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Background: Among the methods that promote quality of life and care, discussing and remembering end-of-life (EOL) wishes for future care may contribute to decision-making about care and the promotion of a good death. Our aim was to investigate the most significant EOL desires among Brazilian cancer patients receiving palliative care (PC)., Methods: This was an exploratory, descriptive, and qualitative study conducted in a Palliative Care Oncology Unit. Fifteen patients played the Go Wish card game (GWCG), choosing and categorizing cards into themes as very important, more or less important, and not important at all. The ten most important cards were discussed, and categories were defined for each card. Cards with the highest frequencies of choice were described. Patients were also asked, "What did playing the cards mean to you?". All data were analyzed using Bardin's content analysis and generated a word cloud to interpret the participants' narratives., Results: Out of the 36 cards, card 19, "I want my family and friends close to me", was the most frequently chosen. Out of the 15 patients studied, only one reported that they initially did not enjoy playing the cards. In this study, the GWCG was effective in fulfilling 90% of the patients' wishes, and this was only possible with the support of the researchers, members of the multi-professional team, and patients' families., Conclusions: The use of the GWCG in the oncology PC setting made an important contribution to open discussions about patients' values and preferences, as well as being an easy-to-use, understandable, and flexible tool. Prioritizing the fulfillment of patients' wishes was one of the main strengths of this study. Our study suggests working with these wishes as a framework for person-centered care.

Introduction: As a result of Industry 5.0's technological advancements, collaborative robots (cobots) have emerged as pivotal enablers for refining manufacturing processes while re-focusing on humans. However, the successful integration of these cutting-edge tools hinges on a better understanding of human factors when interacting with such new technologies, eventually fostering workers' trust and acceptance and promoting low-fatigue work. This study thus delves into the intricate dynamics of human-cobot interactions by adopting a human-centric view. Methods: With this intent, we targeted senior workers, who often contend with diminishing work capabilities, and we explored the nexus between various human factors and task outcomes during a joint assembly operation with a cobot on an ergonomic workstation. Exploiting a dual-task manipulation to increase the task demand, we measured performance, subjective perceptions, eye-tracking indices and cardiac activity during the task. Firstly, we provided an overview of the senior workers' perceptions regarding their shared work with the cobot, by measuring technology acceptance, perceived wellbeing, work experience, and the estimated social impact of this technology in the industrial sector. Secondly, we asked whether the considered human factors varied significantly under dual-tasking, thus responding to a higher mental load while working alongside the cobot. Finally, we explored the predictive power of the collected measurements over the number of errors committed at the work task and the participants' perceived workload. Results: The present findings demonstrated how senior workers exhibited strong acceptance and positive experiences with our advanced workstation and the cobot, even under higher mental strain. Besides, their task performance suffered increased errors and duration during dual-tasking, while the eye behavior partially reflected the increased mental demand. Some interesting outcomes were also gained about the predictive power of some of the collected indices over the number of errors committed at the assembly task, even though the same did not apply to predicting perceived workload levels. Discussion: Overall, the paper discusses possible applications of these results in the 5.0 manufacturing sector, emphasizing the importance of adopting a holistic human-centered approach to understand the human-cobot complex better., Competing Interests: Authors AR and LM were employed by BNP Srl. CP is the CEO of BNP Srl. BNP Srl was a partner of the Co-Adapt project. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers, at the time of submission. PP was Review Editor for Frontiers in Organizational Psychology Employee Well-being and Health and Frontiers in Psychology for Clinical Settings. This had no impact on the peer review process and the final decision., (Copyright © 2023 Pluchino, Pernice, Nenna, Mingardi, Bettelli, Bacchin, Spagnolli, Jacucci, Ragazzon, Miglioranzi, Pettenon and Gamberini.)

Objective(s): To develop a questionnaire that assesses the level of comprehension and decision-making capacity of patients with breast cancer about palliative care and advance care planning. Methods: Questionnaire items were based on the scientific literature. Delphi Consensus, a three-round survey with experts (n  =  14), evaluated the relevance, clarity, and redundancies of the items. A pretest with breast cancer patients (n  =  15) evaluated whether they comprehended each item and identified doubts or discomforts. Results: The initial questionnaire was composed of 38 items. After the Delphi, 18 items were restructured, six were added, and 16 were removed. In the pretest phase, all items with the survey header, guidelines, and Likert model were evaluated. All items accomplished ≥80% cut-off score and were kept as in the original version. The final version of the questionnaire have 28 itens and five domains: determination, responsibility, independence, self-knowledge, and knowledge of reality. Conclusions: This study represents the first step in the development of a questionnaire that may be used in oncology clinical practice. The main findings revealed that Delphi and pretesting increased the quality of the questionnaire, making it compelling to assess breast cancer patients' comprehension and decision-making capacity about PC and ACP.

Background: The Quality of Dying and Death Questionnaire (QoDD) may prove to be an important evaluation tool in the Brazilian context, and, therefore, can contribute to a more precise evaluation of the dying and death process, improving and guiding the end-of-life patient care., Objective: To translate and cross-culturally adapt the QoDD into Brazilian Portuguese and measure its validity (convergent and known-groups) and internal consistency., Design and Setting: A cross-sectional, methodological study was conducted at the Hospital de Câncer de Barretos, Brazil., Methods: A total of 78 family caregivers participated in this study. Semantic, cultural, and conceptual equivalences were evaluated using the content validity index. The construct validity was assessed through convergent validation and known groups analysis [presence of family members at the place of death; feel at peace with dying; and place of death (hospital versus home; hospital versus Palliative Care)]. Internal consistency was evaluated using Cronbach's alpha., Results: The questionnaire was translated into Brazilian Portuguese and presented evidence of a clear understanding of its content. Cronbach's alpha values were ≥ 0.70, except for the domains of treatment preference (α = 0.686) and general concerns (α = 0.599). The convergent validity confirmed a part of the previously hypothesized correlations between the Palliative Care Outcome Scale-Brazil (POS-Br) total scores and the QoDD domain scores. The QoDD-Br domains could distinguish the patients who died in palliative care and general wards., Conclusion: The QoDD-Br is a culturally adapted valid instrument, and may be used to assess the quality of death of cancer patients.

(1) Background: In the context of cancer incurability, the communication processes involving clinicians and patients with cancer are frequently complex. (2) Methods: A cross-sectional study that investigated outpatients with advanced cancers and their oncologists. Both were interviewed immediately after a medical appointment in which there was disease progression and/or clinical deterioration, and were asked about the patient’s chance of curability and the goals of the prescribed cancer treatment. The patients were asked whether they would like to receive information about prognosis and how they would like to receive it. The analyses of agreement on perceptions were performed using the Kappa’s test. (3) Results: the sample consisted of 90 patients and 28 oncologists. Seventy-eight (87.6%) patients answered that they wanted their oncologist to inform them about their prognosis; only 35.2% (n = 31) of them said they received such information at their present appointment. Regarding how they would prefer prognostic disclosure, 61.8% (n = 55) mentioned that the oncologist should consider ways to keep the patient’s hope up; 73% (n = 65) of the patients reported odds >50% of cure. The agreement between oncologists’ and their patients’ perceptions regarding the treatment goals and curability was slight (k = 0.024 and k = 0.017, respectively). (4) Conclusions: The perceptions of patients and their oncologists regarding the goals of treatment and their chances of cure were in disagreement. New approaches are needed to improve the communication process between oncologists and patients with advanced cancer.

Background: Burnout is a syndrome that mostly affects professionals working in contact with patients and their caregivers. In oncology care, nursing professionals are constantly required to provide emotional support for patients and their caregivers, throughout the process of becoming ill, suffering and dying., Objective: To evaluate the prevalence and factors associated with burnout in a sample of nursing professionals at a cancer hospital., Design and Setting: Cross-sectional study conducted at Hospital de Câncer de Barretos., Methods: The study population comprised 655 nursing professionals. Burnout syndrome was assessed using the Maslach Burnout Inventory Human Service Survey. Univariate analysis and binary logistic regression models were used to identify independent predictors associated with burnout., Results: Among 304 nursing professionals included in the study, 27 (8.9%) were classified as presenting burnout according to the two-dimensional criteria, and four (1.3%) were classified based on the three-dimensional criteria. Workplace characteristics were not associated with burnout, while single marital status (odds ratio, OR = 2.695; P = 0.037), perceived workplace stressors, such as impatience with colleagues (OR = 3.996; P = 0.007) and melancholy (OR = 2.840; P = 0.021) were considered to be predictors of burnout. Nursing professionals who would choose the profession again (OR = 0.214; P = 0.001) were least likely to present burnout., Conclusion: Perceived workplace stressors are strongly associated with burnout. Strategies focusing on restructuring of daily work processes and on activities that stimulate positive relationships are important for professionals' health because motivation to continue working in oncology nursing has a protective effect against burnout.

The purpose of this research was to assess how the motor learning skills in 7-years old soccer players can be improved by preventing an internal focus of attention via the use coloured shoes. We painted the classic black soccer shoes in six areas corresponding to six regions of the foot with which it is possible to interact with the ball. Thirty-four 7-years-old soccer players were randomized to two groups (Coloured n = 17 and Black, n = 17) to perform four basic football manoeuvres/tasks: reception (RECP), passing (PASS), ball management (MAGT), and shooting (SHOT). We found highly significant differences (P<0.001) in all four performance tests: mean(sd) RECP: 0.82(0.07) vs. 0.45(0.12); PASS: 0.85(0.07) vs. 0.47(0.09); MAGT: 0.91(0.09); SHOT: 1.00(1.00) vs. 0.44(0.16). Colored shoes appear to draw children's attention away from body centered cues without explicit verbal communications. We propose that this cognitive adaptation enhanced the technical gesture by preventing the negative processes associated with action constraining when adopting an internal focus attention (perhaps by allowing the foot to adapt to surfaces and movements more naturally than conditions that promote a focus on the body movement). Consequently, this type of coloured footwear could be used during childhood to allow children to enhance the performance of basic football exercises through preventing action constraining and promoting intuitive (non-body centered) action knowledge., Competing Interests: The authors have declared that no competing interests exist.

Ataxia Telangiectasia Mutated (ATM) protein kinase is a key effector in the modulation of the functionality of some important stress responses, including DNA damage and oxidative stress response, and its deficiency is the hallmark of Ataxia Telangiectasia (A-T), a rare genetic disorder. ATM modulates the activity of hundreds of target proteins, essential for the correct balance between proliferation and cell death. The aim of this study is to evaluate the phenotypic adaptation at the protein level both in basal condition and in presence of proteasome blockage in order to identify the molecules whose level and stability are modulated through ATM expression. We pursued a comparative analysis of ATM deficient and proficient lymphoblastoid cells by label-free shotgun proteomic experiments comparing the panel of proteins differentially expressed. Through a non-supervised comparative bioinformatic analysis these data provided an insight on the functional role of ATM deficiency in cellular carbohydrate metabolism's regulation. This hypothesis has been demonstrated by targeted metabolic fingerprint analysis SRM (Selected Reaction Monitoring) on specific thermodynamic checkpoints of glycolysis. This article is part of a Special Issue entitled: Translational Proteomics., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) has been proposed as a potent tool to trigger apoptosis in cancer therapy. However, since ∼60% of tumour cell lines and most primary cancers are resistant to TRAIL-induced apoptosis, several combined therapy approaches aimed to sensitize cells to TRAIL have been developed. One of the major targets of these approaches are cFLIP proteins as they interfere with the initiation of apoptosis induction by TRAIL, are over-expressed in many cancers and their down-regulation enhances TRAIL sensitivity. Although, DNA-damaging agents such as 5-fluorouracil (5-FU), etoposide and adriamycin have been successfully employed due to their ability to trigger cFLIP(L) and cFLIP(s) down-regulation the molecular mechanisms underneath their action have been only partially elucidated. We have recently identified ataxia telangiectasia mutated (ATM) as a modulator of cFLIP(L) and cFLIP(S) protein levels in the DNA damage response. Here, we provide genetic evidence that ATM kinase activity is required to trigger 5-FU- and neocarzinostatin-dependent cFLIP(L) and cFLIP(S) down-regulation, which in turn sensitize hepatocellular carcinoma (HCC) cell lines to TRAIL. ATM activity triggers cFLIP proteins down-regulation in HCC cells independently on p53 and enhances cFLIP(L) ubiquitination in response to DNA damage. Therefore, we propose that ATM kinase mediates the interplay between DNA damage and death receptor signalling and suggest that expression of catalytically competent ATM in tumour cells may play a key role for successful combinatorial use of TRAIL receptor agonists and DNA-damaging drugs in cancer therapy.

c-Abl function is strictly dependent on its subcellular localization. Using an in vitro approach, we identify c-Abl as a new substrate for p300, CBP (CREB-binding protein) and PCAF (p300/CBP-associated factor) histone acetyltransferases. Remarkably, acetylation markedly alters its subcellular localization. Point mutagenesis indicated that Lys 730, located in the second nuclear localization signal, is the main target of p300 activity. It has previously been reported that c-Abl accumulates in the cytoplasm during myogenic differentiation. Here, we show that c-Abl protein is acetylated at early stages of myogenic differentiation. Indeed, acetylation on Lys 730 drives c-Abl accumulation in the cytoplasm and promotes differentiation. Thus, Lys 730 acetylation is a novel post-translational modification of c-Abl and a novel mechanism for modulating its subcellular localization that contributes to myogenic differentiation.

Neurophysiological studies were carried out in six female workers of an electromechanical works after accidental exposure to toluene vapours. Electroencephalographic abnormalities and vestibular hyporeflexia were detected immediately after the accident. Six months later the EEG changes were still present, while vestibular findings were found to be markedly improved. Results of this study provide further evidence of the diagnostic value of vestibular investigations after toxic exposure to toluene.