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Rizzi S, Poggianella S, Pavesi MC, Gios L, Bincoletto G, Scolari I, Paoli C, Marroni D, Tassinari I, Baietti B, Gianatti A, Albertini V, Burlon B, Chiodega V, Endrizzi B, Benini E, Guella C, Gadotti E, Forti S, Taddei F. A Mindfulness-Based App Intervention for Pregnant Women: Protocol for a Pilot Feasibility Study. JMIR Res Protoc 2024; 13:e53890. [PMID: 38567964 DOI: 10.2196/53890] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/13/2024] [Accepted: 03/21/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Pregnancy is a complex time characterized by major transformations in a woman, which impact her physical, mental, and social well-being. How a woman adapts to these changes can affect her quality of life and psychological well-being. The literature indicates that pregnant women commonly experience psychological symptoms, with anxiety, stress, and depression being among the most frequent. Hence, promoting a healthy lifestyle focused on women's psychological well-being is crucial. Recently developed digital solutions have assumed a crucial role in supporting psychological well-being in physiologically pregnant women. Therefore, the need becomes evident for the development and implementation of digital solutions, such as a virtual coach implemented in a smartphone, as a support for the psychological well-being of pregnant women who do not present psychological and psychiatric disorders. OBJECTIVE This study aims to assess the feasibility, acceptability, and utility of a mindfulness-based mobile app. The primary objective is to explore the feasibility of using a virtual coach, Maia, developed within the TreC Mamma app to promote women's psychological well-being during pregnancy through a psychoeducational module based on mindfulness. Finally, through the delivery of this module, the level of psychological well-being will be explored as a secondary objective. METHODS This is a proof-of-concept study in which a small sample (N=50) is sufficient to achieve the intended purposes. Recruitment will occur within the group of pregnant women belonging to the pregnancy care services of the Trento Azienda Provinciale per i Servizi Sanitari di Trento. The convenience sampling method will be used. Maia will interact with the participating women for 8 weeks, starting from weeks 24 and 26 of pregnancy. Specifically, there will be 2 sessions per week, which the woman can choose, to allow more flexibility toward her needs. RESULTS The psychoeducational pathway is expected to lead to significant results in terms of usability and engagement in women's interactions with Maia. Furthermore, it is anticipated that there will be improvements in psychological well-being and overall quality of life. The analysis of the data collected in this study will be mainly descriptive, orientated toward assessing the achievement of the study objectives. CONCLUSIONS Literature has shown that women preferred web-based support during the perinatal period, suggesting that implementing digital interventions can overcome barriers to social stigma and asking for help. Maia can be a valuable resource for regular psychoeducational support for women during pregnancy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/53890.
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Affiliation(s)
- Silvia Rizzi
- Digital Health Research, Centre for Digital Health & Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Stefania Poggianella
- Digital Health Research, Centre for Digital Health & Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | | | - Lorenzo Gios
- Digital Health Research, Centre for Digital Health & Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- TrentinoSalute4.0, Competence Center for Digital Health, Trento, Italy
| | - Giorgia Bincoletto
- Facoltà di Giurisprudenza, Università degli Studi di Trento, Trento, Italy
| | - Isabella Scolari
- Operating Unit of Psychology, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Claudia Paoli
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Debora Marroni
- Operating Unit of Psychology, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Irene Tassinari
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Barbara Baietti
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Anna Gianatti
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Veronica Albertini
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Barbara Burlon
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Vanda Chiodega
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Barbara Endrizzi
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Elena Benini
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | - Chiara Guella
- Operating Unit of Psychology, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
| | | | - Stefano Forti
- Digital Health Research, Centre for Digital Health & Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Fabrizio Taddei
- Transmural Obstetric Gynecological Department, Healthcare Trust of the Autonomous Province of Trento (APSS), Trento, Italy
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Pardini S, Gabrielli S, Olivetto S, Fusina F, Dianti M, Forti S, Lancini C, Novara C. Personalized Virtual Reality Compared With Guided Imagery for Enhancing the Impact of Progressive Muscle Relaxation Training: Pilot Randomized Controlled Trial. JMIR Ment Health 2024; 11:e48649. [PMID: 38289673 PMCID: PMC10871070 DOI: 10.2196/48649] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 12/07/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Empirical evidence has shown that virtual reality (VR) scenarios can increase the effects of relaxation techniques, reducing anxiety by enabling people to experience emotional conditions in more vivid settings. OBJECTIVE This pilot randomized controlled study aims to investigate whether the progressive muscle relaxation technique (PMRT) associated with a personalized scenario in VR promotes psychological well-being and facilitates the recall of relaxing images more than the standard complementary intervention that involves the integration of PMRT and guided imagery (GI). METHODS On the basis of a longitudinal, between-subject design, 72 university students were randomly exposed to one of two experimental conditions: (1) standard complementary procedure (PMRT and GI exposure) and (2) experimental procedure (PMRT and personalized VR exposure). Individuals were assessed by a therapist before and after 7 training sessions based on measures investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data were also collected. RESULTS Differences in changes between the 2 groups after the in vivo PMRT session conducted by the psychotherapist (T1) were statistically significant for state anxiety (F1,67=30.56; P<.001) and heart rate (F1,67=4.87; P=.01). Individuals in the VR group obtained lower scores both before (t67=-2.63; P=.01; Cohen d=0.91) and after (t67=-7.23; P<.001; Cohen d=2.45) the relaxation session when it was self-administered by participants (T2). A significant reduction in perceived state anxiety at T1 and T2 was observed for both groups (P<.001). After the VR experience, individuals reported feeling higher engagement in the experience than what was mentioned by participants in the GI group (F1,67=2.85; P=.03; ηp2=0.15), and they experienced the environment as more realistic (F1,67=4.38; P=.003; ηp2=0.21). No differences between groups regarding sense of presence were found (F1,67=1.99; P=.11; ηp2=0.11). Individuals exposed before to the VR scenario (T1) referred to perceiving the scenario recalled in-imagination at T2 as more realistic than what those in the GI group experienced (F1,67=3.21; P=.02; ηp2=0.12). The VR group had lower trait anxiety levels than the GI group after the relaxation session during session 7 (T2; t67=-2.43; P=.02). CONCLUSIONS Personalized relaxing VR scenarios can contribute to improving relaxation and decreasing anxiety when integrated with PMRT as a complementary relaxation method. TRIAL REGISTRATION ClinicalTrials.gov NCT05478941; https://classic.clinicaltrials.gov/ct2/show/NCT05478941. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/44183.
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Affiliation(s)
- Susanna Pardini
- Department of General Psychology, University of Padova, Padova, Italy
- Digital Health Research, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- Human Inspired Technology Research Centre (HIT), University of Padova, Padova, Italy
| | - Silvia Gabrielli
- Digital Health Research, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Olivetto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Francesca Fusina
- Department of General Psychology, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Marco Dianti
- Digital Health Research, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Forti
- Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Cristina Lancini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Caterina Novara
- Department of General Psychology, University of Padova, Padova, Italy
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Pardini S, Gabrielli S, Gios L, Dianti M, Mayora-Ibarra O, Appel L, Olivetto S, Torres A, Rigatti P, Trentini E, Leonardelli L, Bernardi M, Lucianer M, Forti S, Novara C. Customized virtual reality naturalistic scenarios promoting engagement and relaxation in patients with cognitive impairment: a proof-of-concept mixed-methods study. Sci Rep 2023; 13:20516. [PMID: 37993549 PMCID: PMC10665464 DOI: 10.1038/s41598-023-47876-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023] Open
Abstract
Being immersed in a natural context has a beneficial and pervasive impact on well-being. Virtual Reality (VR) is a technology that can help expose people to naturalistic scenarios virtually, overcoming obstacles that prevent them from visiting real natural environments. VR could also increase engagement and relaxation in older adults with and without cognitive impairment. The main aim of this study is to investigate the feasibility of a customized naturalistic VR scenario by assessing motion-sickness effects, engagement, pleasantness, and emotions felt. Twenty-three individuals with a diagnosis of cognitive impairment living in a long-term care home participated in our study. At the end of the entire VR experimental procedure with older adults, five health staff operators took part in a dedicated assessment phase focused on evaluating the VR procedure's usability from their individual perspectives. The tools administered were based on self-reported and observational tools used to obtain information from users and health care staff professionals. Feasibility and acceptance proved to be satisfactory, considering that the VR experience was well-tolerated and no adverse side effects were reported. One of the major advantages emerged was the opportunity to deploy customized environments that users are not able to experience in a real context.Trial Registration: National Institute of Health (NIH) U.S. National Library of Medicine, ClinicalTrials.gov NCT05863065 (17/05/2023).
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Affiliation(s)
- Susanna Pardini
- Department of General Psychology, University of Padova, Padua, Italy.
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy.
- Human Inspired Technology Research Centre (HIT), University of Padova, Padua, Italy.
| | - Silvia Gabrielli
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Lorenzo Gios
- Competence Center for Digital Health, TrentinoSalute4.0, Trento, Italy
| | - Marco Dianti
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Oscar Mayora-Ibarra
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Lora Appel
- OpenLab, University Health Network, Toronto, ON, Canada
- Faculty of Health, School of Health Policy and Management, York University, Toronto, ON, Canada
- Michael Garron Hospital, Toronto, ON, Canada
| | - Silvia Olivetto
- Department of General Psychology, University of Padova, Padua, Italy
| | - Alina Torres
- Faculty of Science, University of Toronto, Toronto, ON, Canada
| | - Patty Rigatti
- Azienda Pubblica di Servizi alla Persona (APSP) "Margherita Grazioli", Trento, Italy
| | - Emanuela Trentini
- Azienda Pubblica di Servizi alla Persona (APSP) "Margherita Grazioli", Trento, Italy
| | - Lucia Leonardelli
- Azienda Pubblica di Servizi alla Persona (APSP) "Margherita Grazioli", Trento, Italy
| | - Michela Bernardi
- Azienda Pubblica di Servizi alla Persona (APSP) "Margherita Grazioli", Trento, Italy
| | - Marzia Lucianer
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- Competence Center for Digital Health, TrentinoSalute4.0, Trento, Italy
| | - Stefano Forti
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Caterina Novara
- Department of General Psychology, University of Padova, Padua, Italy
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Pardini S, Gabrielli S, Olivetto S, Fusina F, Dianti M, Forti S, Lancini C, Novara C. Personalized, Naturalistic Virtual Reality Scenarios Coupled With Web-Based Progressive Muscle Relaxation Training for the General Population: Protocol for a Proof-of-Principle Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e44183. [PMID: 37067881 PMCID: PMC10152380 DOI: 10.2196/44183] [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: 11/09/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Virtual reality (VR) is an innovative tool that can facilitate exposure to either stressful or relaxing stimuli and enables individuals who have difficulties visualizing scenes to be involved in a more realistic sensorimotor experience. It also facilitates multisensory stimulation, a sense of presence, and achievement of relaxation. VR scenarios representing visual and auditory elements of natural relaxing environments can facilitate the learning of relaxation techniques such as the progressive muscle relaxation technique (PMRT). A complementary standardized technique deployed to reduce anxiety symptoms is the integration of PMRT and guided imagery (GI). Exposure to a pleasant imaginary environment helps the establishment of an association between a relaxing scenario and the relaxation technique, consequently promoting relaxation. Empirical evidence has shown that VR scenarios can increase the effects of relaxation techniques by enabling people to experience emotional conditions in more vivid settings. OBJECTIVE The main aim of this pilot study protocol is to investigate the impact on state anxiety of PMRT, associated with a personalized relaxing scenario in VR, and the role of VR scenarios in facilitating the recall of relaxing images and a sense of presence. A secondary aim is to understand if relaxing sessions administered via Zoom are more effective for managing anxiety and stress than a procedural setting based on audio-track guidance. METHODS Based on a longitudinal, between-subject design, 108 university students will be randomly exposed to one of three experimental conditions: (1) PMRT via Zoom and GI exposure, (2) PMRT via Zoom and personalized VR exposure, and (3) PMRT based on audio-track guidance and personalized VR exposure. Individuals are assessed before and after 7 training sessions based on self-report questionnaires investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data are also detected by an Mi Band 2 sensor. RESULTS The experimental procedure is ongoing. In this paper, preliminary data from a sample of 40 participants will be illustrated. The experimental phase is expected to conclude in May 2023, and the final results of the research will be presented in June 2023. CONCLUSIONS The results of this study will help shape the experimental design to apply it on a subsequent randomized controlled trial, also considering clinical samples. This work is expected to measure whether VR is a more engaging and helpful technique in promoting relaxation and decreasing anxiety levels than GI, by making the visualization process easier and by helping people to face more realistic sensory experiences. Assessing the efficacy of the PMRT in alternative delivery modes may extend its applications, especially in situations where the standard procedure is more challenging to be administered. To our knowledge, no equivalent study has been published so far on this matter. TRIAL REGISTRATION ClinicalTrials.gov NCT05478941; https://clinicaltrials.gov/ct2/show/NCT05478941. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44183.
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Affiliation(s)
- Susanna Pardini
- Department of General Psychology, University of Padova, Padova, Italy
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
| | - Silvia Gabrielli
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Olivetto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Francesca Fusina
- Department of General Psychology, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Marco Dianti
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Forti
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Cristina Lancini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Caterina Novara
- Department of General Psychology, University of Padova, Padova, Italy
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Bassi G, Giuliano C, Perinelli A, Forti S, Gabrielli S, Mancinelli E, Salcuni S. Motibot: the Virtual Coach for healthy coping intervention in diabetes. Eur Psychiatry 2022. [PMCID: PMC9563331 DOI: 10.1192/j.eurpsy.2022.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Virtual coaches (VCs) can support people with Diabetes Mellitus (DM) by motivating them to better manage their health. Few VCs were aimed at providing psychosocial support. In this regard, motivation is a pivotal construct in diabetes self-management as it allows adults with DM to adhere to the clinical recommendations. Objectives The present study aimed to develop a VC able to motivate adults with DM to adopt and acquire healthier coping strategies, to decrease symptoms of depression, anxiety, perceived stress, and diabetes-related emotional distress, while also improving their well-being. Methods A total of 12 adults with DM (M=27.91 years; SD=9.82) interacted with a VC, called Motibot using Telegram for an overall duration of 12 sessions. Participants completed a battery of instruments at pre-, post-intervention and follow-up. Results highlighted a decrease in anxiety, and depression symptoms between pre-, post-intervention and follow-up, as also showed by the results that emerged through the text mining. Motibot was perceived as motivating and encouraging in the adoption of appropriate coping strategies, such as mindfulness practices. Motibot was also perceived as trustworthy, reflective, and stimulating in its dialogical interaction. Indeed, adults felt involved in the interaction with Motibot, thereby showing an overall perception of a better quality of life, in the absence of diabetes distress. Conclusions This study sheds light on the importance of VCs in health care for people with DM for psychosocial support. This is the first experimental study on the matter, and thus, further iterations of the intervention are needed using a larger sample size. Disclosure No significant relationships.
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Isidori V, Diamanti F, Gios L, Malfatti G, Perini F, Nicolini A, Longhini J, Forti S, Fraschini F, Bizzarri G, Brancorsini S, Gaudino A. Digital technologies and the role of healthcare professionals: a scoping review exploring nurses’ skills in the digital era and in light of the Covid-19 pandemic. (Preprint). JMIR Nurs 2022; 5:e37631. [PMID: 36194466 PMCID: PMC9579937 DOI: 10.2196/37631] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background The nursing role significantly changed following reforms in the nurse training process. Nowadays, nurses are increasingly trained to promote and improve the quality of clinical practice and to provide support in the assistance of patients and communities. Opportunities and threats are emerging as a consequence of the introduction of new disruptive technologies in public health, which requires the health care staff to develop new digital skills. Objective The aim of this paper is to review and define the role of nurses and the skills they are asked to master in terms of new methodological approaches and digital knowledge in a continuously evolving health care scenario that relies increasingly more on technology and digital solutions. Methods This scoping review was conducted using a thematic summary of previous studies. Authors collected publications through a cross-database search (PubMed, Web of Science, Google Scholar) related to new telemedicine approaches impacting the nurses’ role, considering the time span of 2011-2021 and therefore including experiences and publications related to the first phase of the COVID-19 pandemic. Results The assessment was completed between April and July 2021. After a cross-database search, authors reviewed a selection of 60 studies. The results obtained were organized into 5 emerging macro areas: (1) leadership (nurses are expected to show leadership capabilities when introducing new technologies in health care practices, considering their pivotal role in coordinating various professional figures and the patient), (2) soft skills (new communication skills, adaptiveness, and problem solving are needed to adapt the interaction to the level of digital skills and digital knowledge of the patient), (3) training (specific subjects need to be added to nursing training to boost the adoption of new communication and technological skills, enabling health care professionals to largely and effectively use new digital tools), (4) remote management of COVID-19 or chronic patients during the pandemic (a role that has proved to be fundamental is the community and family nurse and health care systems are adopting novel assistance models to support patients at home and to enable decentralization of services from hospitals to the territory), and (5) management of interpersonal relationships with patients through telemedicine (a person-centered approach with an open and sensitive attitude seems to be even more important in the framework of telemedicine where a face-to-face session is not possible and therefore nonverbal indicators are more problematic to be noticed). Conclusions Further advancing nurses’ readiness in adopting telemedicine requires an integrated approach, including combination of technical knowledge, management abilities, soft skills, and communication skills. This scoping review provides a wide-ranging and general—albeit valuable—starting point to identify these core competences and better understand their implications in terms of present and future health care professionals’ roles.
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Affiliation(s)
- Valentina Isidori
- Department of Medicine and Surgery, University of Perugia, Terni, Italy
| | | | - Lorenzo Gios
- TrentinoSalute4.0, Centro di Competenza per la Sanità Digitale, Trento, Italy
| | - Giulia Malfatti
- TrentinoSalute4.0, Centro di Competenza per la Sanità Digitale, Trento, Italy
| | - Francesca Perini
- TrentinoSalute4.0, Centro di Competenza per la Sanità Digitale, Trento, Italy
| | - Andrea Nicolini
- TrentinoSalute4.0, Centro di Competenza per la Sanità Digitale, Trento, Italy
| | | | - Stefano Forti
- TrentinoSalute4.0, Centro di Competenza per la Sanità Digitale, Trento, Italy
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Bassi G, Donadello I, Gabrielli S, Salcuni S, Giuliano C, Forti S. Early Development of a Virtual Coach for Healthy Coping Interventions in Type 2 Diabetes Mellitus: Validation Study. JMIR Form Res 2022; 6:e27500. [PMID: 35147505 PMCID: PMC8881774 DOI: 10.2196/27500] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/27/2021] [Accepted: 12/20/2021] [Indexed: 11/15/2022] Open
Abstract
Background Mobile health solutions aimed at monitoring tasks among people with diabetes mellitus (DM) have been broadly applied. However, virtual coaches (VCs), embedded or not in mobile health, are considered valuable means of improving patients’ health-related quality of life and ensuring adherence to self-care recommendations in diabetes management. Despite the growing need for effective, healthy coping digital interventions to support patients’ self-care and self-management, the design of psychological digital interventions that are acceptable, usable, and engaging for the target users still represents the main challenge, especially from a psychosocial perspective. Objective This study primarily aims to test VC interventions based on psychoeducational and counseling approaches to support and promote healthy coping behaviors in adults with DM. As a preliminary study, university students have participated in it and have played the standardized patients’ (SPs) role with the aim of improving the quality of the intervention protocol in terms of user acceptability, experience, and engagement. The accuracy of users’ role-playing is further analyzed. Methods This preliminary study is based on the Obesity-Related Behavioral Intervention Trial model, with a specific focus on its early phases. The healthy coping intervention protocol was initially designed together with a team of psychologists following the main guidelines and recommendations for psychoeducational interventions for healthy coping in the context of DM. The protocol was refined with the support of 3 experts in the design of behavioral intervention technologies for mental health and well-being, who role-played 3 SPs’ profiles receiving the virtual coaching intervention in a Wizard of Oz setting via WhatsApp. A refined version of the healthy coping protocol was then iteratively tested with a sample of 18 university students (mean age 23.61, SD 1.975 years) in a slightly different Wizard of Oz evaluation setting. Participants provided quantitative and qualitative postintervention feedback by reporting their experiences with the VC. Clustering techniques on the logged interactions and dialogs between the VC and users were collected and analyzed to identify additional refinements for future VC development. Results Both quantitative and qualitative analyses showed that the digital healthy coping intervention was perceived as supportive, motivating, and able to trigger self-reflection on coping strategies. Analyses of the logged dialogs showed that most of the participants accurately played the SPs’ profile assigned, confirming the validity and usefulness of this testing approach in preliminary assessments of behavioral digital interventions and protocols. Conclusions This study outlined an original approach to the early development and iterative testing of digital healthy coping interventions for type 2 DM. Indeed, the intervention was well-accepted and proved its effectiveness in the definition and refinement of the initial protocol and of the user experience with a VC before directly involving real patients in its subsequent use and testing.
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Affiliation(s)
- Giulia Bassi
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy.,Centre Digital Health & Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Ivan Donadello
- KRDB Research Centre, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Silvia Gabrielli
- Centre Digital Health & Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Salcuni
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy
| | - Claudio Giuliano
- Centre Digital Health & Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Forti
- Centre Digital Health & Wellbeing, Fondazione Bruno Kessler, Trento, Italy
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Passardi A, Foca F, Caffo O, Tondini CA, Zambelli A, Vespignani R, Bartolini G, Sullo FG, Andreis D, Dianti M, Eccher C, Piras EM, Forti S. A Remote Monitoring System to Optimize the Home Management of Oral Anticancer Therapies (ONCO-TreC): Prospective Training-Validation Trial. J Med Internet Res 2022; 24:e27349. [PMID: 35080505 PMCID: PMC8829690 DOI: 10.2196/27349] [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: 01/22/2021] [Revised: 06/10/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background A platform designed to support the home management of oral anticancer treatments and provide a secure web-based patient–health care professional communication modality, ONCO-TreC, was tested in 3 cancer centers in Italy. Objective The overall aims of the trial are to customize the platform; assess the system’s ability to facilitate the shared management of oral anticancer therapies by patients and health professionals; and evaluate system usability and acceptability by patients, caregivers, and health care professionals. Methods Patients aged ≥18 years who were candidates for oral anticancer treatment as monotherapy with an Eastern Cooperative Oncology Group performance status score of 0 to 1 and a sufficient level of familiarity with mobile devices were eligible. ONCO-TreC consisted of a mobile app for patients and a web-based dashboard for health care professionals. Adherence to treatment (pill count) and toxicities reported by patients through the app were compared with those reported by physicians in medical records. Usability and acceptability were evaluated using questionnaires. Results A total of 40 patients were enrolled, 38 (95%) of whom were evaluable for adherence to treatment. The ability of the system to measure adherence to treatment was high, with a concordance of 97.3% (95% CI 86.1%-99.9%) between the investigator and system pill count. Only 60% (3/5) of grade 3, 54% (13/24) of grade 2, and 19% (7/36) of grade 1 adverse events reported by physicians in the case report forms were also reported in the app directly by patients. In total, 94% (33/35) of patients had ≥1 app launch each week, and the median number of daily accesses per patient was 2. Approximately 71% (27/38) and 68% (26/38) of patients used the app for messages and vital sign entering, respectively, at least once during the study period. Conclusions ONCO-TreC is an important tool for measuring and monitoring adherence to oral anticancer drugs. System usability and acceptability were very high, whereas its reliability in registering toxicity could be improved. Trial Registration ClinicalTrials.gov NCT02921724; https://www.clinicaltrials.gov/ct2/show/NCT02921724
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Affiliation(s)
- Alessandro Passardi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, Italy
| | - Flavia Foca
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, Italy
| | - Orazio Caffo
- Department of Medical Oncology, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Carlo Alberto Tondini
- Department of Medical Oncology, Azienda Socio-Sanitaria Territoriale "Papa Giovanni XXIII", Bergamo, Italy
| | - Alberto Zambelli
- Department of Medical Oncology, Azienda Socio-Sanitaria Territoriale "Papa Giovanni XXIII", Bergamo, Italy
| | - Roberto Vespignani
- IT Service, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, Italy
| | - Giulia Bartolini
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, Italy
| | - Francesco Giulio Sullo
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, Italy
| | - Daniele Andreis
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, Italy
| | - Marco Dianti
- Center for Information and Communication Technology, eHealth Unit, Fondazione "Bruno Kessler", Trento, Italy
| | - Claudio Eccher
- Center for Information and Communication Technology, eHealth Unit, Fondazione "Bruno Kessler", Trento, Italy
| | - Enrico Maria Piras
- Center for Information and Communication Technology, eHealth Unit, Fondazione "Bruno Kessler", Trento, Italy
| | - Stefano Forti
- Center for Information and Communication Technology, eHealth Unit, Fondazione "Bruno Kessler", Trento, Italy
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9
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Bassi G, Giuliano C, Perinelli A, Forti S, Gabrielli S, Salcuni S. A Virtual Coach (Motibot) for Supporting Healthy Coping Strategies Among Adults With Diabetes: Proof-of-Concept Study. JMIR Hum Factors 2022; 9:e32211. [PMID: 35060918 PMCID: PMC8817220 DOI: 10.2196/32211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/18/2021] [Accepted: 11/07/2021] [Indexed: 01/19/2023] Open
Abstract
Background Motivation is a core component of diabetes self-management because it allows adults with diabetes mellitus (DM) to adhere to clinical recommendations. In this context, virtual coaches (VCs) have assumed a central role in supporting and treating common barriers related to adherence. However, most of them are mainly focused on medical and physical purposes, such as the monitoring of blood glucose levels or following a healthy diet. Objective This proof-of-concept study aims to evaluate the preliminary efficacy of a VC intervention for psychosocial support before and after the intervention and at follow-up. The intent of this VC is to motivate adults with type 1 DM and type 2 DM to adopt and cultivate healthy coping strategies to reduce symptoms of depression, anxiety, perceived stress, and diabetes-related emotional distress, while also improving their well-being. Methods A total of 13 Italian adults with DM (18-51 years) interacted with a VC, called Motibot (motivational bot) using the Telegram messaging app. The interaction covered 12 sessions, each lasting 10 to 20 minutes, during which the user could dialogue with the VC by inputting text or tapping an option on their smartphone screen. Motibot is developed within the transtheoretical model of change to deliver the most appropriate psychoeducational intervention based on the user’s motivation to change. Results Results showed that over the 12 sessions, there were no significant changes before and after the intervention and at follow-up regarding psychosocial factors. However, most users showed a downward trend over the 3 time periods in depression and anxiety symptoms, thereby presenting good psychological well-being and no diabetes-related emotional distress. In addition, users felt motivated, involved, encouraged, emotionally understood, and stimulated by Motibot during the interaction. Indeed, the analyses of semistructured interviews, using a text mining approach, showed that most users reported a perceived reduction in anxiety, depression, and/or stress symptoms. Moreover, users indicated the usefulness of Motibot in supporting and motivating them to find a mindful moment for themselves and to reflect on their own emotions. Conclusions Motibot was well accepted by users, particularly because of the inclusion of mindfulness practices, which motivated them to adopt healthy coping skills. To this extent, Motibot provided psychosocial support for adults with DM, particularly for those with mild and moderate symptoms, whereas those with severe symptoms may benefit more from face-to-face psychotherapy.
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Affiliation(s)
- Giulia Bassi
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy
| | - Claudio Giuliano
- Digital Health Lab, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Alessio Perinelli
- CIMeC, Center for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Stefano Forti
- Digital Health Lab, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Gabrielli
- Digital Health Lab, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Salcuni
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy
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10
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Passardi A, Serra P, Caffo O, Masini C, Brugugnoli E, Vespignani R, Giardino V, Petracci E, Bartolini G, Sullo F, Anesi C, Dianti M, Eccher C, Piras EM, Gios L, Campomori A, Oberosler V, Forti S. Use of the ONCO-TreC electronic diary compared with a standard paper diary to improve adherence to oral cancer therapy in patients with solid and haematological tumours: protocol for a randomised controlled trial. BMJ Open 2022; 12:e055814. [PMID: 35017254 PMCID: PMC8753414 DOI: 10.1136/bmjopen-2021-055814] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION ONCO-TreC platform consists of a mobile application delivered to patients as electronic diary and a web-based dashboard managed by healthcare professionals. We aim to compare the effectiveness of ONCO-TreC electronic diary with a standard paper diary, in improving adherence to oral cancer therapy in patients with solid and haematological tumours. METHODS AND ANALYSIS This is an open label, superiority, randomised controlled trial conducted in two Italian oncology units. Patients will be randomised with a 1:1 ratio to electronic or paper diary. For both groups a counsellor will be responsible for drug and diary delivery. The evaluation period will end after six cycles of therapy. The primary aim is to compare the proportion of non-adherent patients in the two arms. Adherence will be measured through pill count; anyone who takes less than 90% of the total prescribed drug dose will be considered non-adherent. Assuming a percentage of non-adherent patients to oral therapy of 40% in arm B, and a 60% reduction in this percentage in arm A, a sample of 124 patients will provide 80% power to identify an absolute difference greater than 24 percentage points using a bilateral Fisher's exact test with a significance level of 0.05. Considering a dropout rate of 10%, approximately 136 patients will have to be enrolled. The primary analysis will be performed on the intention-to-treat population. Secondary aims are to describe the reasons for non-adherence, the level of satisfaction of patients and healthcare professionals with the paper and electronic diary, and the impact of non-adherence in terms of healthcare costs. ETHICS AND DISSEMINATION Ethical approval was obtained from Romagna Ethics Committee (CEROM), study ID 2108, prot. n. IRST 100.28 of 10/04/2020. Informed consent will be obtained from all study participants. Findings will be disseminated through peer-reviewed journals, conferences and event presentations. PROTOCOL VERSION Version 2, 6 April 2021. TRIAL REGISTRATION NUMBER NCT04826458.
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Affiliation(s)
- Alessandro Passardi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Patrizia Serra
- Unit of Biostatistic and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Orazio Caffo
- Department of Medical Oncology, Provincia autonoma di Trento Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Carla Masini
- Oncology Pharmacy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Erika Brugugnoli
- Oncology Pharmacy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Roberto Vespignani
- IT Service, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Valeria Giardino
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Elisabetta Petracci
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Giulia Bartolini
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Francesco Sullo
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, Meldola, Italy
| | - Cecilia Anesi
- Department of Medical Oncology, Provincia autonoma di Trento Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Marco Dianti
- eHealth Unit, Bruno Kessler Foundation, Trento, Italy
| | | | | | - Lorenzo Gios
- Competence Center for Digital Health, TrentinoSalute 4.0, Trento, Italy
| | - Annalisa Campomori
- Hospital Pharmacy Unit, Presidio Ospedaliero Santa Chiara, Trento, Italy
| | | | - Stefano Forti
- eHealth Unit, Bruno Kessler Foundation, Trento, Italy
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11
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Krause R, Aeschlimann S, Chávez-Cervantes M, Perea-Causin R, Brem S, Malic E, Forti S, Fabbri F, Coletti C, Gierz I. Microscopic Understanding of Ultrafast Charge Transfer in van der Waals Heterostructures. Phys Rev Lett 2021; 127:276401. [PMID: 35061410 DOI: 10.1103/physrevlett.127.276401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/29/2021] [Accepted: 11/12/2021] [Indexed: 06/14/2023]
Abstract
Van der Waals heterostructures show many intriguing phenomena including ultrafast charge separation following strong excitonic absorption in the visible spectral range. However, despite the enormous potential for future applications in the field of optoelectronics, the underlying microscopic mechanism remains controversial. Here we use time- and angle-resolved photoemission spectroscopy combined with microscopic many-particle theory to reveal the relevant microscopic charge transfer channels in epitaxial WS_{2}/graphene heterostructures. We find that the timescale for efficient ultrafast charge separation in the material is determined by direct tunneling at those points in the Brillouin zone where WS_{2} and graphene bands cross, while the lifetime of the charge separated transient state is set by defect-assisted tunneling through localized sulphur vacancies. The subtle interplay of intrinsic and defect-related charge transfer channels revealed in the present work can be exploited for the design of highly efficient light harvesting and detecting devices.
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Affiliation(s)
- R Krause
- University of Regensburg, Institute for Experimental and Applied Physics, 93040 Regensburg, Germany
- Max Planck Institute for the Structure and Dynamics of Matter, Center for Free Electron Laser Science, 22761 Hamburg, Germany
| | - S Aeschlimann
- University of Regensburg, Institute for Experimental and Applied Physics, 93040 Regensburg, Germany
- Max Planck Institute for the Structure and Dynamics of Matter, Center for Free Electron Laser Science, 22761 Hamburg, Germany
| | - M Chávez-Cervantes
- Max Planck Institute for the Structure and Dynamics of Matter, Center for Free Electron Laser Science, 22761 Hamburg, Germany
| | - R Perea-Causin
- Chalmers University of Technology, Department of Physics, 41296 Gothenburg, Sweden
| | - S Brem
- Philipps-Universität Marburg, Department of Physics, 35032 Marburg, Germany
| | - E Malic
- Chalmers University of Technology, Department of Physics, 41296 Gothenburg, Sweden
- Philipps-Universität Marburg, Department of Physics, 35032 Marburg, Germany
| | - S Forti
- Center for Nanotechnology Innovation at NEST, Istituto Italiano di Tecnologia, 56127 Pisa, Italy
| | - F Fabbri
- Center for Nanotechnology Innovation at NEST, Istituto Italiano di Tecnologia, 56127 Pisa, Italy
- NEST, Istituto Nanoscienze, CNR and Scuola Normale Superiore, 56127 Pisa, Italy
- Graphene Labs, Istituto Italiano di Tecnologia, 16163 Genova, Italy
| | - C Coletti
- Center for Nanotechnology Innovation at NEST, Istituto Italiano di Tecnologia, 56127 Pisa, Italy
- Graphene Labs, Istituto Italiano di Tecnologia, 16163 Genova, Italy
| | - I Gierz
- University of Regensburg, Institute for Experimental and Applied Physics, 93040 Regensburg, Germany
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12
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Eder SD, Hellner SK, Forti S, Nordbotten JM, Manson JR, Coletti C, Holst B. Temperature-Dependent Bending Rigidity of AB-Stacked Bilayer Graphene. Phys Rev Lett 2021; 127:266102. [PMID: 35029489 DOI: 10.1103/physrevlett.127.266102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
The change in bending rigidity with temperature κ(T) for 2D materials is highly debated: theoretical works predict both increase and decrease. Here we present measurements of κ(T), for a 2D material: AB-stacked bilayer graphene. We obtain κ(T) from phonon dispersion curves measured with helium atom scattering in the temperature range 320-400 K. We find that the bending rigidity increases with temperature. Assuming a linear dependence over the measured temperature region we obtain κ(T)=[(1.3±0.1)+(0.006±0.001)T/K] eV by fitting the data. We discuss this result in the context of existing predictions and room temperature measurements.
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Affiliation(s)
- S D Eder
- Department of Physics and Technology, University of Bergen, Allégaten 55, 5007 Bergen, Norway
| | - S K Hellner
- Department of Physics and Technology, University of Bergen, Allégaten 55, 5007 Bergen, Norway
| | - S Forti
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - J M Nordbotten
- Department of Mathematics, University of Bergen, Allégaten 41, 5007 Bergen, Norway
| | - J R Manson
- Department of Physics and Astronomy, Clemson University, Clemson, South Carolina 29634, USA
- Donostia International Physics Center (DIPC), Paseo Manuel de Lardizabal, 4, 20018 Donostia-San Sebastián, Spain
| | - C Coletti
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - B Holst
- Department of Physics and Technology, University of Bergen, Allégaten 55, 5007 Bergen, Norway
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13
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Testa S, Mayora-Ibarra O, Piras EM, Balagna O, Micocci S, Zanutto A, Forti S, Conforti D, Nicolini A, Malfatti G, Moz M, Gios L, Benetollo PP, Turra E, Orrasch M, Zambotti F, Del Greco M, Maines M, Filippi L, Ghezzi M, Romanelli F, Racano E, Marin M, Betta M, Bertagnolli E. Implementation of tele visit healthcare services triggered by the COVID-19 emergency: the Trentino Province experience. Z Gesundh Wiss 2021; 30:77-92. [PMID: 34150467 PMCID: PMC8203489 DOI: 10.1007/s10389-021-01609-8] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 05/27/2021] [Indexed: 12/05/2022]
Abstract
Aim In response to the SARS-CoV-2 emergency, the Competence Centre on digital health ‘TrentinoSalute4.0’ has developed TreC_Televisita, a tele visit solution that meets the needs of the Trentino healthcare system and maintains high-quality patient–doctor interactions while respecting social distancing. This paper highlights how ‘TreC_Televisita’ was integrated into the Trentino healthcare system and its potential to become a structural and durable solution for the future local healthcare service provisioning. Subject and methods This paper presents the multifactorial context that TreC_Televisita has faced for its implementation and the strategies adopted for its structural integration into the healthcare system. The analysis focuses on the main issues faced for the integration of the tele visits (e.g. privacy, payments) and how the context of TrentinoSalute4.0 permitted responding quickly to its implementation during the pandemic. It also describes how TreC_Televisita fits into the healthcare continuum from the organisational and technological standpoint, the end-user perspective and the barriers that could hamper the solution scalability. Results TreC_Televisita has demonstrated to be a technological solution that can be contextualised for different clinical domains beyond SARS-CoV-2. Moreover, it has shown its potential to scale up the solution beyond the COVID-19 emergency to the whole healthcare provisioning system in the long term. Conclusion Being a positive experience in the first months of its implementation, the long-term goal is to transform TreC_Televisita into a structural pillar of the Trentino healthcare system, setting the bases for a sustainable, win–win situation for all the stakeholders involved in healthcare service provisioning.
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Affiliation(s)
- Sara Testa
- Fondazione Bruno Kessler, Via Santa Croce 77, 38122 Trento, Italy
| | | | | | - Olivia Balagna
- Provincia Autonoma di Trento, Piazza Dante 15, 38122 Trento, Italy
| | - Stefano Micocci
- Fondazione Bruno Kessler, Via Santa Croce 77, 38122 Trento, Italy
| | - Alberto Zanutto
- Fondazione Bruno Kessler, Via Santa Croce 77, 38122 Trento, Italy
| | - Stefano Forti
- Fondazione Bruno Kessler, Via Santa Croce 77, 38122 Trento, Italy
| | - Diego Conforti
- Provincia Autonoma di Trento, Piazza Dante 15, 38122 Trento, Italy
| | - Andrea Nicolini
- Fondazione Bruno Kessler, Via Santa Croce 77, 38122 Trento, Italy
| | - Giulia Malfatti
- Fondazione Bruno Kessler, Via Santa Croce 77, 38122 Trento, Italy
| | - Monica Moz
- Fondazione Bruno Kessler, Via Santa Croce 77, 38122 Trento, Italy
| | - Lorenzo Gios
- Fondazione Bruno Kessler, Via Santa Croce 77, 38122 Trento, Italy
| | - Pier Paolo Benetollo
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Ettore Turra
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Massimo Orrasch
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Francesca Zambotti
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Maurizio Del Greco
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Massimiliano Maines
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Lorena Filippi
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Monica Ghezzi
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Federica Romanelli
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Elisabetta Racano
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Mauro Marin
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Marta Betta
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
| | - Elisabetta Bertagnolli
- Azienda Provinciale per i Servizi Sanitari, Via Alcide Degasperi 79, 38123 Trento, Italy
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14
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Gios L, Crema Falceri G, Micocci S, Patil L, Testa S, Sforzin S, Turra E, Conforti D, Malfatti G, Moz M, Nicolini A, Guarda P, Bacchiega A, Mion C, Marchesoni M, Maimone R, Molini PB, Zanella A, Osmani V, Mayora-Ibarra O, Forti S. Use of eHealth Platforms and Apps to Support Monitoring and Management of Home-Quarantined Patients With COVID-19 in the Province of Trento, Italy: App Development and Implementation. JMIR Form Res 2021; 5:e25713. [PMID: 33909586 PMCID: PMC8168637 DOI: 10.2196/25713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/22/2020] [Accepted: 04/13/2021] [Indexed: 02/07/2023] Open
Abstract
Background Italy was the first country to largely experience the COVID-19 epidemic among other Western countries during the so-called first wave of the COVID-19 pandemic. Proper management of an increasing number of home-quarantined individuals created a significant challenge for health care authorities and professionals. This was especially true when considering the importance of remote surveillance to detect signs of disease progression and consequently regulate access to hospitals and intensive care units on a priority basis. Objective In this paper, we report on an initiative promoted to cope with the first wave of the COVID-19 epidemic in the Spring/Summer of 2020, in the Autonomous Province of Trento, Italy. A purposefully built app named TreCovid19 was designed to provide dedicated health care staff with a ready-to-use tool for remotely monitoring patients with progressive symptoms of COVID-19, who were home-quarantined during the first wave of the epidemic, and to focus on those patients who, based on their self-reported clinical data, required a quick response from health care professionals. Methods TreCovid19 was rapidly developed to facilitate the monitoring of a selected number of home-quarantined patients with COVID-19 during the very first epidemic wave. The app was built on top of an existing eHealth platform, already in use by the local health authority to provide home care, with the following functionalities: (1) to securely collect and link demographic and clinical information related to the patients and (2) to provide a two-way communication between a multidisciplinary health care team and home-quarantined patients. The system supported patients to self-assess their condition and update the multidisciplinary team on their health status. The system was used between March and June 2020 in the province of Trento. Results A dedicated multidisciplinary group of health care professionals adopted the platform over a period of approximately 3 months (from March-end to June 2020) to monitor a total of 170 patients with confirmed COVID-19 during home quarantine. All patients used the system until the end of the initiative. The TreCovid19 system has provided useful insights of possible viability and impact of a technological–organizational asset to manage a potentially critical workload for the health care staff involved in the periodic monitoring of a relevant number of quarantined patients, notwithstanding its limitations given the rapid implementation of the whole initiative. Conclusions The technological and organizational model adopted in response to the COVID-19 pandemic was developed and finalized in a relatively short period during the initial few weeks of the epidemic. The system successfully supported the health care staff involved in the periodic monitoring of an increasing number of home-quarantined patients and provided valuable data in terms of disease surveillance.
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Affiliation(s)
- Lorenzo Gios
- TrentinoSalute4.0 - Competence Center for Digital Health of the Province of Trento, Trento, Italy
| | | | | | - Luigi Patil
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | | | - Simona Sforzin
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Ettore Turra
- Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | | | - Giulia Malfatti
- TrentinoSalute4.0 - Competence Center for Digital Health of the Province of Trento, Trento, Italy
| | - Monica Moz
- TrentinoSalute4.0 - Competence Center for Digital Health of the Province of Trento, Trento, Italy
| | - Andrea Nicolini
- TrentinoSalute4.0 - Competence Center for Digital Health of the Province of Trento, Trento, Italy
| | - Paolo Guarda
- Facoltà di Giurisprudenza, Università degli Studi di Trento, Trento, Italy
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Gabrielli S, Rizzi S, Bassi G, Carbone S, Maimone R, Marchesoni M, Forti S. Engagement and Effectiveness of a Healthy-Coping Intervention via Chatbot for University Students During the COVID-19 Pandemic: Mixed Methods Proof-of-Concept Study. JMIR Mhealth Uhealth 2021; 9:e27965. [PMID: 33950849 PMCID: PMC8166265 DOI: 10.2196/27965] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/01/2021] [Accepted: 04/20/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND University students are increasingly reporting common mental health problems, such as stress, anxiety, and depression, and they frequently face barriers to seeking psychological support because of stigma, cost, and availability of mental health services. This issue is even more critical in the challenging time of the COVID-19 pandemic. Digital mental health interventions, such as those delivered via chatbots on mobile devices, offer the potential to achieve scalability of healthy-coping interventions by lowering cost and supporting prevention. OBJECTIVE The goal of this study was to conduct a proof-of-concept evaluation measuring the engagement and effectiveness of Atena, a psychoeducational chatbot supporting healthy coping with stress and anxiety, among a population of university students. METHODS In a proof-of-concept study, 71 university students were recruited during the COVID-19 pandemic; 68% (48/71) were female, they were all in their first year of university, and their mean age was 20.6 years (SD 2.4). Enrolled students were asked to use the Atena psychoeducational chatbot for 4 weeks (eight sessions; two per week), which provided healthy-coping strategies based on cognitive behavioral therapy, positive psychology, and mindfulness techniques. The intervention program consisted of conversations combined with audiovisual clips delivered via the Atena chatbot. Participants were asked to complete web-based versions of the 7-item Generalized Anxiety Disorder scale (GAD-7), the 10-item Perceived Stress Scale (PSS-10), and the Five-Facet Mindfulness Questionnaire (FFMQ) at baseline and postintervention to assess effectiveness. They were also asked to complete the User Engagement Scale-Short Form at week 2 to assess engagement with the chatbot and to provide qualitative comments on their overall experience with Atena postintervention. RESULTS Participants engaged with the Atena chatbot an average of 78 (SD 24.8) times over the study period. A total of 61 out of 71 (86%) participants completed the first 2 weeks of the intervention and provided data on engagement (10/71, 14% attrition). A total of 41 participants out of 71 (58%) completed the full intervention and the postintervention questionnaires (30/71, 42% attrition). Results from the completer analysis showed a significant decrease in anxiety symptoms for participants in more extreme GAD-7 score ranges (t39=0.94; P=.009) and a decrease in stress symptoms as measured by the PSS-10 (t39=2.00; P=.05) for all participants postintervention. Participants also improved significantly in the describing and nonjudging facets, based on their FFMQ subscale scores, and asked for some improvements in the user experience with the chatbot. CONCLUSIONS This study shows the benefit of deploying a digital healthy-coping intervention via a chatbot to support university students experiencing higher levels of distress. While findings collected during the COVID-19 pandemic show promise, further research is required to confirm conclusions.
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Affiliation(s)
| | - Silvia Rizzi
- Digital Health Lab, Fondazione Bruno Kessler, Trento, Italy
| | - Giulia Bassi
- Digital Health Lab, Fondazione Bruno Kessler, Trento, Italy
| | - Sara Carbone
- Digital Health Lab, Fondazione Bruno Kessler, Trento, Italy
| | - Rosa Maimone
- Digital Health Lab, Fondazione Bruno Kessler, Trento, Italy
| | | | - Stefano Forti
- Digital Health Lab, Fondazione Bruno Kessler, Trento, Italy
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Bassi G, Gabrielli S, Donisi V, Carbone S, Forti S, Salcuni S. Assessment of Psychological Distress in Adults With Type 2 Diabetes Mellitus Through Technologies: Literature Review. J Med Internet Res 2021; 23:e17740. [PMID: 33410762 PMCID: PMC7819779 DOI: 10.2196/17740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/09/2020] [Revised: 08/05/2020] [Accepted: 11/11/2020] [Indexed: 01/08/2023] Open
Abstract
Background The use of technological devices can support the self-management of individuals with type 2 diabetes mellitus (T2DM), particularly in addressing psychological distress. However, there is poor consistency in the literature regarding the use of psychological instruments for the web-based screening of patients’ psychological distress and subsequent monitoring of their psychological condition during digital interventions. Objective This study aims to review previous literature on the types of psychological instruments delivered in digital interventions for assessing depression, anxiety, and stress in patients with T2DM. Methods The literature review was conducted using the PsycINFO, CINAHL and PubMed databases, in which the following terms were considered: diabetes mellitus, measure, assessment, self-care, self-management, depression, anxiety, stress, technology, eHealth, mobile health, mobile phone, device, and smartphone. Results In most studies, psychological assessments were administered on paper. A few studies deployed self-reporting techniques employing automated telephonic assessment, a call system for screening and monitoring patients’ conditions and preferences, or through telephone interviews via interactive voice response calls, a self-management support program leveraging tailored messages and structured emails. Other studies used simple telephone interviews and included the use of apps for tablets and smartphones to assess the psychological well-being of patients. Finally, some studies deployed mood rating scales delivered through tailored text message–based support systems. Conclusions The deployment of appropriate psychological tools in digital interventions allows researchers and clinicians to make the screening of anxiety, stress, and depression symptoms faster and easier in patients with T2DM. Data from this literature review suggest that mobile health solutions may be preferred tools to use in such digital interventions.
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Affiliation(s)
- Giulia Bassi
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | | | | | | | | | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
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Bédard A, Antó JM, Fonseca JA, Arnavielhe S, Bachert C, Bedbrook A, Bindslev‐Jensen C, Bosnic‐Anticevich S, Cardona V, Cruz AA, Fokkens WJ, Garcia‐Aymerich J, Hellings PW, Ivancevich JC, Klimek L, Kuna P, Kvedariene V, Larenas‐Linnemann D, Melén E, Monti R, Mösges R, Mullol J, Papadopoulos NG, Pham‐Thi N, Samolinski B, Tomazic PV, Toppila‐Salmi S, Ventura MT, Yorgancioglu A, Bousquet J, Pfaar O, Basagaña X, Aberer W, Agache I, Akdis CA, Akdis M, Aliberti MR, Almeida R, Amat F, Angles R, Annesi‐Maesano I, Ansotegui IJ, Anto JM, Arnavielle S, Asayag E, Asarnoj A, Arshad H, Avolio F, Bacci E, Baiardini I, Barbara C, Barbagallo M, Baroni I, Barreto BA, Bateman ED, Bedolla‐Barajas M, Bewick M, Beghé B, Bel EH, Bergmann KC, Bennoor KS, Benson M, Bertorello L, Białoszewski AZ, Bieber T, Bialek S, Bjermer L, Blain H, Blasi F, Blua A, Bochenska Marciniak M, Bogus‐Buczynska I, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briedis V, Brightling CE, Brozek J, Bucca C, Buhl R, Buonaiuto R, Panaitescu C, Burguete Cabañas MT, Burte E, Bush A, Caballero‐Fonseca F, Caillaud D, Caimmi D, Calderon MA, Camargos PAM, Camuzat T, Canfora G, Canonica GW, Carlsen KH, Carreiro‐Martins P, Carriazo AM, Carr W, Cartier C, Casale T, Castellano G, Cecchi L, Cepeda AM, Chavannes NH, Chen Y, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciaravolo MM, Ciceran A, Cingi C, Ciprandi G, Carvalho Coehlo AC, Colas L, Colgan E, Coll J, Conforti D, Constantinidis J, Correia de Sousa J, Cortés‐Grimaldo RM, Corti F, Costa E, Costa‐Dominguez MC, Courbis AL, Cox L, Crescenzo M, Custovic A, Czarlewski W, Dahlen SE, D'Amato G, Dario C, da Silva J, Dauvilliers Y, Darsow U, De Blay F, De Carlo G, Dedeu T, de Fátima Emerson M, De Feo G, De Vries G, De Martino B, Motta Rubini NP, Deleanu D, Denburg JA, Devillier P, Di Capua Ercolano S, Di Carluccio N, Didier A, Dokic D, Dominguez‐Silva MG, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, El‐Gamal Y, Eklund P, Eller E, Emuzyte R, Farrell J, Farsi A, Ferreira de Mello J, Ferrero J, Fink‐Wagner A, Fiocchi A, Fontaine JF, Forti S, Fuentes‐Perez JM, Gálvez‐Romero JL, Gamkrelidze A, García‐Cobas CY, Garcia‐Cruz MH, Gemicioğlu B, Genova S, Christoff G, Gereda JE, Gerth van Wijk R, Gomez RM, Gómez‐Vera J, González Diaz S, Gotua M, Grisle I, Guidacci M, Guldemond NA, Gutter Z, Guzmán MA, Haahtela T, Hajjam J, Hernández L, Hourihane JO, Huerta‐Villalobos YR, Humbert M, Iaccarino G, Illario M, Ispayeva Z, Jares EJ, Jassem E, Johnston SL, Joos G, Jung KS, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu AF, Karjalainen J, Kardas P, Keil T, Keith PK, Khaitov M, Khaltaev N, Kleine‐Tebbe J, Kowalski ML, Kuitunen M, Kull I, Kupczyk M, Krzych‐Fałta E, Lacwik P, Laune D, Lauri D, Lavrut J, Le LTT, Lessa M, Levato G, Li J, Lieberman P, Lipiec A, Lipworth B, Lodrup Carlsen KC, Louis R, Lourenço O, Luna‐Pech JA, Magnan A, Mahboub B, Maier D, Mair A, Majer I, Malva J, Mandajieva E, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maspero JF, Mathieu‐Dupas E, Matta Campos JJ, Matos AL, Maurer M, Mavale‐Manuel S, Mayora O, Meco C, Medina‐Avalos MA, Melo‐Gomes E, Meltzer EO, Menditto E, Mercier J, Miculinic N, Mihaltan F, Milenkovic B, Moda G, Mogica‐Martinez MD, Mohammad Y, Momas I, Montefort S, Mora Bogado D, Morais‐Almeida M, Morato‐Castro FF, Mota‐Pinto A, Moura Santo P, Münter L, Muraro A, Murray R, Naclerio R, Nadif R, Nalin M, Napoli L, Namazova‐Baranova L, Neffen H, Niedeberger V, Nekam K, Neou A, Nieto A, Nogueira‐Silva L, Nogues M, Novellino E, Nyembue TD, O'Hehir RE, Odzhakova C, Ohta K, Okamoto Y, Okubo K, Onorato GL, Ortega Cisneros M, Ouedraogo S, Pali‐Schöll I, Palkonen S, Panzner P, Park HS, Papi A, Passalacqua G, Paulino E, Pawankar R, Pedersen S, Pépin JL, Pereira AM, Persico M, Phillips J, Picard R, Pigearias B, Pin I, Pitsios C, Plavec D, Pohl W, Popov TA, Portejoie F, Potter P, Pozzi AC, Price D, Prokopakis EP, Puy R, Pugin B, Pulido Ross RE, Przemecka M, Rabe KF, Raciborski F, Rajabian‐Soderlund R, Reitsma S, Ribeirinho I, Rimmer J, Rivero‐Yeverino D, Rizzo JA, Rizzo MC, Robalo‐Cordeiro C, Rodenas F, Rodo X, Rodriguez Gonzalez M, Rodriguez‐Mañas L, Rolland C, Rodrigues Valle S, Roman Rodriguez M, Romano A, Rodriguez‐Zagal E, Rolla G, Roller‐Wirnsberger RE, Romano M, Rosado‐Pinto J, Rosario N, Rottem M, Ryan D, Sagara H, Salimäki J, Sanchez‐Borges M, Sastre‐Dominguez J, Scadding GK, Schunemann HJ, Scichilone N, Schmid‐Grendelmeier P, Sarquis Serpa F, Shamai S, Sheikh A, Sierra M, Simons FER, Siroux V, Sisul JC, Skrindo I, Solé D, Somekh D, Sondermann M, Sooronbaev T, Sova M, Sorensen M, Sorlini M, Spranger O, Stellato C, Stelmach R, Stukas R, Sunyer J, Strozek J, Szylling A, Tebyriçá JN, Thibaudon M, To T, Todo‐Bom A, Trama U, Triggiani M, Suppli Ulrik C, Urrutia‐Pereira M, Valenta R, Valero A, Valiulis A, Valovirta E, van Eerd M, van Ganse E, van Hage M, Vandenplas O, Vezzani G, Vasankari T, Vatrella A, Verissimo MT, Viart F, Viegi G, Vicheva D, Vontetsianos T, Wagenmann M, Walker S, Wallace D, Wang DY, Waserman S, Werfel T, Westman M, Wickman M, Williams DM, Williams S, Wilson N, Wright J, Wroczynski P, Yakovliev P, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zhang L, Zhong N, Zernotti ME, Zhanat I, Zidarn M, Zuberbier T, Zubrinich C, Zurkuhlen A. Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App. Allergy 2020; 75:1672-1688. [PMID: 31995656 DOI: 10.1111/all.14204] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 09/12/2019] [Revised: 11/23/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. METHODS All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. RESULTS A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. CONCLUSIONS VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
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Fornasini S, Dianti M, Bacchiega A, Forti S, Conforti D. Using Geocaching to Promote Active Aging: Qualitative Study. J Med Internet Res 2020; 22:e15339. [PMID: 32525486 PMCID: PMC7317631 DOI: 10.2196/15339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 01/30/2020] [Accepted: 02/22/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Over the past few years, the development of technologies supporting active aging has been increasing. Among the activities that promote physical exercise by using technologies is geocaching-a treasure hunt of sorts in which participants use a receiver GPS to hide or find real or virtual objects. Although this activity is particularly suited to the promotion of healthy lifestyles in older people, geocaching remains to be unexplored in this area. OBJECTIVE This study aimed to investigate the effectiveness of activities combining geocaching and self-tracking technologies to promote active aging, evaluate the usability of technologies, and explore the ways in which technologies have been integrated in the organizational context under examination to determine the user experience of participants. METHODS A group of individuals aged 65 years and older (N=14) attending a senior center managed by a social cooperative was involved in the study. Some of them created the geocaching contents, and others, split into 2 teams, participated in the game. Each participant was given a pedometer bracelet and the geocaching app. The steps taken by individual participants along with the number of caches found by each group translated into team scores. RESULTS The main results of the study were as follows: (1) activities in favor of active aging that involve the use of new technologies can foster the participation of elderly people; in particular, adding gamification to self-tracking can be a valid strategy to promote physical exercise among the elderly; (2) for this to happen, involvement of older people firsthand is crucial, and there must be a focus on their active involvement and empowerment in every phase of the project; and (3) the mediation of conflicts and competition that arise from the gamification could only take place because of the strong support of the organization in the form of social workers. CONCLUSIONS The results show that promoting active aging through technologies requires more effort than simply using these tools; it requires a wider process that involves an articulated organizational network with heterogeneous actors, technologies, and relations.
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Affiliation(s)
- Silvia Fornasini
- Fondazione Bruno Kessler, Trento, Italy
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
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Eccher C, Gios L, Zanutto A, Bizzarri G, Conforti D, Forti S. TreC platform. An integrated and evolving care model for patients' empowerment and data repository. J Biomed Inform 2020; 102:103359. [PMID: 31917253 DOI: 10.1016/j.jbi.2019.103359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 11/13/2018] [Revised: 11/12/2019] [Accepted: 12/15/2019] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Health care has been deeply revolutionized by the new wave of information and communication technology (ICT) development, particularly related to the electronic/personal health record (PHR). The present paper describes the original design and implementation approach followed in the Trentino Province (Italy) to promote an Integrated Care Model for patients' empowerment and data repository, by means of an evolving Personal Health Record - PHR platform, named TreC (Trentino Citizens Clinical Record). MATERIALS AND METHODS The TreC Platform is conceived as a communication hub among different stakeholders. The core assumption of the TreC platform strategy is to consider the citizen/patient as main manager and owner of both his/her own health and his/her contacts with the health care systems. RESULTS Over the years, the TreC platform has represented the core pillar in the digitalization process promoted at Province level. This has been strategically embedded in the multi-faceted e-government strategy endorsed by the Province of Trento. So far (October 2018), more than 89,000 citizens within the Province of Trento are using TreC platform as a way to communicate with the health care system and access their own personal health records. CONCLUSIONS The experience gained through the TreC platform implementation and its results are promising, supporting the idea that a PHR platform can represent a key driving factor in improving health care quality and efficiency, both from a patient and a health care staff perspective.
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Affiliation(s)
- Claudio Eccher
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy.
| | - Lorenzo Gios
- TrentinoSalute 4.0, Competence Center for Digital Health, Trento, Italy
| | - Alberto Zanutto
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy
| | | | | | - Stefano Forti
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy
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Rossi A, Spirito D, Bianco F, Forti S, Fabbri F, Büch H, Tredicucci A, Krahne R, Coletti C. Patterned tungsten disulfide/graphene heterostructures for efficient multifunctional optoelectronic devices. Nanoscale 2018; 10:4332-4338. [PMID: 29443347 DOI: 10.1039/c7nr08703a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
One of the major issues in graphene-based optoelectronics is to scale-up high-performing devices. In this work, we report an original approach for the fabrication of efficient optoelectronic devices from scalable tungsten disulfide (WS2)/graphene heterostructures. Our approach allows for the patterned growth of WS2 on graphene and facilitates the realization of ohmic contacts. Photodetectors fabricated with WS2 on epitaxial graphene on silicon carbide (SiC) present, when illuminated with red light, a maximum responsivity R ∼220 A W-1, a detectivity D* ∼2.0 × 109 Jones and a -3 dB bandwidth of 250 Hz. The retrieved detectivity is 3 orders of magnitude higher than that obtained with graphene-only devices at the same wavelength. For shorter illumination wavelengths we observe a persistent photocurrent with a nearly complete charge retention, which originates from deep trap levels in the SiC substrate. This work ultimately demonstrates that WS2/graphene optoelectronic devices with promising performances can be obtained in a scalable manner. Furthermore, by combining wavelength-selective memory, enhanced responsivity and fast detection, this system is of interest for the implementation of 2d-based data storage devices.
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Affiliation(s)
- A Rossi
- Center for Nanotechnology Innovation @NEST, Istituto Italiano di Tecnologia, Piazza S. Silvestro 12, 56127 Pisa, Italy. and NEST, Istituto Nanoscienze - CNR and Scuola Normale Superiore, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - D Spirito
- Nanochemistry Department, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
| | - F Bianco
- NEST, Istituto Nanoscienze - CNR and Scuola Normale Superiore, Piazza San Silvestro 12, 56127 Pisa, Italy
| | - S Forti
- Center for Nanotechnology Innovation @NEST, Istituto Italiano di Tecnologia, Piazza S. Silvestro 12, 56127 Pisa, Italy.
| | - F Fabbri
- Center for Nanotechnology Innovation @NEST, Istituto Italiano di Tecnologia, Piazza S. Silvestro 12, 56127 Pisa, Italy.
| | - H Büch
- Center for Nanotechnology Innovation @NEST, Istituto Italiano di Tecnologia, Piazza S. Silvestro 12, 56127 Pisa, Italy.
| | - A Tredicucci
- NEST, Istituto Nanoscienze - CNR and Scuola Normale Superiore, Piazza San Silvestro 12, 56127 Pisa, Italy and Dipartimento di Fisica "E. Fermi", Università di Pisa, L.go Pontecorvo 3, 56127 Pisa, Italy
| | - R Krahne
- Nanochemistry Department, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy and Graphene Labs, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
| | - C Coletti
- Center for Nanotechnology Innovation @NEST, Istituto Italiano di Tecnologia, Piazza S. Silvestro 12, 56127 Pisa, Italy. and Graphene Labs, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
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Bousquet J, Agache I, Aliberti MR, Angles R, Annesi-Maesano I, Anto JM, Arnavielhe S, Asayag E, Bacci E, Bedbrook A, Bachert C, Baroni I, Barreto BA, Bedolla-Barajas M, Bergmann KC, Bertorello L, Bewick M, Bieber T, Birov S, Bindslev-Jensen C, Blua A, Bochenska Marciniak M, Bogus-Buczynska I, Bosnic-Anticevich S, Bosse I, Bourret R, Bucca C, Buonaiuto R, Burguete Cabanas MT, Caillaud D, Caimmi DP, Caiazza D, Camargos P, Canfora G, Cardona V, Carriazo AM, Cartier C, Castellano G, Chavannes NH, Cecci L, Ciaravolo MM, Cingi C, Ciceran A, Colas L, Colgan E, Coll J, Conforti D, Correia de Sousa J, Cortés-Grimaldo RM, Corti F, Costa E, Courbis AL, Cousein E, Cruz AA, Custovic A, Cvetkovski B, Dario C, da Silva J, Dauvilliers Y, De Blay F, Dedeu T, De Feo G, De Martino B, Demoly P, De Vries G, Di Capua Ercolano S, Di Carluccio N, Doulapsi M, Dray G, Dubakiene R, Eller E, Emuzyte R, Espinoza-Contreras JG, Estrada-Cardona A, Farrell J, Farsi A, Ferrero J, Fokkens WJ, Fonseca J, Fontaine JF, Forti S, Gálvez-Romero JL, García-Cobas CI, Garcia Cruz MH, Gemicioğlu B, Gerth van Wijk R, Guidacci M, Gómez-Vera J, Guldemond NA, Gutter Z, Haahtela T, Hajjam J, Hellings PW, Hernández-Velázquez L, Illario M, Ivancevich JC, Jares E, Joos G, Just J, Kalayci O, Kalyoncu AF, Karjalainen J, Keil T, Khaltaev N, Klimek L, Kritikos V, Kull I, Kuna P, Kvedariene V, Kolek V, Krzych-Fałta E, Kupczyk M, Lacwik P, La Grutta S, Larenas-Linnemann D, Laune D, Lauri D, Lavrut J, Lessa M, Levato G, Lewis L, Lieten I, Lipiec A, Louis R, Luna-Pech JA, Magnan A, Malva J, Maspero JF, Matta-Campos JJ, Mayora O, Medina-Ávalos MA, Melén E, Menditto E, Millot-Keurinck J, Moda G, Morais-Almeida M, Mösges R, Mota-Pinto A, Mullol J, Muraro A, Murray R, Noguès M, Nalin M, Napoli L, Neffen H, O'Hehir RE, Onorato GL, Palkonen S, Papadopoulos NG, Passalacqua G, Pépin JL, Pereira AM, Persico M, Pfaar O, Pozzi AC, Prokopakis E, Pugin B, Raciborski F, Rimmer J, Rizzo JA, Robalo-Cordeiro C, Rodríguez-González M, Rolla G, Roller-Wirnsberger RE, Romano A, Romano M, Romano MR, Salimäki J, Samolinski B, Serpa FS, Shamai S, Sierra M, Sova M, Sorlini M, Stellato C, Stelmach R, Strandberg T, Stroetmann V, Stukas R, Szylling A, Tan R, Tibaldi V, Todo-Bom A, Toppila-Salmi S, Tomazic P, Trama U, Triggiani M, Valero A, Valovirta E, Valiulis A, van Eerd M, Vasankari T, Vatrella A, Ventura MT, Verissimo MT, Viart F, Williams S, Wagenmann M, Wanscher C, Westman M, Wickman M, Young I, Yorgancioglu A, Zernotti E, Zuberbier T, Zurkuhlen A, De Oliviera B, Senn A. Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA-ARIA) - EIP on AHA Twinning Reference Site (GARD research demonstration project). Allergy 2017; 73:77-92. [PMID: 28600902 DOI: 10.1111/all.13218] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2017] [Indexed: 01/10/2023]
Abstract
The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults.
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Affiliation(s)
- J Bousquet
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,VIMA, INSERM U 1168, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.,Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | | | - R Angles
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - I Annesi-Maesano
- EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris VI, Paris, France
| | - J M Anto
- ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - E Asayag
- Argentine Society of Allergy and Immunopathology, Buenos Aires, Argentina
| | - E Bacci
- Regione Liguria, Genoa, Italy
| | - A Bedbrook
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | | | - M Bedolla-Barajas
- Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalarara, Mexico
| | - K C Bergmann
- Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | | | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University, Bonn, Germany
| | - S Birov
- Empirica Communication and Technology Research, Bonn, Germany
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - A Blua
- Argentine Association of Respiratory Medicine, Buenos Aires, Argentina
| | - M Bochenska Marciniak
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - I Bogus-Buczynska
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - S Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - I Bosse
- Allergist, La Rochelle, France
| | - R Bourret
- Centre Hospitalier Valenciennes, Valenciennes, France
| | - C Bucca
- Chief of the University Pneumology Unit- AOU Molinette, Hospital City of Health and Science of Torino, Torino, Italy
| | - R Buonaiuto
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | | | - D Caillaud
- Service de pneumologie, CHU et université d'Auvergne, Clermont-Ferrand, France
| | - D P Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - D Caiazza
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | - P Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G Canfora
- Mayor of Sarno and President of Salerno Province, Anesthesiology Service, Sarno "Martiri del Villa Malta" Hospital, Sarno, Italy
| | - V Cardona
- S. Allergologia, S. Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
| | - A M Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - C Cartier
- ASA - Advanced Solutions Accelerator, Clapiers, France
| | | | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - L Cecci
- S.O.S Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | | | - C Cingi
- ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - A Ciceran
- Argentine Federation of Otorhinolaryngology Societies, Buenos Aires, Argentina
| | - L Colas
- Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l'institut du thorax, University of Nantes, Nantes, France
| | - E Colgan
- Department of Health, Social Services and Public Safety, Belfast, UK
| | - J Coll
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - D Conforti
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | - J Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | | | - F Corti
- FIMMG (Federazione Italiana Medici di Medicina Generale), Milan, Italy
| | - E Costa
- UCIBIO, REQYULTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), Porto, Portugal
| | | | - E Cousein
- Vice Président de la CME - Centre Hospitalier, Valenciennes, France
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brazil.,GARD/WHO Executive Committee and Federal University of Bahia, Bahia, Brazil
| | - A Custovic
- Department of Pediatric, Imperial College London, London, UK
| | - B Cvetkovski
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - C Dario
- Azienda Provinciale per i Servizi Sanitari di Trento (APSS-Trento), Trento, Italy
| | - J da Silva
- Allergy Service, University Hospital of Federal University of Santa Catarina (HU-UFSC), Florianópolis, Brazil
| | - Y Dauvilliers
- Sleep Unit, Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Inserm U1061, Montpellier, France
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - T Dedeu
- AQuAS, Barcelona, Spain & EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - G De Feo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | | | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - G De Vries
- Peercode DV, Gerdermalsen, The Netherlands
| | | | - N Di Carluccio
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | - M Doulapsi
- Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - E Eller
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | | | - J Farrell
- Department of Health, Social Services and Public Safety, Belfast, UK
| | - A Farsi
- S.O.S Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - J Ferrero
- Andalusian Agency for Healthcare Quality, Seville, Spain
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - J Fonseca
- Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal
| | | | - S Forti
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | | | | | - M H Garcia Cruz
- Allergy Clinic, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - B Gemicioğlu
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - R Gerth van Wijk
- Department of Internal Medicine, Section of Allergology, Erasmus MC, Rotterdam, The Netherlands
| | - M Guidacci
- Member of the Brazilian Society of Pediatrics and Society of Immunization, Representative of GINA (Global Initiative Against Asthma), Brasilia, Brazil
| | - J Gómez-Vera
- Allergy Clinic, Hospital Regional del ISSSTE 'Lic. López Mateos', Mexico City, Mexico
| | - N A Guldemond
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
| | - Z Gutter
- University Hospital Olomouc - National eHealth Centre, Olomouk, Czech Republic
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - J Hajjam
- Centich: centre d'expertise national des technologies de l'information et de la communication pour l'autonomie, Gérontopôle autonomie longévité des Pays de la Loire, Conseil régional des Pays de la Loire, Centre d'expertise Partenariat Européen d'Innovation pour un vieillissement actif et en bonne santé, Nantes, France
| | - P W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | | | - M Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - E Jares
- Libra Foundation, Buenos Aires, Argentina
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (APHP, Paris), Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - A F Kalyoncu
- Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - J Karjalainen
- Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, and Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | | | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - V Kritikos
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - I Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital, Olomouc, Czech Republic
| | - E Krzych-Fałta
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - M Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - P Lacwik
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - S La Grutta
- Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, México City, Mexico
| | | | - D Lauri
- Presidente CMMC, Milano, Italy
| | - J Lavrut
- Head of the Allergy Department of Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
| | - M Lessa
- Faculdade de Medicina da Universidade Federal da Bahia, Salvador de Bahia, Brazil
| | | | - L Lewis
- Promotor B3 Action GRoup EIP on AHA and Senior Fellow, International Foundation for Integreted Care, Aberystwyth, UK
| | - I Lieten
- Tech Life Valley, Diepenbeek, Belgium
| | - A Lipiec
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | | | - A Magnan
- Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l'institut du thorax, University of Nantes, Nantes, France
| | - J Malva
- Faculty of Medicine, Institute of Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal.,Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - J F Maspero
- Argentine Association of Allergy and Clinical Immunology, Buenos Aires, Argentina
| | | | - O Mayora
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | | | - E Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Menditto
- CIRFF, Federico II University, Naples, Italy
| | - J Millot-Keurinck
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - G Moda
- Regione Piemonte, Torino, Italy
| | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - A Mota-Pinto
- Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.,Laboratory of General Pathology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J Mullol
- Clinical & Experimental Respiratory Immunoallergy, ENT Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - A Muraro
- Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | - R Murray
- MedScript Ltd, Dundalk, Co. Louth, Ireland
| | - M Noguès
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | | | - L Napoli
- Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - H Neffen
- Head of Respiratory Medicine, Alassia Children's Hospital, Center for Allergy and Immunology, Santa Fe, Argentina
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - G L Onorato
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - N G Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino Hospital-IST-University of Genoa, Genoa, Italy
| | - J L Pépin
- Department of Pneumology, CHU Grenoble, Grenoble, France
| | - A M Pereira
- Allergy Unit, CUF-Porto Hospital and Institute, Center for Research in Health Technologies and Information Systems, CINTESIS, Universidade do Porto, Porto, Portugal
| | - M Persico
- Sociologist, Municipality, Sorrento, Italy
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Center for Rhinology and Allergology, Wiesbaden, Germany
| | - A C Pozzi
- Vice-Presidente of IML, Milano, Italy
| | - E Prokopakis
- Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - B Pugin
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - J Rimmer
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | | | - C Robalo-Cordeiro
- Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal
| | | | - G Rolla
- Regione Piemonte, Torino, Italy
| | | | - A Romano
- Allergy Unit, Presidio Columbus, Rome, Catholic University of Sacred Heart, Rome, Italy.,IRCCS Oasi Maria S.S., Troina, Italy
| | | | | | - J Salimäki
- Association of Finnish Pharmacists, Helsinki, Finland
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | | | - S Shamai
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - M Sierra
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - M Sova
- Departement of Internal Medicine, University Hospital, Olomouc, Czech Republic
| | - M Sorlini
- IML (Lombardy Medical Initiative), Bergamo, Italy
| | - C Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - T Strandberg
- Center for Life Course Health Research, Helsinki University Hospital, Helsinki University, University of Oulu, Oulu, Finland
| | - V Stroetmann
- Empirica Communication and Technology Research, Bonn, Germany
| | - R Stukas
- Public Health Institute of Vilnius University, Vilnius, Lithuania
| | - A Szylling
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - R Tan
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | | | - A Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - P Tomazic
- Department of ENT, Medical University of Graz, Graz, Austria
| | - U Trama
- Division on Pharmacy and Devices Policy, Campania Region, Naples, Italy
| | - M Triggiani
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - A Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland.,Allergy Clinic, Terveystalo, Turku, Finland
| | - A Valiulis
- Vilnius University Clinic of Children's Diseases and Public Health Institute, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - M van Eerd
- Peercode DV, Gerdermalsen, The Netherlands
| | - T Vasankari
- FILHA, Finnish Lung Association, Helsinki, Finland
| | - A Vatrella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - M T Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - M T Verissimo
- Faculty of Medicine, Institute of Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal.,Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - F Viart
- ASA - Advanced Solutions Accelerator, Clapiers, France
| | - S Williams
- International Primary Care Respiratory Group IPCRG, Aberdeen, UK
| | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - C Wanscher
- EIP on AHA Coordinator, Region of Southern Denmark, Odense, Denmark
| | - M Westman
- Department of Medicine Solna, Immunology and Allergy Unit, Karolinska Institutet and Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - M Wickman
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Young
- Queen's University, Belfast, UK
| | - A Yorgancioglu
- Celal Bayar University Department of Pulmonology, GARD Executive Committee, Manisa, Turkey
| | - E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - T Zuberbier
- Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | - A Zurkuhlen
- Gesundheitsregion KölnBonn - HRCB Projekt GmbH, Kohln, Germany
| | | | - A Senn
- EC-CNECT-H2, European Commission, Brussels, Belgium
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Passardi A, Rizzo M, Maines F, Tondini C, Zambelli A, Vespignani R, Andreis D, Massa I, Dianti M, Forti S, Piras EM, Eccher C. Optimisation and validation of a remote monitoring system (Onco-TreC) for home-based management of oral anticancer therapies: an Italian multicentre feasibility study. BMJ Open 2017; 7:e014617. [PMID: 28554917 PMCID: PMC5729988 DOI: 10.1136/bmjopen-2016-014617] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Despite the growing number of oral agents available for cancer treatment, their efficacy may be reduced due to the lack of adherence, inappropriate adverse event self-management and arbitrary dose adjustment. The management of anticancer therapies could exponentially benefit from the introduction of mobile health technologies in a highly integrated electronic oncology system. METHODS AND ANALYSIS We plan to customise and fine-tune an existing monitoring TreC platform used in different chronic diseases in the oncology setting. This project follows a multistep approach with two major purposes: 1. participatory design techniques driven by Health Literacy and Patient Reported Outcomes principles in order to adapt the system to the oncology setting involving patients and healthcare providers; 2. a prospective training-validation, interventional, non-pharmacological, multicentre study on a series of consecutive patients with cancer (20 and 60 patients in the training and validation steps, respectively) in order to assess system capability, usability and acceptability. The novel Onco-TreC 2.0 is expected to contribute to improving the adherence and safety of cancer care, promoting patient empowerment and patient-doctor communication. ETHICS AND DISSEMINATION Ethical approval was obtained from the Independent Ethics Committees of the participating institutions (CEIIAV protocol Number 2549/2015; reference Number 1315-PU). Informed consent will be obtained from all study participants. Findings will be disseminated through peer-reviewed journals, conferences and event presentations. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT02921724); (Pre-results). Other study ID Number: IRST100.18.
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Affiliation(s)
- Alessandro Passardi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Mimma Rizzo
- Department of Medical Oncology, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Francesca Maines
- Department of Medical Oncology, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Carlo Tondini
- Department of Medical Oncology, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Alberto Zambelli
- Department of Medical Oncology, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Roberto Vespignani
- IT Service, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Daniele Andreis
- Biostatistics and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Ilaria Massa
- Biostatistics and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Marco Dianti
- Center for Information and Communication Technology, eHealth Unit, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Forti
- Center for Information and Communication Technology, eHealth Unit, Fondazione Bruno Kessler, Trento, Italy
| | - Enrico Maria Piras
- Center for Information and Communication Technology, eHealth Unit, Fondazione Bruno Kessler, Trento, Italy
| | - Claudio Eccher
- Center for Information and Communication Technology, eHealth Unit, Fondazione Bruno Kessler, Trento, Italy
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Gabrielli S, Dianti M, Maimone R, Betta M, Filippi L, Ghezzi M, Forti S. Design of a Mobile App for Nutrition Education (TreC-LifeStyle) and Formative Evaluation With Families of Overweight Children. JMIR Mhealth Uhealth 2017; 5:e48. [PMID: 28408361 PMCID: PMC5408135 DOI: 10.2196/mhealth.7080] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/21/2017] [Accepted: 03/14/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Nutrition and diet apps represent today a popular area of mobile health (mHealth), offering the possibility of delivering behavior change (BC) interventions for healthy eating and weight management in a scalable and cost-effective way. However, if commercial apps for pediatric weight management fail to retain users because of a lack of theoretical background and evidence-based content, mHealth apps that are more evidence-based are found less engaging and popular among consumers. Approaching the apps development process from a multidisciplinary and user-centered design (UCD) perspective is likely to help overcome these limitations, raising the chances for an easier adoption and integration of nutrition education apps within primary care interventions. OBJECTIVE The aim of this study was to describe the design and development of the TreC-LifeStyle nutrition education app and the results of a formative evaluation with families. METHODS The design of the nutrition education intervention was based on a multidisciplinary UCD approach, involving a team of BC experts, working with 2 nutritionists and 3 pediatricians from a primary care center. The app content was derived from evidence-based knowledge founded on the Food Pyramid and Mediterranean Diet guidelines used by pediatricians in primary care. A formative evaluation of the TreC-LifeStyle app involved 6 families of overweight children (aged 7-12 years) self-reporting daily food intake of children for 6 weeks and providing feedback on the user experience with the mHealth intervention. Analysis of the app's usage patterns during the intervention and of participants' feedback informed the refinement of the app design and a tuning of the nutrition education strategies to improve user engagement and compliance with the intervention. RESULTS Design sessions with the contribution of pediatricians and nutritionists helped define the nutrition education app and intervention, providing an effective human and virtual coaching approach to raise parents' awareness about children's eating behavior and lifestyle. The 6 families participating in the pilot study found the app usable and showed high compliance with the intervention over the 6 weeks, but analysis of their interaction and feedback showed the need for improving some of the app features related to the BC techniques "monitoring of the behavior" and "information provision." CONCLUSIONS The UCD and formative evaluation of TreC-LifeStyle show that nutrition education apps are feasible and acceptable solutions to support health promotion interventions in primary care.
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Affiliation(s)
- Silvia Gabrielli
- Fondazione Bruno Kessler, High Impact Initiative on Health & Wellbeing, Trento, Italy
| | - Marco Dianti
- Fondazione Bruno Kessler, High Impact Initiative on Health & Wellbeing, Trento, Italy
| | - Rosa Maimone
- Fondazione Bruno Kessler, High Impact Initiative on Health & Wellbeing, Trento, Italy
| | | | | | | | - Stefano Forti
- Fondazione Bruno Kessler, High Impact Initiative on Health & Wellbeing, Trento, Italy
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Galligioni E, Piras EM, Galvagni M, Eccher C, Caramatti S, Zanolli D, Santi J, Berloffa F, Dianti M, Maines F, Sannicolò M, Sandri M, Bragantini L, Ferro A, Forti S. Integrating mHealth in Oncology: Experience in the Province of Trento. J Med Internet Res 2015; 17:e114. [PMID: 25972226 PMCID: PMC4468599 DOI: 10.2196/jmir.3743] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/23/2014] [Accepted: 02/16/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The potential benefits of the introduction of electronic and mobile health (mHealth) information technologies, to support the safe delivery of intravenous chemotherapy or oral anticancer therapies, could be exponential in the context of a highly integrated computerized system. OBJECTIVE Here we describe a safe therapy mobile (STM) system for the safe delivery of intravenous chemotherapy, and a home monitoring system for monitoring and managing toxicity and improving adherence in patients receiving oral anticancer therapies at home. METHODS The STM system is fully integrated with the electronic oncological patient record. After the prescription of chemotherapy, specific barcodes are automatically associated with the patient and each drug, and a bedside barcode reader checks the patient, nurse, infusion bag, and drug sequence in order to trace the entire administration process, which is then entered in the patient's record. The usability and acceptability of the system was investigated by means of a modified questionnaire administered to nurses. The home monitoring system consists of a mobile phone or tablet diary app, which allows patients to record their state of health, the medications taken, their side effects, and a Web dashboard that allows health professionals to check the patient data and monitor toxicity and treatment adherence. A built-in rule-based alarm module notifies health care professionals of critical conditions. Initially developed for chronic patients, the system has been subsequently customized in order to monitor home treatments with capecitabine or sunitinib in cancer patients (Onco-TreC). RESULTS The STM system never failed to match the patient/nurse/drug sequence association correctly, and proved to be accurate and reliable in tracing and recording the entire administration process. The questionnaires revealed that the users were generally satisfied and had a positive perception of the system's usefulness and ease of use, and the quality of their working lives. The pilot studies with the home monitoring system with 43 chronic patients have shown that the approach is reliable and useful for clinicians and patients, but it is also necessary to pay attention to the expectations that mHealth solutions may raise in users. The Onco-TreC version has been successfully laboratory tested, and is now ready for validation. CONCLUSIONS The STM and Onco-TreC systems are fully integrated with our complex and composite information system, which guarantees privacy, security, interoperability, and real-time communications between patients and health professionals. They need to be validated in order to confirm their positive contribution to the safer administration of anticancer drugs.
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Affiliation(s)
- Enzo Galligioni
- Medical Oncology Department, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.
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Baldini M, Ulivieri FM, Forti S, Serafino S, Seghezzi S, Marcon A, Giarda F, Messina C, Cassinerio E, Aubry-Rozier B, Hans D, Cappellini MD. Spine bone texture assessed by trabecular bone score (TBS) to evaluate bone health in thalassemia major. Calcif Tissue Int 2014; 95:540-6. [PMID: 25348077 DOI: 10.1007/s00223-014-9919-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 10/10/2014] [Indexed: 02/03/2023]
Abstract
Due to the increasing survival of thalassemic patients, osteopathy is a mounting clinical problem. Low bone mass alone cannot account for the high fracture risk described; impaired bone quality has been speculated but so far it cannot be demonstrated noninvasively. We studied bone quality in thalassemia major using trabecular bone score (TBS), a novel texture measurement extracted from spine dual-energy X-ray absorptiometry (DXA), proposed in postmenopausal and secondary osteoporosis as an indirect index of microarchitecture. TBS was evaluated in 124 adult thalassemics (age range 19-56 years), followed-up with optimal transfusional and therapeutical regimens, and in 65 non-thalassemic patients (22-52 years) undergoing DXA for different bone diseases. TBS was lower in thalassemic patients (1.04 ± 0.12 [range 0.80-1.30]) versus controls (1.34 ± 0.11 [1.06-1.52]) (p < 0.001), and correlated with BMD. TBS and BMD values correlated with age, indicating that thalassemia negatively affects both bone quality and quantity, especially as the patient gets older. TBS was 1.02 ± 0.11 [0.80-1.28] in the osteoporotic thalassemic patients, 1.08 ± 0.12 [0.82-1.30] in the osteopenic ones and 1.15 ± 0.10 [0.96-1.26] in those with normal BMD. No gender differences were found (males: 1.02 ± 0.13 [0.80-1.30], females 1.05 ± 0.11 [0.80-1.30]), nor between patients with and without endocrine-metabolic disorders affecting bone metabolism. Our findings from a large population with thalassemia major show that TBS is a valuable tool to assess noninvasively bone quality, and it may be related to fragility fracture risk in thalassemic osteopathy.
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Affiliation(s)
- M Baldini
- Rare Diseases Center, Department of Medicine and Medical Specialities, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,
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De Giuseppe R, Forti S, de Liso F, De Vita C, Novembrino C, Maiavacca R, Venturelli G, Bamonti F, Cortelezzi A. PP285-MON: Evaluation of Bone Mineral Density in Down Syndrome Population. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Eccher C, Botteri M, Ortolani D, Forti S, Piras EM. A mobile logbook to diagnose masked hypertension: a pilot application. Stud Health Technol Inform 2014; 205:363-367. [PMID: 25160207] [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: 06/03/2023]
Abstract
In the last years, there has been a growing interest in health mobile applications. Great benefits could be gained by seemingly "simple" solutions if these were designed to build a bridge between doctors and patients. In this paper, we describe a mobile health solution for patients allowing them to measure and record accurately their blood pressure at home, helping doctors to diagnose hypertension. An accurate measurement of the blood pressure, in fact, is a prerequisite for appropriate management of hypertension, a condition causing many serious diseases. The peculiarity of the hypertension kit is that the system requires interaction between the patients and their general practitioner. Finally, we present a pilot study carried out to evaluate the acceptability of the technologies, the compliance of patient to the self-monitoring procedure and the perceived benefits and disadvantages of both doctor and patients in using this kit.
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Affiliation(s)
| | - Maria Botteri
- Scuola di Formazione Specifica in Medicina Generale, Trento, Italy
| | - Daniele Ortolani
- Scuola di Formazione Specifica in Medicina Generale, Trento, Italy
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Eelbo T, Waśniowska M, Thakur P, Gyamfi M, Sachs B, Wehling TO, Forti S, Starke U, Tieg C, Lichtenstein AI, Wiesendanger R. Adatoms and clusters of 3d transition metals on graphene: electronic and magnetic configurations. Phys Rev Lett 2013; 110:136804. [PMID: 23581356 DOI: 10.1103/physrevlett.110.136804] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Indexed: 06/02/2023]
Abstract
We investigate the electronic and magnetic properties of single Fe, Co, and Ni atoms and clusters on monolayer graphene (MLG) on SiC(0001) by means of scanning tunneling microscopy (STM), x-ray absorption spectroscopy, x-ray magnetic circular dichroism (XMCD), and ab initio calculations. STM reveals different adsorption sites for Ni and Co adatoms. XMCD proves Fe and Co adatoms to be paramagnetic and to exhibit an out-of-plane easy axis in agreement with theory. In contrast, we experimentally find a nonmagnetic ground state for Ni monomers while an increasing cluster size leads to sizeable magnetic moments. These observations are well reproduced by our calculations and reveal the importance of hybridization effects and intra-atomic charge transfer for the properties of adatoms and clusters on MLG.
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Affiliation(s)
- T Eelbo
- Institute of Applied Physics, University of Hamburg, Jungiusstrasse 11, D-20355 Hamburg, Germany.
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Caccialanza M, Piccinno R, Veraldi S, Gnecchi L, Forti S. Sun exposure and development of basal cell carcinomas: comparison between 504 patients affected by basal cell carcinoma and 475 non-affected. GIORN ITAL DERMAT V 2012; 147:218-220. [PMID: 22481591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Minetti AM, Forti S, Tassone G, Torretta S, Pignataro L. Efficacy of complex herbal compound of Echinacea angustifolia (Imoviral® Junior) in recurrent upper respiratory tract infections during pediatric age: preliminary results. Minerva Pediatr 2011; 63:177-182. [PMID: 21654598] [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: 05/30/2023]
Abstract
AIM Among pediatric population the recurrent upper respiratory tract infections are very common. Several phytotherapies are been proposed as support therapies and, in particular, the efficacy of Echinacea angustifolia is controversial. This paper presents an evaluation of a new herbal compound in the treatment of recurrent upper respiratory tract infections in a pediatric cohort. METHODS An immunostimulant herbal compound of Echinacea angustifolia, Arabinogalactan, Acerola (Vitamin C), Beta- Glucan e Zinc (Imoviral® Junior) was given to 37 children affected by recurrent pharyngotonsillitis or otitis media. RESULTS The mean number of inflammatory episodes (i.e. tonsillitis or otitis media) during 6 months before treatment was 3±2.19, during the 6 months following treatment initiation it was 1±0.93 (P=0.04). After the complete treatment, 77% of children reported an improvement of chronic inflammatory in frequency of acute episodes. The total score of a questionnaire about life quality is improved (P=0.04). Finally, none collateral effects was occurred. CONCLUSION The herbal compound of echinacea, beta-glucan, vitamin c, arabinoglactan and zinc (Imoviral® Junior) can improve the quality of life in pediatric patients affected by recurrent pharyngotonsillitis and otitis media without contralateral effects.
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Affiliation(s)
- A M Minetti
- Unità Operativa di Otorinolaringoiatria, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italia.
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Airaghi L, Usardi P, Forti S, Orsatti A, Baldini M, Annaloro C, Lambertenghi Deliliers G. A comparison between metabolic syndrome post-hematopoietic stem cell transplantation and spontaneously occurring metabolic syndrome. J Endocrinol Invest 2011; 34:e6-11. [PMID: 20595801 DOI: 10.1007/bf03346702] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Hematopoietic stem cell transplantation (HSCT) is used in the treatment of several hematological and non-hematological disorders. An increasing number of long-term survivors recover from their primary disease, but they are at risk of adverse late effects, including metabolic syndrome (MS), which seems to be common in long-term survivors of HSCT. AIM To compare common metabolic parameters and adipohormone profiles in post-transplant and spontaneously occurring or "classic" MS patients. SUBJECTS AND METHODS Post-transplant MS patients (15 women and 14 men; 49.8±9.3 yr) were compared to "classic" MS patients (15 women and 14 men; 52.9±8.0 yr). For each subject a record of conventional clinical parameters was made; moreover, serum leptin, insulin, quantitative C-reactive protein (CRP), tumor necrosis factor-α [TNF-α], and adiponectin concentrations were measured. RESULTS The patients with post-HSCT MS had significantly higher levels of leptin, CRP, and TNF-α than the patients with "classic" MS. A generalized linear model comprising serum insulin (p=0.022), body mass index (p<0.001), gender (p<0.001), and group (i.e. healthy, post-HSCT with MS, or suffering from "classic" MS; p<0.001) explained serum leptin variability (adjusted R(2)=0.741). Serum leptin concentrations and BMI were related in the patients with "classic" MS but not in those with post-HSCT MS. CONCLUSIONS A possible pathogenetic mechanism in the development of MS after HSCT could be hyperleptinemia. A potential interaction among circulating leptin, components of MS, and immune function might explain the role of this adipokine in mediating cardiovascular risk after HSCT.
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Affiliation(s)
- L Airaghi
- First Internal Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milano, Italy.
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Affiliation(s)
- F Agostinis
- I.R.C.C.S. Fondazione Osp.le Maggiore Policlinico, Mangiagalli e Regina Elena - University ofMilan, Milan, Italy
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Cantarella G, Viglione S, Forti S, Pignataro L. Voice therapy for laryngeal hemiplegia: the role of timing of initiation of therapy. J Rehabil Med 2010; 42:442-6. [DOI: 10.2340/16501977-0540] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Forti S, Crocetti A, Scotti A, Costanzo S, Pignataro L, Ambrosetti U, Del Bo L. Tinnitus sound therapy with open ear canal hearing aids. B-ENT 2010; 6:195-199. [PMID: 21090162] [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: 05/30/2023] Open
Abstract
OBJECTIVE The aims of this study were to evaluate the efficacy of open ear canal hearing aids in tinnitus treatment and to investigate the influence of gender, age, medication usage, tinnitus cause, tinnitus perception side, tinnitus pitch, pure tone audiometry, distortion product otoacoustic emissions, and minimal masking level on outcome. METHODOLOGY One hundred tinnitus patients were evaluated by the tinnitus handicap inventory (THI) at the beginning of the study and after nine months of treatment. All subjects were submitted to counselling and sound enrichment from the simple sound amplification provided by the open ear canal hearing aids. RESULTS Initial mean THI score was 54.22 (+/- 20.37) and final mean score was 28.32 (+/- 16.50), p < 0.0001. No statistically significant correlations were found between THI value reduction and the studied parameters. CONCLUSION Open ear canal hearing aids were useful in all tinnitus patients with mild hearing loss.
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Affiliation(s)
- S Forti
- Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Larcher B, Arisi E, Berloffa F, Demichelis F, Eccher C, Galligioni E, Galvagni M, Martini G, Sboner A, Tomio L, Zumiani G, Graiff A, Forti S. Analysis of user-satisfaction with the use of a teleconsultation system in oncology. ACTA ACUST UNITED AC 2009; 28:73-84. [PMID: 14692585 DOI: 10.1080/14639230310000600470] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There is an increasing interest in assessing telemedicine as alternative method of delivering high quality cancer treatment to patients living in rural areas. In the Province of Trento (north-east Italy) a tele-oncology system was implemented to provide non-surgical oncological consultation to district general hospitals. The aim of this study was to explore user-satisfaction with the system after 6 months of experimentation. During the on-field validation two questionnaires with open and closed-response questions were distributed to 80 physicians and nurses 6 months apart to investigate the users' expected benefits vs. perceived ones. The two questionnaires were compared to assess how perceived benefits differed from expected ones. Significant differences were found regarding improvements in: the standardization of diagnostic-therapeutic procedures using the Electronic Patient Record (EPR)]; information sharing; data updating; consultation speed; and the possibility to diminish patients' travels through the use of teleconsultation (TC). Physicians' responses showed a significant difference regarding the EPR's effects on relationship with patient, the nurses' responses with regards to its effects on care quality. Physicians felt that both modalities of teleconsultation were useful in enhancing communication with colleagues (86% for the synchronous TC, 80% for the asynchronous TC). Responses indicated that the major difficulties encountered were in the introduction of the system into the daily routine. Despite this, user expectations for its future use in clinical field were considerably high.
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Affiliation(s)
- B Larcher
- Medical Informatics and Telemedicine Laboratory, Istituto Trentino di Cultura-Centro per la Ricerca Scientifica e Tecnologica, Trento, Italy.
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Galligioni E, Forti S, Berloffa F, Caffo O, Ferro A, Eccher C, Caldara A, Murgia V, Soini B. Real-time quality assessment of cancer care through information technology instruments incorporated into routine clinical practice. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6620] [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: 11/20/2022] Open
Abstract
6620 Background: Information technology may provide complete and timely data, to monitor process-based and outcomes measurements, which are crucial for health care improvement. Since June 2000, we have developed an Electronic Oncological Patient Record (EOPR), which is routinely used in our Department, providing a powerful link between computer-based technology and clinical practice (Ann. Oncol. 2008). Recently EOPR was implemented with a Clinical Instrument Panel (OncoQual) which enables oncologists to explore clinical data and perform real-time process and outcome measurements, by applying a flexible module to formulate complex population queries. Methods: To evaluate the performance of OncoQual in our pts, we chose as quality indicator, the adherence to ASCO recommendations on adjuvant endocrine therapy (ET), in hormone receptor positive (HR+) breast cancer (BC) pts. In particular, we assessed pts treated from 2000 to 2004 for Tamoxifen (TAM) and pts treated from 2006 to 2007 for Aromatase Inhibitors (AIs). Furthermore TAM results were compared with the adjuvant treatments modalities of 77 italian centres, reported from a cooperative group (NORA) for the same period. Results: The results are shown in the table. Patients characteristics and Tam use in our series, were similar to those of the NORA group, while TAM use decreased and AIs increased in the 2006–07 series, as expected. It took few hours to collect and analyzed our series, which can be easily updated and adapted to different requirements. Conclusions: Our experience shows the feasibility of incorporating real-time process-based measurements into daily practice, to provide self assessment for continuous quality of care monitoring and improving. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- E. Galligioni
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
| | - S. Forti
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
| | - F. Berloffa
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
| | - O. Caffo
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
| | - A. Ferro
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
| | - C. Eccher
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
| | - A. Caldara
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
| | - V. Murgia
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
| | - B. Soini
- Santa Chiara Hospital, Trento, Italy; Fondazione Bruno Kessler, Trento, Italy
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Forti S, Costanzo S, Crocetti A, Pignataro L, Del Bo L, Ambrosetti U. Are Results of Tinnitus Retraining Therapy Maintained over Time? ACTA ACUST UNITED AC 2009; 14:286-9. [DOI: 10.1159/000212106] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 11/07/2008] [Indexed: 11/19/2022]
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Pisanelli DM, Eccher C, Forti S. An ontological approach to support clinical governance: the case of breast cancer guidelines. AMIA Annu Symp Proc 2008:1096. [PMID: 18998850] [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] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Revised: 07/16/2008] [Indexed: 05/27/2023]
Abstract
Guidelines are an essential tool to ensure an optimal clinical governance in oncology. The Province of Trento started a research project whose aim is to develop a system for supporting and controlling the best evidence-based oncological care process based on guidelines. The significant role of ontologies for the semantic interoperability of such a system is pointed out.
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Cristofolini A, Versini W, Tommasini M, Forti S, Barozzi L, Mutinelli R. [Computer terminals. Evaluation of utilization time]. G Ital Med Lav Ergon 2008; 30:340-344. [PMID: 19344086] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The aim of the present study was to compare the duration of computer use assessed through a software package and through self-report by questionnaire. Applied in a large Public Administration the software package led altogether to a remarkable reduction in the number of workers reaching the duration of use which requires medical examination. Nevertheless, it highlighted that self-reporting of a considerable number of workers had underestimated the computer use. The consistency with Italian laws is also discussed.
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Affiliation(s)
- A Cristofolini
- Nucleo Operativo Medico Competente, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.
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Galligioni E, Berloffa F, Caffo O, Tonazzolli G, Ambrosini G, Valduga F, Eccher C, Ferro A, Forti S. Development and daily use of an electronic oncological patient record for the total management of cancer patients: 7 years' experience. Ann Oncol 2008; 20:349-52. [PMID: 18718889 DOI: 10.1093/annonc/mdn567] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We describe our experience with an electronic oncological patient record (EOPR) for the total management of cancer patients. METHODS The web-based EOPR was developed on the basis of a user-centred design including user education and training, followed by continuous assistance; user acceptance was monitored by means of three questionnaires administered after 2 weeks, 6 months and 6 years. RESULTS The EOPR has been used daily for all in-ward, day hospital and ambulatory clinical activities since July 2000. The most widely appreciated functions are its rapid multipoint access, the self-updated summary of the patients' clinical course, the management of the entire therapeutic programme synchronised with working agendas and oncological teleconsultation. Security and privacy are assured by means of the separate storage of clinical and demographic data, with access protected by login and a password. The questionnaires highlighted appreciation of rapid data retrieval and exchange and the perception of improved quality of care, but also revealed a sense of additional work and a negative impact on doctor-patient relationships. CONCLUSIONS Our EOPR has proved to be effective in the total management of cancer patients. Its user-centred design and flexible web technology have been key factors in its successful implementation and daily use.
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Affiliation(s)
- E Galligioni
- Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy.
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Percivalle S, Piccino R, Caccialanza M, Forti S. Narrowband UVB phototherapy in vitiligo: evaluation of results in 53 patients. GIORN ITAL DERMAT V 2008; 143:9-14. [PMID: 18833047] [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: 05/26/2023]
Abstract
AIM Narrowband UVB (NBUVB)phototherapy has been used for vitiligo for years, but today there are no standardized protocols of treatment and follow-up data. A long-term study on 53 patients with localized or diffuse vitiligo is presented with the aim at improving the data availability in the literature. METHODS Phototherapy was administered two times a week on non-consecutive days; the treatment was continued for one year. The mean total dose administered was 201.28 J/cm2.The response to phototherapy was expressed as percentage of repigmentation: a repigmentation greater than 75% was considered excellent, a repigmentation between 74% and 50% good, a repigmentation between 49% and 25% moderate, a repigmentation less than 24% mild. In case of absence of repigmentation, the patient was judged as non-responder RESULTS Three point eight percent of patients showed excellent response, 32.05% good response, 32.05% moderate response, 28.3% mild response, while the remaining 3.8% was not responsive. According to statistical analysis best responses, were observed in non-acral areas (P<0.001), in patients with recent vitiligo (P=0.003), in patients with negative family history for vitiligo (P=0.038), and in those not exposed to previous therapies (P=0.005). In 36 patients a mean follow-up of 19.78 months was obtained. CONCLUSION NBUVB phototherapy is useful and safe for vitiligo, but in the future it will be necessary to compare results of different studies using the same treatment protocols and to obtain data of series endowed with an adequate follow-up.
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Affiliation(s)
- S Percivalle
- Department of Photoradiotherapy, Institute of Dermatological Sciences, University of Milan, Via Pace 9, Milan, Italy.
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Abstract
Heart failure can be the final stage of almost any type of cardiovascular diseases. Such diseases are the leading cause of recurrent hospital stay and mortality in developed countries, and an increasingly important cause of morbidity and mortality in developing countries. In consideration of the growing incidence of this syndrome, the Province of Trento (Northern Italy) supports a research project called e-Heart Failure. The aims of this project include the implementation of a web-based patient record management system which must allow all the professionals involved in the care process to provide a shared and continuous care. This paper emphasizes the role of ontologies in supporting the continuity of care. In a complex scenario where multiple agents co-operate in order to allow continuity of care, ontologies are the essential glue to ensure semantic consistency to data and knowledge shared by the different actors involved in the process, including patients and their families.
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Affiliation(s)
- Claudio Eccher
- ITC-IRST Telemedicine Unit, Laboratory of Medical Informatics, Trento, Italy
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Forti S, Galvagni M, Galligioni E, Eccher C. A real time Teleconsultation System for Sharing an Oncologic Web-based Electronic Medical Record. AMIA Annu Symp Proc 2005; 2005:959. [PMID: 16779246 PMCID: PMC1560873] [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] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This poster presents an innovative real-time Teleconsultation System for synchronized navigation of the pages of a web-based Oncological Electronic Medical Record, designed to provide clinicians a cooperative work tool supporting the oncologic patient management between different hospitals. The system embeds additional tools supporting the discussion: digital whiteboard, chat and a digital audio channel.
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Affiliation(s)
- Stefano Forti
- ITC-irst, Centre for Scientific and Technological Research, Trento
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Purin B, Rigo M, Riccadonna S, Forti S. An interactive real-time visualization environment for patients with heart failure. AMIA Annu Symp Proc 2005; 2005:1088. [PMID: 16779375 PMCID: PMC1560429] [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] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We present an interactive real-time visualization environment of time-ordered medical data aimed to support multidisciplinary disease management of patients with heart failure. Our prototype has been integrated into a working Electronic Patient Record implemented for the integrated management of heart failure patients. Since January 2005, the system has been evaluating in a clinical setting to assess its practical utility involving 30 General Practitioners, 7 Hospital Physicians and 50 Hospital and Community Nurses.
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Affiliation(s)
- Barbara Purin
- ITC-irst, Center for Scientific and Technology Research, Trento, Italy
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Tonazzolli G, Galligioni E, Berloffa F, Forti S. OncoQUAL: a clinical instrument panel for quality assessment in cancer care. AMIA Annu Symp Proc 2005; 2005:1138. [PMID: 16779424 PMCID: PMC1560709] [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] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We present OncoQUAL, a clinical instrument panel for quality assessment in cancer care. OncoQUAL is fully integrated in an oncological electronic patient record (OEPR) and it enables oncologists to interactively retrieve clinical data for performing process and outcome-based measures of quality of care. The capability of incorporating accurate and timely 'internal' quality measurements into the daily work of clinicians is essential for moving towards a user-oriented approach to the improvement of quality of care processes.
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Zauli Sajani S, Forti S, Lauriola P. [Benzene exposure in Modena: historical trend and health risk assessment]. Epidemiol Prev 2005; 29:13-8. [PMID: 15948645] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE The present paper estimates the 1980-2000 trend in exposure to benzene of the population living within the urban area of Modena. An assessment of leukaemia risk is also presented. DESIGN The 2000 annual means of benzene atmospheric concentrations in 73 sites has been derived using a procedure which integrated data from fixed site stations and passive samplers: on this basis, an annual mean for the whole urban area has been calculated. The population exposure trend for the period 1980-2000 has been estimated using the information on traffic emission changes. The expected annual number of leukaemia cases attributable to benzene has been calculated by using two different approaches. SETTING Residents in the urban area of Modena. MAIN OUTCOME MEASURES Annual incidence of leukaemia attributable to benzene. RESULTS In 2000, the mean urban concentration was about 7 microg/m3 and in average the population was exposed to about 9 microg/m3. In the eighties, the population exposure was 5 times higher than the 2000 value, with a maximum of 51 microg/m3 in 1988. The leukaemia risk assessment procedures gave a value of about 4 x 10(-1) with the method based on cumulative exposure and of about 4 x 10(-2) with the method based on weighted exposure. DISCUSSION AND CONCLUSION This study is one of the few examples of evaluation of both the trend in benzene exposure for a population and assessment of leukaemia risk. Uncertainties in the assessment of health impact derive from inconsistencies in the underlyng methods.
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Sboner A, Bauer P, Zumiani G, Eccher C, Blanzieri E, Forti S, Cristofolini M. Clinical validation of an automated system for supporting the early diagnosis of melanoma. Skin Res Technol 2004; 10:184-92. [PMID: 15225269 DOI: 10.1111/j.1600-0846.2004.00066.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early diagnosis and surgical excision is the most effective treatment of melanoma. Well-trained dermatologists reach a high level of diagnostic accuracy with good sensitivity and specificity. Their performances increase using some technical aids as digital epiluminescence microscopy. Several studies describe the development of computerized systems whose aim is supporting dermatologists in the early diagnosis of melanoma. In many cases, the performances of those systems were comparable to those of dermatologists. However, this cannot tell us whether a system is able to support dermatologists. Actually, the computerized system might correctly recognize the same lesions that the dermatologist does, without providing them any useful advice and therefore being useless in recognizing early malignant lesions. PURPOSE We present a novel approach to enhance dermatologists' performances in the diagnosis of early melanoma. We provide results of our evaluation of a computerized system combined with dermatologists. METHODS A Multiple-Classifier system was developed on a set of 152 cases and combined to a group of eight dermatologists to support them by improving their sensitivity. RESULTS The eight dermatologists have average sensitivity and specificity values of 0.83 and 0.66, respectively. The Multiple-Classifier system performs as well as the eight dermatologists (sensitivity range: 0.75-0.86; specificity range: 0.64-0.89). The combination with the dermatologists shows an average improvement of 11% (P=0.022) of dermatologists' sensitivity. CONCLUSION Our results suggest that an automated system can be effective in supporting dermatologists because it recognizes different malignant melanomas with respect to the dermatologists.
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Affiliation(s)
- Andrea Sboner
- ITC-irst, Centre for Scientific and Technological Research, Povo, Trento, Italy.
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Pupa SM, Forti S, Invernizzi AM, Giovanazzi R, Twal WO, Argraves WS, Ménard S. Monoclonal antibody to fibulin-1 generated by genetic immunization. J Cell Biochem 2003; 89:647-52. [PMID: 12858331 DOI: 10.1002/jcb.10563] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Fibulin-1 (Fbln-1) is an extracellular matrix (ECM) and plasma glycoprotein. Considering the growing evidence indicating that Fbln-1 plays a role in cancer we sought to develop monospecific antibodies to better facilitate further studies of the function of Fbln-1 in breast cancer. Using a plasmid expression vector encoding full-length human Fbln-1D as an immunogen and CpG oligodeoxyribonucleotides as adjuvant a monoclonal antibody (MAb) against Fbln-1 was produced. This MAb, designated MEM-2 was of IgM isotype and reacted with bacterially expressed Fbln-1. Furthermore, MEM-2 reacted with Fbln-1 expressed in the ECM released by cultured human breast carcinoma SKBR-3 cells in ELISA, and also with Fbln-1 present in SKBR-3 cell extract in immunoprecipitation and Western blotting. MEM-2 also reacted with Fbln-1 in human breast carcinoma specimens. These findings illustrate the utility of genetic immunization as a means of generating monoclonal antibodies to tumor-related ECM proteins. MEM-2 represents a useful new tool for the study of Fbln-1 in breast cancer.
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Affiliation(s)
- S M Pupa
- Molecular Targeting Unit, Department of Experimental Oncology, Istituto Nazionale Tumori, Milan, Italy
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Abstract
Melanoma is the most dangerous skin cancer and early diagnosis is the key factor in its successful treatment. Well-trained dermatologists reach a diagnosis via visual inspection, and reach sensitivity and specificity levels of about 80%. Several computerised diagnostic systems were reported in the literature using different classification algorithms. In this paper, we will illustrate a novel approach by which a suitable combination of different classifiers is used in order to improve the diagnostic performances of single classifiers. We used three different kinds of classifiers, namely linear discriminant analysis (LDA), k-nearest neighbour (k-NN) and a decision tree, the inputs of which are 38 geometric and colorimetric features automatically extracted from digital images of skin lesions. Multiple classifiers were generated by combining the diagnostic outputs of single classifiers with appropriate voting schemata. This approach was evaluated on a set of 152 digital skin images. We compared the performances of multiple classifiers (2- and 3-classifier groups) between them and with respect to single ones (1-classifier group). We further compared the classifiers' performances with those of eight dermatologists. Classifiers' performances were measured in terms of distance from the ideal classifier. Compared with 1- and 2-classifier groups, performances of 3-classifier systems were significantly higher (P<0.0005 and P<0.001, respectively). No statistically significant differences were found between the 1- and 2-classifier groups (P=0.352). While the dermatologists group showed a level of performances significantly higher than the 1-classifier systems (P<0.020), no differences were found between the multiple classifier groups and the dermatologists groups, indicating comparable performances. This work suggests that a suitable combination of different kinds of classifiers can improve the performances of an automatic diagnostic system.
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Affiliation(s)
- Andrea Sboner
- ITC-irst, Centre for Scientific and Technological Research, Via Sommarive 18, Povo, Trento 38050, Italy.
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Eccher C, Berloffa F, Galligioni E, Larcher B, Forti S. Experience in designing and evaluating a Teleconsultation System supporting shared care of oncological patients. AMIA Annu Symp Proc 2003; 2003:835. [PMID: 14728340 PMCID: PMC1480155] [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] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
This poster present our experience in designing, developing and deploying a Web-based Teleconsultation System based on a Patient Centered Oncological Electronic Medical Record (PEMR) specifically de-signed to provide clinicians a cooperative work tool supporting the oncological patient management. An evaluation phase in a clinical setting was performed when the system was deployed in the hospitals. A second evaluation phase after two year of utilization has been carrying on.
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Affiliation(s)
- Claudio Eccher
- ITC-irst, Centr for Scientific and Technological Research, Trento
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