Search

Aims: To evaluate the effectiveness of eHealth interventions to reduce stress and promote mental health in healthcare professionals, and to compare the efficacy of different types of programs (guided vs. self-guided; ‘third-wave’ psychotherapies vs. other types). Background: Healthcare workers present high levels of stress, which constitutes a risk factor for developing mental health problems such as depression and anxiety. eHealth interventions have been designed to reduce these professional's stress considering that the characteristics of this delivery method make it a cost-effective and very appealing alternative because of its fast and easy access. Design: A systematic review of quantitative studies. Methods: A comprehensive database search for quantitative studies was conducted in PubMed, EMBASE and Cochrane (until 1 April 2022). The systematic review was conducted in accordance with the PRISMA and SWiM reporting guidelines. The quality of the studies was assessed using the National Heart, Lung and Blood Institute tools. Results: The abstracts of 6349 articles were assessed and 60 underwent in-depth review, with 27 fulfilling the inclusion criteria. The interventions were classified according to their format (self-guided vs. guided) and contents (‘third-wave’ psychotherapies vs. others). Twenty-two interventions emerged, 13 of which produced significant posttreatment reductions in stress levels of health professionals (9 self-guided, 8 ‘third wave’ psychotherapies). Significant effects in improving depressive symptomatology, anxiety, burnout, resilience and mindfulness, amongst others, were also found. Conclusion: The evidence gathered in this review highlights the heterogeneity of the eHealth interventions that have been studied; self-guided and ‘third-wave’ psychotherapy programs are the most common, often with promising results, although the methodological shortcomings of most studies hinder the extraction of sound conclusions. Protocol registration: PROSPER

Aims and Objectives: To evaluate the impact of the professional transition of new graduate nurses during the COVID-19 pandemic. Background: The transition from the role of student to the professional role can be challenging for new graduate nurses for the acquisition of higher autonomy and responsibility. The COVID-19 pandemic impacted the quality of the professional transition. Design: This was a cross-sectional observational study following the Strengthening and Reporting of Observational Studies in Epidemiology checklist. Methods: One hundred and two nurses who graduated in three consecutive sessions (November 2019—pre-pandemic, March 2020—pandemic outbreak, and November 2020—2nd wave) in a north Italian university located in the most affected Italian region by the COVID-19 pandemic, completed an online survey assessing well-being, risk of burnout, resilience, perceived stigma, strengths and limitations and quality of the professional transition. The study was performed between March and May 2021. Results: 81.4% of participants described the professional transition as worse than expected, and new graduate nurses who worked in COVID-19 settings reported a more difficult transition to professional life. No differences emerged in burnout, mental well-being and perceived stigma between new graduate nurses who worked in COVID-19 settings and those who did not. Similarly, no differences emerged amongst the three graduated cohort sessions. The most commonly mentioned challenges faced during the transition were organisational aspects, suddenly acquired autonomy and lack of suitable coaching. Conclusion: New graduate nurses reported a challenging academic-professional transition, in particular, those who worked in COVID-19 settings. The mid- and long-term impact of experiencing an academic-professional transition in COVID-19 settings should be assessed and monitored. Relevance to clinical practice: The professional transition of new graduate students should be adequately

The present study contributes to the literature by examining the association between personal values (PVs), assessed with the Schwartz’s Portrait Values Questionnaire, and empathy, assessed with the Davis’ Interpersonal Reactivity Index, in a sample of first-year medical students. We also examined medical students’ PVs profile and gender differences in terms of PVs. All participants (N = 398) were Italian, young (average age = 19.62 years, SD = 1.22), and unmarried; none had children. Zero-order correlations and hierarchical multiple regression models were performed to verify the association between PVs and empathy; in contrast, t-tests were run to explore gender differences in scoring on PVs. Benevolence and Universalism correlated positively with both the emotional and cognitive dimensions of empathy, whereas Power, Achievement, Hedonism, and Security were negatively associated with empathy. The three most important PVs in the whole sample were Benevolence, Self-Direction, and Universalism. Male medical students outscored their female counterparts on Power, Achievement, and Hedonism, whereas female students outscored the males on Benevolence, Universalism, Conformity, and Tradition. Our findings highlight the importance of fostering self-transcending PVs and discouraging self-enhancing PVs in medical students during the early years of medical school, as a means of supporting other-oriented responses such as empathy in future doctors.

Background: The current widespread and compelled usage of facemasks may have a deep impact in healthcare and educational contexts where relational and communicational dimensions are essential to the process of care and teaching. Nevertheless, little is known about the effect of facemask wearing on emotion recognition. In a cross-sectional study, we assessed the impact of facemasks on emotion recognition in healthcare students of a North Italian University. Methods: As part of an in-progress study, out of the 1572 medical and nursing students invited to take part in the study, 208 completed the study survey. Participants were randomly assigned to a masked vs unmasked version of the widely used and standardized emotion recognition task (DANVA2) that presents 24 faces expressing four emotions (happiness, fear, anger, sadness) with high and low intensity. Findings: A statistically significant higher number of errors in the masked (9.6 ±2.21) vs unmasked condition (4.96 ±2.78) (t(206) = -13.25, p ≤ .001) was found. A significant difference for happy (t(206) = -13.2, p ≤ .001), sad (t(206) = -4.54, p ≤ .001) and angry (t(206) = -12.05, p ≤ .001) faces but not for fearful (t(206) = -1.5, p = .134 ns) faces was found between conditions. When gender type of course (medical vs nursing) and year of course were examined, no difference has been found. Discussion: Teaching communication in the healthcare context must be adapted to the new situation that requires the universal use of facemask. The higher risk of misinterpretation of facial emotion can cause severe problems in terms of doctor-patient communication and intra/interprofessional communication. Healthcare teachers and students should be trained to express and recognize emotions in masked conditions.

Mental health of undergraduate students is receiving more attention because of the increase in the prevalence and intensity of psychological distress. Our aim is to verify the effectiveness of a cognitive behavioural counselling service in reducing psychological distress and improving academic self-efficacy in a sample of 124 students (57% above the clinical cut-off) using a pre-post assessment design. Data show a significant reduction of distress and symptoms scores among students who completed the intervention and half of them had a reliable change. Preliminary data also show a significant improvement in academic self-efficacy. University counselling services represent common first-line services for students and are effective in treating psychological distress in a wide range of clinical and sub-clinical situations.

Ovarian cancer is the deadliest gynecologic cancer, with a 5-year survival rate of 30%, when the disease has spread throughout the peritoneal cavity. We investigated the efficacy to delay disease progression by the DNA-dependent protein kinase (DNA-PK) inhibitor AZD7648, administered in combination with two of the therapeutic options for patient management: either pegylated liposomal doxorubicin (PLD) or the PARP inhibitor olaparib. Patient-derived ovarian cancer xenografts (OC-PDX) were transplanted subcutaneously to evaluate the effect of treatment on tumor growth, or orthotopically in the peritoneal cavity to evaluate the effect on metastatic spread. AZD7648 was administered orally in combination with PLD (dosed intravenously) or with olaparib (orally). To prove the inhibition of DNA-PK in the tumors, we measured pDNA-PKcs, pRPA32, and g H2AX, biomarkers of DNA-PK activity. AZD7648 enhanced the therapeutic efficacy of PLD in all the OC-PDXs tested, regardless of their BRCA status or sensitivity to cisplatin or PLD. The treatment caused disease stabilization, which persisted despite therapy discontinuation for tumors growing subcutaneously, and significantly impaired the abdominal metastatic dissemination, prolonging the lifespan of mice implanted orthotopically. AZD7648 potentiated the efficacy of olaparib in BRCA-deficient OC-PDXs but did not sensitize BRCA-proficient OC-PDXs to olaparib, despite an equivalent inhibition of DNA-PK, suggesting the need of a preexisting olaparib activity to benefit from the addition of AZD7648. This work suggests that AZD7648, an inhibitor of DNA-PK, dosed in combination with PLD or olaparib is an exciting therapeutic option that could benefit patients with ovarian cancer and should be explored in clinical trials.

The COVID-19 vaccine development timelines offered a unique opportunity to explore the public’s vaccine intention in an unusual situation characterised by great uncertainty about the vaccine’s features and the disease it intended to prevent. To advance our knowledge of vaccine intention mechanisms under these unusual circumstances, to plan effective vaccination strategies, and to better direct communication efforts in similar scenarios, this study explored i) COVID19-related information needs, information-seeking behaviours, and perceived trustworthiness of news media; ii) COVID-19 vaccination intention and its determinants, during the first wave of COVID-19 pandemic in Italy. In particular, it was investigated whether and to what extent the perception of severity and susceptibility to the infection, trust in authorities, and demographics shaped people’s vaccine intention. Between April and May 2020 in a cross-sectional study, 1373 Italian participants completed an online survey measuring demographic features, perception of the disease severity, disease risk perception, COVID19-related worry, disease-related information needs and behaviours, vaccination intention, and level of trust in authorities and news media. The leading information needs were the COVID-19 incubation period and transmission modalities, with the majority of people actively looking for information from one to three times a day. Despite uncertainty around the details of a COVID-19 vaccination, 68% of participants reported intending to be vaccinated for COVID-19. Greater COVID-19 vaccination intention was associated with having a regular history of seasonal flu vaccine, a greater COVID19-related worry, a higher perception of disease severity, and a higher trust in the Government. These findings further our understanding of vaccine intention in a pandemic scenario where a vaccine is still hypothetical and provide valuable information on the public’s representation of the infection and future acceptan

Backgrounds: Healthy volunteers play a key role in clinical trials and it is crucial to develop recruitment strategies that capitalise on their motivations and maximise their participation. The COVID-19 pandemic has shown the importance of finding motivated healthy volunteers for the development of new vaccines. Public registers represent a promising way to promote the participation of healthy volunteers in the research field, but their adoption is still limited. The current study aimed to explore the motivations of healthy volunteers to enrol in an Italian public register for clinical trials during the COVID-19 pandemic and their attitude toward participating in a phase 1 COVID-19 vaccine clinical trial. The impacts of different enrolling interview modalities (in person, by phone, by mail) on motivation, understanding of information and trust in researchers were also investigated. Methods: An online survey investigating experience with COVID-19, motivations to enrol, trust in researchers, political and healthcare authorities and pharmacological companies was presented to people applying as healthy volunteers in the public register for clinical trials at Phase 1 Unit Research Centre of ASST Monza, Italy, and considering to participate in a COVID-19 vaccine clinical trial. Data were collected in June 2021. Results: Altruistic motivations were the main driver for enrolling in the public register, while self-interested motivations were secondary. No gender differences were found. As for enrolling modalities, no differences emerged between in-person and interviews for motivation to enrol, understanding of information and trust in researchers. Email modality led to significantly lower volunteers’ satisfaction and understanding of information but similar trust in research. Conclusions: This study supports the validity of different interview modalities (in person and by phone) for the enrolment of healthy volunteers for clinical trials and highlights the positive role of p

Background: What leads healthy people to enter in a volunteer register for clinical trials? This study aimed to investigate the relationship between the decision to volunteer in clinical trials for a COVID-19 vaccine and social capital, in a sample of healthy volunteers in Italy. Since social capital is characterized by trust, reciprocity, and social and political participation, we claim that it is key in leading individuals to actively take action to protect public health, and to take a risk for the (potential) benefit not only of themselves but for the entire community. Methods: This study was conducted through the administration of a questionnaire to healthy volunteers registered for a phase 1 clinical trial for a COVID-19 vaccine in the Unit Research Centre of ASST-Monza, in September 2020. The primary purpose of a phase 1 study is to evaluate the safety of a new drug candidate before it proceeds to further clinical studies. To approximate a case–control study, we randomly matched the 318 respondents to healthy volunteers (cases) with 318 people randomly selected by Round 9 of the European Social Survey (controls), using three variables, which we considered to be associated with the decision to volunteer: gender, age, and education level. To execute this matching procedure, we used the “ccmatch” module in STATA. Results: The findings highlight the positive impact of social capital in the choice of healthy individuals to volunteer in COVID-19 vaccine clinical trials. Controlling for possible confounding factors, some exemplary results show that people with a high level of general trust have a greater likelihood of volunteering compared to people with low trust (OR = 2.75, CI = 1.58–4.77); we also found that it is more probable that volunteers are people who have actively taken action to improve things compared with people who have not (for individuals who did three or more actions: OR = 7.54, CI = 4.10–13.86). People who reported voting (OR = 3.91, CI = 1.70–8.99

This study aimed to evaluate the psychometric proprieties of the Italian version of the Patient-Practitioner Orientation Scale (PPOS) in a large sample (N = 854) of Italian second-year medical students from six consecutive academic years. The 18 items of the PPOS were translated into Italian using a standard translation/back-translation process. The construct validity of the PPOS was established with Confirmatory Factor Analyses. Multi-group measurement invariance between males and females was also performed. Finally, convergent validity and Raykov’s composite reliability were used as indicators of PPOS internal consistency. Results supported the two original factors labeled Caring and Sharing, but the validated Italian version of the PPOS includes 8 items out of the 18 of the original questionnaire. The PPOS-8-IT resulted in a reliable and valid self-report measure of patient-centeredness among Italian undergraduate medical students. The PPOS-8-IT might be used for assessing and monitoring the attitudes of Italian medical students towards the doctor-patient relationship for educational, evaluative, and research purposes.

The present study contributes to the literature by examining the association between personal values (PVs), assessed with the Schwartz’s Portrait Values Questionnaire, and empathy, assessed with the Davis’ Interpersonal Reactivity Index, in a sample of first-year medical students. We also examined medical students’ PVs profile and gender differences in terms of PVs. All participants (N = 398) were Italian, young (average age = 19.62 years, SD = 1.22), and unmarried; none had children. Zero-order correlations and hierarchical multiple regression models were performed to verify the association between PVs and empathy; in contrast, t-tests were run to explore gender differences in scoring on PVs. Benevolence and Universalism correlated positively with both the emotional and cognitive dimensions of empathy, whereas Power, Achievement, Hedonism, and Security were negatively associated with empathy. The three most important PVs in the whole sample were Benevolence, Self-Direction, and Universalism. Male medical students outscored their female counterparts on Power, Achievement, and Hedonism, whereas female students outscored the males on Benevolence, Universalism, Conformity, and Tradition. Our findings highlight the importance of fostering self-transcending PVs and discouraging self-enhancing PVs in medical students during the early years of medical school, as a means of supporting other-oriented responses such as empathy in future doctors.

Since the approval of poly (ADP-ribose) polymerase inhibitors (PARPi) for BRCA-mutated ovarian cancer patients, different PARPi have been developed and have shown efficacy in homologous recombination deficient (HRD) tumours. These first-generation drugs inhibit both PARP1 and PARP2 (as well as other PARP family members) and present undesirable adverse effects, such as haematological and intestinal toxicity, that restricted their use especially in combination with already poorly tolerated chemotherapeutic agents. Here, patient-derived ovarian cancer xenografts (OC-PDXs) were used i) to evaluate the dose response efficacy of AZD5305, a next generation, potent and selective PARP1 inhibitor and ii) to investigate the effect of the combination with carboplatin, a standard-of-care treatment for ovarian cancer patients. AZD5305 was administered orally (po) once daily (QD) for 8 weeks as monotherapy (0.1, 1 and 10 mg/kg) and in combination with carboplatin (CPT) dosed intravenously (35 mg/kg; Q7x4). Two BRCA1 mutated (HOC106 and HOC107) and a BRCA wild-type (HOC84) OC-PDXs (all TP53 mutated) were implanted subcutis and the effect of treatments on tumour growth evaluated. AZD5305 dosed at 0.1, 1 and 10 mg/kg to mice bearing HOC106 tumours, inhibited tumours growth in a dose dependent manner. Administered in combination at 0.1 and 1 mg/kg, AZD5305 potentiated the effect of carboplatin, causing a significant and sustained regression of HOC106 tumours. The anti-tumour efficacy was also evident against the PARPi-resistant OC-PDX HOC107, whereby the tumour growth was inhibited by AZD5305 at 1 and 10 mg/kg dose. Combined with carboplatin, AZD5305 stabilized the growth of HOC107 tumours at doses as low as 0.1 mg/kg that on its own was not effective. As expected, none of the treatments affected the growth of the BRCA wild-type HOC84 (PARPi and carboplatin resistant OC-PDX). Overall, AZD5305 a next generation PARP1-selective inhibitor and trapper, shows improved efficacy and tolerabi