Vincenza Cofini

Evaluation Plan of TERENCE: When the User-Centred Design Meets the Evidence-Based Approach

TERENCE is an FP7 EU project that aims at developing an adaptive learning system with the twofold objective of helping children in improve deep text understanding, and supporting teachers in their daily work. The present paper focuses on the design of the evaluation of the pedagogical effectiveness and the usability of the TERENCE software. It starts from the user-centred design experience, evidence-based medicine, psychology, and from discussions about statistical methods and ethics considerations. The objective is to provide an innovative, evidence-based and efficient support, for children and teachers, that could be an efficient alternative to the traditional method of reading, so as to prevent and reduce problems of text comprehension that represent a public health and social problem. For this purpose, we developed an evaluation protocol within a reading laboratory in collaboration with teachers, to be hosted in the school structures that will join the project in Italy.

The Manual Revision of the TERENCE Italian Smart Games

TERENCE is an FP7 ICT European project, highly multidisciplinary, that is developing an adaptive learning system for supporting poor comprehenders and their educators. The paper describes the automatic smart games generation process in TERENCE, motivates the need for a manual revision and describes it in detail. The paper thus provides a thorough insight in understanding the quality level of the automatic smart games generation process in TERENCE, and the time/effort needed for their manual revisions.

Design smart games with requirements, generate them with a click, and revise them with a GUIs

TERENCE is an FP7 ICT European project that is developing an adaptive learning system for supporting poor comprehenders and their educators. Its learning material are books of stories and games. The games are specialised into smart games, which stimulate inference-making for story comprehension, and relaxing games, which stimulate visual perception and not story comprehension. The paper focuses on smart games. It first describes the TERENCE system architecture, thus delves into the design of smart games starting from the requirements and their automated generation, by highlighting the role of the reasoning module therein. Finally, it outlines the manual revision of the generated smart games, and ends with short conclusions about the planned improvements on the automated generation process.

The TERENCE Smart Games Revision Guidelines and Software Tool

TERENCE is an FP7 ICT European project, highly multidisciplinary, that is developing an adaptive learning system for supporting poor comprehenders and their educators. The paper introduces the automatic smart games generation process in TERENCE and presents the guidelines for the manual revision as well as the software system supporting it.

Unilateral paravertebral block compared with subarachnoid anesthesia for the management of postoperative pain syndrome after inguinal herniorrhaphy: a randomized controlled clinical trial.

Abstract Inguinal herniorrhaphy is a common surgical procedure. The aim of this investigation was to determine whether unilateral paravertebral block could provide better control of postoperative pain syndrome compared with unilateral subarachnoid block (SAB). A randomized controlled study was conducted using 50 patients with unilateral inguinal hernias. The patients were randomized to receive either paravertebral block (S group) or SAB (C group). Paravertebral block was performed by injecting a total of 20 mL of 0.5% levobupivacaine from T9 to T12 under ultrasound guidance, whereas SAB was performed by injecting 13 mg of 0.5% levobupivacaine at the L3 to L4 level. Data regarding anesthesia, hemodynamic changes, side effects, time spent in the postanesthesia care unit, the Karnofsky Performance Status, acute pain and neuropathic disturbances were recorded. Paravertebral block provided good anesthesia of the inguinal region without patient or surgeon discomfort, with better hemodynamic stability and safety and with a reduced time to discharge from the postanesthesia care unit compared with SAB. During the postsurgical and posthospital discharge follow-ups, rest and incident pain and neuropathic positive phenomena were better controlled in the S group than in the C group. The consumption of painkillers was higher in the C group than in the S group throughout the follow-up period. Paravertebral block can be considered a viable alternative to common anesthetic procedures performed for inguinal hernia repair surgery. Paravertebral block provided good management of acute postoperative pain and limited neuropathic postoperative disturbances.

Office hysteroscopic-guided selective tubal chromopertubation: acceptability, feasibility and diagnostic accuracy of this new diagnostic non-invasive technique in infertile women

Abstract The aim of this study was to evaluate accuracy, tolerability and side effects of office hysteroscopic-guided chromoperturbations in infertile women without anaesthesia. Forty-nine infertile women underwent the procedure to evaluate tubal patency and the uterine cavity. Women with unilateral or bilateral tubal stenosis at hysteroscopy with chromoperturbation, and women with bilateral tubal patency who did not conceive during the period of six months, underwent laparoscopy with chromoperturbation. The results obtained from hysteroscopy and laparoscopy in the assessment of tubal patency were compared. Sensitivity, specificity, accuracy, positive-predictive value and negative-predictive value were used to describe diagnostic performance. Pain and tolerance were assessed during procedure using a visual analogue scale (VAS). Side effects or late complications and pregnancy rate were also recorded three and six months after the procedure. The specificity was 87.8% (95% CI: 73.80–95.90), sensitivity was 85.7% (95% CI 57.20–98.20), positive and negative predictive values were 70.6% (95% CI: 44.00–89) and 94.7% (95% CI: 82.30–99.40), respectively. Pregnancy rate (PR) within six months after performance of hysteroscopy with chromoperturbation was 27%. Office hysteroscopy-guided selective chromoperturbation in infertile patients is a valid technique to evaluate tubal patency and uterine cavity.

The addition of continuous wound infusion of local anaesthetics to local infiltration in the management of postoperative pain and rehabilitation after total hip arthroplasty: a double-blind randomized controlled trial

BACKGROUND Total hip arthroplasty is one of the most common procedures in orthopedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anesthetics in the first 72 hours after surgery could provide more effective postoperative analgesia with better rehabilitation. METHODS A double-blind, randomized, controlled study was conducted with 96 patients who underwent total hip arthroplasty. The patients were randomized to receive either a local infiltration analgesia and continuous wound infusion of anesthetics or a local infiltration analgesia and continuous wound infusion of saline solution. The patients in both groups received subarachnoid anesthesia and a local infiltration analgesia. A multihole catheter was placed next to the implant and connected to an electronic pump containing a 300-mL solution of 0.2% levobupivacaine (experimental group) or saline (control group). RESULTS A total of 96 consecutive patients were enrolled and randomized. Of these, 48 patients received local infiltration analgesia and continuous wound infusion of local anesthetics, and the remainder received local infiltration analgesia and continuous wound infusion of saline solution. The analysis showed a significant main effect of treatment on the postoperative incident of pain (Ftreat(1,93)=22.62, P=0.000) and on resting pain during the post-surgery follow-up (Ftreat(1,93)=15.62, P=0.0002). The pain scores during the rehabilitation period were significantly less in the experimental group. Analgesic consumption was less in the experimental group. CONCLUSIONS The addition of continuous wound infusion of anesthetics to local infiltration analgesia provided an extended analgesic effect associated with good rehabilitation performance.

The Pedagogical Evaluation of TERENCE: Preliminary Results for Hearing Learners in Italy

TERENCE is a European FP7 ICT multidisciplinary project that is developing an Adaptive Learning System (ALS) for supporting poor comprehenders and their educators. The paper reports on the evaluation of the pedagogical effectiveness of TERENCE, i.e., its ability of increasing reading comprehension. The evaluation, for hearing children, in Italy, showed the efficiency of TERENCE in the improvement of comprehension ability, by means of silent reading associated with smart games in scholar age.

A Case Study on the Integration of Heterogeneous Data Sources in Public Health

The paper reports on a case study regarding the integration of heterogeneous data sources, coming from different institutions, needed to support several studies related to the health status of the population of L’Aquila (Italy) after the earthquake of April 6th 2009. In detail, the paper initially describes all the health studies, then the data sources required to support them, finally proposes a simplified federated architecture and a straightforward technological solution to implement it.

The effect of voluntary termination of pregnancy on female sexual and emotional well-being in different age groups

Abstract Introduction: To evaluate the impact of voluntary termination of pregnancy (VTOP) on the psycho-sexological well-being of females before/six months after the abortion. Methods: A sample of 194 women was recruited from three obstetrics and gynaecological divisions. The women were evaluated for the variables “sexual functioning” with the Female Sexual Function Index (FSFI), “depression” with the Beck Depression Inventory (BDI-II), and “anxiety state” with the Self-Rating Anxiety Scale (SAS) at time 0 (the beginning of the abortion procedure) and time 1 (six months after the abortion). Since 24 women refused to fill out the questionnaires, the final sample was composed of 170 women. Results: The women showed a slight although significant improvement in the mean FSFI score from time 0 (16.7 ± 12.9) to time 1 (20.9 ± 13.8) (p < 0.001) which paralleled with a slight decrease in the incidence of clinically significant sexual dysfunction [49% (84/170) (time 0) versus 34.1% (58/170) (time 1)], (McNemar’s test; p = 0.0241). The sub-group of younger women (18–25) showed a lesser increase in FSFI score from time 0 to time 1. In addition, both depression (p = 0.048) and anxiety (p < 0.001) significantly decreased over time. However, the female sexuality remained impaired since more than two thirds (69.5%) of women were sexually dysfunctional six months after VTOP. Discussion: Voluntary TOP may influence the sexuality of younger females differently from how it influences that of older women. Hence, the sexuality of younger female should be regularly supervised in follow-up examinations.