Search

• IVR (immersive virtual reality) intervention is more effective than conventional CRP (cardiac rehabilitation programs) in reducing depression, anxiety and stress in patients with CVD (cardiovascular diseases). • The effectiveness of IVR is major on depression, anxiety and stress when it is used as supplemental intervention to CRP. • IVR devices a safe, producing minimal adverse event and increasing the adherence to the therapy. Current literature suggests that immersive virtual reality (IVR) could be an efficacious therapeutic approach for patients with cardiovascular diseases (CVD) undergoing cardiac rehabilitation program (CRP). However, this has only been affirmed in individual studies and is yet to be confirmed by a systematic review. To determine the efficacy of IVR interventions on depression, anxiety, and stress symptoms in patients with CVD. A meta-analysis was performed in line with PRISMA guidelines following a literature search between inception and June 2024 in PubMed, SCOPUS, WOS, CINAHL and PEDro for retrieving randomized controlled trials (RCTs) that compared the efficacy of IVR versus conventional CRPs on depression, anxiety and stress in patients with CVD. The PEDro scale was used to evaluate the methodological quality of the studies. Pooled effects were calculated using the Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI), or mean difference (MD) if studies used the same measure. Eight RCTs, providing data from 510 patients with CVD (63.8±5.4 years, 60% men), were included. The methodological quality was moderate (M=5.1±1 points). A large rehabilitative effect of IVR was found for reducing depression (SMD=-0.54; 95% CI -0.77 to -0.31; p<0.001), anxiety (SMD=-0.43; 95% CI -0.74 to -0.12; p=0.006) and stress (MD=-14.96; 95% CI -20.1 to -9.8; p<0.001). The findings suggest that combine IVR and CRP is the most appropriate approach for reducing depression, anxiety and stress. IVR, especially when combined with a traditional CRP, reduces depression, anxiety and stress in patients with CVD. [ABSTRACT FROM AUTHOR]

• VRBT, combined with physiotherapy, could be effective in early rehabilitation after THA. • Physical exercises using VRBT, especially NIVR devices, suggest to be effective in increasing function and reduce disability. • Cognitive exercises using VRBT improves cognitive function and increase the subjective perception of improvement. • Passive immersive VRBT did not seem to be effective in reducing pain intensity after THA. To investigate the effectiveness of virtual reality-based therapy (VRBT) after total hip arthroplasty (THA). PubMed, SCOPUS, WOS, PEDro and CINAHL were consulted for results up to April 2024. Randomized controlled trials (RCTs) that assessed the effectiveness of VRBT (physical and cognitive videogames) in patients after THA were included. Pooled effect was assessed using standardized mean difference (SMD). This systematic review included 5 RCTs with 287 patients. Meta-analyses showed that VRBT, specifically non-immersive virtual reality (NIVR), combined with physiotherapy can be effective in reducing hip disability (SMD=-0.46; P = 0.018) and increasing hip function (SMD = 0.6; P = 0.002) after THA. The qualitative synthesis suggested that cognitive exercises using NIVR can improve disability, physical function, cognitive abilities and subjective perception of improvement. In contrast, passive immersive VRBT did not seem to have an impact on pain and hip function. Combining VRBT (mainly NIVR) with physiotherapy could be effective in early rehabilitation after THA. [ABSTRACT FROM AUTHOR]

• VRBT improves functional capacity, pulmonary function, and functional mobility skills in patients with COPD. • No differences in improving functional capacity were found between applying VRBT alone or in combination. • To combine non-immersive VRBT plus PR may be more adequate for increasing functional mobility skills. • Non-immersive VRBT is the VR modality most used in PR. In addition to conventional pulmonary rehabilitation (PR) programs for the treatment of chronic obstructive pulmonary disease (COPD), the use of virtual reality-based therapy (VRBT) has been proposed as an effective complementary tool to be included in PR programs for COPD. To analyze the effectiveness of VRBT on functional capacity, pulmonary function, and functional mobility in patients with COPD. A meta-analysis was carried out through a bibliographic search in PubMed (Medline), WOS, PEDro, CINAHL, CENTRAL, and Scopus since inception up to June 2023. The risk of bias was assessed using the PEDro scale, and the effect was determined using the standardized mean difference (SMD) and its 95 % confidence interval (95 % CI) in a random effects model. Five RCTs, providing data from 344 participants with a mean age 65.7 ± 5.3 years old, were included. The mean methodological quality of the studies included was good (6.8 ± 1.6 points). The meta-analysis showed that VRBT was effective in increasing functional capacity, assessed with the 6 Min Walking Test, (SMD=0.4, 95 % CI 0.07 to 0.71, p = 0.017); pulmonary function, assessed with FEV1 (SMD=0.33, 95 %CI 0.01 to 0.65, p = 0.048); and functional mobility, assessed with the Get Up and Go Test (SMD=0.77, 95 % CI 0.5 to 1.1, p <0.001) in patients with COPD. VRBT is suggested to be effective in increasing functional capacity, pulmonary function, and functional mobility in patients with COPD. Non-immersive VRBT is the most used modality of VRBT in PR. [ABSTRACT FROM AUTHOR]

Introduction: Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder characterized by motor dysfunction, cognitive impairment, and psychiatric disorders. These symptoms cause functional limitations in occupational performance. This study aimed to describe the difficulties in self-care, productivity, and leisure activities and to analyze the patients' own perception and satisfaction and the association with sex, age, disability, HD severity, and quality of life. Method: We conducted an observational, retrospective study in 38 patients with HD without cognitive impairment at the Burgos University Hospital. We assessed occupational performance, quality of life, and HD severity with the Canadian Occupational Performance Measure, Short-Form Health Survey 12, Unified Huntington's Disease Rating Scale, Total Functional Capacity, and the Problems Behavior Assessment. Results: One hundred sixty-five occupations (median 4, range 2–7) were categorized as self-care (50.90%), leisure (30.30%), and productivity (18.79%). Patients reported a higher degree of satisfaction with the activities prioritized than with the degree of performance. Elderly HD patients reported more satisfaction in leisure and women in self-care. Self-ratings of satisfaction in productivity were associated with higher levels of mental wellbeing. Conclusions: HD patients have problems with their daily life occupations, particularly with self-care. This underlines the need for assessment tools that capture the complexity of occupations. [ABSTRACT FROM AUTHOR]

Copyright of Medicina y Seguridad del Trabajo is the property of Escuela Nacional de Medicina del Trabajo - Instituto de Salud Carlos III and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The ongoing coronavirus disease 2019 (COVID-19) pandemic has affected millions of people in over 180 territories, causing a significant impact on healthcare systems globally. Older adults, as well as people living with cancer, appear to be particularly vulnerable to COVID-19 related morbidity and mortality, which means that older adults with cancer are an especially high-risk population. This has led to significant changes in the way geriatric oncologists provide care to older patients, including the implementation of novel methods for clinical visits, interruptions or delays in procedures, and modification of therapeutic strategies, both in the curative and palliative settings. In this manuscript, we provide a global overview of the perspectives of geriatric oncology providers from countries across Europe, America, and Asia, regarding the adaptive strategies utilized to continue providing high quality care for older patients with cancer during the COVID-19 pandemic. Through these perspectives, we attempt to show that, although each country and setting has specific issues, we all face similar challenges when providing care for our older patients with cancer during these difficult times. [ABSTRACT FROM AUTHOR]

Individuals with autism spectrum disorder (ASD) often have sleep disturbances, executive functioning difficulties, and learning problems. The aim of this study was twofold. First, to examine the quality of sleep in children with ASD without intellectual disability and typically developing (TD) children. Second, to explore the implication of sleep disturbances in the association between daily executive functioning and learning problems in children with ASD without intellectual disability. The sample included 47 children with autism without intellectual disability and 32 TD children. Parent-reported questionnaires were used to assess participants' sleep disturbances, daily executive functions, and learning problems. All statistical analyses performed were adjusted for age, IQ, and medication. As expected, the prevalence of sleep disturbances was significantly higher in the ASD group than in the TD group. Regarding the second aim of the study, the total score of sleep disturbances was significantly associated with learning problems and the metacognition subdomain of executive functioning in children with autism without intellectual disability. In turn, executive functions and learning problems were also significantly associated. Finally, sleep disturbances were found to mediate the relationship between global executive functioning and learning problems in children with ASD without intellectual disability. The findings suggest that sleep disturbances are common in children with autism, and that they play a mediating role in the association between executive functions and learning problems. Therefore, sleep should be a crucial aspect of interventions to improve the learning and academic performance of school-aged children with ASD without intellectual disability. • Sleep disturbances are more prevalent in children with ASD without ID than in TD children. • Sleep and executive functioning are predictors of learning problems in children with ASD without ID. • Sleep disturbances mediate the link between executive functioning and learning problems in children with ASD without ID. • Sleep interventions may enhance executive functions and academic achievement in children with ASD without ID. [ABSTRACT FROM AUTHOR]

Gastric cancer is one of the most frequent and deadly tumours worldwide. However, the evidence that currently exists for the treatment of older adults is limited and is derived mainly from clinical trials in which older patients are poorly represented. In this article, a group of experts selected from the Oncogeriatrics Section of the Spanish Society of Medical Oncology (SEOM), the Spanish Group for the Treatment of Digestive Tumours (TTD), and the Spanish Multidisciplinary Group on Digestive Cancer (GEMCAD) reviews the existing scientific evidence for older patients (≥65 years old) with gastric cancer and establishes a series of recommendations that allow optimization of management during all phases of the disease. Geriatric assessment (GA) and a multidisciplinary approach should be fundamental parts of the process. In early stages, endoscopic submucosal resection or laparoscopic gastrectomy is recommended depending on the stage. In locally advanced stage, the tolerability of triplet regimens has been established; however, as in the metastatic stage, platinum- and fluoropyrimidine-based regimens with the possibility of lower dose intensity are recommended resulting in similar efficacy. Likewise, the administration of trastuzumab, ramucirumab and immunotherapy for unresectable metastatic or locally advanced disease is safe. Supportive treatment acquires special importance in a population with different life expectancies than at a younger age. It is essential to consider the general state of the patient and the psychosocial dimension. [ABSTRACT FROM AUTHOR]

Improving the adaptive capacity of small-scale irrigation systems to the impacts of climate change is crucial for food security in Asia. This study analyzes the capacity of small-scale irrigation systems dependent on the Asian monsoon to adapt to variability in river discharge caused by climate change. Our study is motivated by the Pumpa irrigation system, a small-scale irrigation system located in Nepal that is a model for this type of system. We developed an agent-based model in which we simulated the decisions farmers make about the irrigation strategy to use according to available water flow. Given the uncertainty associated with how climate change may affect the Asian monsoon, we simulated the performance of the system under different projections of climate change in the region (increase and decrease in rainfall, reduction and expansion of the monsoon season, and changes in the timing of the onset of the monsoon). Accordingly to our simulations, farmers might need to adapt to rainfall intensification and a late onset in the monsoon season. The demands for collective action among farmers (e.g. infrastructure repair, meetings, decisions, etc.) might increase considerably due to climate change. Although our model suggests that investment in new infrastructure might increase the performance of the system under some climate change scenarios, the high inequality among farmers when water availability is reduced might hinder the efficiency of these measures due to a reduction of farmers’ willingness to cooperate. Our modeling exercise helps to hypothesize about the most sensitive climate change scenarios for smallscale irrigation farming in Nepal and helps to frame a discussion of some possible solutions and fundamental trade-offs in the process of adaptation to improve for food and water security under climate change. [ABSTRACT FROM AUTHOR]

Encouragement of learning is considered to be central to resilience of social–ecological systems (SESs) to unknown and unforeseeable shocks. However, despite the consensus on the centrality of learning, little research has been done on the details of how learning should be encouraged to enhance adaptive capacity for resilience. This study contributes to bridging this research gap by examining the existing data from a behavioral experiment on SES that involves learning. We generate new hypotheses regarding how learning should be encouraged by comparing the learning processes of human-subject groups that participated in the experiment. Our findings suggest that under environmental stability, groups may be able to perform well without frequent outer-loop (or double-loop) learning. They can still succeed as long as they tightly coordinate on shared strategies along with active monitoring of SESs and user participation in decision-making. However, such groups may be fragile under environmental variability. Only the groups that experience active outer-loop learning and monitoring of SESs are likely to remain resilient under environmental variability. [ABSTRACT FROM AUTHOR]

Should a species be translocated? Uncertainty regarding the necessity and feasibility of many translocations complicates answering this question. Here, we review translocation projects, both published and unpublished. Our results indicate that most projects (1) addressed fewer than half of the basic criteria established for translo-cations and (2) were either unjustifiable from a conservation perspective or inadequately designed to guarantee success or preclude negative consequences. We propose a hierarchical decision-making system - an explicit method that integrates existing guidelines, thereby covering a key gap in conservation science - to reduce ambi-guity when deciding whether to implement a given translocation project. This method will improve the likeli-hood of success in translocation projects and contribute to the efficient use of the limited resources available for these conservation efforts INSETS: In a nutshell:;Panel 1. Definition of terms. [ABSTRACT FROM AUTHOR]

The article focuses on a study which examined the effect of terrestrial wind farms on diurnal raptors using a raptor sensitivity index (RSI), spatial vulnerability index (SVI) and potential vulnerability maps. Factors considered for inclusion in the RDI are flight type, flight attitude, manoeuvrability, seasonality, population size, conservation status and breeding capacity. The SVI index was applied to the Boquerón mountain range in Valencia, Spain. RSI index results show that flight type for most of the species observed received a score 3 while the highest score was received by the booted eagle Hieraaetus pennatus. In terms of manoeuvrability, the golden eagle Aquila chrysaetos and griffon vulture Gyps Fulvus received the lowest scores.

Apart from being the main cause of biodiversity loss, humans are also essential for sustainability and biological conservation. Regulations for the conservation of threatened species are key to respond to this challenge. Here we evaluate the efficacy of mandatory regulations in Spain, a decentralized country, for the effective protection of threatened terrestrial vertebrates. We studied the association between the number of both "vulnerable" and "endangered" species on regional lists of threatened species and approved management plans for such species (mandatory) with ecological (e.g. percentage of forest and agricultural areas), social (e.g. environmental awareness and GPD per capita) and geographical (e.g. total and protected areas) variables on the regional scale. Our results showed that an approved management plan is available for only 20% of threatened terrestrial vertebrates and there were important taxonomical and regional biases. Higher protection levels appeared in regions with higher percentages of protected area, more citizens' environmental awareness, lower GPD per capita and shorter regional lists. Herpetofauna has fewer approved management plans than mammals or birds. Our results highlight the importance of integrating the perspective, knowledge and practices of all stakeholders (Academia, governments and society) to effectively apply environmental regulations. [ABSTRACT FROM AUTHOR]