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Background: While evidence-based practice (EBP) is widely accepted across healthcare professions, research investigating its implementation in manual therapy professions such as osteopathy is limited. The primary aim of this study was to investigate Italian osteopaths' attitudes, skills, and use of EBP. A secondary purpose was to understand the obstacles and enablers to EBP adoption in the Italian osteopathic context. Methods: A cross-sectional national survey was conducted (April to June 2020) among a sample of Italian osteopaths. Eligible participants were invited to complete the Italian-translated Evidence-Based practice Attitude and Utilization Survey (EBASE) anonymously online using various recruitment strategies, including email and social media campaigns. In addition to the three EBASE sub-scores (attitudes, skills and use), the demographic characteristics of the sample were considered. Results: A total of 473 osteopaths responded to the survey. The sample appeared to represent the Italian osteopathic profession. The majority of participants had a favorable attitude toward EBP. Eighty-eight percent of respondents agreed that EBP was necessary for osteopathy practice and that scientific literature and research findings were beneficial to their clinical scenario (95%). Perceived skill levels in EBP were rated as moderate, with the lowest scores for items relating to clinical research and systematic review conduct. Apart from reading/reviewing scientific literature and using online search engines to locate relevant research papers, participant engagement in all other EBP-related activities was generally low. Clinical practice was perceived to be based on a very small proportion of clinical research evidence. The primary obstacles to EBP implementation were a dearth of clinical evidence in osteopathy, and poor skills in applying research findings. The primary enablers of EBP adoption were access to full-text articles, internet connectivity at work, and access to online databases. Conclusions: Italian osteopaths were largely supportive of evidence-based practice but lacked basic skills in EBP and rarely engaged in EBP activities. The updating of osteopathic training curriculum and professional formal regulation in Italy could provide a suitable framework to improve EBP skills and use. [ABSTRACT FROM AUTHOR]

Hybrid professionals have a two-fold – professional and managerial – role, which requires appropriate management skills. Investing on managerial training programs aims to empower professionals with managerial skills and competencies. Does this pay back? Assessing the impact of such training programs is still a limited practice. This paper explores whether participation in managerial training programs in healthcare can enhance the involvement of hybrid professionals (namely, clinical directors) in top management decision-making. The mediational effects of knowledge of performance information and its use are explored. Survey data were collected from more than 3000 clinical directors of 69 public health authorities from five regional healthcare systems in Italy. Relationships between participation in managerial training programs, performance management practices (i.e., knowledge and use of performance information) and the level of clinicians' involvement by the top management were studied using a three-path mediation analysis with structural equation modelling. Propensity score matching was also performed to mitigate selection bias. Knowledge and use of performance information positively mediate, both independently and sequentially, the relationship between clinical directors' participation in managerial training programs and the level of their involvement in decision-making. The results of the study suggest that managerial training can support hybrid professionals in engaging with managerialism and playing upward influence on top management decision-making. [ABSTRACT FROM AUTHOR]

papastavrou e., efstathiou g., tsangari h., suhonen r., leino-kilpi h., patiraki e., karlou c., balogh z., palese a., tomietto m., jarosova d. & merkouris a. (2011) A cross-cultural study of the concept of caring through behaviours: patients' and nurses' perspectives in six different EU countries. Journal of Advanced Nursing 68(5), 1026-1037. Abstract Aim. This paper is a report of an international study of patients' and nurses' perceptions of nurse caring behaviours. Background. Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers' perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses' caring actions when compared to nurses' views. Method. A descriptive comparative survey design was used to analyse a sample of surgical patients ( n = 1659) and their nurses ( n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory-24. Nurses' and patients' responses were compared using both inferential and descriptive statistics. Results. Independent samples t-tests showed important differences between nurses' and patients' views. Although both groups perceived knowledge and skill as being the most important sub-scale, the nurses' responses were higher compared to patients ( P < 0·05) with important differences in the 'assurance of human presence' ( P < 0·001) and the 'respectful deference to others' ( P < 0·001) sub-scales. Cross-country comparisons showed important differences between the nurses' ( F = 24·199, P < 0·001) and patients' views on caring ( F = 26·945, P < 0·001). Conclusions. Important differences were observed between patient-nurse perceptions in the participating countries. The results form a foundation for future research into the development of a common international perspective about caring behaviours between patients and their nurses. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to determine trends in the prevalence of underweight, overweight, obesity and their putative risk factors in different cohorts from a representative population of adolescents in Central Italy. Subject and methods: After random sampling, five cohorts of adolescents attending public high schools – aged 14 to 18 years – were evaluated from 2005 to 2018 (n: 25,174). Collected information included self-reported body mass index (BMI), descriptors of family environment, eating behaviour, physical activity, screen use, bullying victimisation, sexual behaviour (age at first intercourse, number of partners) and perceived psychological distress. For these data, between-cohort prevalence differences were used to esteem prevalence variations across time. In the 2018 cohort, the association between these factors and body weight was evaluated through multinomial regressions with sex-specific crude relative risk ratios for different BMI categories. Results: An increased prevalence of overweight was observed for both boys and girls. The study outlined a transition towards higher parental education and unemployment, reduced soft drinks consumption and higher psychological distress. Sex-specific changes were observed for physical and sexual activity, and a rising percentage of girls reported being bullied and distressing family relationships. Parental education and employment, together with physical activity, confirmed to be protective factors against pathological weight. The latter clustered with reduced soft drinks consumption, bullying victimisation, early sexual activity, worse family relationships and higher distress. Conclusion: An increased prevalence of both overweight and underweight was observed across time. Economic factors associated with unemployment and changes in behavioural patterns may have contributed to this trend. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea can have a negative impact on children's and adolescents' neurocognitive abilities and hinder their academic and adaptive progress in academic, social, and/or behavioral dimensions. In this retrospective cross-sectional study, we investigated the influence of body weight conditions and allergy status on long-term mental health, cognitive development, and quality of life in children and adolescents who snored. Methods: The study sample included 47 subjects (age range 4.1 to 15.3 years) who exhibited high levels of snoring and underwent home-based polysomnography between 2015 and 2019. Follow-up assessments (3 years on average between baseline and follow-up) entailed phone interviews with the subject's parents/caregivers who completed three validated questionnaires investigating sleep, quality of life, and parental ratings. Results: We found a correlation between age at diagnosis and being retrospectively overweight and high levels of snoring. In addition to a higher risk of developing emotional symptoms (8.2% increase in retrospective overweight status for each unit increase in the emotional score at follow-up) and oppositional behavior (9% increase in retrospective overweight status for each unit of oppositional T points at follow-up), we also noted reduced long-term social symptoms (11% decrease in retrospective overweight status for each unit increase in the social score at follow-up) and cognitive symptoms (10.6% decrease in retrospective overweight status for each unit increase in the cognitive score at follow-up), as well as a 6.1% increase in retrospective allergy status for each unit increase in academic performance at follow-up. Conclusions: Snoring can have negative impacts on mental health and cognitive development in the long term. Early detection and intervention for neuropsychological disorders is important in children and adolescents who score high on snoring. In the long term, the effects of snoring on neuropsychological disorders may vary based on previous body weight and allergy status. [ABSTRACT FROM AUTHOR]

BATTISTELLI A., PORTOGHESE I., GALLETTA M. & POHL S. (2013) Beyond the tradition: test of an integrative conceptual model on nurse turnover. International Nursing Review 60, 103-111 Aim: This paper aimed to extend research on nurse turnover by developing and testing a theoretical model of turnover intention that includes two emergent key off-the-job constructs, work-family conflict (WFC) and community embeddedness (CE). Background: Nurse turnover is considered one of the most significant issues in health care. There is a considerable body of knowledge that has focused on the study of the on-the-job factors of nurse turnover, showing the important role of job attitudes. Recently, WFC and job embeddedness (JE) have been identified as variables that could help explain levels of nurse turnover. Methods: Using structural equation modelling from a cross-sectional survey, the relationships between the variables were explored in a sample of 440 nurses from an Italian public hospital. The questionnaire measures demographic data and psychosocial factors such as job satisfaction, organizational commitment, WFC, CE and turnover intentions. Results: The findings supported the importance of non-work dimensions in turnover models. Conclusions: The results suggest that when studying turnover phenomena in health organizations, the extra-work domains (WFC and JE) can contribute to a decrease in the intention to leave, in addition to the more typically emphasized attitude dimension. [ABSTRACT FROM AUTHOR]

Background: Exposure to secondhand smoke (SHS) is a serious public health threat and represents a preventable cause of morbidity among children. Sleep bruxism is characterised by teeth grinding or clenching movements during sleep and may begin in adulthood as well as in childhood. Objectives: To investigate the association between SHS exposure and sleep bruxism in children. Methods: Sleep bruxism was investigated in 498 children (mean age: 9.261.9). Family members were interviewed and asked whether they smoked in the presence of their children. Children were classified according to their exposure to SHS into heavily, moderately, lightly and occasionally exposed. Children with sleep bruxism and exposed to SHS were randomly divided into two groups: children in group 1 were not exposed to SHS for 6 months, whereas children in group 2 were. Results: Thirty-one per cent of the children under investigation suffered from bruxism. Among them, 116 children (76%) were exposed to SHS. Exposed children showed a higher risk of sleep bruxism (p<0.05). After 6 months, sleep bruxism was found in 38% and in 90% of children, in the first and in the second group, respectively, this difference was statistically significant (p<0.05). In group 1, changes were statistically significant in those who were heavily and moderately exposed (p<0.05) but not in those lightly and occasionally exposed (p>0.05). In group 2, changes were not statistically significant (p>0.05). Conclusion: The findings showed that high and moderate exposure to SHS is associated with sleep bruxism in children. [ABSTRACT FROM AUTHOR]

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Researchers interested in intimate partner violence (IPV) have focused primarily on male-against-female cases. We conducted two experimental investigations to examine the influence of moral evaluation, attribution of responsibility, and right-wing authoritarianism (RWA) on the willingness of bystanders to provide help to the victim in an IPV case involving a same-sex couple. Study 1 (N = 195) surveyed a heterosexual participant sample, and Study 2 (N = 120) surveyed a sample of gay and lesbian participants. In both studies, participants read a fictitious article describing an alleged IPV episode that occurred either in a male–male or a female–female couple. Each participant read an article describing one of two versions of a case of IPV: In one account, the victim admitted to infidelity and in the other, the victim did not confess to infidelity. The participants subsequently evaluated the victim and expressed their willingness (or lack thereof) to support and provide help to the injured party. In both studies, participants in the condition that included the admission of infidelity assessed the victim to be less moral and more responsible for the violent episode. Consequently, participants of both studies expressed lesser willingness to provide help to the victim. Moreover, in Study 1, the relationship between the admission of infidelity and the respondents' willingness to support the victim was moderated by RWA. Particularly, the admission of infidelity by the victim reduced the respondents' willingness to extend support only when they reported a medium to a high level of RWA ideology. By focusing specifically on same-sex IPV cases, this study contributes to a more comprehensive understanding of the reactions of witnesses with regard to IPV. Furthermore, it provides evidence about the underlying mechanisms mitigating the intervention of bystanders in such cases and identifies boundary conditions that exacerbate their (un)willingness to intervene. [ABSTRACT FROM AUTHOR]

It has been shown that disadvantaged groups who endorse system‐justifying beliefs tend to internalize their state of inferiority by expressing ingroup derogation and opposing collective action for change. In the present research, we recruited women – as disadvantaged group – from different countries (the United States, the United Kingdom, Italy) and examined whether their moral conviction against gender inequality, as an absolute stance that does not tolerate any violation, may interact with and overpower system‐justifying beliefs. Results from three studies provided support for our hypotheses. First, when women held strong moral conviction, they expressed higher identification with their disadvantaged ingroup and, in turn, higher collective action intentions, independent of system‐justifying beliefs. Second, when women held weak moral conviction, higher system‐justifying beliefs reduced women's ingroup identification and, in turn, undermined their collective action intentions. This support is found across different contexts of gender inequality (the gender leadership gap, the gender pay gap, and the gender power imbalance), using different methodological approaches (online survey, online experiment, laboratory experiment). Implications, limits, and future directions are discussed. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the sociodemographic and academic characteristics of nursing students who report academic failure and to identify the determinants of academic failure (no degree on time) in a population of nursing students. Background: Although prior studies have shown that academic failure is influenced by multiple factors, the studies mentioned have mostly focused on specific single variables associated with academic failure, and they have reported inconsistent results. Design: A prospective follow‐up study design was used in an Italian Baccalaureate Nursing Degree program. A total sample of 2,040 at baseline and a random subsample of 753 students were considered for academic failure determinants. The study followed the recommendations of STROBE (Strengthening the Reporting of Observational studies in Epidemiology). Methods: We included in the model academic background, self‐efficacy, sociodemographic variables and self‐efficacy in psychomotor skills and motivation. We used the Academic Nurse Self‐Efficacy Scale (ANSEs), the Nursing Self‐Efficacy in Psychomotor Skill Scale (NSE‐PS) and the Motivation Nursing Students' Scale (MNSS) which have been validated on nursing students. For the assessment of predictors of academic failure, a two‐stage hierarchical logistic regression analysis was performed. Results: Students who had academic failure were 69.4% of the sample. Predictors of academic failure were the secondary school certification grade, the university pre‐admission test score; the academic self‐efficacy, self‐efficacy in psychomotor skills and clinical training examination grades were additional predictors. Conclusions: The secondary school certification grade, the University pre‐admission test score, low academic self‐efficacy, low self‐efficacy in psychomotor skills and low clinical training examination grades were predictors of academic failure in nursing students. Relevance to clinical practice: Our findings suggest that the universities could consider a cut‐off in the pre‐admission test score as a critical value for identifying students who are likely to fail. In addition, nursing faculty staff should consider strategies for developing self‐efficacy and motivation. [ABSTRACT FROM AUTHOR]

Aim and objectives: To assess the prevalence of anxiety, sleep disorders and self‐efficacy and their predicting factors among nurses facing COVID‐19. Background: The spread of COVID‐19 throughout the world determined a series of modifications of several National Health Service organisations, with a potential series of psychological consequences among nurses, who were particularly afflicted by this situation of changes and precariousness. Design: A cross‐sectional study was carried out from February–April 2020. Methods: A total of 1,005 nurses employed in different Italian hospital wards, during the COVID‐19 pandemic, were recruited. Analyses were based on descriptive statistics and multivariate logistic regression. The STROBE checklist for cross‐sectional studies was used in this study. Results: The prevalence of sleep disturbances, moderate anxiety and low self‐efficacy was 71.4%, 33.23% and 50.65%, respectively. We found a positive correlation between anxiety and sleep quality (0.408; p <.0001) and negative correlations between self‐efficacy and anxiety (−0.217; p <.0001) and sleep quality and self‐efficacy (−0.134; p <.0001). The factor independently associated with all variables was gender. Females were more prone to sleep disturbances, anxiety and low levels of self‐efficacy than males (p <.05). Conclusions: The prevalence of anxiety, sleep disorders and low self‐efficacy among Italian nurses during the COVID‐19 pandemic was high. Healthcare managers should recognise and consider these results to reduce the risk of the onset of major mental problems that could result in post‐traumatic stress disorder. Relevance to clinical practice: Nurses facing major incidents as COVID‐19 pandemic are among healthcare personnel exposed to a high risk to develop psychological disturbance that should be assessed and recognised, in order to find helpful coping strategies to inform support services and avoid to hesitate in post‐traumatic stress disorders. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to test the Common Sense Model of Self-Regulation among persons with multiple sclerosis (MS), hypothesizing direct relations between illness beliefs and psychological adjustment, and indirect relations through coping strategies and social support. Materials and methods: Questionnaires were administered cross-sectionally to 680 participants (Mage =40.1; 64.4% women) recruited in eight MS units to assess illness beliefs, coping strategies, social support, and adjustment indicators including life satisfaction, psychological well-being, mental health, and depression. Multiple mediational analyses were conducted to identify direct and indirect paths connecting illness beliefs to psychological outcomes. Results: Controlling for disability level, significant direct and indirect relationships were observed: Beliefs on illness coherence, personal and treatment control were associated with better adjustment; emotion representations and cyclic timeline with worse adjustment; illness identity, consequences, psychological and chance/bad luck causes with mixed positive and negative outcomes. Notably, findings identified recurrent and unique pathways connecting illness beliefs to the different indicators through meaning- and problem-focused coping strategies, avoidance and social support. Conclusions: The Common Sense Model can represent a useful framework to be tested in rehabilitation programs, jointly addressing illness beliefs and coping resources for the promotion of psychological adjustment among persons with MS. Based on the Common Sense Model, the beliefs held by persons with MS about their illness are related to various aspects of psychological adjustment in multiple ways, both directly and indirectly through engagement in specific coping strategies and perception of social support. Clinicians supporting patients' adjustment may take into account that some illness beliefs were consistently associated with positive adjustment, some with poor adjustment, and some yielded mixed positive and negative results. Some ways in which coping strategies and social support connected illness beliefs to psychological adjustment were specific to the adjustment indicator under consideration including satisfaction with life, psychological well-being, mental health and depression. It may be worth testing comprehensive psychological interventions with the aim of raising awareness of one's illness beliefs, the strategies enacted in response to these beliefs, and the positive and negative relations of these processes with psychological adjustment, encompassing broad areas of individuals' lives and not only health-related issues or depression. [ABSTRACT FROM AUTHOR]

Informal caregivers play a crucial role in supporting persons with multiple sclerosis (MS), a neurodegenerative disease resulting in progressive worsening of physical and cognitive functioning. While research extensively showed that caregiving workload can be perceived as burdensome, little attention was devoted to the relation connecting workload and caregivers' well‐being. Building on previous literature on stress and coping, the aim of this study was to test the mediational role of coping between caregivers' tasks and well‐being. A group of 680 caregivers of persons with MS (M age = 46.45; 51.2% women) was recruited in eight Italian MS centres between June 2015 and December 2016. Caregiving tasks related to basic activities of daily living (ADL), instrumental ADL, psycho‐emotional and social‐practical care were assessed through the Caregiving Tasks in MS Scale; coping strategies (avoidance, criticism and coercion, practical assistance, supportive engagement, positive reframing) were investigated through the Coping with MS Caregiving Inventory; well‐being was evaluated through the Psychological Well‐Being Scales. Analyses substantiated a multi‐mediation model including tasks in basic ADL, psycho‐emotional and social‐practical care, and the coping strategies avoidance, criticism/coercion, supportive engagement, positive reframing. Basic ADL care was negatively related to psychological well‐being through lower use of supportive engagement and positive reframing. By contrast, psycho‐emotional and social‐practical tasks were both negatively and positively related to psychological well‐being, through higher use of avoidance and criticism/coercion as well as supportive engagement and positive reframing. Findings suggest that caregiving tasks are not solely detrimental to well‐being, but they may also provide a positive contribution through the adaptive coping strategies supportive engagement and positive reframing. Findings also highlighted task‐specific areas that could be targeted in intervention in order to effectively lighten burden and promote well‐being among caregivers. [ABSTRACT FROM AUTHOR]

Cannabis use remains an important concern in modern societies, adolescence being the critical period when the adolescents start to use cannabis. This study is aimed at extending and validating the Cannabis Use Intention Questionnaire (CUIQ), which was previously developed in Spain and based on the Theory of Planned Behaviour, in Italy, Portugal, and Romania. There are existing questionnaires which assess cannabis use problems and several risk factors; however, there is a need for a questionnaire based on a proven theory to assess interventions. A total of 3447 adolescents aged between 14 and 18 years old from Italy (43.14%), Portugal (23.90%), and Romania (32.96%) participated in this study. The data were analyzed using structural equation modeling. The scores were validated against cannabis use and the risk of experiencing problems related to cannabis use. The cut-off points were calculated using Receiver Operating Characteristic (ROC) curve analysis. The reliability index, α ordinal, indicated good reliability on the scales of attitudes, perceived behavioral control and intention. The results confirmed the four dimension structure of CUIQ. The invariance tests indicated that the structure and measurement of the scales were equivalent in all countries. The cut-off points showed good classification capability, especially for intention and attitudes. The CUIQ allows comparative studies addressed to study underlying psychological processes in adolescents’ decisions to use cannabis as well as to assess interventions aimed to reduce the problem of cannabis use. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Intensive care units ( ICUs) are challenging work environments because of the critical condition of patients, and ICU nurses frequently lament low job satisfaction and high staff turnover. Nevertheless, organizational and work characteristics, and the quality of relationships with staff can help to maintain nurses' enthusiasm and increase job satisfaction. Aim The aim of this study was to analyse how nursing work environment factors affect identification and commitment among ICU nurses. Design A cross-sectional study was carried out in 12 ICUs from four Italian urban hospitals. Method A total of 222 nurses participated and completed a self-reported questionnaire. Results and conclusion Results show that nursing work characteristics are directly related to team commitment, and that the nursing work characteristics and team commitment relationship was mediated by both perceived supervisor support and job satisfaction. Relevance to clinical practice Our findings may concretely contribute to literature and offer additional suggestions to improve nurses' work conditions and patient health in ICUs. [ABSTRACT FROM AUTHOR]

Purpose: To test whether the inflammatory potential of diet, as measured using the dietary inflammatory index (DII), is associated with risk of lung cancer or other respiratory conditions and to compare results obtained with those based on the aMED score, an established dietary index that measures adherence to the traditional Mediterranean diet. Methods: In 4336 heavy smokers enrolled in a prospective, non-randomized lung cancer screening program, we measured participants' diets at baseline using a self-administered food frequency questionnaire from which dietary scores were calculated. Cox proportional hazards and logistic regression models were used to assess association between the dietary indices and lung cancer diagnosed during annual screening, and other respiratory outcomes that were recorded at baseline, respectively. Results: In multivariable analysis, adjusted for baseline lung cancer risk (estimated from age, sex, smoking history, and asbestos exposure) and total energy, both DII and aMED scores were associated with dyspnoea ( p trend = 0.046 and 0.02, respectively) and radiological evidence of emphysema ( p trend = 0.0002 and 0.02). After mutual adjustment of the two dietary scores, only the association between DII and radiological evidence of emphysema (Q4 vs. Q1, OR 1.30, 95 % CI 1.01-1.67, p trend = 0.012) remained statistically significant. At univariate analysis, both DII and aMED were associated with lung cancer risk, but in fully adjusted multivariate analysis, only the association with aMED remained statistically significant ( p trend = 0.04). Conclusions: Among heavy smokers, a pro-inflammatory diet, as indicated by increasing DII score, is associated with dyspnoea and radiological evidence of emphysema. A traditional Mediterranean diet, which is associated with a lower DII, may lower lung cancer risk. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The ability to understand and manage emotional experience is critical to children's health. This study confirmed the validity of the How I Feel ( HIF) Questionnaire, a measure of children's emotional arousal and regulation, exploring its associations with measures of emotional and social functioning. METHODS The sample was comprised of 1379 Italian students (aged 8 to 12 years) who attended schools interested in the study aims. Participants completed the 30-item HIF scale, and measures of emotional self-efficacy and social desirability (SD). Factor structures were assessed using confirmatory factor analysis. Invariance by age and gender, internal consistency, temporal stability, and concurrent validity were also tested. RESULTS A 3-factor model was identified: frequency and intensity of (1) positive emotion - PE (8 items, α = .82), (2) negative emotion - NE (12 items, α = .86), and (3) positive and negative emotion control - EC (10 items, α = .77). This factor structure was invariant across age and gender groups. The HIF displayed moderate longitudinal stability over a 15-month period and a low social desirability effect. Positive emotion was positively associated with social acceptance and visibility, and negatively with social withdrawal. CONCLUSIONS The HIF is a reliable and valid measure for research and school intervention promoting students' emotional and mental health. [ABSTRACT FROM AUTHOR]

We assume that emotions (anger, shame and hope) mediate the relationship between perceiving a discriminatory context and civic/political engagement. Results of a survey with 1242 participants (mean age 20.7 years; 53% men; 32.8% migrants) showed that such emotions play a different role according to the type of engagement and the population (native Italians versus migrants). Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the effectiveness of a follow-up telephone call to reduce the number of issues after hospital discharge. Background The postdischarge period is often a time of uncertainty and risk. The decreasing length of hospital stays has increased the need for specific instructions about the postdischarge period. A telephone follow-up could be a valuable tool to fill this information gap. Design Double-blind, randomised controlled trial. Methods The participants included medium or low-intensity orthopaedic patients. We implemented a structured telephone follow-up call conducted by a senior orthopaedic nurse to provide educational support to the intervention group ( n = 110), while the control group ( n = 109) received routine care after being discharged. Data were collected between September 2011-January 2012. Statistical differences between the two groups were tested using chi-square test or Wilcoxon rank sum test, as appropriate. A linear regression model was performed to investigate factors involved into postdischarge outcomes. Results The intervention group had a statistically significant reduction in all postdischarge problems except for pain and mobilisation; the group also had a lower chance of experiencing frequent or severe problems. The educational intervention and prior poor health had a strong correlation with problems after discharge. Patients who received a telephone follow-up call believed the information provided was valuable. Conclusion This nurse-led follow-up intervention significantly contributed to solving or reducing postdischarge health problems and contributed to reduce unnecessary burden on the community health system. Relevance to clinical practice A nurse-led telephone follow-up is a simple, feasible and low-cost tool to improve patients' outcomes after discharge. [ABSTRACT FROM AUTHOR]

This study examines the processes underlying the association between job insecurity and emotional exhaustion, proposing that lack of reciprocity in the organizational exchange relationship is a main theoretical explanation for this association. Specifically, based on the social exchange perspective, we compared and tested two distinct mediating mechanisms: psychological contract breach and distributive injustice. These two indicators of lack of reciprocity constitute the explanatory process through which job insecurity relates to emotional exhaustion, the primary component of burnout. Data analyses from a sample of 322 blue-collar workers in Italy confirmed the mediational hypotheses. A contrast test revealed that distributive injustice was the indicator with more explanatory strength. The results contribute to research on the theoretical explanations of the adverse consequences of job insecurity, considering the nature and antecedents of psychological distress from an organizational exchange perspective. [ABSTRACT FROM AUTHOR]

This article examines the association between a target’s perceived humanness and individuals’ willingness to provide help and support in cases of violence against women (VAW), specifically, intimate partner violence (IPV). In an experimental study, undergraduates read a fictitious article from a newspaper describing an IPV episode of a man hitting his wife and accusing her of cheating on him. According to the experimental condition, they then read that the victim either had or had not admitted the infidelity. Participants then judged the victim on an infra-humanization scale and expressed their willingness to provide help and support to the victim herself as if they were a neighbor witnessing the attack. Results showed that a victim admitting an affair with another man (admission condition) elicited lower perceived humanness and lower willingness to provide help than a victim denying such adultery (no admission condition). Moreover, targets’ perceived humanness mediated the effect of contextual features on participants’ willingness to provide help to the victim. Results are discussed in terms of victim blaming, and practical implications for prevention strategies are presented. [ABSTRACT FROM PUBLISHER]

Grounded in achievement goal theory and self-determination theory, this cross-sectional study examined the relationship between perceived motivational climate and individuals’ motivation as well as the mediation effect of psychobiosocial states as conceptualised within the individual zones of optimal functioning (IZOF) model. Young students (N= 167, age range 14–15 years) taking part in physical education classes completed measures of teacher-initiated motivational climate, task and ego orientation, motivation and psychobiosocial states. Simple and serial mediation analyses indicated that a perceived mastery climate and individuals’ task orientation were related to intrinsic motivation and identified regulation through the mediation of pleasant/functional psychobiosocial states. In contrast, a perceived performance climate was related to external regulation and amotivation through the mediation of unpleasant/dysfunctional psychobiosocial states. Regression analysis results also showed that discrete psychobiosocial states accounted for a significant proportion of variance in motivational variables. Taken together, findings highlight the role of psychobiosocial states as mediators of the relationship between motivational climate and an individual’s motivation, and suggest that educators should consider a wide range of individual’s functional and dysfunctional reactions deriving from their instructional activity. [ABSTRACT FROM PUBLISHER]

Although the problem of accident under-reporting is increasingly recognized in the literature, less is known regarding work environment variables that predict the severity of such under-reporting. Data on perceived job insecurity and on the numbers of both accidents that were experienced and accidents that were actually reported over a period of one year were obtained from 786 employees in 24 US organizations and 563 employees in 20 Italian organizations in sectors where safety is highly relevant. Analysis of these data suggested that not only is job insecurity related to the likelihood of experiencing an accident, but also perceptions of job insecurity may serve to inhibit the reporting of accidents to appropriate company officials. Overall, the rate of accidents was lower in Italy than the United States. Moreover, in both countries, when job insecurity was low, there was little difference between the total number of experienced accidents and the number that employees reported. However, as job insecurity increased, the under-reporting of accidents increased. The implications of these results are discussed in light of the globally increasing prevalence of job insecurity in today's workplace. [ABSTRACT FROM PUBLISHER]

Past research adopting a configural approach to organisational commitment has yielded support for differentiated profiles (i.e. different combinations of different levels of commitment components) and for their relationship with attitudinal and behavioral outcomes. The present study aimed to: (a) investigate, in an Italian privatised organisation, the emergence of commitment profiles derived from the combination of affective (AC) and continuance (CC) organisational commitment, following Sinclair and colleagues' conceptualisation (2005); and (b) examine whether these profiles differed in absenteeism, as an objective outcome, job satisfaction, and job performance. Results from cluster analysis supported the presence of four groups (Allied, Free Agents, Trapped, and Complacent). The Allied and the Complacent profiles reported higher job satisfaction. Moreover, the Complacent profile displayed the highest job performance and the Allied showed the lowest level of absenteeism; both were significantly different from the Trapped profile. Implications for theory and practice are discussed. [ABSTRACT FROM AUTHOR]

Aim To validate the Staff Attitudes to Nutritional Nursing Care Geriatric scale in Italian, a tool created in Sweden to measure nurses' attitudes towards nutritional care in older people. Background Malnutrition in institutionalized older people is a serious problem having negative impact on patient outcomes. It is reported in the literature that nurses have negative attitudes towards nutritional care. Methods Forward and back-translation were carried out to build the Italian version of the tool. Content and face validity were then examined by pilot study. Test-retest reliability with Spearman's rho (rs) correlation, intraclass correlation ( ICC) and internal consistency reliability with Cronbach's α were assessed. Differences between test-rest were assessed by t-test. Results Linguistic and semantic adaptation of the tool into Italian was successful. Thirty-three nurses skilled in caring for older patients did pilot testing and 46 test-retesting. SANN- G GITA-scale achieved good content and face validity, good internal consistency reliability ( Cronbach's α = 0.85) and acceptable stability [rs = 0.75, P = 0.001; ICC = 0.76, 95% confidence interval ( CI) 0.63-0.86; P = 0.001]. The t-test showed no significant difference between test and retest results, confirming stability of the tool ( t(64) = −0.98; P = 0.33). Discussion The process of adaptation of the scale from Swedish to Italian language was successful. Thus, the SANN-GITA scale can be useful to assess attitudes of nursing staff to nutritional care in the Italian context. Conclusions This tool will allow the identification of areas where Italian nurses have negative attitudes and where to implement strategies to improve overall nutritional care. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to test the factor structure of an Italian version of the Maslach Burnout Inventory for Human Service employees. In addition we examined the reliability and construct validity of the scale. Background There is increasing evidence that nurses are at risk of experiencing burnout. Despite the vast international use of the Maslach Burnout Inventory- Human Service Survey, its factor structure and reliability are not beyond question. Method In a sample of nurses ( N = 1613) six alternative factor models of the instrument were tested using confirmatory factor analysis. Furthermore, we examined the invariance of the pattern of factor loadings of the model that better fitted the data across gender groups. To test construct validity, participants completed four subscales of Symptoms Check List 90-R. Internal consistency was evaluated computing Cronbach's alpha estimates of the scales. The study was conducted in 2007 and 2008 in Italy. Results The factor analysis provided support for a 20-item version identifying the three original dimensions. The model was found to be factorially invariant between men and women. Correlations between the latent MBI- HSS dimensions and distress variables were in line with theoretical predictions. Reliability was supported by acceptable Cronbach's alpha indexes. Conclusion The Maslach Burnout Inventory- Human Service Survey has acceptable validity and reliability for measuring burnout among nurses, and can help healthcare managers to offer interventions to reduce burnout among nurses. Limitations of the study and suggestions for further research are highlighted. [ABSTRACT FROM AUTHOR]

Using data from Italy, Spain, and Germany ( N= 1,569), this study investigated the role of basic values (universalism and security) and basic traits (openness and agreeableness) in predicting perceptions of the consequences of immigration. In line with Schwartz's (1992) theory, we conceptualized security as having two distinct components, one concerned with safety of the self (personal security) and the other with harmony and stability of larger groups and of society (group security). Structural equation modelling revealed that universalism values underlie perceptions that immigration has positive consequences and group security values underlie perceptions that it has negative consequences. Personal security makes no unique, additional contribution. Multi-group analyses revealed that these associations are invariant across the three countries except for a stronger link between universalism and perceptions of the consequences of immigration in Spain. To examine whether values mediate relations of traits to perceptions of immigration, we used the five-factor model. Findings supported a full mediation model. Individuals' traits of openness and agreeableness explained significant variance in security and universalism values. Basic values, in turn, explained perceptions of the consequences of immigration. [ABSTRACT FROM AUTHOR]

Although it has been suggested that a poor work environment can be related to the incidence of bullying, little work with robust research designs has been conducted on the matter. By drawing on the concept of hindrance stressors and using a longitudinal research design, we investigated whether role conflict and role ambiguity predicted being a victim of bullying twelve months later, over and above personal vulnerability factors. With a parallel analysis we also investigated whether the same role stressors predicted the enactment of bullying. The sample consisted of 234 employees of a National Health Service agency in Italy, including medical, nursing and administrative staff. The results indicated that role conflict positively affected both being bullied and bullying enactment, with personal vulnerability (reporting a doctor's diagnosis of depression at baseline) affecting only the first of the two outcomes. However, some evidence also emerged of reciprocal relationships between role stressors and bullying. Directions for future research on the relations between working conditions and bullying are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Benzene is an established leukemogen at high exposure levels. Although low-level benzene exposure is widespread and may induce oxidative damage, no mechanistic biomarkers are available to detect biological dysfunction at low doses. OBJECTIVES: Our goals were to determine in a large multicenter cross-sectional study whether low-level benzene is associated with increased blood mitochondrial DNA copy number (mtDNAcn, a biological oxidative response to mitochondrial DNA damage and dysfunction) and to explore potential links between mtDNAcn and leukemia-related epigenetic markers. METHODS: We measured blood relative mtDNAcn by real-time polymerase chain reaction in 341 individuals selected from various occupational groups with low-level benzene exposures (> 100 times lower than the Occupational Safety and Health Administration/European Union standards) and 178 referents from three Italian cities (Genoa, Milan, Cagliari). RESULTS: In each city, benzene-exposed participants showed higher mtDNAcn than referents: mtDNAcn was 0.90 relative units in Genoa bus drivers and 0.75 in referents (p = 0.019); 0.90 in Milan gas station attendants, 1.10 in police officers, and 0.75 in referents (p-trend = 0.008); 1.63 in Cagliari petrochemical plant workers, 1.25 in referents close to the plant, and 0.90 in referents farther from the plant (p-trend = 0.046). Using covariate-adjusted regression models, we estimated that an interquartile range increase in personal airborne benzene was associated with percent increases in mtDNAcn equal to 10.5% in Genoa (p = 0.014), 8.2% (p = 0.008) in Milan, 7.5% in Cagliari (p = 0.22), and 10.3% in all cities combined (p < 0.001). Using methylation data available for the Milan participants, we found that mtDNAcn was associated with LINE-1 hypomethylation (-2.41%; p = 0.007) and p15 hypermethylation (+15.95%, p = 0.008). CONCLUSIONS: Blood MtDNAcn was increased in persons exposed to low benzene levels, potentially reflecting mitochondrial DNA damage and dysfunction. [ABSTRACT FROM AUTHOR]

There is limited knowledge on the relationship between the living conditions of community-dwelling older people and their quality of life (QOL) considered in all its specific domains. The purpose of this study was to determine (1) which dimensions of QOL were independently associated with living alone and (2) the independent correlates of these dimensions of QOL amongst older outpatients. We conducted a cross-sectional survey of 239 community-dwelling outpatients aged 65+ (mean age 81.5 years) consecutively referred to a geriatric medicine clinic in Italy between June and November 2009 (response rate 93%). Subjects underwent a comprehensive geriatric assessment including QOL, which was evaluated by using the Older People's QOL questionnaire. In multivariate logistic regression analyses, living alone was associated with the lowest score-based tertile of two specific dimensions of QOL out of seven, namely 'social relationships and participation' [odds ratio (OR) 2.73, 95% confidence interval (CI) 1.08-6.91] and 'home and neighbourhood' (OR 4.96, 95% CI 1.75-14.07), independently of the main demographic, social, functional and clinical characteristics of the subjects. Amongst the 107 subjects living alone, independent correlates of these dimensions of QOL were depression, having no caregiver and having never been married. Depression, having no caregiver and having never been married could provide a valuable means of identifying older people living alone who are at greater risk of a poor QOL and who would most benefit from effective social and medical interventions. [ABSTRACT FROM AUTHOR]

Background: Nursing students report care of the older people as an undesirable career pathway. Positive clinical placement experiences influence students' attitudes and career intentions with respect to nursing home (NH) setting. The clinical environment's quality depends on meaningful learning opportunities, the relationship with the preceptors, and the pedagogical atmosphere as influenced by the staff–student interactions. Aim: The aim of this study was to explore nursing students' perceptions on their clinical learning experience and competence learned in the NH setting as compared to other clinical areas. Methods: A secondary analysis was performed of an Italian national cross‐sectional study involving 9,607 nursing students attending 95 different three‐year bachelor laureate nursing programmes in 27 universities. A questionnaire exploring individual and nursing programme variables was devised. Moreover, students self‐reported the perceived quality of the clinical learning experience using the Clinical Learning Quality Evaluation Index tool and the degree of competence learned using a four‐point Likert‐type scale. Results: Students in the NH setting scored the overall quality of the learning environment significantly higher (p = 0.046) compared to those experiencing other clinical settings, and they scored higher learning occasions (p = 0.002) and self‐directed learning opportunities (p = 0.018). No difference emerged in the perceived mean degree of competences learned at the end of the clinical rotation (p = 0.271). Conclusion: Nursing students perceive the NH setting to be a good quality learning environment with valuable learning opportunities and self‐directed learning opportunities compared to other settings. The nursing home setting provides opportunities to acquire clinical competences comparable to the ones in other clinical settings such as hospital units. Implications for practice: Nursing home settings should be considered by all nursing programmes as a learning environment particularly worthy for students at different levels of their education. [ABSTRACT FROM AUTHOR]