the attempt to best detect subjects requiring subspecialist intervention. We enrolled 25 patients affected with 22q11.2DS. Anatomic and functional ENT findings were investigated using clinical, laboratory and instrumental data. Immunophenotype and frequency of infections were evaluated. Univariate and multivariate analyses were performed. ENT anomalies were found in 88% of patients, and in 20% congenital palate defects required surgery. Adenoids hypertrophy or palatine tonsils hypertrophy were noted in 80 and 48%. Fourty-eight percent of subjects had rhinolalia/phonia, severe in half of these. We also found nasal regurgitation or laryngeal penetration/aspiration in 20 and 16%, respectively. Instrumental exams revealed a mild conductive hypoacusia in 32% (bilateral in most cases), tympanometric anomalies in 28%, and swallowing abnormalities in 16%. Statistical univariate analysis showed a direct association between rhinolalia/phonia and episodes of laryngeal aspiration (P=0.016) and between tympanometric anomalies and increased adenoid volume (P=0.044). No association between episodes of food aspiration and palatal anomalies was found. Moreover, no statistically significant association was observed between the number of airway infections and the ENT findings. This study contributes to better define the ENT phenotype in patients with 22q11.2DS, helpful to prevent potential complications. Furthermore, the identification of a subcategory of patients may allow the early adoption of specific speech therapy programs to improve the clinical outcome of 22q11.2DS patients

Reliability of forced internal rotation and active internal rotation to assess lateral instability of the biceps pulley

Purpose: the aim of this study was to investigate the relationship between positive painful forced internal rotation (FIR) and lateral pulley instability in the presence of a pre-diagnosed posterosuperior cuff tear. The same investigation was conducted for painful active internal rotation (AIR). Methods: a multicenter prospective study was conducted in a series of patients scheduled to undergo arthroscopic posterosuperior cuff repair. Pain was assessed using a visual analog scale (VAS) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) was administered. The VAS score at rest, DASH score, and presence/absence of pain on FIR and AIR were recorded and their relationships with lesions of the lateral pulley, cuff tear patterns and shape of lesions were analyzed. Results: the study population consisted of 115 patients (mean age: 55.1 years) recruited from 12 centers. The dominant arm was affected in 72 cases (62.6%). The average anteroposterior extension of the lesion was 1.61 cm. The mean preoperative VAS and DASH scores were 6.1 and 41.8, respectively. FIR and AIR were positive in 94 (81.7%) and 85 (73.9%) cases, respectively. The lateral pulley was compromised in 50 cases (43.4%). Cuff tears were partial articular in 35 patients (30.4%), complete in 61 (53%), and partial bursal in 19 (16.5%). No statistical correlation between positive FIR or AIR and lateral pulley lesions was detected. Positive FIR and AIR were statistically associated with complete lesions. Negative FIR was associated with the presence of partial articular tears. Conclusions: painful FIR in the presence of a postero-superior cuff tear does not indicate lateral pulley instability. When a cuff tear is suspected, positive FIR and AIR are suggestive of full-thickness tear patterns while a negative FIR suggests a partial articular lesion. Level of evidence: level I, validating cohort study with good reference standards

ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients

Zappatori, mungitori e raccoglitori: i rischi del lavoro primario da Bernardino Ramazzini alla scuola medica di Nicolò Castellino

Una prima descrizione dei fattori di rischio causa di malattia nei contadini fu fatta da Bernardino Ramazzini nel De morbis artificum diatriba (1713), riconoscendone fondamentalmente due, l’aria e la cattiva alimentazione; tali fattori, oltre a condizionare la comparsa di patologie, ne influenzavano la diversa risposta alle terapie mediche: egli consigliava, per esempio, di “non prelevare loro sangue in abbondanza come si fa invece nella gente di città”. Dopo circa due secoli, il mondo rurale diventa oggetto d’interesse scientifico per la peculiarità delle cause ambientali, biologiche e fisiopatologiche alla base dei processi morbosi, che, nonostante il passare dei secoli, restano gli stessi indicati da Ramazzini. Tuttavia, per il ritardato sviluppo del mondo rurale, riconducibile in parte a ragioni storiche, ma in parte anche ad un mancato coordinamento tra interventi di bonifica ambientale, sanitaria e tecnologica, ancora nel 1932, come affermò al congresso di Medicina del Lavoro di quell’anno Pellegrini, riprendendo un’affermazione di Castellino, il rurale restava un grande sconosciuto, mentre al XIX congresso del 1953, col contributo fondamentale dell’INAIL, si cercava ancora di fotografare un mondo nel quale le auspicate bonifiche socio-sanitarie non erano state sostanzialmente applicate. In effetti, pur essendo stata l’Italia ad economia in prevalenza agricola fino agli anni ’60, poche ricerche mediche e sociali avevano affrontato sistematicamente il problema del rapporto tra lavoro agricolo e insorgenza di malattia. Anche per tale motivo, nel corso del ‘900 i lavoratori dell’agricoltura ottennero le tutele assicurative su malattia, infortunio. vecchiaia e invalidità, rispetto alla classe operaia dell’industria, con notevole ritardo e sempre con qualche limitazione. Il sostanziale disinteresse pubblico, legislativo e scientifico per la sicurezza e tutela della salute degli agricoltori era dovuto, e in parte è ancora dovuto, alla tipologia organizzativa del lavoro agricolo, basata prevalentemente sulla conduzione familiare, o sul lavoro non strutturato di dipendenza, quale il cottimo, la mezzadria, o il lavoro stagionale. Giuridicamente tali attività hanno sempre ostacolato l’applicazione degli obblighi di prevenzione e tutela a carico di datori di lavoro e in favore dei prestatori d’opera agricola: zappatori, mungitori e raccoglitori, presi a mo’ d’esempio di mansioni lavorative rurali, hanno dovuto assicurarsi da loro stessi il minimo di prevenzione dai rischi della vita, rimanendo in pratica esclusi da diritti che all’oggi sembrano scontati, quali quelli ad una dignitosa salute fisica e sociale e ad un lavoro esente da pericoli. La Medicina del Lavoro, nata come disciplina autonoma nel corso del secolo scorso proprio per contribuire allo studio del rapporto fra malattie e lavoro, ha risentito di tale disinteresse, dedicando e sviluppando pochi studi e ricerche per la conoscenza dei fattori di rischio in agricoltura rispetto a quelli d’altri comparti lavorativi. Già Ramazzini nel De morbis su 55 trattazioni di malattie in lavoratori, riassume in un solo capitolo quelle dei contadini, pur essendo l’umanità alla sua epoca quasi tutta dedita ai lavori agricoli. Così nel ‘900, al primo congresso italiano di Medicina del Lavoro (1907, Palermo) non si discusse di medicina rurale: eppure essa rappresentava la gran parte dell’emergenza sanitaria dell’epoca non solamente come effetto d’esposizione a rischio lavorativo, ma anche di ordine sociale e ‘geografico’, vedi la piaga della malaria e dell’anchilostomiasi, che hanno condizionato demograficamente e socialmente larghe fette del territorio nazionale. La scuola medica napoletana da Ferrannini a Castellino e Caccuri ha dato contributi occasionali, limitati ad una generica analisi descrittiva del multiforme mondo della ruralità, senza approfondimento epidemiologico dei fattori di rischio, tipologia di lavoro ed insorgenza di patologie nei lavoratori agricoli della Campania. Pertanto, anche nel Congresso internazionale di Medicina del Lavoro tenuto a Napoli nel 1954, il tema fu del tutto trascurato: ancora nel 1960 S. Caccuri riassumeva in suo scritto la patologia dei rurali senza apporti nuovi di conoscenza. Nel frattempo, il problema, e l’interesse scientifico per esso, si esauriva da sé, con qualche ritardo nel Meridione ma inesorabile, con l’industrializzazione, l’urbanizzazione e i conseguenti spopolamento e abbandono di quel mondo rurale, che rimase, pertanto, per sempre ‘sconosciuto’

Adhesive capsulitis

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