Objectives: This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We first describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during different medical procedures, such as burn injury treatments, chemotherapy, surgery, dental treatment, and other diagnostic and therapeutic procedures. Methods: A broad literature search was performed using as main terms “virtual reality,” “distraction,” and “pain.” No date limit was applied and all the retrieved studies on immersive VR distraction during medical procedures were selected. Results: VR has proven to be effective in reducing procedural pain, as almost invariably observed even in patients subjected to extremely painful procedures, such as patients with burn injuries undergoing wound care, and physical therapy. Moreover, VR seemed to decrease cancer-related symptoms in different settings, including during chemotherapy. Only mild and infrequent side effects were observed. Discussion: Despite these promising results, future long-term randomized controlled trials with larger sample sizes and evaluating not only self-report measures but also physiological variables are needed. Further studies are also required both to establish predictive factors to select patients who can benefit from VR distraction and to design hardware/software systems tailored to the specific needs of different patients and able to provide the greatest distraction at the lowest cost.

A meta-analytic review of the relationship of cancer coping self-efficacy with distress and quality of life

The so called “Triple Negative Breast Cancer” (TNBC) represents approximately 15-20% of breast cancers. This acronym simply means that the tumour does not express oestrogen receptor (ER) and progesterone receptor (PR) and does not exhibit amplification of the human epidermal growth factor receptor 2 (HER2) gene. Despite this unambiguous definition, TNBCs are an heterogeneous group of tumours with just one common clinical feature: a distinctly aggressive nature with higher rates of relapse and shorter overall survival in the metastatic setting compared with other subtypes of breast cancer. Because of the absence of well-defined molecular targets, cytotoxic chemotherapy is currently the only treatment option for TNBC.

In the last few decades, several studies have investigated the role of personality traits and attitudes toward traffic safety in predicting driving behaviors in diverse types of drivers across several countries. However, to the best of our knowledge, no studies so far have investigated the possible moderating role played by age in relation to predictors of accident risk. Answering this open question would provide information about the generalizability of the model across different subpopulations and would make possible the tailoring of the interventions to specific target groups. The study involved 1,286 drivers from three different age groups (young: n = 435; adult: n = 412; old: n = 439) which completed a questionnaire measuring drivers’ personality traits (i.e., anxiety, hostility, excitement seeking, altruism, normlessness), positive attitudes toward traffic safety, risky driving behaviors (i.e., errors, lapses, and traffic violations), accident involvement and number of traffic fines issued in the last 12 months. Multi-group Variance Based Structural Equation Modeling (VB-SEM) across the three age groups showed that the hypothesized model had a good fit with the data in all the three age groups. However, some pattern of relationships between the variables varied across the three groups, for example, if considering the direct effects of personality traits on risky driving behaviors, anxiety, altruism, and normlessness predicted violations only in young and adult drivers, whereas excitement seeking was associated with lapses only in young drivers; anxiety was a positive predictor of drivers’ errors, both in adult and older drivers, whereas excitement seeking predicted errors in adult and young drivers. On the other hand, attitudes significantly and negatively predicted violations and errors in all the three age groups, whereas they significantly and negatively predicted lapses only in young and older drivers. The results of the present study provided empirical basis to develop evidence-based road safety interventions differently tailored to the specific life’s stage of the drivers.

School situations trigger affective states that influence students’ achievement and well-being. In the present study, we investigated, on the basis of a sample of 26,470 high-school students and 1,472 classrooms, the relationship of individual characteristics (immigrant background, gender, socioeconomic status, and achievement) as well as classroom characteristics (group composition and size) with students’ feelings at school. The results showed that females, low achievers, immigrants, and low-SES students are more at risk of psychological distress at school, with gender and achievement being the most important factors. A doubly latent model analysis revealed that whereas individual socioeconomic status and achievement have a positive impact on students’ feelings, the effect of the two variables at the classroom level is negative. The impact of immigrant classroom composition seems to be limited to positive affect and dependent on students’ immigrant generation. Finally, students in smaller classrooms show more psychological well-being at school.