PurposeThe paper aims to contribute to the debate concerning the use of knowledge translation for implementing co-production processes in the healthcare sector. The study investigates a case study, in which design was used to trigger knowledge translation and foster co-production.Design/methodology/approachThe paper employs a case study methodology by analysing the experience of “Oncology in Motion”, a co-production program devoted to the recovery of breast cancer patients carried on by the IRCCS C.R.O. of Aviano, Italy.FindingsResults show how design could help to translate knowledge from various stakeholders with different skills (e.g. scientists, physicians, nurses) and emotional engagement (e.g. patients and patients' associations) during all the phases of a co-production project to support breast cancer patients in a recovery path. Stewardship theory is used to show that oncology represents a specific research context.Practical implicationsThe paper highlights the vast practical contribution that design can have in empowering knowledge translation at different levels and in a variety of co-production phases, among different stakeholders, facilitating their engagement and the achievement of the desired outcomes.Originality/valueThe paper contributes to the literature on knowledge translation in co-production projects in the healthcare sector showing how design can be effectively implemented.

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Knowledge translation (KT) is the ability to make knowledge accessible to different stakeholders by translating it into various contexts. Translating knowledge is particularly crucial in the healthcare sector, which is currently under significant pressure due to technological innovation, increasing demand of services by an ageing population, budget reductions, and new organisational challenges posed by the latest events like the COVID‑19 pandemic. While the first definition of KT was focused on the translation of scientific research into clinical practice, other types of KT later emerged. In healthcare, while stakeholders have different skills and competencies (such as clinical scientists versus physicians or other healthcare professionals), others experience diverse emotional feelings (like the patients or their families). An effective KT allows the transfer, sharing, and creation of new knowledge, enhancing innovation and co‑production dynamics. The paper employs a case study by analysing the Breast Unit of the C.R.O. National Cancer Institue of Aviano, Italy, one of the most acknowledged hospitals and research centres in Europe in the field of cancer surgery and treatments. The paper aims at studying the knowledge translation dynamics and tools by analysing the various relationships with the internal as well as the external stakeholders of the Breast Unit. Internally, knowledge translation is needed to merge the competencies of highly skilled multidisciplinary teams, which include surgeons and physicians with various specialities, researchers, psychologists, nurses and other healthcare professionals. Externally, knowledge is translated to meet the needs of patients, patients' associations, sponsors, citizens, and policymakers. Results highlight how different techniques and dynamics allow KT to happen within internal as well as external groups. Contributing to the knowledge management and knowledge translation theories, our findings open up to practical as well as research implications.

IntroductionThe present study aims to describe: 1. How the side effects of radiotherapy (RT) could impact sexual health in women; 2. The effectiveness of physical rehabilitation including pelvic floor muscle training (PFMT) in the management of sexual dysfunction after RT.Materials and MethodsSearch keys on PubMed, Web of Science, Scopus, PEDro, and Cochrane were used to identify studies on women treated with radical or adjuvant RT and/or brachytherapy for gynecological cancers with an emphasis on vulvo-vaginal toxicities and PFMT studies on sexual dysfunction for this group of women.ResultsRegarding the first key question, we analyzed 19 studies including a total of 2,739 women who reported vaginal dryness, stenosis, and pain as the most common side effects. Reports of dosimetric risk factors and dose-effect data for vaginal and vulvar post-RT toxicities are scant. Only five studies, including three randomized controlled trials (RCTs), were found to report the effect of PFMT alone or in combination with other treatments. The results showed some evidence for the effect of training modalities including PFMT, but to date, there is insufficient evidence from high-quality studies to draw any conclusion of a possible effect.ConclusionsGynecological toxicities after RT are common, and their management is challenging. The few data available for a rehabilitative approach on post-actinic vulvo-vaginal side effects are encouraging. Large and well-designed RCTs with the long-term follow-up that investigate the effect of PFMT on vulvo-vaginal tissues and pelvic floor muscle function are needed to provide further guidance for clinical management.

Telemedicine and remote visits are becoming more and more popular in several medical disciplines, including oncology. The Covid-19 pandemic has enhanced the need to continue to meet patients' ambulatory care necessities ensuring social distancing and limiting the access to clinical facilities. The National Cancer Institute of Aviano, Italy, has recently launched a program called "Doctor @ Home" (D@H). The pillars of the program are the co-production of the oncological care and the co-learning approach, which sees the clinical staff "hand in hand" with patients to maximize the outcome of the care, trying to take advantage of the new tools offered by modern technologies.

Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.

In the United States, from 1999 to 2019, opioid overdose, either regularly prescribed or illegally acquired, was the cause of death for nearly 500,000 people. In addition to this pronounced mortality burden that has increased gradually over time, opioid overdose has significant morbidity with severe risks and side effects. As a result, opioid misuse is a cause for concern and is considered an epidemic. This article examines the trends and consequences of the opioid epidemic presented in recent international literature, reflecting on the causes of this phenomenon and the possible strategies to address it. The detailed analysis of 33 international articles highlights numerous impacts in the social, public health, economic, and political spheres. The prescription opioid epidemic is an almost exclusively North American problem. This phenomenon should be carefully evaluated from a healthcare systems perspective, for consequential risks and harms of aggressive opioid prescription practices for pain management. Appropriate policies are required to manage opioid use and prevent abuse efficiently. Examples of proper policies vary, such as the use of validated questionnaires for the early identification of patients at risk of addiction, the effective use of regional and national prescription monitoring programs, and the proper dissemination and translation of knowledge to highlight the risks of prescription opioid abuse.