Service Interaction Flow Analysis Technique for Service Personalization

Abstract Service interaction flows are difficult to capture, analyze, outline, and represent for research and design purposes. We examine how variation of personalized service flows in technology-mediated service interaction can be modeled and analyzed to provide information on how service personalization could support interaction. We have analyzed service interaction cases in a context of technology-mediated car rental service. With the analysis technique we propose, inspired by Interaction Analysis method, we were able to capture and model the situational service interaction. Our contribution regarding technology-mediated service interaction design is twofold: First, with the increased understanding on the role of personalization in managing variation in technology-mediated service interaction, our study contributes to designing service management information systems and human-computer interfaces that support personalized service interaction flows. Second, we provide a new analysis technique for situated interaction analysis, particularly when the aim is to understand personalization in service interaction flows

Outcomes of minimally invasive partial nephrectomy among very elderly patients: Report from the resurge collaborative international database

The aim of the study was to perform a comprehensive investigation of clinical outcomes of robot-assisted partial nephrectomy (RAPN) or laparoscopic partial nephrectomy (LPN) in elderly patients presenting with a renal mass.The REnal SURGery in Elderly (RESURGE) collaborative database was queried to identify patients aged 75 or older diagnosed with cT1-2 renal mass and treated with RAPN or LPN. Study outcomes were: overall complications (OC); warm ischemia time (WIT) and 6-month estimated glomerular filtration rate (eGFR); positive surgical margins (PSM), disease recurrence (REC), cancer-specific mortality (CSM) and other-cause mortality (OCM). Descriptive statistics, Kaplan-Meier, smoothed Poisson plots and logistic and linear regression models (MVA) were used.Overall, 216 patients were included in this analysis. OC rate was 34%, most of them being of low Clavien grade. Median WIT was 17 minutes and median 6-month eGFR was 54 ml/min/1.73 m(2). PSM rate was 5%. After a median follow-up of 20 months, the 5-year rates of REC, CSM and OCM were 4, 4 and 5%, respectively. At MVA predicting perioperative morbidity, RAPN relative to LPN (odds ratio [OR] 0.33; p <0.0001) was associated with lower OC rate. At MVA predicting functional outcomes, RAPN relative to LPN was associated with shorter WIT (estimate [EST]-4.09; p <0.0001), and with higher 6-month eGFR (EST 6.03; p = 0.01).In appropriately selected patients with small renal masses, minimally-invasive PN is associated with acceptable perioperative outcomes. The use of a robotic approach over a standard laparoscopic approach can be advantageous with respect to clinically relevant outcomes, and it should be preferred when available

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

Background: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care

Impact of gastrointestinal side effects on patients’ reported quality of life trajectories after radiotherapy for prostate cancer: Data from the prospective, observational pros-it CNR study

Radiotherapy (RT) represents an important therapeutic option for the treatment of localized prostate cancer. The aim of the current study is to examine trajectories in patients’ reported quality of life (QoL) aspects related to bowel function and bother, considering data from the PROState cancer monitoring in ITaly from the National Research Council (Pros-IT CNR) study, analyzed with growth mixture models. Data for patients who underwent RT, either associated or not associated with androgen deprivation therapy, were considered. QoL outcomes were assessed over a 2-year period from the diagnosis, using the Italian version of the University of California Los Angeles-Prostate Cancer Index (Italian-UCLA-PCI). Three trajectories were identified for the bowel function; having three or more comorbidities and the use of 3D-CRT technique for RT were associated with the worst trajectory (OR = 3.80, 95% CI 2.04–7.08; OR = 2.17, 95% CI 1.22–3.87, respectively). Two trajectories were identified for the bowel bother scores; diabetes and the non-Image guided RT method were associated with being in the worst bowel bother trajectory group (OR = 1.69, 95% CI 1.06–2.67; OR = 2.57, 95% CI 1.70–3.86, respectively). The findings from this study suggest that the absence of comorbidities and the use of intensity modulated RT techniques with image guidance are related with a better tolerance to RT in terms of bowel side effects

Factors predictive of shockwave lithotripsy failure for ureteral stones: Why we need to hurry

Background: The Aims of This Study Are to Evaluate The Prognostic Factors of Extracorporeal Shockwave Lithotripsy In Patients With Ureteric Stones, and to Identify Which Patients Might Directly Benefit of An Endoscopic Treatment. Methods: We Performed a Prospective Study From January 2013 and July 2016 On Patients With Single Ureteric Stone and Undergoing Extracorporeal Shockwave Lithotripsy (Swl). We Divided Patients Into Two Groups: First Group (Success Group) Included Cases Resolved With Swl Only, and a Second Group (Failure Group) Including Patients With Stone Not Resolved By Swl and Requiring An Endoscopic Treatment. We Evaluated Age, Weight, Height, Body Mass Index, Stone Size, Hydronephrosis, Laterality, Location, Days Elapsed From Onset of Symptoms to Swl and Stone Density When Computed Tomography Was Performed. In Case of Stone Fragments >4 Mm, The Procedure Was Repeated Up to a Maximum of Three Times. Swl Was Considered As Failed If Patients Had a Residual Stone of Any Size After a Follow-Up of 3 Months or If a Complication Occurred. Results: 274 Patients Completed Follow-Up and Were Enrolled In The Study. Mean Age Was 53.22 Years (Standard Deviation: 13.98). Swl Overall Success Rate Was 84.3% (231 Patients Successfully Treated With Shockwaves) and Failure Rate Was 15.7% (43 Patients Underwent Auxiliary Endoscopic Procedure). At The Univariate Analysis, We Observed a Statistically Significant Difference for Hydronephrosis (P=0.006), Time Elapsed From Symptoms Onset (P=0.013), Patients\u2019 Age (P=0.06) and Mean Stone Density (0.023). In The Multivariate Logistic Regression, Patients\u2019 Age (or: 1.517), and Time Elapsed From Obstruction to Swl (or: 3.005) Were Independent Predictive Factors for Swl Failure. Furthermore, Moderate and Severe Hydronephrosis Seemed to Be Independent Predictive Factors for Swl Failure, Presenting An or of 2.451 and 4.207 Respectively. High Stone Density Resulted to Be a Predictive Factor for Swl Failure (or: 2.293 If Density Was Higher Than 1100 Hounsfield Units). Conclusions: We Report a Large Series of Patients Undergone Primary Swl for Ureteric Stones. Our Data Demonstrated The Role of Hydronephrosis, Time Elapsed From Obstruction Onset to Treatment and Stone Density As Independent Predictive Factors of Swl Failure