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Background: This study aimed to examine whether dyadic coping (DC) is associated with relationship satisfaction (RS) among couples facing cardiac diseases. Furthermore, the moderating role of both partners’ anxiety and depression was tested. Methods: One hundred cardiac patients (81.5% men) and their partners (81.5% women) completed a self-report questionnaire during hospitalization. The Actor–Partner Interdependence Model (APIM) and moderation analyses were used to assess the above associations. Results: Results showed that positive DC was significantly related to higher levels of RS, and negative DC was related to lower levels of RS. Furthermore, patient and partner psychological distress significantly moderated the link between DC and RS: patient-perceived positive DC was associated with higher partner RS when partner depression was high; partner-perceived positive DC was associated with higher patient RS when patient anxiety was low; patient-perceived negative DC has associated with lower patient RS when patient anxiety and depression were high. Conclusion: This study showed that positive DC is associated with a more satisfying relationship and identified under what conditions of cardiac-related distress this can happen. Furthermore, this study underlined the importance of examining DC in addition to the individual coping skills as a process pertaining to personal well-being and couple’s outcomes.

Objective A two-arm parallel randomised controlled trial was conducted to evaluate the efficacy of a group acceptance-based treatment (ABT) in improving pain acceptance, pain catastrophising, kinesiophobia, pain intensity and physical functioning compared to treatment as usual in patients with fibromyalgia (FM) and comorbid obesity. Methods Female individuals diagnosed with FM and obesity (n = 180) were randomly assigned to either a three-weekly group acceptance-based treatment plus treatment as usual (ABT+TAU) or only TAU. The variables of interest were assessed at baseline (T0) and after the interventions (T1). The treatment protocol for the ABT+TAU condition, designed for an inpatient rehabilitation context, is based on acceptance and commitment therapy but focuses specifically on pain acceptance, a crucial factor in fostering a more functional adaptation to chronic pain. Results Participants in the ABT+TAU group showed significant improvements in pain acceptance (i.e. the primary outcome), but also in pain catastrophising, kinesiophobia, and performance-based physical functioning (i.e. the secondary outcomes) compared to those in the TAU group. However, there were no significant differences in pain intensity between the two groups. Conclusion These findings indicate that a brief group-based ABT intervention is effective in enhancing pain acceptance, reducing pain catastrophising and kinesiophobia, and improving performance-based physical functioning. Furthermore, the observed improvements in kinesiophobia and physical functioning may have particular relevance for individuals with comorbid obesity, as they can facilitate greater adherence to physical activity and promote weight loss.

Objective: Mild Cognitive Impairment (MCI) is rapidly becoming one of the most common clinical manifestation affecting the elderly. The main aim of the SENIOR Project [SystEm of Nudge theory-based Information and Communications Technology (ICT) applications for OldeR citizens] is the development and validation of a new Nudge theory-based ICT coach system for monitoring and empowering persons with MCI. Methods: a multi-center randomized controlled clinical trial (RCT) involving 200 senior citizens with MCI will be implemented. Online assessment of demographic, psychological, neuropsychological, and behavioral outcomes will be carried out through the user’s device/smartwatch. A machine learning algorithm-based customized profile will elaborate specific nudge-based notifications and suggestions will be provided to the user via SENIOR app. Expected results and conclusions: real-time monitoring and tutoring will decelerate the worsening of clinical condition and will improve the general perceived wellbeing of persons with MCI – also empowering care providers through dissemination of knowledge on the condition functioning and therapy. Moreover, the provision of tailored care actions will contribute to a more sustainable national and local healthcare systems.

Background/Aim: The aim of the study was to investigate boost volume definition, doses, and delivery techniques for rectal cancer dose intensification. Patients and Methods: An online survey was made on 25 items (characteristics, simulation, imaging, volumes, doses, planning and treatment). Results: Thirty-eight radiation oncologists joined the study. Twenty-one delivered long-course radiotherapy with dose intensification. Boost volume was delineated on diagnostic magnetic resonance imaging (MRI) in 18 centres (85.7%), and computed tomography (CT) and/or positron emission tomography-CT in 9 (42.8%); 16 centres (76.2%) performed co-registration with CT-simulation. Boost dose was delivered on gross tumor volume in 10 centres (47.6%) and on clinical target volume in 11 (52.4%). The most common total dose was 54-55 Gy (71.4%), with moderate hypofractionation (85.7%). Intensity-modulated radiotherapy (IMRT) was used in all centres, with simultaneous integrated boost in 17 (80.8%) and image-guidance in 18 (85.7%). Conclusion: A high quality of treatment using dose escalation can be inferred by widespread multidisciplinary discussion, MRI-based treatment volume delineation, and radiation delivery relying on IMRT with accurate image-guided radiation therapy protocols.

The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cognitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. One hundred and fifty-five adults (BMI: Kg/m2 = 43.8 [6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demographical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were administered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation effects for gender and Eating Disorders (ED) have been considered. From baseline to discharge, no significant differences between interventions were found, with the only exception of an improvement in the CORE-OM total score and in the CORE-OM subjective wellbeing subscale for those in the CBT condition. From discharge to follow-up, ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II wellbeing, symptoms, and psychological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM subscale reporting the risk for self-harm or harm of others. The presence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-OM symptoms and psychological problems subscales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥ 5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.

The literature assumes that activating patients in the treatment is associated with positive health-related outcomes, such as clinical indicators in the normal range, high medication adherence, and low emergency department utilization. In the cardiac population, patient activation, that is the patient’s knowledge, skills, confidence, and behaviors needed for managing one’s own health and health care, has been less investigated. In addition, limited attention has been given to the role of the partner as an informal caregiver. However, the patient in the care process is rarely alone, and the partner may play a key role in this process. The goal of this dyadic study (N = 100 heterosexual couples with one partner suffering from an acute cardiac event) is to analyze how individual factors (patients’ anxiety, depression, medication adherence, pessimistic perception of illness) and the couple’s relationship functioning (e.g., different kinds of partner support and dyadic coping) are associated with patient activation. The results showed that patient activation is not a mere question of age. It is positively related to medication adherence and to the partner’s support patient activation. It is negatively correlated with the patient’s psychological distress, pessimistic perception of illness, and to the partner’s hostility. The need for a dyadic approach to both research and intervention with this population is discussed.

Objective: Mild Cognitive Impairment (MCI) is rapidly becoming one of the most common clinical manifestation affecting the elderly. The main aim of the SENIOR Project [SystEm of Nudge theory-based Information and Communications Technology (ICT) applications for OldeR citizens] is the development and validation of a new Nudge theory-based ICT coach system for monitoring and empowering persons with MCI. Methods: a multi-center randomized controlled clinical trial (RCT) involving 200 senior citizens with MCI will be implemented. Online assessment of demographic, psychological, neuropsychological, and behavioral outcomes will be carried out through the user’s device/smartwatch. A machine learning algorithm-based customized profile will elaborate specific nudge-based notifications and suggestions will be provided to the user via SENIOR app. Expected results and conclusions: real-time monitoring and tutoring will decelerate the worsening of clinical condition and will improve the general perceived wellbeing of persons with MCI – also empowering care providers through dissemination of knowledge on the condition functioning and therapy. Moreover, the provision of tailored care actions will contribute to a more sustainable national and local healthcare systems.