Search

This study aimed to evaluate psychometric properties of the Italian version of the Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF34) in a cancer population. A multicenter prospective observational study was carried out in outpatient and inpatient settings. The evaluated psychometric properties were as follows: the five-domain structure, the internal consistency, the convergent validity with the Edmond Symptom Assessment System (ESAS) questionnaire, the discriminant validity and test–retest reliability. A total of 714 patients with different types, stages and treatment settings of cancer were recruited. A total of 56% of participants were women, the median age 59 years (range 18–88). The prevalence of patients reporting at least one unmet need was 78.7%. The factor analysis explained 71.3% of the total variance, confirming the five-domain structure of the original model. Internal consistency was good, with Cronbach’s alpha values ranging from 0.87 (“psychosocial need”, “patient support and health system”, “information”) to 0.90 (“sexuality”). The convergent validity of the SCNS-SF34-It with the ESAS scale was low, suggesting that these questionnaires cover different concepts. The SCNS-SF34-It was able to discriminate differences between groups, and the test–retest reliability was good (ICC 0.72–0.84). The SCNS-SF34-It proved to be a reliable instrument for use in clinical practice for evaluating unmet needs in the Italian population of cancer patients. This study was not registered.

Background: “Ricominciare” is a single-center, prospective, pre-/post-intervention pilot study aimed at verifying the feasibility and safety of the ARC Intellicare (ARC) system (an artificial intelligence-powered and inertial motion unit-based mobile platform) in the home rehabilitation of people with disabilities due to respiratory or neurological diseases. Methods. People with Parkinson’s disease (pwPD) or post-COVID-19 condition (COV19) and an indication for exercise or home rehabilitation to optimize motor and respiratory function were enrolled. They underwent training for ARC usage and received an ARC unit to be used independently at home for 4 weeks, for 45 min 5 days/week sessions of respiratory and motor patient-tailored rehabilitation. ARC allows for exercise monitoring thanks to data from five IMU sensors, processed by an AI proprietary library to provide (i) patients with real-time feedback and (ii) therapists with information on patient adherence to the prescribed therapy. Usability (System Usability Scale, SUS), adherence, and adverse events were primary study outcomes. Modified Barthel Index (mBI), Barthel Dyspnea Index (BaDI), 2-Minute Walking Test (2MWT), Brief Fatigue Inventory (BFI), Beck Depression or Anxiety Inventory (BDI, BAI), and quality of life (EQ-5D) were also monitored pre- and post-treatment. Results. A total of 21 out of 23 eligible patients were enrolled and completed the study: 11 COV19 and 10 pwPD. The mean total SUS score was 77/100. The median patients’ adherence to exercise prescriptions was 80%. Clinical outcome measures (BaDI, 2MWT distance, BFI; BAI, BDI, and EQ-5D) improved significantly; no side effects were reported. Conclusion. ARC is usable and safe for home rehabilitation. Preliminary data suggest promising results on the effectiveness in subjects with post-COVID condition or Parkinson’s disease.

Abstract Background It is known that occupational injury rates are higher for immigrant than for native workers, however the effects of the economic cycles on these differences has not been assessed to date. The aim of the paper is to test if the crisis has the same mechanism of selection in the two groups by comparing injury rates in 2005 (before the crisis) and in 2010 (after the crisis). Methods The Work History Italian Panel-Salute integrated database was interrogated to identify employment contracts in the metalworking and construction industries for the years 2005 and 2010 and the occupational injuries. A definition based on the type of injury, less likely to be biased by underreporting, was used to select serious events. Immigrants and natives were matched using the propensity score method and injury rates were calculated in the two years. Analyses were stratified by industry. Results In the metalworking industry injury rates slightly increased over time for both groups, and were higher among immigrant than native workers in both 2005 and 2010. In the construction industry the 2005 injury rate was the same in the two groups, and there was a negative trend over time in both groups. However the decline in the 2010 injury rate for Italian workers was much larger, which led to a considerable increase of the incidence rate ratio of immigrants with respect to native (IRR 3.83, 95% CI 2.52–5.75). Conclusions The economic recession had an impact on the risk of workplace injury. Though the main observed factors (18 variables) usually reported in literature to explain the higher injury rates of the immigrant workers were controlled through the matching, there were still differences between immigrants and natives. The main reason is that immigrants continue to be assigned to the more dangerous jobs and the more dangerous tasks within these job. Furthermore, also differences in the perception of workplace injury risks, linguistic barriers, and cultural factors may have a role in explaining this gap.

Background The COVID-19 pandemic caused drastic changes in healthcare and severe social restrictions. Healthcare workers (HCWs) are on the front line against the virus and have been highly exposed to pandemic-related stressors, but there are limited data on their psychological involvement for a large sample in Italy. Aims To investigate the prevalence of anxiety, distress and burnout in HCWs of North-West Italy during the COVID-19 pandemic, and to detect potential psychosocial factors associated with their emotional response. Method This cross-sectional, survey-based study enrolled 797 HCWs. Participants completed the Impact of Event Scale – Revised, the State-Trait Anxiety Inventory – Form Y and the Maslach Burnout Inventory; demographic, family and work characteristics were also collected. Global psychological outcome, differences among professions and independent factors associated with worst psychological outcome were assessed. Results Almost a third of the sample had severe state anxiety and distress, high emotional exhaustion and depersonalisation, and low personal accomplishment. Distress was higher in women and nurses, whereas depersonalisation was higher in men. Family division, increased workload, job changes and frequent contact with COVID-19 were associated with worst psychological outcome. Trait anxiety was associated with significantly higher risk for developing state anxiety, distress and burnout. Conclusions An elevated psychological burden related to the COVID-19 pandemic was observed in HCWs of North-West Italy. The identification of family and work characteristics and a psychological pre-existing condition as factors associated with worst psychological outcome may help provide a tailored, preventive, organisational and psychological approach in counteracting the psychological effects of future pandemics.

Patients with advanced cancer suffer from psychosocial distress that may impair quality of life and that may be ameliorated by psychotherapeutic treatment. We describe here the methodology of a randomized controlled trial (RCT) to assess the effectiveness of a novel, brief, semi-structured psychotherapeutic intervention to reduce distress and increase well-being in patients with advanced or metastatic cancer. The intervention, called Managing Cancer and Living Meaningfully (CALM), was originally developed in Canada and we are now testing its Italian adaptation (CALM-IT).The study is a single-blinded phase III RCT with assessment at baseline, 3 and 6 months with two conditions: CALM-IT versus a nonspecific supportive intervention (SPI). Eligibility criteria include: ≥ 18 years of age; fluency in the Italian language; no cognitive deficit, and diagnosis of advanced or metastatic cancer with an expected survival of 12–18 months. CALM-IT includes up to 12 sessions, delivered over 6 months and covers 4 domains: i) Symptom Management and Communication with Health Care Providers; ii) Changes in Self and Relations with Close Others; iii) Sense of Meaning and Purpose; and iv) the Future and Mortality. The primary outcome is difference in severity of depressive symptoms between treatment arm and the primary endpoint is 6 months. The secondary endpoint is 3 months and secondary outcomes are: generalized anxiety, distress about dying and death, demoralization, spiritual well-being, attachment security, posttraumatic growth, communication with partners, quality of life, and satisfaction with clinical care.If shown to be effective, CALM-IT can be implemented nationally to relieve distress and to promote psychological well-being in patients with advanced cancer.

Mixed plumes of chlorinated organics and oxidized metals are a common contaminant at many sites. The oxidized metals can be mediated by the establishment of moderately reducing conditions. The chlorinated organics have been demonstrated to be degradable by specific dechlorinating microrganisms in anaerobic environment such as Dehalococcoides sp. Enhanced biological dechlorination requires the presence of an effective electron donor to provide molecular hydrogen (H2) to completely degrade chlorinated ethenes. Distribution of the electron donor results in the biologically mediated establishment of highly reducing conditions in the treatment zone. This process also results in the reduction and precipitation of the oxidized metals via sulphate-reducing conditions. Peroxychem LLC has developed an innovative electron donor, ELS® Microemulsion Reagent (ELS) for in situ treatment of chlorinated organics and metals. This substrate has been successfully applied at numerous sites to address a variety of contaminants. ELS® is an organic electron donor composed of an easily fermentable organic substrate based on lecithin, and designed to enhance in situ anaerobic bioremediation aquifers contaminated by organochlorine compounds and heavy metals such as hexavalent chromium Cr[VI]. The product is easy to mix, dilute and inject into the subsurface. Once in the groundwater, indigenous microorganisms utilize ELS to rapidly generate highly reducing conditions, favoring biotic dechlorination reactions and the reduction of oxidized metals such as Cr[VI]. This innovative technology was successfully applied to a former manufacturing site in the center of Italy, where groundwater was historically contaminated with Tetrachloroethylene (PCE > 5.5 milligrams per Liter; mg/L), Trichloroethylene (TCE > 2 mg/L), 1,2-Dichloroethene (1,2-DCE > 1 mg/L) and, to a lesser extent, Vinyl Chloride (VC) and 1,2-Dichloropropane (DP). A pump-and-treat system (P&T) installed in the source was active as a source containment measure and to speed up the overall groundwater remediation. However, there was concern that the pumping could affect the ELS treatment effectiveness because of the increased groundwater flow velocity and the potential for removal of the injected bioremediation substrate. To mitigate this potential some wells were switched off the flow rates of others was adjusted to ensure compatibility with the planned product injection. In particular, an upstream low-flow-rate pump and treat system was maintained over the ELS® treatment period, primarily to delay the fast-downstream diffusion of the amendments in the aquifer, thus enhancing the source treatment. Following the calibration of the P&T system, approximately 4,900 kg of ELS® concentration was injected under high pressure at 51 locations into the source area. In about 12 months from injection of ELS® Microemulsion into the groundwater in the main source area, concentrations of PCE, TCE and the recognized catabolites, such as DCE and VC, rapidly reduced, compared to the pre-treatment concentrations, until they reached the statutory national limits (CSC D.lgs 152/06) in the main monitoring piezometers of the area, also highlighting the establishment of clear and enhanced biotic reducing conditions. No rebound effects have been observed in the next three years of monitoring.

BACKGROUND:Four percent of the world's population suffers from depression, which is a major public health issue. Medical students are at risk, as their depressive symptoms (DS) prevalence is reported to be approximately 27% worldwide. Since few data on Italian medical students exist, this study aimed to estimate their DS prevalence and assess risk and protective factors. METHODS:The PRIMES was a multicentre cross-sectional study performed in 12 Italian medical schools. Questionnaires were self-reported and included 30 sociodemographic items and the Beck Depression Inventory-II (BDI-II). The primary outcome was the presence of DS (BDI-II score≥14). The main analyses were chi-squared tests and multivariable logistic regressions with a p-value

BACKGROUND: Previous studies have reported that medical students show high rates of depression, anxiety, and stress levels, but mixed findings were found regarding possible differences between gender and different years of medical training. This study evaluated depression, anxiety, and stress levels and psychiatric drug use in students in an Italian medical school and investigated the differences between gender and year of study. MATERIALS AND METHODS: This cross-sectional study included 694 medical students in their 1st (n = 286), 4th (n = 209), and 6th (n = 199) year of study. The questionnaire included demographic information, self-report questionnaires regarding depression, anxiety, and stress, and questions about psychiatric drug use. Data analysis was performed using SPSS/Ver 22 through descriptive and analytic statistics, including Mann–Whitney U-test, Fisher's exact test, and GLM two-way ANOVA. RESULTS: Depression, anxiety, and stress symptoms were reported by 365 (52.6%), 428 (61.7%), and 545 (78.5%) medical students, respectively. Female students in their 4th year of study reported higher depression levels than males of the same year (P = 0.004), whereas levels of anxiety were higher in 6th-year female students compared with those in their 1st and 4th years (P = 0.001; P = 0.025). Stress levels were consistently higher in females than in males for all 3 years (1st year: P = 0.041; 4th year: P < 0.001; 6th year: P = 0.004). No gender differences were found in the use of psychiatric and stimulant drugs. CONCLUSION: This study provides preliminary evidence suggesting the importance of planning interventions aimed at reducing emotional distress among medical students that should be targeted on gender and year of the study.

Abstract Background The relationship between labour market flexibility, job insecurity and occupational injuries is not univocal. The literature generally focuses on the temporary character of work arrangements rather than on the precarity of careers. The aim of this paper is to identify, without defining a priori what a precarious career is, the most common professional profiles of young people who entered the labour market in the 2000s and to correlate them with occupational injury risks. Methods Using the Whip-Salute database, which combines individual work and health histories, we selected the subjects under 30 years of age whose first appearance in the database is dated after 2000. The occupational history of each individual between 2000 and 2005 was described according to 6 variables (type of entry contract, number of contracts, number of jobs, economic activities, work intensity and duration of the longest period of non-employment). Workers were grouped into homogeneous categories using cluster analysis techniques, which enable to identify different career profiles. Injury rates were calculated for each cluster, and compared within and between the groups. Results We selected 56,760 workers in the study period, who were classified in 6 main career profiles. About 1/3 of the subjects presented an employment-secure career profile, while about 45 % of them were classified into 3 clusters showing precarious career profiles with different work intensities. Precarious workers present significantly higher injury rates than those with secure careers, with an increase in risk between 24 and 57 % (p

To date there is no agreement on the usefulness of physical symptoms to express a mood disorder diagnosis in psychoncology. The aim of this study was to evaluate the relevance of somatic, affective and cognitive clusters in mood disorders in oncological comorbidity. 151 consecutive in-patients of the Surgical Oncology Unit of S. Giovanni Battista Hospital (Turin, Italy) were evaluated for depression using the HADS and the MADRS. In addition, behavioural, somatic and cognitive clusters of the MADRS were analysed, comparing depressed and non-depressed patients, subdivided according to the HADS-D scores. Since the HADS does not consider the somatic symptoms of depression this comparison allowed us to evaluate the relevance of the three different clusters for depressive symptoms. According to the HADS, 57.4% of patients scored above the cut-off (≥ 8) for depression and 47,3% scored above the cut-off (≥ 8) for anxiety. As for the MADRS, 44% of patients scored between 0-9, indicating the absence of depression, 43.7% were found to have mild/moderate depressive symptoms and 12.3% showed severe mood depression. Comparison between patients above and below the cut-off of HADS-D showed significant differences in all the three clusters (p < 0.01). In addition, more relevant differences were observed in the affective and somatic clusters than in the cognitive cluster. Results of the present study suggest the importance of somatic symptoms in the perception and expression of psychological suffering in cancer patients.

Paolo Leombruni, Luca Lavagnino, Secondo FassinoDepartment of Neurosciences, Psychiatry Section, University of Torino, Centre for Eating Disorders and Obesity, Torino, ItalyAbstract: Topiramate is an anticonvulsant drug used for the treatment of epilepsy and prophylaxis of migraine. Some authors have proposed its use as a mood stabilizer and have reported its efficacy in reducing impulsiveness and improving mood regulation, possibly via its antagonism to glutamatergic transmission in the lateral hypothalamus, although this indication is still controversial. Weight loss is a side effect consistently reported in the medical literature in patients treated with topiramate. Given its potential role in stabilizing mood and reducing impulse control problems and weight, topiramate has been proposed as a treatment for obese patients with binge eating disorder (BED). The aim of this paper is to review published data on the efficacy and safety of topiramate for the treatment of obese subjects with BED. Although the evidence is preliminary, topiramate appears to be a relatively safe and effective treatment for obese subjects with BED. Limitations of the studies and future directions for research are discussed.Keywords: topiramate, binge eating disorder, obesity

The mixture of volatile compounds emitted by Brassica oleracea var. sabauda changed significantly in response to feeding and/or oviposition by Murgantia histrionica (Heteroptera: Pentatomidae). Volatiles were collected from (1) healthy plants and those with (2) feeding punctures, (3) a combination of feeding punctures and oviposition, (4) feeding punctures and one hatched egg mass and (5) plants bearing only an egg mass. In the case of plants with feeding punctures or feeding punctures plus an egg mass, the volatiles were also collected at different time intervals after plants were subjected to these two treatments (0-24 h, 24-48 h and 48-72 h). Gas chromatographic and gas chromatograph-mass spectrometric analysis showed that the percent emission of several compounds changed significantly from plants subjected to the feeding and oviposition or just oviposition. Percentage of terpenes generally decreased after feeding and oviposition, although the percentage emission of (E)-β-caryophyllene from these plants and those with just feeding punctures significantly increased. Plants with just an egg mass emitted linalool de novo but not (E)-β-ocimene. The emission of jasmonates, mainly methyl jasmonate, increased from plants with feeding punctures plus an egg mass compared to those with only an egg mass. Higher percentages of the volatile glucosinolate derivatives (VGSs), mainly 4-methoxy-3-indolylacetonitrile, were emitted by plants with feeding punctures and an egg mass. The percentage emission of most of these compounds increased during the first 24 h after the treatment and then decreased over the next 24 h, except for methyl jasmonate, which remained high also 48-72 h later. The possible ecological roles of such volatiles in plant interactions with the second and third trophic levels are discussed.