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The transition to higher education at University is a critical moment for young adults to acquire unhealthy habits regarding physical activity (PA) and adherence to a healthy diet. Negative behaviors might be maintained in the years to come with a major risk of suffering from a Non-Communicable Disease. This study aims to determine the relationship between diet and PA in the student community of University of Milano-Bicocca. Students between 18 and 30 years old completed an online survey (6949 students). Two analyses of covariance (ANCOVA), chi-square tests of independence, and a binomial logistic regression were performed to examine the relationship between adequacy of food consumption and PA, in association also with sociodemographic characteristics. Data show a strong correlation between behaviors analyzed, with a proportional positive association between PA and healthy diet. Nevertheless, a third of the sample students incur in incorrect habits for both diet and PA. Further, students performing intensive PA have the healthiest food consumption in general but the worst red meat and pork intake. Accordingly, men practice more PA but have a less adequate diet, exactly contrary to women. In conclusion, policies promoting consciousness of well-being would transform Universities into healthy hubs for virtuous habits.

Negli ultimi anni, la neuroriabilitazione ha mostrato un crescente interesse nell'integrazione di tecnologie emergenti, come la robotica e la realtà virtuale (VR), grazie alla loro trasversalità applicativa e il loro potenziale nel recupero funzionale del paziente. Sebbene fino ad ora siano stati forniti risultati promettenti sulla loro efficacia in diverse popolazioni cliniche, l’estensione degli effetti nei contesti di vita quotidiana del paziente rimane ancora ad oggi una sfida aperta. Inoltre, per garantire che gli interventi basati sull’utilizzo della tecnologia producano gli esiti desiderati, una conoscenza sempre più esaustiva sul come sviluppare ed implementare in modo ottimale la tecnologia riabilitativa è ancora necessaria. La presente tesi di dottorato ha l'obiettivo di affrontare queste sfide adottando un approccio multidisciplinare e user-centred. Nella prima parte, sono state condotte due revisioni sistematiche della letteratura con l’obiettivo di fornire una panoramica completa dei risultati più recenti in materia di accettazione della tecnologia robotica e della VR, di applicabilità clinica e di efficacia percepita nei programmi di neuroriabilitazione. In particolare, la prima revisione (Studio 1) ha sintetizzato gli studi che hanno indagato l'usabilità e l'esperienza d'utilizzo della tecnologia, considerando sia il punto di vista sia dei pazienti che quello dei professionisti sanitari impegnati nei processi riabilitativi. All’interno del contributo, sono state evidenziate e discusse le limitazioni e i punti di forza relativi all'utilizzo dei dispositivi tecnologici, nonché alla loro implementazione futura. La seconda revisione (Studio 2), invece, ha riassunto gli studi che hanno riportato gli effetti della riabilitazione robotizzata, con o senza l’integrazione di dispositivi di VR, sulla qualità della vita connessa alla salute e su outcome non-motori, fornendo infine raccomandazioni per future ricerche e pratiche riabilitative mirate al rec, Over the last decades, neurorehabilitation has shown a growing interest in the integration of emerging technologies, like robotics and virtual reality (VR), due to their multipurpose application and potential for patient recovery. While mixed evidence on their efficacy has been provided across different clinical populations, the broader effectiveness in real-world settings remains unclear. Besides, to ensure that technology-enhanced interventions produce the intended outcomes, more comprehensive knowledge on how to optimally develop and implement rehabilitation technology is required. The present Ph.D. thesis aimed to step into these challenges by adopting a multidisciplinary and user-centred approach. In the first part, two systematic literature reviews were conducted to provide a comprehensive overview of recent evidence on robotic and VR technology acceptance, clinical applicability, and effectiveness in neurorehabilitation programs. Specifically, the first one (Study 1) synthetized research that investigated technology usability and experience of use according to both patients’ and rehabilitation healthcare professionals’ viewpoints. Perceived limitations and strengths concerning the use of the technological devices and their future implementation were pointed out and discussed. The second one (Study 2) summarized the evidence on the effects of robot-assisted therapy (RAT) alone and combined with VR devices on patient-reported health-related quality of life (HRQoL) and non-motor outcomes across various neurological populations, ultimately advancing recommendations for future research and practice aiming to address multi-domain recovery. Based on the literature reviewed, the second part of the present thesis included the description and the main findings of an ad-hoc developed study protocol intended to deepen knowledge of robotic and VR technology experience of use and biopsychosocial effects. In particular, two empirical studies were conducted. In the first one

To date, at least 2.41 billion people with Non-Communicable Diseases (NCDs) are in need of rehabilitation. Rehabilitation care through innovative technologies is the ideal candidate to reach all people with NCDs in need. To obtain these innovative solutions available in the public health system calls for a rigorous multidimensional evaluation that, with an articulated approach, is carried out through the Health Technology Assessment (HTA) methodology. In this context, the aim of the present paper is to illustrate how the Smart&TouchID (STID) model addresses the need to incorporate patients’ evaluations into a multidimensional technology assessment framework by presenting a feasibility study of model application with regard to the rehabilitation experiences of people living with NCDs. After sketching out the STID model’s vision and operational process, preliminary evidence on the experiences and attitudes of patients and citizens on rehabilitation care will be described and discussed, showing how they operate, enabling the co-design of technological solutions with a multi-stakeholder approach. Implications for public health are discussed including the view on the STID model as a tool to be integrated into public health governance strategies aimed at tuning the agenda-setting of innovation in rehabilitation care through a participatory methodology.

Ad oggi, la comunicazione della salute si configura sempre più come un’area di studio e di intervento fondamentale nella promozione di comportamenti e stili di vita salutari. Su questo tema, la letteratura scientifica continua a sottolineare l’importanza di veicolare contenuti informativi sulla salute che tengano conto delle caratteristiche dell’individuo, nonché dei suoi bisogni. Da qui, il concetto di comunicazione tailorizzata, ovvero una comunicazione “tagliata su misura”, basata sul profilo non solo comportamentale, ma anche psicologico dell’individuo. Con l’ingresso nell’era digitale, tale approccio comunicativo ha iniziato a servirsi di componenti tecnologiche, capaci di automatizzare il processo di tailorizzazione e di rendere la comunicazione della salute più accessibile, coinvolgente e applicabile. Questa evoluzione ha però portato a profondi cambiamenti sia metodologici che applicativi, che a loro volta hanno fornito nuovi spunti di riflessione. In occasione del simposio proposto, il presente contributo avrà l’obiettivo di discutere dei recenti cambiamenti in tema di salute e comunicazione tailorizzata, con una particolare attenzione al ruolo delle nuove tecnologie. Inoltre, a livello applicativo, verrà presentato un progetto di ricerca attualmente in corso che ha l’obiettivo di valutare l’efficacia di un intervento basato sull’utilizzo di una App (MyPocketHealth®), volta a migliorare comportamenti salutari come l’attività fisica.

La promozione di comportamenti e di stili di vita salutari è ampiamente riconosciuta come una delle principali strategie in materia di prevenzione. Contrastare fattori di rischio come la sedentarietà rimane una sfida ad oggi ancora aperta. Con l’ingresso nell’era digitale, l’interesse nell’utilizzo di strumenti tecnologici come supporto ad affrontare tale sfida è sempre più in aumento. Il presente contributo ha l’obiettivo di descrivere un progetto di ricerca finalizzato a valutare l’efficacia preliminare di un intervento randomizzato basato sull’utilizzo di un’App (MyPocketHealth) per la promozione dell’attività fisica, in termini di aumento del numero di passi giornaliero. Ad un campione tratto dalla popolazione generale sedentaria, sono stati inviati su base quotidiana, per un periodo di 30 giorni, messaggi volti al raggiungimento dell’obiettivo di 7.000 passi giornalieri, nonché notifiche finalizzate al monitoraggio del numero di passi fatti giornalmente. In particolare, un primo gruppo di partecipanti ha ricevuto messaggi personalizzati sulla base delle caratteristiche psicologiche rilevate in fase pre-intervento, valutate tramite l’applicazione di due modelli di cambiamento comportamentale (l’Health Action Process Approach e la Teoria del Comportamento Pianificato), mentre un secondo gruppo ha ricevuto messaggi non personalizzati centrati sul benessere emotivo connesso all’attività fisica. Infine, un terzo gruppo ha esclusivamente ricevuto notifiche di monitoraggio. Nel corso dell’intervento verranno presentati i risultati preliminari dello studio, la cui raccolta dati è tuttora in corso, con l’obiettivo di mettere a confronto l’efficacia dei tipi diversi di messaggi inviati ai partecipanti, nonché di discutere più in generale il valore aggiunto della tecnologia nella promozione della salute.

This study aimed to examine the role of resilience resources in patients' lifestyle changes after the first Acute Coronary event. 275 Italian patients (84.0% men; mean age = 57.5, SD = 7.9) participated in a longitudinal study. Resilience resources (Self-esteem, Dispositional Optimism, Sense of Coherence – SOC, General and Disease-specific Self-efficacy), and lifestyles (diet, physical activity, and smoking) were assessed twice (at baseline and after 6 months). Path analysis using latent change models was performed to model the combined effect of levels and changes of the resilience resources over lifestyle changes. Patients with strong SOC at baseline were less prone to smoke and more prone to decrease smoking; enhancement in SOC was associated with a smoking decrease. High Disease-specific Self-efficacy at baseline was associated with an improvement in all lifestyles; enhancement in Disease-specific Self-efficacy predicted an increase in physical activity. Findings underline the need to design psychological interventions that promote patients' Disease-specific Self-efficacy and SOC.

BACKGROUND: In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients' health-related quality of life (HRQoL) has been investigated across neurological populations but still remains unclear. The present study aimed to systematically review the studies investigating the effects of RAT alone and with VR on HRQoL in patients with different neurological diseases. METHODS: A systematic review of the studies evaluating the impact of RAT alone and combined with VR on HRQoL in patients affected by neurological diseases (i.e., stroke, multiple sclerosis, spinal cord injury, Parkinson's Disease) was conducted according to PRISMA guidelines. Electronic searches of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsychINFO (2000-2022) were performed. Risk of bias was evaluated through the National Institute of Health Quality Assessment Tool. Descriptive data regarding the study design, participants, intervention, rehabilitation outcomes, robotic device typology, HRQoL measures, non-motor factors concurrently investigated, and main results were extracted and meta-synthetized. RESULTS: The searches identified 3025 studies, of which 70 met the inclusion criteria. An overall heterogeneous configuration was found regarding the study design adopted, intervention procedures and technological devices implemented, rehabilitation outcomes (i.e., related to both upper and lower limb impairment), HRQoL measures administered, and main evidence. Most of the studies reported significant effects of both RAT and RAT plus VR on patients HRQoL, whether they adopted generic or disease-specific HRQoL measures. Significant post-intervention within-group changes were mainly found across neurological populations, while fewer studies reported significant between-group comparisons, and then, mostly in patients with stroke. Longitudinal invest

A considerable amount of research has illustrated that negative attitudes toward one’s own aging can directly hinder mental and physical well-being or lead to maladjustment in later stages of life (Swift et al. in Social Issues Policy Rev 11(1):195–231, https://doi.org/10.1111/sipr.12031, 2017). Research so far has focused on the analysis of individual factors related to attitudes toward aging, often related to personality traits. Our study proposes and tests a model of positive contact with aging (PCA). It analyses both individual and social antecedents of attitudes towards one’s own aging, hypothesizing that individual health self-efficacy directly affects attitudes towards one’s own aging and that the quality and quantity of contact with older adults indirectly impacts on attitudes towards one’s own aging through attitudes towards older adults. The model was tested in a wide sample of the Italian population (N = 753) with a varied age range. The PCA model tested showed excellent fit to the data, explaining a moderate amount of variance in attitudes toward one’s own aging (12%). This model promises to offer implications for active policies that can improve attitudes towards one’s own aging, promoting educational strategies to increase intergenerational exchanges and foster health-related self-efficacy.

A key factor to successful secondary prevention of cardiovascular disease (CVD) is optimal patient adherence to treatment. However, unsatisfactory rates of adherence to treatment for CVD risk factors and CVD have been observed consistently over the last few decades. Hence, achieving optimal adherence to lifestyle measures and guideline-directed medical therapy in secondary prevention and rehabilitation is a great challenge to many healthcare professionals. Therefore, in this European Association of Preventive Cardiology clinical consensus document, a modern reappraisal of the adherence to optimal treatment is provided, together with simple, practical, and feasible suggestions to achieve this goal in the clinical setting, focusing on evidence-based concepts.