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Barbagelata M, Morganti W, Seminerio E, Camurri A, Ghisio S, Loro M, Puleo G, Dijk B, Nolasco I, Costantini C, Cera A, Senesi B, Ferrari N, Canepa C, Custodero C, Pilotto A. Resilience improvement through a multicomponent physical and cognitive intervention for older people: the DanzArTe emotional well-being technology project. Aging Clin Exp Res 2024; 36:72. [PMID: 38488883 PMCID: PMC10942916 DOI: 10.1007/s40520-023-02678-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/08/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND Resilience is a crucial component of successful aging. However, which interventions might increase resilience in older adults is yet unclear. AIMS This study aims to assess the feasibility and the physical and psychological effects of a technology-based multicomponent dance movement intervention that includes physical, cognitive, and sensory activation in older people living in community-dwelling and nursing home. METHODS DanzArTe program consists of four sessions on a weekly basis, using a technological platform that integrates visual and auditory contents in real time. 122 participants (mean age = 76.3 ± 8.8 years, 91 females = 74.6%) from seven nursing homes and community-dwelling subjects were assessed, before and after the intervention, with the Resilience Scale-14 items (RES-14), the Multidimensional Prognostic Index (MPI), the Psychological General Well-Being Index (PGWBI-S), and the Client Satisfaction Questionnaire-8 (CSQ-8). Mann-Whitney and Wilcoxon signed-ranks tests were used for statistical analyses. RESULTS At baseline significant differences in MPI and RES-14 between community-dwelling and nursing home residents were observed (p < 0.001 for both analyses). After the intervention, resilience significantly increased in total sample (RES-14 mean T1 = 74.6 Vs. T2 = 75.7) and in the nursing home residents (RES-14 mean T1 = 68.1 Vs. T2 = 71.8). All participants showed high overall satisfaction for DanzArTe program (CSQ-8 mean = 23.9 ± 4.4). No differences in MPI and PGWBI-S were observed. DISCUSSION DanzArTe was a feasible intervention and high appreciated by all older adults. Nursing home residents revealed improvements in resilience after DanzArTe program. CONCLUSION The DanzArTe technology-based multi-component intervention may improve resilience in older people living in nursing homes.
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Affiliation(s)
- Marina Barbagelata
- Department Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy.
| | - Wanda Morganti
- Department Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy
| | - Emanuele Seminerio
- Department Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy
| | - Antonio Camurri
- Department of Informatics, Bioengineering, Robotics and Systems' Engineering (DIBRIS), University of Genova, Genoa, Italy
| | - Simone Ghisio
- Department of Informatics, Bioengineering, Robotics and Systems' Engineering (DIBRIS), University of Genova, Genoa, Italy
| | - Mara Loro
- Foundation "Fondazione Piemonte dal Vivo", Turin, Italy
| | - Gianluca Puleo
- Department Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy
| | - Babette Dijk
- Ligurian Health Agency, Memory Clinic, Chiavari, Italy
| | | | | | - Andrea Cera
- Department of Informatics, Bioengineering, Robotics and Systems' Engineering (DIBRIS), University of Genova, Genoa, Italy
| | - Barbara Senesi
- Department Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy
| | - Nicola Ferrari
- Department of Italianistics, Romanistics, Antiquities, Arts and Performing Arts, University of Genova, Genoa, Italy
| | - Corrado Canepa
- Department of Informatics, Bioengineering, Robotics and Systems' Engineering (DIBRIS), University of Genova, Genoa, Italy
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - Alberto Pilotto
- Department Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
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Morganti W, Veronese N, Barbagelata M, Castagna A, Custodero C, Solimando L, Burgio MI, Montana Lampo SE, Seminerio E, Puleo G, Senesi B, Cammalleri L, Ruotolo G, Sabbà C, Barbagallo M, Pilotto A. Validation of a Brief Form of the Self-Administered Multidimensional Prognostic Index: The SELFY-BRIEF-MPI Project. J Clin Med 2023; 12:6026. [PMID: 37762966 PMCID: PMC10531940 DOI: 10.3390/jcm12186026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
In clinical practice, self-administered and brief tools to promptly identify older people at risk of frailty are required. The Multidimensional Prognostic Index (MPI), derived from the Comprehensive Geriatric Assessment (CGA) seems reliable enough to serve this purpose, but despite the several versions developed over the past 15 years, it lacks a self-administered and brief version. In this study, we aimed to evaluate the agreement between an abbreviated form of the SELFY-MPI (i.e., SELFY-BRIEF-MPI) and the standard version of the MPI. Four Italian hospitals consecutively enrolled outpatients and inpatients >65 years. The sample included 105 participants (mean age = 78.8 years, 53.3% females). Overall, the two versions showed non-statistically significant differences (Standard-MPI 0.42 ± 0.19 vs.. SELFY-BRIEF-MPI 0.41 ± 0.18; p = 0.104) and a very strong correlation (R = 0.86, p < 0.001). The Bland-Altman Plot revealed that only 5/105 measurements (4.76%) were outside the limits of agreement. The accuracy of the SELFY-BRIEF-MPI in identifying frail people (defined as a Standard-MPI > 0.66) was optimal (area under the curve, AUC = 0.90, p < 0.001). To predict multidimensional frailty, a SELFY-BRIEF-MPI score of 0.60 exhibited the greatest sensitivity/specificity ratio. In conclusion, the SELFY-BRIEF-MPI reported a good agreement with the standard version of the MPI, indicating its application in the screening of multidimensional frailty among older people.
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Affiliation(s)
- Wanda Morganti
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Marina Barbagelata
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Alberto Castagna
- Primary Care Department, Health District of Soverato, Catanzaro Provincial Health Unit, 88068 Soverato, Italy;
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy;
| | - Luisa Solimando
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Marianna Ilarj Burgio
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Sofia Elena Montana Lampo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Emanuele Seminerio
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Gianluca Puleo
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Barbara Senesi
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Lisa Cammalleri
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
| | - Giovanni Ruotolo
- Geriatric Medicine Department, Azienda Sanitario Ospedaliero “Renato Dulbecco”, 88100 Catanzaro, Italy;
| | - Carlo Sabbà
- Department of Internal Medicine, and Rare Diseases Centre “C. Frugoni”, University Hospital of Bari, 70120 Bari, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90127 Palermo, Italy; (L.S.); (M.I.B.); (S.E.M.L.); (M.B.)
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Ente Ospedaliero Galliera Hospital, 16128 Genoa, Italy; (W.M.); (M.B.); (E.S.); (G.P.); (L.C.)
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy;
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Bossi E, Tringali M, Colombo P, Mazzali C, Puleo G, Caruggi M, Branchi M, Odone A. Quality Assessment of HTA reports: a Critical Appraisal Toolkit within an institutional HTA program. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue
With population aging, increased demand for healthcare and limited availability of economic and human resources, well-functioning and sustainable health systems have to rely on rigorous and evidence-based assessments of complex technologies' clinical effectiveness and safety. The Lombardy Region in Northern Italy has a well-established HTA program that offers technical support to its hospitals' network to produce and to review Health Technology Assessment (HTA) reports.
Description of the Problem
To better coordinate the HTA network and to reduce self-referencing of University and Community hospitals, Lombardy Region carried out an intense field training and distance learning from year 2017, with a project aimed at involving health care professionals in an accurate evaluation of technologies in 18 HTA reports. The regional HTA Supporting Centre developed a Toolkit for the critical appraisal of reports and supporting literature to improve the quality of hospital-based reports.
Results
In compliance with the regional Law DGR XI/1046 17.12.2018 and the framework proposed, during year 2019 hospitals used the Toolkit to help writing complete and good quality HTA reports on 37 different technologies. With a Public Health resident internship, the Toolkit was revised, extended and then used in 2020 by the hospital's HTA network during the double blinded peer review, mandated by the regional Law DGR XI/2672 16.12.2019, of the year 2019 HTA reports. Detailed results will be presented at the conference.
Lessons
We observed an increase in number of HTA reports from 2018 to 2019, a greater language's and format's homogeneity and an improvement in the quality of some reports, which will be submitted to the Regional HTA Committee for appraisal and reimbursement.
Key messages
The development and use of a Critical Appraisal Toolkit in an Regional HTA program can help hospitals write complete and good quality HTA reports. A centrally supported quality improvement of distributed assessment activities in a network of hospitals can enhance the production of HTA reports, relevant to the needs of a local healthcare system.
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Affiliation(s)
- E Bossi
- School of Public Health, Vita-Salute San Raffaele University, Milan, Italy
| | - M Tringali
- HTA Supporting Centre, Welfare General Directorate, Lombardy Region, Milan, Italy
| | - P Colombo
- HTA Supporting Centre, Welfare General Directorate, Lombardy Region, Milan, Italy
| | - C Mazzali
- HTA Supporting Centre, Welfare General Directorate, Lombardy Region, Milan, Italy
| | - G Puleo
- HTA Supporting Centre, Welfare General Directorate, Lombardy Region, Milan, Italy
| | - M Caruggi
- HTA Supporting Centre, Welfare General Directorate, Lombardy Region, Milan, Italy
| | - M Branchi
- HTA Supporting Centre, Welfare General Directorate, Lombardy Region, Milan, Italy
| | - A Odone
- School of Public Health, Vita-Salute San Raffaele University, Milan, Italy
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Fiocchi A, Vignati B, Cinquepalmi P, Machado E, Peano L, Pulejo R, Puleo G, Lietti D, Merazzi D, Caramia G. [Treatment using immucytal in children with recurrent respiratory infections: an Italian multicenter experience]. Pediatr Med Chir 1989; 11:285-91. [PMID: 2687818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
120 children, 71 male and 49 female, aged between 2 years and 15 years (mean 6.15 +/- 3.52 years) with recurrent respiratory infections, were treated with Immucytal, an immunomodulator of bacterial origin, based on membrane proteoglycan fractions plus bacterial ribosomes. The children, selected on the basis of the previous year's clinical score, were treated according to a random design with either Immucytal or placebo, using the same dosage of one puff per nostril plus one puff in the oropharyngeal cavity three times a day, as follows: 1st month: two weeks' treatment, one week wash out, one week's treatment. 2nd, 3rd, 4th months: two weeks' treatment, two week's wash out. Monthly throughout the treatment period the frequency and severity of airway infections episodes were assessed using the same score as for admission. Blood chemistry test, immunological assays (circulating Ig, lymphocyte subpopulations, Merieux Multitest in vivo blastization test) and respiratory tests (spirometry using a pneumotachigraph) were done before and after the treatment. 118/120 children completed treatment; the two dropouts were in the placebo group, one for compliance and the other because of headaches. Respiratory symptoms improved significantly in the actively treated children already from the first month, but not in the placebo group. This improvement consisted of reduction of the respiratory infectious episodes in both the upper and lower airways. No changes were noted in respiratory function parameters. From the immunological viewpoint, there were significant rises in serum IgA and IgM and enhanced skin response tot he Multitest; there was no change in the percentages of different circulating lymphocyte subpopulations.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Fiocchi
- Clinica Pediatrica, Ospedale San Paolo, Milano, Italia
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