94 research outputs found
Open-ended design. Local re-appropriations through imperfection.
No full textDesign for Sustainability (DfS) focuses on wicked problems that cannot be modelled in reductionist ways. Furthermore,
when bottom-up local interventions prove to have positive effects in their context, they remain hard to
spread and might face failure if transferred the other contexts. Here, a research-through-design approach is presented for highlighting a new paradigm, that questions the very nature of both design process and outcomes. Specifically,
Open-ended Design (OeD) is introduced pursuing the creation of unfinished and ever-evolving outcomes (imperfect
by intention), embracing the out-of-control local instances. In this approach balance between openness and
over-design is sought, to facilitate both the global diffusion of design outcomes and their local re-appropriation.
The aim of the research is to highlight existing connections between OeD and DfS, listing its values and limitations
through some reported cases. In conclusion, designers might start designing for emergent aspects of the designed
solutions, supporting multiple local re-appropriations
The role of connections and users involvement in designing sustainable and longer lasting artefacts
No full text[Carbohydrate metabolism in gross obesity]
No full textResults obtained in an investigation of two groups of obese and grossly obese subjects are presented. Poorer carbohydrate tolerance was noted in the latter. Blood insulin patterns after oral glucose loading, however, were less easy to interpret. Overall, the values were much the same in the two groups. Nevertheless, analysis of the curves showed that the grossly obese displayed a later peak
Is the role of medical consultation in rheumatoid arthritis a timely topic?
No full textBackground: Despite the treat-to-target recommendations and the efforts in dissecting factors that contribute to achieving disease control, the goal of remission in rheumatoid arthritis (RA) is accomplished in less than half of patients. Disease activity is assessed using composite indexes which are reliant on patient-reported outcomes, mainly the patient global assessment of disease activity (PGA). The debate on variables that can influence PGA is still open, and different internal and external factors had been taken into account: the origin of pain symptoms, psychosocial and lifestyle factors.
Objectives: To canvass the opinion of RA Italian patients concerning patient-perceived topics that matter most for future research.
Methods: A cross-sectional no-profit on-line anonymous survey was devised to evaluate opinions of the rheumatic diseases patients. In this sub-study we focused only on the data about RA patients. Patients were asked to rate the following topics: food/nutrition, air pollution, smoking, type of work, social participation, physical activity, emotional well-being/stress, alternative medicine, patient-physician relationship. Moreover, patients were inquired about why the topic was considered important (disease prevention, stop disease progression, control symptoms, cure the disease). The survey was disseminated between June and October 2019. Descriptive statistics were used to summarize the patient demographic, clinical data and survey results.
Results: 94% (82/87) of RA patients (81 female, median age 50 yrs) rated the patient-physician relationship as the main topic for future research (figure below). Likewise, intriguing results came from the reasons of previous patient rating: the patient-physician relationship was considered important for a better control of RA symptoms (48.8%), to cure the disease (30.5%), to stop disease progression (19.5%), and to prevent the disease (1.2%). These results were similar in all age groups.
Conclusion: These results highlight that the importance of medical consultation to patients and its impact on disease control should not be under-estimated. Administrative duties, time and economic constraints undermine the patient-physician relationship that is central to clinical care. The limited time spent for medical consultation is directly related to patient dissatisfaction, which in turn, may influence the patient’s perception about the absence of disease activity and could be one of motives behind the worse evaluation of PGA.
Acknowledgments: We wish to thank the Lombard Association of Rheumatic Diseases (ALOMAR), Maria Vittoria Ausilio and Patrizia Angiolillo from the IT service of the University of Milan
Peso desiderato, peso ottimale e soddisfazione corporea nei soggetti con bulimia Nervosa
No full text
(Un)disclosed. Disease disclosure in people living with rheumatic diseases: An exploratory study
No full textObjective: Little is known about disease-related disclosure (DD) in patients with rheumatic musculoskeletal diseases (RMDs). We aim to investigate DD behaviors and to explore which socio-demographic, clinical and psychological factors play a role in this self-disclosure process among patients with RMDs. Methods: A cross-sectional Italian nationwide study captured DD in RMDs in different contexts (workplace, family, friends, partner, social networks). An ad hoc survey was developed and disseminated by the Patients' Association ALOMAR ODV (Lombard Association for Rheumatic Diseases) between June and July 2020. Patient demographics, clinical data, and questionnaires assessing anxiety, depression, anticipated stigma, patient health engagement, perceived social support, and perceived general health status were collected. Results: There were 376 rheumatic patients who completed the survey. There were 73.9% of the participants who talk to others about their RMD “sometimes”; 18.7% disclose their RMD “always/very often”, while 7.4% “never” talk about their RMD. A significant association was detected between DD and both perceived visibility (P =.04) and psychological support (P =.01). Moreover, participants who never/sometimes disclose their RMD reported significantly lower scores in the “Total” Social Support (P <.01) and in the “Friends” subscale (P <.001) compared to others. Psychological support and the “Friends” subscale were the only significant predictors of DD (both P =.002). Conclusions: The majority of RMD patients disclosed their disease “sometimes”. The DD behavior is not associated with any specific demographic or clinical variables. Further research on the subject might help to foster better DD decision-making processes for rheumatic patients in different contexts of daily life
Patient Perception of Depressive Symptoms in Rheumatic Diseases: A Cross-sectional Survey
No full textObjectives: The presented study aimed to explore the presence and the self-identification of depressive symptoms among patients with rheumatic musculoskeletal diseases (RMDs) through the use of the Patient Health Questionnaire (PHQ-9).
Methods: Between June and October 2019, patients from the regional association for people with RMDs in Lombardy, Italy (ALOMAR), were invited to participate in a cross-sectional online survey. Participants completed PHQ-9 along with a survey about their perception of depressive symptoms. Patients were stratified according to PHQ-9 score as follows: not depressed (<4), subclinical or mild depression (5-9), moderate depression (10-14), moderately severe depression (10-14), and severe depression (20-27). Descriptive statistics and analyses of variance were used to explore data.
Results: Of the 192 RMD patients who completed PHQ-9, 35 (18.2%) were not depressed, 68 (35.4%) had subclinical or mild depression, 42 (21.9%) had moderate depression, 30 (15.6%) had moderately severe depression, and 17 (8.9%) had severe depression. Contrary to the above findings, only 16 respondents (8.3%) reported that they experienced depressive symptoms, and only 7 of the 16 were being followed by a psychiatrist. Respondents with higher PHQ-9 scores tended to have concomitant fibromyalgia, to be younger, and to be overweight.
Conclusions: The current results indicate the overall burden of depressive symptoms in RMD patients. While clinical depression (PHQ-9 >10) was detected in 41.2% of respondents, only 8.3% reported that they experience depressive symptoms. Routine screening of RMD patients for depression is therefore critical
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