Infra-Low Frequency Neurofeedback: A Systematic Mixed Studies Review

INTRODUCTION: Neurofeedback training is increasingly applied as a therapeutic tool in a variety of disorders, with growing scientific and clinical interest in the last two decades. Different Neurofeedback approaches have been developed over time, so it is now important to be able to distinguish between them and investigate the effectiveness and efficiency characteristics of each specific protocol. In this study we intend to examine the effects of Neurofeedback based on slow brain activity, the so-called Infra-Low Frequency (ILF) training a recently developed methodology that seems promising for the regulation of the central nervous system. AIMS: With this review we intend to summarize the currently existing literature on ILF-Neurofeedback, examine its quality and formulate indications about the clinical effectiveness of ILF-Neurofeedback. METHODS: Literature search was first conducted according to PRISMA principles, described, and then assessed using the MMAT appraisal tool. 18 well-documented studies of ILF-Neurofeedback training in human subjects were picked up and analyzed. Reports include group interventions as well as single case studies. RESULTS: Research data indicates good potential for ILF-Neurofeedback to influence brain activity and neurovegetative parameters. From the clinical profile, a salient common observation is a high level of individualization as a specific characteristic of ILF-Training: this feature seems to correlate with effectiveness of ILF-Neurofeedback, but also poses a challenge for researchers in terms of producing controlled and comparable findings; according to this point, some recommendation for future research on ILF-Neurofeedback are proposed. In conclusion, ILF-neurofeedback shows great potential for application for all those conditions in which the regulation of brain activity and neurophysiological processes are crucial. Further research will make it possible to complete the available data and to have a broader overview of its possible applications

Italian adaptation of the brief modified experiences in close relationships scale in a sample of cancer patients: factor analysis and clinical implications

Many previous studies have indicated that the attachment pattern developed during infancy shapes the adult attachment style, which in turn affects responses to stress and help-seeking behaviors. It may be relevant within clinical contexts to have easy-to-administer and rapid tools aimed to investigate attachment dimensions. The current study presents the Italian adaptation of the Brief Modified Experiences in Close Relationships (ECR-M16) – a self-reported measure of the attachment-style dimensions with reference to close others – and assesses its factorial structure. The questionnaire was administered to cancer outpatients. The number of factors to be extracted was calculated via parallel analysis. Subsequently, an exploratory factor analysis was run to calculate the first-order factor structure, which was compared to the original one via Procrustes rotation and Tucker’s coefficient. Finally, a second-order factor structure was calculated by factor analyzing the first-order factor scores. The Italian adaptation of the ECR-M16 is characterized by a first-order factor structure comprising four factors, like the original. The degree of similarity between the two ranges between fair and dissimilar. The second-order factor structure comprises two higher order dimensions, like in the original study. Although partially similar, the two second-order factor structures show relevant differences. A clinically oriented discussion centered on the similarities and differences between the two factor structures is provided, along with indications for future studies

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries