[Registers as central real world data source: the experience of the Italian Multiple Sclerosis and Related Disorders Register]. / I registri come importante fonte di real world data: l'esperienza del Registro Italiano Sclerosi Multipla e Patologie Correlate.

Registers collecting data from clinical practice (real world data) have gained increasing interest in recent years in the scientific, administrative, and regulatory fields. The value of longitudinal data collection in deepening knowledge about a specific pathology and its healthcare complexity is increasingly recognized. This article describes the development, organizational structure, and technical characteristics of the Italian Multiple Sclerosis and Related Disorders Register (RISM). This multicentre and prospective study gathers demographic, clinical, and epidemiological data from the Italian population with multiple sclerosis and related diseases. The study, officially launched in 2015, but containing data collected since the 1990's, currently involves the active participation of 136 specialized clinical centres and more than 80,000 enrolled patients. The analysis of data in RISM allows for a detailed description of the characteristics of multiple sclerosis and related diseases, providing new insights useful for healthcare planning, cost evaluation, treatment efficacy and safety assessment, and scientific research studies. The main demographic and clinical data of enrolled patients are reported, with a focus on specific study cohorts. In a continuous effort to improve data quality, RISM has implemented specific quality indicators. Starting from the RISM experience, crucial aspects such as the institutional recognition of the disease register, the contribution that register can provide in pharmacovigilance studies, the organizational and management challenges, and privacy issues are discussed.

One-year clinical performance of ABSORB bioresorbable vascular scaffold in patients presenting with acute coronary syndromes: Results from the RAI registry.

OBJECTIVES: To report 1-year clinical outcomes of bioresorbable vascular scaffold (BVS) in acute coronary syndromes (ACS) population. BACKGROUND: BVS use has rapidly extended to high-risk patients as those presenting with ACS. To date limited data have been reported on BVS performance in ACS patients. METHODS: RAI is a multicenter, prospective registry that included 1,505 patients treated with at least 1 successful BVS implantation. A subgroup analysis on ACS patients was performed and the 1-year outcomes of this cohort compared to the remaining stable coronary artery disease (SCAD) population are reported here. Coprimary endpoints were target-lesion revascularization (TLR) and scaffold thrombosis (ScT) at 1-year follow-up. RESULTS: Fifty-nine percent of the patients presented with ACS, of whom 36.5% with ST-elevation myocardial infarctions. ACS patients were significantly younger, with a better cardiovascular risk profile, a lower rate of multivessel disease, chronic total occlusion or in-stent restenosis and a lower Syntax score. Predilation and postdilation were performed in 97.4% and in 96.5% of cases, respectively. No differences were noted in terms of TIMI 3 final flow, but acute gain was greater in ACS compared to SCAD group (P < 0.001). At one-year follow-up no differences were found in terms of TLR (3.3% vs. 3.3%, P = 0.98), and device-oriented composite end-point (4.3% vs. 3.4%, P = 0.4) between ACS and SCAD groups. The rate of definite/probable ScT was numerically higher in ACS vs. stable CAD patients (1.3% vs. 0.8%, P = 0.2). CONCLUSIONS: Our data suggest that the use of BVS in ACS patients is associated with a numerically higher rate of ScT compared to SCAD population numerically higher, but without statistical significance.

Clinical outcomes of overlapping versus non-overlapping everolimus-eluting absorb bioresorbable vascular scaffolds: An analysis from the multicentre prospective RAI registry (ClinicalTrials.gov identifier: NCT02298413).

OBJECTIVES: To compare clinical outcomes of patients treated with overlapping versus non-overlapping Absorb BVS. BACKGROUND: Limited data are available on the clinical impact of stent overlap with the Absorb BVS bioresorbable stent. METHODS: We compared outcomes of patients receiving overlapping or non-overlapping Absorb BVS in the multicenter prospective RAI Registry. RESULTS: Out of 1,505 consecutive patients treated with Absorb BVS, 1,384 were eligible for this analysis. Of these, 377 (27%) were in the overlap group, and 1,007 (73%) in the non-overlap group. The most frequent overlap configuration was the marker-to-marker type (48%), followed by marker-over-marker (46%) and marker-inside-marker (6%) types. Patients of the overlap group had higher prevalence of multivessel disease and higher SYNTAX score, and required more frequently the use of intravascular imaging. At a median follow-up of 368 days, no difference was observed between overlap and non-overlap groups in terms of a device-related composite endpoint (cardiac death, TV-MI, ID-TLR) (5.8% vs. 4.1%, P = 0.20) or of a patient-related composite endpoint (any death, any MI, any revascularization) (15.4% vs. 12.5%, P = 0.18). Cardiac death (1.0% vs. 1.3%, P = 0.54), MI (4.5% vs. 3.6%, P = 0.51), TVR (4.5% vs. 3.6%, P = 0.51) and stent thrombosis (1.1 vs. 1.5%, P = 1.00) were also comparable between groups. When assessing outcomes of the overlap population according to overlap configurations used, no difference was observed in terms of the device- or patient-related composite endpoints. CONCLUSIONS: Outcomes of patients with or without overlapping BVS were comparable at mid-term follow-up despite higher angiographic complexity of the overlap subset. © 2017 Wiley Periodicals, Inc.

The role of deep breathing on stress.

The objective of this study was to verify, in a sample of university students, whether a relaxing technique called deep breathing (stress Intervention Functional IFA) is capable to improve the mood and to reduce the levels of stress. Thirty-eight adult healthy subjects (aged between 18 and 28 years) volunteered the study. They were randomly divided in two groups, the Experimental Group (N = 19) and the Control Group (N = 19). The subjects of the Experimental Group were submitted, once per week, to 10 treatment's sessions of Anti-stress Protocol, each lasting 90 min, whereas subjects of the Control Group sat ten times for 90 min, once per week, without practicing any treatment. The psychological state of mood and stress was evaluated using Measurement of Psychological Stress (MSP) and Profile of Mood State (POMS), while the biological profile of the stress was detected by measuring the heart rate and the salivary cortisol. The results obtained from the present research support the possibility that deep breathing technique is capable to induce an effective improvement in mood and stress both in terms of self-reported evaluations (MPS and POMS) and of objective parameters, such as heart rate and salivary cortisol levels. No statistically significant difference was found between men and women.

SELF-EFFICACY, EMOTIONAL STATES, AND PERFORMANCE IN CAROM BILLIARDS.

Based on an integrative approach to the study of the emotional-cognitive-motor linkage in sport competition, the purpose was to examine the mediating role of emotion-related (psychobiosocial) states in the relationship between self-efficacy (technical and cognitive) and performance in carom billiards. Forty-five male players of master or intermediate categories, between 30 and 74 years of age (M=51.2, SD=10.8), participated in the study. Measures included scores of technical and cognitive self-efficacy, functional (i.e., facilitative to performance) and dysfunctional (i.e., debilitative to performance) psychobiosocial states, and performance outcome. The assessment took place prior to one game of a national or an international competition. Results showed technical self-efficacy, cognitive self-efficacy, functional states, and performance to be significantly and positively related among them. Functional psychobiosocial states mediated the effect of both technical and cognitive self-efficacy on performance. Overall, the findings supported an integrative approach to the study of the linkage among cognition, emotion, and action in sport.

Vividness and transformation of mental images in karate and ballet.

While imagery research has become popular in recent years, little research has specifically investigated differences in imagery ability between open- and closed-skill sport activities. The purpose of this study was to investigate whether the type of task, open or closed, affects vividness and controllability differently. Thirty female classic dancers (closed skill), 30 female karate athletes (open skill), and 30 female non-athlete students, between 14 and 20 years of age (M = 17.0, SD = 1.6), participated. They completed the Vividness of Visual Imagery Questionnaire, the Vividness of Movement Imagery Questionnaire, and the Subtraction of Parts Task. There was no difference in imagery ability between open- and closed-skill sport groups. Furthermore, dancers and karatekas had higher mean scores on imagery ability than the non-athlete group. A positive correlation was observed between the two questionnaires, supporting findings on the componential basis of imagery. This study contributed to increase the research in the specific area of open- and closed-skill sports and imagery ability.

Attention and blood lactate levels in equestrians performing show jumping.

In equestrian show jumping, attention is particularly important to ensure maximum accuracy. Due to the anaerobic nature of the jumping and its requirement for precision coordination between human and horse, there may be a relation between the onset of lactic threshold and decrease in attention. In 12 healthy and injury-free equestrians (6 men, 6 women), the effects (blood lactate and glucose) of a show jumping course (250 m long with eight vertical obstacles with a height of 1.15 m height) on capacity and selectivity of attention was assessed. A typical reaction time paradigm and test of divided attention were administered. At the end of the course a significant increase of blood lactate was observed, whereas blood glucose did not significantly change. A deterioration of attention (intensity and selectivity) and a worsening of performance with increasing of blood lactate were observed. The present results led to the conclusion that the increase in blood lactate that occurs in riders executing a show jumping course is associated with worsening of both attentive capabilities and performance.

Anthropometrics related to the performance of a sample of male swimmers.

The main purpose of the present investigation of 21 elite male swimmers was to assess whether the Ape Index (the ratio between the individual's arm span and height) and/or the second-to-fourth digit length ratio (2D:4D), i.e., the ratio between the length of the second and the fourth fingers of the right hand, are associated with the performance of high-level swimmers, when mood and/or executive function are covaried. The results showed no statistically significant correlation between the Ape Index and 2D:4D ratio, performance, executive function, or mood. In contrast, statistically significant correlations were found between 2D:4D ratio and performance, executive function, and mood. Regressions indicated that 2D:4D ratio and not Ape Index is related to the performances of a sample of male swimmers.

Effects of Proprioceptive Insoles and Specific Core Training on Postural Stability for Preventing Injuries in Tennis.

Tennis is a complex sport based on unpredictability that requires adequate physical and psychological preparation to prevent injuries. The aim of this study was to investigate the effects of 8-week specific core stability training on postural stability in competitive adolescent tennis players, aged between 14 and 19 years old. Sixty-one participants were randomly allocated into two groups: experimental (n = 32) and control (n = 29) groups. The first group wore proprioceptive insoles 8 h a day and performed a detailed training 3 times a week for 8 weeks; the second group only received proprioceptive insoles to wear 8 h a day for 8 weeks. The postural stability parameters (center-of-pressure length, center-of-pressure velocity, and 95% confidence ellipse sway area) included three assessment times: baseline (T0), intermediate test (T1), post-test (T2), and retention test (T3). Data analysis showed a significant improvement in the experimental group compared with the control group, indicating a large effect size in center-of-pressure length, ellipse sway area, and center-of-pressure velocity at T2 and T3 (p < 0.05). In conclusion, our results suggest that a specific and detailed core stability training plays a significant role in improving balance and postural stability in young tennis players, especially in terms of preventing the risk of injury.

The Relationship between Anger Expression and Performance Score in Parents and Coaches: The Mediating Role of Self-Efficacy and Assertiveness.

BACKGROUND: Youth sport provides regular physical activity for millions of children. It is a global system, which includes coaches, referees, athletes, and parent spectators; consequently, the behavior of each member can influence the experiences of others. This study aimed to investigate the mediating role of self-efficacy and assertiveness in the relationship between the degree of anger expression and the performance children's score in a group of parents and coaches. METHODS: 200 parents (96 fathers, 104 mothers) and 200 coaches (119 males, 81 females) responded to the General Self-efficacy Scale, The Scale for Interpersonal Behavior, and the State-Trait Anger Expression Inventory-2; an indicator of performance was asked of each coach. The age range of parents was 28-59 years (M = 41.39, SD = 7.07), while that of coaches was 27-43 years (M = 35.91, SD = 3.35). RESULTS: Results revealed that self-efficacy and assertiveness were the direct and indirect predictors of performance score. CONCLUSIONS: The study provided an understanding of the nature and magnitude of this profoundly interpersonal experience. Future studies may advance relevant education programs and effective interventions aimed at reducing angry expressions and lack of communication.

Short-Term Effects of Specific Sensorimotor Training on Postural Assessment in Healthy Individuals: A Pilot Study with a Randomized Placebo-Controlled Trial.

It is well-known that sensorimotor training aims to increase the performance of the sensorimotor system to maintain an upright position. Through the use of a randomized placebo-controlled trial, the specific aim of this study was to investigate the short-term effects of a specific session of sensorimotor training on postural balance, stability and coordination in healthy, recreationally active participants. Ninety subjects were randomly allocated into three groups: experimental (n = 30), placebo (n = 32) and control (n = 28). The experimental group performed a 5 min warm-up, with the sensorimotor training consisting of 60-min specific sensorimotor exercises; the control group was not allowed to perform any sensorimotor training; the placebo group observed a video clip of an individual belonging to the experimental group performing the sensorimotor training accurately. All participants were seen three times per week for 4 weeks. Before and after the entire training, all groups of participants undertook stabilometric parameter assessment. The intervention-mediated sensorimotor training confirmed significant enhancement in the proprioceptive system. Significant improvement in the motor and/or sensory function was observed in the experimental and placebo groups. In conclusion, our findings suggest that specific sensorimotor training performed 3 days per week for 4 weeks could improve postural balance, stability and coordination in healthy individuals.

Self-Efficacy and the Digit Ratio in a Group of Sports University Students.

Self-efficacy is one's awareness of being able to cope optimally with different situations. Perceived self-efficacy is a belief that closely involves emotional and personological functioning. In fact, when one perceives oneself as capable, the likelihood of success increases significantly. The aim of this research was to verify a possible correlation between self-efficacy and the Digit Ratio (2D:4D), referred to as prenatal androgen levels, and whether these correlate with some psychological variables, considering possible gender differences. This study involved 56 sports university students, whose 2D:4D ratio was calculated. Moreover, self-assessment questionnaires: the Self-efficacy Scale (SES), the Big Five Questionnaire-2 (BFQ-2), the Profile of Mood State (POMS), the State-Trait Anxiety Inventory Form Y (STAI-Y) and the Emotional Regulation Questionnaire (ERQ) were administered. The data show that the perceived levels of self-efficacy seem to be influenced by an innate predisposition linked to prenatal androgen values to which the subjects were exposed during uterine life (2D:4D). This negative correlation indicates that the higher the value of the digit ratio, the more likely it is that the level of perceived self-efficacy will be lower. Finally, the degree of perceived self-efficacy also seems to depend on the levels of subjective anxiety, understood both as a personological disposition and a contingent condition, and the latter also seems to be influenced by prenatal androgen levels, particularly in women.

Experimental study on physical exercise in diabetes: pathophysiology and therapeutic effects.

Diabetes is a chronic disease. Some complications can be prevented, their effects can be slowed down.  Sedentary lifestyle increases the risk of obesity and consequently the predisposition to diabetes II. The article aimed to demonstrate the positive and negative effects of exercise on active and sedentary diabetics and on pathophysiology, evaluating the effects after 3 and 6 months. The study involved 90 participants, both male and female, with type II diabetes, aged 45, divided into two groups: Group A (n=50, sedentary) and Group B (n=40, active). We evaluated anthropometric parameters, blood chemistry values, which are fundamental for the transversal evaluation of the results. In group A improvements were less noticeable than group B. The most improved parameter is blood sugar, Glycemic values and BMI. Cholesterol and Hb1Ac decreased but more slowly than previous parameters. The expectations of the study were, not only in recognizing the therapeutic and preventive powers of exercise, but above all in choosing to program a motor protocol after a team work between diabetologist, sports doctor and kinesiologist and/ or personal trainer. Physical activity is an additional therapy to insulin.

A Moderated Mediation Analysis of the Effects of the COVID-19 Pandemic on Well-Being and Sport Readiness of Italian Team Sports Players: The Role of Perceived Safety of the Training Environment.

BACKGROUND: The protective restrictions (e.g., lockdowns, quarantines, social and physical distancing) consequent to the global pandemic caused by COVID-19 posited new challenges to athletes practicing competitive team sports. This study aimed to gain an understanding of the impact of the ongoing COVID-19 pandemic on the well-being and sports readiness to train and to compete of competitive female and male athletes practicing outdoor (i.e., rugby, soccer) and indoor (i.e., volleyball, basketball) team sports who were active during the Italian first and second waves of COVID-19. METHODS: An online survey assessing demographic characteristics, perceived safety of the training environment, COVID-19 risk, fear of COVID-19, well-being, and sport (training and competition) readiness was administered to 619 team sports players. We examined differences by gender, previous COVID-19 experience, and team sport setting (i.e., outdoor vs. indoor). A moderated mediation analysis was conducted to assess the impact of perceived COVID-19 risk and fear of COVID-19 on athletes' well-being and sports readiness, using perceived safety of the training environment as a mediator and gender and sport setting as moderators. RESULTS: Indoor team sports and female athletes showed higher perceived COVID-19 risk, while athletes with no-COVID-19 experience reported higher fear of COVID-19. Perceived COVID-19 risk (directly and via perceived safety of the training environment) and fear of COVID-19 were negatively associated with athletes' well-being and sports readiness. CONCLUSIONS: This study highlighted an understanding of the psychological implications of the COVID-19 pandemic, emphasizing the role of the perceived safety of the training environment on athletes' well-being and sports readiness. Future studies may advance safety-based interventions to promote well-being and a safer return to sport.

Dynamic Interactive Model of Sport Motivation.

Motivation variables in 11 motivational instruments of 357 Slovenian male athletes (168 elite and 189 young athletes from age 12-14) in nine different sport disciplines (basketball, football, handball, water polo, ice hockey, ski jumping, alpine skiing, sport climbing, and judo) were obtained. Different concepts of motivation were researched, such as achievement motivation, incentive motivation, participation motivation, goal orientation, satisfaction and enjoyment in sport, self-efficacy, effort, and ability attributions. The most popular framework for motivation in sport lately has been social cognitive perspective. The aim of this study was to form a dynamic interactive model of sport motivation. We tried to upgrade different models of motivation to one unique meta model of sport motivation, which would explain possible behaviours and motivation in sport situations. Different statistic methods were used to define differences among young and elite athletes and between athletes in group and individual sports. The results show important differences among those groups and suggest that specific sport discipline also has a specific footprint inside motivation. Factor analysis and discriminant analysis were used to explore sport motivation space. The results also suggest that it is possible to define some main determinants of sport motivation that can be connected to previous models of sport motivation.

The Moderated Mediating Effect of Hope, Self-Efficacy and Resilience in the Relationship between Post-Traumatic Growth and Mental Health during the COVID-19 Pandemic.

As a major life trauma, COVID-19 had negative impacts on psychological well-being. The aim of this study was to test and verify the mediation of resilience, hope and self-efficacy and to analyze the moderating effect of gender and COVID-19 contagion on the association between symptoms of anxiety, stress and depression, and post-traumatic growth among adults during COVID-19. A cross-sectional study was conducted via an online survey with self-administered questionnaires. The Depression, Anxiety, and Stress Scale, the Post-traumatic Growth Inventory, the Resilience Scale, the General Self-Efficacy Scale, and the Comprehensive State Hope Scale were used. A total of 493 (n = 262 female and n = 231 male) participated in the survey (Mage = 33.40 years, SD = 13.41, range = 20 to 60). A multiple mediation model was used to verify the mediating effect of resilience, hope and self-efficacy on the relationship between symptoms of anxiety, stress and depression, and PTG. A moderated mediation model was examined to find and test the moderated effects of gender and COVID-19 contagion on the mediation model. Results showed the indirect effects of anxiety (ß = 0.340 (0.120); 95% CI [from 0.128 to 0.587]) and depression (ß = 0.222 (0.095); 95% CI [0.048, 0.429]) on PTG trough resilience and hope. Symptoms of anxiety, stress and depression, and self-efficacy were significantly highest in females. Moreover, males and participants with COVID-19 contagion had significantly higher levels of resilience and post-traumatic growth. These findings suggest that hope and resilience, as protective factors, could be an important key to developing an intervention strategy to enhance and improve psychological health during a crisis.

Attentive Processes and Blood Lactate in the Sambo.

BACKGROUND: Sambo is a martial art and combat sport that originated in the Soviet Union. There are two main stiles, Sport Sambo and Combat Sambo which resembles modern mixed martial arts. Very little literature is available about physiological aspects of Sambo and, in particular, on the possible effects on cognitive domains. The purpose of the present research was to determine if there is a correlation between a blood lactate increase and the intensity and/or selectivity of attentions. METHODS: Sixteen male athletes practicing Sambo for at least 5 years participated voluntarily in the study. Each athlete had to sustain, with an interval of one week, both a Sport Sambo match and a Combat Sambo match, each lasting 5 min. Blood lactate levels as well as attentive capacities were evaluated at three different times: at rest, i.e., 5 min before the start of the session (pre), at end of the session and 15 min after its conclusion. Reaction time protocol was used to evaluate the intensity of attention, whereas divided attention was assessed for analyzing the selectivity of attention together with errors and omissions. RESULTS: Concerning Sport Sambo, blood lactate was 1.66 mmol/L (±0.55 SD) before the session, reached a mean value of 3.40 mmol/L (±0.45 SD) at the end of the session (end) and returned to values similar to initial ones (a mean value of 1.98 mmol/L (±0.37 SD) after 15 min (15-end). None of the attentive parameters examined, showed statistically significant differences. Conversely, for Combat Sambo, it was found a significant increase in blood lactate levels that went from 1.66 mmol/L (±0.55 SD) before the session (pre), to 4.76 mmol/L (±0.60 SD) at the end (end) and then back to values similar to those observed before the session 15 min after its conclusion (15-end), i.e., 1.97 mmol/L (±0.37 SD); however, after a Combat Sambo session increases in blood lactate were associated with significant worsening of attentional mechanisms. CONCLUSIONS: In conclusion, in all the participants, the worsening of attentional mechanisms was observed only after the Combat Sambo session in which blood lactate values exceeded 4 mmol/L. This figure, also known as the Onset of Blood Lactate Accumulation (OBLA), is commonly used to determine the anaerobic threshold.

Decent work and hope for the future among young migrants.

Work is a multidimensional construct that plays a crucial role in people's lives, assuring their psychological well-being, social connections, and self-determination. "Decent" work is conceptualized as a satisfactory job in conditions of equity, security, and respect for human rights. The paper reports the results of a study on the perception of the future and decent work in young immigrants, at risk of undertaking undignified and unsatisfactory jobs. The data were collected through a semi-structured interview, aimed at exploring the representations of decent work and hope. Data analysis was conducted through both qualitative and quantitative methods. The results of the study are discussed with reference to career counseling promoting decent work for immigrant people, activating the motivation to plan the future, including hope.

Mood States and Performance in Elite Canoe Polo Players: The Mediating Role of Stress.

Sport performance is characterized by competitive stressful conditions that elicit emotional states. The purpose of the study was to examine whether stress mediated the relationship between mood states and performance. Thirty-two elite canoe polo players from four different Italian teams (16 senior males and 16 senior females), aged between 29 and 38 years old (M = 32.3, SD = 2.71), participated in the study. Measures included level of psychological stress, six mood dimensions, and performance outcome. We also detected the digit ratio-the lower second-to-fourth digit length (2D:4D) ratio-as it was demonstrated to be correlated to high sports performance. The assessment took place one day before the first game of the national competition "ITALY CUP". Male athletes reported lower scores on dysfunctional emotion-related states and on 2D:4D ratio than female athletes. The results of the mediation analysis showed that psychological stress plays a mediating role between moods and performance. Overall, given the limited literature, the findings supported an integrative approach to the study of the linkage between emotion and action in canoe polo.

The Influence of Self-Efficacy and Locus of Control on Body Image: A Path-Analysis in Aspiring Fashion Models, Athletes and Students.

It is widely documented that negative body image is a significant public health concern due to its association with symptoms of disordered eating and worse psychological well-being. The purpose of the study was to develop a path model of intrapersonal dimensions (self-efficacy and internal locus of control) as antecedents of perceived stress toward females' body dissatisfaction and eating attitude disorders. A total of 300 females, including 100 aspiring fashion models, 100 athletes and 100 students (controls), between 15 and 24 years of age (M = 19.6, SD = 1.85) participated in the study. Measures included level of psychological stress, self-efficacy and locus of control dimensions, body dissatisfaction and eating attitude disorder indices. A path analysis confirmed our research hypothesis. Comparing the three subsamples, we found better fit indexes in the two subgroups with elevated investment on their body image with respect the control group. More specifically, the model in the group of aspiring fashion models showed the best fit index. These results indicated that aspiring fashion models have a strong desire to maintain their low body mass or to become thinner. For this reason, a suitable involvement of expert health workers in the nutritional and psychological field could be extremely essential in the fashion world to maintain a healthier well-being.