Digital Interventions for Psychological Comorbidities in Chronic Diseases-A Systematic Review.

Chronic diseases represent one of the main causes of death worldwide. The integration of digital solutions in clinical interventions is broadly diffused today; however, evidence on their efficacy in addressing psychological comorbidities of chronic diseases is sparse. This systematic review analyzes and synthesizes the evidence about the efficacy of digital interventions on psychological comorbidities outcomes of specific chronic diseases. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of PubMed, PsycInfo, Scopus and Web of Science databases was conducted. Only Randomized Controlled Trials (RCTs) were considered and either depression or anxiety had to be assessed to match the selection criteria. Of the 7636 identified records, 17 matched the inclusion criteria: 9 digital interventions on diabetes, 4 on cardiovascular diseases, 3 on Chronic Obstructive Pulmonary Disease (COPD) and one on stroke. Of the 17 studies reviewed, 14 found digital interventions to be effective. Quantitative synthesis highlighted a moderate and significant overall effect of interventions on depression, while the effect on anxiety was small and non-significant. Design elements making digital interventions effective for psychological comorbidities of chronic diseases were singled out: (a) implementing a communication loop with patients and (b) providing disease-specific digital contents. This focus on "how" to design technologies can facilitate the translation of evidence into practice.

The Benefits of emotion Regulation Interventions in Virtual Reality for the Improvement of Wellbeing in Adults and Older Adults: A Systematic Review.

The impact of emotion regulation interventions on wellbeing has been extensively documented in literature, although only in recent years virtual reality (VR) technologies have been incorporated in the design of such interventions, in both clinical and non-clinical settings. A systematic search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, was therefore carried out to explore the state of the art in emotion regulation interventions for wellbeing using virtual reality. The literature on this topic was queried, 414 papers were screened, and 11 studies were included, covering adults and older adults. Our findings offer an overview of the current use of VR technologies for the enhancement of emotion regulation (ER) and wellbeing. The results are promising and suggest that VR-based emotion regulation training can facilitate the promotion of wellbeing. An overview of VR-based training interventions is crucial for better understanding how to use these tools in the clinical settings. This review offers a critical debate on the structure of such intervention protocols. It also analyzes and highlights the crucial role played by the selection of the objective and subjective wellbeing assessment measures of said intervention protocols.

Episode of Situated Learning to Enhance Student Engagement and Promote Deep Learning: Preliminary Results in a High School Classroom.

Teaching is now experiencing a new centrality due to the fast socio-cultural transformations, the vertical growth of digital media and, therefore, the new ways children and young people learn. New paradigms and teaching methodologies are emerging to meet the new educational needs; among them, the "Episodes of Situated Learning" approach (EAS in Italian) was chosen for this study. This approach broadly refers to the "Flipped Class" model, in which the lesson structure reverses the traditional teaching/learning cycle with a positive outcome on engagement and learning. The present study aims to explore whether the EAS teaching methodology, according to literature about the Flipped Class model, has a positive outcome on student engagement, focusing on its emotional, cognitive and behavioral components. In particular, we hypothesize that the EAS teaching methodology changes teachers' behavior in classroom, increasing their movements and body expression during the lesson. Moreover, we expect higher levels of self-efficacy and positive emotions and lower levels of perceived anxiety in teachers, thus improving students' level of engagement. The research was conducted in a secondary school, in Milan, and includes a classroom of sixteen students and three teachers. We chose a quasi-experimental nested design, a mixed-method approach that combines the qualitative and quantitative collection and analysis of data, in order to reach, as far as possible, a holistic, effective and exhaustive representation of the studied phenomenon. Pre-post measures, including video-recording, systematic observation and questionnaires, of both students and teachers were collected during the 8 months of experimentation. This research project could foster positive outcomes for participants as well as the broader society, in which school dropout is increasing. Many authors positively associate low levels of students' engagement to high rates of school dropout; for this reason, working on improving teaching methodologies and students' engagement measurement, could be an effective way to enhance learning and opposing school dropout.

Negative social emotions and cognition: Shame, guilt and working memory impairments.

Negative emotions can have an impact on a variety of cognitive domains, including Working Memory (WM). The present work investigated whether shame and guilt modulate WM performance in a dual-task test both in a non-clinical and a clinical population. In Experiment 1, 76 non-clinical participants performed a dual-task before and after being randomly assigned to shame, guilt or neutral inductions elicited by the writing of autobiographical past experiences. Shame and guilt elicitations were related to impaired WM performances. In Experiment 2, 65 clinical inpatients with eating disorders were assigned to the same procedure. The negative relationship of self-conscious emotions and WM was confirmed. Taken together these results suggest that shame and guilt are related to impairments of WM in both clinical and non-clinical participants.

T-Pattern Analysis and Cognitive Load Manipulation to Detect Low-Stake Lies: An Exploratory Study.

Deception has evolved to become a fundamental aspect of human interaction. Despite the prolonged efforts in many disciplines, there has been no definite finding of a univocally "deceptive" signal. This work proposes an approach to deception detection combining cognitive load manipulation and T-pattern methodology with the objective of: (a) testing the efficacy of dual task-procedure in enhancing differences between truth tellers and liars in a low-stakes situation; (b) exploring the efficacy of T-pattern methodology in discriminating truthful reports from deceitful ones in a low-stakes situation; (c) setting the experimental design and procedure for following research. We manipulated cognitive load to enhance differences between truth tellers and liars, because of the low-stakes lies involved in our experiment. We conducted an experimental study with a convenience sample of 40 students. We carried out a first analysis on the behaviors' frequencies coded through the observation software, using SPSS (22). The aim was to describe shape and characteristics of behavior's distributions and explore differences between groups. Datasets were then analyzed with Theme 6.0 software which detects repeated patterns (T-patterns) of coded events (non-verbal behaviors) that regularly or irregularly occur within a period of observation. A descriptive analysis on T-pattern frequencies was carried out to explore differences between groups. An in-depth analysis on more complex patterns was performed to get qualitative information on the behavior structure expressed by the participants. Results show that the dual-task procedure enhances differences observed between liars and truth tellers with T-pattern methodology; moreover, T-pattern detection reveals a higher variety and complexity of behavior in truth tellers than in liars. These findings support the combination of cognitive load manipulation and T-pattern methodology for deception detection in low-stakes situations, suggesting the testing of directional hypothesis on a larger probabilistic sample of population.

Measuring Dispositional Flow: Validity and reliability of the Dispositional Flow State Scale 2, Italian version.

OBJECTIVE: The aim of this study is to evaluate the psychometric properties of the Italian version of the Dispositional Flow Scale-2 (DFS-2), for use with Italian adults, young adults and adolescents. METHOD: In accordance with the guidelines for test adaptation, the scale has been translated with the method of back translation. The understanding of the item has been checked according to the latest standards on the culturally sensitive translation. The scale thus produced was administered to 843 individuals (of which 60.69% female), between the ages of 15 and 74. The sample is balanced between workers and students. The main activities defined by the subjects allow the sample to be divided into three categories: students, workers, athletes (professionals and semi-professionals). RESULTS: The confirmatory factor analysis, conducted using the Maximum Likelihood Estimator (MLM), showed acceptable fit indexes. Reliability and validity have been verified, and structural invariance has been verified on 6 categories of Flow experience and for 3 subsamples with different with different fields of action. Correlational analysis shows significant high values between the nine dimensions. CONCLUSIONS: Our data confirmed the validity and reliability of the Italian DFS-2 in measuring Flow experiences. The scale is reliable for use with Italian adults, young adults and adolescents. The Italian version of the scale is suitable for the evaluation of the subjective tendency to experience Flow trait characteristic in different contest, as sport, study and work.

How Game Location Affects Soccer Performance: T-Pattern Analysis of Attack Actions in Home and Away Matches.

The influence of game location on performance has been widely examined in sport contexts. Concerning soccer, game-location affects positively the secondary and tertiary level of performance; however, there are fewer evidences about its effect on game structure (primary level of performance). This study aimed to detect the effect of game location on a primary level of performance in soccer. In particular, the objective was to reveal the hidden structures underlying the attack actions, in both home and away matches played by a top club (Serie A 2012/2013-First Leg). The methodological approach was based on systematic observation, supported by digital recordings and T-pattern analysis. Data were analyzed with THEME 6.0 software. A quantitative analysis, with nonparametric Mann-Whitney test and descriptive statistics, was carried out to test the hypotheses. A qualitative analysis on complex patterns was performed to get in-depth information on the game structure. This study showed that game tactics were significantly different, with home matches characterized by a more structured and varied game than away matches. In particular, a higher number of different patterns, with a higher level of complexity and including more unique behaviors was detected in home matches than in the away ones. No significant differences were found in the number of events coded per game between the two conditions. THEME software, and the corresponding T-pattern detection algorithm, enhance research opportunities by going further than frequency-based analyses, making this method an effective tool in supporting sport performance analysis and training.

Shame proneness and eating disorders: a comparison between clinical and non-clinical samples.

PURPOSE: To explore the relationship between shame proneness, eating disorders outcomes and psychological aspects of patients with eating disorders (ED). METHODS: Sixty-six girls applying for inpatient treatment for ED and 110 female undergraduate students were assessed using the Eating Disorder Inventory-3 and the Shame Proneness Scale of the Test of Self-Conscious Affect. RESULTS: Shame proneness showed significant correlations with several ED components and psychological scales of EDI-3, with some variations across the subgroups. Shame proneness levels were significantly higher in the clinical group than in controls. CONCLUSIONS: Shame proneness can be an important component for the development and the maintenance of ED due to a strong correlation not only with ED symptoms but also with psychological aspects of this disease, in both clinical and non-clinical samples.

T-pattern analysis in soccer games: relationship between time and attack actions / Detección de T-pattern en los partidos de fútbol: relación entre las acciones del equipo y de ataque / Análise T-pattern em jogos de futebol: relação entre as ações do tempo e de ataque

Sports performance consists of a multiple series of strategies that tend to follow one another. Performance analysis in team sports is usually focused on primary (fundamental skill execution), secondary (scoring) and tertiary (match result) outcomes. While there is general agreement over measuring secondary and tertiary outcomes, literature does not show a unanimous agreement over a unique measure of the primary level of performance. The aim of this study was to investigate primary performance outcomes through an analysis of temporal patterns. In particular, we were interested in verifying if changes in tertiary performance outcomes may be related to changes in primary ones. We selected three soccer matches played by a top club during the Serie A league over the 2012-2013 season in which there was a change in match result between first and second half (tertiary level of performance). The methodological approach was based on observational design, supported by digital recordings and computer analysis. Data were analyzed with theme 6 beta software, which detects the temporal and sequential structure of datasets, revealing repeated patterns that may regularly or irregularly occur within a period of observation (Tpatterns). Striking differences were found comparing first and second half temporal patterns, especially when the final match outcome showed an improvement of the first half ’s one. Our results suggest that theme software and T-pattern enhance research opportunities by identifying a useful tool to study the link between primary and tertiary level of performance, making this an effective research and support instrument for sports analysis (AU)

El rendimiento en el deporte viene condicionado por múltiples estrategias que tienden a sucederse entre sí. El análisis del rendimiento en los deportes de equipo se centra especialmente en resultados primarios (ejecución de competencias básicas), secundarios (marcadores al puntuar) y terciarios (resultados de los partidos). Mientras que existe un acuerdo general acerca de cómo medir los resultados secundarios y terciarios, la literatura no es tan unánime respecto a hallar una única medida relativa al nivel primario de rendimiento. El objetivo de este estudio es la investigación acerca de estos resultados primarios de rendimiento mediante un análisis de patrones temporales. En concreto, estamos interesados en verificar si los cambios en resultados terciarios están relacionados con los primarios. Seleccionamos tres partidos de fútbol que se jugaron en un club situado en muy buena posición durante la liga de la Serie A en la temporada 2012-2013, en la cual se produjeron cambios en el resultado entre la primera y segunda mitad de los partidos (nivel secundario de rendimiento). El planteamiento metodológico se ha basado en un diseño observacional, que se ha desplegado mediante el apoyo de registros digitales y análisis informatizados. Los datos se analizaron mediante el programa informático Theme 6 beta, que permite detectar la estructura temporal y secuencial de los datos, detectándose patrones repetidos que pueden ocurrir de forma regular o irregular en el período de observación (T-patterns). Se hallaron diferencias sorprendentes al comparar los patrones temporales de la primera y segunda mitad, y especialmente cuando el resultado final del partido mostraba una mejora del marcador respecto a la primera mitad. Nuestros resultados sugieren que el programa Theme aporta posibilidades de mejora en la investigación, convirtiéndose en un instrumento útil para estudiar la conexión existente entre los niveles primario y terciario de rendimiento, a la vez que se demuestra que es un importante apoyo para una investigación eficaz en el deporte

O rendimento no desporto está condicionado por múltiplas estratégias que tendem a suceder-se entre si. A análise do rendimento nos desportos de equipa centra-se especialmente nos resultados primários (execução de competências básicas), secundários (pontuação), terciários (resultados dos jogos). Embora exista um consenso geral acerca de como medir os resultados secundários e terciários, a literatura não é tão unanime no que concerne a uma única medida relativa ao nível primário de rendimento. O objectivo deste estudo é a investigação acerca destes resultados primários de rendimento através da análise de padrões temporais. Em concreto, estamos interessados em verificar se as mudanças nos resultados terciários estão relacionadas com os primários. Seleccionámos três jogos de futebol de um clube em muito boa posição classificativa durante a liga Serie A na temporada de 2012-2013, no qual se produziram alterações entre no resultado entre a primeira e a segunda metade dos jogos (nível secundário de rendimento). O planeamento metodológico baseou-se num delineamento observacional, que se levou a cabo com o apoio de registos digitais e de análises informatizadas. Os dados foram analisados através do programa informático Theme 6 beta, que permite detectar a estructura temporal e sequencial dos dados, detectando-se padrões repetidos que podem ocorrer de forma regular ou irregular no período de observação (T-patterns). Foram verificadas diferenças surpreendentes ao comparar os padrões temporais da primeira e segunda parte, e especialmente quando o resultado final do jogo revelava uma melhoria do marcador relativamente à primeira parte. Os nossos resultados sugerem que o programa Theme permite possibilidades de melhoria na investigação, convertendo-se num instrumento útil para estudar a conexão existente entre os níveis primário e terciário de rendimento, demonstrando de igual modo que é um importante suporte para a investigação no contexto desportivo

Detecting regularities in soccer dynamics: a T-pattern approach / Detección de regularidades en la dinámica del fútbol: un enfoque desde los t-pattern

The dynamics of play during professional soccer matches are complex phenomena that traditional approaches to the quantification of team sports are not fully able to identify. The aim of this study was to detect such dynamics through an analysis of temporal patterns. In particular, the objective was to reveal the hidden yet stable structures which underlie the interactive situations that determine the attack actions of play in soccer. The methodological approach is based on observational design, supported by digital recordings and computer analysis. Data were analyzed with Theme 6 beta software, which detects the temporal and sequential structure of data sets, revealing repeated patterns that may regularly or irregularly occur within a period of observation. Theme detected many temporal patterns (T-patterns) in the soccer matches analyzed. Striking differences were found when won and lost matches were compared. The number of pattern occurrences and the number of different T-patterns detected was greater for lost matches and lower for the won matches, whereas the number of events coded was similar. Theme software and T-pattern enhance research opportunities by moving further than frequency-based analysis of performance, making this method an effective research and support tool for sports analysis. Our results indicate a need for further investigation upon the possible links between temporal structure detection and human observations in soccer performance. This approach could assist both soccer teams’ staff and coaches in obtaining a greater understanding of game dynamics, providing information that current methods may overlook or not detect at all

La dinámica del juego en partidos de fútbol profesional es un fenómeno complejo que no ha estado resuelto de forma óptima a través de las vías tradicionales que han pretendido la cuantificación en deportes de equipo. El objetivo de este estudio es el de detectar la dinámica existente mediante un análisis de patrones temporales. Específicamente, se pretenden revelar las estructuras ocultas pero estables que subyacen a las situaciones interactivas que determinan las acciones de ataque en el fútbol. El planteamiento metodológico se basa en un diseño observacional, y con apoyo de registros digitales y análisis informatizados. Los datos se analizaron mediante el programa Theme 6 beta, el cual permite detectar la estructura temporal y secuencial de las series de datos, poniendo de manifiesto patrones que regular o irregularmente ocurren repetidamente en un período de observación. El Theme ha detectado muchos patrones temporales (T-patterns) en los partidos de fútbol analizados. Se hallaron notables diferencias entre los partidos ganados y perdidos. El número de distintos T-patterns detectados fue mayor para los partidos perdidos, y menor para los ganados, mientras que el número de eventos codificados fue similar. El programa Theme y los T-patterns mejoran las posibilidades investigadoras respecto a un análisis de rendimiento basado en la frecuencia, y hacen que esta metodología sea eficaz para la investigación y constituya un apoyo procedimental en el análisis del deporte. Nuestros resultados indican que se requieren posteriores investigaciones relativas a posibles conexiones entre la detección de estas estructuras temporales y las observaciones humanas respecto al rendimiento en el fútbol. Este planteamiento sería un apoyo tanto para los miembros de los equipos como para los entrenadores, permitiendo alcanzar una mejor comprensión de la dinámica del juego y aportando una información que no ofrecen los métodos tradicionales

A dinâmica do jogo em competições de futebol de competição é um fenómeno complexo que não é abordado de forma suficiente através das vias tradicionais que se pretendem na qualificação em desportos de equipa. O objectivo deste estudo é detectar a dinâmica existente mediante uma análise de padrões temporais. Especificamente, pretende-se revelar as estructuras ocultas mas estáveis subjacentes às situações interactivas que determinam as acções de ataque no futebol. O planeamento metodológico baseia-se no delineamento observacional, a registos digitais e a análises informatizadas. Os dados foram analisados mediante o programa Theme 6 beta, o qual permite detectar a estrutura temporal e sequencial das séries de dados, pondo em relevo padrões que regular ou irregularmente ocorrem repetidamente num período de observação. O Theme detectou vários padrões temporais (padrões- T) nos jogos de futebol analisados. Verificaram-se notáveis diferenças entre os jogos ganhos e perdidos. O número de distintos padrões-T detectados foi maior para os jogos perdidos, e menor para os ganhos, enquanto que o número de eventos codificados foi semelhante. O programa Theme e os padrões- T melhoram as possibilidades de investigação a respeito da análise de rendimento baseada na frequência, fazendo com que esta metodologia seja eficaz para a investigação e se constitua como um suporte procedimental na análise desportiva. Os resultados obtidos requerem posteriores investigações relativas às possíveis conexões entre a detecção destas estruturas temporais e as observações humanas relativas ao rendimento no futebol. Este planeamento seria um suporte tanto para os membros das equipas como para os treinadores, permitindo alcançar uma melhor compreensão da dinâmica de jogo e fornecendo informação que não se obtém através dos métodos tradicionais

Short-term effects of local microwave hyperthermia on pain and function in patients with mild to moderate carpal tunnel syndrome: a double blind randomized sham-controlled trial.

OBJECTIVE: To determine the short-term effects of local microwave hyperthermia on pain and function in patients with mild to moderate idiopathic carpal tunnel syndrome. DESIGN: Double-blind randomized sham-controlled trial. SETTING: Outpatient clinic of the Department of Physical Medicine and Rehabilitation, University Hospital. PARTICIPANTS: Twenty-two patients with idiopathic carpal tunnel syndrome, 12 of whom had bilateral involvement, for a total of 34 wrists, divided into two groups: a hyperthermia active treatment group (number of wrists = 17) and a sham-controlled group (number of wrists = 17). INTERVENTION: Six sessions, two per week, of either hyperthermia or sham treatment were provided over a period of three weeks. MAIN MEASURES: Visual analogue scale, Levine-Boston Self-Assessment Questionnaire (part I: evaluation of pain intensity; part II: evaluation of functional status) and neurophysiological assessments, were determined at baseline and at the end of the treatment. RESULTS: The hyperthermia group experienced a significant improvement in pain (visual analogue scale: P = 0.002; Levine-Boston part I: P < 0.0001) and functional status (Levine-Boston part II: P = 0.002) relative to baseline. No improvements in pain intensity or functionality were observed in the sham-treated group. Changes in pain severity between baseline and the end of treatment were larger in the hyperthermia group than in the sham-controlled group (Δ visual analogue scale P = 0.004; Δ Levine-Boston part I: P = 0.009). No differences either intra or between groups were observed for median nerve conduction velocity. CONCLUSION: Hyperthermia provides short-term improvements in pain and function in patients with mild to moderate carpal tunnel syndrome.

Effects of rehabilitation treatment on thyroid function.

OBJECTIVE: The aim of the study was to evaluate the effects of an intensive rehabilitation programme on thyroid metabolism, the relationship between disability and thyroid hormone level, and the occurrence of nonthyroidal illness syndrome (NTIS) before and after rehabilitation. DESIGN, SUBJECTS AND MEASUREMENTS: This was a clinical prospective study. Orthopaedic surgery patients (n = 82) were classified into two groups: patients in whom early active mobilization and walking were possible (walking group, WG, n = 45), and patients in whom these were not recommended (nonwalking group, NWG, n = 37). Levels of free T3 (fT3), fT4, TSH and rT3 were measured before and after surgery, and then at 1, 3, 7, 14 and 30 days from the beginning of rehabilitation. Personal, nutritional and clinical data were acquired for all patients. The Barthel Index (BI) was used to assess disability before and after rehabilitation. RESULTS: Immediately after surgery, both groups of patients showed a significant decrease in mean fT3 concentrations and a significant increase in rT3; mean fT4 values decreased significantly only in NWG patients. Once rehabilitation had been completed, fT3 and rT3 levels returned to baseline values in WG patients. In NWG patients mean fT3 and fT4 levels continued to decrease significantly and rT3 values remained significantly high until the end of rehabilitation. NTIS occurred in 38% of the NWG patients. No significant changes in TSH levels were observed in either group. Finally, we observed a direct correlation between fT3 levels and the BI in WG patients. CONCLUSIONS: Our data suggest that early patient mobilization and physical activity during an active and intensive rehabilitation programme induce recovery of thyroid function and avoid occurrence of NTIS.

[Criteria for classification of upper limb work-related musculo-skeletal disorders due to biomechanical overload in occupational health. Consensus document by an Italian Working Group]. / Criteri per la trattazione e la classificazione di casi di malattia da sovraccarico biomeccanico degli arti superiori nell'ambito della medicina del lavoro. Documento di consenso di un gruppo di lavoro nazionale.

BACKGROUND AND OBJECTIVE: In a preliminary consensus document the authors proposed criteria and methods to identify upper limb work-related MSDs due to biomechanical overload. With this document they intend to define severity according to shared models and procedures so as to fit behaviours to diagnostic procedures and their medical-legal assessment. This becomes especially important in view of Ministerial Decree of April 27 2004 fixing the new lists of diseases having a possible work-related origin that must be reported by law in accordance with art. 139 of law n. 1124, and also on account of the impact of such diseases which, for the first time in Italy, are regulated by law. CONTENTS: The working group, which included INAIL and ISPESL experts and was fully supported by SIMFER (Italian Society of Physical Medicine and Rehabilitation) and SINC (Italian Society of Clinical Neurophysiology), defined a general clinical procedure (anamnesis, objective examination and instrumental assessment) regarding each portion of the concerned upper limb (shoulder, elbow and wrist/hand). Once the presence and characteristics of anatomic and functional damages are established, the results allow a classification scheme to be proposed of upper limb diseases (tendon disorders and entrapment neuropathy) divided into 6 increasing severity stages: initial, medium, medium-severe, severe and extremely severe. Special attention was paid to two instrumental examinations that proved to be of great clinical interest, at least in occupational health: echography of soft tissues (in appendix) and electroneurography for entrapment neuropathy. The limitations of this proposal are discussed but the main goal was achieved: to standardize terms and provide homogeneous criteria to achieve classification of upper limb damage due to biomechanical overload for increasing severity levels. The working group research activity is part of a research project funded by ISPESL.