685 research outputs found
La criminalisation de la contestation politique : un échec du libéralisme
No full textExtermann L. La criminalisation de la contestation politique : un échec du libéralisme. In: Déviance et société. 1978 - Vol. 2 - N°2. pp. 199-213
Cancer in the older person
No full textCancer in the older person is an increasingly common problem, due to the progressive prolongation of the life-expectancy of the Western population. This article reviews the mechanisms associating aging and cancer, age-related changes in cancer biology, assessment of the older person to estimate life-expectancy, treatment tolerance, and medical and social conditions that may interfere with cancer treatment, effectiveness of cancer prevention and cancer treatment in older individuals. A comprehensive geriatric assessment (CGA) is commonly used to predict life-expectancy and functional reserve and to unearth conditions that may jeopardize cancer prevention and treatment. In the interest of cost and time, shortened forms of CGA are being explored. Chemoprevention of cancer is a promising form of prevention that at present has no conclusive clinical indications. Early diagnosis of breast and colon cancer through screening of asymptomatic patients at risk may be beneficial for individuals with a life-expectancy of 5 years or longer. Early detection of lung cancer in ex-smokers is undergoing clinical trials, as this disease is becoming more and more common. Age should not prevent appropriate treatment of cancer in older individuals, especially in those with adequate life-expectancy and functional reserve. The National Cancer Center Network (NCCN) has issued a series of guidelines to minimize the toxicity and promote the effectiveness of cancer in older patients. Important interventions include prevention of neutropaenic infections with filgrastim and peg-filgrastim, prevention of anaemia with epoietin or darbepoietin, and prevention and early management of mucositis
«[...] tanta potenza di critica e tanta solida dottrina archeologica»: Pietro Selvatico, Santo Varni e l’erudizione artistica agli albori dell’Unità d’Italia
No full textIl volume raccoglie una serie di contributi sulla personalità multiforme di Santo Varni (1807-85), fin qui conosciuto soprattutto come scultore, di cui vengono indagati i suoi molteplici altri interessi: dall’archeologia alla storia dell’arte, dal collezionismo al restauro. Le sue tante atti-vità lo hanno condotto a studiare, oltre che la sua città, Genova, il Basso Piemonte, Savona, la Lomellina, il Tigullio e la Versilia. A partire da un fondo archivistico di Santo Varni inedito e da alcune opere rintracciate per l’occasione, il volume ricostruisce gli studi e le scoperte ef-fettuate dallo scultore, ricollegandole ai materiali superstiti, oggi dispersi nei musei di tutto il mondo (da quelli genovesi ai Cloisters del Metropolitan, al Victoria & Albert, etc.) e restituendo siginificativi materiali oggi perduti
La fontana dell'Acqua Felice: il cantiere della decorazione scultorea gestito da Giovanni Fontana (1587-1590)
No full textIl presente contributo ha inteso apportare chiarezza per la comprensione dei ruoli effettivamente ricoperti dagli architetti ticinesi Domenico e Giovanni Fontana nella gestione del cantiere papale della fontana dell’Acqua Felice e in particolare nella delicata fase del trasporto e della posa in opera dell’apparato scultoreo. Si è reso possibile tale approfondimento attraverso la consultazione della misura e stima dei lavori, conservata presso l’Archivio di Stato di Roma, fonte documentaria finora trascurata. L’incrocio di notizie ricavate dal libro dei conti, dai mandati di pagamento e dal libro mastro, ha permesso di ricostruire fasi esecutive, di identificare maestranze, ma anche di fare chiarezza sulle modalità operative, sulle soluzioni tecniche e sulla provenienza dei materiali e dei manufatti di spoglio utilizzati che, come nel caso della colossale statua del Mosè, ne hanno determinato le sproporzionate fattezze
Fatigue and functional dependence in older cancer patients
No full textFunctional dependence is a costly manifestation of aging that compromises the quality of life of elderly individuals and their caregivers. In this study, we hypothesized that fatigue may be a cause of functional dependence in older cancer patients. To establish whether fatigue was associated with dependence in 1 or more activities of daily living (ADLs) or instrumental activities of daily living (IADLs), and declining performance status (PS). In addition, we studied the prevalence of fatigue and its correlation with anemia, depression, and nutritional status. MATERIALS AND METHODS: Retrospective cross-sectional study of 214 patients aged 70 and older were seen over a 3-month period by the Senior Adult Oncology Program of the H. Lee Moffitt Cancer Center in Tampa, FL. Each patient was screened with a questionnaire assessing ADLs, IADLs, PS, cognitive impairment, depression, and malnutrition. In addition, each patient underwent assessment of fatigue with the fatigue symptom inventory and a determination of complete blood counts and complete chemical panel. RESULTS: Fatigue was reported by 81% of the patients. The interference score of fatigue seemed to be a mediator for dependencies in ADLs and IADLs (P < 0.001 and 0.001), and poorer PS (P < 0.001). CONCLUSIONS: Fatigue is a common chronic problem for older cancer patients and may represent a major cause of functional dependence
Rilavorazione quattrocentesca di un marmo antico nel chiostro di San Giorgio a Moneglia.
No full textPubblicazione di un'inedita stele antica rilavorata nel '400
Treating Cancer in Older and Oldest Old Patients
No full textThe so-called "silver tsunami" is a metaphor that the individuals 65 and older represent the most rapidly growing segment of the Western world population. Aging is an ongoing process that leads to the loss of functional reserve of multiple organ systems, increased susceptibility to stress, it is associated with increased prevalence of chronic disease, and functional dependence. Determined by a combination of genetic and environmental factors, this process is highly individualized and poorly reflected in chronologic age. The heterogeneity and the complexity of the older old population represent the main challenge to the treatment of cancer in those patients. We should discern "fit" elderly in whom standard cancer treatment appears to be comparable to a younger population and "unfit" or "frail" elderly, in which the risks of the treatment may overwhelm potential benefits. There are many aspects that have to be assessed before treating an elderly patient, or before to choose the treatment itself. In our review we will try to explain and describe the meaning and the most important aspects related to the oldest old complex patients, and how to manage those patients
Use of secondary analysis of large databases to explore impact of occupation on quality of life for cancer patients
No full textResearchers across many disciplines use large national databases to further understand health outcomes such as quality of life. Outcomes research is relevant to a number of stakeholders including patients, families, payers and researchers. However, the possibility to use such datasets to study occupation and participation has largely been overlooked. This type of research can influence policy makers’ decisions regarding the role of certain fields (e.g., occupational science and therapy) in promoting quality of life (Lipscomb et al., 2004). To more adequately investigate if and how occupation is related to health and quality of life, and to widen our disciplinary scope and be heard in other circles besides our own, collaboration on national and international research teams using large databases is important. This paper discusses these broader issues and uses a specific example to illustrate possibilities for occupational science through analysis of large secondary datasets.
Research looking at those with cancer provides an interesting opportunity to examine occupation through secondary data analysis. For numerous reasons, cancer patients tend to have lower levels of participation in occupations (Hurria, 2009; Extermann & Hurria, 2007), and those may be related to mortality and morbidity in older patients who undergo cancer treatment (Extermann & Hurria, 2007). One approach to more definitively examine those relationships is with the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS), a national database designed to improve the quality of cancer care in the US. CanCORS includes a longitudinal survey and medical chart data on over 10,000 people newly diagnosed with lung and colorectal cancer. After a life-threatening illness and subsequent disruption within the typical daily routine, a decrease in participation may challenge how people perceive themselves within society (Vrkljan, & Miller-Polgar, 01). The concept of participation, itself, is situated deep in context and can determine wellbeing and overall quality of life (Law, 2002). With this focus, using a large sample allows for use of structural equation modeling to examine the mediating and/or moderating effects of occupation with more power. In conclusion, the use of large-scale, secondary datasets such as CanCORS could be one-way occupational scientists may examine the relationships among health-related outcomes, participation and occupation to further our scope and impact.
Objectives for Discussion Period: To engage in scholarly discussion regarding the use of large databases and secondary analysis to increase the knowledge and exposure of occupational science. Discussion concerning the use of secondary analysis to examine impact of participation in occupation on HRQOL. Dialog about the ways that occupational scientists may utilize large databases to examine concepts such as participation and quality of life
Communication within the comprehensive geriatric assessment
No full textThe comprehensive geriatric assessment (CGA) forms a cornerstone of geriatric care; the process is designed to assess the complex interaction of biological , psychological, and social challenges often faced by elder patients (e .g ., Extermann, 2003). Using a narrative case study of a patient undergoing a CGA by members of an interdisciplinary geriatric oncology team. I explore some of the communication challenges and opportunities for healthcare providers caring for geriatric patients. My goal in offering readers narratives of geriatric patient-healthcare provider communication-rather than only analysis of those interactions - is to complement typical analysis of research findings with an opportunity to do what Prank ( 1995) called thinking with a story, that is, to bear witness to someone\u27s experience and empathize with it. To contextualize the communication issues exemplified in the case study, I begin by defining the CGA, exploring its use by geriatric healthcare teams, providing a brief overview of common communication issues in the geriatric patient population, and introducing the project from which this case study is drawn
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