Italian Translation and Validation of the Original ABC Taxonomy for Medication Adherence

Medication adherence represents a complex and multifaceted process. Standardized terminology is essential to enable a reproducible process in various languages. The study's aim was to translate and adapt the original Ascertaining Barriers for Compliance (ABC) Taxonomy on medication adherence, first proposed in 2012, into Italian language. The study was carried out according to the Preferred Methods for Translation of the ABC Taxonomy for Medication Adherence adopted by the ESPACOMP. Key steps included: (1) a systematic literature review using PubMed and Embase according to the PRISMA Guidelines to identify published Italian terms and definitions, and Italian adherence experts; (2) a forward translation of terms and definitions; (3) panelists' selection; (4) a three-round Delphi survey. From the systematic review, 19 studies allowed detection of 4 terms, 4 definitions and 767 Italian experts. To these, Italian ESPACOMP members and experts though snowball sampling were added. The identified Italian adherence experts received the Delphi questionnaire. The Italian ABC Taxonomy was achieved after three rounds of Delphi survey by reaching at least a moderate consensus on unambiguous naming and definition of medication adherence-related terms. The Taxonomy is intended to be used in research, academic, and professional fields in order to harmonize adherence terminology and avoid confusion in comparing research findings

Current and Emerging Treatment Options for Patients with Relapsed Myeloma

Multiple myeloma (MM) is a neoplastic disorder. It results from proliferation of clonal plasma cells in bone marrow with production of monoclonal proteins, which are detectable in serum or urine. MM is clinically characterized by destructive bone lesions, anemia, hypercalcemia and renal insufficiency. Its prognosis is severe, with a median survival after diagnosis of approximately 3 years due to frequent relapses. Treatments for patients with relapsed/refractory MM include hematopoietic cell transplantation, a rechallenge using a previous chemotherapy regimen or a trial of a new regimen. The introduction of new drugs such as thalidomide, lenalidomide and bortezomib has markedly improved MM outcomes. When relapse occurs, the clinician's challenge is to select the optimal treatment for each patient while balancing efficacy and toxicity. Patients with indolent relapse can be first treated with a 2-drug or a 3-drug combination. Patients with more aggressive relapse often require therapy with a combination of multiple active agents. Autologous stem cell transplantation should be considered as salvage therapy at first relapse for patients who have cryopreserved stem cells early in the disease course. The aim of this review is to provide an overview on the pharmacological and molecular action of treatments used for patients with relapsed/refractory multiple myeloma

Global shark fishing mortality still rising despite widespread regulatory change

Over the last two decades, sharks have been increasingly recognized among the world’s most threatened wildlife, and hence received heightened scientific and regulatory scrutiny. Yet, the effect of protective regulations on shark fishing mortality has not been evaluated at a global scale. Here we estimate that total fishing mortality increased from 76 to 80 million sharks between 2012-2019, ~25 million of which were threatened species. Mortality increased by 4% in coastal waters but decreased 7% in pelagic fisheries, especially across the Atlantic and Western Pacific. By linking fishing mortality data to the global regulatory landscape, we show that widespread legislation designed to prevent shark finning did not reduce mortality, but regional shark fishing or retention bans had some success. These analyses combined with expert interviews highlight evidence-based solutions to reverse the continued overexploitation of sharks

Las escuelas como territorios de paz. Construcción social del niño y la niña como sujetos políticos en contextos de conflicto armado

Este libro está preocupado no sólo por mostrar las formas en que la violencia militar descompone la vida social y acaba con la vida de los niños, las niñas y los jóvenes, sino sobre todo con mostrar las condiciones de reconstitución de la ciudadanía política. En este sentido, es un libro sobre la reconstrucción de la ciudadanía política a partir de los procesos de paz. Este es el eje central de todo el texto, el planteamiento de que el desarrollo de la ciudadanía en Colombia pasa por la construcción de las condiciones de paz. Se lo hace en particular en torno a las experiencias de las escuelas de paz, que son espacios de recuperación de niños, niñas y jóvenes que han pasado por la experiencia de la militarización y sus efectos. La paz no significa la eliminación del debate y el conflicto, sino que las diferencias sobre las orientaciones políticas y el sentido que queremos darle a la vida comunitaria o a la vida común se hacen sin violencia física, a través de debate y deliberación, a partir de las capacidades propias de cada individuo como sujeto que se constituye en sujeto político en tanto su destino personal lo liga a la discusión de la vida y destino comunes

Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline

Very elderly (> 75 years) chronic myeloid leukaemia (CML) patients at diagnosis are sometimes treated with different doses of imatinib (IM) based on concomitant diseases and physicians' judgement. However, data on long-term follow-up of these patients are still lacking. To investigate treatment response and outcome, we retrospectively revised an Italian database of 263 very elderly CML patients receiving IM from the time of diagnosis. Median age at diagnosis was 78.5 years and 56% of patients had 2 or 3 comorbidities. A complete haematological and cytogenetic response were achieved in 244 (92.8%) and 184 (69.9%) patients, respectively. In 148 cases (56.2%), a major molecular response was observed, which was deep in 63 cases (24%). A blastic phase occurred in 11 patients (4.2%). After a median follow-up of 45.0 months, 93 patients have died (9 from disease progression) and 104 (39.5%) are still in treatment with IM. Incidence of grades 3-4 haematological and non-haematological toxicity was similar to those reported in younger patients. Five-year event-free survival was 54.5% and 45.2% in patients ≤ 80 years and > 80 years, respectively (p = 0.098). Five years OS was 75.7% and 61.6% in patients ≤80 years and > 80 years, respectively (p = 0.003). These findings show that IM plays an important role in frontline treatment of very elderly CML patients without increased toxicity and any effort to treat these patients with standard doses should be made in order to achieve responses as in younger subjects

Pensar la infancia desde América Latina : un estado de la cuestión

Gracias a la ingente información proporcionada por los distintos capítulos que componen esta obra, quienes se aproximen a su lectura podrán contestar, a partir de un mejor conocimiento de la niñez en diversos contextos socioculturales latinoamericanos, una pregunta sencilla pero fundamental: ¿qué sociedad estamos construyendo? Saberlo o al menos preguntárselo, como sucede con todos los avances e investigaciones científicas, abrirá perspectivas insospechadas tanto para la continuidad de la investigación como para la implementación de políticas y acciones, en tanto la cuestión de la niñez está planteada en términos absolutamente nuevos con implicaciones sobre las prácticas y comportamientos culturales