The lived experience of patients receiving radiotherapy for head and neck cancer: A literature review

It is estimated that 60% of patients diagnosed with head and neck cancer will receive radiotherapy at some stage in their disease trajectory. The aim of this literature review was to find and analyse papers pertaining to the lived experiences of patients with head and neck cancer receiving radiotherapy. The review identified a limited number of high-quality research papers focusing on this topic, with only 10 papers fitting the inclusion/exclusion criteria. The majority of the investigative studies were not generalisable owing to small sample sizes and many of them being conducted in only one centre. However, the findings do highlight and contribute to the understanding of the lived experiences of this patient group and provide some insight into the unique physical, social, and psychological difficulties they encounter as a result of their treatment. There appears to be a need for further high-level research into these patients, particularly focusing on the provision of support and information prior to, during, and following radiotherapy. Further attention needs to be paid to preparing patients for the slow recovery following radiotherapy. Interventional studies are also required to develop clinical guidelines and protocols that can assist health professionals in meeting the holistic needs of this patient group.

Endodontic 'solutions' part 1:A literature review on the use of endodontic lubricants, irrigants and medicaments

Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of 'solutions' could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic 'solution' usage within dental schools. The literature review was undertaken under the following headings: pre-op oral rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases. The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2.

Total arsenic, inorganic arsenic, and other elements concentrations in Italian rice grain varies with origin and type

Rice is comparatively efficient at assimilating inorganic arsenic (As _i), a class-one, non-threshold carcinogen, into its grain, being the dominant source of this element to mankind. Here it was investigated how the total arsenic (As_t) and As_i content of Italian rice grain sourced from market outlets varied by geographical origin and type. Total Cr, Cd Se, Mg, K, Zn, Ni were also quantified. As_t concentration on a variety basis ranged from means of 0.18 mg kg^-1 to 0.28 mg kg ^-1, and from 0.11 mg kg^-1 to 0.28 mg kg^-1 by production region. For As_i concentration, means ranged from 0.08 mg kg^-1 to 0.11 mg kg^-1 by variety and 0.10 mg kg ^-1 to 0.06 mg kg^-1 by region. There was significant geographical variation for both As_t and As_i; total Se and Ni concentration; while the total concentration of Zn, Cr, Ni and K were strongly influenced by the type of rice.

Health status and 6 years survival of 552 90+ Italian sib-ships recruited within the EU Project GEHA (GEnetics of Healthy Ageing).

In a scenario of increasing life expectancy worldwide, it is mandatory to identify the characteristics of a healthy aging phenotype, including survival predictors, and to disentangle those related to environment/lifestyle versus those related to familiarity/genetics. To this aim we comprehensively characterised a cohort of 1,160 Italian subjects of 90 years and over (90+, mean age 93 years; age range 90-106 years) followed for 6 years survival, belonging to 552 sib-ships (familiar longevity) recruited (2005-2008) within the EU-funded GEHA project in three Italian geographic areas (Northern, Central and Southern Italy) different for urban/rural and socio-economical characteristics. On the whole, the following factors emerged as significant predictors of survival after 90 years of age: absence of cognitive impairment and physical disability, high hand grip strength scores and body mass index (BMI) values, "excellent/good" self-reported health, high haemoglobin and total cholesterol levels and low creatinine levels. These parameters, excluding BMI values, were also significantly associated within sib-ships, suggesting a strong familial/genetic component. Geographical micro-heterogeneity of survival predictors emerged, such as functional and physical status being more important in Southern than in Central and Northern Italy. In conclusion, we identified modifiable survival predictors related to specific domains, whose role and importance vary according to the geographic area considered and which can help in interpreting the genetic results obtained by the GEHA project, whose major aim is the comprehensive evaluation of phenotypic and genetic data.

How to classify the Oldest Old according to Health Status: A study of 1160 subjects belonging to 552 90+ Italian sibships characterised by familial longevity recruited within the GeHA EU project

The health status of the oldest old, the fastest increasing population segment worldwide, progressively becomes more heterogeneous, and this peculiarity represents a major obstacle to their classification. We compared the effectiveness of four previously proposed criteria (Franceschi et al., 2000; Evert et al., 2003; Gondo et al., 2006; Andersen-Ranberg et al., 2001) in 1160 phenotypically fully characterized Italian siblings of 90 years of age and older (90+, mean age: 93 years; age range: 90–106 years) belonging to 552 sib-ships, recruited in Northern, Central and Southern Italy within the EU-funded project GEHA, followed for a six-year-survival. Main findings were: (i) ‘‘healthy’’ subjects varied within a large range, i.e. 5.2% (Gondo), 8.7% (Evert), 17.7% (Franceschi), and 28.5% (Andersen-Ranberg); (ii) Central Italy subjects showed better health than those from Northern and Southern Italy; (iii) mortality risk was correlated with health status independently of geographical areas; and (iv) 90+ males, although fewer in number, were healthier than females, but with no survival advantage. In conclusion, we identified a modified version of Andersen-Ranberg criteria, based on the concomitant assessment of two basic domains (cognitive, SMMSE; physical, ADL), called ‘‘Simple Model of Functional Status’’ (SMFS), as the most effective proxy to distinguish healthy from not-healthy subjects. This model showed that health status was correlated within sib-ships, suggesting a familial/genetic component.

Paranoia and self-concepts in psychosis: A systematic review of the literature.

The purpose of the present study was to review systematically, research exploring the relationship between self-concepts and paranoia in psychosis. A literature search was performed by two independent raters in relevant databases (MedLine, PsychInfo and Web of Science) and articles meeting the inclusion criteria were cross-referenced. Following scrutiny according to inclusion criteria, 18 studies were selected for review. A narrative synthesis of findings, in which methodological variability is discussed, is presented relative to three key areas: the nature of the relationship between paranoia and self-concepts; the association between paranoia and discrepancies in self-concepts; the nature of the relationship between paranoia and self-concepts when other, dimensional aspects of these constructs are taken into account. The systematic literature review indicated relatively consistent findings, that paranoia is associated with more negative self-concepts when measured cross-sectionally. Results are somewhat more mixed in regards to research on paranoia and self-concept discrepancies. Studies investigating dimensional aspects of self-concepts and paranoia yield findings of particular interest, especially in regards to the association indicated between instability of self-concepts and paranoia. Limitations in research and of the present systematic review are discussed. Clinical and theoretical implications of findings are outlined and possible directions for future research are suggested.

Literature Focus

Literature focus is a feature consisting of short abstracts highlighting recent developments of interest in the literature selected
by postgraduate researchers.

Italy's got talent. How Italian leading companies in confectionery industry overcame the crisis

The crisis that spread worldwide since 2007 started from the financial sector and ended to affect also real economy. This process has attracted the attention of many scholars seeking to study its causes and impacts. Notwithstanding many works on this topic, the impact of the crisis on specific industries is still rather unexplored. The present work seeks to address this issue by analyzing the confectionery industry, with particular emphasis for Italian market leaders, Ferrero S.p.A. and Perfetti Van Melle S.r.l.. The aim of the study is to assess if they have been successful in tackling the crisis, keeping a satisfactory level of profitability associated to a good financial health notwithstanding ongoing difficulties. Moreover, we seek to analyze the strategies the companies employed to survive the crisis. The concern of the paper is both quantitative and qualitative. Thus, we calculated a complete set of indicators using a specific methodology for financial statement analysis which has been conceived especially for studying Italian firms; these data have been integrated with other information retrieved from the annual reports of the companies (especially the notes to the accounts and the directors’ report). The analysis highlights that both the firms benefit from a good financial health, with Perfetti Van Melle presenting a large amount of liquidity. On the contrary, liquidity should be the main concern of Ferrero because of an excessive reliance on current liabilities. Both the firms have a good level of profitability, even if Perfetti Van Melle’s one is decreasing. The key-strategies for the success of these firms are ongoing investments in state-of-the-art plant and machinery, an increasing use of equity as the main source of funding, along with huge investments in research and advertising.

Brunetta’s reform swan song? An assessment of its success in local governments through the analysis of its tools

The work aims at assessing the success of Brunetta’s reform (Legislative Decree n. 150/2009), a far-reaching reform that aimed at improving both organizational and individual performance in Italian public administration through a specific planning and control process (the performance cycle) and most of all through two new tools, Performance Plan and Performance Report. The success of the reform is assessed, with particular emphasis on local governments, analyzing the diffusion and use of these new tools. The study has been conducted using a deductive-inductive methodology. Thus, after a study of managerial reforms in Italy and performance measurement literature, a possible model (PerformEL Model) local governments could follow to draw up Performance Plan and Report as effective tools for performance measurement has been designed (deductive phase). Performance Plans 2011-2013 and Performance Report 2011 downloaded from Italian big sized municipalities’ websites have been analyzed in the light of PerformEL Model, to assess the diffusion of the documents and their coherence with legal requirements and suggestions from literature (inductive phase). Data arising from the empirical analysis have been studied to evaluate the diffusion and the effectiveness of big sized municipalities’ Performance Plans and Reports as performance measurement tools and thus to assess the success of the reform (feedback phase). The study shows a scarce diffusion of the documents; they are mostly drew up because of their compulsoriness or to gain legitimization. The results testify the failure of Brunetta’s reform, at least with regard to local governments.