1,720,959 research outputs found
Sopravvissuti al cancro: la sfida della cronicità in fisioterapia e la nuova frontiera dell'auto-cura assistita
No full textBackground: La cura dei sopravvissuti al cancro è un campo emergente in oncologia e richiede interventi basati su evidenze per affrontare i bisogni complessi e a lungo termine dei sopravvissuti (CSs). I Piani di Cura per i Sopravvissuti (SCP) sono essenziali per offrire strategie di auto-gestione e monitoraggio medico. Questa tesi contribuisce allo sviluppo di un SCP completo, specifico per il contesto e basato sui bisogni dei CSs. Un approccio a metodi misti è stato utilizzato per descrivere i domini dei bisogni insoddisfatti e identificare gli strumenti di valutazione che misurano in modo affidabile tali bisogni nel contesto dello studio.
Metodi: Lo studio si è articolato in quattro fasi:
1. Revisione sistematica delle revisioni e valutazione psicometrica degli strumenti Patient-Reported Outcome Measures (PROMs) per la valutazione dei bisogni insoddisfatti dei CSs.
2. Collegamento dei PROMs al framework della Classificazione Internazionale del Funzionamento, Disabilità e Salute (ICF).
3. Esplorazione qualitativa delle esperienze dei CSs mediante focus group e interviste semi-strutturate.
4. Valutazione della completezza dei PROM rispetto ai bisogni espressi dai CSs mediante analisi tematica e valutazione della validità del contenuto.
Risultati: La revisione ha identificato 14 PROMs con proprietà psicometriche eterogenee. È stata riscontrata una variabilità significativa nella copertura dei domini ICF tra i PROMs, rivelando una specificità nel catturare diverse sfumature di problemi. L'analisi qualitativa ha evidenziato quattro temi chiave relativi ai bisogni insoddisfatti: dignità e rispetto, l’importanza di un trattamento rispettoso; desiderio di normalità, il bisogno di recuperare la normalità dopo il trattamento; controllo sulla propria vita, la necessità di autonomia nelle decisioni terapeutiche; e fragilità esistenziale, che cattura la vulnerabilità dei sopravvissuti e il bisogno di supporto emotivo. Questi risultati sottolineano la necessità di interventi personalizzati e centrati sul paziente.
L'integrazione dei risultati quantitativi e qualitativi ha portato all'identificazione di 35 categorie core ICF di bisogni insoddisfatti, principalmente legati all’attività fisica, al benessere emotivo e alla navigazione nel sistema sanitario. Il Cancer Rehabilitation Evaluation System (CARES) è stato identificato come il PROM più adeguato, coprendo il 94,3% di queste categorie. Lievi lacune sono state riscontrate nei domini della spiritualità e delle problematiche scolastiche, suggerendo che una minima integrazione nel CARES potrebbe soddisfare pienamente i bisogni locali.
La metodologia sviluppata enfatizza la sensibilità al contesto, considerando la storia clinica, le caratteristiche individuali e le preferenze dei sopravvissuti, garantendo che i PROM selezionati siano psicometricamente robusti e rilevanti per le popolazioni specifiche.
Conclusioni: Questa tesi fornisce un quadro metodologico rigoroso per l'integrazione di PROMs basati su evidenze con i bisogni dei pazienti. Questo approccio affronta le sfide multifattoriali della sopravvivenza al cancro, offrendo indicazioni pratiche per lo sviluppo di un SCP completo volto a migliorare gli esiti dei CSs. Le limitazioni includono il focus sul contesto sanitario italiano, che potrebbe limitare la generalizzabilità. Le ricerche future dovrebbero concentrarsi sull'implementazione e verifica di un SCP specifico per il contesto, in conformità con il framework del Medical Research Council per interventi complessi. Successivamente, il SCP dovrebbe essere applicato in contesti clinici diversi e valutato per la sua efficacia a lungo termine.
Questo lavoro contribuisce al campo della sopravvivenza al cancro, proponendo un approccio strutturato alla valutazione dei bisogni insoddisfatti, enfatizzando l'importanza di cure mirate e individualizzate per migliorare gli esiti a lungo termine.Background: Cancer survivorship care is an emerging field in oncology, necessitating evidence-based interventions to address the complex, long-term needs of cancer survivors (CSs). Survivorship Care Plans (SCPs) are crucial, providing a roadmap for ongoing care that includes self-management strategies and professional follow-up. This thesis contributes to the development of a comprehensive, context-specific SCP, based on CSs’ needs. A mixed-methods approach was employed to define the domains of unmet needs for CSs and to identify reliable assessment tools for those needs in the context of the study.
Methods: This study employed a four-phase design:
1. Systematic overview of reviews and psychometric evaluation of Patient-Reported Outcome Measures (PROMs) for assessing CSs' unmet needs.
2. Linkage of identified PROMs to the International Classification of Functioning, Disability and Health (ICF) framework.
3. Qualitative exploration of CSs' experiences through focus groups and semi-structured interviews.
4. Evaluation of PROM completeness against expressed unmet needs of CSs using thematic analysis and content validity assessment.
Results: The overview identified 14 PROMs meeting inclusion criteria, with heterogeneous psychometric properties.
Significant variability was observed across PROMs in ICF health domain coverage, revealing their own specificity in capturing different nuances of apparently similar problems.
Qualitative analysis revealed four key themes related to unmet needs among CSs: dignity and respect, emphasising the importance of ensuring respectful treatment within healthcare settings; the desire for normality, reflecting survivors' wish to regain a sense of normalcy after treatment; control over one’s life, highlighting the need for autonomy in managing information and treatment decisions; and existential frailty, capturing CSs’ vulnerability and need for emotional support. These findings underscore the necessity for tailored, patient-centred interventions.
Integration of quantitative and qualitative findings resulted in the identification of 35 ICF core-categories of unmet needs, primarily related to physical activity, emotional well-being, and healthcare navigation. The Cancer Rehabilitation Evaluation System (CARES) was identified as the most suitable PROM, covering 94.3% of these categories. Minor gaps were noted in spirituality and school-related issues, suggesting minimal integration into CARES is necessary to address local needs fully.
The developed methodology for PROM selection emphasises context-sensitivity, considering treatment history, individual survivor characteristics, and preferences, ensuring chosen PROMs are both psychometrically robust and relevant to specific CS populations.
Conclusion:
This thesis provides a methodologically rigorous framework for integrating evidence-based PROMs with patient-centred insights. This approach addresses the multifaceted challenges of cancer survivorship, offering practical guidance for healthcare systems to develop a comprehensive SCP that can improve CS outcomes.
Limitations include the focus on the Italian healthcare context, potentially limiting generalisability. Future research should focus on testing and implementing a context-specific SCP, stemming from the evidence in this thesis, in line with the Medical Research Council framework for complex interventions. Afterwards, the SCP should also be applied to diverse clinical settings and assessed for its long-term effectiveness in improving well-being of CSs.
This work contributes to cancer survivorship by offering a structured approach to assessing and addressing unmet needs, emphasising the importance of targeted, multidisciplinary, and individualised care in improving long-term outcomes for CSs
The Dance Functional Outcome Survey: Cultural Adaptation and Psychometric Validation in Italian (DFOS-IT)
No full textObjective: To translate, culturally adapt, and validate the psychometric characteristics of the Italian version of the Dance Functional Outcome Survey (DFOS-IT) in adult dancers.
Design: Clinical measurement study.
Methods: The DFOS-IT was forward translated, reconciled, backward translated, and reviewed by an expert committee to establish optimal correspondence with the original English DFOS. We examined test-retest reliability in 58 dancers within a 10-day period, using intraclass correlation coefficients (ICC2,1). In a sample of 265 healthy and injured dancers, the following were examined: 1) construct validity, comparing the DFOS-IT to SF-36 using Pearson correlations; 2) exploratory factor analysis and internal consistency; and 3) sensitivity, by generating receiver operating characteristic curves and determining area under the curve (AUC). In a subgroup of 44 dancers, we determined internal responsiveness across three time-points using repeated measures ANOVA (p<0.05). Injured dancers' scores were analyzed for floor and ceiling effects.
Results: The DFOS-IT demonstrated very high test-retest reliability (ICC≥0.98). Single-factor loading in exploratory factor analysis supported unidimensionality of the scale, with high internal consistency (a=0.93). DFOS-IT total, activities of daily living (ADL), and Dance Technique scores had strong construct validity compared with scores on the SF-36 PCS (r≥0.71). There was excellent sensitivity, with high AUC values (AUC≥0.80). There were significant differences across time for DFOS-IT scores (p<0.001), demonstrating responsiveness to change, and no floor or ceiling effects.
Conclusion: The DFOS-IT is a valid, reliable, and responsive tool that can be used as an outcome and screening measure for Italian adult ballet and modern dancers following lower extremity or low back injury
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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