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The initial state parameters s[subscript 0] and w[subscript 0] are intricate issues of the averaging cognitive models in Information Integration Theory. Usually they are defined as a measure of prior information (Anderson, 1981; 1982) but there are no general rules to deal with them. In fact, there is no agreement as to their treatment except in specific situations such as linear models where they can be merged with the arbitrary zero inter-response scale C[subscript 0]. We present some considerations on their meaning and usefulness in the Functional Measurement approach, starting from different points of view. Furthermore, we suggest a method to deal with their complexity both within each single trial of a factorial design, and between the overall trials of an experiment. (Contains 2 tables and 1 footnote.)

The Functional Measurement approach, proposed within the theoretical framework of Information Integration Theory (Anderson, 1981, 1982), can be a useful multi-attribute analysis tool. Compared to the majority of statistical models, the averaging model can account for interaction effects without adding complexity. The R-Average method (Vidotto & Vicentini, 2007) can be used to estimate the parameters of these models. By the use of multiple information criteria in the model selection procedure, R-Average allows for the identification of the best subset of parameters that account for the data. After a review of the general method, we present an implementation of the procedure in the framework of R-project, followed by some experiments using a Monte Carlo method. (Contains 1 figure and 6 tables.)

Davide Massidda,1 Ines Giorgi,2 Giulio Vidotto,3 Salvatore Tringali,4 Marcello Imbriani,4,5 Paola Baiardi,6 Giorgio Bertolotti7 1Giunti O.S. Organizzazioni Speciali, Firenze, Italy; 2Psychology Unit, ICS Maugeri, IRCCS, Pavia, Italy; 3Department of General Psychology, University of Padova, Padova, Italy; 4ICS Maugeri, IRCCS, UOOML, Pavia, Italy; 5Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; 6Scientific Direction, ICS Maugeri, IRCCS, Pavia, Italy; 7Psychology Unit, ICS Maugeri, IRCCS, Tradate, Italy Introduction and objectives: A multidimensional self-report questionnaire to evaluate job-related stress factors is presented. The questionnaire, called Maugeri Stress Index – reduced form (MASI-R), aims to assess the impact of job strain on a team or on a single worker by considering four domains: wellness, resilience, perception of social support, and reactions to stressful situations. Material and methods: The reliability of a first longer version (47 items) of the questionnaire was evaluated by an internal consistency analysis and a confirmatory factor analysis. An item reduction procedure was implemented to obtain a short form of the instrument, and the psychometric properties of the resulting instrument were evaluated using the Rasch measurement model. Results: A total of 14 items from the initial pool were deleted because they were not productive for measurement. The analysis of internal consistency led to the exclusion of eight items, while the analysis performed using structural equation models led to the exclusion of another six items. According to the Rasch model, item properties and the reliability of the instruments appear good, especially for the scales for wellness and resilience. In contrast, the scales for perception of social support and negative coping styles show a lower internal consistency. Conclusions: The Maugeri Stress Index – reduced form provides a reliable and valid measure, useful for early identification of stress levels in workers or in a team along the eustress–vadistress continuum. Keywords: occupational stress, stress, psychometrics, questionnaire, validation

Background: The most widely used system for peripheral blood progenitor cell (PBPC) cryopreservation is controlled-rate freezing (CRF). Uncontrolled-rate freezing (URF) at -80 degrees C has also been used, but its clinical impact has not been studied sufficiently yet.Study Design and Methods: Two groups of patients were compared: Group A consisted of 69 patients autotransplanted with PBPCs cryopreserved with CRF; Group B consisted of 192 patients autotransplanted with PBPCs cryopreserved with URF at -80 degrees C. The same cryoprotectant solution and storage system were used.Results: A significant delay of hematologic reconstitution (HR) in the URF group was observed for neutrophils greater than 0.5 x 10(9) per L and for platelets greater than 20 x 10(9) per L and greater than 50 x 10(9) per L; we did not observe any differences in the clinical course. The long-term HR was comparable in the two groups, all patients showed stable engraftment, and no late graft failures were observed.Conclusion: Our study confirms that URF is safe and allows sustained long-term engraftment without increasing the risks of transplantation, even though the early engraftment after URF is slower. [ABSTRACT FROM AUTHOR]

Background: Although Moral Distress (MD) is a matter of concern within the Pediatric Intensive Care Unit (PICU), there is no validated Italian instrument for measuring the phenomenon in nurses and physicians who care for pediatric patients in Intensive Care. The authors of the Italian Moral Distress Scale-Revised (Italian MDS-R), validated for the adult setting, in 2017, invited further research to evaluate the generalizability of the scale to clinicians working in other fields. Our study aims to reduce this knowledge gap by developing and validating the pediatric version of the Italian MDS-R., Methods: We evaluated the new instrument for construct validity, then we administered it in a multicenter, web-based survey that involved healthcare providers of three PICUs and three adult ICUs admitting children in northern, central, and southern Italy. Finally, we tested it for internal consistency, confirmatory factorial validity, convergent validity, and differences between groups analysis., Results: The 14-item, three-factor model best fit the data. The scale showed good reliability (a = 0.87). Still, it did not correlate with the Emotional Exhaustion and Depersonalization sub-scales of the Maslach Burnout Inventory (MBI) or with the 2-item Connor-Davidson Resilience Scale (CD-RISC 2) or the Satisfaction with Life Scale (SWLS). A mild correlation was found between the Italian Pediatric MDS-R score and intention to resign from the job. No correlation was found between MD and years of experience. Females, nurses, and clinicians who cared for COVID-19 patients had a higher MD score., Conclusions: The Italian Pediatric MDS-R is a valid and reliable instrument for measuring MD among Italian health workers who care for critically ill children. Further research would be helpful in better investigating its applicability to the heterogeneous scenario of Italian Pediatric Critical Care Medicine.

This study assesses the levels of and relationships between the Motivation to donate, Job crafting propensity, and the Organizational citizenship behavior of blood collection volunteers in a non-profit association. An Italian sample of AVIS (the Italian Association of Voluntary Blood donors) blood donors (N = 1215) actively involved in organizing blood collection, were asked to complete the Italian version of the Volunteer Function Index, the Job crafting scale, and the Organizational citizenship behavior scale. The tools were verified by Confirmatory factor analysis and their relationships were explored using Structural equation modeling for hidden variables. The three constructs have overall high scores. Motivation to donate and Job crafting show a clear correlation, with the latter influencing volunteer Organizational citizenship behavior. The study highlights the need to take into consideration the Motivation to donate, Job crafting and Organizational citizenship behavior of volunteers, particularly in countries such as Italy, where blood collection is almost exclusively carried out thanks to spontaneous, altruistic, and disinterested commitment., Competing Interests: The authors declare no conflict of interest.

This study aimed to explore the influence of the visuospatial active working memory subcomponents on early math skills in young children, followed longitudinally along the first 2 years of primary school. We administered tests investigating visual active working memory (jigsaw puzzle), spatial active working memory (backward Corsi), and math tasks to 43 children at the beginning of first grade (T1), at the end of first grade (T2), and at the end of second grade (T3). Math tasks were selected according to the children's age and their levels of formal education: the "Battery for the evaluation of numerical intelligence from 4 to 6 years of age" (BIN 4-6) at T1 to test early numerical competence and the "Test for the evaluation of calculating and problem-solving abilities" (AC-MT 6-11) to test math skills at T2 and T3. Three regression models, in which the predictors were identified through a backward selection based on the use of the Bayesian information criterion (BIC) index, were performed to study the relationship between visual and spatial working memory and math ability at the three points in time. The results show that spatial working memory influences early numerical performance at T1, while early numerical performance is the unique predictor of math performance at T2. At the end of the second grade, the regression model reveals a relationship between math performance and both visual and spatial working memory and the attenuation of the importance of domain-specific predictors. The study depicts the different implications of visual and spatial working memory predictors over the children's development periods and brings additional evidence to the debate on the relationship between visuospatial working memory and math ability in young children., (Copyright © 2019 Fanari, Meloni and Massidda.)

Background: Paranoid thoughts are relatively common in the general population and can increase the risk of developing mental health conditions. In this study, we investigate the latent structure of paranoia in a sample of young people., Methods: Cross-sectional survey; 243 undergraduate students (males: 44.9%) aged 24.3 years (SD 3.5). The participants completed the Green et al. Paranoid Thought Scales GPTS, a 32-item scale assessing ideas of social reference and persecution; the 12-item General Health Questionnaire (GHQ-12), and the 74-item Schizotypal Personality Questionnaire (SPQ). Confirmatory factor analysis (CFA) was used to confirm the two-factor structure of the GPTS. Factor mixture modeling analysis (FMMA) was applied to map the best combination of factors and latent classes of paranoia., Results: The GPTS showed excellent internal reliability and test-retest stability. Convergent validity was good, with stronger links with measures of ideas of reference and of suspiciousness than with other measures of psychosis-proneness. CFA showed excellent fit for the two-factor solution. FMMA retrieved a three-class solution with 176 subjects (72.5%) assigned to a baseline class, 54 (22.2%) to a "suspicious and mistrustful" class, and 13 (5.3%) to a "paranoid thinking" class. Compared to the baseline class, the other two classes had a higher risk of psychological distress and psychosis-proneness., Conclusions: The latent structure of paranoid thinking in young people appears dimensional. Although caution is advised when generalizing from studies on college students, screening for paranoid ideation in young people who complain about psychological distress might prove useful to prevent the development of severe and potentially debilitating conditions.

Objective: To assess health-related quality of life (HRQoL) parameters in patients who received radical cystectomy (RC) with ileal orthotopic neobladder (IONB) reconstruction and to identify clinic-pathologic predictors of HRQoL., Patients and Methods: From January 2010 to December 2013, a multicenter, retrospective on 174 RC-IONB patients was carried out. All patients completed the following questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer-specific instruments (QLQ-BLM30) and the IONB-Patient Reported Outcome (IONB-PRO). Univariate and multivariate analyses were computed to identify clinic-pathologic predictors of HRQoL., Results: Median age was 66 years (range, 31-83), and 91.4% of patients were men. Median follow-up period was 37 months (range, 3-247). The EORTC QLQ-C30 revealed that age >65 years, absence of urinary incontinence, and absence of peripheral vascular disease were independent predictors of deteriorated body image. A follow-up > 36 months and the presence of urinary incontinence were independent predictors of worsened urinary symptoms, whereas the absence of urinary incontinence was an independent predictor of a worsened body image according to EORTC QLQ-BLM30 results. A follow-up >36 months and the absence of urinary incontinence were independent predictors of better functioning in terms of relational life, emotional life, and fatigue as revealed by the IONB-PRO., Conclusion: Age, presence of urinary incontinence, length of follow-up, and comorbidity status may influence postoperative HRQoL and should all be taken into account when counseling RC-IONB patients., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: The ileal orthotopic neobladder (IONB) is often used in patients undergoing radical cystectomy. The IONB allows to void avoiding the disadvantages of the external urinary diversion.In IONB patients the quality of life (QoL) appears compromised by the need to urinate voluntarily. The patients need to wake up at night interrupting the sleep-wake rhythm with consequences on social and emotional life.At present the QoL in IONB patients is evaluated by generic questionnaires. These are useful when IONB patients are compared with patients with different urinary diversions but they are less effective when only IONB patients are evaluated. To address this problem a specific questionnaire-the IONB-PRO-was developed., Methods: A) Based on a conceptual framework, narrative-based interviews were conducted on 35 IONB patients. A basic pool of 43 items was produced and organized throughout two clinical and four QoL dimensions. An additional 15 IONB patients were interviewed for face validity testing.B) Psychometric testing was conducted on 145 IONB patients. Both classic test strategy and Rasch analysis were applied. Psychometric properties of the resulting scales were comparatively tested against other QoL-validated scales., Results: The IONB-PRO questionnaire includes two sections: one on the QoL and a second section on the capability of the patient to manage the IONB. For evaluation of the QoL, three versions were delivered: 1) a basic 23-item QoL version (3 domains 23-items; alpha 0.86÷ 9.69), 2) a short-form 12-item QoL scale (alpha = 0.947), and 3) a short-form 15-item Rasch QoL scale (alpha = 0.967). Correlations of the long version scales with the corresponding dimensions of the EORTC-QLQ C30 and the EORTC-BLM30 were significant. The short forms exhibited significant correlations with the global health dimension of the EORTC-QLQ and with the urinary subscales of the EORTC-BLM30. The effect size was approximately 1.00 between patients at the 1-year follow-up period and those with 3, 5, and > 5-year follow-up periods for all scales. No relevant differences were observed between the 12-item short-form and the Rasch scale., Conclusions: The IONB-PRO long and short-forms demonstrated a high level of internal consistency and reliability with an excellent discriminanting validity.

Introduction: Workplace mobbing represents a severe type of occupational stress. The aim of this study is to evaluate the discriminant validity of the Maugeri Stress Index-Revised questionnaire (MASI-R) for the perceived work stress assessment., Methods: A total of 105 patients were enrolled at the Occupational Medicine Uinit of our Institute for mobbing-related issues; they were compared to a control group matched for age, sex and professional category. Work stress perception was assessed in both samples using the self-report questionnaire MASI-R, which is the Maugeri Stress Index short form., Results: Workers who perceived exposure to mobbing scored significantly lower compared to the control group in the four MASI-R scales (p < 0.001) and in the two visual analogue scales measuring job satisfaction (p < 0.001) and life satisfaction (p < 0.001). Further analyses have identified the items which significant discriminate between the two groups of workers., Conclusions: These findings show a good discriminant validity of the MASI-R questionnaire: workers who perceived exposure to workplace mobbing reveal higher work stress levels compared to the control group in all aspects measured.

Background: The introduction of screening questionnaires, such as the Mood Disorder Questionnaire (MDQ), has stimulated clinical and epidemiological studies on bipolar disorders. In this work, we studied the item response pattern of the MDQ in the Italian population and compared the results with those of the validation of the MDQ in Asian studies (Chinese and Korean), analyzing similarities and differences among the populations studied., Methods: The sample was made up of 2278 participants, distributed as follows: 56.6% females, 50.8% living in the north-central Italy, and 33.7% living in rural areas. The factor analysis was run on the matrix of tetrachoric correlations. The psychometric properties of the MDQ were also studied using the Rasch logistic model., Results: The parallel analysis found two significant components. The first includes symptoms referring to acceleration, danger and irritability as risky behaviors, social interaction problems and mental flow. The second includes symptoms referring to self-confidence and energy. With respect to the Korean/Chinese results, the Italian sample, item 11 ("much more sex"), appears related to self-confidence and energy, while in Asia it is connected with items expressing risky behaviors and irritability., Limitations: Differences in the frequency of comorbid disorders in Asian and Italian populations should be considered. The results should be confirmed and compared with those of other populations., Conclusions: Cultural differences appear to be associated with a different symptomatic expression of bipolar spectrum disorders. Future research will investigate the role of gene-environment interaction in the genesis of these differences., (© 2013 Elsevier B.V. All rights reserved.)

Background: This survey followed a cohort of patients with chronic psychosis recruited from five catchment areas (DSMs) of the Sardinian community mental health services. The objective was to examine whether the amount of resources in the different sites may be a determinant of the outcomes., Methods: Naturalistic follow-up study on 309 consecutive users with diagnosis of schizophrenic disorder, schizoaffective disorder, bipolar affective disorder with psychotic symptoms (DSM-IV TR) of five Sardinian community mental health services. Mental state and clinical symptoms along with functioning were assessed using semi-structured clinical interviews (ANTAS), Clinical Global Impression Severity Scale (CGI-S), Global Assessment of Functioning Scale (GAF) and Health of the Nation Outcome Scales (HONOS). Assessments were conducted at the beginning of the study and after one year., Results: The proportion of professionals working in all DSMs participating in the study was found lower than the national Italian standard (0.7 vs. 1.0 per 1,500 inhabitants). Follow-up revealed significant differences between DSMs in the improvement of the Honos scores (F = 5.932, p = 0.000). These differences correlate with the improvement of resources in terms of number of professionals during, and one year prior, to the trial., Conclusions: The study shows that mental health services provided in the public sector in Sardinia are still very resource-poor, at least in terms of human resources. Our findings suggest that mental health service resources influence outcomes as regards the social functioning of users. We urge policy makers to take these observations into account when planning future services.

Introduction: The objective was to estimate the rate of subjects who tested positive at a screening for bipolar disorders among the people insured by a French Health Company, and subsequently to measure treatment patterns., Methods: Cross-sectional postal survey on the "Mutuelle Générale de l'Education Nationale" (MGEN) policyholders. A self-rated questionnaire was sent by mail to 20,099 individuals randomly selected among MGEN policyholders. Tools: questionnaire on socio-demographic variables and health-care use; Mood Disorder Questionnaire (MDQ); Composite International Diagnostic Interview Short Form Self-Administered (CIDI-SA)., Results: Responders were 10,288 (53%). The prevalence of MDQ positivity (MDQ(+)) was 3.6%. The respondents older than 65 showed the lowest frequencies. High frequencies were recorded by the people who had left work because of long term sickness and by people with invalidity. Subjects having a diagnosis of ICD-10 major depression were found to be at risk. Positive subjects had no more contacts with general practitioners than negative subjects; on the contrary they had more contacts with psychiatrists, alternative medicine professionals, psychologists, psychoanalysts, spiritual guides or welfare workers. MDQ+ subjects had a higher risk to use all kinds of psychodrugs, including antidepressants (27.7%, OR=2.7, CI95% 1.9-3.9)., Discussion: The prevalence of MDQ(+) was similar to the surveys in the USA and Italy. The use of ADs in people with MDQ(+) and MDD diagnosis needs to be taken into account when managing the public health-care system. A large rate of positive subjects reported to have used ineffective treatments for bipolar disorders., Limits: Relative low response rate and observational design., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Chemotherapy followed by autologous transplantation may be an efficient salvage treatment in malignant lymphomas. We investigated the feasibility, tolerability and efficacy of an outpatient schedule of dexamethasone, cytarabine and cisplatin (DHAP), followed by peripheral blood progenitor cell autografting as salvage treatment in patients with high grade (HG), low grade (LG) non-Hodgkin's lymphoma (NHL) and Hodgkin's Disease (HD). A total of 159 DHAP courses (median: 2, range: 1-5), was administered on outpatient basis to 79 patients (31 LG-NHL, 28 HG-NHL and 20 HD), with the intention to mobilize and to transplant. A successful collection was not achieved in 40% LG-NHL, 10% HD and 20% HG-NHL patients. The risk to fail the collection was significantly related to the number of previous chemotherapy courses (>6) (P = 0.005, RR = 1.4), to the pretransplant status (P = 0.04, RR = 13.5) and to the previous fludarabine administration (P = 0.01, RR = 20). High dose therapy (HDT) was feasible in 60 patients (76%). The overall treatment related mortality was 3.8%. The overall response rate (ORR) was 81% with a 57.6% overall survival (OS) at 62 months (95% CI: 45-69.3%) and a progression free survival (PFS) of 42% at 74 months (95% CI: 26.7-58%). The diagnosis of HG-NHL and the non-response to DHAP resulted to reduce respectively the OS (P = 0.007, RR = 2.8) and PFS probability (P = 0.01, RR = 4.1). In conclusion this outpatient schedule of DHAP is a well tolerated, efficient salvage and mobilizing regimen not only in HG-NHL, but also in LG-NHL and in HD. Randomized studies are needed to better define the role of DHAP in LG-NHL and HD patients.

In the last 3 years, 300 consecutive patients (110 men, 190 women) were treated for gallstone disease using either traditional open surgery or the video laparoscopic approach. The relative clinical data and results were compared and analysed. The Authors conclude that video laparoscopy presents a number of advantages such as minor costs, reduced pain, quick return to work, compared to traditional surgery, especially when correctly indicated.