Paving the way to better understand the effects of prolonged spaceflight on operational performance and its neural bases.

Space exploration objectives will soon move from low Earth orbit to distant destinations like Moon and Mars. The present work provides an up-to-date roadmap that identifies critical research gaps related to human behavior and performance in altered gravity and space. The roadmap summarizes (1) key neurobehavioral challenges associated with spaceflight, (2) the need to consider sex as a biological variable, (3) the use of integrative omics technologies to elucidate mechanisms underlying changes in the brain and behavior, and (4) the importance of understanding the neural representation of gravity throughout the brain and its multisensory processing. We then highlight the need for a variety of target-specific countermeasures, and a personalized administration schedule as two critical strategies for mitigating potentially adverse effects of spaceflight on the central nervous system and performance. We conclude with a summary of key priorities for the roadmaps of current and future space programs and stress the importance of new collaborative strategies across agencies and researchers for fostering an integrative cross- and transdisciplinary approach from cells, molecules to neural circuits and cognitive performance. Finally, we highlight that space research in neurocognitive science goes beyond monitoring and mitigating risks in astronauts but could also have significant benefits for the population on Earth.

The "common" experience of voice-hearing and its relationship with shame and guilt: a systematic review.

BACKGROUND: Despite Auditory Verbal Hallucinations (AVHs) having been long associated with mental illness, they represent a common experience also in the non-clinical population, yet do not exhibit distress or need for care. Shame and guilt are emotions related to one's perception of oneself and one's responsibility. As such, they direct our attention to aspects of AVHs that are under-researched and elusive, particularly about the status of voices as others, their social implications and the constitution and conceptualisation of the self. OBJECTIVES: This paper aims to provide a systematic review of studies that investigated the relationship between auditory hallucinations, shame, and guilt in people without relevant signs of psychiatric issues. METHODS: We searched studies reporting information about voices characteristics, the relationship between voices and hearers, hearer's reactions, and beliefs, paying peculiar attention to shame and guilt issues. Included papers were evaluated for risk of bias. RESULTS: Eleven studies that explored the relationship between AVHs, shame and guilt, were extracted. Phenomenological, pragmatic, as well as neuropsychological features of hearing voices in non-clinical populations, allowed us to note a dynamic relationship and the constellation of subjective experiences that can occur. The role of guilt was characterized by few studies and mixed results, while shame was mainly common. CONCLUSIONS: Due to the high heterogeneity detected and the scarce sources available, further studies should focus on both the aetiology and the bidirectional relationship between hearing voices, shame, and guilt in non-clinical people. This can be helpful in therapies for non-clinical populations who are distressed by their voices (e.g., psychotherapy), and for whom shame, and guilt may contribute to negative consequences such as isolation, anxiety or future depression. Moreover, it might favour the development and implication of different treatments considering emotion regulation, distress tolerance and interpersonal sensitivity on the clinical populations.

Age-based stereotype threat: a scoping review of stereotype priming techniques and their effects on the aging process.

Objectives: In the current study, we reviewed and classified the different experimental methods reported in the literature to induce age-base stereotype threat in older adults, providing a comprehensive view of the methodologies present in the literature to date.Method: The current study has been developed as a literature scoping review. The PubMed, PsycINFO, Scopus, ISI Web of Science, and CINAHL database were searched. With this approach, we assessed developments in experimental age-based stereotype manipulations in the last decades.Results: 26 articles were considered for this scoping review. Through a thematic analysis, we classified the papers into three broad categories based on the priming technique addressed: manipulation by instructions, manipulation by tests and, manipulation by mental imagery.Conclusion: Our results seem to suggest how manipulations by instructions appeared to be more largely used and capable of producing more clear performance variations on cognitive, memory, and physical tasks. Age-related stereotypes showed potentially stronger effects when they are negative, implicit, and temporally closer to the test of performance.

The evolution of IBD perceived engagement and care needs across the life-cycle: a scoping review.

BACKGROUND: The chronic and progressive evolution of Inflammatory Bowel Diseases (IBD), with its prototypical fluctuating trend, creates a condition of psycho-social discomfort, impacting the quality of life in terms of personal, working, and interpersonal. AIMS: In this article, we want to identify the nature and extent of the research evidence on the life experiences, the perceived engagement, the psychological, social care and welfare needs of people affected by IBD across the lifecycle. METHODS: Following the approach set out by Arksey and O'Malley and the PRISMA extension for scoping reviews, we conducted a scoping review in March 2019 and closed the review with an update in October 2019. It was performed using electronic databases covering Health and Life Sciences, Social Sciences and Medical Sciences, such as PubMed, Medline, Embase, Scopus, Cochrane, Web of Science, PsycInfo. RESULTS: We identified 95 peer-reviewed articles published from 2009 to 2019, that allowed to detection the main needs in children (psychological, need to be accepted, physical activity, feeding, parent style, support, social needs), adolescents (to understand, physical and psychological needs, protection, relational, gratitude, respect, and engagement) and adults (information, medical, psychological, social, work-related, practical, future-related, engagement). Although the literature confirms that the majority of the IBD units have planned provision for the different types of transitions, the quality and appropriateness of these services have not been assessed or audited for all the kinds of challenges across the life cycle. CONCLUSIONS: The literature shows the relevance of organizing a flexible, personalized health care process across all the critical phases of the life cycle, providing adequate benchmarks for comparison in a multidisciplinary perspective and ensuring continuity between hospital and territory.

Technologically-enhanced psychological interventions for older adults: a scoping review.

BACKGROUND: The world population is getting older. As life expectancy increases, traditional health care systems are facing different challenges in terms of cost reduction and high-quality service delivery capability. New ways to improve older adults' quality of life have been explored, taking advantage of new technological solutions. Our focus is on the integration of technology in clinical treatments to facilitate or deliver psychological interventions meant to improve well-being in older adults. Our aims were to describe the main technology-based interventions supporting seniors' quality of life or psychological well-being and to provide greater clarity to what is described in the current literature as their effects on seniors' cognitive and psychological outcomes and healthcare policies. METHODS: We reviewed the scientific literature looking for studies that investigated how technology can be implemented into clinical psychology treatments for older adults. Our search was conducted using the following databases: PubMed, PsycINFO, Scopus, ISI Web of Science, and CINAHL. The search provided 350 articles, mostly (≈90%) dated after 2002. Abstract analysis narrowed the selection to 150 papers, according to their relevance and actuality as judged by a restricted group of independent researchers. RESULTS: Through a thematic analysis, we found that virtual reality (VR), robots, telemedicine, software, video games, and smartphone applications could potentially support older adults' psychological treatment with a positive impact on healthcare systems. CONCLUSION: Findings from the literature are encouraging, although most of these results are only preliminary.

Meditation training for people with amyotrophic lateral sclerosis: a randomized clinical trial.

BACKGROUND AND PURPOSE: Studies investigating psychological interventions for the promotion of well-being in people with amyotrophic lateral sclerosis (ALS) are lacking. The purpose of the current study was to examine the use of an ALS-specific mindfulness-based intervention for improving quality of life in this population. METHODS: A randomized, open-label and controlled clinical trial was conducted on the efficacy of an ALS-specific meditation programme in promoting quality of life. Adults who received a diagnosis of ALS within 18 months were randomly assigned either to usual care or to an 8-week meditation training based on the original mindfulness-based stress reduction programme and tailored for people with ALS. Quality of life, assessed with the ALS-Specific Quality of Life Revised scale, represented the primary outcome, whilst secondary outcomes included anxiety and depression, assessed with the Hospital Anxiety and Depression Scale, and specific quality of life domains. Participants were assessed at recruitment and after 2, 6 and 12 months. The efficacy of the treatment was assessed on an intention-to-treat basis of a linear mixed model. RESULTS: A hundred participants were recruited between November 2012 and December 2014. Over time, there was a significant difference between the two groups in terms of quality of life (ß = 0.24, P = 0.015, d = 0.89). Significant differences between groups over time were also found for anxiety, depression, negative emotions, and interaction with people and the environment. CONCLUSIONS: An ALS-specific meditation programme is beneficial for the quality of life and psychological well-being of people with ALS.

Resentment, hate, and hope in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a fatal and progressive neurodegenerative disease. Despite much research having been conducted about psychological issues involved in living with ALS, anger, and resentment have yet to be investigated. Moreover, the construct of "hope" has received little attention, so far. An online survey was created to investigate hate, resentment, and hope issues in people with ALS, in relation to the willingness to adopt a strict nutrient-dense diet if it were shown to increase longevity. Results indicate that there is a high level of hope in the sample. People who have lived with ALS for more time expressed a higher level of hope to live 10 years or more. Those who are married were more likely to have hope of living 10 years or longer and more likely to have lower levels of hate against ALS. Dietary self-care choices appear to be related to hope issues. Resentment and hate tended to be higher in people who have had ALS for less time, and in women. Despite some methodological limitations, the results suggest that hope, hate, and resentment could be important issues to explore in future studies.

Immunological activity of photodynamic therapy for genital warts.

BACKGROUND: An increasing body of evidence supports the usefulness of photodynamic therapy (PDT) in the treatment of non-neoplastic pathological conditions, including genital warts. In particular, PDT has demonstrated good clinical cure rates and low recurrence, and is now suggested as a safe alternative means of treating condylomata. OBJECTIVE: To confirm the suitability of aminolaevulinic acid (ALA)-PDT for the treatment of this condition and to investigate the recruitment and significance of immune cells in lesional areas by immunohistochemical analysis at different time intervals after treatment. METHODS: Fifteen subjects with histologically proven, recalcitrant condylomata acuminata of the penis, urethra, vulva or perianal area underwent several cycles of PDT following ALA application. Biopsies were taken at baseline and at different intervals during the trial, and infiltrating immune cells, CD3, CD4, CD8, CD1a and CD68, were evaluated by double immunocytochemical alkaline phosphatase antialkaline phosphatase (APAAP) staining. RESULTS: Our trial provided a complete cure rate of nine of 15 subjects after five PDT sessions. Perianal lesions showed a particularly rapid remission. While progressing towards total lesion clearance, the immunohistochemical pattern was dominated by dense CD4+ T lymphocytes infiltrating the superficial dermis, accompanied by an accumulation of Langerhans cells. Simultaneously, CD8 began to increase in the lesions of responding patients, and Langerhans cells seemed to migrate towards the dermis. CD68+ macrophages apparently did not participate in the immune inflammatory response. CONCLUSIONS: This study, to the best of our knowledge, represents the first attempt to clarify the effect of ALA-PDT on infiltrating immune cells in condylomata acuminata. Our results appear to confirm previously reported clinical data, suggesting that rapid activation of specific immunity in lesional skin, CD4+ T lymphocytes and dendritic cells could be responsible for healing.

[Towards a multi-step informed consent: considerations and proposals for a good practice]. / Verso un consenso informato a più fasi: considerazioni e proposte per una buona prassi.

Any therapeutic intervention needs consent from the patient, after have received information from the physician. This is often seen as a bureaucratic accomplishment but it could enhance therapeutic alliance. We propose to divide consent from information, offering a place in which doubts and emotions can be explored, with the assistance of a psychological interview. We believe that this new approach can enhance physician-patient relationship, with an improvement in patient satisfaction and a decrease of claims and complaints.