Linee guida per una formazione degli adulti di qualit\ue0

Il tema della formazione oggi \ue8 terreno di incontro di molteplici paradigmi e metodologie. Sono diverse le chiavi di lettura e le definizioni disponibili, tanto da generare spaesamento. L\u2019elemento condiviso \ue8 il concetto di cambiamento, il cui legame \ue8 evidenziato dalla stessa etimologia della parola formare: dare forma. La formazione d\ue0 luogo, attraverso la strutturazione di percorsi di apprendimento, a una nuova configurazione nel formando, di solito di tipo mentale (Nicolini, 2015). La complessit\ue0 nella formazione degli adulti deriva dal lavorare con soggetti che hanno gi\ue0 un\u2019organizzazione mentale radicata e sperimentata attraverso l\u2019esperienza quotidiana. Il formatore si scontra con un modello di credenze, competenze ed esperienze gi\ue0 convalidato, che il soggetto fa fatica ad abbandonare in favore dell\u2019acquisizione dei nuovi contenuti, in quanto funzionante e funzionale, dal proprio punto di vista. Quasi mai, infatti, il percorso formativo avviene per la necessit\ue0 avvertita dal formando, quanto piuttosto per i bisogni di ammodernamento dei processi che partono dall\u2019organizzazione del lavoro. L'articolo propone linee guida per superare alcune di queste impasse

Validity and reliability of a light-based electronic target for testing response time in fencers

Response time is a fencing fundamental sensorimotor skill. Therefore, the aim of the current study was to examine the efficacy of a light-based electronic target in fencers, designed to measure and train this entity. Ninety-five fencers (M=53; F=42) were tested in regard to their response time, using a light-based electronic target, for three different attack types: simple attack, the lunge, and an attack following a 1.5-m thrust. All participants were divided into elite vs. novice fencers. Elite fencers had national and international rankings, and were again divided with regard to used weapon: épéeists (n=32; M=19; F=13) and foilists (n=30; M=13; F=17). Measurement was evaluated for validity/reliability, sensitivity/specificity, and correlation. Reliability was high for all attack types (ICC 0.94-0.96). Lower response times were found in males for two attack types with good sensitivity (81-93%)/specificity (50-91%) for all attack types. Elite fencers responded faster than novice fencers for all attack types (P<0.001), whereas elite males were faster than females for two attack types (P<0.01). Lower response times in females correlated with level for one attack type (r=0.797, P<0.05). In conclusion, the light-based electronic target system was found to be highly reliable and therefore could be used by fencing athletes as a further measure of performance

A Robot-Assisted Framework for Rehabilitation Practices: Implementation and Experimental Results

One of the most interesting characteristics of collaborative robots is their ability to be used in close cooperation scenarios. In industry, this facilitates the implementation of human-in-loop workflows. However, this feature can also be exploited in different fields, such as healthcare. In this paper, a rehabilitation framework for the upper limbs of neurological patients is presented, consisting of a collaborative robot that helps users perform three-dimensional trajectories. Such a practice is aimed at improving the coordination of patients by guiding their motions in a preferred direction. We present the mechatronic setup, along with a preliminary experimental set of results from 19 volunteers (patients and control subjects) who provided positive feedback on the training experience (52% of the subjects would return and 44% enjoyed performing the exercise). Patients were able to execute the exercise, with a maximum deviation from the trajectory of 16 mm. The muscular effort required was limited, with average maximum forces recorded at around 50 N

Validity and reliability of a light-based electronic target for testing response time in fencers

Response time is a fencing fundamental sensorimotor skill. Therefore, the aim of the current study was to examine the efficacy of a light-based electronic target in fencers, designed to measure and train this entity. Ninety-five fencers (M=53; F=42) were tested in regard to their response time, using a light-based electronic target, for three different attack types: simple attack, the lunge, and an attack following a 1.5-m thrust. All participants were divided into elite vs. novice fencers. Elite fencers had national and international rankings, and were again divided with regard to used weapon: épéeists (n=32; M=19; F=13) and foilists (n=30; M=13; F=17). Measurement was evaluated for validity/reliability, sensitivity/specificity, and correlation. Reliability was high for all attack types (ICC 0.94-0.96). Lower response times were found in males for two attack types with good sensitivity (81-93%)/specificity (50-91%) for all attack types. Elite fencers responded faster than novice fencers for all attack types (P<0.001), whereas elite males were faster than females for two attack types (P<0.01). Lower response times in females correlated with level for one attack type (r=0.797, P<0.05). In conclusion, the light-based electronic target system was found to be highly reliable and therefore could be used by fencing athletes as a further measure of performance

Early Botulinum Toxin Type A injection for post-stroke spasticity: a longitudinal cohort study

Early management of spasticity may improve stroke outcome. Botulinum toxin type A (BoNT-A) is recommended treatment for post-stroke spasticity (PSS). However, it is usually administered in the chronic phase of stroke. Our aim was to determine whether the length of time between stroke onset and initial BoNT-A injection has an effect on outcomes after PSS treatment. This multicenter, longitudinal, cohort study included stroke patients (time since onset &lt;12 months) with PSS who received BoNT-A for the first time according to routine practice. The main outcome was the modified Ashworth scale (MAS). Patients were evaluated before BoNT-A injection and then at 4, 12, and 24 weeks of follow-up. Eighty-three patients with PSS were enrolled. MAS showed a significant decrease in PSS at 4 and 12 weeks but not at 24 weeks after treatment. Among the patients with a time between stroke onset and BoNT-A injection &gt;90 days, the MAS were higher at 4 and 12 weeks than at 24 weeks compared to those injected ≤90 days since stroke. Our findings suggest that BoNT-A treatment for PSS should be initiated within 3 months after stroke onset in order to obtain a greater reduction in muscle tone at 1 and 3 months afterwards

Cervical cancer elimination in Italy: Current scenario and future endeavors for a value based prevention

BackgroundCervical Cancer (CC) is a vaccine-preventable disease, and it is treatable if diagnosed early and managed properly. However, it is the fourth most common cancer in women worldwide with about 604,127 cases and 341,831 deaths in 2020. In Italy, it represents the fifth most common cancer in women under 50 years of age with about 2,400 new cases in 2020. The CC elimination is today a global public health goal published by the World Health Organization (WHO) in 2020 and a commitment of the European Union that has included it in Europe's Beating Cancer Plan. Therefore, urgent action is needed, at international and national level, to implement value-based interventions regarding vaccination, screening and timely management of the disease. Our study aims to describe the state of the art of Human Papilloma Virus (HPV) prevention in Italy and to get a consensus on indicators for monitoring the progress toward CC elimination at national level. MethodsThe study envisaged the following activities: research and synthesis of the evidence on strategies and actions for CC elimination at regional Italian level; identification of indicators to monitor such strategies/actions; organization of a multi-stakeholder consensus to reach the agreement on main indicators to be used in Italy. ResultsAs for HPV vaccination coverage, the last Italian available data (December 31st, 2020) showed that it was way below the target (95%) with full cycle vaccination coverage ranging from 6 to 61.7% in female adolescents and from 5.4 to 55.4% in male adolescents (2008 birth cohorts). The coverage rate of CC screening is variable with a range of 61.7-89.6%. Furthermore, coverage rates due to organized screening programs (excluding out-of-pocket screening) shows a range from 20.7 to 71.8%. The mapping of the Italian Regions highlighted an important regional heterogeneity in respect to organizational/operational issue of HPV vaccination and CC screening. Indicators for monitoring CC elimination strategies have been drawn from the Australian experience and distinguished by disease outcomes, vaccination coverage, screening participation and treatment uptake. The highest consensus was reached for the following indicators: CC incidence; detection of high-grade cervical disease; CC mortality; full cycle vaccination coverage; screening participation; high-grade cervical disease treatment rates; CC treatment rates. ConclusionsThe assessment of the current status of CC elimination as overarching goal beyond the achievement of vaccine, screening and treatment targets represents the first step for the identification of interventions to be implemented to accelerate the path toward CC elimination. Based on this and following the WHO call, a value-based approach is proposed to untangle the full benefit of HPV-related cancers elimination strategies and identify priority and best practices

Clinical efficacy of botulinum toxin type A in patients with traumatic brain injury, spinal cord injury, or multiple sclerosis: An observational longitudinal study

Botulinum toxin type A (BoNT-A) is the treatment of choice for focal spasticity, with a concomitant effect on pain reduction and improvement of quality of life (QoL). Current evidence of its efficacy is based mainly on post stroke spasticity. This study aims to clarify the role of BoNT-A in the context of non-stroke spasticity (NSS). We enrolled 86 patients affected by multiple sclerosis, spinal cord injury, and traumatic brain injury with clinical indication to perform BoNT-A treatment. Subjects were evaluated before injection and after 1, 3, and 6 months. At every visit, spasticity severity using the modified Ashworth scale, pain using the numeric rating scale, QoL using the Euro Qol Group EQ-5D-5L, and the perceived treatment effect using the Global Assessment of Efficacy scale were recorded. In our population BoNT-A demonstrated to have a significant effect in improving all the outcome variables, with different effect persistence over time in relation to the diagnosis and the number of treated sites. Our results support BoNT-A as a modifier of the disability condition and suggest its implementation in the treatment of NSS, delivering a possible starting point to generate diagnosis-specific follow-up programs.Clinical trial identifierNCT04673240