Synchronization of a Virtual Reality Scenario to Uterine Contractions for Labor Pain Management: Development Study and Randomized Controlled Trial.

Background: Labor is described as one of the most painful events women can experience through their lives, and labor pain shows unique features and rhythmic fluctuations. Purpose: The present study aims to evaluate virtual reality (VR) analgesic interventions for active labor with biofeedback-based VR technologies synchronized to uterine activity. Materials and Methods: We developed a VR system modeled on uterine contractions by connecting it to cardiotocographic equipment. We conducted a randomized controlled trial on a sample of 74 cases and 80 controls during active labor. Results: Results of the study showed a significant reduction of pain scores compared with both preintervention scores and to control group scores; a significant reduction of anxiety levels both compared with preintervention assessment and to control group and significant reduction in fear of labor experience compared with controls. Conclusion: VR may be considered as an effective nonpharmacological analgesic technique for the treatment of pain and anxiety and fear of childbirth experience during labor. The developed system could improve personalization of care, modulating the multisensory stimulation tailored to labor progression. Further studies are needed to compare the synchronized VR system to uterine activity and unsynchronized VR interventions.

Emotional Distress Symptoms, Coping Efficacy, and Social Support: A Network Analysis of Distress and Resources in Persons With Cancer.

BACKGROUND: The study's main aim was to analyze the structure and configuration of distress symptoms and resource factors. PURPOSE: Common methods of assessing distress symptoms in cancer patients (i) do not capture the configuration of individual distress symptoms and (ii) do not take into account resource factors (e.g., social support, coping, caring health professionals). Network analysis focuses on the configuration and relationships among symptoms that can result in tailored interventions for distress. Network analysis was used to derive a symptom-level view of distress and resource factors. METHODS: Nine hundred and ninety-two cancer patients (mixed diagnoses) completed an abridged Distress Screening Schedule that included 24 items describing symptoms related to distress (depression, anxiety) and resource factors (social support, coping, caring health professionals). RESULTS: In network analysis, the centrality strength index (CSI) is the degree to which an item is connected to all other items, thus constituting an important focal point in the network. A depression symptom had the highest CSI value: felt lonely/isolated (CSI = 1.30). In addition, resource factors related to coping efficacy (CSI = 1.20), actively seeking support (CSI = 1.10), perceiving one's doctor as caring (CSI = 1.10), and receiving social support (CSI = 1.10) also all had very high CSI scores. CONCLUSIONS AND IMPLICATIONS: These results emphasize the integral importance of the social symptoms of loneliness/isolation in distress. Thus, distress symptoms (loneliness) and resource factors (coping efficacy, seeking social support, and perceiving medical professionals as caring) should be integral aspects of distress management and incorporated into assessment tools and interventions to reduce distress.

Many persons with cancer experience emotional distress (i.e., depression and anxiety). Traditional methods of assessing distress do not capture the complex organization of individual symptoms of depression/anxiety or their relationship with specific personal resources such as seeking support and coping strategies. This study used network analysis to represent the structural configuration of individual distress symptoms and specific resources (agentic coping, seeking support, receiving support, satisfaction with medical care) and relationships between them. Participants were 992 persons with cancer who completed an inventory assessing distress and personal resources. The network configuration showed that loneliness and social isolation were most central to the network of distress symptoms, suggesting that these feelings are the most significant aspects of distress for persons with cancer. Importantly, agentic coping, seeking support, perceiving one's doctor as caring, and receiving social support were also highly central in the network. The results highlight the significance of the social symptoms of distress, namely loneliness and isolation, as well as the central importance of resource factors such as coping efficacy, seeking social support, and perceiving medical professionals as caring. These distress symptoms and resources can be incorporated into assessment tools and interventions to alleviate distress among persons with cancer.

Aging well in an aging society: physical health in older lesbian, gay, and bisexual adults.

Introduction: Older sexual minority people meet a double stigma in our society related to their sexual identity and chronological age. The present study explores how experiences of discrimination and prejudice, coming out, and personal resiliency influence physical health of older lesbian, gay, and bisexual (LGB) adults. Methods: Respondents were recruited through online advertisements and an online-based survey. The sample included 82 Italian cisgender LGB adults over 65 years: young older adults (65-70 years; 78%) and old-old adults (over 71 years; 22%). Regarding sexual orientation, the sample was composed of sexual minority women (n = 30; 37%) and sexual minority men (n = 52; 63%). Results: ANOVAs' findings showed that sexual minority women described lower levels of physical health compared to sexual minority men. At the same time, old-old adults reported higher experiences of discrimination and prejudice compared to young older adults. Moreover, findings from hierarchical multiple regression analysis described that coming out, higher levels of personal resiliency, and fewer experiences of discrimination were predictors of physical health, regardless of age and sexual minority categories. Conclusion: These findings seem to align with previous studies that underline the relevance of investigating aging well in sexual minority people. Knowledge and awareness of LGBTQ+ issues are necessary for recognizing the unique needs and resources of older LGB people for promoting a healthy aging process.

Daily associations between global self-esteem and self-concept clarity and their relationships with subjective well-being in a sample of adult workers.

OBJECTIVES: The present pre-registered study examined the reciprocal day-to-day associations between global self-esteem and self-concept clarity and their incremental validity with respect to daily life satisfaction, positive affect, and negative affect. METHODS: We used intensive longitudinal data from 153 adult workers (45.1% women), over a period of 31 days. Data were analyzed using dynamic structural equation modeling. RESULTS: Results attested higher global self-esteem and self-concept clarity mean levels for older vs. younger participants, and lower global self-esteem and self-concept clarity variability for older vs. younger participants. Furthermore, global self-esteem and self-concept clarity were correlated at a cross-sectional daily level, yet only self-concept clarity states positively predicted subsequent global self-esteem states, while global self-esteem states did not predict subsequent self-concept clarity states. Daily global self-esteem and daily self-concept clarity further predicted subsequent daily higher life satisfaction and positive affect, respectively. CONCLUSION: Overall, our findings shed light on the short-term relationships linking global self-esteem and self-concept clarity, pointing to their discriminant validity in predicting individuals' subjective well-being.

The relationship between caregiver contribution to self-care and patient quality of life in heart failure: A longitudinal mediation analysis.

BACKGROUND: Patients with heart failure may experience poor quality of life due to a variety of physical and psychological symptoms. Quality of life can improve if patients adhere to consistent self-care behaviors. Patient outcomes (i.e., quality of life) are thought to improve as a result of caregiver contribution to self-care. However, uncertainty exists on whether these outcomes improve as a direct result of caregiver contribution to self-care or whether this improvement occurs indirectly through the improvement of patient heart failure self-care behaviors. AIMS: To investigate the influence of caregiver contribution to self-care on quality of life of heart failure people and explore whether patient self-care behaviors mediate such a relationship. METHODS: This is a secondary analysis of the MOTIVATE-HF randomized controlled trial (Clinicaltrials.gov registration number: NCT02894502). Data were collected at baseline and 3 months. An autoregressive longitudinal path analysis model was conducted to test our hypotheses. RESULTS: We enrolled a sample of 510 caregivers [mean age = 54 (±15.44), 24% males)] and 510 patients [mean age = 72.4 (±12.28), 58% males)]. Patient self-care had a significant and direct effect on quality of life at three months (ß = 0.20, p < .01). Caregiver contribution to self-care showed a significant direct effect on patient self-care (ß = 0.32, p < .01), and an indirect effect on patient quality of life through the mediation of patient self-care (ß = 0.07, p < .001). CONCLUSION: Patient quality of life is influenced by self-care both directly and indirectly, through the mediation of caregiver contribution to self-care. These findings improve our understanding on how caregiver contribution to self-care improves patient outcomes.

Integration of Psychosocial Theory into Palliative Care: Implications for Care Planning and Early Palliative Care.

Palliative care improves patients' symptoms, quality of life and family satisfaction with caregiving, reduces hospital admissions and promotes alignment of medical care with the patient's needs and goals. This article proposes the utility of integrating three psychosocial theories into standard palliative care with implications for care planning, early palliative care and optimizing quality of life. First, Control Theory focuses on the complex juxtaposition of promoting agency/empowerment in patients and carers and coping with often highly uncertain outcomes. Second, Optimal Matching Theory accounts for the alignment of need and provision of care to potentiate the quality of life effects of supportive care in a complex social process involving health care providers, patients and carers. Third, Hope Theory represents a dynamic process, which is marked by variation in the qualities of hope as the patient and carer confront challenges during palliative care. Future work will be translational in nature to adapt both assessment and interventions based on this theoretically driven augmentation of palliative care as well as to evaluate whether it provides a conceptual framework that has incremental utility in palliative care planning.

"I RUN CLEAN Project"-An Innovative and Self-Sustainable Approach to Develop Clean Sport Behaviours in Grassroots Athletes.

The phenomenon of doping is a public health issue that poses threats to sport and society. In recent decades, the emphasis on efforts to address the issue and reduce the incidence of doping by young people in sport has shifted from deterrence through testing and punishment to the promotion of clean sport behaviours through values-based education. The "I Run Clean project" sought to develop new and effective tools targeting grassroots athletes and those around them (coaches, medical support personnel, sport leaders, parents). These included sport-specific e-learning and in-person peer-to-peer workshops led by trained volunteer ambassadors. The aim of all "I Run Clean" measures is to go beyond the warnings and provision of factual information about early anti-doping campaigns to a more holistic educational approach that focuses participants on their personal and sport-related values in order to encourage good decision-making and resistance to doping-related behaviours. This study evaluates the efficacy of the peer-to-peer workshops and their impact on selected psycho-social variables. The collaboration of the volunteer ambassadors is shown to effectively transmit the desired reasoning, reduce doping risk factors and enhance protective factors.

"I Am on Top!": An Interactive Intervention Program to Promote Self-Regulation Processes in the Prevention of the Use of Doping in Sports High Schools.

The use of substances to improve sports performance is a widespread phenomenon among adolescents. Several anti-doping programs have been developed, mainly based on knowledge-based evidence. The main aim of the present study was to implement an anti-doping intervention in sports high school students, based on a psychological framework, such as Socio-Cognitive Theory, through the development of a Serious Game (SG), i.e., digital learning based on the game. The experimental design included an intervention group (n = 167; F = 37.7%; Meanage = 17.5 years; SD = 0.58) and a control group (n = 112; F = 42%; Meanage = 17.6; SD = 1). Both of the groups completed the same questionnaire on two different occasions (i.e., time 1 and time 2) for measuring doping intention, self-regulatory efficacy to resist social pressure for the use of substances, moral disengagement, and doping knowledge. Data were analyzed through repeated measures of Group X Time ANOVA, demonstrating some degree of efficacy of the intervention, in particular in terms of the decrease in doping intention and the strengthening of doping knowledge. Moreover, the study demonstrated that the score obtained during the implementation of the SG could partially represent a coherent measure of the participants' beliefs regarding doping. These results could be considered a starting point for future research to better develop technological anti-doping interventions.

Is the Behavioral Regulation in Exercise Questionnaire a Valid Measure in Older People?

BACKGROUND: Despite the widely recognized benefits of physical activity for preventing physical and cognitive decline during aging, global estimates indicate that most older adults do not achieve the recommended amount of physical activity due to a lack of motivation. The current research examined the validity and psychometric properties of the Behavioral Regulation in Exercise Questionnaire (BREQ-3) among older adults. Based on Self-Determination Theory (SDT), the BREQ-3 stands out as one of the most extensively utilized tools among exercise motivation studies. METHODS: A sample of older adults (N = 383; M age = 73.2 years, SD age = 7.2) completed the BREQ-3 and the Godin-Shepard Leisure-Time Physical Activity Questionnaire (GSLTPAQ). RESULTS: Confirmatory factor analyses confirmed the six-factor structure postulated by SDT, showing good fit indices (CFI= 0.95; RMSEA = 0.05; SRMR = 0.04) and supporting the full measurement invariance of the scale across sex and age groups (65 to 74 years; over 75 years). The construct and criterion validity of the BREQ-3 was upheld through the latent correlations between its subscales and their correlations with the GSLTPAQ. CONCLUSIONS: We demonstrated for the first time the effectiveness of the BREQ-3 in assessing all forms of behavioral regulation proposed by SDT in older adults, suggesting that older adults similarly interpreted the items across sex and age groups.

The role of sense of presence in expressing cognitive abilities in a virtual reality task: an initial validation study.

There is a raised interest in literature to use Virtual Reality (VR) technology as an assessment tool for cognitive domains. One of the essential advantages of transforming tests in an immersive virtual environment is the possibility of automatically calculating the test's score, a time-consuming process under natural conditions. Although the characteristics of VR can deliver different degrees of immersion in a virtual environment, the sense of presence could jeopardize the evolution of these practices. The sense of presence results from a complex interaction between human, contextual factors, and the VR environment. The present study has two aims: firstly, it contributes to the validation of a virtual version of the naturalistic action test (i.e., virtual reality action test); second, it aims to evaluate the role of sense of presence as a critical booster of the expression of cognitive abilities during virtual reality tasks. The study relies on healthy adults tested in virtual and real conditions in a cross-over research design. The study's results support the validity of the virtual reality action test. Furthermore, two structural equation models are tested to comprehend the role of sense of presence as a moderator in the relationship between cognitive abilities and virtual task performance.

The Effects of Social Processing and Role Type on Attention Networks: Insights from Team Ball Athletes.

(1) Background: Several findings have shown how social stimuli can influence attentional processes. Social attention is crucial in team ball sports, in which players have to react to dynamically changing, unpredictable, and externally paced environments. Our study aimed at demonstrating the influence of social processing on team ball sports athletes' attentional abilities. (2) Methods: A total of 103 male players divided by sport (soccer, handball, and basketball) and by role (striker, midfielder, or defender) were tested through a modified version of the Attention Network Test (ANT) in which they were exposed to both social and non-social stimuli. (3) Results: Social stimuli positively impacted the athletes' abilities to focus on target stimuli and ignore conflicting environmental requests (t = -2.600, p = 0.011 *). We also found that the athletes' roles impacted their performance accuracy. Specifically, differences were found in the ability to maintain a general state of reactivity between athletes (strikers vs. midfielders: t = 3.303, p = 0.004 **; striker vs. defenders: t = -2.820, p = 0.017 *; midfielders vs. defenders: t = -5.876, p < 001 ***). (4) Conclusion: These findings revealed that social stimuli are crucial for performance enhancement in team ball sports athletes. Further, we suggest that it is possible to draw specific attentional profiles for athletes in different roles.

Puppies Raised during the COVID-19 Lockdown Showed Fearful and Aggressive Behaviors in Adulthood: An Italian Survey.

During the COVID-19 pandemic, the Prime Minister's decree issued by the Italian government on 9 March 2020, known as "#Iorestoacasa" (I stay at home), required everyone to stay indoors, with a few exceptions, from 11 March to 3 May 2020. This decree had a substantial impact on the mental health of both people and dogs. We carried out a national survey to compare the personalities of adult dogs who were puppies in lockdown (from March to May 2020) with those of adult dogs born after that time (from June 2020 to February 2021). Our results highlighted a significant increase in personality traits related to fear and aggression in dogs who experienced lockdown restrictions during their socialization period, further confirming that the COVID-19 pandemic strongly impacted the behavioral development of dogs. Therefore, it may be advantageous for these dogs to be closely monitored by veterinary behaviorists and receive specialized behavioral rehabilitation therapy to lower the risk of episodes of aggression and fearfulness as well as to increase the wellbeing of dogs raised under social restrictions.

Recreational Athletes' Use of Performance-Enhancing Substances: Results from the First European Randomized Response Technique Survey.

BACKGROUND AND AIM: Measuring the prevalence of doping in recreational sport is difficult. However, to fit their initiatives, National Anti-Doping Organizations are interested in knowing the numbers, so their scarce resources are not wasted. The present study aimed to estimate the prevalence of doping and over-the-counter medicine use for performance enhancement among recreational athletes in eight European countries. DESIGN: A survey covering + 200 sports aimed at recreational athletes 15 years and older was distributed via social media to sports clubs and individuals in eight European countries. To overcome social desirability bias, we applied indirect questioning by using the Randomized Response Technique and asked for the use of over-the-counter medicine and doping for the year 2019. RESULTS: The prevalence of the use of over-the-counter medications for performance enhancement was estimated at 10.4%. We differentiated between the concept of "doping" as the behavior to enhance performance in a certain sport and the concept of "a doper" as a property of a person. The prevalence of dopers in recreational sport was found to be 0.4%, with 3.1% male and 0% female dopers. Responses were separated into four categories: "Artistic sports," "Combat sports," "Games," and "CGS sports" (i.e., sports measured in centimeters, grams, and seconds). The overall prevalence of doping in recreational sports was found to be 1.6%, and the results from Artistic and CGS sports did not differ significantly from this. However, in Games we found an estimated doping prevalence of 6.9%. DISCUSSION: The estimates for the prevalence of dopers and doping in this study do not equal Anti-Doping Rule Violations as stipulated by the World Anti-Doping Agency. Still, while doping is not absent in recreational sport in Europe, it appears to be a low frequent phenomenon. Also, the differences in doping prevalence between the sports categories might reflect structural and competition-related differences, rather than differences in the logic of the sporting competition or discipline-related subcultures. CONCLUSION: While few recreational athletes appear to use illegal drugs to enhance performance, those who do use them are more often men than women. Yet, 1 in 10 recreational athletes uses over-the-counter medication for performance enhancement and more than 4 out of 10 use medication for other reasons than performance enhancement when doing sports. The highest doping prevalence was found in the sub-category of Games, which can likely be attributed to competition-related differences between the categories. Therefore, research on doping in recreational sports needs tailored approaches to come to a better understanding of the phenomenon.

Physical Inactivity and Depression: The Gloomy Dual with Rising Costs in a Large-Scale Emergency.

At the end of October of 2022, the World Health Organization (WHO) released "the Global status report on physical activity 2022" [...].

Addressing Adolescents' Prejudice toward Immigrants: The Role of the Classroom Context.

According to social learning theory, classrooms are essential socialization contexts for intergroup attitudes, but analyses of contextual factors net of the impact of individual variables affecting prejudice toward immigrants are very limited. This study was conducted on a large sample of Italian adolescents (N = 2904; Mage = 13.70; females = 48.5%; 168 classrooms). It examined the role of classroom contextual factors affecting adolescents' prejudice toward immigrants, relying on the combination of groups' warmth and competence, and their antecedents (i.e., competition and status). Multilevel structural equation analyses revealed that classroom contextual factors (i.e., classroom socio-economic status-SES; classroom open to discussion climate; classroom educational achievements) indirectly affected, at the class level, adolescents' perceived warmth and competence of immigrants through the mediating role of perceived competition (and status) of immigrants. These findings suggest that interventions targeting the classroom context can help to hinder prejudice in adolescence at the class level.

Exploring the Psychological Nexus of Virtual and Augmented Reality on Physical Activity in Older Adults: A Rapid Review.

With the global population of older adults projected to double to 2.1 billion by 2050, it becomes crucial to promote healthy aging to alleviate the associated disease burden. In this context, technology, particularly virtual reality (VR) and augmented reality (AR), has garnered attention for its potential to augment physical activity in older adults. These immersive technologies offer interactive and enjoyable exercise experiences, making physical activity more appealing. However, the effectiveness of these interventions is not solely attributed to technology itself but is deeply intertwined with psychological processes. This rapid review examines the effectiveness of VR and AR interventions in enhancing physical exercise among healthy older adults while exploring the role of psychological variables, including mood, self-efficacy, and motivation. The results of the study show that technology-enhanced physical activity interventions hold great promise but call attention to the need for a comprehensive understanding of psychological dynamics that will pave the way for more tailored and effective interventions. Future research endeavors should aim to bridge these gaps in knowledge to optimize the impact of technology on healthy aging.

Validation study of the Italian brief version of the multidimensional jealousy scale: Psychometric properties, measurement invariance across gender, and convergent validity.

Introduction: The multidimensional jealousy scale (MJS) is among the most internationally used instruments for the assessment of jealousy in its three dimensions: cognitive, emotional, and behavioral. This study aimed to replicate the Italian validation process of the shortened MJS in order to confirm its psychometric properties and measurement invariance across gender. Materials and methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted in a large sample of adults (n = 2,928). To reliably estimate mean differences across gender, the measurement invariance of the scale was first established by means of CFA. Convergent validity was than tested by administrating the tool to a convenient sample (n = 304). Results: A 15-item version of the Italian MJS was retained in its three-factor structure. The tool showed good fit with both the CFA (χ2 = 211.827, CFI = 0.969, TLI = 0.959, RMSEA = 0.047, RMSEA 90% CI = 0.039-0.055) and the results confirmed the strong measurement invariance of the MJS across gender. The internal consistency measures were found to be fully satisfactory. Predictive associations with constructs such as avoidance and anxiety referred to attachment in relationships (ECR-R), obsessive jealousy, depressive jealousy, jealousy associated with separation anxiety, paranoid jealousy (QUEGE), and basic self-esteem (BSE) were confirmed. Discussion: The MJS is particularly apt to collect information quickly and efficiently about jealousy in a current relationship. The multidimensional and brief structure makes it particularly suitable for preliminary screening, couple therapy assessment, and research purposes.

Sensory Processing Disorders in Children and Adolescents: Taking Stock of Assessment and Novel Therapeutic Tools.

Sensory processing disorders (SPDs) can be described as difficulty detecting, modulating, interpreting, and/or responding to sensory experiences. Because SPDs occur in many individuals with autism spectrum disorder and in other populations with neurodevelopmental disorders, it is important to distinguish between typical and atypical functioning in sensory processes and to identify early phenotypic markers for developing SPDs. This review considers different methods for diagnosing SPDs to outline a multidisciplinary approach useful for developing valid diagnostic measures. In particular, the advantages and limitations of the most commonly used tools in assessment of SPDs, such as caregiver reports, clinical observation, and psychophysical and neuroimaging studies, will be reviewed. Innovative treatment methods such as neuromodulation techniques and virtual reality will also be suggested.

The use of the Decision Regret Scale in non-clinical contexts.

The Decision Regret Scale (DRS) was assessed for its psychometric qualities in measuring decision regret in ordinary life scenarios. Although the scale has typically been used with patients and in the context of medical decision-making in earlier studies, this contribution shows that the instrument may have a variety of uses, retaining excellent metric properties even in non-medical contexts. The tool showed good fits with both the CFA and the gender Measurement Invariance. A non-probabilistic selection of 2,534 Italian university students was conducted. The internal consistency measures were found to be completely appropriate. Correlations with the General Decision-Making Style (GDMS) and Scale of Regulatory Modes were used to check for convergent validity (SRM). Convergence analysis showed that participants with higher regret scores were those who favored a rational decision-making style, while lower regret scores correlated with avoidant and spontaneous styles. With regard to the regulatory modes, the relationship between regret and locomotion was positive. Overall, the directions of association point to an interesting predictive measure of a person's decision-making and self-regulatory orientation through the evaluation of regret using the DRS. The excellent psychometric properties found foreshadow a reliable use in various contexts where knowledge of post-decisional attitude becomes important: school, university, professional orientation, marketing studies, relationship choices, as well as for use in research.