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PurposeThis research aims to identify and organise the conditions of organisational readiness for digital transformation.Design/methodology/approachThis qualitative study comprises three case studies within manufacturing companies from different sizes and industries located in Sweden. Plant visits and in-depth interviews bring to light companies' experiences with initial steps towards digital transformation. A set of conditions for digital organisational readiness was translated into a questionnaire and tested with one of the studied companies.FindingsThis paper organises and tests digital organisational readiness conditions to support companies' initial steps on digital transformation. The results are put in perspective of established change management theory and previous studies about digital transformation. The findings will conclude in a questionnaire to support dialogue and digital organisational readiness assessments.Research limitations/implicationsAdditional conditions for the initial phase of digital transformation could possibly be found if more cases had been included in the study.Practical implicationsThe article identifies a set of conditions translated into a questionnaire that should be used as a dialogue tool to create strategic alignment and support companies in their initial discussions. If this process can be faster and more efficient, the company can achieve a competitive advantage against competitors.Originality/valueThis research's relevance relies on the fact that companies are advancing in adopting digital technologies without being ready from an organisational perspective. This gap creates barriers for companies' digital maturing processes, stopping them from having full access to digital technologies' benefits.

Digitalization and the use of advanced technologies for more flexible and resource efficient production processes are changing the industrial competitive environment. However, new technologies are not seldom implemented without the whole organization being ready to fully utilize its benefits. This readiness can be expressed as organizational digital maturity. Previous studies identified that the level of digitalization is increasing, but, in many cases, due to lack of foundation, it is not aligned with the business strategy and/or supported by the organizational and technological infrastructures. There is a gap in existing models to provide practical starting-up steps to support the organizational digital readiness. A conceptual readiness framework for organizational digital readiness was tested through the analysis and reflection of four cases implemented by a Swedish manufacturing company. Findings point out that it is important to create a proper organizational foundation, a readiness, to ensure a company to evolve in digital maturity. That can be developed based on three main stages of change management practices. The tool can be used to identify the organizational readiness and thereby the gaps and thresholds necessary to overcome. This will enable companies to utilize the technology level necessary to increase cost and resource efficiency, and hence competitiveness. In addition, dimensions and a roadmap for organizational, digital, and smart readiness is presented.

Despite the fact that proton pump inhibitors (PPIs) are one of the most prescribed medications, several epidemiological studies have reported many adverse effects related to their long-term usage. Nevertheless, there were inconsistent findings in the literature with regard to PPI use and bone mineral density (BMD) change. The aim of this systematic review and meta-analysis is to evaluate the association between the use of PPIs and change in BMD. The PubMed/MEDLINE, EMBASE, Cochrane and CINAHL databases were searched up to March 2019. Ten studies fulfilled the eligibility criteria (4761 cases and 30,809 controls), from which the mean difference and mean annualized percent change in BMD were pooled using RevMan 5.3.5 The results showed no statistically significant association between PPI users and non-users in mean annualized percent change in BMD (0.06; 95% CI −0.07, 0.18) with moderate heterogeneity (I2: 63%). There was a statistically significant reduction in the mean BMD difference among PPI users (−0.03; 95% CI −0.04, −0.01) with no substantial heterogeneity (I2: 26%). This meta-analysis reported inconsistent results regarding the use of PPIs and BMD loss. Thus, the effect of PPIs on BMD needs to be elucidated by other studies, and healthcare providers should prescribe PPIs with caution considering their unfavorable consequences on bone health.

Background: Fever in children is a common presenting complaint during health visits. Parents frequently have concerns about fever and perceive it as a disease rather than a symptom of illness. Parent's practice of home managing of fever varies according to their background and experience. Objective: To explore parents' perception and practice in home management of fever in their preschool children in Riyadh, Saudi Arabia (SA). Materials and Methods: This is a cross-sectional study. Data were collected from 250 parents attending three main family medicine centers at King Abdul-Aziz Medical City, Riyadh, SA, using self-administered questionnaire. Results: Most of the parents (64%) defined fever correctly and 56% identified high fever. Almost all the parents (95%) believed fever is harmful, and febrile convulsion was the most concerned complication of fever (74%), followed by loss of consciousness, dehydration, brain damage, and hearing loss. Most of the parents (82%) touch their children to confirm fever, 68% use oral thermometer, and 63% use axillary thermometer. Most parents (84%) applied cold compression, 75% gave their children nonprescribed fever medication, 61% gave their children plenty of fluids, and 64% took their children to the doctor right away. Almost one-third of participants reported having difficulty either in choosing fever medicine or giving the proper dose and frequency. No difference in knowledge or practice was found in relation to difference in demographic characteristics of participants. Conclusion: Results of this study indicate poor knowledge and practice in regard to parent's management of febrile children, overuse of nonprescribed fever medication, and possible waste of health resources.

[1] The objective of this investigation is to examine the characteristics of the low-level tropospheric temperature inversions to a height of 4 km above a suburban site in Oman by using 10-year records of daily upper-air meteorological data. The temperature profile data included in this study were derived from the radiosonde data collected by the Meteorology Department at Seeb International Airport station. The study addresses the statistical analysis of inversion parameters and investigates whether changes in these parameters (i.e., depth and strength) have occurred during the last decade. Both surface-based and elevated inversions are investigated. The study indicated a monthly change in inversion frequency, depth, and strength. Overall, most of the inversions tended to be surface based. The surface-based inversion was more common in winter compared with summer. An opposite trend in elevated inversion was seen where a maximum in their frequencies was found in summer. The elevated inversions were generally shallower and weaker than the surface-based inversions. The data for the past 10 years also indicated a reduction in surface-based inversion depths, accompanied by a rise in both the strength of the surface-based inversions and surface temperatures. It was found that the surface temperature increased by about 0.33°C per year, and the inversion depths declined by about 16.3 m yr−1.

We report on 11 patients (nine unrelated and a brother pair) with severe haemophilia A and factor VIII (FVIII) inhibitor, in whom immune tolerance (IIT) was induced with recombinant FVIII (r-FVIII). Their age ranged from 11 months to 47 years. The number of exposure days (ED) at inhibitor detection varied from 11 to 130. Nine of the 11 patients were high responders ¿>10 Bethesda units (BU) with peak inhibitor levels ranging from 10 to 566 BU. The other two were low responders with peak levels between 0.7 and 2 BU. Before inhibitor detection, the patients had been receiving products of various purities. The IIT regimens were very heterogeneous, and the treatment schedule varied from a short period with 50 IU kg-1 every 2 days, followed by 100 IU kg-1 every 2 days and then 220 IU kg-1 daily. The outcome was considered successful when the inhibitor level fell to 0.6 BU or lower after IIT treatment. The outcome overall was successful in nine out of 11 patients (81.8%), with the nine successful cases comprising seven of the nine high responders (77.8%) and the two low responders. Definite failure of IIT was observed in one high responder after two different IIT regimens. A second high responder is still on IIT treatment. All patients in whom IIT was successful are currently receiving r-FVIII on demand or prophylactically at various dosages. Despite the variability of the patient characteristics and the IIT schedules, this study demonstrates that r-FVIII represents an effective alternative for the eradication of inhibitors through IIT.

Cefixime in a dose 20 mg/kg/day, orally, divided into two doses 12 h apart for a minimum of 12 days, was administered to 50 children with proven S. typhi septicaemia. Forty four of the patients were infected with strains of S. typhi resistant to multiple antibiotics including chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole. All patients responded rapidly to treatment and were cured clinically and bacteriologically. Fever subsided within a mean of 5.3 days (range 3-8 days). Only two of the 50 patients treated relapsed during the 8 week follow-up period. No serious adverse reactions attributable to the drug were observed. Cefixime proved to be an effective oral drug in this open treatment trial and was associated with minimal side effects. It may provide a therapeutic alternative to the treatment of Salmonella infection with organisms multi-resistant to the standard drug regimens. Its oral formulation may provide an efficient alternative to parenteral therapy in less severely ill patients who can tolerate oral feeding.