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The aim of this paper is to assess small and medium‐sized enterprises' (SMEs') readiness to initiate a mature dialogue with stakeholders in the exceptional context of a strategic crisis, when information on business model sustainability has become universally material for all stakeholders. A quantitative study is carried out by developing a business model content analysis and applying it to a data sample of 109 manufacturing SMEs in Italy with annual revenues ranging from €10 to €50 million. After analyzing the literature on SMEs stakeholder communication and arguing the conflicting influences of stakeholder and legitimacy motivations in the context of a strategic crisis, three hypotheses are tested by collecting data from annual reports. Despite increased stakeholder expectations, the level of communication was limited to a minimum amount of information, demonstrating no relationship with the firms' relative size and proving a prominent influence of legitimacy motivations, with a specific relevance of legal pressures. Under the stress of the crisis, all SMEs, particularly those that were strategically and financially vulnerable, provided extremely limited information, demonstrating the tendency to conceal strategic risks and the difficulties in engaging in mature dialogue with stakeholders. To the best of our knowledge, this is the first quantitative study focusing on unlisted SMEs' sustainability communication. The paper contributes to the policymaker debate on the possibility of extending the current legal obligation on sustainability reporting and transparency to smaller businesses. [ABSTRACT FROM AUTHOR]

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Viola sect. Melanium, the so-called pansy, is an allopolyploid morphologically well-defined lineage of ca. 110 perennial and annual species in the northern hemisphere, characterized by markedly complex genomic configurations. Five annual pansies occur in Italy, four of which are morphologically very similar and belong to the informal 'V. tricolor species complex': V. arvensis (2n = 34), V. hymettia (2n = 16), V. kitaibeliana (2n = 16), and V. tricolor (2n = 26). Their field recognition is difficult and reflects a long-debated taxonomy often resulting in doubtful records in field inventories and across European herbaria. The current lack of comprehensive intra- and interspecific comparative studies and a relative scarcity of appropriate genetic markers coupled with unambiguous cytological descriptions are hindering clear taxa circumscription and phylogenetic inferences within this group. In this work, we tested DNA sequence variation of three highly variable plastid markers and High-Throughput Sequencing (HTS) of the nuclear ribosomal 5S-IGS region in an attempt to decipher species identity within the V. tricolor species complex and to obtain an insight on their genome organization and evolution. Our results document the close relationships within this species group, a reliable molecular resolution for V. tricolor, and the common ancestry of V. arvensis and the poorly differentiated V. kitaibeliana and V. hymettia. Evidence of an important inter-population geographical divergence was recorded in V. tricolor and V. arvensis, pointing at the existence of different eco-cytotypes within these entities. Overall diversity patterns and the occurrence of two to four differently diverging 5S-IGS lineages are discussed in the light of the acknowledged taxonomy and genomic evolutive trajectories of sect. Melanium. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to analyze three characteristics of strategic alliances in Italy to estimate their influence on financial performance. The authors test how alliance complexity, strategic planning and accounting control influence revenue growth, asset growth and EBITDA margin. Design/methodology/approach: This paper uses contractual and financial data to test hypothesized relationships in structural equation modelling (SEM) using partial least squares (PLSs). Findings: This paper highlights that the extent of strategic planning positively influences the growth in assets but not in revenue or EBITDA margin. In addition, the findings of this paper support the idea that the complexity in the alliance is significantly related to the quantity of accounting controls within alliance. Originality/value: This paper improves existing research on the subject, as it contributes to open the black box of alliances' internal operations by examining the details of 50 Italian contracts to create a multidimensional profile of each alliance. [ABSTRACT FROM AUTHOR]

Acute gastroenteritis (AG) represents both the main cause of acute vomiting in children under 3 years old and a major cause of access to the emergency department. Even if several drugs may be able to reduce the emesis, the pharmacological treatment of vomiting in children remains a controversial issue, and several drugs are prescribed outside their authorized drug label with respect dosage, age, indication, or route of administration and are named as off-label. The aim of present study was to assess the off-label use of antiemetic drugs in patients less than 18 years with vomiting related to AG. This study was carried out in eight pediatric emergency departments in Italy. The following data were obtained crossing the pharmacy distribution records with emergency departments' patient data: sex and age of the patients and detailed information for each drug used (indication, dose, frequency, and route of administration). We recorded that antiemetic drugs were prescribed in every year, particularly in children up to 2 years old, and compared with both literature data and data sheet; 30 % of the administered antiemetics were used off-label. In particular, domperidone was the only antiemetic used labeled for AG treatment in pediatric patients, while metoclopramide and ondansetron have been off-label for both age and indications (i.e., AG treatment). Conclusions: In conclusion, we documented an off-label use of antiemetics in children, and this could represents a problem of safety for the patient and a legal risk for the prescribing physician if patients have an unwanted or bad outcome from treatment. [ABSTRACT FROM AUTHOR]

The widespread detection of antibiotics in terrestrial and aquatic systems has engendered significant scientific and regulatory concern. Overall, knowledge concerning the ecotoxicology and sub-lethal effects in water is scarce, but some experimental studies show that antibiotics can induce pathogen resistance and they can also have detrimental effects on natural microbial communities and their key functions. The main aim of this study was to investigate the occurrence of the biodegradation and photodegradation processes of the fluoroquinolone ciprofloxacin (CIP) in the River Tiber waters, in a stretch highly impacted from human pressure. Two set of microcosms consisting of river water containing the natural microbial community and treated with 500 μg/L of CIP in absence or presence of UV-light were performed. Moreover, some microcosms were filled with river water previously sterilized and then treated with the antibiotic. The combined experimental set made it possible to evaluate if the antibiotic CIP could be photodegraded and/or biodegraded. CIP residual concentrations were measured over time by using HPLC coupled to fluorescence detection (FLD) and the effects of the antibiotic on the natural microbial community were assessed in terms of live cell abundance. The key role of light in CIP disappearance was confirmed, but also its biodegradation in natural river water was demonstrated. In fact, differently from other experiments we found a higher degradation rate (DT 50 = 10.4 d), in presence of both light and the natural river bacterial populations than in the same sterilized river water (DT 50 = 18.4 d). Moreover, even in the dark, a partial CIP biodegradation was also observed (DT 50 = 177 d). The overall results were supported by the increase in live cell numbers with the decrease of CIP concentrations both in the dark and light condition. [ABSTRACT FROM AUTHOR]

Background Adn Aim: Healthcare workers and Biomedical students are continuously exposed to biological risk in their clinical practice. The objective of this study was to evaluate the validity and reliability of an Italian questionnaire on the knowledge and perception of biological risk in Biomedical students at the beginning of their professional training., Materials and Methods: An electronic questionnaire was administered to students attending the second semester of the first year of Biomedical Courses at Sapienza University of Rome. The questionnaire consists of 40 questions divided into five sections collecting sociodemographic data, health status and level of knowledge and perception of biological risk. The statistical analysis was performed with Statistical Package for Social Sciences (SPSS) version 25., Results: A total of 309 individuals answered the online questionnaire, with a response rate of 83.5%. The analysis of internal consistency was performed by two dichotomous variables that measured the knowledge level on hygiene behaviour and gloves use. The analysis showed a standardized Cronbach's alpha equal to 0.765, corresponding to a good reliability. A better reliability was found out among physiotherapy and medical students, with a Cronbach's alpha equal to 0.944 and 0.881, respectively. Regarding vaccines, 97.7% of the sample was given a Hepatitis B vaccination and 98.7% of students consider vaccinations essential for healthcare workers., Conclusions: Results of Cronbach's alpha showed a good reliability of the questionnaire. First-year Biomedical students may be exposed to occupational biological risk mainly because of their inexperience. A training educational path should be implemented in order to acquire competences, knowledge, attitudes and practical skills, correct behaviors and a personal and professional responsibility.

The aim of this contribution is to explain a recent tubercolosis "prevention and control" program in health care workers. The same program was implemented in an university hospital since 2007, and revised in 2011 as a result of a new Mycobacterium tubercolosis exposure assessment in the different works environment.

Acute toxic exposures in childhood are quite a frequent event in Paediatric Emergency Medicine. Despite that, there are few papers about clinical toxicology in children, at least in Italy. This paper is the first that takes into account both epidemiological aspects and clinical features of acute poisoning in children on a national basis. Collected data show the increased use of activated charcoal as a treatment and the use of the short stay observation unit as an appropriate answer to the real clinical situation, although some aspects are still controversial. It will be necessary to reconsider the whole matter widening the number of participating centres, so that the most controversial aspects may be clarified.

In middle-age hypertensives from the Gubbio Population Study, we evaluated the relationship between blood pressure (BP) control over a long time and the prevalence of left ventricular hypertrophy (LVH). A population survey was performed in 1982-1985 and repeated in 1989-1992. During the second survey, subjects in the age range 40-60 years were invited to undergo an M-mode echocardiographic examination. A total of 487 subjects who participated in both surveys are included in the present analysis. Some of them (294) were normotensive (Group 1), 110 were hypertensive but had never taken antihypertensive drugs (Group 2), 47 hypertensives on drugs were in good BP control (Group 3) and 36 hypertensives on drugs had uncontrolled hypertension (Group 4). BP values at the 1989-1992 examination were, respectively, 122/77, 145/86, 124/78 and 153/91 mmHg, while 7 years earlier were 122/77, 133/84, 136/85 and 152/95 mmHg. Despite normal BP levels in Group 3, left ventricular mass index (LVMi, g/m(2.7)) was greater than in normotensives (42.4+/-10, 46.6+/-13, 47.0+/-10, 51.9+/-15 g/m(2.7)). Accordingly, the prevalence of LVH (LVMi >51 g/m(2.7)) was 18, 26.4, 36.7 and 50% in groups 1-4, respectively. The 193 hypertensives were, thereafter, divided according to BP control (ie <140/90 mmHg) on both surveys (1983-1985 and 1989-1992): 27 hypertensives with optimal BP levels on both visits also had a ventricular mass similar to normotensives and significantly lower than the other hypertensives (LVMi 44.6+/-11.6 vs 48.5+/-13.2, P<0.001). In conclusion, these findings indicate that hypertensive patients with BP values at levels similar to those in normotensives for a long period do not increase their left ventricular mass in comparison to subjects with normal BP levels.

The problems of the use/abuse of alcohol need a special attention by the Public Authorities, based on the scientific evidences related to the subject. We would like to define in the present paper the procedures for alcohol testing (and drug testing) in the sailors, following the international aviation authorities (ICAO, JAR-OPS-1, FAA) recommendations. A Working Group was established to study both the scientific and the legal aspects of the problems related to alcohol testing in Italy. Experts from the Università "La Sapienza" and from Alitalia studied the alcohol testing issues abroad to set out criteria, guidelines and procedures for random testing in Italy.