Adulthood with Turner Syndrome: Quality of life, psychosocial adjustment and clinical management in 70 Italian women

Abstract Background: Turner syndrome (TS) is a chromosomal abnormality (total or partial absence of one of the sexual chromosomes in some or all cells of the body), which affects approximately 1:2000 female. Principal characteristics are short stature and gonadal disgenesis. Clinical management consist of Growth Hormone (GH) treatment and oestrogen replacement therapy (HRT), to induce development of secondary characteristics and to avoid the sequelae of oestrogen deficiency. Aim of the study: To assess clinical management, quality of life (QoL) and general psychosocial adjustment of women with TS. Population: 70 adult Caucasian females with TS (mean age: 27.8, ± 7.6; range 18-48 y.). Setting: Specialist service for Rare Disease care, University Hospital. Methods: Subjects were required to fill in questionnaires collecting ASR, WHOQOL, and 8 open questions. Data were compared with those of the Italian population or to those collected in a comparison group (70 healthy females, mean age: 27.9, ±7.3, range 21-48 y.). Results: Women with TS are educated as well as the Italian Population, but they have a less successful professional life. They show good QoL in general, but they appeared less satisfied in social area. They had statistically higher scores than the comparison group for depression, anxiety and withdrawal. Are less involved in a love relationship. Diagnosis communication was mostly performed by doctors or parents, satisfaction was higher when information was given by parents. Main preoccupation about TS are infertility, feeling of being different and future health problem. Conclusions: Italian people with TS were generally well adapted and have a good QoL, but lived more often with parents and show impaired sentimental and sexual life. They have higher degree of psychological distress compared to a comparison group. Psychological intervention should firstly address parents in order to encourage an open communication on diagnosis issues and on sexual education.

Proposta di sottotitolaggio e analisi di un episodio della serie Game of Thrones

Lo scopo della seguente tesi è di presentare una proposta e analisi di sottotitolaggio dell’episodio Blackwater della seconda stagione della serie Game of Thrones. A spingermi a scegliere questo tema è stata la mia passione per la serie e la saga di libri da cui è stata adattata e il desiderio di redigerne i sottotitoli. È stata un’esperienza utile e stimolante perché mi ha dato la possibilità di mettere in pratica le nozioni teoriche acquisite durante questi anni di studio. Il mio lavoro si sviluppa in tre capitoli e un’appendice. Il primo capitolo è dedicato alla contestualizzazione dell’episodio. Nel secondo capitolo sono analizzati gli aspetti tecnici della traduzione multimediale e del sottotitolaggio. Il terzo capitolo contiene l’analisi delle principali difficoltà incontrate nel processo traduttivo, mentre l’appendice contiene la tabella dei sottotitoli sia in inglese sia in italiano.

The role of language in tv shows and its impact on the audience: A linguistic analysis of Game of Thrones

Through the analysis of American TV show Game of Thrones, this dissertation will focus on the linguistic issues concerning the adaptation from books to television, the power of language over the audience, and the creation of two languages, with all the linguistic and cultural implications related to this phenomenon.

Recycling of end of life concrete fines (0 - 4 mm) into silica and cement

The purpose of this work is to find a methodology in order to make possible the recycling of fines (0 - 4 mm) in the Construction and Demolition Waste (CDW) process. At the moment this fraction is a not desired by-product: it has high contaminant content, it has to be separated from the coarse fraction, because of its high water absorption which can affect the properties of the concrete. In fact, in some countries the use of fines recycled aggregates is highly restricted or even banned. This work is placed inside the European project C2CA (from Concrete to Cement and Clean Aggregates) and it has been held in the Faculty of Civil Engineering and Geosciences of the Technical University of Delft, in particular, in the laboratory of Resources And Recycling. This research proposes some procedures in order to close the loop of the entire recycling process. After the classification done by ADR (Advanced Dry Recovery) the two fractions "airknife" and "rotor" (that together constitute the fraction 0 - 4 mm) are inserted in a new machine that works at high temperatures. The temperatures analysed in this research are 600 °C and 750 °C, cause at that temperature it is supposed that the cement bounds become very weak. The final goal is "to clean" the coarse fraction (0,250 - 4 mm) from the cement still attached to the sand and try to concentrate the cement paste in the fraction 0 - 0,250 mm. This new set-up is able to dry the material in very few seconds, divide it into two fractions (the coarse one and the fine one) thanks to the air and increase the amount of fines (0 - 0,250 mm) promoting the attrition between the particles through a vibration device. The coarse fraction is then processed in a ball mill in order to improve the result and reach the final goal. Thanks to the high temperature it is possible to markedly reduce the milling time. The sand 0 - 2 mm, after being heated and milled is used to replace 100% of norm sand in mortar production. The results are very promising: the mortar made with recycled sand reaches an early strength, in fact the increment with respect to the mortar made with norm sand is 20% after three days and 7% after seven days. With this research it has been demonstrated that once the temperature is increased it is possible to obtain a clean coarse fraction (0,250 - 4 mm), free from cement paste that is concentrated in the fine fraction 0 - 0,250 mm. The milling time and the drying time can be largely reduced. The recycled sand shows better performance in terms of mechanical properties with respect to the natural one.

Spondylodiscitis in the elderly patient: clinical mid-term results and quality of life

Focusing on spondylodiscitis in elderly patients current literature does not contain much information.

Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents' well-being and health-related quality of life

Background To assess the criterion and construct validity of the KIDSCREEN-10 well-being and health-related quality of life (HRQoL) score, a short version of the KIDSCREEN-52 and KIDSCREEN-27 instruments. Methods The child self-report and parent report versions of the KIDSCREEN-10 were tested in a sample of 22,830 European children and adolescents aged 8–18 and their parents (n = 16,237). Correlation with the KIDSCREEN-52 and associations with other generic HRQoL measures, physical and mental health, and socioeconomic status were examined. Score differences by age, gender, and country were investigated. Results Correlations between the 10-item KIDSCREEN score and KIDSCREEN-52 scales ranged from r = 0.24 to 0.72 (r = 0.27–0.72) for the self-report version (proxy-report version). Coefficients below r = 0.5 were observed for the KIDSCREEN-52 dimensions Financial Resources and Being Bullied only. Cronbach alpha was 0.82 (0.78), test–retest reliability was ICC = 0.70 (0.67) for the self- (proxy-)report version. Correlations between other children self-completed HRQoL questionnaires and KIDSCREEN-10 ranged from r = 0.43 to r = 0.63 for the KIDSCREEN children self-report and r = 0.22–0.40 for the KIDSCREEN parent proxy report. Known group differences in HRQoL between physically/mentally healthy and ill children were observed in the KIDSCREEN-10 self and proxy scores. Associations with self-reported psychosomatic complaints were r = −0.52 (−0.36) for the KIDSCREEN-10 self-report (proxy-report). Statistically significant differences in KIDSCREEN-10 self and proxy scores were found by socioeconomic status, age, and gender. Conclusions Our results indicate that the KIDSCREEN-10 provides a valid measure of a general HRQoL factor in children and adolescents, but the instrument does not represent well most of the single dimensions of the original KIDSCREEN-52. Test–retest reliability was slightly below a priori defined thresholds.

Predictors of readmission and health related quality of life in patients with chronic heart failure: a comparison of different psychosocial aspects

Psychological distress is common in patients with chronic heart failure. The impact of different psychological variables on prognosis has been shown but the comparative effects of these variables remain unclear. This study examines the impact of depression, anxiety, vital exhaustion, Type D personality, and social support on prognosis in chronic heart failure patients. One hundred eleven patients (mean age 57 ± 14 years) having participated in an exercise based ambulatory cardiac rehabilitation program were enrolled in a prospective cohort study. Psychological baseline data were assessed at program entry. Mortality, readmission, and health-related quality of life were assessed at follow up (mean 2.8 ± 1.1 years). After controlling for disease severity none of the psychological variables were associated with mortality, though severe anxiety predicted readmission [HR = 3.21 (95% CI, 1.04-9.93; P = .042)]. Health-related quality of life was independently explained by vital exhaustion, anxiety and either body mass index (physical dimension) or sex (emotional dimension). As psychological variables have a strong impact on health-related quality of life they should be routinely assessed in chronic heart failure patients` treatment.

Scoliosis surgery: correction not correlated with instrumentation, quality of life not correlated with correction or instrumentation

The authors conducted a retrospective study on 24 consecutive adolescent scoliosis patients, 11 of whom were instrumented with hooks and 13 with hooks and screws (hybrid technique). The mean preoperative Cobb angle was 62.2 degrees (range: 48 degrees-96 degrees). The mean correction of the primary curve was 56.6% at followup after +/- 1.18 years ; there was no statistically significant difference between groups. Special attention was given to the postoperative quality of life (QOL) by means of the following scores: COMI patient self-assessment, SF-36, ODI, and VAS. Again, there was no statistical difference between groups but, interestingly, there was no correlation between QOL and degree of correction, after a follow-up period of +/- 2.1 years. Nevertheless, on the COMI patient self-assessment, there was a high level of satisfaction with treatment. Further studies should concentrate on how to achieve a high QOL, and abandon the best possible correction as a primary endpoint of success.

Quality of life 9 years after an intensive care unit stay: A long-term outcome study

The purpose of the study was to assess long-term mortality after an intensive care unit (ICU) stay and to test the hypotheses that (1) quality of life improves over time and (2) predictions of outcome made by caregivers during an ICU stay are reliable.

Heart valve sound of various mechanical composite grafts, and the impact on patients' quality of life

The closing sounds of mechanical heart valves can be disturbing for patients and their closest relatives. Although some investigations into mechanical heart valve sounds have been performed, the particularities of the valve sound when it is attached to a vascular prosthesis to replace the aortic root and the ascending aorta has not been studied to date. The study aim was to compare the closing sounds of three various mechanical composite graft prostheses, and to analyze the impact of such sounds on the patients' quality of life.

Longitudinal analysis of quality of life in patients receiving conformal radiation therapy for prostate cancer

To prospectively assess quality of life (QoL) in patients receiving conformal radiation therapy (CRT) for prostate cancer.