This article describes a randomized controlled trial to evaluate the effectiveness of a supervised online delivery of self-help plus (SH+), during the second wave of COVID-19 contagions in Northern Italy. The SH+ is a psychological intervention developed by the World Health Organization to increase a person's ability to deal with stress. In this trial, it was tested primarily as a tool to reduce anxiety and post-traumatic symptomatology in workers of residential nursing and care homes. In order to partial out non-specific effects of the intervention, the SH+ was compared to an equally supervised and structured alternative activity. Secondarily, in view of future emergencies, the potential of SH+ as a tool to reduce perceived stress, increase subjective well-being and foster individual resilience was explored. At post-intervention, the preregistered analysis revealed no difference in self-reported anxiety and/or post-traumatic symptomatology between the group receiving the SH+ and the group engaged in an alternative activity. Some specific and positive effects of the SH+ intervention were only found on self-reported intervention effectiveness and engagement in exploratory analyses. These findings raise the question whether the previously documented effectiveness of the SH+ on self-reported symptomatology and on the prevention of psychiatric conditions could be attributed mostly to non-specific rather than specific factors connected with participant enrolment in a psychological intervention. Indeed, the effects of the SH+ had been previously compared only to the effects of not being engaged in any alternative activity (often described in the literature as ‘treatment as usual’—or ‘enhanced treatment as usual’, when some relevant information is given to the control group as a one-off). Given the negative findings of this study, before the SH+ is implemented in clinical practice, further studies should be conducted to examine its short- and long-term beneficial effects, by means of randomized studies that employ alternative but similarly structured interventions as control conditions, aiming to minimize the confounding effect of non-specific factors.
The magnetic nature of the formation of solar active regions lies at the heart of understanding solar activity and, in particular, solar eruptions. A widespread model, used in many theoretical studies, simulations and the interpretation of observations, is that the basic structure of an active region is created by the emergence of a large tube of pre-twisted magnetic field. Despite plausible reasons and the availability of various proxies suggesting the accuracy of this model, there has not yet been a methodology that can clearly and directly identify the emergence of large pre-twisted magnetic flux tubes. Here, we present a clear signature of the emergence of pre-twisted magnetic flux tubes by investigating a robust topological quantity, called magnetic winding, in solar observations. This quantity detects the emerging magnetic topology despite the significant deformation experienced by the emerging magnetic field. Magnetic winding complements existing measures, such as magnetic helicity, by providing distinct information about field line topology, thus allowing for the direct identification of emerging twisted magnetic flux tubes.