Patrizia Steca

Introduction Effective cardiovascular (CV) prevention requires accurate risk estimation and patient engagement, which depends on perceived risk. The Perception of Risk of Heart Disease Scale (PRHDS) is a validated tool, yet clinical thresholds for its brief Italian version are lacking. Aim To provide further validation of the Brief Italian version of the PRHDS (PRHDS-BI) in a new cohort, examining convergent and divergent validity, and to establish clinical thresholds and a discrepancy index comparing perceived risk with objective estimates. Methods 285 adults (40–69 years) were involved in this multicentre cross-sectional study (NCT06190743). Participants were without a history of CV disease and completed the PRHDS-BI and the Patient Health Questionnaire-4 (PHQ-4). CV real risk was estimated using the Systematic Coronary Risk Evaluation 2 (SCORE2). Confirmatory Factor Analysis (CFA), correlation analyses, and cut-off definitions were used to validate the scale and analyze risk discrepancies. Results The PRHDS-BI showed good internal consistency and strong convergent validity. Clinical thresholds were defined by percentiles: scores 6–12 (low/moderate), 13–17 (high), and 18–24 (very high). A significant mismatch emerged: 63.5% of participants at low/moderate actual risk overestimated their risk, while 80% at very high actual risk underestimated it. This perception–reality gap was statistically confirmed. Conclusions The PRHDS-BI is a valid tool for assessing CV risk perception. Establishing thresholds allows for tailored risk communication and patient-centered interventions, particularly by nursing professionals in primary prevention settings.

Objective: Robot-assisted therapy (RAT) has shown promise in post-stroke motor recovery. However, its effects on non-motor outcomes remain unclear. This systematic review evaluated RAT impact on post-stroke quality of life (QoL), cognition, and psychosocial functioning. Methods: Following PRISMA guidelines, electronic searches were performed from Web of Science, PubMed, Cochrane Library, CINAHL, Embase, and PsycINFO. Risk of bias was assessed using NIH Quality Assessment Tools. Data on study design, participants, intervention characteristics, outcomes, and results were extracted and synthetized descriptively. Results: A total of 90 studies met the inclusion criteria. Considerable heterogeneity was found in participants’ characteristics, intervention duration (2–52 weeks), and dosage (20–240 min/session). Most studies reported significant RAT effects on QoL (emotional, physical, cognitive, social subdomains), cognition (attention, executive functions, memory, language, visuo-spatial abilities, intelligence), and psychosocial outcomes (anxiety, depression, self-efficacy, fear of falling, motivation, coping). Some studies also showed greater improvements compared with conventional training controls. Longitudinal effects were generally absent, except for QoL variations observed up to 12 months. Cognitive and psychological factors were also identified as moderators/predictors of RAT response. Conclusion: Despite variability across studies, findings suggest RAT may have a broad impact beyond motor recovery. Future large-scale, standardized, longitudinal trials are recommended to confirm these results.

Background: Dietary habits established during young adulthood have long-term implications for health, and food choices among university students are strongly shaped by contextual factors. Institutional eating environments represent a relevant setting for promoting healthier dietary behaviors, yet limited evidence integrates students’ engagement with these settings, their food consumption patterns across contexts, and the individual decision-making processes underlying food choice. Methods: This cross-sectional study analyzed survey data from 1519 students enrolled at a large Italian university. Measures included sociodemographic characteristics, self-identified dietary style, engagement with the university canteen, consumption frequency of selected food categories across institutional and non-institutional contexts, and category-specific food-choice motivations. Data were analyzed using descriptive analyses, Borda count rankings, paired comparisons, and multiple linear regression models. Results: Clear contextual differences in food consumption emerged across all food categories, with consistently lower consumption frequencies within the university canteen compared to outside settings (all p < 0.001). The largest contextual gap was observed for fruit consumption (d = 0.94), with similarly pronounced differences for plant-based foods. Taste was the most salient decision-making factor across food categories (overall M ≈ 4.4), while health-related motives were more prominent for healthier foods and gratification for desserts. Across contexts, self-identified dietary style was the most consistent predictor of food consumption, explaining substantial variance for animal-based protein consumption (R² = 0.293 in the canteen; R² = 0.353 outside), whereas age and gender showed smaller, food-specific associations. Conclusions: The findings highlight institutional eating settings as distinct food environments in which individual dietary preferences are only partially expressed. Effective strategies to promote healthier eating among university students should move beyond generic approaches and integrate interventions targeting service-related engagement, category-specific choice architecture, and students’ dietary identities.

Background: Polyneuropathies impair sensory, motor, and autonomic functions, affecting functional status, cognition, and quality of life. This pilot study investigated the effects of exergame with biofeedback training (Riablo system) versus standard rehabilitation on these outcomes in outpatients with mixed-etiology polyneuropathies. Methods: Seventeen outpatients were assigned to standard rehabilitation (Group 1, n = 9) or combined standard plus Riablo training (Group 2, n = 8) over three weeks. Functional status, pain, cognition, quality of life, and psychological well-being were assessed pre- and post-intervention, with a 6-month follow-up. Outcome measures included the Morse Fall Scale, Visual Analogue Scales for pain and autonomy, Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Stroop Test, Frontal Assessment Battery (FAB), Verbal fluency test, the Short-Form Health Survey-12 (SF-12), and the Patient Health Questionnaire-4 (PHQ-4). Longitudinal changes and between-group differences were analyzed using nonparametric statistics. Results: Both groups showed significant improvements in functional status and global cognition at post-intervention. Group 2 demonstrated greater improvements in executive functions and attention, with significant reductions in pain and fall risk. At 6-month follow-up, Group 2 maintained post-intervention gains in QoL and psychological outcomes, while Group 1 showed a significant decline. Technology evaluation revealed high usability and positive psychosocial impact in Group 2, with strong correlations between executive function improvements and device usability. Conclusions: Integrating exergames with biofeedback into standard rehabilitation may provide broader and longer-lasting benefits for polyneuropathy patients. These findings support further large-scale trials to confirm efficacy and optimize technology-assisted rehabilitation protocols.

Background: Plant-based diets have been widely recommended as sustainable, ethical, and health-conscious alternatives. However, their adoption remains limited due to nutritional and cultural concerns, which may be reinforced in contexts associated with masculinity. This study aimed to explore (a) whether physical activity represents a barrier to plant-based food choices, and (b) whether beliefs about plant-based diets differ between sedentary and physically active individuals. Methods: A mixed-methods study was conducted, combining focus groups and survey data. Twenty-six Italian volunteers were divided into four groups: (I) physically active omnivores; (II) sedentary omnivores; (III) physically active veg*ans; and (IV) sedentary veg*ans. The discussions focused on protein-rich foods (animal-based vs. plant-based) and addressed nutritional concerns related to athletic performance, as well as attitudes toward plant-based proteins and veg*an individuals. Results: Omnivores—particularly active ones—favored animal-based proteins, perceiving them as more palatable, nutritious, and better suited for physical performance, a view often reinforced by coaches. This group also emphasized sensory pleasure as a barrier to adopting plant-based alternatives. It addressed masculinity-related themes more frequently; moreover, while veg*an participants were more inclined to seek professional advice to ensure a balanced diet, omnivores referred to the traditional Mediterranean diet as their primary source of nutritional guidance. This factor may further hinder openness to plant-based choices. Conclusions: The findings highlight stronger stigma among physically active individuals and suggest the need for interventions that replace the current narrative of plant-based diets as a restrictive or dietetic alternative with one that frames it as compatible with strength, vitality, and overall well-being.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: AI-driven mobile health (mHealth) applications are emerging as a promising tool for health management, yet little is known about users' psychological perceptions and attitudes towards these technologies. Understanding these aspects is crucial for both the appropriate design and the effective use of these technologies, ensuring the psychological and physical well-being of potential end users. Objective: This study aimed to investigate the attitudes and perceptions of young adults towards a possible use of AI-driven mHealth applications, focusing on the perceived benefits and potential concerns related to their future adoption. Methods: A qualitative focus group methodology was employed. Fifteen participants (12 men, 3 women, mean age 27 years) were recruited. Data were analyzed using thematic analysis to identify key themes influencing engagement with these technologies. Results: Four main themes emerged: “Usability,” which emphasized the importance of user-friendly, personalized experiences; “Innovation and Reliability,” where participants expressed both enthusiasm and skepticism towards AI’s potential; “Affectivity and Interaction with AI,” highlighting mixed opinions on the emotional impact of AI interactions; and “Perceived Risks,” which focused on concerns regarding data privacy and the need for human supervision. These factors contributed to ambivalent attitudes towards AI-driven mHealth apps, with some participants being open to adoption, while others remained cautious. Conclusions: To foster greater engagement with AI-driven mHealth apps, developers should prioritize usability, trust, emotional support, and privacy issues, considering users’ psychological needs and expectations. The findings offer valuable insights for designing more user-oriented mHealth solutions. Further research should explore how perceptions evolve with direct experience and long-term use.

BACKGROUND AI-driven mobile health (mHealth) applications are emerging as a promising tool for health management, yet little is known about users' psychological perceptions and attitudes towards these technologies. Understanding these aspects is crucial for both the appropriate design and the effective use of these technologies, ensuring the psychological and physical well-being of potential end users. OBJECTIVE This study aimed to investigate the attitudes and perceptions of young adults towards a possible use of AI-driven mHealth applications, focusing on the perceived benefits and potential concerns related to their future adoption. METHODS A qualitative focus group methodology was employed. Fifteen participants (12 men, 3 women, mean age 27 years) were recruited. Data were analyzed using thematic analysis to identify key themes influencing engagement with these technologies. RESULTS Four main themes emerged: “Usability,” which emphasized the importance of user-friendly, personalized experiences; “Innovation and Reliability,” where participants expressed both enthusiasm and skepticism towards AI’s potential; “Affectivity and Interaction with AI,” highlighting mixed opinions on the emotional impact of AI interactions; and “Perceived Risks,” which focused on concerns regarding data privacy and the need for human supervision. These factors contributed to ambivalent attitudes towards AI-driven mHealth apps, with some participants being open to adoption, while others remained cautious. CONCLUSIONS To foster greater engagement with AI-driven mHealth apps, developers should prioritize usability, trust, emotional support, and privacy issues, considering users’ psychological needs and expectations. The findings offer valuable insights for designing more user-oriented mHealth solutions. Further research should explore how perceptions evolve with direct experience and long-term use.

Background: Although insect-based foods (IBFs) have been recently proposed as a way to face climate crisis and starvation, they encounter aversion from Western countries, which express fear, disgust, and high risk. The contribution of psychology research to food choices highlights how decisions are made, not only through reasoned attitudes and goal-directed behavior, but also through more automatic associations (dual-system models). Methods: In this paper, we investigated people’s dispositions towards IBFs by combining (a) explicit attitudes (as assessed via self-report scales), (b) automatic associations (as measured via indirect measures), and (c) intention to taste, and comparing different profiles based on (d) psychological factors, including decision-making style, food neophobia, and trust in science and scientist. A pilot sample of 175 Italian university students participated in the study. Results: The analyses of the general sample highlighted rather negative attitudes. The cluster analysis identified 4 decision-making profiles: ‘the gut feeling’, ‘the suspicious’, ‘the vicarious’, and ‘the mind’. It revealed more favorable opinions in ‘the mind’ profile, characterized by a rational decision-making style and high trust in science, and very aversive reactions from ‘the suspicious’ profile, characterized by high food neophobia and low trust in science. Conclusions: The results underline the importance of psychological factors in interpreting people’s reactions to IBF and changes in dietary habits based on the decision-making process. They suggest possible strategies to promote eco-friendly diets.