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Daniela Paola Roggeri,1 Alessandro Roggeri,1 Elisa Rossi,2 Salvatore Cataudella,2 Nello Martini,3 1ProCure Solutions, Nembro, Bergamo, 2CINECA Interuniversity Consortium, Bologna, 3Accademia Nazionale di Medicina, Rome, Italy Purpose: Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Patients and methods: Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1–3) with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures). Results: Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases) and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively). The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in infants hospitalized for bronchiolitis during the entire follow-up period. Conclusion: Preterm infants hospitalized for bronchiolitis in the first year of life were associated with increased resource consumption and costs throughout the entire period of observation; even in the fourth year, the difference versus paired controls was relevant. Keywords: bronchiolitis, cost, preterm, hospitalizations

Bowen and colleagues argued through their clinical observations that psychological distress is a result of low levels of differentiation of self. Starting from these premises, the main objective of the present investigation was to compare a normative sample and a sample of adults seeking services at a systemic therapy clinic. Initially, we assessed differences between groups in dimensions related to differentiation of self and psychological distress. In the second step, we examined whether differentiation of self dimensions would increase or reduce the likelihood that an individual belonged to either of the two groups. The help-seeking sample was comprised of 64 adults seeking therapeutic services, and the normative sample was comprised of 85 students. All participants completed the Differentiation of Self Inventory and the Symptom Checklist-90-Revised. We found that the participants of the help-seeking sample had significantly higher scores on the Global Severity Index and in I-position and emotional cutoff dimensions. We also found that higher emotional cutoff was the strongest predictor of the probability of belonging to the help-seeking group in the hypothesized model. These data suggest that information about differentiation of self might enable counseling psychologists and therapist to define effective interventions. [ABSTRACT FROM AUTHOR]