Information and communication technologies nella gestione integrata del diabete mellito: stato dell'arte, progetto Metabo come caso di studio

Il Diabete, modello paradigmatico delle malattie croniche, sta assumendo negli ultimi anni le proporzioni di una pandemia, che non ha intenzione di arrestarsi, ma del quale, con l’aumento dei fattori di rischio, aumentano prevalenza e incidenza. Secondo stime autorevoli il numero delle persone con diabete nel 2035 aumenterà fino a raggiungere i 382 milioni di casi. Una patologia complessa che richiede lo sforzo di una vasta gamma di professionisti, per ridurre in futuro in maniera significativa i costi legati a questa patologia e nel contempo mantenere e addirittura migliorare gli standard di cura. Una soluzione è rappresentata dall'impiego delle ICT, Information and Communication Technologies. La continua innovazione tecnologica dei medical device per diabetici lascia ben sperare, dietro la spinta di capitali sempre più ingenti che iniziano a muoversi in questo mercato del futuro. Sempre più device tecnologicamente avanzati, all’avanguardia e performanti, sono a disposizione del paziente diabetico, che può migliorare tutti processi della cura, contenendo le spese. Di fondamentale importanza sono le BAN reti di sensori e wearable device, i cui dati diventano parte di un sistema di gestione delle cure più ampio. A questo proposito METABO è un progetto ICT europeo dedicato allo studio ed al supporto di gestione metabolica del diabete. Si concentra sul miglioramento della gestione della malattia, fornendo a pazienti e medici una piattaforma software tecnologicamente avanzata semplice e intuitiva, per aiutarli a gestire tutte le informazioni relative al trattamento del diabete. Innovativo il Clinical Pathway, che a partire da un modello Standard con procedimenti semplici e l’utilizzo di feedback del paziente, viene progressivamente personalizzato con le progressive modificazioni dello stato patologico, psicologico e non solo. La possibilità di e-prescribing per farmaci e device, e-learning per educare il paziente, tenerlo sotto stretto monitoraggio anche alla guida della propria auto, la rendono uno strumento utile e accattivante.

Localization, web communication and seo for museum websites: The case of the Pinacoteca di Brera

La presente tesi di laurea si concentra sulla localizzazione in inglese di varie sezioni del nuovo sito web della Pinacoteca di Brera. Il progetto di localizzazione è stato contestualizzato da un lato all’interno della letteratura sulla comunicazione museale, e dall’altro sulla comunicazione web, per poter avanzare proposte di miglioramento alla luce di ricerche nel campo della SEO (Search Engine Optimization). Lo studio della comunicazione museale si è arricchito grazie all’esperienza di documentazione presso la University of Leicester (UK). La tesi mira a porre le basi per la produzione di contenuti museali adatti ad una lettura sul web, in modo da offrire non solo una traduzione ben fatta dal punto di vista linguistico e culturale, ma anche facilmente fruibile per un utente online e reperibile attraverso motori di ricerca. L’elaborato intende fornire ai musei italiani alcuni spunti di riflessione circa possibili miglioramenti delle proprie piattaforme online grazie alla localizzazione e ad un’analisi approfondita dei contenuti web secondo principi di usabilità e visibilità. Il capitolo 1 introduce la letteratura sugli studi museali, prestando particolare attenzione alla comunicazione. Il capitolo 2 fornisce una panoramica generale sul web: vengono suggerite buone pratiche di web writing, analizzate le strategie di SEO per migliorare la visibilità dei siti e delineato le principali caratteristiche del processo di localizzazione. Il capitolo 3 riunisce i due universi finora esplorati individualmente, ovvero i musei e il web, concentrandosi sulla comunicazione online dei musei e concludendo con uno schema di valutazione dei siti dei musei. Il capitolo 4 applica le strategie precedentemente discusse al caso specifico della Pinacoteca di Brera, concentrandosi sulla valutazione del sito, sulla localizzazione di alcune sezioni e sulla proposta di strategie SEO. Infine, il capitolo 5 tira le fila dell’intero lavoro mettendo in evidenza i principali risultati ottenuti.

Is computer-assisted telephone triage safe? A prospective surveillance study in walk-in patients with non-life-threatening medical conditions

Background Patients often establish initial contact with healthcare institutions by telephone. During this process they are frequently medically triaged. Purpose To investigate the safety of computer-assisted telephone triage for walk-in patients with non-life-threatening medical conditions at an emergency unit of a Swiss university hospital. Methods This prospective surveillance study compared the urgency assessments of three different types of personnel (call centre nurses, hospital physicians, primary care physicians) who were involved in the patients' care process. Based on the urgency recommendations of the hospital and primary care physicians, cases which could potentially have resulted in an avoidable hazardous situation (AHS) were identified. Subsequently, the records of patients with a potential AHS were assessed for risk to health or life by an expert panel. Results 208 patients were enrolled in the study, of whom 153 were assessed by all three types of personnel. Congruence between the three assessments was low. The weighted κ values were 0.115 (95% CI 0.038 to 0.192) (hospital physicians vs call centre), 0.159 (95% CI 0.073 to 0.242) (primary care physicians vs call centre) and 0.377 (95% CI 0.279 to 0.480) (hospital vs primary care physicians). Seven of 153 cases (4.57%; 95% CI 1.85% to 9.20%) were classified as a potentially AHS. A risk to health or life was adjudged in one case (0.65%; 95% CI 0.02% to 3.58%). Conclusion Medical telephone counselling is a demanding task requiring competent specialists with dedicated training in communication supported by suitable computer technology. Provided these conditions are in place, computer-assisted telephone triage can be considered to be a safe method of assessing the potential clinical risks of patients' medical conditions.

Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis

Objective: Group training in communication skills [communication skills training (CST)] has become partly mandatory for oncology staff. However, so far, a comprehensive meta-analysis on the efficacy is lacking. Design: Included studies either compare the efficacy of a specific training with a control group or look at the additional effect of booster sessions on communication behaviour, attitudes or patient outcomes. Methods: Four electronic databases were searched up to July 2008 without language restriction, and reference lists of earlier reviews were screened. Effect sizes (ESs) were extracted and pooled in random effects meta-analyses. Results: We included 13 trials (three non-randomised), 10 with no specific intervention in the control group. Meta-analysis showed a moderate effect of CST on communication behaviour ES = 0.54. Three trials compared basic training courses with more extensive training courses and showed a small additional effect on communication skills ES = 0.37. Trials investigating participants' attitudes ES = 0.35 and patient outcomes ES = 0.13 (trend) confirmed this effect. Conclusions: Training health professionals by CST is a promising approach to change communication behaviour and attitudes. Patients might also benefit from specifically trained health professionals but strong studies are lacking. However, feasibility and economic aspects have to be kept in mind when considering providing a training of optimal length.

Synthesis and cytotoxic activity of non-naturally substituted 4-oxycoumarin derivatives

Coumarins are a large family of natural and synthetic compounds exerting different pharmacological effects, including cytotoxic, anti-inflammatory or antimicrobial. In the present communication we report the synthesis of a series of 12 diversely substituted 4-oxycoumarin derivatives including methoxy substituted 4-hydroxycoumarins, methyl, methoxy or unsubstituted 3-aryl-4-hydroxycoumarins and 4-benzyloxycoumarins and their anti-proliferative effects on breast adenocarcinoma cells (MCF-7), human promyelocytic leukemia cells (HL-60), human histiocytic lymphoma cells (U937) and mouse neuroblastoma cells (Neuro2a). The most potent bioactive molecule was the 4-hydroxy-5,7-dimethoxycoumarin (compound 1) which showed similar potency (IC(50) 0.2-2 μM) in all cancer cell lines tested. This non-natural product reveals a simple bioactive scaffold which may be exploited in further studies.

Is gamma band EEG synchronization reduced during auditory driving in schizophrenia patients with auditory verbal hallucinations?

Auditory verbal hallucinations (AVH) in schizophrenia patients assumingly result from a state inadequate activation of the primary auditory system. We tested brain responsiveness to auditory stimulation in healthy controls (n=26), and in schizophrenia patients that frequently (n=18) or never (n=11) experienced AVH. Responsiveness was assessed by driving the EEG with click-tones at 20, 30 and 40Hz. We compared stimulus induced EEG changes between groups using spectral amplitude maps and a global measure of phase-locking (GFS). As expected, the 40Hz stimulation elicited the strongest changes. However, while controls and non-hallucinators increased 40Hz EEG activity during stimulation, a left-lateralized decrease was observed in the hallucinators. These differences were significant (p=.02). As expected, GFS increased during stimulation in controls (p=.08) and non-hallucinating patients (p=.06), which was significant when combining the two groups (p=.01). In contrast, GFS decreased with stimulation in hallucinating patients (p=0.13), resulting in a significantly different GFS response when comparing subjects with and without AVH (p<.01). Our data suggests that normally, 40Hz stimulation leads to the activation of a synchronized network representing the sensory input, but in hallucinating patients, the same stimulation partly disrupts ongoing activity in this network.

Phonetic Aspects of Speech Communication

Nadeina set out to develop methods of speech development in Russian as a mother tongue, focusing on improving diction, training in voice quality control, intonation control, the removal of dialect, and speech etiquette. She began with training in the receptive skills of language, i.e. reading and listening, since the interpretation of someone else's language plays an important role in language production. Her studies of students' reading speed of students showed that it varies between 40 and 120 words per minute, which is normally considered very slow. She discovered a strong correlation between speed of reading and speaking skills: the slower a person reads the worse is their ability to speak and has designed exercises to improve reading skills. Nadeina also believes that listening to other people's speech is very important, both to analyse its content and in some cases as an example, so listening skills need to be developed. Many people have poor pronunciation habits acquired as children. On the basis of speech samples from young Russians (male and female, aged 17-22), Nadeina analysed the commonest speech faults - nasalisation, hesitation and hemming at the end of sense-groups, etc. Using a group of twenty listeners, she looked for a correlation between how voice quality is perceived and certain voice quality parameters, e.g. pitch range, tremulousness, fluency, whispering, harshness, sonority, tension and audible breath. She found that the less non-linguistic segment variations in speech appeared, the more attractive the speech was rated. The results are included in a textbook aimed at helping people to improve their oral skills and to communicate ideas to an audience. She believes this will assist Russian officials in their attempts to communicate their ideas to different social spheres, and also foreigners learning Russian.

Impaired verbal memory in Parkinson disease: relationship to prefrontal dysfunction and somatosensory discrimination

OBJECTIVE: To study the neurocognitive profile and its relationship to prefrontal dysfunction in non-demented Parkinson's disease (PD) with deficient haptic perception. METHODS: Twelve right-handed patients with PD and 12 healthy control subjects underwent thorough neuropsychological testing including Rey complex figure, Rey auditory verbal and figural learning test, figural and verbal fluency, and Stroop test. Test scores reflecting significant differences between patients and healthy subjects were correlated with the individual expression coefficients of one principal component, obtained in a principal component analysis of an oxygen-15-labeled water PET study exploring somatosensory discrimination that differentiated between the two groups and involved prefrontal cortices. RESULTS: We found significantly decreased total scores for the verbal learning trials and verbal delayed free recall in PD patients compared with normal volunteers. Further analysis of these parameters using Spearman's ranking correlation showed a significantly negative correlation of deficient verbal recall with expression coefficients of the principal component whose image showed a subcortical-cortical network, including right dorsolateral-prefrontal cortex, in PD patients. CONCLUSION: PD patients with disrupted right dorsolateral prefrontal cortex function and associated diminished somatosensory discrimination are impaired also in verbal memory functions. A negative correlation between delayed verbal free recall and PET activation in a network including the prefrontal cortices suggests that verbal cues and accordingly declarative memory processes may be operative in PD during activities that demand sustained attention such as somatosensory discrimination. Verbal cues may be compensatory in nature and help to non-specifically enhance focused attention in the presence of a functionally disrupted prefrontal cortex.

Highly Efficient Non-palladium Catalyzed Controlled Synthesis and X-ray Analysis of Functionalized 1,2-Diaryl-, 1,2,3-Triaryl- and 1,2,3,4-Tetraarylbenzene

A general, two-step highly efficient synthesis of 1,2-diaryl-, 1,2,3-triaryl- and 1,2,3,4-tetraarylbenzenes from simple stitching of alpha-oxo-ketene-S,S-acetals and active methylene compounds via a ‘lactone intermediate’ is described. This procedure offers easy access to highly functionalized arylated-benzenes containing sterically demanding groups in good to excellent yields. The novelty of the procedure lies in the fabrication of aromatic compounds with desired conformational flexibility along the molecular axis in a transition metal-free environment through easily accessible precursors. The crystal analysis of these arylated-benzene scaffolds showed that the peripheral aryl rings are arranged in propeller-like fashion with respect to the central benzene rings. Examination of the crystal packing in the structure of a 1,2,3,4-tetraarylbenzene 12c revealed a “N…pi interaction” between molecules related by a two-fold screw axis running in a direction. It is interesting that the repeat of the array of N…pi interaction around the axis of the 1,2,3,4-tetraarylbenzene 12c enforces the molecules in a helical pattern.

Potentials and limitations of coordinated spatial and non-spatial information

Information management and geoinformation systems (GIS) have become indispensable in a large majority of protected areas all over the world. These tools are used for management purposes as well as for research and in recent years have become even more important for visitor information, education and communication. This study is divided into two parts: the first part provides a general overview of GIS and information management in a selected number of national park organizations. The second part lists and evaluates the needs of evolving large protected areas in Switzerland. The results show a wide use of GIS and information management tools in well established protected areas. The more isolated use of singular GIS tools has increasingly been replaced by an integrated geoinformation management. However, interview partners pointed out that human resources for GIS in most parks are limited. The interviews also highlight uneven access to national geodata. The view of integrated geoinformation management is not yet fully developed in the park projects in Switzerland. Short-term needs, such as software and data availability, motivate a large number of responses collected within an exhaustive questionnaire. Nevertheless, the need for coordinated action has been identified and should be followed up. The park organizations in North America show how an effective coordination and cooperation might be organized.

E-mail-“inspired” changes in non-native legal discourse

At IDC, students use electronic resources for research and online interactive communication with instructors, usually in English. This paper discusses preliminary research into the overlap between the informality of e-mail communication between students and instructors and the growing use (or misuse) of e-mail-type informal discourse in formal written legal assignments. Four students were given a hypothetical legal case and requested to write: (a) a formal letter that would be sent by e-mail to one of the parties in the case, and (b) an executive memo e-mail to the senior partner in one of the law firms representing the parties. No instruction was given as to constructing a formal legal letter or an executive memo. In the resulting e-mail communications, many examples of typical informal e-mail shorthand were used. The students were interviewed and were able to locate and change most of the errors in their letters. Several students expressed the belief that this type of “shorthand” is or should be acceptable when the formal message is an e-mail communication.

Spanish-English Codeswitching in Email Communication

While spoken codeswitching (CS) among Latinos has received significant scholarly attention, few studies have examined written CS, specifically naturally-occurring CS in email. This study contributes to an under-studied area of Latino linguistic practices by reporting the results of a study of CS in the emails of five Spanish-English bilingual Latinos. Methods are employed that are not often used in discourse analysis of email texts, namely multi-dimensional scaling and tree diagrams, to explore the contextual parameters of written Spanish-English CS systematically. Consistent with the findings of other studies of CS in CMC, English use was most associated with professional or formal contacts, and use of Spanish, the participants’ native language, was linked to intimacy, informality, and group identification. Switches to Spanish functioned to personalize otherwise transactional or work-related English-dominant emails. The article also discusses novel orthographic and linguistic forms specific to the CMC context.

“Facebook Style”: The use of non-standard features in virtual speech conditioned by the medium Facebook

Facebook is a medium of social interaction producing its own style. I study how users from Malaga create this style through phonic features of the local variety and how they reflect on the use of these features. I then analyse the use of non-standard features by users from Malaga and compare them to an oral corpus. Results demonstrate that social factors work differently in real and virtual speech. Facebook communication is seen as a style serving to create social meaning and to express linguistic identity.

Multimodal viral communication: a social semiotic analysis of the popular Spanish "Ola ke ase" meme

Multimodality – the interdependence of semiotic resources in text – is an existential element of today’s media. The term multimodality attends systematically to the social interpretation of a wide range of communicational forms used in meaning making. A primary focus of social- semiotic multimodal analysis is on mapping how modal resources are used by people in a given social context. In November 2012 the “Ola ke ase” catchphrase, which is a play on “Hola ¿qué hace?”, appeared for the first time in Spain and immediately has been adopted as a Twitter hashtag and an image macro series. Its viral spread on social networks has been tremendous, being a trending topic in various Spanish-speaking countries. The objective of analysis is how language and image work together in the “Ola ke ase” meme. The interplay between text and image in one of the original memes and some of its variations is quantitatively analysed applying a social-semiotic approach. Results demonstrate how the “Ola ke ase” meme functions through its multimodal character and the non-standard orthography. The spread of uncountable variations of the meme shows the social process that goes on in the meaning making of the semiotic elements.

Facebook style: The use of non-standard features in virtual speech conditioned by the medium Facebook

Over the last few years Facebook has become a widespread and continuously expanding medium of communication. Being a new medium of social interaction, Facebook produces its own communication style. My focus of analysis is how Facebook users from the city of Malaga create this style by means of phonic features typical of the Andalusian variety and how the users reflect on the use of these phonic features. This project is based on a theoretical framework which combines variationist sociolinguistics with CMC to study the emergence of a style peculiar of the online social networks. In a corpus of Facebook users from three zones of Malaga, I have analysed the use of non-standard phonic features and then compared them with the same features in a reference corpus collected on three beaches of Malaga. From this comparison it can be deduced that the analysed social and linguistic factors work differently in real and virtual speech. Due to these different uses we can consider the peculiar electronic communication of Facebook as a style constrained by the electronic medium. It is a style which serves the users to create social meaning and to express their linguistic identities.