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Purpose: The impact of dietary counseling on body composition in early breast cancer patients (EBC) treated with aromatase inhibitors (AIs) is uncertain. The aim of this study was to assess the effects of a diet counseling program on weight, BMI, total and regional body composition in patients treated with AIs. Methods: This observational study involved 194 EBC patients, of which 97 attended a 6-month personalized counseling program, based on Mediterranean diet principles (cohort A) and 97 did not (cohort B). Dual-energy X-ray absorptiometry (DXA) scan was used to measure the total and regional fat and lean body mass, before (baseline) and after at least 18 months of AI-therapy. Results: Weight and BMI increased significantly, on the average, in cohort B, but not in cohort A. In the cohorts A and B, fat mass increased by 10 % and 7.7 % respectively, while lean mass decreased by 3.3 % and 2.6 % from before to after AI therapy, without statistically significant differences between them using the Mann-Whitney test. The changes in body composition were greater in premenopausal than in postmenopausal women at cancer diagnosis. The proportion of patients with sarcopenia, obesity and sarcopenic obesity increased from before to after AI therapy, similarly in both cohorts. Conclusions: Patients treated with AIs reported an increase in fat mass and a decrease in lean mass, and consequently an increase in sarcopenia and obesity, regardless of the participation in a dietary counseling program. A combined dietary counseling and physical exercise program may be necessary for preventing these unfavourable changes in these patients.

Abstract Background Suicide is one of the leading causes of death among young people and university students. Research has identified numerous socio-demographic, relational, and clinical factors as potential predictors of suicide risk, and machine learning techniques have emerged as promising ways to improve risk assessment. Objective This cross-sectional observational study aimed at identifying predictors and college student profiles associated with suicide risk through a machine learning approach. Methods A total of 3102 students were surveyed regarding potential suicide risk, socio-demographic characteristics, academic career, and physical/mental health and well-being. The classification tree technique and the multiple correspondence analysis were applied to define students’ profiles in terms of suicide risk and to detect the main predictors of such a risk. Results Among the participating students, 7% showed high potential suicide risk and 3.8% had a history of suicide attempts. Psychological distress and use of alcohol/substance were prominent predictors of suicide risk contributing to define the profile of high risk of suicide: students with significant psychological distress, and with medium/high-risk use of alcohol and psychoactive substances. Conversely, low psychological distress and low-risk use of alcohol and substances, together with religious practice, represented the profile of students with low risk of suicide. Conclusions Machine learning techniques could hold promise for assessing suicide risk in college students, potentially leading to the development of more effective prevention programs. These programs should address both risk and protective factors and be tailored to students’ needs and to the different categories of risk.

Abstract Trauma scientists have raised the alarm about the devastating consequences of the Ukraine war on mental health. We examined how higher education students—as indirect victims—coped with this conflict and how they emotionally reacted during 2022. We involved 2314 students from 16 countries through an online survey. A structural equation model indicated significant relations between war-related worry about military and macroeconomics domains and two coping strategies (opposition, support giving), in turn significantly linked with six emotions. The model was strongly invariant across gender, study field, and geographic area. The most frequent emotions were anger and anxiety, followed by two future-centred emotions (hopelessness and hope). Emotions were more frequent for females and students of the countries geographically close to the war region. Our findings call for evidence-based policy recommendations to be implemented by institutions to combat the negative short and long-term psychological sequelae of being witnesses of armed conflicts.

It is estimated that one in three students drop out of university by the end of the first year of study. Dropping out of university has significant consequences, not only for the student but also for the university and for society as a whole. A total of 1.154 Italian freshmen were involved in this study and were divided based on their intention to dropout from university. The intention to dropout was assessed using five questions, and motivation was assessed through the Academic Motivation Scale. Differences in socio-demographic factors, extra-curriculum activities, academic characteristics, and academic motivation between freshmen with low and high dropout risks were assessed for highlighting potential intervention for limiting dropout rates. The majority of the freshmen were female, from low-income families, had attended high school, and lived out of town; the most represented field of study was health professions. The results indicate that the variables increasing the likelihood of belonging to the high dropout risk group are as follows: unsatisfactory relationships with lecturers/professors and fellow students, low income, amotivation, and extrinsic motivation. This study underlines the importance of adopting new teaching approaches that include spaces and time dedicated to fostering relationships, supporting academic success, and promoting the psychosocial well-being of students.

Abstract Background Mental health issues are common among university students, but the latter are unlikely to seek professional help even when mental health services are available. Coping strategies, stigma and psychological distress are often considered as factors that can affect help-seeking intentions in university students. Methods This study aimed to determine the role of coping strategies, stigma and psychological distress on the intentions to seek professional help for psychological problems. All students (N = 13,886) from an Italian medium-sized university were asked to participate in a multidimensional online survey and 3754 (27.1%) agreed to participate. A Structural Equation Modelling approach was applied to explore the simultaneous direct and indirect effects of distress, stigma and coping strategies on professional help-seeking intentions. Results Results showed that students were not very likely to seek professional help and, through the Structural Equation Model, psychological distress was found to be positively correlated with coping strategies, which in turn was negatively associated with the stigma of seeking help. The latter was negatively associated with professional help-seeking intentions. These effects suggest that students with significant psychological distress use coping strategies to face the stigma of seeking help: the lower the stigma of seeking help, the higher the chance of developing intentions to seek professional help. Conclusions This study suggests the importance of implementing programs to encourage college students to seek help, including measures that foster a stigma-free environment, reduce psychological distress and promote the use of adaptive coping strategies. Interventions should be focused firstly on self-stigma and secondly on perceived stigma, taking into consideration the level of psychological distress and social stereotypes associated with mental disorders and help seeking behaviours. Programs about coping are also essential and should focus on promoting emotion-focused strategies and problem-focused strategies.

Abstract Pressures and responsibilities of medical school put a strain on medical student's personal wellbeing, leading among all to high rates of anxiety, emotional discomfort and stress. In this work we evaluated the effectiveness of a comprehensive Mindfulness-Based Intervention (MBI) in reducing this load. The intervention comprised 10 twice-a-week Integral Meditation classes, dietary advice, and brief yoga sessions. We performed a randomized trial on two cohort of medical students from Italian universities: 239 in cohort 1 (106 treated and 133 controls), and 123 in cohort 2 (68 treated and 55 control) for a total sample of 362 students. Nine questionnaires for evaluating the effectiveness of our intervention on stress (PSS), state anxiety (STAIX-1), well-being (WEMWBS), mind-wandering (MW-S), overall distress (PANAS), emotion regulation (DERS), resilience (RS-14), and attentional control (ACS-C and ACS-D) were collected both pre and post intervention. Linear mixed effect models were run on the whole sample showing that, after multiple testing correction, our intervention was effective in reducing perceived stress (β = − 2.57 [− 4.02; − 1.12], p = 0.004), improving mental well-being (β = 2.82 [1.02; 4.63], p = 0.008) and emotional regulation (β = − 8.24 [− 12.98; − 3.51], p = 0.004), resilience (β = 3.79 [1.32; 6.26], p = 0.008), reducing the tendency to wander with the mind (β = − 0.70 [− 0.99; − 0.39], p = 0.0001), ameliorating the ability to maintain attention (AC-S (β = − 0.23 [− 0.44; − 0.02], p = 0.04) and AC-D (β = − 0.19 [− 0.36; − 0.01], p = 0.04)), and the overall distress (β = 1.84 [0.45; 3.23], p = 0.02).

Abstract COVID-19 pandemic had a negative impact on the mental health and well-being (WB) of citizens. This cross-sectional study included 4 waves of data collection aimed at identifying profiles of individuals with different levels of WB. The study included a representative stratified sample of 10,013 respondents in Italy. The WHO 5-item well-being scale (WHO-5) was used for the assessment of WB. Different supervised machine learning approaches (multinomial logistic regression, partial least-square discriminant analysis—PLS-DA—, classification tree—CT—) were applied to identify individual characteristics with different WB scores, first in waves 1–2 and, subsequently, in waves 3 and 4. Forty-one percent of participants reported “Good WB”, 30% “Poor WB”, and 28% “Depression”. Findings carried out using multinomial logistic regression show that Resilience was the most important variable able for discriminating the WB across all waves. Through the PLS-DA, Increased Unhealthy Behaviours proved to be the more important feature in the first two waves, while Financial Situation gained most relevance in the last two. COVID-19 Perceived Risk was relevant, but less than the other variables, across all waves. Interestingly, using the CT we were able to establish a cut-off for Resilience (equal to 4.5) that discriminated good WB with a probability of 65% in wave 4. Concluding, we found that COVID-19 had negative implications for WB. Governments should support evidence-based strategies considering factors that influence WB (i.e., Resilience, Perceived Risk, Healthy Behaviours, and Financial Situation).

Abstract Among forensic patients with schizophrenia spectrum disorders, the association between symptomatology and violence is still not entirely clear in literature, especially because symptoms shift both during the acute phase of the illness and after. The aims were to investigate the level of symptomatology in forensic patients and to evaluate if there are differences in the level of symptoms between forensic and non-forensic patients. According to PRISMA guidelines, a systematic search was performed in PubMed, Web of Science, and ProQuest, using the following key words: “forensic” AND “Positive and Negative Syndrome Scale” OR “PANSS”. A total of 27 studies were included in the systematic review, while only 23 studies in the meta-analysis. The overall sample included a total of 1702 participants, most commonly male and inpatients in forensic settings. We found that studies with an entirely male sample had significantly lower Positive PANSS ratings than studies with mixed samples. Although both forensic and non-forensic patients were affected by mild psychopathological symptoms, forensic patients presented higher ratings in all four PANSS scales. This meta-analysis shows that forensic patients reported a mild level of symptomatology, as assessed with the PANSS, and therefore might be considered as patients in partial remission. Among patients with schizophrenia, the association between symptoms and violence is very complex: many factors might be considered as key mediators and thus should be taken into account to explain this association. Further studies are needed. Trial registration all materials and data can be found on the OSF framework: https://osf.io/5ceja (date of registration: 8 September 2021)

Dropout is a critical concern in higher education, with a considerable number of students leaving within the first two years of university. Dropout affects students’ well-being and their academic and career prospects, and institutions’ retention and graduation rates. The aim of this study was to explore the mediating role of motivation and cognitive strategies for learning in the relationship among self-efficacy, connectedness, and university dropout intention. A total of 790 Italian college freshmen were involved in this study. The sample was recruited through a web survey consisting of the Academic Motivation Scale, Perceived School Self-Efficacy Scale, University Connectedness Scale, and Self-Regulated Knowledge Scale-University. The freshmen’s intentions to drop out were assessed with five questions. The average age of the freshmen was 20.9 years, most of them were female, and were attending a degree program in the medical area. The results show that self-efficacy is the most important predictor of dropout intentions, followed by university connectedness. Self-regulated knowledge has an important role in predicting dropout intention by acting as a mediator between self-efficacy and motivation.This study underlines the importance of investing in training and orientation interventions in order to develop the skills to face the university path, increasing self-efficacy, motivation, and consequently students’ well-being.

Objectives To investigate the early information needs of women with a recent diagnosis of breast cancer (BC) according to their employment status.Design Cross-sectional.Setting Secondary-care patients attending three outpatient oncology clinics in northern Italy.Participants 377 women with a recent diagnosis of early-stage, non-metastatic BC aged 18–75 were recruited. Of them, 164 were employed, 103 non-employed and 110 retired.Outcome measures The first consultation visit with an oncologist was audio-recorded and analysed for the number and type of questions asked. Linear regression models considering consultations’ and patients’ characteristics as confounding variables were applied.Results Employed patients asked significantly more questions than non-employed and retired patients (17 vs 13 and 14; F=6.04; p

Aims: The aims of the present study were to assess: the effectiveness of psychoeducation in mental health service (MHSs) in terms of time to first hospitalization during 4-year follow-up; the number and the days of hospitalizations, and the number of people hospitalized at 4-year follow-up; and variables associated with better outcome in BD patients.Methods: This is a controlled study involving an experimental group (N = 57) and a control group (N = 52). The treatment phase consists of 21 weeks, in which all participants received TAU, while the experimental group received additional psychoeducation.Results: The survival analysis showed significant differences in terms of time to first hospitalization of up to 4-year follow-up: the patients in the psychoeducation group showed a longer time free from hospitalizations than the control group. Concerning the predictors of time to first hospitalization, the only factor that showed a trend to statistical significance was psychoeducation.Conclusions: This is one of few studies assessing the long-term effectiveness of psychoeducation in a naturalistic setting. The data confirm that psychoeducation can impact illness course, in terms of longer time free from hospitalizations.Trial registration: ISRCTN17827459