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- Executive function in gambling disorder: A meta-analysis on neuropsychological evidencePublication . Peixoto, Miguel; Dores, Artemisa; Monteiro, Maria; Marques, António; Barbosa, Fernando; Pereira da Silva Marques, António José; Dores, Artemisa; de Faria Távora Moreira Peixoto, MiguelGambling disorder (GD) is associated with defcits in various cognitive functions. Specifcally for executive function (EF), previous fndings are inconsistent, despite defcits being reported for shifting, inhibition, planning, and working memory domains. Although a worse performance in EF measures related to GD severity is often reported, there is a need to clarify current evidence. This study aims to systematically review and perform a meta-analysis to clarify the association between EF defcits and GD. The current study followed the preferred reporting items for systematic reviews and meta-analyses protocols. The meta-analysis used a random efects model and robust variance estimation to analyze the data, using Hedge’s g to report efect sizes. A total of 21 studies were systematically reviewed, of which 17 were included for meta-analysis. Meta-analysis was performed for shifting, inhibition, planning, and verbal fuency. Due to a lower number of studies, working memory data was systematically reviewed, but no meta-analysis was performed. Significant efect sizes were found for shifting and inhibition, indicative of defcits in participants with GD. No signifcant defcits were found for the other EF domains. Working memory results revealed inconsistent evidence, even when divided into verbal and visuospatial modalities. There is enough evidence of defcits in shifting and inhibition in participants with GD. However, better sample characterization should be considered in future studies to better understand the sources of potential heterogeneity. Consideration of gambling severity as a continuous variable could allow for a more detailed analysis of EF alterations across the various degrees of GD.
- How useful is mixed reality in surgical treatment? - a Delphi StudyPublication . Magalhães, Renato; Lima, Ana Carolina; Marques, António; Pereira, Javier; Pereira da Silva Marques, António José; Magalhães, RenatoMixed reality (MR) is a tool that integrates elements from both the real and virtual worlds. Its potential applications are manifold, with promising developments observed in diverse fields, including healthcare, particularly in the context of surgical procedures. A number of studies have been conducted on mixed reality headsets, including the Microsoft HoloLens 2®, which may be employed in surgical training, planning, and navigation. It is imperative to ascertain whether medical professionals consider this technology indispensable in their professional lives. This study employs the Delphi method to assess the utility of MR in surgical settings and utilizes the Welphi online platform to facilitate this process. Furthermore, a PRISMA-like approach is employed to analyze the results of the initial round. The objective of this study is to examine the feasibility and advantages of mixed reality technology in surgical contexts. The findings are intended to inform and direct healthcare professionals, researchers, and developers in the advancement of mixed reality integration in surgical environments, with the ultimate goal of optimizing the quality and safety of treatments. A Delphi approach comprising of three rounds was implemented to ascertain consensus on the utility of MR surgical treatment. Participants were purposefully selected from experts with professional experience with technologies that provide a more immersive or interactive experience, such as virtual reality (VR), augmented reality (AR), 3D laparoscopy, robotics, and other similar technologies applied in the surgical field. The initial round of the study was designed to allow surgeons to provide their insights into the potential applications of MR in surgical procedures. This phase employed a structured approach, with open-ended questions organized into five distinct sections. In the second round, the questions were derived from the analysis of the first round and organized according to main and sub-topics for hierarchical structuring. In the third round, the questions were identical to those posed in the second round, including the percentage results obtained in the previous round. This afforded the experts the opportunity to review their previous responses. A consensus round was subsequently conducted. In the analysis, Kendall's tau-b coefficient for correlation analysis was employed and significant correlations between distinct aspects were identified. Twenty-two of the invited experts provided responses in both the initial and subsequent rounds, representing a 100% response rate. In the third round and consensus round, 20 experts participated, representing 91% response rate. The consensus round was conducted to present the results that had achieved a level of majority consensus of 95% on the usefulness of MR in surgical treatment. The objective was to have experts validate the results. The primary benefits of MR in surgery were identified as surgical navigation (with 75% of consensus), surgical planning (with 75% of consensus), and teaching and training (with 70% of consensus). According to the Delphi study, the areas where MR technology is most beneficial in surgical contexts are surgical navigation, training, and planning. However, the costs and investments required for implementation may present a potential limitation for the integration of this technology in surgical procedures. Moreover, it is of crucial importance to comprehend the ethical implications associated with this matter, which may have implications for the security of patients.
- Mixed reality in the operating room: A systematic reviewPublication . Magalhães, Renato; Oliveira, Ana; Terroso, David; Vilaça, Adélio; Veloso, Rita; Marques, António; Pereira, Javier; Pereira da Silva Marques, António José; Magalhães, RenatoMixed Reality is a technology that has gained attention due to its unique capabilities for accessing and visualizing information, becoming a valuable tool for medicine, particularly for the operating room and surgical learning; A systematic review was conducted following the PRISMA guidelines to answer the research questions established using the PICO framework; Although implementation of Mixed Reality applications in the operations room presents some challenges, when used appropriately, it can yield remarkable results. It can make learning easier, flatten the learning curve for several procedures, and facilitate various aspects of the surgical processes; Technical complexity, equipment costs, and steep learning curves present significant obstacles to the widespread adoption of Mixed Reality and computer-assisted evaluation. The possibility of integration of distinct medical imaging modalities and innovative functionalities holds promise for clinical applications. However, it is important to consider issues related to usability, bias, and statistical analyses need consideration. Mixed Reality offers significant benefits, but there are still open challenges such as ergonomic issues, limited field of view, and battery autonomy that must be addressed to ensure widespread acceptance.
- Nature-based interventions targeting elderly people’s health and well-being: an evidence mapPublication . Catissi, Giulia; Gouveia, Gabriela; Savieto, Roberta Maria; Silva, Cristiane Pavanello Rodrigues; Almeida, Raquel Simões de; Borba, Gustavo Benvenutti; Rosario, Kaue Alves; Leão, Eliseth Ribeiro; Simões de Almeida, RaquelHealthy aging encompasses more than the absence of disease, emphasizing the preservation of functional abilities for enhanced well-being and quality of life. Nature-based interventions are scientifically proven contributors to healthy aging. To develop an evidence map showcasing nature-based interventions targeting older individuals’ health and well-being. The evidence map was developed through critical analysis of systematic reviews and clinical trials utilizing the tools AMSTAR2 and CONSORT. A systematic search spanning the past decade was conducted across databases: Cochrane, SCOPUS, PubMed, Web of Science, Embase, and LILACS. Twelve articles met the eligibility criteria. Nature-based interventions such as forest bathing, hiking, therapeutic gardens, virtual reality, and forest sounds were identified. Outcomes were categorized into physical aspects (cardiovascular and pulmonary; neuro-immuno-endocrinological) and mental/behavioral aspects. The final map integrated interventions, outcomes, and quality assessments. The survey highlights the positive impact of nature-based interventions on the health of the elderly. This study provides insights across various domains, fostering the development of programs and policies in management to promote healthy aging. Regarding healthcare, it encourages discourse among professionals regarding the integration of nature-based practices for equitable care in both individual and group settings. Furthermore, it underscores the need for research in the Southern Hemisphere, particularly in Brazil, where the study was conducted.
- The use of digital technologies to promote physical activity in mental healthcare settings: A scoping reviewPublication . Almeida, Raquel Simões de; Soutelo, Ana Paula; Portugal, Paula; Marques, António; Pereira da Silva Marques, António José; Simões de Almeida, Raquel; Soutelo, Ana Paula; Portugal, PaulaOver the past decade, there has been an increase in the number of digital technologies available for mental health purposes. At the same time, engaging in regular physical activity has been shown to promote mental health and well-being, but activity levels are still low in people with mental illness due to several factors. The aim of this study is to identify and better understand what digital technologies are available for physical activity promotion in mental healthcare contexts. A scoping review was conducted in accordance with the Arksey and O’Malley scoping review framework and the PRISMA-ScR guidelines. Systematic literature searches of PsycINFO, Academic Search Complete, Web of Science, and PubMed was performed with a focus on the last ten years. Overall, 11 papers were included. Data was charted and synthesized, and a narrative synthesis was conducted. This scoping review provides a broad overview of the digital tools or technologies that are being used, such virtual reality, wearable devices and mobile applications, and the health benefits or barriers associated with their use for people with mental illness in clinical settings. The results also show that digital technologies could promote willingness to engage in physical activity. Conclusions: These findings could guide further research on how digital technologies for physical activity promotion can be effectively integrated into psychosocial rehabilitation settings and support mental health and recovery.
- Using immersive environments in e-mental health rehabilitation programs directed to future health professionals to promote empathy and health literacy about SchizophreniaPublication . Gomes, Paulo Veloso; Marques, António; Pereira, Javier; Pimenta, Rui; Donga, João; Almeida, Raquel Simões de; Machado Veloso Gomes, Paulo Sérgio; Pereira da Silva Marques, António José; Pimenta, Rui; Rucha das Dores da Costa Donga, João Paulo; Simões de Almeida, RaquelRehabilitation involves all types of patients, including people with schizophrenia. Schizophrenia is considered a complex syndrome characterized in general by fundamental and characteristic distortions of thinking and perception. The quality of life of a person with schizophrenia can be compromised by difficulty in carrying out their daily tasks and by the social stigma of their condition. The importance of training and sensitizing students in rehabilitation areas to this type of problem to improve the rehabilitation processes in which they will participate as future professionals involves empathy and the ability to communicate with these populations. It is possible through virtual reality to create immersive environments to simulate some psychotic symptoms characteristic of people with schizophrenia, such as visual hallucinations and hearing voices. The aim of this study was to test the effect of exposure to experiences characteristic of schizophrenia through two different types of immersive environments, graphical computational virtual reality and 360° video, on students from areas of social rehabilitation regarding empathy, social distance, and attitudes towards people with schizophrenia. Although the results were positive for the three parameters under study, no significant differences were found for each of them between the environments to which the participants were exposed. This study concluded that the choice between the two types of immersive environments should be based on the project’s objectives, the target audience’s needs, and available resources, rather than the type of environment itself, as their impact was similar.
- Art as a therapeutic medium: the SuperART project mediumPublication . Alves, Isa; Almeida, Raquel Simões de; Algado, Salvador Simó; Marques, António; Simões de Almeida, Raquel; Pereira da Silva Marques, António JoséEvidence of the role of the arts in mental health is growing, but artistic approaches are still developing in rehabilitation services. The SuperART project is based on the therapeutic potential of art, proposing an innovative intervention, combining arts, nature and virtual reality to promote well-being in individuals with mental illness. This mixed study evaluated the effectiveness of an artistic intervention on the well-being of people with mental illness. Methods Eight participants took part in activities such as art exhibitions, creating outdoor art and using virtual reality. The Non-pharmacological Therapy Experience Scale (NPT-ES) assessed participants' experiences during sessions, and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) measured well-being before and after the intervention. At the end, a focus group was conducted. Most of the study participants were male, aged between 35 and 56, with a predominant diagnosis of Schizophrenia. Significant changes were observed in the well-being reported by the participants (p-value = .011). There were no differences in engagement and participation across sessions, but overall interest in the intervention increased. Qualitative feedback was promising and participants were satisfied with the project. Conclusion The study highlights the potential of museums as therapeutic contexts for the use of art to promote well-being in individuals with mental illness. The intervention demonstrated encouraging results, including greater well-being and evoked memories. More research with more representative samples is needed to develop effective strategies to promote well-being and provide individuals with genuine opportunities to contribute to the community. growing services wellbeing well being illness exhibitions Nonpharmacological Non pharmacological NPTES NPT ES (NPT-ES sessions WarwickEdinburgh Warwick Edinburgh WellBeing Well Being WEMWBS (WEMWBS end conducted male 3 56 Schizophrenia pvalue p value .011. 011 .011 . .011) increased results memories community 5 01 .01 0 .0 Resumo Introdução A evidência do papel das artes na saúde mental está crescendo, mas as abordagens artísticas ainda estão em desenvolvimento nos serviços de reabilitação. O projeto SuperART baseia-se no potencial terapêutico da arte, propondo uma intervenção inovadora, combinando artes, natureza e realidade virtual para promover o bem-estar em indivíduos com doença mental. Objetivo Este estudo misto avaliou a eficácia de uma intervenção artística no bem-estar de pessoas com doença mental. Métodos Oito participantes participaram de atividades como exposições de arte, criação de arte ao ar livre e uso de realidade virtual. A Non-pharmacological Therapy Experience Scale (NPT-ES) avaliou as experiências dos participantes durante as sessões, e a escala Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) mediu o bem-estar antes e após a intervenção. No final foi conduzido um grupo focal. A maioria dos participantes eram homens, entre 35 e 56 anos, com diagnóstico predominante de Esquizofrenia. Observaram-se mudanças significativas no bem-estar relatado pelos participantes (p-value = .011). Não houve diferenças no envolvimento e na participação ao longo das sessões, mas o interesse geral pela intervenção aumentou. O feedback qualitativo foi promissor e os participantes mostraram-se satisfeitos com o projeto. Conclusão O estudo realça o potencial dos museus como contextos terapêuticos para a utilização da arte na promoção do bem-estar em indivíduos com doença mental. A intervenção demonstrou resultados encorajadores, incluindo um maior bem-estar e memórias evocadas. É necessária mais investigação com amostras mais representativas para desenvolver estratégias eficazes de promoção do bem-estar e proporcionar aos indivíduos oportunidades genuínas de contribuição na comunidade. crescendo reabilitação baseiase baseia se inovadora bemestar bem estar Nonpharmacological Non pharmacological NPTES NPT ES (NPT-ES sessões WarwickEdinburgh Warwick Edinburgh WellBeing Well Being WEMWBS (WEMWBS focal homens 3 5 anos Esquizofrenia Observaramse Observaram pvalue p value .011. 011 .011 . .011) aumentou mostraramse mostraram encorajadores evocadas comunidade 01 .01 0 .0
- Impact of VR-Based Cognitive Training on working memory and inhibitory control in IDD young adultsPublication . Trigueiro, Maria João; Lopes, Joana; Simões-Silva, Vítor; Melo, Bruno Bastos Vieira de; Almeida, Raquel Simões de; Marques, António; Trigueiro, Maria João; Simões-Silva, Vitor; Simões de Almeida, Raquel; Pereira da Silva Marques, António José; Bastos Vieira de Melo, BrunoYoung people with intellectual developmental disabilities have a persistent delay in the development of executive functions. Virtual reality (VR) is increasingly being used as a cognitive intervention tool, with significant effectiveness demonstrated in different types of populations. This pilot study aims to investigate the impact of a cognitive training program utilizing VR on young adults diagnosed with intellectual developmental disabilities (IDDs). The participants (N = 15) served as their own control group and were assessed three times: weeks 0, 8, and 16, with a rest period (0–8 weeks) and an intervention period (8–16 weeks). The assessments included measures of cognitive function provided by E-Prime® (Version 3). Overall, an improvement in working memory and inhibitory control was found after the intervention, but not in sustained attention. These findings suggest that VR-based cognitive training holds promise as an effective intervention for enhancing cognitive abilities in young adults with intellectual developmental disabilities. This study provides a foundation for future investigations into VR’s role in cognitive rehabilitation and its potential to support daily living skills and overall quality of life for individuals with IDDs. Further research is needed to explore the long-term effects and broader applicability of VR interventions.
- The effect of a virtual reality based intervention on processing speed and working memory in individuals with ADHD - A pilot-studyPublication . Cunha, Filipa; Campos, Sara; Simões-Silva, Vítor; Brugada-Ramentol, Victòria; Sá-Moura, Bebiana; Jalali, Hossein; Bozorgzadeh, Amir; Trigueiro, Maria João; Trigueiro, Maria João; Simões-Silva, VitorThis study aimed to evaluate the effectiveness of a virtual reality based intervention in processing speed and working memory in students with ADHD symptomatology. A randomized experimental study was conducted, with a sample consisting of 25 adult participants recruited from the Escola Superior de Saúde do Politécnico do Porto. The participants were allocated into two groups: a passive control group and an intervention group that completed 10 sessions using virtual reality-based games from the Enhance VR app. The intervention included 6 games: Whack-a-mole, Shuffled, Assembly, React, Memory Wall, and Maestro. The participants underwent pre- and post-intervention evaluations using the Southwestern Assessment of Processing Speed (SWAPS) and the Sequence of Letters and Numbers and Spatial Location of the Wechsler Adult Intelligence Scale - 3rd Edition - WAIS-III. Descriptive statistics were used to characterize the sample and a mixed ANOVA was used to test the effectiveness of the intervention. There was an improvement in the results of processing speed in the group exposed to the intervention (p < 0.001) and the value of the interaction between intervention and time was also significant (p = 0.004). There were no statistically significant differences between the participants’ working memory in the different variables under study, except for the values of the Spatial location test in the experimental group that improved relative to the initial assessment (p = 0.034). A virtual reality cognitive training intervention resulted in improvements in the processing speed measures, which were not found in the control group. Although we cannot make the same conclusions regarding working memory, these results suggest that the VR intervention resulted in progress in the experimental group, possibly influenced by the intervention, which should be verified in future studies with longer interventions
- Stigma and discrimination among professionals in portuguese integrated continuing care units: stigma and discrimination in ICCUsPublication . Rocha, Patrícia Castro; Sousa, Sara de; Marques, António; Almeida, Raquel Simões de; Trigueiro, Maria João; Campos, Filipa; Portugal, Paula; de Sousa, Sara; Pereira da Silva Marques, António José; Simões de Almeida, Raquel; Trigueiro, Maria João; Campos, Filipa; Portugal, PaulaStigma surrounding mental illness (MI) poses a significant obstacle to treatment access, hinders recovery, and may lead to suboptimal care. Breaking the chains of prejudice and embracing tolerance are essential steps in fostering understanding and compassion for those living with MI. This study aims to describe the levels of stigma and discrimination against individuals suffering from MI among professionals in Portuguese Integrated Continuing Care Units (ICCUs). A quantitative, observational, cross-sectional study involving 163 participants utilized a sociodemographic questionnaire, alongside two assessment instruments – the Attribution Questionnaire (AQ-27) and Com-munity Attitudes Toward Mental Illness (CAMI). Revealed significant differences in stigma levels based on education (pprejudice = .001; ptolerance = .007) and occupation (pprejudice = .025), higher stigma being associated with lower education levels and specific healthcare occupations (medical assistant). Additionally, a positive correlation was found between age and stigma perception (r = -236, pprejudice = .002; r = -167, ptolerance = .033). The findings underscore the urgent necessity for targeted an-ti-stigma interventions within Portuguese integrated continuing care units, focusing on mitigating education-based disparities, and addressing specific healthcare occupations that exhibit heightened stigma. Effectively combat-ing stigma among professionals is crucial for fostering a more inclusive and compassionate environment in these care settings.