The multiscale nexus among land use-land cover changes and water quality in the Suquía River Basin, a semi-arid region of Argentina

Agricultural intensification and urban sprawl have led to significant alterations in riverscapes, and one of the critical consequences is the deterioration of water quality with significant implications for public health. Therefore, the objectives of this study were the assessment of the water quality of the Suquía River, the assessment of LULC change at different spatial scales, and the analysis of the potential seasonal correlation among LULC change and Water Quality Index (WQI). The Sample Sites (SS) 1 and 2 before Cordoba city had the highest WQI values while from SS3 the WQI decreased, with the lowest WQI close to the wastewater treatment plant (SS7) after Cordoba city. From SS8 in a agricultural context, the WQI increases but does not reach the original values. In light of analysis carried out, the correlation between water quality variables and the different LULC classes at the local and regional scales demonstrated that WQI is negatively affected by agricultural and urban activities, while natural classes impacted positively. The spatialization of the results can help strongly in assessing and managing the diffusion of point and non-point pollution along the riverscape. The knowledge gained from this research can play a crucial role in water resources management, which supports the provision of river ecosystem services essential for the well-being of local populations.

Maternal Concerns in Home Care for the Premature Newborn: An Integrative Review

OBJECTIVE

To identify and analyze the scientific literature, both national and international, concerning the primary maternal concerns about caring for premature newborns at home.

METHODS

This integrative review is based on the guiding question: "What scientific publications from 2012 to 2021 address maternal concerns about the care of premature newborns at home?". Searches were conducted in the electronic databases: Embase, Medline, Web of Science, Lilacs, Scielo, and Cochrane Library.

RESULTS

A total of 21 articles were identified. The qualitative analysis showed that maternal concerns pertained to breastfeeding, hygiene, sunbathing practices, managing infant colic, identifying signs, symptoms, and clinical changes, temperature control, and the third phase of the kangaroo method.

CONCLUSIONS

Maternal uncertainties underscore the importance of enhancing strategies focused on supporting families and ensuring continued care for neonates at home.

Assessment of the psychometric properties of the Italian version of the New Freezing of Gait Questionnaire (NFOG-Q-IT) in people with Parkinson disease: a validity and reliability study

INTRODUCTION

Freezing of gait (FOG) in Parkinson's disease (PD) is a challenging clinical symptom to assess, due to its episodic nature. A valid and reliable tool is the New FOG Questionnaire (NFOG-Q) used worldwide to measure FOG symptoms in PD.

OBJECTIVE

The aim of this study was to translate, to culturally adapt, and to test the psychometric characteristics of the Italian version of the NFOG-Q (NFOG-Q-It).

METHODS

The translation and cultural adaptation was based on ISPOR TCA guidelines to finalize the 9-item NFOG-Q-It. Internal consistency was assessed in 181 Italian PD native speakers who experienced FOG using Cronbach's alpha. Cross-cultural analysis was tested using the Spearman's correlation between the NFOG-Q-It and the Modified Hoehn-Yahr Scale (M-H&Y). To assess construct validity, correlations among NFOG-Q-It, Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Falls Efficacy Scale-International (FES-I), the 6-min Walking Test (6MWT), the Mini Balance Evaluation System Test (Mini-BESTest) and the Short Physical Performance Battery (SPPB) were investigated.

RESULTS

The Italian N-FOGQ had high internal consistency (Cronbach's α = 0.859). Validity analysis showed significant correlations between NFOG-Q-IT total score and M-H&Y scores (r = 0.281 p < 0.001), MDS-UPDRS (r = 0.359 p < 0.001), FES-I (r = 0.230 p = 0.002), Mini BESTest (r = -0.256 p = 0.001) and 6MWT (r = -0.166 p = 0.026). No significant correlations were found with SPPB, MOCA and MMSE.

CONCLUSION

The NFOG-It is a valuable and reliable tool for assessing FOG symptoms, duration and frequency in PD subjects. Results provide the validity of NFOG-Q-It by reproducing and enlarging previous psychometric data.

Occupational Therapy Intervention in the Child with Leukodystrophy: Case Report

BACKGROUND

There are many different types of Leukodystrophies. Specifically, children with hypomyelination and congenital cataract syndrome (HCC) in addition to motor retardation development, hypotonia and progressive spastic paraplegia, associated with cerebellar ataxia and peripheral neuropathy, have early bilateral cataracts and intellectual disability as pathognomonic symptoms. HCC rehabilitation treatment is not well defined, but a significant amount of evidence in the literature has demonstrated the effectiveness of occupational therapy (OT) treatment in children with similar symptomatology. For this reason, the aim of this study was to describe the improvement in the autonomies and social participation of a child with HCC following OT treatment.

METHODS

A.E. was a 9-year-old child with HCC with severe intellectual disability. OT intervention lasted 3 months biweekly and each session lasted 45 min. Each session was divided into two parts: The first part aimed to increase the child's active involvement through activities; the second part involved training in Activities of Daily living (ADL). The outcome measures were: ABILHAND-Kids; Pediatric Evaluation of Disability Inventory; Comprehensive OT Evaluation Scale; ADL and Instrumental Activities of Daily Living.

RESULTS

A.E.'s outcome measure reported an improvement from an autonomy standpoint and in the child's general activity participation; there was also an increase in A.E.'s interpersonal skills.

CONCLUSION

OT treatment improved A.E.'s autonomy.

Brief Autism Mealtime Behavior Inventory (BAMBI): Italian Translation and Validation

Food selectivity is among the most common problems for children with Autism Spectrum Disorder (ASD). The present study aims to validate the Brief Autism Mealtime Behavior Inventory (BAMBI) in an Italian population of children with ASD. BAMBI was translated and cross-culturally adapted following international guidelines, then we investigated internal consistency as measured by Cronbach's alpha and test-retest reliability, as measured by the Intraclass Correlation Coefficient (ICC) in a sample of both children with ASD and with typical development (TD). A total of 131 children were recruited in a clinical and community sample. Internal consistency revealed significant data for both TD and ASD children, with a Cronbach's Alpha of 0.86 and 0.71, respectively. Test-retest reliability showed excellent values for each item of the BAMBI (range 0.83-1.00). Furthermore, we investigated differences in gender and body max index; however, no significant differences were found among groups. In conclusion, the Italian version of the BAMBI showed good internal consistency and test-retest reliability and it can be used for clinical and research purposes.

Emotional Regulation Interventions on Developmental Course for Preterm Children: A Systematic Review of Randomized Control Trials

Children born preterm (<37 weeks of gestation) are at increased risk of socio-emotional difficulties. This study aims to determine the effects of rehabilitation intervention on the emotional regulation of children born preterm through a systematic review. We conducted a systematic review according to PRISMA guidelines. The literature screening was carried out on PUBMED, SCOPUS and WEB OF SCIENCE in August 2022. An author identified eligible studies based on predefined inclusion criteria and extracted the data. RCT quality was assessed using the JADAD and PEDro scales. We selected five RCTs for qualitative synthesis, having the common objective of evaluating the changes in emotional regulation after a rehabilitation intervention. Evidence of benefits was found after parent training intervention (PCIT; p < 0.05). Moreover, there was an improvement in day-to-day executive life and fewer behavioral problems after mindfulness intervention. Clinical, but not statistical, efficacy was found for the group-based physiotherapy intervention. In conclusion, parent training and mindfulness interventions can be helpful rehabilitation techniques, but the relatively small sample limited statistical power, so the discovery needs to be interpreted cautiously. Further research on these aspects is recommended.

Validation and Analysis of the Psychometric Properties of Two Irritability-Measuring Tools: The Affective Reactivity Index (ARI) and the Born-Steiner Irritability Scale (BSIS) in the Italian Adult and Adolescent Populations

Irritability is a transdiagnostic symptom that affects quality of life during the lifespan of individuals. The objective of the present research was to validate two assessment tools, namely the Affective Reactivity Index (ARI) and the Born-Steiner Irritability Scale (BSIS). We investigated internal consistency as measured with Cronbach's alpha, test-retest with intraclass correlation coefficient (ICC) and convergent validity confronting ARI and BSIS scores with the strength and difficulties questionnaire (SDQ). Our results revealed ARI good internal consistency with a Cronbach's α of 0.79 for adolescent and 0.78 for adults. The BSIS also demonstrated good internal consistency for both samples with Cronbach's α = 0.87. Test-retest analysis showed excellent values for both tools. Convergent validity showed positive and significant correlation with SDW, albeit weak for some sub-scales. In conclusion, we found ARI and BSIS to be good tools for measuring irritability in adolescents and adults, and now, Italian healthcare professionals can use it with more confidence.

Therapeutic educational workshops for caregivers of patients with severe acquired brain injury

Abstract

Severe acquired brain injury (sABI) leads to a wide range of functional limitations in cognitive, moto and behavioural abilities. These changes impact the patient's family in terms of the feeling of emotional and physical health, social life and financial condition. Caregivers are often intensely involved in the patient's management exposing them to negative effects of caregiving including stress, mood disorders and decreased quality of life. Implementing forms of active involvement of caregivers in the rehabilitative program could be useful. Thus, in the present study, therapeutic educational workshops (TEWs) for caregivers during the post-acute intensive hospitalization were organized during the post-acute intensive hospitalization of patients with sABI. The caregivers were asked to participate in the workshops to actively involve them in the patient's care and neurorehabilitation program. Each workshop session provided indications regarding the management of the patient with aphasia, neglect, behavioural and swallowing disorders. A questionnaire of 22 items has been designed in order to represent possible indicators of usefulness and effectiveness of the TEWs. The primary aim of this study was to develop a reliable and valid questionnaire able to assess the caregivers' satisfaction with the modalities of carrying out the TEW as a novel activity during the post-acute hospitalization of patients with sABI. The second aim was to assess the caregivers' satisfaction with the utility of the TEW as a tool to enhance their skills in the management of patients' disabilities. 100 caregivers of patients with sABI who attended at least one TEW session and completed the questionnaire were included in the analysis. In conclusion the administered questionnaire has proven to be a valid and reliable tool to evaluate sABI caregivers' satisfaction with TEW. Moreover, caregivers were satisfied with the organization of the TEW and with their usefulness in the management of the patients with sABI.

Measuring Disability among Migrants with Washington Group Tools: Reflections for Field Use

Measuring disability among migrants is a significant challenge; however, there is no consensus on how to measure disability and functional limitations. The present study reports a methodological approach to measure disability in refugees and asylum seekers using Washington Group (WG) tools, namely the WG Short Set (WG-SS), the Short Set Enhanced (WG-SS-E), and the Extended Set on Functioning (WG-ES). We interviewed 161 migrants in different regions of Italy. The recommended threshold for each WG tool was used. We identified 13.7% of migrants with disabilities using the WG-SS, 21.7% using the WG-SS-E, and 31.6% using the WG-ES. Anxiety and depression were the main weights to identify migrants with disabilities (11.8%). The WG-SS does not measure mental health, and therefore we do not suggest its use in the field. However, the WG-SS-E, together with some questions on pain and fatigue, should be considered to identify migrants with a greater risk of disability.

Sleep Disturbance Scale for Children: Italian Validation in Autism Spectrum Disorder Population

Sleep disorders in children with autism spectrum disorders (ASDs) are well-described. However, there is a lack of specific assessment tools to investigate sleep disturbance in this target population. The present investigation reports the Italian validation of the Sleep Disturbance Scale for Children (SDSC) in the ASD population, also investigating the correlation between sleep disorders In both children and parents. Internal consistency and test−retest reliability were investigated using Cronbach’s alpha and intraclass correlation coefficient (ICC), respectively. Concurrent validity was analyzed by comparing the score of the SDSC with the Pittsburgh Sleep Quality Index (PSQI), while the correlation between the SDCS score and the General Sleep Disturbance Scale (GSDS) was used to analyze the correlation between sleep disorders in children and sleep disorders in their parents. In total, 99 children with a diagnosis of ASD participated in the study. Cronbach’s alpha revealed satisfactory value (0.853), as well as reliability (ICC 0.972) and concurrent validity (0.745). Our results also revealed a significant linear correlation between children’s and parents’ sleep disorders (p < 0.05). In conclusion, we found the SDSC to be a useful tool for measuring sleep disorders in ASD children. Our findings offer concrete inputs to achieve adequate pathways for taking care of children with ASDs and their parents.

Early Neuro-Psychomotor Therapy Intervention for Theory of Mind and Emotion Recognition in Neurodevelopmental Disorders: A Pilot Study

The aim of the present study is to explore the effect of early neuro-psychomotor therapy to improve theory of mind skills and emotion recognition in children with neurodevelopmental disorders. A pilot study was set up, consisting of in-group training activities based on the neuro-psychomotor approach. Children were evaluated using Neuropsychological Assessment for Child (Nepsy-II), Test of Emotion Comprehension (TEC), and Social Communication Questionnaire (SCQ). For data analysis, one-sample Wilcoxon signed rank test was used with a significance of p < 0.05. Two children with a developmental language disorder and four children with autism spectrum disorders participated in a 3-month training program. Our findings revealed significant improvement in emotion recognition, as measured with Nepsy-II (p = 0.04), while no statistical improvement was found for theory of mind. Despite the limited sample, early neuro-psychomotor therapy improves emotion recognition skills in children with neurodevelopmental disorders. However, considering the explorative nature of the study, findings should be interpreted with caution.

Italian Translation, Cultural Adaptation, and Validation of the Toileting Habit Profile Questionnaire Revised (THPQ-R) in Typically Developing Children: A Cross-Sectional Study

The Toileting Habit Profile Questionnaire Revised (THPQ-R) identifies sensory integration issues in children with defecation problems. Sensory integration issues are recognized as a factor linked to some defecation disorders and identifying such issues is needed to guide the development of an appropriate intervention. The aim of this cross-sectional study was to translate, culturally adapt, and validate the THPQ-R in a population of typically developing (TD) Italian children by measuring its internal consistency and cross-cultural validity. The translation and cultural adaptation were performed according to international guidelines. The questionnaire was administered to the caregivers of TD children, and the analysis was performed on data obtained from 118 TD children. The construct validity of the scale was calculated through the exploratory factor analysis that indicated two factors; Cronbach’s alpha was calculated for internal consistency and showed a value >0.7, demonstrating good internal consistency. Cross-cultural validity was also analyzed and showed higher levels of defecation problems at age 5 years. Italian occupational therapists now have a tool to assess possible sensory issues linked to defecation disorders in children aged 3 to 6 years, which may promote more effective clinical practice in this area. Moreover, it will be possible to compare the results obtained from studies conducted in Italy with those conducted in other countries.

Correlation between Quality of Life and severity of Parkinson's Disease by assessing an optimal cut-off point on the Parkinson's Disease questionnaire (PDQ-39) as related to the Hoehn & Yahr (H&Y) scale

PURPOSE

Strong evidence shows that symptoms in individuals with Parkinson's Disease (PD) restrict both their independence and social participation, leading to a low Quality of Life (QoL). Conversely, a reduced QoL has a negative impact on symptoms. The aim is to evaluate the correlation between QoL and severity of PD by assessing the presence of an optimal cut-off point on the Parkinson's disease questionnaire (PDQ-39) as related to the Hoehn &Yahr (H&Y) scale in a cohort of Italian adults with PD.

METHODS

A multicenter, cross-sectional study was performed. This study was conducted on a cohort of consecutive individuals. All participants were evaluated with the PDQ-39, and the severity of PD was recorded according to the H&Y scale by a neurologist. Receiver op-erating characteristic (ROC) curves and coordinates, visually inspected, were used to find cut-off points with optimal sensitivity and specificity. These were in turn used to determine the optimal PDQ-39 cut-off score for identifying disease severity according to H&Y stages.

RESULTS

513 individuals were included in the study. The ROC curve analysis showed that QoL worsened with an increase in disease severity and age. Moreover, QoL was worse in females.

CONCLUSIONS

The results of this study allowed for the correlation of QoL and disease severity in a cohort of individuals with PD. With this cut-off point, it is now possible to make a determination of QoL of an individual with PD at a certain stage of the disease, in a specific age range, and of a particular gender.

Psychometric properties of the Community Integration Questionnaire - Revised (CIQ-R) in an Italian population with spinal cord injury

STUDY DESIGN

Psychometric study.

OBJECTIVES

The aim of this study was to evaluate the internal consistency and validity of the Community Integration Questionnaire - Revised (CIQ-R) in Italian individuals with spinal cord injury (SCI).

SETTING

Patients' associations, foundations, sport clubs, and federations in Italy.

METHODS

The psychometric properties were evaluated following international guidelines. Internal consistency was assessed using Cronbach's alpha (α) coefficient, and test-retest reliability was assessed using intraclass correlation coefficient (ICC); concurrent validity was assessed through Pearson's Correlation Coefficient with the Short Form-12 health survey (SF-12).

RESULTS

The test was administered to 80 people with SCI. Cronbach's α showed a value of 0.825 for the Home Integration subscale, while the other subscales and the total showed values <0.70. 30 of the 80 recruited individuals were submitted to test-retest, which showed ICC values ranging from 0.94 to 1. CIQ-R also showed a correlation between Physical Component Summary (PCS12) of the SF-12, and between Social Integration subscale's score and PCS12 and Mental Component Summary (MCS12). Correlations are also shown between Productivity subscale and PCS12 and MCS12, as well as between the total score and PCS12 and MCS12.

CONCLUSION

This study provided Italian clinicians and researchers with the first international outcome measure for measuring community integration. The validation of this measurement tool for people with SCI allows to compare outcomes of various studies. It is useful for testing the effectiveness of a treatment in various diseases and define which treatment is more effective than others.

Evaluation of test-retest reliability and concurrent validity of the Italian version of the pediatric evaluation of disability inventory in children with down syndrome: A cross-sectional study

PURPOSE

Down Syndrome (DS) is a common genetic disorder caused by trisomy 21. Due to cognitive challenges associated with DS, individuals often experience difficulty performing activities of daily living (ADLs), at levels that can range from mild to significant. This study aimed to measure psychometric properties of the Italian version of the Pediatric Evaluation of Disability Inventory (PEDI-I) in the DS population.

METHODS

The PEDI-I was administered to children with DS. The internal consistency was examined using Cronbach's Alpha. Test-retest reliability was demonstrated by intraclass correlation coefficient (ICC) and Bland-Altman plots. The concurrent validity was evaluated with the Italian version of the Barthel Index.

RESULTS

The PEDI-I was administered to 54 children with DS. Cronbach's Alpha showed statistically significant values (0.899 -0.986). The ICC confirmed the reproducibility of the scale with a range of (0.988 -1), while Bland-Altman plots showed a smallest detectable change of (0.18-1.63). The Pearson Correlation Coefficient with the Barthel Index showed statistically significant values for all PEDI-I subscales (range 0.75-0.95).

CONCLUSION

The study provides evidence of good test-retest reliability and convergent validity when used in children with DS. Other psychometric proprieties need to be investigated in future studies.

Fighting COVID-19 Contagion among University Students of Healthcare Professions: An Italian Cross-Sectional Study

During the pandemic, most governments around the world temporarily closed educational institutions to contain the spread of the Coronavirus Disease 2019 (COVID-19). The objective of the present study is to evaluate the efficacy of an e-learning course on COVID-19 transmission for healthcare university students, in order to advance the preparedness of healthcare university students against contracting COVID-19 within the general university population. The e-learning course was run using a free web service for education. Access to the course was limited to participants enrolled in degree courses related to healthcare professions within the Italian university system. A specific and validated questionnaire was administered at two different times (pre-test and post-test). A paired sample t-test was then used to evaluate their knowledge on COVID-19. Furthermore, a questionnaire measuring their satisfaction was distributed. Data were analyzed from a qualitative point of view. The course was made available from March to July 2020. Over 25,000 students from different Italian universities and various backgrounds participated in the course. The analysis of final test scores revealed that approximately 97% of participants acquired new knowledge and skills on COVID-19, with a statistically significant improvement (p < 0.05). Therefore, it is possible to state that most students enrolled in degrees relating to healthcare at Italian universities are adequately trained with respect to COVID-19 knowledge. Furthermore, students declared a high satisfaction rate both with the course content, and with the management of the telematic platform used.

What if sharing music as a language is the key to meeting halfway? Absolute pitch, pitch discrimination and Autism Spectrum Disorder

BACKGROUND

Absolute pitch is the ability to identify a given note in the absence of a reference note. The prevalence of absolute pitch in autism is between 5% and 11% and autism involves notably enhanced abilities in pitch discrimination.

OBJECTIVES

To summarize the evidence about the role and the meaning of these special skills in autism.

METHODS

Systematic electronic database searches were conducted using Pubmed, Scopus, Psycinfo, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRI-SMA) guideline was followed, and, after thorough screening by two independent reviewers, 17 articles remained eligible for inclusion in this study.

RESULTS

We have two different groups of results. Eight case-control studies discuss pitch discrimination and autism. The second group included four case reports about autistic individuals with absolute pitch and five case-control studies. These results strongly suggest that music elicits special attention for children with autism, and taken together, this evidence supports a major frequency of AP in autistic children.

CONCLUSION

Based on this evidence, future perspectives could include studies aiming to detect absolute pitch at an early age and to use this special skill to stimulate joint attention, as well as socio-communicative skills.

Development and validation of a test for the assessment of knowledge learned by healthcare students during an online course on COVID-19: cross-sectional study

Abstract

Many Italian universities during the COVID-19 pandemic had numerous students attending hospital wards. The training of health care students was necessary to prepare for good practices in implementing knowledge about COVID-19 and minimizing contagion among students who carried out the internship. In February 2020, a course aiming to guide health personnel so that they can appropriately address the health emergency posed by the new coronavirus was created, making use of the scientific evidence currently available as well as official sources of information and updates. The aim of this study was the development and validation of a useful tool to evaluate the progress in knowledge regarding COVID-19 of students in degree courses for the health care professions. The reliability of the test was assessed using Cronbach's alpha (α) coefficient, while the responsiveness of the test between T0 and T1 was measured with a student t test. The standard error of measurement was used to calculate the minimal detectable change of the tool. The test is made up of 31 items with four multiple-choice answers, one of which is correct. Fifteen bachelor's degree courses at the Sapienza University of Rome were enrolled, for a total population of 1,017 students from different course years. The test showed good internal consistency, with Cronbach's α values of 0.82. The item-total analysis also showed good results, with homogeneous α values from 0.80 to 0.82 for each item. The student t test showed a difference of 3.59 between T0 and T1 (p < 0.001). The minimal detectable change was 0.47. The test is a useful tool for assessing progress in skills regarding COVID-19 for students from bachelor's degree courses in the health professions. It allows the improvement and acquisition of skills as well as a qualitative analysis of the organization of internship degree courses.

Evaluation instruments for executive functions in children and adolescents: a systematic review

INTRODUCTION

The present study aimed to perform a systematic review of instruments for evaluating the executive functions (EFs) in a pediatric population to assess their measurement properties, focusing on the professional who administers it.

AREA COVERED

A systematic search of the literature was performed on Cinahl, PsycINFO, Scopus, Web of Science and Medline to identify studies in which an instrument for evaluating the EFs was described. Included only were the papers reporting the evaluation of EFs, with any instrument, on a population aged 0 to 18 consisting of healthy individuals or people with neurodevelopmental disorder. The evaluation of the Risk of Bias has been carried out with the administration of a part of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Checklist.

EXPERT OPINION

The search ended on the 2nd of August. Only 19 articles met the inclusion criteria and were included in the study; the papers refer to 16 different evaluation tools of the EF. Analysis of the methodological quality shows that most of the papers assessed received an 'inadequate' or 'insufficient' score. Indeed, only two articles received six or five 'sufficient' out of 8 items; instead, ten papers received one or zero 'sufficient.'

Landscape service flow dynamics in the metropolitan area of Córdoba (Argentina)

Human decisions, policies, and management strategies play an important role in structuring landscape patterns in a metropolitan area. Land-use/land-cover (LULC) changes can be considered probably the most important factor affecting the environment and the maintenance of landscape service flow. In particular, processes such as agricultural intensification, deforestation, urbanization and industrialization affect landscape heterogeneity in terms of composition and configuration. However, the multifunctional aspect of LULC as well as traditional agricultural practices can contribute to the maintenance of landscape service flow. This research aims to analyze and assess: (1) LULC dynamics and change from 1988 to 2019 within the metropolitan area of Córdoba (Argentina); (2) the effect of this change on landscape composition and configuration; (3) the flow of landscape services from 1988 to 2019, with the identification of hot-spots of landscape service provision. To analyze LULC dynamics and change within the study area, three Landsat images were utilized, while change detection analysis has been performed to identify the areas most affected by changes, the spatial distribution of change and the change trajectories of LULC classes in terms of landscape composition and configuration. Finally, the valuation of landscape service flow has been carried out by placing an economic value on the LULC classes, through the use of proxies. LULC pattern change has resulted in the expansion of extensive agriculture. The total variation from 1988 to 2019 has highlighted a significant reduction of Horticulture, Forests, and Grasslands, which have been converted into other classes (Urban and Extensive Agriculture). This conversion of LULC classes has had profound effects on landscape service flow, which guarantees the well-being of local communities. This research has contributed to the knowledge of where the hot-spots of landscape service' provision are located by helping landscape managers to identify suitable local policies able to preserve them, thus avoiding their loss, and enhancing landscape integrity, functionality, and resilience.

Transcultural reliability and validity of an Italian language version of the Constant–Murley Score

Purpose:

The present study was designed to carry out an Italian translation of the Constant–Murley Score (CMS-IT) and, subsequently, evaluate its reliability and validity.

Methods:

This study included adults diagnosed with any type of clinical shoulder dysfunction who could read and respond to the questionnaires. Those individuals who underwent surgeries of any kind on the affected shoulder during the previous 12 months and individuals with shoulder instabilities were excluded. All of the participants were evaluated by two operators, and the CMS-IT, Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and visual analog scale (VAS) were administered. The internal consistency was evaluated using Cronbach’s α, whereas the intra-rater and inter-rater reliabilities were evaluated using the intraclass correlation coefficient (ICC). The validity of the construction was evaluated using Pearson’s correlation coefficient between the scores of the administered scales.

Results:

A population of 72 individuals participated in this study. The internal consistency of the CMS-IT showed a value of 0.81. The ICC values showed that inter- and intra-rater reliability were 0.994 and 0.963, respectively. CMS-IT is inversely correlated with the VAS (−0.55) and DASH (−0.47) scales.

Conclusions:

This study revealed that the CMS-IT contained good internal consistency and good reliability. The results suggested that the CMS-IT questionnaire is a reliable and valid tool for assessing the shoulder dysfunctions of the Italian population, and it deserves broad applications in both clinical practice and research contexts. The scale can also be used as an alternative to the current “gold standard” VAS and DASH.

Tools to assess the quality of life in patients with Parkinson's disease: a systematic review

INTRODUCTION

The clinical, social, and economic implications of Parkinson's disease (PD) are significant; disability occurs leading to a low quality of life (QoL). Information on the QoL of patients with PD and studies on the relationship between QoL and motor and cognitive function are necessary for both research and clinical use to make informed decisions in healthcare and rehabilitation. The aim of this study was to determine which scales are most used to assess QoL in patients with PD.

AREA COVERED

A literature search was conducted in MEDLINE, Scopus, CINAHL, PsycINFO, and Web of Science. Two authors independently identified eligible studies based on predefined inclusion criteria and extracted the data. Study quality and the risk of bias were assessed using the COSMIN checklist.

EXPERT OPINION

116 suitable studies were included, and 42 different instruments were identified. The most frequently used scales were the 39-items and 8-items Parkinson's Disease Questionnaire (PDQ-39) (PDQ-8). These findings suggest further investigation of existing PD outcome measures would benefit patients, researchers, and clinicians. Validated, universal outcome measures are required to allow comparisons across practice; therefore, we recommend that future researchers use a common set of outcome assessments based on the results of this review.

Efficacy of Occupational Therapy Interventions on Quality of Life in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis

Objective

To review studies assessing the efficacy of occupational therapy interventions on quality of life in patients with Parkinson's disease.

Method

We followed the international guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Databases (PubMed, Physiotherapy Evidence Database, OTsekeer, Scopus, Cinhal, and Web of Science) were searched to identify randomized controlled trials of occupational therapy interventions in patients with Parkinson's disease up to 2019 and with no restriction on language. The primary outcome of the meta-analysis was the evaluation of quality of life following occupational therapy interventions. Because of the heterogeneity of the studies, we examined the data by using a random effect model.

Results

We identified 15 randomized controlled trials that met the inclusion criteria, and 4 of these were included in the meta-analysis. Studies with a follow-up of 2 to 3 months showed that occupational therapy interventions significantly improved the quality of life in patients with Parkinson's disease, with a mean difference of -2.08 (95% confidence interval, -2.52 to -1.64; P < 0.00001). Studies reporting a longer follow-up (6-12 months) also showed that occupational therapy interventions improved the quality of life, with a mean difference of -2.56 (95% confidence interval, -3.52 to -1.61; P < 0.00001).

Conclusion

Different occupational therapy interventions may be effective in improving the quality of life in patients with Parkinson's disease. However, because of the limited number of studies available, the strength of the evidence should be considered moderate.

Measuring Environmental Barriers: Validation and Cultural Adaptation of the Italian Version of the Craig Hospital Inventory of Environmental Factors (CHIEF) Scale

The study aimed to validate an Italian translation of the Craig Hospital Inventory of Environmental Factors (CHIEF) environmental assessment tool. The CHIEF scale was administered throughout Italy to 506 individuals who did not present with serious and/or disabling diseases. The results show an excellent interrelation between CHIEF scale items and the subscales. Furthermore, our analysis demonstrates that following repeated administration to the same participants, the instrument maintains excellent stability of each subscale for the frequency, magnitude, and impact of the barriers. This study demonstrates that the Italian version of the CHIEF scale is reliable for measuring environmental barriers. The findings show that the scale is suitable for the clinical and research fields to broaden our knowledge about this relevant yet poorly studied field.

The Italian version of the General Sleep Disturbance Scale (GSDS-IT): Psychometric properties in a sample with hip and knee replacement

OBJECTIVE

To use the Italian version of the General Sleep Disturbance Scale (GSDS-IT) to assess the psychometric properties in a sample of orthopedic patients.

METHODS

Participants were divided into sleepless and non-sleepless according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V). Reliability was assessed with Cronbach's alpha. To evaluate responsiveness, the scale was administered a second time after the rehabilitation program.

RESULTS

The scale was administered to the 158 patients recruited. The GSDS-IT had good internal consistency (Cronbach's α of 0.752) and good responsiveness (ICC of 0.78). The optimal cut-off point for the GSDS-IT was 48.5.

CONCLUSION

The GSDS-IT was demonstrated to be a valid and rapid tool to detect the presence of sleep disorders in a clinical setting in patients admitted to an intensive care unit and allowed the detection of the onset one week after admission and persisting until the time of discharge.

Frustration and inhomogeneous environments in relaxation of open chains with Ising-type interactions

Frustration can contribute to very slow relaxation times in large open chains, as in spin glasses and in biopolymers. However, frustration may not be sufficient to produce broken ergodicity in finite systems. Here we employ a system-plus-reservoir approach to investigate how strongly inhomogeneous environments and frustration compete in the relaxation of finite open chains. We find a sufficient condition for our inhomogeneous environments to break ergodicity. We use the microscopic model to derive a Markovian quantum master equation for a generic chain with ultrastrong intrachain couplings. We show that this microscopic model avoids a spurious broken ergodicity we find in the phenomenological model. We work out an explicit example of broken ergodicity due to the inhomogeneous environment of an unfrustrated spin chain as far as simulating a recent experiment on protein denaturation (where environment inhomogeneity is especially relevant). We finally show that an inhomogeneous environment can mitigate the effects of frustration-induced degeneracies.

Development of the Pregnancy and Motherhood Evaluation Questionnaire (PMEQ) for evaluating and measuring the impact of physical disability on pregnancy and the management of motherhood: a pilot study

PURPOSE

The aim of this study was to develop a questionnaire that allows researchers to investigate and measure the impact of physical disability on pregnancy and the management of motherhood. Such a questionnaire requires good internal consistency.

METHODS

The tool was developed following a study conducted in 2013 in the United States consisting of a semi-structured interview with open-ended questions. A team of three experts drafted and refined the questions, generating 31 retrospective, self-rated, and predefined questions (answered using a 5-point Likert scale). A statistical analysis of the instrument was also included, to assess its reliability and internal consistency.

RESULTS

The Pregnancy and Motherhood Evaluation Questionnaire (PMEQ) was prepared. It is a self-administered questionnaire consisting of an initial section and three subscales. In this phase of the study, 35 women with different pathologies leading to physical disability were recruited and completed the questionnaire. The PMEQ was found to have a good internal consistency. Cronbach's α was 0.812 (p > 0.05).

CONCLUSION

The PMEQ has proven to be a valid, reliable, and rapid administrative tool useful for investigating and measuring the impact of physical disability on the management of pregnancy and motherhood.IMPLICATION FOR REHABILITATIONThis study provides researchers and clinicians a new tool for the evaluation of motherhood and pregnancy in women with physical disabilities.The PMEQ has proven to be a valid, reliable, and rapid administrative tool (10 min) useful for investigating and measuring the impact of physical disability on the management of pregnancy and motherhood.It is a new tool useful in both clinical and research practice to underline the importance of carrying out preventive and woman-centered assistance interventions.This tool is useful for promoting the autonomous management of pregnancy and motherhood in women with physical disabilities, and improving these women's quality of life and sense of satisfaction and competence in managing maternal tasks.

Cognitive remediation for the treatment of neuropsychological disturbances in subjects with euthymic bipolar disorder: findings from a controlled study

INTRODUCTION

Individuals with euthymic Bipolar Disorder (BD) can experience deteriorated cognitive functioning, with such deterioration being associated with functional impairment. Cognitive remediation (CR) is considered an effective add-on intervention for neuropsychological impairments, but relatively few CR controlled studies have been performed on BD. In the present study the efficacy of a CR intervention designed for the improvement of cognition and functioning in patients with euthymic BD was tested.

METHODS

Patients (n = 54) with euthymic BD were assigned to receive active (n = 27) or control (n = 27) intervention. The active intervention (i.e. the Cognitive Remediation in Integrated Treatment - CRIIT - protocol) was made of 20 individual sessions focused on the treatment of attention, memory and executive functioning through the COGPACK software; each session was integrated with psychoeducation and rehabilitation interventions implemented through a metacognitive approach aimed at ameliorating personal agency.

RESULTS

A significant (p ≤ 0.015) time x group interaction at repeated measures MANOVA was observed on Rey Auditory Verbal Learning Test, Rey Complex Figure Test, Wisconsin Card Sorting Test, Trail Making Test, Visual Search, Life Skills Profile, and Barratt Impulsiveness Scale.

LIMITATIONS

A single-blind approach was used.

DISCUSSION

The results showed that patients undergoing active intervention improved in domains related to executive functions, attention, memory, functioning and impulsivity more significantly than patients undergoing control interventions. This study adds to the evidence that CR improves neurocognition in BD, and suggests that CRIIT protocol represents an add-on intervention of potential relevance to increase cognition and functioning in BD euthymic patients.

Athletes with disability' satisfaction with sport wheelchairs: an Italian cross sectional study

PURPOSE

Physical activity is essential for health and well-being. People with physical disability often experience barriers in performing sports due to the lack of appropriate assistive technologies. The present research aimed to investigate athletes with disability satisfaction when using sports wheelchairs and to explore clinometric properties of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

MATERIALS AND METHODS

One hundred and twenty-eight athletes were involved in the present study. Data on sport discipline and wheelchair provision were collected with qualitative approach. Internal consistency and reliability of QUEST were respectively analyzed with Cronbach's Alpha and Intraclass Correlation Coefficient. Validity was investigated with the correlation of the Wheelchair Use Confidence Scale for Manual users.

RESULTS

Results revealed good internal consistency (.858) and moderate inter-rater reliability for service subscale (.664) and for the total score (.675), while for device subscale (.802) reliability was high. Validity revealed moderate correlation (.300) with a p < 0.05. Qualitative analysis highlighted economic barriers as primary social determinant who affect participation in sport activities.

CONCLUSIONS

The present study confirms preliminary evidence of the QUEST for athletes with disability. The research group also recommends an international effort to promote a comprehensive evaluation of sports wheelchair involving rehabilitation professionals, sport technicians and people with disability.Implications for rehabilitationEconomic factors linked to the purchase of a wheelchair seem being the main barrier for practising sportThe Quebec User Evaluation of Satisfaction with Assistive Technology is a useful tool to measure athletes' satisfaction using a wheelchairRehabilitation professionals and sport technicians should collaborate together with people with disability in determining how choose appropriate sport wheelchairs.

Validity and reliability of the 12-item Berg Balance Scale in an Italian population with Parkinson's disease: A cross sectional study

BACKGROUND

The Berg Balance Scale is widely used to measure balance ability in clinical practice. Recently, the original version was redefined from 14 into 12 items. Its psychometric properties were investigated for different populations. However, for Parkinson disease the new version has not been validated yet.

OBJECTIVE

The purpose of the present study was to evaluate psychometric properties of the 12-item Berg Balance Scale (BBS-12) in a population with Parkinson disease.

METHODS

Internal consistency was evaluated with Cronbach's alpha coefficient, whereas reliability was assessed with the intraclass correlation coefficient. For validity analysis, the Pearson correlation coefficient of the BBS-12 was evaluated with the Tinetti Scale and the Physical Activity Scale for the Elderly.

RESULTS

The BBS-12 was applied to 50 individuals with a mean age of 65.6 years (SD 11.8). The internal consistency showed a good value (Cronbach's alpha 0.886) and reproducibility reveled very high performances for both inter-rater and intra-rater reliabilities (ICC 0.987 and 0.986, respectively). The validity study demonstrated good linear correlation with the Tinetti Scale (p<0.01) and with the Sport and Home Subscales of the Physical Activity Scale for the Elderly (p<0.01).

CONCLUSIONS

The present findings revealed the BBS-12 as a reliable and valid assessment tool to measure balance ability in Parkinson disease. Italian health professionals can now use it with more confidence.

The effect of aquatic physical therapy in patients with stroke: A systematic review and meta-analysis

Objective: The purpose of this study was to evaluate the literature reports of qualitative and quantitative results of physical therapy treatments in the alternative aquatic setting for individuals affected by strokes. Method: PRISMA guidelines were used to carry out the systematic review and meta-analysis. Three bibliographic databases were searched: MEDLINE, PEDro, and the Cochrane Library. Papers included in the study were required to: (a) have a randomized controlled trial (RCT) design of research; and (b) be published in English; (c) be published during the last 10 years (2008-2018). Only randomized controlled trials were employed in the study. The quality of the clinical trials to be included was evaluated according to the Jadad scale. The internal validity was assessed according to the PEDro scale. Results: Eleven RCTs were initially identified in the systematic review. Eight of these were involved in the meta-analysis comparing outcomes and follow-up. Eight studies received a Jadad score of three, indicating a high level of quality. The remaining three studies achieved a lower score which indicated lower qualitative level. Nearly all of the results of the quantitative analysis were statistically significant (P < 0,05) and most of them favored of the experimental group subject to aquatic treatment. Conclusion: Aquatic physical therapy may be a valid means for the rehabilitation of people affected by stroke. The integration of this methodological approach with conventional physical therapy should be considered. However, more studies; a larger number of participants; and varying lengths of follow-up times are necessary.

The effect of aquatic physical therapy on patients with multiple sclerosis: A systematic review and meta-analysis

BACKGROUND

The aquatic environment has unique properties, such a buoyancy, turbulence, hydrostatic pressure, and resistance, which can be used to gain a range of exercise benefits. During the last decade, hydrotherapy has spread in a very heterogeneous rehabilitation field. However, the efficacy of this kind of rehabilitation is not clear in scientific literature. The purpose of this study is to conduct a systematic review with meta-analysis to evaluate the qualitative and quantitative results of physical therapy treatments in an aquatic setting for individuals with Multiple Sclerosis.

METHOD

PRISMA guidelines were used to carry out the systematic review and meta-analysis. Three bibliographic databases were searched: MEDLINE, PEDro, and the Cochrane Library. Papers included in the study have the following characteristics: (a) a randomized controlled trial design of research and (b) published in English. The quality of the clinical trials included were evaluated according to a Jadad score and through meta-analysis.

RESULTS

After the elimination of duplicates, 116 records were screened. Among these, 11 Randomized Controlled Trials (RCTs) were included in the systematic review. Ten of these were involved in the meta-analysis. From the qualitative analysis, a larger number of studies were found with a high level of quality. Most of the results of the quantitative analysis were statistically significant (p< 0.05).

CONCLUSION

Aquatic physical therapy is a valid means of rehabilitation for people with Multiple Sclerosis. The integration of this methodological approach with conventional physical therapy is recommended. Nevertheless, more studies, a larger number of participants, and short-, medium-, and long-term follow-up are required to confirm current results.

Validation of the Pediatric Evaluation of Disability Inventory in an Italian Population with Autism Spectrum Disorder: a Cross-Sectional Study

OBJECTIVES

To measure psychometric properties of the Italian version of the Pediatric Evaluation of Disability Inventory (PEDI-I) in a population with Autism Spectrum Disorder (ASD).

METHODS

The PEDI-I was administered to different children with ASD. The internal consistency was examined by using Cronbach's Alpha, while the intraclass correlation coefficient (ICC) was used to investigate both inter-observer and intra-observer reproducibility. Its concurrent validity was evaluated with the Italian version of the Barthel Index.

RESULTS

The PEDI-I was administered to 60 children with a diagnosis of ASD. Cronbach's Alpha showed statistically significant values (.885-.965). Inter-observer and intra-observer investigations confirm the reproducibility of the scale with a range of high and very high parameters. The Pearson Correlation Coefficient with the Barthel Index showed significant data for all PEDI-I subscales with a p<0.01.

CONCLUSIONS

The PEDI-I showed good psychometric properties and it is possible to confirm its validity and reliability in ASD population. However, for better understanding of how PEDI-I works in clinical practice, further researches are recommended.

Occupational Therapy's efficacy in children with Asperger's syndrome: a systematic review of randomized controlled trials

This systematic review of randomized controlled trials (RCTs) aims at evaluating the efficacy of Occupational therapy (OT) interventions in Asperger's syndrome (AS) pediatric patients. We conducted a systematic review according to PRISMA guidelines. The screening of the literature was carried out on PUBMED, SCOPUS, WEB OF SCIENCE and OT SEEKER databases, TO December 2018. We selected three RCTs having the common objective to evaluate whether children with AS can improve their social skills thanks to OT treatments. The interventions targeted by the three selected studies were: LEGO therapy, Social Use of Language Programme, Let's Face It! software and Parent Training combined with the administration of risperidone. All the studies showed that the intervention groups improved their overall social ability.This review shows that OT interventions can help concretely AS children in overcoming their social issues. Nevertheless, more RCTs are needed to better understand the OT's benefits and limitations in AS patients.

A study validating the Italian version of the Level of Sitting Scale in children with cerebral palsy

Objectives:

To assess measurement properties of the Italian version of the Level of Sitting Scale when classifying sitting ability of children with cerebral palsy.

Design:

Methodological study.

Setting:

Children’s hospital (inpatients and outpatients).

Subjects:

Children 18 years of age or younger with cerebral palsy.

Methods:

The original English version of the Level of Sitting Scale was translated and culturally adapted for the Italian culture following international guidelines. Examination of reliability and validity of the Italian Level of Sitting Scale was then undertaken. Inter-rater and one-week test–retest reliability were estimated using both intraclass correlation coefficients (ICCs) with 95% confidence intervals and Bland–Altman plots. Construct validity of the Italian Level of Sitting was evaluated using three approaches examining Pearson’s correlation coefficient ( r) and Mann–Whitney U test ( P-value < 0.05).

Main measures:

Italian Level of Sitting Scale and Gross Motor Function Classification System.

Results:

The Italian Level of Sitting Scale was administered to 109 subjects. Inter-rater reliability and one-week test–retest showed excellent value with ICCs of 0.99 for both. (1) The Pearson correlation coefficient comparing Italian Level of Sitting Scale with Gross Motor Function Classification System was −0.91 and (2) correlation with total amount of adaptive seating components was −0.90. Differences in sitting abilities and use/non-use of wheelchair were found. All reported a statistical significance of P < 0.01.

Conclusion:

Our findings provide evidence of reliability and validity when using the Italian Level of Sitting Scale to classify seated postural abilities in a sample of Italian children with cerebral palsy.

Construct validity, test-retest reliability, and the ability to detect change of the Canadian Occupational Performance Measure in a spinal cord injury population

Study design

Cross-sectional study.

Objectives

To examine the construct validity and the ability to detect change, of the Italian version of the Canadian Occupational Performance Measure (COPM) in a spinal cord injury (SCI) population.

Settings

Rehabilitation service of the Paraplegic Center of Ostia, Italy.

Methods

Thirty-nine spinal cord injury participants were recruited. The clinimetric properties of the measure were assessed following international guidelines. Cronbach's alpha and the intraclass correlation coefficient were assessed for internal consistency and test-retest reliability, respectively. Construct validity was evaluated, by calculating correlation between COPM and the Spinal Cord Independence Measure (SCIM) through Pearson's correlation coefficient and Spearman's Rho. The ability to detect change was evaluated on the overall sample.

Results

The COPM was shown to be reliable in a spinal cord injury sample with positive and statistically significant results for Cronbach's alpha (0.89) and ICC (0.99 for the performance subtest and 0.98 for the satisfaction subtest). Correlation coefficients did not show a correlation between the COPM total score and the SCIM. The COPM scores improved significantly during in-patient rehabilitation, moreover the mean change between the start of treatment and the end of the therapy as evaluated with the Wilcoxon signed-rank test was -4.25 points for the performance score and -2.96 points for the satisfaction score.

Conclusions

This study showed that the COPM is a reliable tool for assessing SCI clients' perceived performance of daily activities and their satisfaction with their performance.

Italian Version of the Jebsen-Taylor Hand Function Test for the Assessment of Hand Disorders: A Cross-Sectional Study

IMPORTANCE

Having a test to evaluate hand function is fundamental to occupational therapy practice.

OBJECTIVE

To assess the psychometric properties of the Italian version of the Jebsen-Taylor Hand Function Test (JTHFT).

DESIGN

Cross-sectional study.

SETTING

Three health care institutions in Rome, Italy.

PARTICIPANTS

136 people with injuries, burns, or neurological diseases of the hand.

INTERVENTION

No intervention was provided.

OUTCOMES AND MEASURES

We administered the JTHFT, an assessment of fine motor skills during performance of activities of daily living, and compared results with dynamometer readings.

RESULTS

The mean ± standard deviation total time required to perform all subtests was 89.47 ± 67.98 s for the dominant hand (DH) and 167.11 ± 257.58 s for the nondominant hand (NDH). Reliability procedures were applied to data from 51 participants; mean intrarater intraclass correlation coefficient (ICC) was .814 for the DH and .981 for the NDH, and mean interrater ICC was .818 for the DH and .821 for the NDH. Pearson's correlation coefficients were significant.

CONCLUSION AND RELEVANCE

Results support the use of the Italian version of the JTHFT as a measure of functional dexterity in people with upper limb disorders.

WHAT THIS ARTICLE ADDS

The JTHFT is a valid and reliable assessment tool for nonspecific hand diseases. Italian health professionals can now use the JTHFT with more confidence.

Psychometric properties of the Italian version of the Barthel Index in patients with Parkinson's disease: a reliability and validity study

The Barthel Index (BI) is used in Italy to measure the severity of disability and to identify patients suitable for admission to rehabilitation units. The objective of this psychometric study was to validate the Italian version of the BI in a population of patients with Parkinson's disease (PD). The study was conducted at three neurological and rehabilitation centres in Rome, Italy. The BI was administered to outpatients with PD. The reliability of the scale was assessed using Cronbach's alpha for internal consistency; the intra-class correlation coefficient (ICC) was used to measure its intra- and inter-rater reliability. Pearson's correlation coefficient was calculated to evaluate its validity, comparing it with the Parkinson's disease Questionnaire (PDQ-39), the Italian version of the Geriatric Depression Scale (GDS), the Hospital Anxiety and Depression Scale (HADS), and the Short Form 36-Health Survey Questionnaire (SF-36). The BI was administered to 94 patients with PD. The psychometric properties measured were significant: Cronbach's alpha was 0.866 and the ICC for intra- and inter-rater reliability was 0.998 and 0.993, respectively. Pearson's correlation coefficient showed good correlation with the PDQ-39, GDS, HADS and SF-36 (p < 0.01). The BI is a valid and reliable tool for measuring disability in a PD population.

The effect of physiotherapy on fatigue and physical functioning in chronic fatigue syndrome patients: A systematic review

OBJECTIVE

The objectives of this work were to fill the gap in the scientific literature and to evaluate the results of physical therapy treatments in individuals affected by chronic fatigue syndrome, considering only studies that employed a randomized controlled trial.

METHODS

A systematic review was carried out according to PRISMA guidelines. Three bibliographic databases were searched: MEDLINE, Cochrane Library, and PEDro. The minimum prerequisites for papers to be included in the systematic review were that they had to (a) employ a randomized controlled trial; (b) be published in English; and (c) be published during the last ten years (2007-2017). The studies were evaluated according to Jadad score.

RESULTS

Four studies were included. This systematic review suggests that a treatment that is more effective than all the others cannot be defined. This conclusion is related to the low number of investigated studies; therefore, the collected results cannot be generalized.

CONCLUSION

Chronic fatigue syndrome is not yet a well-understood pathology, and the physical mechanisms that influence the outcomes still need more study. Rehabilitation programs that promote physiotherapy techniques such as exercise, mobilization, and body awareness (e.g., MRT and GET) are the most effective in reducing medium and long-term fatigue severity in CFS patients.

Exploring Validity, Reliability, and Factor Analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology in an Italian Population: A Cross-Sectional Study

This study explores validity, reliability, and factor analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology (IT-QUEST) for users of assistive technology devices in an Italian population. It was administered to 75 people to determine which of the 24 original items were relevant to the Italian context using exploratory and confirmatory factor analyses (EFAs and CFAs) were conducted with internal consistency and test-retest reproducibility also evaluated. The EFA and CFA showed that the 24-item survey may have limited relevance to the Italian context. We individuated 12 significative items, divided into two subscales, as well as the original validation. The test-retest showed high values of the Intraclass Correlation Coefficient (ICC) (0.7-0.9), with a 0.812 ICC for the total scale providing support and evidence for Italian professionals to evaluate user satisfaction with assistive technology devices. This research also lays the foundation for developing a validation study of the IT-QUEST 2.0 that is relevant to the Italian culture. Further research may investigate psychometric properties involving more participants and different users of assistive technology devices.