Outdoor education: are we really ready?

Outdoor education (OE) has recently gained popularity also in Italy, especially after the indoor confinement experienced due to the pandemic. OE has shown to foster children’s stress recovery, cognitive performance, and affiliation with Nature, exploiting benefits produced by natural ecosystems (i.e. the Ecosystem Services, ES). To explore the hypothesis to implement OE programs in the Venice lagoon, we assessed the “information for cognitive development” ES focusing on the valli da pesca, a peculiar habitat of the lagoon that still maintain the main features of transitional waters environments. According to the results of our questionnaire addressed to teachers in the Metropolitan City of Venice, all the respondents would be very interested in conducting OE in such environments, suggesting a high demand that could potentially involve more than 2700 teachers. Obtained results, however, revealed that 37.5% of the teachers are frightened by the additional bureaucratic effort it might require, and 20.8% expressed concerns about risk/safety conditions. The results reveal also that their current idea of OE is more similar to schoolyard playtime, or to the occasional engagement in a school trip: 40.2% of the interviewed teachers consider indeed one trip per year sufficient to stand for OE, whereas only 3.9% agreed that the ideal frequency should be at least one day per month. Another frequently reported drawback dwells with the difficulty of adapting for OE a frontal lesson on the topics addressed in the classroom. Therefore, despite the high capacity of the valli da pesca to provide suitable places for OE, we highlight that a non-negligible portion of the local school system does not seem currently ready for this kind of experience, as they are portrayed simply like “experiences outside the classroom” where the environmental features don't really ‘make the difference’. The concerns expressed by the majority of the interviewed teachers suggest they need strong support in implementing a real OE program, as opposed to just “teaching in outdoor settings”, so that lack of the classical teaching tools (such as blackboard, desks and school furniture) is not seen anymore as an obstacle, but as an opportunity to discover the affordances of the environmental elements that could stimulate the students to learn-by-doing

Patient education and rehabilitation after hip arthroplasty in an Italian spa center: a pilot study on its feasibility

Nowadays, some spa centers are suitable for providing rehabilitative and preventive treatment in association with traditional spa therapy. This study aims to evaluate the feasibility and the effectiveness of an intensive rehabilitation program after hip arthroplasty in an Italian spa center. Early after total hip arthroplasty for severe osteoarthritis ( 64 10 days after the intervention), 12 consecutive patients (5 males and 7 females) aged between 50 and 85 years were enrolled for this study. All the patients performed a 2-week thermal multimodal rehabilitation program, which consisted of education and physical rehabilitative measures. Patients had 2-h and half/day session of land-based and hydrokinesitherapy (aquatic therapy) consisted in active and passive joint mobilization, respiratory and functional re-education exercises, gait and balance training, resistance exercise, and power training mainly for the upper limb associated to physical therapy modalities (electrotherapy and low-level laser therapy). An educational program was performed to both patients and families. Both before and after the rehabilitation treatment, patients underwent clinical evaluation, hip flexion/abduction range of motion, and Numeric Pain Rating Scale. Harris Hip Score (HHS) and SF-12 questionnaires (physical\u2014PCS-12\u2014and mental health component\u2014MCS-12) were also administered. After the 2- week thermal spa treatment, hip flexion/abduction improved significantly (p < 0.05), but there was no statistically significant reduction in pain (p = 0.350). The HHS score improved significantly from 62.6 \ub1 12.8 to 82.15 \ub1 12.7 (p < 0.05), and the PCS-12 score from 36.37 \ub1 8.4 to 43.61 \ub1 8.95 (p < 0.05). There was no adverse event during spa treatment. After total hip arthroplasty, patients who underwent an intensive post-acute multimodal rehabilitation program showed an improvement in motor and functional recovery and a positive impact on quality of life. Therefore, we believe that the thermal setting is a suitable place for providing intensive rehabilitative treatment in orthopedic musculoskeletal disability

The effects of transcranial direct current stimulation (tDCS) combined with group exercise treatment in subjects with chronic low back pain: a pilot randomized control trial

Objective: To test the efficacy of transcranial direct current stimulation (tDCS) in addition to group exercise on non-specific chronic low back pain. Design: Double-blinded randomized control trial. Subjects: Patients with non-specific chronic low back pain. Methods: A total of 35 subjects were recruited and allocated to real- or sham-tDCS followed by a group exercise protocol. Each patient underwent five sessions of brain stimulation followed by 10 sessions of group exercise. Subjects were evaluated before and after tDCS, after group exercise and one month after the combined treatment. Outcome measures were Visual Analog Scale for pain intensity, Roland Morris Disability Questionnaire, EuroQuol-5 Dimension and Patient Health Questionnaire-9. Results: Significant between-group difference in pain intensity (−27.7 ± 30.4 mm in real-tDCS group compared to −2.2 ± 30.1 mm in sham-tDCS group) and Patient Health Questionnaire-9 (−4.9 ± 4.2 in real-tDCS group compared to −1.1 ± 2.7 in sham-tDCS group) was found one month after the combined treatment (P < 0.05). Conclusion: Our results showed that real-tDCS can induce significant larger effects on pain and psychological well-being, compared to sham-tDCS, when it is associated with a group exercise program. The effects were observed mostly in the follow-up

A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting

The abdominal microsurgical flap based on the deep inferior epigastric artery perforator (DIEP) flap has become the most popular option worldwide for autologous breast reconstruction. Several authors have investigated the results of reconstructed breasts, but the literature lacks systematic reviews exploring the donor site of the abdominal wall. To fulfil our aims, a new diagnostic muscle imaging analysis was designed and implemented. This study focused on rectus abdominal muscle morphology and function in a single series of 12 consecutive patients analysed before and after breast reconstruction with a microsurgical DIEP flap. Patients were divided into two groups, namely, “ipsilateral reconstruction” and “contralateral reconstruction”, depending on the side of the flap harvest and breast reconstruction, then evaluated by computed tomography (CT) scans scheduled for tumor staging, and clinically examined by a physiatrist. Numerous alterations in muscle physiology were observed due to surgical dissection of perforator vessels, and rectus muscle distress without functional impairment was a common result. Postoperatively, patients undergoing “contralateral reconstruction” appeared to exhibit fewer rectus muscle alterations. Overall, only three patients were impacted by a long-term deterioration in their quality of life. On the basis of the newly developed and implemented diagnostic approach, we concluded that DIEP microsurgical breast reconstruction is a safe procedure without major complications at the donor site, even if long-term alterations of the rectus muscle are a common finding

supplementary material, SUPPLEMENTARY_MATERIAL – The effects of transcranial direct current stimulation (tDCS) combined with group exercise treatment in subjects with chronic low back pain: a pilot randomized control trial

<p>supplementary material, SUPPLEMENTARY_MATERIAL for The effects of transcranial direct current stimulation (tDCS) combined with group exercise treatment in subjects with chronic low back pain: a pilot randomized control trial by Sofia Straudi, Sergio Buja, Andrea Baroni, Claudia Pavarelli, Giulia Pranovi, Felipe Fregni and Nino Basaglia in Clinical Rehabilitation</p