Combining mindfulness and cognitive training in children with attention deficit hyperactivity disorder: study protocol of a pilot randomized controlled trial (the NeuroMind study).

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) has a global mean prevalence of 5%. Cognitive Training (CT) and Mindfulness-Based Interventions (MBIs) have shown promising results in managing ADHD symptoms, but they are not its Treatment-As-Usual (TAU). The NeuroMind Study aims to evaluate the preliminary effectiveness and feasibility of three interventions: Mindfulness for Health (M4H), CT using the NeuronUP® platform (CT), and a combination of both, Mindfulness Cognitive Training (MCT). There is empirical evidence supporting the effectiveness of the M4H and NeuronUP® platform; however, this study explores for the first time the effectiveness of MCT and CT, as well as the integration of M4H into TAU. The objectives of this 5-month Randomized Controlled Trial (RCT) are: (1) To analyze the preliminary effectiveness and feasibility of M4H, CT or a combination of both (MCT) added to TAU for children with ADHD; (2) To evaluate the role of psychological process variables (mindfulness and emotional regulation) as mediators of 5-month follow-up clinical outcomes; (3) To preliminarily explore whether specific sociodemographic and clinical characteristics can predict the short-and medium-term clinical response to the specific treatments. Methods and analysis: Participants will be 120 children (7 to 12 years) with ADHD recruited at Child and Adolescent Mental Health Service (CAMHS) Sant Joan de Déu Terres de Lleida (Spain) randomly allocated to one of the four study arms: TAU vs. TAU + CT vs. TAU + M4H vs. TAU + MCT. An assessment to collect ADHD symptoms, Executive Functions (EF), comorbid symptoms and global functioning will be conducted pre-intervention, post-intervention (2 months after baseline) and at the 5-month follow-up. Linear mixed models and mediational models will be computed. Discussion: If the preliminary effectiveness and feasibility of the MCT are demonstrated, this study could be a preliminary basis to do a full RCT with a larger sample to definitively validate the intervention. The MCT could be applied in clinical practice if it is definitively validated.Clinical trial registration:ClinicalTrials.gov, identifier, NCT05937347. https://clinicaltrials.gov/study/NCT05937347?locStr=Spain&country=Spain&cond=ADHD&intr=Mindfulness&rank=1.

The Toronto Mindfulness Scale and the State Mindfulness Scale: psychometric properties of the Spanish versions.

Objectives: The Toronto Mindfulness Scale (TMS) and the State Mindfulness Scale (SMS) are two relevant self-report measures of state mindfulness. The purpose of this study was to examine the internal structure and to offer evidence of the reliability and validity of the Spanish versions of the TMS and SMS. Methods: Data from six distinct non-clinical samples in Spain were obtained. They responded to the TMS (n = 119), SMS (n = 223), and measures of trait mindfulness, decentering, non-attachment, depression, anxiety, stress, positive and negative affect, self-criticism, and self-reassurance. The internal structure of the TMS and SMS was analyzed through confirmatory factor analysis. Reliability, construct validity, and sensitivity to change analyses were performed. Results: The correlated two-factor structure (curiosity and decentering) was the best-fitting model for the TMS (CFI = 0.932; TLI = 0.913; RMSEA = 0.100 [0.077-0.123]; WRMR = 0.908). The bifactor structure (general factor, mindfulness of body, and mindfulness of mind) was the best-fitting model for the SMS (CFI = 0.961; TLI = 0.950; RMSEA = 0.096 [0.086-0.106]; WRMR = 0.993). Adequate reliability was found for both measures. The reliability of the SMS specific factors was very poor when controlling for the general factor. The patterns of correlations were mainly as expected and according to previous literature. The TMS and SMS have been able to detect state mindfulness changes after different meditation practices. Conclusion: Validity evidence is provided to support the use of the TMS and SMS in Spanish populations, though the reliability of the SMS specific factors merit revision.

Efficacy of a mindfulness and compassion-based intervention in psychotherapists and their patients: Empathy, symptomatology, and mechanisms of change in a randomized controlled trial.

In recent years, mindfulness and compassion-based interventions (MCBI) have been found to beneficially influence the acquisition of essential skills in psychotherapy and are a promising way to improve relationships with patients. In this regard, new studies are needed to evaluate the effects of MCBI on psychotherapists and their patients and to analyze the influence of these effects on the processes and outcomes of psychotherapy. In this randomized controlled trial, we evaluate the efficacy of an MCBI in psychotherapists' mindfulness skills and self-reported empathy, as well as its indirect effect on patients (patient-reported psychotherapists' empathy, therapeutic bond, and symptomatology). Finally, we present a multilevel structural equation model (MSEM) to analyze the relationship between these variables in psychotherapists and their patients. A group of psychotherapists (N = 63) were randomized to an MCBI or an active control group (empathy diary). We assessed psychotherapists and their patients (N = 121) before and after the MCBI and at follow-up evaluation. Psychotherapists' results showed an increase in psychotherapeutic mindfulness skills (PMS) after the MCBI and at follow-up, whereas self-reported empathy improved at follow-up. Patients' results showed an improvement in perceived empathy, therapeutic bond, and symptomatology after the MCBI. The improvements in symptomatology were maintained for somatization and anxiety at follow-up. According to the MSEM, the increase in PMS is related to an increase in patient-reported psychotherapists' empathy, which produces an improvement in therapeutic bond and their symptomatology. These results support the benefits of introducing MCBI in psychotherapists' training to improve the psychotherapy outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Advancing the treatment of long-lasting borderline personality disorder: a feasibility and acceptability study of an expanded DBT-based skills intervention.

BACKGROUND: Long-term follow-up studies in patients with borderline personality disorder (BPD) consistently show persistent impairment in psychosocial adjustment, although symptoms tend to decrease over time. Consequently, it might be better to deemphasize symptom-oriented interventions and instead promote interventions that incorporate patient perspectives on recovery. In this study we aimed to examine the feasibility and acceptability of a novel intervention (dialectical behavioral therapy combined with positive psychology and contextual-based skills) in the clinical treatment of long-lasting BPD difficulties. METHODS: This was a qualitative study. We developed an initial 8-week group intervention for long-lasting BPD. Upon completion of the 8-week program, the participants were asked to participate in a group discussion to provide feedback. Based on that feedback, the intervention protocol was modified and then offered to a second group of patients, who also provided feedback. The protocol was revised again and administered to a third group. A total of 32 patients participated in the group interventions; of these, 20 provided feedback in the qualitative study. The main outcome measure was acceptability. RESULTS: The following overarching themes emerged from the group interviews: helpful, unhelpful and neutral practices; internal/external barriers; facilitators; and effects. Participants reported difficulties in imagining an optimal future and self-compassion. By contrast, positive skills were associated with an increase in positive emotions. The main internal barrier was facing difficult emotions. The main external barriers were language-related issues. The group format was perceived as a facilitator to success. Dropout rates, which were assessed as an additional measure of acceptability, decreased substantially in each successive group, from 60 to 40% and finally 20%. CONCLUSIONS: The intervention was feasible to implement in the clinical setting and participants rated the final set of skills highly. Most of the skills were considered useful. Participant feedback was invaluable to improve the intervention, as evidenced by the large increase in the retention rate from 40 to 80%. Randomized clinical trials are needed to test the efficacy of this intervention in promoting well-being in participants with long-lasting BPD.

Wellbeing Training Based on Contemplative Practices in a Sample of Intensive Care and Homecare Professionals: A Pilot and Feasibility Non-Randomized Clinical Trial.

BACKGROUND: Intensive care unit (ICU) and homecare unit professionals are susceptible to higher levels of stress and burnout than other healthcare professionals, which has an impact on their well-being, and in turn on their patients. In terms of data, there is not much research about the effects of psychological interventions on ICU and homecare professionals. The aim of this study was to investigate the effectiveness of Wellbeing Training based on Contemplative Practices (WTCP) for the increase of psychological functioning in a sample of ICU and homecare professionals. METHODS: A pilot and feasibility non-randomized clinical trial was conducted. Participants in the WTCP group (n = 19) attended an at-work 8-session/2 h group WTCP program aimed at directly training four basic skills: (a) sustained positive emotions, (b) recovery from negative emotions, (c) pro-social behavior and generosity, and (d) mind wandering, mindfulness, and "affective stickiness". Nineteen professionals were allocated in the control group. RESULTS: Results indicated that WTCP had a positive impact on self-compassion, personal accomplishment (burnout), and frequency of negative emotions. Moreover, a thematic analysis of participant interviews (n = 14) was conducted. CONCLUSIONS: These preliminary results are promising, though future research is needed to evaluate the effectiveness of WTCP using randomized controlled trial methodologies.

Mindfulness Component in a Dialectical Behavioural Therapy Group Intervention for Family Members of Borderline Personality Disorder Patients.

BACKGROUND: Family members of people with borderline personality disorder (BPD) are seriously affected by the disease and it is common for them to ask for professional help. The main objective of this study is to assess, in an open clinical trial, a treatment protocol based on Dialectical Behaviour Therapy (DBT) strategies for relatives of individuals with BPD, compared to the same protocol plus a mindfulness component (DBT-M). METHOD: The interventions were conducted in a sample of 108 relatives of 83 patients diagnosed with BPD from a Specialized Unit for Personality Disorders. Relatives and patients completed the assessment protocol before and after the intervention. RESULTS: Significant improvements in almost all the relevant variables tested were observed after the treatment in both the relatives and the patients. However, there were only statistically significant differences between the groups in the negative attitude towards the illness, where relatives in the DBT-M condition showed greater improvement than those in the DBT condition. CONCLUSIONS: The results indicate that the intervention helps both patients and relatives to improve on key issues. It is essential to consider and offer support to the families of people with severe psychological disorders.

Meditators' Non-academic Definition of Mindfulness.

Objectives: Mindfulness has been defined differently in academic scientific contexts and in Buddhist academic contexts. An under-studied area is that of lay (non-academic) theories of mindfulness. The goal of this article is to identify, organize, analyze in detail, and provide themes from the meditators' definitions of mindfulness. Possible differences and similarities of the collected definitions of mindfulness with the scientific-academic definitions and with the academic-Buddhist definitions are also checked. Methods: A qualitative and inductive thematic analysis on the definitions of mindfulness offered by the participants was carried out. Results: The sample consisted of 326 meditators who offered a definition of mindfulness through an open question. Seven themes were identified: (1) mindfulness defined as attention/awareness; (2) mindfulness defined as a non-evaluative attitude; (3) mindfulness defined as strategy; (4) mindfulness defined from a theoretical analysis; (5) mindfulness defined as a psycho-affective-spiritual state; (6) mindfulness defined as personal development; and (7) lack of understanding of mindfulness. From these themes, it can be deduced that the definitions collected share more patterns of meaning with the scientific-academic definition of mindfulness than with the academic-Buddhist one. Conclusions: The findings of this study provide new insights into the complexity and heterogeneity of the definition of mindfulness. What has been discovered may indicate the complexity of the mindfulness construct itself. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-022-01899-3.

Impact of Mindfulness Training on Spanish Police Officers' Mental and Emotional Health: a Non-Randomized Pilot Study.

Objectives: The purpose of this exploratory non-randomized controlled study was to determine the acceptance and effectiveness of an 8-week mindfulness-based intervention (MBI) co-designed by a police officer. Methods: A pretest-posttest control group design was followed. Participants (MBI group = 20; control group = 18) answered baseline and post-training self-reported measures. In addition, the weekly emotional state of the MBI group was collected. Paired-samples t-test and analysis of covariance were performed for pre-post within-group and between-group differences, respectively, as well as linear mixed effects analysis of repeated measures for week-by-week data. Results: High acceptance and attendance rates, as well as significant pre-post within-group differences in the MBI group in mindfulness (η 2 = 0.43), self-compassion (η 2 = 0.43), depression (η 2 = 0.54), anxiety (η 2 = 0.46), stress (η 2 = 0.51), difficulties in emotion regulation, sleep quality (η 2 = 0.57), and burnout (η 2 = 0.31-0.47), were identified. Moreover, police officers who underwent the MBI experienced a week by week decrease of anger, disgust, anxiety, sadness, and desire. Finally, after adjusting for pre-test scores, significant between-group differences were found in the way of attending to internal and external experiences (observing mindfulness facet; η p 2 = 0.21), depression symptoms (η p 2 = 0.23), general distress (η p 2 = 0.24), and the degree of physical and psychological exhaustion (personal burnout; η p 2 = 0.20). Conclusions: The preliminary effectiveness of this MBI on psychopathology and quality of life outcomes in Spanish police officers was discussed. Previous evidence regarding the promising use of MBIs in this population was supported.

Can Avatar Appearance Influence Physical Activity? User-Avatar Similarity and Proteus Effects on Cardiac Frequency and Step Counts.

This study combined user-avatar similarity and Proteus effect predictions to incentivize physical activity. 305 participants ran while wearing accelerometers and a heart rate monitor. They were randomly assigned to onscreen motion-capturing avatars displaying either participant or stranger faces dressed in sports or formal clothes. Participants assigned to avatars displaying their own face showed increased cardiac frequency compared with those exposed to avatars with a stranger's face. Relative to the remaining conditions, participants assigned to avatars with their own face also wearing sports clothes showed increased cardiac frequency but participants assigned to avatars with a stranger's face wearing formal clothes showed decreased cardiac frequency. The results imply that user-avatar similarity and the Proteus effect can be harnessed to influence physical activity.

Mindfulness Training for Children with ADHD and Their Parents: A Randomized Control Trial.

OBJECTIVE: The aim of this randomized control trial is to analyze the efficacy of a Mindfulness-based program (MYmind) in improving ADHD symptoms, associated problems, executive functions, and family functioning. METHOD: The sample was composed of 30 children (9-14 years old) with an ADHD diagnosis and their parents. Participants were randomized into two groups, the MYmind group (n = 15) and a wait-list group (n = 15). Participants were assessed in three time periods: pre-, post-intervention, and at 6-month follow-up. RESULTS: After the program, parents reported a decrease in parenting stress and improvements in parenting styles. Six months after the intervention, parents reported significant improvements in children's inattention symptoms, executive functions, learning problems, aggression, and peer relations. Overreactivity was the only variable that showed a decrease in both the post-test and follow-up periods. CONCLUSION: These results suggest that the MYmind program is a promising treatment for children with ADHD and their parents.

Effectiveness of mindfulness-based interventions on psychotherapy processes: A systematic review.

In the field of psychotherapy, scientific research has highlighted the importance of empathy and therapeutic alliance in regard to the effectiveness and better results of psychological treatments. In recent years, mindfulness-based interventions (MBIs) have shown to be effective at increasing empathy and therapeutic alliance and how this could affect the patients' symptomatology. In this study, we conducted a systematic review of the effectiveness of MBIs applied to psychotherapists to improve their empathy, the therapeutic alliance and the patients' symptomatology. Sixteen studies evaluating the impact of an MBI on some of these variables were identified, of which six included measures evaluated by the patients whose psychotherapists received the MBI. The risk of bias of the included studies was analysed following the methodological standards. We found very different designs and methodologies in the studies included in this review, with few of them including a control group. The results show a limited increase in empathy, measured by the psychotherapist, after an MBI. However, the results in therapeutic alliance are not conclusive, as well as the improvements in the perception of patients about their symptomatology. It is concluded that MBIs can have a beneficial effect on the psychotherapeutic practice, through the development of psychotherapists' empathy. Future research would require new studies with a higher methodological quality, and in which the effects of MBIs on empathy, therapeutic alliance and patients' symptomatology and the relationships between them are analyzed.

Mindfulness Component in a Dialectical Behavioural Therapy Group Intervention for Family Members of Borderline Personality Disorder Patients / Mindfulness en una Intervención Grupal de Terapia Dialéctica Conductual para Familiares de Pacientes con Trastorno Límite de la Personalidad

Background: Family members of people with borderline personality disorder (BPD) are seriously affected by the disease and it is common for them to ask for professional help. The main objective of this study is to assess, in an open clinical trial, a treatment protocol based on Dialectical Behaviour Therapy (DBT) strategies for relatives of individuals with BPD, compared to the same protocol plus a mindfulness component (DBT-M). Method: The interventions were conducted in a sample of 108 relatives of 83 patients diagnosed with BPD from a Specialized Unit for Personality Disorders. Relatives and patients completed the assessment protocol before and after the intervention. Results: Significant improvements in almost all the relevant variables tested were observed after the treatment in both the relatives and the patients. However, there were only statistically significant differences between the groups in the negative attitude towards the illness, where relatives in the DBT-M condition showed greater improvement than those in the DBT condition. Conclusions: The results indicate that the intervention helps both patients and relatives to improve on key issues. It is essential to consider and offer support to the families of people with severe psychological disorders.(AU)

Antecedentes: Los familiares de las personas con trastorno límite de la personalidad (TLP) son unos de los grandes afectados por el trastorno, y resulta frecuente que soliciten ayuda profesional. El objetivo estudio es evaluar un protocolo de tratamiento basado en estrategias de Terapia Dialéctica Conductual (DBT) para familiares de personas con TLP, en comparación con el mismo protocolo más un componente de mindfulness (DBT-M). Método: Las intervenciones se realizaron en una Unidad Especializada en Trastornos de la Personalidad, en una muestra 108 familiares de 83 pacientes diagnosticados de TLP. Familiares y pacientes completaron el protocolo de evaluación antes y después de la intervención. Resultados: Se observan mejoras significativas tanto en los familiares como en los pacientes tras el tratamiento, en casi todas las variables relevantes. Sin embargo, sólo hubo diferencias estadísticamente significativas entre las dos condiciones en la actitud negativa hacia la enfermedad, donde los familiares en la condición DBT-M mostraron una mejoría mayor que los de la condición DBT. Conclusiones: Los resultados indican que la intervención ayuda, tanto a los pacientes como a los familiares, a mejorar en aspectos clave. Resulta fundamental tener en cuenta y ofrecer apoyo a los familiares de personas con trastornos psicológicos graves.(AU)

Decentering, Acceptance, and Non-Attachment: Challenging the Question "Is It Me?"

Among mindfulness measures the three constructs acceptance, decentering, and non-attachment are psychometrically closely related, despite their apparent semantic differences. These three facets present robust psychometric features and can be considered core themes in most "third wave" clinical models. The aim of the present study was to explore the apparently different content domains (acceptance, decentering, and non-attachment) by administering various psychometric scales in a large sample of 608 volunteers. Resilience and depression were also assessed. Exploratory and confirmatory factor analyses performed in two randomly selected subsamples showed a bifactor approximation. The explained common variance suggested a unidimensional nature for the general factor, with good psychometric properties, which we named "Delusion of Me" (DoM). This construct is also strongly correlated with resilience and depression, and appears to be a solid latent general construct closely related to the concept of "ego." DoM emerges as a potentially transdiagnostic construct with influence on well-being and clinical indexes such as resilience and depression. Further studies should analyze the potential utility of this new construct at a therapeutic level.

Changes in the Semantic Construction of Compassion after the Cognitively-Based Compassion Training (CBCT®) in Women Breast Cancer Survivors.

The growing body of research on compassion has demonstrated its benefits for healthcare and wellbeing. However, there is no clear agreement about a definition for compassion, given the novelty of the research on this construct and its religious roots. The aim of this study is to analyze the mental semantic construction of compassion in Spanish-speaking women breast cancer survivors, and the effects of the Cognitively-Based Compassion Training (CBCT®) on the modification of this definition, compared to treatment-as-usual (TAU), at baseline, post-intervention, and six-month follow-up. Participants were 56 women breast cancer survivors from a randomized clinical trial. The Osgood's Semantic Differential categories (evaluative, potency, and activity scales) were adapted to assess the semantic construction of compassion. At baseline, participants had an undefined idea about compassion. The CBCT influenced subjects' semantic construction of what it means to be compassionate. Findings could lead to future investigations and compassion programs that adapt to a specific culture or population.

Assessing self-criticism and self-reassurance: Examining psychometric properties and clinical usefulness of the Short-Form of the Forms of Self-Criticizing/Attacking & Self-Reassuring Scale (FSCRS-SF) in Spanish sample.

The Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS) was designed to measure self-criticism (SC) through Inadequate Self (IS) and Hated Self (HS) factors, as well as self-reassurance (RS). However, its long and short forms have yet to be validated in the Spanish Population. The present study examines the psychometric properties of the short form (FSCRS-SF) and its clinical usefulness in a sample of 576 adult individuals, 77 with psychiatric disorders and 499 without. Non-clinical participants were split according to their previous experience with meditation (active meditators, n = 133; non-active meditators, n = 41; and non-meditators, n = 325) and differences between these subgroups were explored. Additionally, a subsample of 20 non-clinical participants took part in a mindfulness- and compassion- based intervention (MCBI) to assess the usefulness of the scale as an outcome measure. Results confirmed the original three-factorial structure, good internal consistency, acceptable test-retest reliability, and a pattern of correlations consistent with previous literature. Regarding differences between groups, the clinical subsample showed significant higher SC and lower RS levels than non-clinical participants and active meditators had significant lower IS and higher RS levels than non-meditators. Participants who participated in the MCBI showed significant RS improvement and a decrease in IS and HS levels. Moreover, a hierarchical multiple regression showed that RS made a significant predictive contribution to distress at three months' time. In conclusion, results show that the Spanish version of the FSCRS-SF is a reliable and valid measure of SC and RS in non-clinical populations and an adequate instrument to detect changes after MCBIs.

Introducing mindfulness and compassion-based interventions to improve verbal creativity in students of clinical and health psychology.

OBJECTIVES: In the field of psychotherapy, verbal creativity has been suggested as an important aspect in psychotherapists' training. In the present study, the effects of a mindfulness and compassion-based intervention (MCBI) on verbal creativity are analysed in students of clinical and health psychology (N = 90). DESIGN: Students were randomly assigned to an experimental group (n = 37), in which an MCBI was applied, and a waiting list group (n = 26) with no intervention. We also assessed a non-randomized active control group (n = 27), in which students received training in basic psychotherapy skills. METHODS: Verbal creativity (fluency, flexibility, and originality) was evaluated in a pre-, post-, and follow-up assessment. RESULTS: Results indicated a significant increase in fluency (p = .001, d = .64), flexibility (p = .017, d = .67), and originality (p = .004, d = .72) in the experimental group, relative to the waiting list group, in the post-assessment. Fluency (p = .010, d = .64) and flexibility (p = .033, d = .62) were also found to be higher in the follow-up assessment. In addition, results indicated a significant increase in flexibility (p = .034, d = .74) in the experimental group, relative to the active control group, in the follow-up assessment. CONCLUSIONS: Introducing MCBI in the university education of psychotherapists seems to be a useful strategy to improve their verbal creativity, which could positively influence their ability to explore and appropriately respond to their patients' needs. PRACTITIONER POINTS: Mindfulness and compassion-based interventions (MCBIs) could be a useful strategy to improve verbal creativity in the university education of psychotherapists. After the MCBI, students of clinical and health psychology increased the number of ideas they produced when facing a specific situation, as well as their variety and originality.

Adolescent Motivation Toward Physical Exercise: The Role of Sex, Age, Enjoyment, and Anxiety.

Physical exercise declines during adolescence due to several factors, such as lack of intrinsic motivation or enjoyment, high physical exercise anxiety, and so on. The objectives of this study were to validate the psychometric structure of the Behavioral Regulation in Exercise Questionnaire-2 to confirm the existence of five levels of motivation toward physical exercise in adolescent population, as well as to analyze the differences in motivation according to sex and age, and the role of age and sex in the relationship between motivation and enjoyment. To do so, 666 students between 10 and 16 years old completed the Behavioral Regulation in Exercise Questionnaire-2 and questionnaires related to enjoyment and physical exercise anxiety. The confirmatory factor analysis of the Behavioral Regulation in Exercise Questionnaire-2 showed a five-factor structure. However, a more parsimonious four-factor structure with a single intrinsic-identified regulation emerged through an exploratory factor analysis. The more self-determined types of motivation were positively associated with enjoyment and negatively with anxiety, the type of physical exercise motivation fluctuated depending on age and sex, and the age moderated the relationship between motivation and enjoyment. This study highlights the importance of fostering specific types of motivation to improve the physical exercise and the relevance of age and sex when developing interventions.

Efficacy and acceptability of a web platform to teach nutrition education to children / Eficacia y aceptabilidad de una plataforma web para enseñar educación nutricional a niños

INTRODUCTION: Nutrition Education (NE) has been identified as a key factor to prevent children obesity. Teachers and dietitians are the professionals in charge of transmitting this knowledge to children; however, it has been identified that they do not possess either proper training, or the proper tools to perform this activity. OBJECTIVES: to evaluate the acceptability and usability of a NE Internet platform and its two "Serious Games" (SGs) among a sample of elementary school teachers, dietitians, and education students. In addition, to evaluate the efficacy of this platform to teach NE in a sample of children aged 9 to 12 years. METHODS: a total of 66 NE professionals and 135 children participated. Usability and acceptability questionnaires of the platform and an instrument to measure the acceptability, immersion, and playability of the SGs were administered to the professionals. The children fulfilled a questionnaire on nutritional knowledge. Descriptive statistics analyzed the main responses of the professionals involved, and an ANOVA compared the differences observed. For the children's data a t-test of repeated samples and a repeated-measures ANOVA were performed. RESULTS: dietitians and education students responded with a favorable opinion about the platform; however, the scores given by all professionals to the SGs ranged from low to moderate. Children increased their nutritional knowledge from pre to post evaluation (p < 0.001). This increase was observed in 10-year-old children and in children with 11 to 12 years of age, but not in 9-year-olds. CONCLUSIONS: this platform proved to be an effective tool to increase children's nutritional knowledge. Professionals expressed a medium level in terms of acceptability and usability for this platform, but also effectiveness in providing NE to children

INTRODUCCIÓN: la educación nutricional (EN) se ha identificado como un factor clave para prevenir la obesidad infantil. Los profesionales encargados de transmitir este conocimiento a los niños son maestros y dietistas; sin embargo, se ha identificado que no cuentan ni con la capacitación, ni con las herramientas adecuadas para realizar esta actividad. OBJETIVOS: evaluar la aceptabilidad y la facilidad de uso de una plataforma de Internet de EN y sus dos "Juegos Favoritos" (JF) en una muestra de maestros de primaria, nutricionistas y estudiantes de educación. Además, evaluar la eficacia de esta plataforma para enseñar EN en una muestra de niños de 9 a 12 años. MÉTODOS: participaron un total de 66 profesionales de EN y 135 niños. Se administraron a los profesionales cuestionarios de usabilidad y aceptabilidad de la plataforma, y un instrumento para medir la aceptabilidad, la inmersión y la jugabilidad de los JF. Los niños completaron un cuestionario sobre conocimiento nutricional. Se analizaron con estadísticas descriptivas las principales respuestas de los profesionales y las diferencias se compararon con un ANOVA. Para los datos de los niños se realizaron una prueba "t" de muestras repetidas y un ANOVA de medidas repetidas. RESULTADOS: los nutricionistas y los estudiantes de educación dieron una opinión favorable sobre la plataforma; sin embargo, las puntuaciones de todos los profesionales acerca de los JF fueron de bajas a medias. Los niños aumentaron su conocimiento nutricional al comparar la evaluación antes y después de la plataforma (p < 0.001). El aumento se observó en los niños de 10 años y en los niños de 11 a 12 años, pero no en los niños de 9 años. CONCLUSIONES: esta plataforma demostró ser una herramienta efectiva para aumentar el conocimiento nutricional de los niños. Los profesionales expresaron un nivel medio en términos de aceptabilidad y usabilidad para esta plataforma, pero también efectividad para impartir EN a los niños

Mindfulness, promoção da saúde e semiótica: bases para modelos comunicacionais em saúde online / Mindfulness, health promotion, and semiotics: Bases for communication models in online health / Mindfulness, promoción de la salud e semiótica: bases para modelos de comunicación en salud em línea

OBJETIVO: identificar como o texto verbo-visual do curso produz sentidos e como isso pode auxiliar na construção do design de outros cursos. MÉTODO: foi feita a análise semiótica de duas práticas e de um print de tela do curso denominado Programa de Autocuidado Baseado em Mindfulness, na modalidade Educação à Distância, desenvolvido pelo Centro Brasileiro de Mindfulness e Promoção da Saúde ("Mente Aberta"), do Departamento de Medicina Preventiva da Universidade Federal de São Paulo. Foram avaliados os elementos estéticos que contribuiriam para a construção de um ambiente de prática eufórico (ligado à saúde) e estabelecidas relações entre o plano de conteúdo e o plano de expressão das práticas, responsáveis pela construção de um sistema semissimbólico. RESULTADOS: confirmou-se a valorização de uma estética da simplicidade de cores e formas que converge para uma afirmação dos valores calma e bem-estar compatíveis com as práticas de mindfulness. CONCLUSÃO: a partir dessa análise, busca-se refletir sobre as bases para o desenvolvimento de modelos comunicacionais relacionados à promoção da saúde em ambiente digital.

OBJECTIVE: to analyze an online course on health promotion based on mindfulness (mindfulness) through the theory of discursive semiotics in one of its most recent developments, the visual or plastic aspect. The objective is to identify how the verbal-visual text of the course produces meanings and how it can help in the design of other courses. METHOD: a semiotic analysis of two practices and a screen print of the course called Mindfulness-Based Self-Care Program, in distance learning, developed by the Brazilian Center for Mindfulness and Health Promotion ("Open Mind"), of the Department of Preventive Medicine at the Federal University of São Paulo. RESULTS: the aesthetic elements that contributed to the construction of an euphoric practice environment (linked to health) were evaluated and relationships were established between the content plan and the practice expression plan, responsible for the construction of a semi-symbolic system. CONCLUSION: it was confirmed the appreciation of an aesthetics of simplicity of colors and shapes that was converged to an affirmation of the values ​​of calm and well-being compatible with the practices of mindfulness. From this analysis, we seek to reflect on the bases for the development of communicational models related to health promotion in a digital environment.

OBJETIVO: analizar un curso en línea sobre promoción de la salud basado en la atención plena (mindfulness) a través de la teoría de la semiótica discursiva en uno de sus desarrollos más recientes, el aspecto visual o plástico. El objetivo es identificar cómo el texto verbal-visual del curso produce significados y cómo puede ayudar en el diseño de otros cursos. MÉTODO: se llevó a cabo un análisis semiótico de dos prácticas y una impresión de pantalla del curso llamado Programa de autocuidado basado en la atención plena, en educación a distancia, desarrollado por el Centro Brasileño de Mindfulness y Promoción de la Salud ("Mente Abierta"), del Departamento de Medicina Preventivade de la Universidad Federal de São Paulo. RESULTADOS: se evaluaron los elementos estéticos que contribuyeron a la construcción de un entorno de práctica eufórica (vinculado a la salud) y se establecieron relaciones entre el plan de contenido y el plan de expresión de práctica, responsables de la construcción de relaciones semi-simbólicas. CONCLUSIÓN: se confirmó la valoración de una estética de simplicidad de colores y formas, que convergió en una afirmación de los valores de calma y bienestar compatibles con las prácticas de mindfulness. A partir de este análisis, buscamos reflexionar sobre las bases para el desarrollo de modelos comunicacionales relacionados con la promoción de la salud en un entorno digital.

Virtual Reality as a Medium to Elicit Empathy: A Meta-Analysis.

The current meta-analysis aims to investigate and clarify existing research on virtual reality (VR) as a medium to elicit empathy. An exhaustive literature search (updated to February 29, 2020) enabled us to locate seven published articles, yielding a total of nine independent samples. The results reveal statistically significant positive changes in perspective-taking outcomes after VR exposure (d+ = 0.51 [95 percent CI: 0.15-0.88]) but they did not note in empathy (d+ = 0.21 [95 percent confidence interval, CI: -0.37-0.79]). A potential limitation of this work is the low number of studies included. Implications and directions for theoretical development and empirical research are also discussed.