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Purpose: The present study is aimed to assess the availability and use of complementary medicine (CM) therapies in Italian palliative care hospices, and the support services available to caregivers and hospice staff.Methods: A national sample of 30 hospices meeting study criteria provided data by means of telephone interviews.Results: All hospices offered spiritual assistance and at least one other form of CM, with the most common being massage therapy (n = 24) and relaxation therapy (n = 10). When offered complementary therapies, 65% or more of the patients accepted them. Twenty-nine hospices provided spiritual and psychological support to caregivers during patient stays, but only 12 offered support at home. All hospices offered support services to their staff, both in individual and group formats.Conclusions: Despite limited empirical support, CM has become an important part of palliative care for end-of-life patients in Italy, as in many other countries. [ABSTRACT FROM AUTHOR]

Every year, many university athletes find themselves experiencing sports injuries while practicing their sport. Not all athletes are equal to each other, and some get injured more often. Individual differences in personality could explain these differences. This study focuses on how within-person combinations of perfectionistic strivings and perfectionistic concerns are associated with the risk of traumatic injury in university athletes. Two most prominent person-oriented approaches of perfectionism (the tripartite and 2x2 models) were tested in a retrospective (N=143) and a prospective (N=98) sample. Cluster analyses identified perfectionism profiles consistent with the two theoretical models in both samples. Furthermore, the profile with high levels of perfectionistic strivings and concerns was found to be the most at risk of experiencing a traumatic injury using both designs. This study supports the tripartite model of perfectionism in recognizing the exacerbating role of perfectionistic strivings on the maladaptive effect of perfectionistic concerns. Coaches and sports specialists will need to consider monitoring athletes' levels of PC, especially in conjunction with high PS levels, to reduce the risk of injury in athletes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aggressiveness and unethical behaviors are an important problem in sports today. Understanding how to properly measure and manage an athlete's aggressive tendency is a crucial lesson to be learned within the rulesets of a sporting environment. This study aims at validating the Italian version of the Competitive Aggressiveness and Anger Scale (CAAS), specifically developed to measure aggressiveness and anger in athletes. The second aim is to investigate how aggressive and antisocial behaviors are modulated by sex, competitive level (i.e., amateur and competitive), sport contact (i.e., contact and no-contact), and sport type (i.e., team and individual). Two hundred and ninety-six athletes (mean age = 22.42 years, SD = 2.86) were asked to fill out a survey about sociodemographic variables, sport specific data, attitudes to moral decisions, past cheating behavior, and aggression. The Italian version of the CAAS presented a good fit of the data, adequate internal consistency and its construct validity was supported via convergent and discriminant validity. Both aggressiveness and anger dimensions of CAAS positively related with acceptance of cheating and gamesmanship, and past cheating behavior, while only the aggressiveness dimension of the CAAS negatively related with prosocial attitude. Competitive male athletes practicing contact sport showed the highest levels of aggressiveness, while competitive athletes practicing team sport showed the highest level of anger. This study represents the first empirical construct validity evidence of CAAS among Italian athletes and provides a deeper understanding of how athletes' aggressive tendencies and antisocial behavior differ across athlete populations., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

The use of substances to improve sports performance is a widespread phenomenon among adolescents. Several anti-doping programs have been developed, mainly based on knowledge-based evidence. The main aim of the present study was to implement an anti-doping intervention in sports high school students, based on a psychological framework, such as Socio-Cognitive Theory, through the development of a Serious Game (SG), i.e., digital learning based on the game. The experimental design included an intervention group (n = 167; F = 37.7%; Mean age = 17.5 years; SD = 0.58) and a control group (n = 112; F = 42%; Mean age = 17.6; SD = 1). Both of the groups completed the same questionnaire on two different occasions (i.e., time 1 and time 2) for measuring doping intention, self-regulatory efficacy to resist social pressure for the use of substances, moral disengagement, and doping knowledge. Data were analyzed through repeated measures of Group X Time ANOVA, demonstrating some degree of efficacy of the intervention, in particular in terms of the decrease in doping intention and the strengthening of doping knowledge. Moreover, the study demonstrated that the score obtained during the implementation of the SG could partially represent a coherent measure of the participants' beliefs regarding doping. These results could be considered a starting point for future research to better develop technological anti-doping interventions.

The peritoneum is an unusual site of metastases from lung cancer, and optimal management at the moment remains unclear and mostly based on palliative strategies. Therefore, the aim of the study was to investigate demographic characteristics, management and overall survival of patients with peritoneal metastases from lung cancer (PCLC). A PRISMA-compliant systematic review and pooled analysis was performed searching all English studies published until December 2022. PROSPERO, CRD42022349362. Inclusion criteria were original articles including patients with peritoneal carcinomatosis from lung cancer, specifying at least one outcome of interest. Exclusion criteria were being unable to retrieve patient data from articles, and the same patient series included in different studies. Among 1746 studies imported for screening, twenty-one were included (2783 patients). Mean overall survival was between 0.5 and 5 months after peritoneal carcinomatosis diagnosis and 9 and 21 months from lung cancer diagnosis. In total, 27% of patients underwent first-line or palliative chemotherapy and 7% of them surgery. Management differs significantly among published studies. The literature on PCLC is scarce. Its incidence is low but appears to be substantially rising and is likely to be an underestimation. Prognosis is very poor and therapeutic strategies have been limited and used in a minority of patients. Subcategories of PCLC patients may have an improved prognosis and may benefit from an aggressive oncological approach, including cytoreductive surgery. Further investigation would be needed in this regard.

Lung-protective ventilation (LPV) with low tidal volumes can significantly increase the survival of patients with acute respiratory distress syndrome (ARDS) by limiting ventilator-induced lung injuries. However, one of the main concerns regarding the use of LPV is the risk of developing hypercapnia and respiratory acidosis, which may limit the clinical application of this strategy. This is the reason why different extracorporeal CO 2 removal (ECCO 2 R) techniques and devices have been developed. They include low-flow or high-flow systems that may be performed with dedicated platforms or, alternatively, combined with continuous renal replacement therapy (CRRT). ECCO 2 R has demonstrated effectiveness in controlling PaCO 2 levels, thus allowing LPV in patients with ARDS from different causes, including those affected by Coronavirus disease 2019 (COVID-19). Similarly, the suitability and safety of combined ECCO 2 R and CRRT (ECCO 2 R-CRRT), which provides CO 2 removal and kidney support simultaneously, have been reported in both retrospective and prospective studies. However, due to the complexity of ARDS patients and the limitations of current evidence, the actual impact of ECCO 2 R on patient outcome still remains to be defined. In this review, we discuss the main principles of ECCO 2 R and its clinical application in ARDS patients, in particular looking at clinical experiences of combined ECCO 2 R-CRRT treatments.

An online survey (N = 210) is presented on how the perceived utility of correct and exaggerated countermeasures against Covid-19 is affected by different pronominalization strategies (impersonal form, you, we). In evaluating the pronominalization effect, we have statistically controlled for the roles of several personal characteristics: Moral Disengagement, Moral Foundations, Health Anxiety, and Embracing of Fake News. Results indicate that, net of personal proclivities, the you form decreases the perceived utility of exaggerated countermeasures, possibly due to simulation processes. As a second point, through a Structural Equation Model, we show that binding moral values (Authority, Ingroup, and Purity) positively predict both fake news embracing and perceived utility of exaggerated countermeasures, while individualizing moral values (Harm and Fairness) negatively predict fake news embracing and positively predict the perceived utility of correct countermeasures. Lastly, fake news embracing showed a doubly bad effect: not only does it lead people to judge exaggerated countermeasures as more useful; but, more dangerously, it brings them to consider correct countermeasures as less useful in the struggle against the pandemic.

Coronavirus disease 2019 (COVID-19) is a rapidly changing disease. Therefore, in this study, to evaluate the evolution of COVID-19 in hemodialysis patients, we retrospectively compared patients affected by COVID-19 during the first pandemic waves of 2020 (from March to December 2020-Group 1) with patients with COVID-19 from September 2021 to February 2022 (Group 2) after the full completion of vaccination. Group 1 was constituted of 44 patients (69.3 ± 14.6 years), and Group 2 of 55 patients (67.4 ± 15.3 years). Among Group 2, 52 patients (95%) were vaccinated. Patients of Group 2, compared with Group 1, were more often asymptomatic (38 vs. 10%, p = 0.002) and reported less frequent fever and pulmonary involvement. At diagnosis, Group 2 showed a significantly higher number of lymphocytes and lower levels of circulating IL-6 (16 ± 13.3 vs. 41 ± 39.4 pg/mL, p = 0.002). Moreover, in Group 2, inflammatory parameters significantly improved after a few days from diagnosis. Patients of Group 2 presented a lower hospitalization rate (12.7 vs. 38%, p = 0.004), illness duration (18.8 ± 7.7 vs. 29.2 ± 19.5 days, p = 0.005), and mortality rate (5.4 vs. 25%, p = 0.008). Finally, responders to the vaccination (80% of vaccinated patients) compared with nonresponders showed a reduction in infection duration and hospitalization (5 vs. 40%, p = 0.018). In conclusion, we found that COVID-19 presentation and course in hemodialysis patients have improved over time after the implementation of vaccine campaigns. However, due to the evolving nature of the disease, active surveillance is necessary.

Background: This study aimed to investigate differences in adolescents' social relationships with classmates of diverse gender, socioeconomic status, immigrant background, and academic achievement., Methods: A population of 10th-grade students (N = 406,783; males = 50.3%; M age = 15.57 years, SD age = 0.75) completed the Classmates Social Isolation Questionnaire (CSIQ), an instrument specifically designed to measure two distinct but correlated types of peer relationships in class: peer acceptance and peer friendship. To obtain reliable comparisons across diverse adolescent characteristics, the measurement invariance of the CSIQ was established by means of CFAs and then latent mean differences tests were performed., Results: Immigrant background, academic achievement, and socioeconomic status all proved to be important factors influencing relationships with classmates, while being a male or a female was less relevant. Being a first-generation immigrant adolescent appears to be the foremost risk factor for being less accepted by classmates, while having a low academic achievement is the greatest hindrance for having friends in the group of classmates, a finding that diverges from previous studies., Conclusions: This population study suggests that adolescent characteristics (especially immigrant background, socioeconomic status, and academic achievement) seem to affect social relationships with classmates.

Research on attention in sport using eye-tracking methodology has highlighted that the highest levels of expertise and performance are characterized by a specific gaze behavior consisting of a perception-action variable named quiet eye. The present study aimed to understand the role of quiet eye during the three-point shot, especially in game conditions in which even a single point may determine victory or defeat. Twenty-one basketball players (twelve competitive elites and nine semi-elites) with a high-shooting style performed three-point shots in four game scenarios different from each other for the time available (time pressure) and the relevance of the score (performance pressure). The results showed that competitive elites performed a longer quiet eye online duration and a shorter QE preprogramming duration than semi-elites, especially in the highest-pressure condition. On the one hand, these results suggest that quiet eye during three-point shots could fulfill an online control function. On the other hand, the findings stressed the importance of implementing experimental conditions that can resemble as closely as possible actual sport situations. Finally, we suggest that sport professionals interested in administering to athletes a quiet eye training protocol in order to improve three-point shot performance consider the shooting style of the players.

Background: Motivation to engage in physical activity plays a central role in ensuring the health of the population. The present study investigated the psychometric properties and validity in Italy of the Behavioral Regulation in Exercise Questionnaire (BREQ-3), a widely used instrument for assessing individuals' motivation to exercise based on self-determination theory (SDT)., Methods: A large sample (N = 2222; females = 55.4%; M age = 36.4 years, SD age = 13.9, min = 20, max = 69) of young people, and middle aged and older adults completed the Italian translation of the BREQ-3, also indicating their intentions to exercise in the following weeks., Results: Confirmatory factor analyses showed that the posited six-factor structure of the BREQ-3 fitted the data well (CFI = 0.96; RMSEA = 0.05; SRMR = 0.04) and provided evidence for full measurement invariance across gender and different age groups. The construct validity of the BREQ-3 was supported by the latent correlations among the subscales, which were consistent with the quasi-simplex pattern theorized by SDT. The overall level of self-determination and the intention to exercise were positively correlated, providing evidence for the criterion validity of the scale., Conclusions: The Italian version of the BREQ-3 has proved to be a reliable and valid instrument for measuring the behavioral regulation of exercise in individuals with different demographic characteristics.

One of the most used instruments to assess perfectionism is Hewitt and Flett's Multidimensional Perfectionism Scale (HFMPS). This article reports result of two studies aimed at evaluating and comparing two short HFMPS versions provided by literature in Italian samples. In Study 1, two previously proposed short forms-Cox and colleagues' and Hewitt and colleagues'-were compared in terms of factor structure and concurrent validity in a community sample of 324 participants. In Study 2, validity and reliability of the two short scales in 102 university students and 58 patients with a primary diagnosis of Obsessive-Compulsive Disorder were examined. Results revealed mixed findings concerning which of the two short form should be preferred.

The COVID-19 pandemic and the associated governmental restrictions suddenly changed everyday life and potentially affected exercise behavior. The aim of this study was to explore whether individuals changed their preference for certain types of physical exercise during the pandemic and to identify risk factors for inactivity. An international online survey with 13,881 adult participants from 18 countries/regions was conducted during the initial COVID-19 related lockdown (between April and May 2020). Data on types of exercise performed during and before the initial COVID-19 lockdown were collected, translated, and categorized (free-text input). Sankey charts were used to investigate these changes, and a mixed-effects logistic regression model was used to analyze risks for inactivity. Many participants managed to continue exercising but switched from playing games (e.g., football, tennis) to running, for example. In our sample, the most popular exercise types during the initial COVID-19 lockdown included endurance, muscular strength, and multimodal exercise. Regarding risk factors, higher education, living in rural areas, and physical activity before the COVID-19 lockdown reduced the risk for inactivity during the lockdown. In this relatively active multinational sample of adults, most participants were able to continue their preferred type of exercise despite restrictions, or changed to endurance type activities. Very few became physically inactive. It seems people can adapt quickly and that the constraints imposed by social distancing may even turn into an opportunity to start exercising for some. These findings may be helpful to identify individuals at risk and optimize interventions following a major context change that can disrupt the exercise routine.

The novel coronavirus disease 2019 (COVID-19) represents a massive global health crisis leading to different reactions in people. Those reactions may be adaptive or not depending on situational or psychological processes. Disordered eating attitudes and behaviors are likely to be exacerbated by the pandemic through multiple pathways as suggested by Rodgers et al. (2020). Among the psychological variables that may have increased dysfunctional eating attitudes and behaviors as a consequence of the social distancing and isolation, we looked at perfectionism. Perfectionism is a well-recognized risk and maintaining factor of eating-related symptoms and interact with stress increasing the probability of dysfunctional reactions (e.g., Wang and Li, 2017). The present study investigated the relationship between multidimensional perfectionism and eating behaviors by considering the mediating role of psychological distress. Data were collected from two countries (Italy and Spain) by means of an online survey. The samples included 465 (63.4% female) participants from Italy and 352 (68.5% female) from Spain. Participants completed the short form of the Hewitt and Flett Multidimensional Perfectionism Scale (Lombardo et al., 2021) to assess self-oriented, other-oriented and socially prescribed perfectionism, as well as the short form of Three Factors Eating Questionnaire (Karlsson et al., 2000) and the Italian version of Depression Anxiety and Stress Scale-21 (Bottesi et al., 2015), respectively used to assess restrictive, emotional and uncontrolled eating on one hand, and depression, anxiety and stress on the other. Multigroup analysis was performed to test the hypothesized model. Results showed that other-oriented and socially prescribed perfectionism were indirectly related to most of the dysfunctional eating aspects through the mediation of psychological distress, and the pattern obtained was consistent in both countries. These findings evidence that the psychological distress potentially related to the COVID-19 disease mediates the negative impact of interpersonal perfectionism and the tendency to eat in response to negative emotions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer IT declared a past collaboration with several of the authors, ADM and LM, to the handling editor., (Copyright © 2021 Vacca, De Maria, Mallia and Lombardo.)

The outbreak of coronavirus required adjustment regarding the delivery of interventions. Media literacy interventions are necessary to help people acquire relevant skills to navigate the complexities of media communications, and to encourage health-promoting behaviors. The present study aimed to promote a media literacy intervention regarding performance and appearance enhancement substances use in sports high school students. The COVID-19 contingency allowed us to evaluate whether online sessions can effectively promote greater awareness of media influence, a stronger sense of confidence in persuading others to deal with media messages, and healthier attitudes about PAES use among high school students. The study relied on an "intervention group" comprising 162 students (31.5% female) and a "control group" comprising 158 students (42% female). Data were analyzed through repeated measures of Group X Time MANOVA and ANOVA, demonstrating some degree of efficacy of the media literacy intervention. The "intervention group" reported higher awareness of potential newspapers' influence and a significant increase in their sense of confidence in dealing with media influence compared to the "control group". Findings support the efficacy of online media literacy programs to prevent doping consumption in adolescents.