ObjectiveThe aim of this double-blind, placebo-controlled and parallel- arm randomized clinical trial was to evaluate the effects of Lactobacillus rhamnosus SP1-containing probiotic sachet and azithromycin tablets as an adjunct to nonsurgical therapy in clinical parameters and in presence and levels of Tannerella forsythia, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Material and MethodsForty-seven systemically healthy volunteers with chronic periodontitis were recruited and monitored clinically and microbiologically at baseline for 3, 6 and 9 months after therapy. Subgingival plaque samples were collected from four periodontal sites with clinical attachment level ≥1 mm, probing pocket depth ≥4 mm and bleeding on probing, one site in each quadrant. Samples were cultivated and processed using the PCR technique. Patients received nonsurgical therapy including scaling and root planing (SRP) and were randomly assigned to a probiotic (n=16), antibiotic (n = 16) or placebo (n = 15) group. L. rhamnosus SP1 was taken once a day for 3 months. Azithromycin 500mg was taken once a day for 5 days.ResultsAll groups showed improvements in clinical and microbiological parameters at all time points evaluated. Probiotic and antibiotic groups showed greater reductions in cultivable microbiota compared with baseline. The placebo group showed greater reduction in number of subjects with P. gingivalis compared with baseline. However, there were no significant differences between groups.ConclusionsThe adjunctive use of L. rhamnosus SP1 sachets and azithromycin during initial therapy resulted in similar clinical and microbiological improvements compared with the placebo group.

Circular economy (CE) has garnered increasing attention in political circles and practitioner literature thanks to its potential to overcome the harmful consequences of linear patterns of growth. Nonetheless, the adoption of sustainable practices entails a holistic approach requiring businesses to make significant changes to their production, technologies and stakeholder management. These challenges resulted in limited progress in terms of the practical implementation of CE. This paper addresses the need for more literature focused on the pragmatic aspects of applying this paradigm to incumbent firms. The author presents the journey that Lucart S.p.A., a major European tissue paper manufacturer, has undertaken between 2014 and 2020 to apply CE principles to its practices. Insights from the transformation process, reconstructed through interviews with the firm's management and environmental impact data, suggest that to succeed it takes innovating (plants, products and marketing strategies) and setting up supply chains that reconcile environmental and economic sustainability.

Purpose The authors have systematically reviewed 534 corporate social responsibility communication (CSRC) papers, updating the current debate about the ontological and epistemological paradigms that characterize the field, and providing evidence of the interactions between these paradigms and the related methodological choices. The purpose of this paper is to provide theoretical and methodological implications for future research in the CSRC research domain. Design/methodology/approach The authors used the Scopus database to search for titles, abstracts and related keywords with two queries sets relating to corporate social responsibility (e.g. corporate ethical, corporate environmental, social responsibility, corporate accountability) and CSRC (e.g. reporting, disclosure, dialogue, sensemaking). The authors identified 534 empirical papers (2000–2016), which the authors coded manually to identify the research methods and research designs (Creswell, 2013). The authors then developed an ad hoc dictionary whose keywords relate to the three primary CSRC approaches (instrumental, normative and constitutive). Using the software Linguistic Inquiry and Word Count, the authors undertook an automated content analysis in order to measure these approaches’ relative popularity and compare the methods employed in empirical research. Findings The authors found that the instrumental approach, which belongs to the functionalist paradigm, dominates the CSRC literature with its relative weight being constant over time. The normative approach also belongs to the functionalist paradigm, but plays a minor yet enduring role. The constitutive approach belongs to the interpretive paradigm and grew slightly over time, but still remains largely beyond the instrumental approach. In the instrumental approach, many papers report on descriptive empirical analyses. In the constitutive approach, theory-method relationships are in line with the various paradigmatic traits, while the normative approach presents critical issues. Regarding methodology, according to the findings, the literature review underlines three major limitations that characterize the existing empirical evidence and provides avenues for future research. While multi-paradigmatic research is promoted in the CRSC literature (Crane and Glozer, 2016; Morsing, 2017; Schoeneborn and Trittin, 2013), the authors found no empirical evidence. Originality/value This is the first paper to systematically review empirical research in the CSRC field and is also the first to address the relationship between research paradigms, theoretical approaches, and methods. Further, the authors suggest a novel way to develop systematic reviews (i.e. via quantitative, automated content analysis), which can now also be applied in other literature streams and in other contexts.

Objective Medication errors are one of the leading causes of patient harms. Medication reconciliation is a fundamental process that to be effective, it should be embraced during each single care transition. Our objectives were to investigate current medication reconciliation practices in the 2 Fondazione Toscana Gabriele Monasterio hospitals and comprehensively assess the quality of medication reconciliation practices between inpatient and outpatient care by analyzing the medication patterns 6 months before admission, during hospitalization, and 9 months after discharge for a selected group of patients with cardiovascular diseases. Methods A retrospective observational study was conducted in the Cardiothoracic Department of the Fondazione Toscana Gabriele Monasterio hospitals. Medication history was reviewed for all the patients admitted from and discharged to the community, from January to March 2013. Patients were excluded if they had less than 4 drugs or less than 2 drugs for cardiovascular system in their prescription list at admission or if they died during follow-up. We selected 714 patients, and we obtained the clinical charts and all drug prescriptions collected during patients’ hospitalization by the electronic clinical recording system. We also analyzed the list of prescriptions of this sample of patients, from 6 months before admission to 9 months after discharge, extracted from the regional prescription registry. In the resulting sample, prescriptions were analyzed to assess unintentional discrepancies. Results The study included 298 patients (mean age, 71.2 years), according to the inclusion and exclusion criteria. Among 14,573 prescriptions analyzed, we found 4363 discrepancies (14.6 discrepancies per patient). Among these discrepancies, 1310 were classified as unintentional (4.4 discrepancies per patient). Among unintentional discrepancies, only 63 (4.8%) took place during hospitalization. Although at the hospital-home interface, 33.1% of unintentional discrepancies were detected through the comparison between the patients’ declared therapy and the previous medication consumption and 62.1% were identified in the comparison between the prescription at the discharge and the following medication pattern at home. Conclusions Medication errors have important implications for patient safety, and their identification is a main target for improving clinical practice. The comparison between the medication patterns acquired through the regional prescription registry before and after hospitalization outlined critical touchpoint in the current medication reconciliation process, calling for the definition of shared medication reconciliation standards between hospitals and primary care services to minimize medication discrepancies and enhance patient safety.

In the 1980s, a profound change in the information technology (IT) market forced IBM to modify the organisation and management of its selling structure. There was only an internal sales channel at first and IBM had interactive relationships with individual customers. The process of change began when the number of customers increased and their average size decreased. IBM began to support its internal channel of sales representatives with an external channel of business partners for the distribution of high volume products. Having to face new problems, like business partner loyalty and the loss of market control, IBM has decided to adopt, as a general strategy, a new go‐to‐market model called the hybrid model. By mixing and coordinating direct activities, such as mailings, phone calls and tele‐coverage, with commercial business partner actions and operations, IBM now has a new competitive advantage.

We analyze differences in gambling motivations for skill and luck gamblerson the basis of a questionnaire distributed to students from the University of Pisa (Italy). We find that the probability of playing skill rather than luck games is positively correlated to being a male, to the socialization motive and to having a planning attitude, that we use to define the kind of amusement experienced in gambling, while it is negatively correlated to the money motive, the perceived risk of losing social esteem, and age. Results are then applied to marketing strategies and public policies, with particular attention to the online environment.

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The reverse logistics applies to the flow of products and materials in the opposite direction to direct logistics, from the market to the production sites or the specialised centres, where they are sent to be appropriately treated.The growing attention to reverse logistics is explained primarily by the need to comply with regulations on environmental protection, Given the intensified competition caused by rising costs of energy and raw materials, the truly marketdriven companies cannot consider the residual value as solely residual anymore.In global competition, the management of the products rejected by the market, previously considered a costly activity, that companies had to deal with to avoid negative consequences for the management, is now presenting unexpected opportunities.