Browsing by Author "Molinari, Enrico"
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- ItemACTonHEALTH study protocol: promoting psychological flexibility with activity tracker and mHealth tools to foster healthful lifestyle for obesity and other chronic health conditions.(0000-00-00) Cattivelli, Roberto; Castelnuovo, Gianluca; Musetti, Alessandro; Varallo, Giorgia; Spatola, Chiara A M; Riboni, Francesco Vailati; Usubini, Anna Guerrini; Tosolin, Fabio; Manzoni, Gian Mauro; Capodaglio, Paolo; Rossi, Alessandro; Pietrabissa, Giada; Molinari, EnricoBACKGROUND Obesity and the state of being overweight are increasing steadily and becoming a global epidemic Recent research reports 64 of the adult population as overweight in Europe and the USA The social and economic impacts are increasing and most of the rehabilitation programs while effective in the short term do not produce long lasting results An explanatory model from a behavioral perspective can describe the phenomena with the lack of sources of reinforcement related to healthful habits in a daily life context METHODS DESIGN A randomized clinical trial combining single subject studies and a four arm group design will be conducted to compare the effect of the current standard in obesity treatment to Acceptance and Commitment Therapy ACT and wearable technology at different times before starting intervention at the end and at follow up visits of 3 6 and 12 months measuring changes over time of physical activity and psychological well being DISCUSSION The goal of this project combining ACT and wearable technology is to develop an effective intervention efficient and sustainable which even after discharge can provide adequate contingencies of reinforcement in the natural environment integrating systematic measurements continuous feedback and individualized values based objectives The intervention is aimed to provide a contingent reinforcement for healthful behaviors instead of reinforcing only the achievement of a significant weight loss The aim of the project combining Acceptance and Commitment Therapy and Wearable Technology is to develop an effective efficient and sustainable intervention able to provide a contingent reinforcement for healthy behaviors The intervention is aimed to promote adequate healthy behaviors in the natural environment integrating systematic measurements continuous feedback and individualized values based objectives instead of reinforcing only the achievement of a significant weight loss TRIAL REGISTRATION ClinicalTrials gov NCT03351712 Registered on 24 November 2017
- ItemCybertherapy in practice: the VEPSY updated project.(2004-08-05) Riva, Giuseppe; Botella, Cristina; Castelnuovo, Gianluca; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, EnricoRapid and far reaching technological advances are changing the ways in which people relate communicate and live Technologies that were hardly used ten years ago such as the Internet e mail and video teleconferencing are becoming familiar methods for diagnosis therapy education and training This is producing an emerging field cybertherapy whose focus is the use of communication and information technologies to improve the health care processes To exploit and understand this potential was the aim of the Telemedicine and Portable Virtual Environment in Clinical Psychology VEPSY UPDATED an European Community funded research project IST 2000 25323 http www cybertherapy info The chapter describes the clinical and technical rationale behind the cybertherapy applications developed by the project Further the actual role of virtual reality in the cybertherapy field is discussed focusing on the advantages provided by its three different faces technological experiential and communicative
- Item[Disease management for heart failure patients: role of wireless technologies for telemedicine. The ICAROS project].(2007-04-03) Villani, Alessandra; Malfatto, Gabriella; Della Rosa, Francesco; Branzi, Giovanna; Boarin, Simona; Borghi, Claudio; Cosentino, Eugenio; Gualerzi, Massimo; Coruzzi, Paolo; Molinari, Enrico; Compare, Angelo; Cassi, Maurizio; Collatina, Stefano; Parati, GianfrancoHealthcare costs for heart failure are increasing The need for a better care however has to be matched with a policy of cost containment A way to improve the cost effectiveness of heart failure care is the disease management approach in which therapy education and follow up are tailored for each patient by a multidisciplinary team Such a complex intervention can be facilitated by the use of telemedicine which allows the remote control of considerable amounts of clinical data In Italy a few studies with telemedicine have been reported A recent development in this field is represented by the ICAROS project Integrated Care vs Conventional Intervention in Cardiac Failure Patients Randomized Open Label Study whose aim is to improve the clinical and psychological care of heart failure patients employing advanced wireless telecommunication technology So far we randomized 60 patients 30 in usual ambulatory care 30 in an intensive treatment group The latter patients were instructed to use a portable computer to get in touch daily with the heart failure clinic and receive feedback instruction for the management of drug therapy and daily problems At the first year of follow up the treatment group showed good compliance to drug prescriptions and could easily handle the portable computer The preliminary results of this ongoing study support the feasibility and appropriateness of new technologies for the management of heart failure even in elderly patients in whom a limited expertise with these appliances could have been anticipated
- Iteme-health in eating disorders: Virtual Reality and telemedicine in assessment and treatment.(2004-10-01) Riva, Giuseppe; Bacchetta, Monica; Cesa, Gianluca; Conti, Sara; Molinari, Enricoe health the integration of telehealth technologies with the Internet and shared virtual reality could become a significant enabler of consumer health initiatives In fact they provide an increasingly accessible communication channel for a growing part of the population In the past decade medical applications of virtual reality VR and telemedicine have been rapidly developing and the technology has changed from a research curiosity to a commercially and clinically important area of medical informatics technology The chapter details the characteristics of the Experiential Cognitive Therapy ECT an integrated inpatient outpatient 4 weeks and telemedicine approach 24 weeks that tries to enhance the classical cognitive behavioral method used in the treatment of eating disorders through VR sessions and telemedicine support in the follow up stage Particularly using VR and telemedicine ECT is able to address body experience disturbances interpersonal relationships self efficacy and motivation to change key issues for the development and maintenance of eating disorders that are somehow neglected by actual clinical guidelines
- ItemNew tools in cybertherapy: the VEPSY web site.(2004-08-05) Castelnuovo, Gianluca; Buselli, Claudio; De Ferrari, Roberta; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Villamira, Marco; Riva, GiuseppeIn the last years the rapid development of the Internet and new communication technologies has had a great impact on psychology and psychotherapy Psychotherapists seem to rely with more and more interest on the new technological tools such as videophone audio and video chat e mail SMS and the new Instant Messaging Tools IMs All these technologies outline a stimulating as well as complex scenario in order to effectively exploit their potential it is important to study which is the possible role played by the Internet based tools inside a psychotherapeutic iter Could the technology substitute the health care practitioners or are these tools only a resource in addition to the traditional ones in the therapist s hand The major aim of this chapter is to provide a framework for the integration of old and new tools in mental health care Different theoretical positions about the possible role played by e therapy are reported showing the possible changes that psychotherapy will necessarily face in a cyber setting The VEPSY website an integration of different Internet based tools developed within the VEPSY UPDATED Project is described as an example of clinical application matching between old and functional practices with new and promising media for the treatment of different mental disorders A rationale about the possible scenarios for the use of the VEPSY website in the clinical process is provided
- ItemObesity and outpatient rehabilitation using mobile technologies: the potential mHealth approach.(2014-06-24) Castelnuovo, Gianluca; Manzoni, Gian Mauro; Pietrabissa, Giada; Corti, Stefania; Giusti, Emanuele Maria; Molinari, Enrico; Simpson, SusanObesity is currently an important public health problem of epidemic proportions globesity Inpatient rehabilitation interventions that aim at improving weight loss reducing obesity related complications and changing dysfunctional behaviors should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists dieticians psychiatrists endocrinologists nutritionists physiotherapists etc Long term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation Internet based technologies can improve long term obesity rehabilitation within a collaborative approach by enhancing the steps specified by psychological and medical treatment protocols These outcomes may be augmented further by the mHealth approach through creating new treatment delivery methods to increase compliance and engagement mHealth m health mobile health can be defined as the practice of medicine and public health supported by mobile communication devices for health services and information mHealth applications which can be implemented in weight loss protocols and obesity rehabilitation are discussed taking into account future research directions in this promising area
- ItemThe STRATOB study: design of a randomized controlled clinical trial of Cognitive Behavioral Therapy and Brief Strategic Therapy with telecare in patients with obesity and binge-eating disorder referred...(2011-06-14) Castelnuovo, Gianluca; Manzoni, Gian Mauro; Villa, Valentina; Cesa, Gian Luca; Pietrabissa, Giada; Molinari, EnricoBACKGROUND Overweight and obesity are linked with binge eating disorder BED Effective interventions to significantly reduce weight maintain weight loss and manage associated pathologies like BED are typically combined treatment options dietetic nutritional physical behavioral cognitive behavioral pharmacological surgical Significant difficulties with regard to availability costs treatment adherence and long term efficacy are present Particularly Cognitive Behavioral Therapy CBT is the therapeutic approach indicated both in in patient and in out patient settings for BED In recent years systemic and systemic strategic psychotherapies have been implemented to treat patients with obesity and BED involved in familiar problems Particularly a brief protocol for the systemic strategic treatment of BED using overall the strategic dialogue has been recently developed Moreover telemedicine a new promising low cost method has been used for obesity with BED in out patient settings in order to avoid relapse after the in patient step of treatment and to keep on a continuity of care with the involvement of the same clinical in patient team METHODS The comparison between CBT and Brief Strategic Therapy BST will be assessed in a two arm randomized controlled clinical trial Due to the novelty of the application of BST in BED treatment no other RCTs including BST have been carried out a pilot study will be carried out before conducting a large scale randomized controlled clinical trial RCT Both CBT and BST group will follow an in hospital treatment diet physical activity dietitian counseling 8 psychological sessions plus 8 out patient telephone based sessions of psychological support and monitoring with the same in patient psychotherapists Primary outcome measure of the randomized trial will be the change in the Global Index of the Outcome Questionnaire OQ 45 2 Secondary outcome measures will be the percentage of BED patients remitted considering the number of weekly binge episodes and the weight loss Data will be collected at baseline at discharge from the hospital c a 1 month after and after 6 12 24 months from the end of the in hospital treatment Data at follow up time points will be collected through tele sessions DISCUSSION The STRATOB Systemic and STRATegic psychotherapy for OBesity a comprehensive two phase stepped down program enhanced by telepsychology for the medium term treatment of obese people with BED seeking intervention for weight loss will shed light about the comparison of the effectiveness of the BST with the gold standard CBT and about the continuity of care at home using a low level of telecare mobile phones TRIAL REGISTRATION ClinicalTrials gov Identifier NCT01096251
- ItemThe use of VR in the treatment of eating disorders.(2004-08-05) Riva, Giuseppe; Bacchetta, Monica; Cesa, Gianluca; Conti, Sara; Molinari, EnricoIn the treatment of eating disorders the cognitive behavioral therapy CBT is still considered the best approach but could present different limitations related to costs of behavioural procedures such as exposure and desensitization or difficulty of cognitive techniques such as imagination of daily scenarios The major aim of this contribution is the description of a new Virtual Reality enhanced treatment named Experiential Cognitive Therapy ECT Rationale and protocols about this new approach are explained Moreover data about clinical trials carried on with the VEPSY Project are shown comparing different groups experimental group ECT cognitive behavioural therapy group CBT nutritional group and control group
- ItemWELL.ME - Wellbeing therapy based on real-time personalized mobile architecture, vs. cognitive therapy, to reduce psychological distress and promote healthy lifestyle in cardiovascular disease patients:...(2012-11-08) Compare, Angelo; Kouloulias, Vassilis; Apostolos, Vontas; Peña, Wendy Moreno; Molinari, Enrico; Grossi, Enzo; Efstathios, Efstathopoulos; Carenini, MicheleBACKGROUND There is compelling evidence that psychological factors may have the same or even greater impact on the possibility of adverse events on cardiac diseases CD than other traditional clinical risk factors Anxiety and depression are predictors of short and long term adverse outcomes increased risk for higher rates of in hospital complications re infarction malignant arrhythmias and mortality in CD patients Despite researchers finding that cognitive behavior therapy CBT reduced depressive and anxiety symptoms the fact that such results are maintained only in the short term and the lack of maintenance of the long term affects the absence of changes in lifestyles preventing the possibility of a wide generalization of results Recently wellbeing therapy WBT has been proposed as a useful approach to improve healthy lifestyle behaviors and reduce psychological distress METHODS DESIGN The present randomized controlled study will test WBT in comparison with CBT as far as the reduction of symptoms of depression anxiety and psychological distress and the improvement of lifestyle behaviors and quality of life in cardiac patients are concerned Moreover innovations in communication technologies allow patients to be constantly followed in real life Therefore WBT based on personalized mobile technology will allow the testing of its effectiveness in comparison with usual WBT DISCUSSION The present study is a large outpatient study on the treatment of co morbid depression anxiety and psychological distress in cardiac patients The most important issues of this study are its randomized design the focus on promotion of health related behaviors and the use of innovative technologies supporting patients wellbeing in real life and in a continuous way First results are expected in 2012 TRIAL REGISTRATION ClinicalTrials gov Identifier NCT01543815