The role of non-medical therapeutic approaches in the rehabilitation of Complex Regional Pain Syndrome

Purpose of the review: Non-medical therapeutic approaches are fundamental to the management of Complex Regional Pain Syndrome (CRPS) in order to promote the best outcome for patients. This review focuses on three key approaches underpinning CRPS rehabilitation, namely: physiotherapy and occupational therapy, psychological approaches and education and self-management. Recent Findings: Recently published European standards outline the quality of therapeutic care that people with CRPS must receive. Early initiated therapy is essential to optimise outcomes, underpinned by patient education. Therapists should promote early movement of the affected limb and encourage re-engagement with usual activities as immobilisation is known to have negative outcomes. There is evidence to support the possible long-term benefit of graded motor imagery and mirror therapy. Psychological assessment should include identification of depression and post-traumatic stress disorder, as treatment of these conditions may improve the trajectory of CRPS. Novel therapies include neurocognitive approaches and those addressing spatial bias, both of which should provide a focus for future research.Summary: There exists a broad range of non-medical therapeutic approaches to rehabilitation for CPRS that are thought to be important. However, the evidence for their efficacy is limited. Further research using standardised outcomes would be helpful in developing targeted therapies for the future

Put It in Your Shoe It Will Make You Limp: British Men’s Online Responses to a Male Pill

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.This article analyzes online interactions between British men and other online readers’ comments in response to two news articles focused on a male contraceptive pill. The aim of the study was to explore how British men’s online accounts construct a male pill as a potential contraceptive option for family planning. The two online articles reported the scientific innovations, as well as the production and marketing, of a nonhormonal, plant-based pill for men. Discourse analysis was used to analyze the online comments, from which two discourses emerged: (a) “Men as responsible health consumers” and (b) “‘Killing sperm’ and other side effects on semen.” When provided with the opportunity to take future responsibility for family planning, male readers were found to be unlikely to use a contraceptive pill. The men expressed the need for new options of contraception but, overall, felt a male pill was not the solution

Place4Carers: a multi-method participatory study to co-design, piloting, and transferring a novel psycho-social service for engaging family caregivers in remote rural settings

Background Family caregivers are key actors in the ageing society. They are mediators between practitioners and patients and usually provide also essential daily services for the elders. However, till now, few services have been deployed to help caregivers in their care tasks as in improving their mental health which can experience sever burden due to caregiving duties. The purpose of the study is to implement a community-based participatory research project to co-design an innovative organizational model of social services for family caregivers of elderly health consumers living in remote rural areas in Italy. Methods This is a community-based participatory research project in the remote area of Vallecamonica involving four main phases. These included a quantitative analysis of caregiver needs, a scoping review on existing services for caregivers, co-design workshops with local stakeholders and caregivers to create a novel service the piloting and a first implementation of the service and the assessment of project transferability to other contexts. Results As the hours dedicated to elder care increases, both objective and developmental caregiver’s burden significantly increases. Conversely, higher levels of engagement were associated with lower physical and emotional burden, and caregiver engagement was positively correlated with their perceived self-efficacy in managing disruptive patient behaviours. Based on these preliminary results, four co-design workshops with caregivers were conducted and led to the definition of the SOS caregivers service, built on four pillars structured upon the previous need analysis: a citizens’ management board, training courses, peer-to-peer meetings, and project and service information. We found that co-design is an effective means of creating new services for family caregivers, whose experiential knowledge proved to be a key resource for the project team in delivering and managing services. Less positively, the transferability analysis indicated that local municipalities remain reluctant to acknowledge caregivers’ pivotal role. Conclusions A dedicated support service for caregivers can ameliorate caregiving conditions and engagement levels. The service has resulted a successful co-productive initiative for a psycho-social intervention for family caregivers. For the future, we suggest that family caregiver should be considered an active partner in the process of designing novel psycho-social services and not just as recipients to enhance a better aging-in-place process

Engaging Consumers via Twitter: Three Successful Communicative Strategies

The interactive nature of social networking sites contributes to reinforce engagement between consumers and brands in terms of co-creation of shared values. According to Hollebeek (2011), consumer-brand engagement (CBE) implies cognitive, emotional, behavioral factors, which connect a brand with its followers. This chapter will show three successful Twitter strategies from three different brands, using a methodological approach focusing on the relational conditions that turn a brand into an engaging player on Twitter. Interviews with brand communication managers and followers were conducted. Moreover, initiatives were explored through the stream of tweets produced around the brands; pragmatic, semantic, syntactic and structural features of tweets were considered. Results show that, while the three initiatives considered here lean on a cognitive-based CBE, a full engagement in the/a brand's world is needed to build a long-lasting and successful relationship between brand and consumer, in order to co-construct a future shared reality

Patient's choice of observational strategy for early-stage prostate cancer

Active Surveillance (AS) may represent for selected patients with low risk, potentially indolent prostate cancer (PCa) a viable alternative to radical therapies, thus reducing the risk of over-treatment.Researchers and clinicians emphasized that the choice of AS may be acontroversial one as patients have the chance to avoid the side effects of radical therapies but also the burden of living with an untreated PCa. The aim of our study is to focus on the decision-making process leading patients to elect AS amongst different therapeutic options.An observational, qualitative study was conducted. Between 2007 and 2009, 46 patients (mean age 67 years) were administered a semi-structured interview at enrolment in the Prostate Cancer Research International: Active Surveillance protocol. The focus of the interview was onthe first question, i.e. "Why did you choose AS?". Interviews were audio-recorded and verbatim transcriptions were made. Content analyses were performed by using a text-driven, automatic software (T-lab). Four clusters of themes emerged. In cluster 1, the most meaningful theme was the ambivalence in front of different therapeutic options. In cluster 2, the focus was on patients' assessment of the aggressivenessof their PCa. In cluster 3, the topic was the collection of information from specialists. In cluster 4, the main theme was the collection of data through informal sources. Patients are motivated to opt for AS based on the subjective evaluation of medical information as well as characteristics of their psycho-social context. Understanding motivation for AS will help clinicians support patients in making the bestchoice for them

Place4Carers: a multi-method participatory study to co-design, piloting, and transferring a novel psycho-social service for engaging family caregivers in remote rural settings

Background: Family caregivers are key actors in the ageing society. They are mediators between practitioners and patients and usually provide also essential daily services for the elders. However, till now, few services have been deployed to help caregivers in their care tasks as in improving their mental health which can experience sever burden due to caregiving duties. The purpose of the study is to implement a community-based participatory research project to co-design an innovative organizational model of social services for family caregivers of elderly health consumers living in remote rural areas in Italy. Methods: This is a community-based participatory research project in the remote area of Vallecamonica involving four main phases. These included a quantitative analysis of caregiver needs, a scoping review on existing services for caregivers, co-design workshops with local stakeholders and caregivers to create a novel service the piloting and a first implementation of the service and the assessment of project transferability to other contexts. Results: As the hours dedicated to elder care increases, both objective and developmental caregiver\u2019s burden significantly increases. Conversely, higher levels of engagement were associated with lower physical and emotional burden, and caregiver engagement was positively correlated with their perceived self-efficacy in managing disruptive patient behaviours. Based on these preliminary results, four co-design workshops with caregivers were conducted and led to the definition of the SOS caregivers service, built on four pillars structured upon the previous need analysis: a citizens\u2019 management board, training courses, peer-to-peer meetings, and project and service information. We found that co-design is an effective means of creating new services for family caregivers, whose experiential knowledge proved to be a key resource for the project team in delivering and managing services. Less positively, the transferability analysis indicated that local municipalities remain reluctant to acknowledge caregivers\u2019 pivotal role. Conclusions: A dedicated support service for caregivers can ameliorate caregiving conditions and engagement levels. The service has resulted a successful co-productive initiative for a psycho-social intervention for family caregivers. For the future, we suggest that family caregiver should be considered an active partner in the process of designing novel psycho-social services and not just as recipients to enhance a better aging-in-place process

Assessment of GRAS Ionospheric Measurements for Ionospheric Model Assimilation

We conducted a study to assess the GNSS (Global Navigation Satellite System) Receiver for Atmospheric Sounding (GRAS) ionospheric data quality by processing Radio Occultation (RO) observations of ionospheric products. The main objective of the study is to validate ionospheric data generated at EUMETSAT, such as ionospheric bending angle profiles, amplitude and phase scintillations, topside Total Electron Content (TEC) from MetOp-A GRAS instrument as well as generating and validating new ionospheric products derived from GRAS RO observations such as the TEC, rate of TEC and vertical electron density profiles. The assessment is conducted by comparing and evaluating the systematic differences between similar products from other Low Earth Orbit (LEO) satellite missions or from ground-based ionospheric measurements. The study confirms that the GNSS topside and RO observations recorded by the GRAS instrument onboard MetOp satellites are of good quality and are a valuable source of data for ionospheric research

Educational Interventions for Promoting Food Literacy and Patient Engagement in Preventing Complications of Type 2 Diabetes: A Systematic Review

The present review aims to map the current literature on educational interventions to promote food literacy in type 2 diabetes, with a particular focus on the concept of patient engagement. The systematic review was implemented on five databases with no restrictions on the publication year. The studies selected for the review were focused on patients with type 2 diabetes, ranging from 2003 to 2021 and published in 13 countries (44% USA). Thirty-three articles were analyzed. Twenty-seven articles targeted singular patients; fifteen articles conceptualized patient engagement as self-management. In seven articles, the provider is a multidisciplinary team. Twenty articles did not report a theoretical framework in the intervention development, and eleven did not use an intervention material. Twenty-six articles did not use a technology proxy. Outcome categories were narratively mapped into four areas: clinical, psychological, behavioral, and literacy. To date, most of the interventions are heterogeneous in the adopted methodology, measures, and outcomes considered. More attention should be given to the psychosocial characterization of patient engagement as well as the technological support. High-quality, randomized controlled trials and longitudinal studies are lacking and need to be conducted to verify the efficacy of these insights

SosCaregivers: piloting of a psycho-social service for family caregiver in a hard-to-reach setting

Background \u201dAgeing-in-place\u201d may improve elderly citizens' quality of life and the sustainability of welfare systems. In this process engaging family caregivers is crucial. Methods A community-based participatory research in the remote area of Vallecamonica was enacted. First, we surveyed unmet needs of family caregivers. Then, a scoping literature review on existing interventions for engaging family caregivers was performed. Third, 4 co-design workshops were conducted to co-generate a new service. Finally, the service was piloted for a period of 6 months and evaluated. Results 51 caregivers participated in the survey: they were mainly females, mean 60 y.o and with medium-low level of education. The scoping review resulted in only 14 interventions targeted to elderly's caregivers in remote areas. The workshops involved 27 caregivers and co-designed a new psycho-social service (SOSCargivers) articulated into: 1) a structured informative platform to facilitate health literacy and information seeking; 2) a tailored educational program focused on medical and practical aspects related to elderly care; 3) a set of peer-to-peer meetings for experience sharing and mutual support; 4) a \u201ccaregivers board\u201d was created to lead the service. In the piloting 5 training sessions, 5 peer-to-peer meetings, 3 meeting with the \u201ccitizens board\u201d were enabled. Conclusions The service was positively received by caregivers, although participation wasn't high. Co-designing the service with its expected users facilitates the depth understanding of local people's needs and expectations. SOSCaregivers may support family caregivers of elderly citizens in hard to reach areas by both delivering more value and giving them an active role in the social-care network. Key messages Family caregivers\u2019 engagement is crucial for integrated and sustainable services in hard to reach communities. Co-designing the service with its expected users facilitates the Department understanding of local people\u2019s needs and expectations

Patient's choice of observational strategy for early-stage prostate cancer

Active Surveillance (AS) may represent for selected patients with low risk, potentially indolent prostate cancer (PCa) a viable alternative to radical therapies, thus reducing the risk of over-treatment.Researchers and clinicians emphasized that the choice of AS may be acontroversial one as patients have the chance to avoid the side effects of radical therapies but also the burden of living with an untreated PCa. The aim of our study is to focus on the decision-making process leading patients to elect AS amongst different therapeutic options.An observational, qualitative study was conducted. Between 2007 and 2009, 46 patients (mean age 67 years) were administered a semi-structured interview at enrolment in the Prostate Cancer Research International: Active Surveillance protocol. The focus of the interview was onthe first question, i.e. "Why did you choose AS?". Interviews were audio-recorded and verbatim transcriptions were made. Content analyses were performed by using a text-driven, automatic software (T-lab). Four clusters of themes emerged. In cluster 1, the most meaningful theme was the ambivalence in front of different therapeutic options. In cluster 2, the focus was on patients' assessment of the aggressivenessof their PCa. In cluster 3, the topic was the collection of information from specialists. In cluster 4, the main theme was the collection of data through informal sources. Patients are motivated to opt for AS based on the subjective evaluation of medical information as well as characteristics of their psycho-social context. Understanding motivation for AS will help clinicians support patients in making the bestchoice for them