The Role of Preoperative Opioid Use in Foot and Ankle Surgery: A Systematic Review.

Prescription opioids, particularly for treating musculoskeletal pain, are a significant contributor to the opioid epidemic in North America. There is also evidence to suggest that chronic use of opioids is associated with poor outcomes after orthopedic surgery. However, whether this association is relevant in foot and ankle surgery is still unclear. Accordingly, a systematic review of the literature was undertaken to assess the impact of preoperative opioid use in patients undergoing foot and ankle surgery concerning postoperative pain, complications, and postoperative opioid dependence. Four databases, including EMBASE, MEDLINE, PubMed, and CINAHL, were searched to March 2022 for studies reporting preoperative opioid use and its effect on postoperative outcomes or opioid use after foot and ankle surgery. A total of 22,092 patients were included in the final synthesis of 8 studies. Most of which were level 3 evidence (5 studies). Around 18% of the patients used opioids preoperatively. Preoperative opioid use was associated with more quantities and prolonged use of opioids postoperatively. Two studies showed an increased risk of complications postoperatively in patients who used opioids preoperatively compared to the nonopioid group. Preoperative opioid use in patients undergoing foot and ankle surgeries is associated with increased and prolonged use of opioids postoperatively and may therefore predict the potential for misuse.

The Use of Voice Assistant for Psychological Assessment Elicits Empathy and Engagement While Maintaining Good Psychometric Properties.

This study aimed to use the Alexa vocal assistant as an administerer of psychometric tests, assessing the efficiency and validity of this measurement. A total of 300 participants were administered the Interpersonal Reactivity Index (IRI). After a week, the administration was repeated, but the participants were randomly divided into groups of 100 participants each. In the first, the test was administered by means of a paper version; in the second, the questionnaire was read to the participants in person, and the operator contemporaneously recorded the answers declared by the participants; in the third group, the questionnaire was directly administered by the Alexa voice device, after specific reprogramming. The third group was also administered, as a post-session survey, the Engagement and Perceptions of the Bot Scale (EPVS), a short version of the Communication Styles Inventory (CSI), the Marlowe-Crowne Social Desirability Scale (MCSDS), and an additional six items to measure degrees of concentration, ease, and perceived pressure at the beginning and at the end of the administration. The results confirmed that the IRI did keep measurement invariance within the three conditions. The administration through vocal assistant showed an empathic activation effect significantly superior to the conditions of pencil-paper and operator-in-presence. The results indicated an engagement and positive evaluation of the interactive experience, with reported perceptions of closeness, warmth, competence, and human-likeness associated with higher values of empathetic activation and lower values of personal discomfort.

Effects of Cognitive Appraisals on Perceived Self-Efficacy and Distress during the COVID-19 Lockdown: An Empirical Analysis Based on Structural Equation Modeling.

During the COVID-19 lockdown, individuals and households had to responsibly manage the difficulties and problems caused by the restrictions on their mobility, such as the interruptions to work schedules, insecure food supplies, and the procurement of services and health care. The perceptions of risk as well as the fear of disease were strongly linked to worry, defined as a sequence of thoughts that evoke negative emotions and elevated levels of anxiety and distress. This study evaluated how different cognitive appraisals of an individual's sources of worry could influence their perceived self-efficacy and directly or indirectly moderate their perceived general distress. A sample of 544 participants completed a survey that included questions based on the generalized self-efficacy scale, the sources of concern during the epidemic, the cognitive appraisal scale in emergency, and perceived discomfort. Subsequently, a structural-equation-modeling (SEM) analysis was performed to test the moderating role of cognitive appraisals and perceived self-efficacy on participants' overall distress during a lockdown. Overall, the model reported acceptable fit values and confirmed the hypotheses of the study. An individual's worries activated either a dysfunctional threat appraisal, which prompted a fear-and-closure response that then increased their overall state of distress; or two other functional appraisals (i.e., adaptive or supportive) that contributed to significantly improving the individual's self-efficacy. Higher self-efficacy was shown to be associated with lower levels of perceived distress. For the purposes of prevention and distress containment, it would be appropriate to promote psycho-educational interventions that promote the adoption of appraisal strategies that are functional and beneficial for perceived self-efficacy.

Assessing Decentering Capacity in Athletes: A Moderated Mediation Model.

Decentering has received more attention in sports literature as a self-regulating skill capable of significantly limiting episodes of mental block in competitive situations. This contribution depicts a comparative study conducted with 375 Italian national and international athletes. The objective was to evaluate athletes' decentralization skills across different sports and levels of competition and test a mediation model of decentering in sports with coping and emotional balance variables. Pearson bivariate correlations, linear hierarchical regression, and simple mediation analysis were conducted for all main measures (The Decentering Sport Scale, The Emotion Regulation Questionnaire, and The Coping Orientations to Problems Experienced). Outputs reported significant associations with emotional regulation and coping styles. Mediation analysis confirmed the central mediating role of decentering capacity which has indirect effects on both the coping ability of problem solving (z-value = 2.986; p = 0.003) and cognitive reappraisal (z-value = 2.779; p = 0.005). Decentering acts as a mediator between an athlete's positive attitude, problem-orientation ability, and management of emotions in competition through cognitive reappraisal. The study highlights the significance of evaluating and enhancing decentralization skills in order to establish specific action mechanisms, which are crucial for both peak performance and the athlete's health.

Validation study of the Italian brief version of the multidimensional jealousy scale: Psychometric properties, measurement invariance across gender, and convergent validity.

Introduction: The multidimensional jealousy scale (MJS) is among the most internationally used instruments for the assessment of jealousy in its three dimensions: cognitive, emotional, and behavioral. This study aimed to replicate the Italian validation process of the shortened MJS in order to confirm its psychometric properties and measurement invariance across gender. Materials and methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted in a large sample of adults (n = 2,928). To reliably estimate mean differences across gender, the measurement invariance of the scale was first established by means of CFA. Convergent validity was than tested by administrating the tool to a convenient sample (n = 304). Results: A 15-item version of the Italian MJS was retained in its three-factor structure. The tool showed good fit with both the CFA (χ2 = 211.827, CFI = 0.969, TLI = 0.959, RMSEA = 0.047, RMSEA 90% CI = 0.039-0.055) and the results confirmed the strong measurement invariance of the MJS across gender. The internal consistency measures were found to be fully satisfactory. Predictive associations with constructs such as avoidance and anxiety referred to attachment in relationships (ECR-R), obsessive jealousy, depressive jealousy, jealousy associated with separation anxiety, paranoid jealousy (QUEGE), and basic self-esteem (BSE) were confirmed. Discussion: The MJS is particularly apt to collect information quickly and efficiently about jealousy in a current relationship. The multidimensional and brief structure makes it particularly suitable for preliminary screening, couple therapy assessment, and research purposes.

The use of the Decision Regret Scale in non-clinical contexts.

The Decision Regret Scale (DRS) was assessed for its psychometric qualities in measuring decision regret in ordinary life scenarios. Although the scale has typically been used with patients and in the context of medical decision-making in earlier studies, this contribution shows that the instrument may have a variety of uses, retaining excellent metric properties even in non-medical contexts. The tool showed good fits with both the CFA and the gender Measurement Invariance. A non-probabilistic selection of 2,534 Italian university students was conducted. The internal consistency measures were found to be completely appropriate. Correlations with the General Decision-Making Style (GDMS) and Scale of Regulatory Modes were used to check for convergent validity (SRM). Convergence analysis showed that participants with higher regret scores were those who favored a rational decision-making style, while lower regret scores correlated with avoidant and spontaneous styles. With regard to the regulatory modes, the relationship between regret and locomotion was positive. Overall, the directions of association point to an interesting predictive measure of a person's decision-making and self-regulatory orientation through the evaluation of regret using the DRS. The excellent psychometric properties found foreshadow a reliable use in various contexts where knowledge of post-decisional attitude becomes important: school, university, professional orientation, marketing studies, relationship choices, as well as for use in research.

Psychometric properties and measurement invariance across gender of the Italian version of the tempest self-regulation questionnaire for eating adapted for young adults.

The prevalence of overweight and obesity in young adults has increased dramatically in recent decades. The unhealthy eating habits that develop at this time can often lead to negative health consequences in the future. It is therefore important to learn about self-regulation and self-control strategies and help young adults to have healthy eating behaviours. This study aims to present an Italian version of the Tempest Self-Regulation Questionnaire for Eating (TESQ-E) adapted for young adults. The instrument assesses self-regulation and self-control strategies to counteract the desire and temptation to eat unhealthy food and to choose healthy foods. A total of 645 students (271 males and 374 females with an average age of 24.82 and SD = 4.34) took part in the study. The results of the confirmatory factor analysis supported the six first-order factors model concerning specific self-regulation strategies and a higher-order structure of the TESQ-E [χ2 (152) = 336.480, p < 0.001; CFI = 0.95; RMSEA = 0.04; SRMR = 0.04]: three correlated second-order factors (addressing the temptation directly, addressing the psychological meaning of temptation, and addressing the goal directly) and one-third-order factor (self-regulatory competence). The results also confirmed the strong measurement invariance of the TESQ-E across gender. To have reliable comparisons across males and females, the latent mean differences tests were performed on the six specific self-regulation strategies. The analysis showed that females appear to prefer strategies that directly address the goal by expressing explicit intentions or plans to eat in a healthy way. Convergence validity was tested through correlations with Eating-Self-Efficacy Brief Scale (ESEBS), Emotional Eating Scale (EES), Scale of Attitudes towards Healthy Eating (SAHE), and Body Mass Index (BMI). In conclusion, the TESQ-E appears to be a psychometrically sound questionnaire that can be effectively used with young adults to measure self-regulation strategies in eating in order to plan personalised interventions for the prevention and control of the metabolic syndrome, and to reduce a wide range of diet-related diseases.

Impulsivity and Depressive Brooding in Internet Addiction: A Study With a Sample of Italian Adolescents During COVID-19 Lockdown.

This contribution presents a study conducted on a sample of Italian adolescents (n = 411) in the period of the first COVID-19 lockdown. The study investigated the role and predictive weight of the impulsivity and depressive brooding variables on Internet addiction, using a hierarchical regression analysis. The participants were administered the Uso-Abuso e Dipendenza da Internet [Internet Use-Abuse and Addiction] (UADI-2), the Barratt Impulsiveness Scale-11 (BIS-11), and the Ruminative Response Scale (RRS). In terms of percentage distribution, 28% of the participants were in the full dependency range, while 34.7% demonstrated Internet abuse behavior. The results highlighted not only the predictive value of impulsiveness (ß = 0.323) and ruminative thinking (ß = 0.258), but also the role of gender (ß = -0.205) on Internet addiction. Thus, male participants showed higher levels of Internet addiction, with higher scores on impulsiveness and brooding way of thinking. The study shows that the issue in question is significantly present among adolescents; in addition, not only targeted awareness programmes but also psycho-educational and clinical interventions to promote greater emotional and cognitive control would be necessary as a preventive and mitigating measure. Psychological interventions can help increase self-awareness, develop emotional regulation and impulse control, and correct maladaptive cognitions which in adolescents are mostly driven by a ruminative cognitive style.

A Psychoeducational Intervention in Prenatal Classes: Positive Effects on Anxiety, Self-Efficacy, and Temporal Focus in Birth Attendants.

BACKGROUND: Previous studies have reported associations between high maternal anxiety, temporal perceptions during pregnancy, and a poor sense of self-efficacy. One type of anxiety expecting mothers experience is associated with childbirth, which previous studies have shown can be reduced by antenatal training. Recent contributions have pointed out that current prenatal courses, while providing important and useful knowledge, do not devote sufficient content to the mental health of the parturient and to the psychological issues that can arise before and after the birth. METHODS: In total, 80 pregnant women were provided with a special prepartum course in which ample space was devoted to topics such as maternal mental health, parenting skills and couple relationship, relaxation techniques, and assertiveness. Perception of threat, state anxiety, temporal focus, needs and expectations, and self-efficacy were assessed by comparing this psychoeducational intervention group with a traditional antenatal course group (n = 80), and a control group (n = 80). Two-way mixed ANOVAS (3 × 2) were performed for each dependent variable considered, including the time variable (pre-course-post-course) as a factor within the participants and the group variable as a factor between the subjects. RESULTS: The psychoeducational intervention actually induced significant and positive changes primarily on four dimensions: state anxiety, perceived self-efficacy, the need for information, and reassurance of the pregnant women who participated in this trial. CONCLUSIONS: The study suggests improving the quality of prenatal classes by paying particular attention to the content and communication used within the group, in order to gratify at the highest level, the need for information, reassurance, and sharing that characterize the parturient's request for support. The evidence collected recommends further replicating the intervention protocol described in order to improve the psychophysical well-being of women in a delicate moment such as pregnancy and preparation for childbirth, but especially in terms of the prevention and containment of the risks of psychological distress that currently affect a significant number of women after childbirth.

Intention to Screen for Hepatitis C Among University Students: Influence of Different Communicative Scenarios.

This study aimed to evaluate the influence of different narrative scenarios regarding students' intentions to undergo diagnostic screening for hepatitis C, and whether gender identification with the characters of the scenario could influence the students' intentions to undergo a medical test. A sample of 600 participants was administered three narrative scenarios with different frames (positive, negative, and ambivalent), including two gender options (male and female) for the main character of the story. A statistically significant three-way interaction between scenario, gender identification, and time resulted. There were significant simple main effects on the intention to have a diagnostic test for hepatitis C for the scenarios with the protagonist of the same gender as the participant and after the administration of the negative scenario. The use of a negative scenario with the same gender character was always more effective than the use of a positive framed scenario, even though there was a high level of knowledge regarding the disease. Personal diagnostic testing was not directly associated with knowledge regarding the infection. The findings of this study can ultimately help policymakers develop communication campaigns adapted to target populations such as college students, in order to raise awareness of the risk, promote prevention and behavioral change, and encourage medical screening.

A Mediating Model of Emotional Balance and Procrastination on Academic Performance.

Deficit in the management of time continues to be an important difficulty students are faced with. The present work aimed to test the hypothesis that self-regulation is the major predictor of academic performance and that this effect can be mediated both by the student's emotional regulation and his propensity for procrastination. Participants were 450 university students who were administered MPP and AIP. The procedures involved the administration of instruments and the collection of average exam grades as a measure of academic performance. The effect of a specific component of self-regulation on academic performance, namely action orientation, was significant, while procrastination showed a limiting effect on the performative quality of the student. The model confirmed the mediation role of emotional balance on the effect that action orientation exerts on procrastination, and the mediation of procrastination in the relationship between action orientation and Academic Performance. Results of the study suggest focusing on student support and on prevention of procrastinating behavior through programs that enhance first of all student's proactive attitude, planning skills, self-monitoring and effective/efficient time management, and secondly, emotional awareness and regulation of emotional response in situations of stress and performance anxiety.

Development and Preliminary Italian Validation of the Emergency Response and Psychological Adjustment Scale.

Evaluating the personal adaptation response to the emergency situations is very important for the prevention of mental distress, for the activation of network and community synergies and for the planning and implementation of appropriate psycho-social interventions. So far there are no short tools for the overall assessment of cognitive, emotional and behavioral responses of psychological adaptation to the emergency in the psychometric panorama. The Emergency Response and Psychological Adjustment Scale (ERPAS) was administered to a sample of 1,088 participants, while the concurrent validity was tested through a second administration to 600 participants along with the GSE (Generalized Self-Efficacy Scale) and the BDI-II (Beck Depression Inventory-II). Confirmatory factor analysis bore out a five-factor solution (including 18 items) with good fit indices of adaptation to data, χ2/df = 1.440, RMSEA = 0.028, RMSEA 90% CI = 0.018-0.038, GFI = 0.996, AGFI = 0.959, CFI = 0.982, and NFI = 0.944. Evidence of convergent validity was provided by the significant correlations with variables such as cognitive and somatic depression, and perceived general self-efficacy. The analyses also showed a strong invariance across gender. The ERPAS tool prefigures application during the assessment in multiple emergency contexts (e.g. earthquakes, floods, pandemics, terrorist attacks, war events, major accidents, major fires). This validation study of the ERPAS has shown that this version is a reliable and valid measurement for assessing people's modes of personal response (cognitive, emotional, behavioral) in emergency contexts.

Perception of Risk, Self-Efficacy and Social Trust during the Diffusion of Covid-19 in Italy.

The Coronavirus pandemic has affected the lives of people all over the world. The perception of risk and people's consequent behaviour during a pandemic are very complex and are affected by multiple cultural and psychological factors. The aim of this study was to investigate the change in risk perception, perceived self-efficacy and the perceived trust in the behaviour of others, the decisions of health authorities and government provisions, as well as the variation of self-restraint behaviours during the spread of the Covid-19 epidemic in Italy. We used a convenience sample of 707 university students (Mage = 22.99; SD = 4.01) from a central area of Italy. Participants freely joined the research by answering an online questionnaire between February and March 2020. Three time intervals defined by the progressive containment measures implemented by the Italian Government were considered. Main outcome measures were the Generalized Self-Efficacy Scale, the Risk Perception Index, the Index of Self-restraint Behaviours, and Institutional and Interpersonal Trust Measures. Results confirmed that significant changes in the time progression have occurred in the perception of risk, in the perception of individual self-efficacy, in the value attributed to social responsibility, in interpersonal trust and in trust in health authorities. The study also identified the participants' personality traits and locus of control as predictors (positive and negative) of perceived self-efficacy and tested a mediation model of trust on the effect of risk perception on self-restraint intentions.

Validation study of the Italian version of Temporal Focus Scale: psychometric properties and convergent validity.

BACKGROUND: Over the last decade, international research has produced a large number of studies that have stressed the importance of temporal focus in various aspects of the lives of individuals, groups and organizations. This first Italian validation study of the Temporal Focus Scale (TFS) has shown a reliable measurement to assess the tendency of individuals to characteristically think about different periods of their lives. METHODS: TFS/I was administered to a sample of 1458 participants, while three other convenience samples (N1 = 453; N2 = 544; N3 = 168) were used for convergent validity testing. RESULTS: Confirmatory factor analysis confirmed a three-factor solution (including 10 items) with good indices of fit to data, e.g., χ2 = 49.533, CFI = 0.992, TLI = 0.986, RMSEA = 0.034, RMSEA 90% CI .018-.048. Convergent validity assessment confirmed predictive indications with variables such as life satisfaction, optimistic/pessimistic orientation, perceived general self-efficacy, self-regulatory modes, anxiety, depression. CONCLUSION: The temporal focus has proven to be a significant feature associated with various aspects of both well-being and personal discomfort. By virtue of its good psychometric properties, the TFS can be an integrative tool along with others for a better evaluation of the person's profile in different contexts such as education, coaching, psychotherapy, counseling and career guidance.

Metric Goodness and Measurement Invariance of the Italian Brief Version of Interpersonal Reactivity Index: A Study With Young Adults.

The Interpersonal Reactivity Index (IRI) is a widely used multidimensional measure to assess empathy across four main dimensions: perspective taking (PT) empathic concern (EC) personal distress (PD) fantasy (F). This study aimed to replicate the Italian validation process of the shortened IRI (Interpersonal Reactivity Index) scale in order to confirm its psychometric properties with a sample of young adults. The Gender Measurement Invariance of empathy in this age group was also an objective of the work in order to increase the data on this aspect. A total of 683 Italian university students participated in a non-probabilistic sampling. The 16-item version was confirmed in its four-factor structure but with changes to some items. The model showed good fits with both the CFA and the gender Measurement Invariance. The internal consistency measures were found to be fully satisfactory. Convergent validity was tested by the correlations with the Prosocialness Scale for Adults and The Toronto Alexithymia Scale-20. As hypothesized the measure proved good convergent validity with Prosocialness, i.e., the willingness to assist, help, share, care and empathy with others, and a relevant inverse association with the External Oriented Thinking, characterizing individuals with emotionally poor thinking. This research provided additional evidence for a link between alexithymia and poor empathic abilities in young adults.

The Principal at Risk: Stress and Organizing Mindfulness in the School Context.

Background: In recent years the role of school principals is becoming increasingly complex and responsible. Methods: This study was voluntarily attended by 419 Italian school principals who were administered the Psychological Stress Measurement (MSP), Mindfulness Organizing Scale (MOS), Polychronic-Monochronic Tendency Scale (PMTS), and the Scale of Emotions at Work (SEW). Results: The study has produced a path analysis model in which the relationships between the main predictors of principals' work discomfort were explained. The effect of depressive anxiety on perceived discomfort (ß = 0.517) found a protective mediator in the mindfulness component that recognizes the sharing as a fundamental operational tool (ß = -0.206), while an increasing sense of effort and confusion could significantly amplify the experience of psychological discomfort associated with the exercise of school leadership (ß = 0.254). Conclusions: The model developed in this study suggests that focusing on organizing mindfulness can be a valuable guideline for interventions.

Psychometric Properties and a Preliminary Validation Study of the Italian Brief Version of the Communication Styles Inventory (CSI-B/I).

People will typically develop a communication style that tends to be coherent with their own fundamental personality traits. The current debate on communication style acknowledges the construct of adaptive behavior as an appropriate area where to include both the strictly personal aspects and social learning and cultural assimilation, which translate into communicative style as a specific form of adaptation integrating the behavioral and personality perspectives. Due to the lack of instruments in the Italian psychometric scenario to assess communication styles, the present study included the translation and validation of the Italian short version of the Communication Styles Inventory (CSI-B/I). METHODS: The CSI-B/I was administered to a sample of 1,044 participants, while the concurrent validity was tested through a second administration to 518 participants along with the MPP (Multidimensional Personality Profile). RESULTS: Confirmatory factor analysis bore out a three-factor solution (including 18 items) with good indices of adaptation to data, e.g., χ2/df = 1.251, RMSEA = 0.027, RMSEA 90% CI = 0.008-0.040, GFI = 0.958, AGFI = 0.937, CFI = 0.983 and NFI = 0.922. The CSI-B/I allows to measure three main dimensions of the communication style: impression manipulativeness; emotionality; expressiveness. Internal consistency reliability and significant correlations with the MPP supported the concurrent validity of the tool. CONCLUSION: By virtue of its good psychometric properties, CSI-B/I represents an important addition to the assessment in multiple contexts: companies, institutions, staff selection, individual and group profile analysis, coaching, psychotherapy, counseling, career guidance.

Femoral head material loss at the head-neck junction in total hip arthroplasty: the effect of head size, stem material and stem offset.

INTRODUCTION: Material loss at the head-neck junction in total hip arthroplasty may cause adverse clinical symptoms and implant failure. The purpose of this study was to quantitatively examine the effects of head size, stem material and stem offset on material loss of the head-neck taper interface of a single trunnion design in retrieval implants of metal on polyethylene bearing surfaces. METHODS: A retrieval study was performed to identify all 28-mm and 32-mm femoral heads from a single implant/taper design implanted for >2 years. This included n = 56 of the 28-mm heads and n = 23 of the 32-mm heads. The 28-mm femoral heads were matched to 32-mm femoral heads based on time in vivo and head length. A coordinate measuring machine was used to determine maximum linear corrosion depth (MLD). Differences in MLD for head diameter, stem material, and stem offset were determined. RESULTS: There were no differences between groups for age, gender, BMI, or implantation time. There was no difference in MLD between 28 mm and 32 mm matched paired head diameters (p = 0.59). There was also no difference in MLD between titanium or cobalt-chromium stems (p = 0.79), and regular or high-offset stems (p = 0.95). CONCLUSION: There is no statistical difference in femoral head MLD at the head-neck junction in THA between 28-mm and 32-mm matched paired femoral heads, similar or mixed alloy coupled femoral head stem constructs, and regular or high offset stems.

The role of physical activity in the CKD setting.

A sedentary lifestyle contributes to the development of cardiovascular disease, hypertension, diabetes and probably cancer in the general population; this cluster of disease may be defined the diseasome of physical inactivity. Also in CKD/ESRD patients physical activity is strikingly low. As a result of growing evidence suggestive of cardiovascular benefit among the CKD population with exercise, the National Kidney Foundation recommended counseling by nephrologists to increase patients' levels of physical activity in their guideline about management of cardiovascular disease. Therefore, to maintain the well-being and functional capacity of renal patients attention should be directed toward maintaining strength and aerobic fitness as well as focusing on renal function and anemia or other comorbidities. All CKD/ESRD patients should be counseled and regularly encouraged by nephrology and dialysis staff to increase their level of physical activity.