Le linee guida italiane sulle terapie psicologiche di ansia e depressione: un’innovazione o un’occasione persa?

In questo contributo mi propongo di riassumere i miei commenti al dibattito in corso sulla Consensus Conference sulle Terapie Psicologiche per Ansia e Depressione. Nell’ottica scientifica di implementazione delle linee guida avviate dall’Istituto Superiore di Sanità, ho scelto di impostare le mie riflessioni nel formato di una peer-review, andando dunque ad individuare cinque aree che potrebbero beneficiare di una revisione. Ovviamente quelle che qui esprimo sono opinioni fallibili che cerco di motivare a partire dalla letteratura scientifica esistente

Organisational Problems and Solutions in Oncology: A Content Analysis of the Narratives of Italian Cancer Unit Professionals

The aim of this qualitative research is to explore the perception of the organizational climate in Italian cancer units. The survey was the first step of a two year action-research project, involving 14 hospitals and different professions (n=475). We report the methodology and the thematic clusters that emerged in analysing the answers to three questions: (i) perceived problems with colleagues, (ii) perceived problems with patients and their relatives, and (iii) coping strategies. Narratives were analysed through computer aided qualitative data analysis software. The results identify two main significant issues in describing problems and solutions: interpersonal communication and group cohesiveness

Advances in centerline estimation for autonomous lateral control

The ability of autonomous vehicles to maintain an accurate trajectory within their road lane is crucial for safe operation. This requires detecting the road lines and estimating the car relative pose within its lane. Lateral lines are usually retrieved from camera images. Still, most of the works on line detection are limited to image mask retrieval and do not provide a usable representation in world coordinates. What we propose in this paper is a complete perception pipeline based on monocular vision and able to retrieve all the information required by a vehicle lateral control system: road lines equation, centerline, vehicle heading and lateral displacement. We evaluate our system by acquiring data with accurate geometric ground truth. To act as a benchmark for further research, we make this new dataset publicly available at http://airlab.deib.polimi.it/datasets/.Comment: Presented at 2020 IEEE Intelligent Vehicles Symposium (IV), 8 pages, 8 figure

LiDAR point-cloud processing based on projection methods: a comparison

An accurate and rapid-response perception system is fundamental for autonomous vehicles to operate safely. 3D object detection methods handle point clouds given by LiDAR sensors to provide accurate depth and position information for each detection, together with its dimensions and classification. The information is then used to track vehicles and other obstacles in the surroundings of the autonomous vehicle, and also to feed control units that guarantee collision avoidance and motion planning. Nowadays, object detection systems can be divided into two main categories. The first ones are the geometric based, which retrieve the obstacles using geometric and morphological operations on the 3D points. The seconds are the deep learning-based, which process the 3D points, or an elaboration of the 3D point-cloud, with deep learning techniques to retrieve a set of obstacles. This paper presents a comparison between those two approaches, presenting one implementation of each class on a real autonomous vehicle. Accuracy of the estimates of the algorithms has been evaluated with experimental tests carried in the Monza ENI circuit. The position of the ego vehicle and the obstacle is given by GPS sensors with RTK correction, which guarantees an accurate ground truth for the comparison. Both algorithms have been implemented on ROS and run on a consumer laptop

Effectiveness of a Mindful Compassion Care Program in reducing burnout and psychological distress amongst frontline hospital nurses during the COVID-19 pandemic: a study protocol for a randomized controlled trial

Background: Recent studies have shown that nurses have been more affected by the COVID-19 pandemic than any other group of hospital workers in terms of anxiety, depression, and burnout. Several clinical studies had previously demonstrated the effectiveness of mindfulness and compassion interventions in reducing burnout and emotional distress amongst healthcare professionals. Methods and analysis: A parallel-group randomized controlled trial will assess the feasibility, acceptability, and efficacy of a mindfulness and compassion-focused programme on frontline nurses who had been working during the COVID-19 pandemic. Seventy-two participants will be recruited from Verona University Hospital Trust (Veneto Region, north-east Italy) and will be divided equally into an intervention group and a control group. Primary outcome will be assessed using the Emotional Exhaustion subscale of the Maslach Burnout Inventory General Survey (MBI-GS). Secondary outcomes will be measured by the Cynicism and Professional Efficacy subscales of the MBI-GS, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), the Insomnia Severity Index (ISI), the Impact of Stressful Events (IES-R), the Perceived Stress Scale (PSS), the Five Facet Mindfulness Questionnaire (FFMQ), and the Forms of Self-Criticising/attacking and Self-Reassuring Scale (FSCRS). Discussion: The study aims to fill a gap in the literature and present a scientifically validated intervention for those healthcare professionals most exposed to the stressful conditions of working during the COVID-19 pandemic. Trial registration: ClinicalTrials.gov; Identifier: NCT05308537

An Urgent Human Health Dilemma Facing Refugees and Their Host Caregivers

The continuous waves of refugees from Africa and the Middle East to Europe present major inter¬cultural challenges to European health professionals and to society at large. A recent workshop in Sicily brought together local physicians, nurses, psychologists and managers of governmental agencies, along with representatives from Lebanon, Israel, Iraq, Iran, Sudan, Tunisia, Jordan and the European Society of Medical Oncology (ESMO) to develop training programs aimed at formulating dialogue between regional professionals and refugees. A major barrier refugees face is a lack of verbal and cultural communication, which hinders their smooth absorption into the new society. Cultural mediators who speak Arabic and Italian and understand the refugees' faith, tradition and beliefs are vital to successfully build bridges of trust between caregivers and refugees. Most asylum seekers experience anxiety, fear, and depression upon arrival in Europe. To achieve trust, all workshop participants agreed to develop a palliative care model that would best suit the unique circumstances now facing some Mediterranean countries and assist in overcoming the suffering of refugees during their initial stay in Europe. Such a model would include bio-psychosocial elements, essential for a culturally sensitive approach and based on core ethical principles

A cognitive model of diminished expression in schizophrenia: The interface of metacognition, cognitive symptoms and language disturbances

The resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research has shown that higher levels of diminished expression relate to deficits in metacognitive capacity. We propose a more complex model in which diminished expression occurs when impairments in metacognitive self-reflectivity, alterations in higher-order language structure, and cognitive symptoms interact and thus interfere with persons' ability to understand and express emotions in ways others can recognize. Individuals with schizophrenia-spectrum disorders (N = 201) provided personal narratives detailing their life story and reflections about their mental illness. Self-reflectivity was measured with the Metacognition Assessment Scale-Abbreviated, and situation models were extracted from participants' personal narratives via Coh-Metrix 3.0, an automated program that calculates language indices. Diminished expression and cognitive symptoms were measured with the Positive and Negative Syndrome Scale. Structural equation models (SEM) examined whether self-reflectivity mediated the impact of cognitive symptoms and situation models on diminished expression. Results of the SEM revealed that self-reflectivity partially mediated the impact of situation models on diminished expression (β = -.073, p = .008, ±95% CI [-0.126, -0.019]). and fully mediated the influence of cognitive symptoms in diminished expression (β = 0.099, p = .001, ±95% CI [0.038, 0.160]). In conclusion, results suggest that self-reflectivity, linguistic cohesion, and cognitive symptoms may be useful targets for intervention in efforts to treat diminished expression in psychosis