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Background and objectives: Facemasks represent an essential measure of prevention against the spread of infectious diseases; however, they lessen the ability to convey and understand emotions through facial expressions. In blood donation settings, facemask wearing could interfere with professionals' tasks, reduce the satisfaction of blood donors and affect their future blood donation behaviour. This preliminary cross-sectional study explored the association of mandatory facemask wearing with the quality of the blood donation process at the end of the coronavirus 2019 (COVID-19) pandemic. Materials and methods: A sample of 615 voluntary unpaid Italian blood and plasma donors completed an online survey assessing their attitude towards facemask wearing, the perceived distress due to facemasks in the different steps of the donation process, self-reported vasovagal reactions after donation and the intention to donate again. Results: Nearly 24% of donors reported a worsened quality of the donation process due to facemask wearing, and 36% reported moderate to severe distress during the donation itself. Donors with a more negative attitude towards facemasks reported a worse donation experience, mainly related to the interactions and the communication with physicians and nurses, and a higher probability of experiencing vasovagal reactions at their last donation. No significant correlations were observed between negative facemask attitudes towards facemask wearing, distress or future intention to donate blood/plasma. Conclusion: Facemasks have worsened the quality of blood and plasma donations for one fourth of donors, confirming the interference with the quality of communications and relationships with healthcare professionals.

Introduction: University psychological counselling services represent a frontline defence to detect, treat or refer students with a wide range of (clinical and non-clinical) difficulties. Nevertheless, only few studies describe their impact on academic self-efficacy and report follow-up data. Evidence on students' actual access to further psychological support in times of hardship is also scant and most needed. This study aimed to fill these gaps, exploring the stability of improvement in clinical conditions in a wide sample of university students and reporting post-intervention referrals to mental health services. Methods: In a longitudinal study, 218 students who accessed a psychological counselling service at the University of Milano-Bicocca between 2015 and 2019 completed an assessment at the beginning (T0), conclusion (T1) and 6 months after (T2) a brief cognitive behavioural intervention. The assessment included psychological symptoms, general distress, emotion dysregulation and academic self-efficacy. Information about students' choices to continue a psychological intervention in other services was also collected and contrasted with the counsellor's indication. Results: At follow-up, the improvement in academic self-efficacy remained stable, with more than 60% of the students maintaining a reliable clinical change, and nearly half of them reporting having accessed (or being willing to contact) a mental health service outside the university services. Conclusion: These findings highlight the key role of counselling services in addressing students' distress and academic performances in the long term and in building bridges with mental health services outside the university system for students who need longer and specialised treatment.

Background: Assessing medically-related fears is of paramount importance to foster medical positive experiences and outcomes and requires an easy-to-administer tool. The Medical Fear Survey-Short Version (MFS-SV) is a 25-item questionnaire assessing 5 medically related fears (Injections and Blood Draws, Sharp Objects, Blood, Mutilation, and Examinations and Symptoms). Methods: To examine the psychometric properties of the Italian version of the MFS-SV, exploratory and confirmatory factor analysis were performed on data from 1010 young adults (68.8% female, mean age= 23.9±5.05) who provided demographic information and completed the MFS-SV, the Padua Inventory-Contamination Fear Subscale, the Disgust Propensity and Sensitivity Scale revised (DPSS-R) and the Injection Phobia Scale-Anxiety (IPS-Anx). Convergent validity, reliability, test-retest stability, and multigroup invariance were assessed. Discriminant analysis explored the potential screening function of the MFS-SV. Results: The 5-factor structure of the questionnaire was confirmed, explaining the 68.8% of variance. Raykov’s composite reliability coefficients ranged between.84 and.95. Test-retest stability, convergent validity, and the consistency of the scores across gender were confirmed. The MFS-SV could discriminate subjects with a history of blood donations (Wilk’s Lambda = 0.915; p < 0.001). Conclusion: The overall results supported the psychometric properties of the MFS-SV and its suitability for both research and clinical uses to assess different medical fears

Psychological counselling represents sensitive frontline services for the detection and treatment of early signs of distress in students. This study aims to assess psychological distress in medical students at the beginning of their academic career and the access rate to a counselling service during medical school. Predictors of access to the service and the effectiveness of the service were also explored. Distress and emotional dysregulation were measured in three consecutive cohorts of first-year students (n = 385, 53% female). Students accessing the counselling service at any time during the 6 years of medical school all completed the same baseline measurements and a pre/post assessment of the intervention. Nearly one-third of first-year students reported levels of distress above the clinical cutoff. The access rate to the counselling service was 13.9%. Only 21% of the students with clinical levels of distress contacted the counselling service. Living alone and having high distress at the beginning of the medical course were the main predictors of access to the service. Students reported a significant reduction of distress and dysregulation after counselling interventions. More efforts are needed to develop effective tools for identifying and tracking medical students in psychological hardship and to increase their willingness to attend the counselling services.

Item does not contain fulltext, BACKGROUND: Endoscopic-post-operative-recurrence [ePOR] in Crohn's disease [CD] after ileocecal resection [ICR] is a major concern. We aimed to evaluate the effectiveness of early prophylaxis with biologics and to compare anti-tumour necrosis factor [anti-TNF] therapy to vedolizumab [VDZ] and ustekinumab [UST] in a real-world setting. METHODS: A retrospective multicentre study of CD-adults after curative ICR on early prophylaxis was undertaken. ePOR was defined as a Rutgeerts score [RS] ≥ i2 or colonic-segmental-SES-CD ≥ 6. Multivariable logistic regression was used to evaluate risk factors, and inverse probability treatment weighting [IPTW] was applied to compare the effectiveness between agents. RESULTS: The study included 297 patients (53.9% males, age at diagnosis 24 years [19-32], age at ICR 34 years [26-43], 18.5% smokers, 27.6% biologic-naïve, 65.7% anti-TNF experienced, 28.6% two or more biologics and 17.2% previous surgery). Overall, 224, 39 and 34 patients received anti-TNF, VDZ or UST, respectively. Patients treated with VDZ and UST were more biologic experienced with higher rates of previous surgery. ePOR rates within 1 year were 41.8%. ePOR rates by treatment groups were: anti-TNF 40.2%, VDZ 33% and UST 61.8%. Risk factors for ePOR at 1 year were: past-infliximab (adjusted odds ratio [adj.OR] = 1.73 [95% confidence interval, CI: 1.01-2.97]), past-adalimumab [adj.OR = 2.32 [95% CI: 1.35-4.01] and surgical aspects. After IPTW, the risk of ePOR within 1 year of VDZ vs anti-TNF or UST vs anti-TNF was comparable (OR = 0.55 [95% CI: 0.25-1.19], OR = 1.86 [95% CI: 0.79-4.38]), respectively. CONCLUSION: Prevention of ePOR within 1 year after surgery was successful in ~60% of patients. Patients treated with VDZ or UST consisted of a more refractory group. After controlling for confounders, no differences in ePOR risk were seen between anti-TNF prophylaxis and other groups.

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.

Anxiety related to medical procedures is pervasive, in particular for those involving needles and blood, such as injections and blood donations. Therefore, assessment and detection of anxiety before and during these procedures is critical for developing timely interventions for the at-risk population, and thereby increasing the panel of potential blood donors. The Injection Phobia Scale-Anxiety (IPS-Anx) was an 18 item questionnaire for estimating anxiety related to blood and needles; however, it had never been used among blood donors. The measures were translated and tested during a pre-pilot phase (Study 1). During Study 2 (n = 344) and 3 (n = 370), the model of measurement of IPS-IT-Anx was evaluated by exploratory factor analysis and confirmatory factor analysis. Test-retest stability, convergent validity, and reliability of measures were assessed during Study 4 (n = 243). Finally, the scores from participants in the different studies were pooled (Study 5; n = 957) in order to test whether the factor structure showed multigroup invariance, and to evaluate whether IPS-IT-Anx scores were associated with blood donation. The overall results of the statistical analysis supported a 12-item measurement model comprising the two original dimensions, distal and contact fear, of the IPS-IT-Anx. The findings of the study supported IPS-IT-Anx, suggesting it had excellent psychometric properties and was suitability for each clinical research uses focused on the assessment of blood-injection anxiety.

Most studies on gender and psychosis have focused on gender differences at illness onset or on the long-term outcome, whereas little is known about the impact of gender on the first years after psychosis onset. A total of 185 first episode psychosis (FEP) patients were followed for 5 years after psychosis onset, and gender differences were explored in psychopathology (PANSS), needs for care (CAN), and insight (SAI-E). Male patients showed more negative symptoms than females over time, whereas female patients showed higher levels of depressive symptoms than males throughout the study period. In addition, female patients presented more functioning unmet needs for care, but higher levels of insight into illness than males. Therapy and rehabilitative programs for FEP patients should be gender-targeted, as gender has proved to impact on psychopathology, needs for care, and insight in the very first years following psychosis onset.