The interplay between risk and protective factors during the initial height of the COVID-19 crisis in Italy: The role of risk aversion and intolerance of ambiguity on distress.

The present study aimed to test a model of relations to ascertain the determinants of distress caused by lockdown for COVID-19. It was hypothesized that the exposure to the COVID-19 increased distress directly and through the mediation of worry, health-related information seeking, and perception of the utility of the lockdown. It was also expected that higher levels of ambiguity intolerance corresponded to higher distress directly and through the mediation of worry, health information seeking behaviors, and perceived utility of the lockdown. Finally, it was expected that risk aversion positively influenced distress directly and through the increasing of worry, health-related information seeking behavior, and more positive perception of the utility of the lockdown The study was conducted in Italy during the mandatory lockdown for COVID-19 pandemic on 240 individuals (age range 18-76). Data recruitment was conducted via snowball sampling. COVID-19 exposure was positively associated with worry and health-related information seeking. Risk-aversion was positively associated with health-related information seeking and perceived utility of the lockdown to contain the spread of the virus. Worry and health-related information seeking were positively associated with distress, whereas the perceived utility of the lockdown was negatively associated with distress. Intolerance for the ambiguity was directly linked to distress with a positive sign. Findings suggest that risk aversion represents both a risk factor and a protective factor, based on what kind of variable mediates the relationship with distress, and that the intolerance to the ambiguity is a risk factor that busters distress.

Interpersonal trust in doctor-patient relation: Evidence from dyadic analysis and association with quality of dyadic communication.

RATIONALE: Although they form a dyadic relationship, doctor's and patient's levels of trust in the other have usually been investigated separately. As members of dyadic relationships, they influence each other's behaviors and are interdependent because they share a past history and eventually a common future. OBJECTIVES: The aim of this paper was to examine the composition of trust in doctor-patients relationship and estimate its association with quality of doctor's communication. One-With-Many analyses (OWM) were used to examine the composition of trust variance into "doctor and patient effects", "relationship effects", and "reciprocity effects," taking into account the interdependence of the data. METHOD: Twelve General Practitioners (GPs; Mage = 54.16, SD = 12.28, 8 men) and 189 of their patients (Mage = 47.48, SD = 9.88, 62% women) took part in the study. GPs and their patients completed postconsultation questionnaires on trust and quality of communication. RESULTS: The findings revealed that "doctor" and "patient" effects were significant. However, the most important part of the variance was attributable to the relationship and reciprocity effects, meaning that if a doctor reported high trust in a particular patient, then the patient reported a similarly high level of trust. Higher quality of communication was positively associated to those relationship effects of trust. CONCLUSIONS: Our study stresses the importance to investigate trust in doctor-patients relationship as a dyadic and interdependent phenomenon applying appropriate methodological design and analysis. Convergence between doctor's and patients' perceptions of their relationship may enhance trust more than conventional intervention and may ultimately contribute to better health outcomes.

A case of suicide by double gunshot wounds to the head: the ability to act after the first shot.

A single gunshot (or multiple) does (do) not necessarily lead to immediate loss of consciousness or rapid neurological deficits, so the victim may be able to repeatedly pull the trigger before achieving the lethal effect. Despite multiple gunshot wounds can lead to the suspicious participation of other person to the death of the victim, in the medico-legal literature suicides with multiple gunshot wounds are reported, demonstrating the ability of the victim to act after two or more gunshots. In this case, a 47-years-old man was found dead in a pool of blood in the kitchen of his house. According to findings and analysis, the victim modified a single-shot, pneumatic toy gun branded "Condor" Cal. 7 mm (a gun that is made mainly with "ZAMAK" zinc-based alloy, designed to shoot one soft-polymer bullet at a time, with an initial kinetic energy lower than 1 Joule) into an improvised firearm weapon. With this gun, the victim achieved shooting of two bullets into his head, both entering from the right temporal region of his head, with one stopped in the left occipital lobe and the other one in the left temporal lobe. His death was caused by cranium-meningo-encephalic gunshot wounds. The conditions supporting the hypothesis that the victim was able to fire two shots to his head before the onset of incapacitation (the type of bullets used, the location of injuries and their consequences) and the characteristics that typically allow to distinguish the manner of death (suicide vs homicide) were evaluated. Based on all the collected elements, it was possible to confirm that suicide was the manner of death. This case underlines the importance of evaluating all available elements (post-mortem imaging, autopsy and toxicological findings, ballistics and neuropathological evaluations) to distinguish suicide from homicide and to prevent incorrect conclusions.

Frailty and resilience in an older population. The role of resilience during rehabilitation after orthopedic surgery in geriatric patients with multiple comorbidities.

Hip fracture is common in the elderly and it is usually associated with comorbidities and physiological changes which may have an impact on functioning and quality of life. The concept of resilience may explain why this impact varies among patients. The aim of this open, prospective cohort study was to explore the relationships between resilience, frailty and quality of life in orthopedic rehabilitation patients, and also to assess whether these factors might affect rehabilitation outcome. Eighty-one patients, older than 60 years, underwent a multidisciplinary assessment at the beginning and at the end of the rehabilitation period following orthopedic surgery to the lower limb. The assessments were performed using the Resilience Scale, the Multidimensional Prognostic Index (as a measure of frailty), the WHO Quality of Life-BRIEF, the Geriatric Depression Scale, and the Functional Independence Frailty and resilience in an older population. The role of resilience during rehabilitation after orthopedic surgery in geriatric patients with multiple comorbidities Measure (as a measure of the rehabilitation outcome). A negative correlation between disability and resilience emerged and this association interacted with frailty level. We also found that resilience and quality of life are positive predictors of functional status at discharge.

Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience.

PURPOSE: The aim of this study was to analyse our 8 years of experience with endovascular treatment of visceral aneurysms and pseudoaneurysms. MATERIALS AND METHODS: From January 2002 to September 2009, we used an endovascular approach to treat 30 patients (22 men, eight women) affected by aneurysm (n=18) or pseudoaneurysm (n=13) of the splenic (n=11), hepatic (n=6), renal (n=5), pancreaticoduodenal (n=3), left gastric (n=2), gastroduodenal (n=1), rectal (n=1) or middle colic (n=1) arteries and the coeliac axis (n=1). Of these, 26/31 were treated with metal coils, 3/31 with Cardiatis multilayer stent, 1/31 with a coated stent and 1/31 with coils and Amplatzer plug. Procedures were performed electively in 10/30 cases and during haemorrhage in 20/30 cases. Follow-up was performed clinically (cessation of bleeding) and at 1, 6 and 12 months by colour-Doppler ultrasound (CDUS) and computed tomography (CT) angiography. RESULTS: In 31/31 aneurysms and pseudoaneurysms we obtained immediate exclusion. In four patients with aneurysm and in four with pseudoaneurysm, parenchymal ischaemia occurred; one was treated with surgical splenectomy. One patient with pseudoaneurysm of the coeliac axis died 10 days later because of new bleeding. During follow-up, all aneurysms and pseudoaneurysms remained excluded. CONCLUSIONS: Percutaneous treatment is effective and safe, with a small number of complications, especially when compared with traditional surgery.

Accessing source information in analogical problem-solving.

Several studies showed that people presented with source information fail to apply it to an analogous target problem unless they are instructed to use the source. Seven experiments were carried out to assess whether such a lack of spontaneous transfer occurs because individuals do not activate the source during the target task or because they do not realize the source-target relationship. Experiment 1 compared a condition in which the source was activated with no cue about the source-target connection to conditions in which subjects were informed about this connection. Results suggested that the lack of spontaneous transfer does not depend on failure in activating source information. Experiments 2, 3, and 4 were devised to falsify this finding by activating the source closer and closer to the target and by focusing participants' attention toward the relevant aspects of the source. Experiments 5, 6, and 7 were aimed at stressing source-target correspondences by introducing surface similarities. All experiments showed that the mere activation of the source does not facilitate analogical transfer. Results suggested that two processes should be distinguished in the access phase of analogical problem-solving: Source retrieval and identification of the source-target connection.

Suggesting strategies improves creative visual synthesis.

An experiment assessed whether a figural or an interpretative strategy can enhance creative visual synthesis. 45 undergraduates were presented a set of simple figures and asked to imagine combining them to obtain a whole pattern corresponding to a creative product. In the figurative condition participants were instructed to combine figures in unusual ways; in the interpretative condition they were induced to look for unusual meanings embedded in the combinations; in the control condition no strategy was suggested. Results showed that certain strategies induced a more flexible visual synthesis.

Metacognitive knowledge about problem-solving methods.

BACKGROUND: The effective application of a problem-solving method requires the knowledge of what task is relevant, what the abilities involved are and how much effort is needed. However, as yet too little is known about these metacognitive representations. AIM: This study was aimed at describing beliefs about problem-solving methods and at assessing whether they vary according to the kind of method and of problem and are modified by psychological courses attended. SAMPLE: Forty-six Italian undergraduates in psychology and 37 in non-psychological disciplines. METHODS: Participants had to rate how frequently each of five problem-solving methods (free production, analogy, step-by-step analysis, visualisation and combining) is employed and how effective and easy each one is to apply. Ratings were requested for interpersonal, practical and study problems. Participants were also asked to identify which abilities they thought would be involved in each method. RESULTS: According to students' ratings, the most frequently used problem-solving method was analogy, which was also considered the easiest method to apply, whereas step-by-step analysis and combining were considered the most difficult. Problem-solving techniques were perceived as being relevant above all for practical problems, whereas they were conceived as less suitable for interpersonal problems. For study problems the most relevant strategy was step-by-step analysis. Students were aware of the abilities relevant to each problem-solving method. CONCLUSIONS: Undergraduates both in psychology and non-psychological disciplines can identify some critical features in the methods used to solve problems, even though some misconceptions emerged. Since metacognition plays a causal role in problem-solving, trainers should take into account trainees' folk representations of problem-solving strategies.

The Verbalizer-Visualizer Questionnaire: a review.

The psychometric properties of Richardson's 1977 Verbalizer-Visualizer Questionnaire have been studied by analyzing papers in which this questionnaire was employed. Such review showed that the Verbalizer-Visualizer Questionnaire does not measure a unidimensional construct and does not predict the actual use of mental imagery in thinking. Further, a lack of long-term reliability of the questionnaire emerged. In conclusion, use of the questionnaire to assess the verbal-visual cognitive style appears questionable.

Creative synthesis of visual images is not associated with individual differences.

50 undergraduates were tested on a mental synthesis task aimed at producing creative visual patterns and were administered three questionnaires measuring imagery vividness and control. Analysis did not support a relationship between scores on visual synthesis and imagery and showed that neither kind of score was influenced by sex and studies attended.

Representation of mental imagery functions.

A questionnaire was administered to 250 undergraduates to study their conceptions about the efficacy of mental images in thinking. Analysis showed that subjects rated differently the usefulness of visual imagery according to the kind of content rather than the mental process involved.

Solution of an insight problem at different age levels.

The purpose was to study performance on an insight problem by 3- to 25-yr.-olds. A task involving restructuring and requiring two wooden blocks be fitted together to form a tetrahedron was presented to five groups of 20 subjects each from kindergarten, primary school, secondary school, high school, and a university. The frequencies of solvers within each group increased from the first age group to the third but then remained constant. Solution times and frequencies of solutions attempted were not significantly different among the five groups. Perhaps insight does not follow the same developmental trend as other thinking processes.

Undergraduates' conceptions of cognitive functions of mental imagery.

A questionnaire was administered to 42 undergraduates to study what they thought about the role of mental images in memorizing, problem-solving, musing, and everyday-life activities. Analysis showed that, according to students' conceptions, imagery is more useful in undirected than in directed thinking and that the efficacy of visual images is rated higher when they are employed to represent mentally concrete than abstract material.

Mental visualization before and after problem presentation: a comparison.

Three experiments were carried out to study the effects on problem solving of visualization when subjects (secondary-school students and undergraduates) were instructed to generate mental images before the problem was presented and when they received such a hint after being given the problem. In each experiment an arithmetic, a geometric, and a practical problem were presented in three different conditions, a control condition, an "imagery-before" condition, and an "imagery-after" condition. Analysis showed that, in general, the "imagery-after" task helps subjects to overcome the misleading or fixating tendencies which interfere with problem solution; in contrast, the "imagery-before" task may enhance such tendencies.

Effects of tryptophan depletion on Poggendorff illusion, corner Poggendorff illusion, and attention.

The effects of a tryptophan-free amino acid mixture on Poggendorff illusion, corner Poggendorff illusion, and attention were investigated with 12 male subjects who ingested either a balanced amino acid mixture or a tryptophan-free mixture, the latter known to cause a marked depletion of brain tryptophan and serotonin. No significant difference between the two mixtures on the perceptual illusions was found.

An increase in strength of tilt aftereffect associated with tryptophan depletion.

The effects of a tryptophan-free amino acid mixture on tilt aftereffect, movement aftereffect, and the Mueller-Lyer illusion were studied. 12 male subjects ingested either a balanced amino acid mixture or a tryptophan-free mixture which causes a marked depletion of brain tryptophan and serotonin. The tryptophan-free mixture significantly increased the strength of tilt aftereffect but had no effect on movement aftereffect or the Mueller-Lyer illusion. These results were discussed with reference to the pharmacological activity of serotonin and its influence on the strength of lateral inhibition in mammalian brains.