Scientific evidence supporting the newly developed one-health labeling tool "Med-Index": an umbrella systematic review on health benefits of mediterranean diet principles and adherence in a planeterranean perspective.

BACKGROUND: Med-Index is a one-health front-of-pack (FOP) label, based on Mediterranean diet (MedDiet) principles, developed to summarize information about the nutritional properties and related-health benefits of any food as well as its sustainable production processes, and the associated food company's social responsibility parameters in a new "Planeterranean" perspective. Thus, Med-Index can be adopted in and by any European region and authority as well as worldwide; this is achieved by consumption and cooking of locally available and sourced foods that respect MedDiet principles, both in terms of healthy nutrition and sustainable production. The huge body of scientific evidence about the health benefits of the MedDiet model and principles requires a comprehensive framework to encompass the scientific reliability and robustness of this tool. A systematic review was carried out to examine the association between human health and adherence to MedDiet patterns upon which the "Med-Index" tool was subsequently developed. METHODS: MEDLINE and PubMed databases were searched for eligible publications from 1990 to April 2023. Systematic literature reviews, with or without meta-analysis, of clinical trials and observational studies were screened by two independent investigators for eligibility, data extraction, and quality assessment. English language and the time interval 1990-2023 were applied. A registry code CRD42023464807 was generated on PROSPERO and approved for this search protocol. The corrected covered area (CCA), calculated to quantify the degree of overlap between reviews, gave a slight overlap (CCA = 4%). RESULTS: A total of 84 systematic reviews out of 6681 screened records were selected. Eligible reviews included studies with predominantly observational designs (61/84, 72.6%%), of which 26/61 referenced studies of mixed observational and RCT designs, while 23/84 (27.4%) were RCT-only systematic reviews. Seventy-nine different entries were identified for health outcomes, clustered into 10 macro-categories, each reporting a statistically significant association with exposure to the MedDiet. Adherence to MedDiet was found to strongly benefit age-related chronic diseases (21.5%), neurological disorders (19%), and obesity-related metabolic features (12.65), followed by CVDs (11.4%), cancer (10.1%), diabetes (7.5%), liver health (6.3%), inflammation (5%), mortality (5%), and renal health (1.2%). The quality of the studies was moderate to high. CONCLUSION: In the context of a "Planeterranean" framework and perspective that can be adopted in any European region and worldwide, MedDiet represents a healthy and sustainable lifestyle model, able to prevent several diseases and reduce premature mortality. In addition, the availability of a FOP, such as Med-Index, might foster more conscious food choices among consumers, paying attention both to human and planetary health.

Vaccination as a social practice: towards a definition of personal, community, population, and organizational vaccine literacy.

BACKGROUND: A comprehensive and agreed-upon definition of vaccine literacy (VL) could support the understanding of vaccination and help policy-makers and individuals make informed decisions about vaccines. METHODS: To shed some light on this debate and provide clarity, a scoping review was conducted to collect, summarize, and analyse available definitions of VL. Based on the findings of the scoping review, a new and comprehensive definition was proposed by a panel of experts. RESULTS: Fifty-three articles were included, and two of them appeared to be the milestones around which the other definitions were grouped. The new definition proposed by the panel of experts included not only the personal perspective, but also the community, population, and organizational perspectives. Moreover, due to the increasing complexity of the social context with respect to the ability to navigate, understand, and use information and services, the definition of organizational vaccine literacy and the attributes of a vaccine literate healthcare organization have been proposed. CONCLUSION: The new definition can contribute to the overall paradigm of health literacy and its distinct component of vaccine literacy, possibly improving the implementation of public health strategies to allow vaccination to be understood as a social practice by the entire community. This study describes the conceptual foundations, the competencies, and the civic orientation to be considered when developing measurement tools devoted to assessing VL at the different levels and in different contexts.

Development and validation of the sitting balance assessment for spinal cord injury (SitBASCI).

STUDY DESIGN: Multicentric psychometric study. OBJECTIVES: The aim of this study is to introduce the development of the Sitting Balance Assessment for Spinal Cord Injury (SitBASCI) and assess its inter-rater reliability and internal consistency. SETTING: The study was developed among the three Spinal Units of San Bortolo Hospital in Vicenza, Niguarda Hospital in Milan and AOU Careggi in Florence. METHODS: SitBASCI is a 13-item scale developed to evaluate trunk control in individuals with SCI. Subjects were filmed while performing the 13 items of the scale. The videotapes were submitted to 25 examiners who evaluated patients' performances with the scale. The power of the study was estimated. The interclass correlational coefficient (ICC) was used to assess the inter-rater reliability of the examiner's evaluations regarding each item and the total. Cronbach's alpha was used to assess internal consistency of the scale and internal consistency of the scale on the eliminated item. RESULTS: The study showed to have a significant power. The inter-rater reliability for the total score was ptot = 0.997 (item's values were p = 0.876-0.998). The internal consistency of the scale was alpha = 0.925, while the internal consistency of the scale on the eliminated item was alpha = 0.912-0.930. CONCLUSION: SitBASCI had a high inter-rater reliability and internal consistency. Items had also good inter-rater reliability and item-total correlation. Therefore, SitBASCI could be proposed as a good and reliable instrument for Italian clinicians to evaluate sitting balance and trunk control in patient with SCI despite of aetiology and level of injury.

Biodanza as a Nonpharmacological Dance Movement-Based Treatment in Older People With Alzheimer's Disease: An Italian Pilot Study in 2 Tuscan Nursing Homes.

The aim of this pilot, feasibility study was to assess health improvements in 16 institutionalized older people with Alzheimer's disease, after the Biodanza intervention, a nonpharmacological dance movement-based treatment. Biodanza significantly decreased agitated and neuropsychiatric behaviors. Effectiveness studies will be performed in order to assess the implication of such interventions.

User-friendly system (a smartphone app) for reporting violent incidents in the Emergency Department: an Italian multicenter study.

BACKGROUND: Nurses, particularly emergency nurses, are among the health workers most exposed to workplace violence. Although reporting systems are increasingly used, under-reporting remains high. Recent studies suggest that the use of easy registration systems could facilitate violence reporting. OBJECTIVES: To verify if a friendly reporting system based on a Mobile-app can facilitate the reporting of violent episodes and reduce under-reporting. METHODS: Twenty emergency departments of five North and Central Italian regions participated in an interventional, multicentric, pre-post study to verify if a user-friendly reporting system based on a mobile app can facilitate the reporting of violent episodes and reduce under-reporting. RESULTS: Three hundred and eighty-four out of 754 potentially eligible nurses answered the short questionnaire at time T0, and 318 registered for the use of the app. One hundred and eighty-nine answered the questionnaire at time T1. The t-Test for Paired Samples, although with a low mean difference, shows a significant difference in the change in the frequency of the reporting of violent episodes. The correlational tests showed no significant differences in the subgroups divided by demographic and professional characteristics. The usability of the app was considered very high. CONCLUSIONS: The simplification of the reporting system and the preliminary acquisition of data on the characteristics of the ED and each nurse, can save time and facilitate the reporting, but technology alone is not enough to solve the under-reporting.

Can a user-friendly system improve reporting of workplace violence towards emergency nurses? Findings of a multicenter study.

BACKGROUND: Nurses, particularly emergency nurses, are among the health workers most exposed to workplace violence (WPV). Despite WPV recording systems are becoming more common, the under-reporting is still widespread. Studies suggest that the use of simple and easy registration systems could facilitate the reporting of violent events. AIM: To verify if a friendly reporting system based on a Mobile-app can facilitate the WPV reporting. METHODS: The University of Florence has developed an application for Android and iOs to report incidents of violence towards emergency nurses. Started from 5 February 2018 and ended on 17 March 2019 in 20 Italian emergency departments, our 6-month study involved the participation of 386 nurses enabled to use this mobile app. RESULTS: 189 participants answered the questionnaire at the beginning (time T0) and at the end (time T1) of the trial period. The questionnaire item about the frequency of reporting of violent events in the last 6 months was scored: 1 for "Yes, all", 2 for "Yes, some", 3 for "No, only informally", and 4 for "No, not at all". The answers obtained the following arithmetic mean values (M), standard deviation (SD) at time T0 and T1, respectively M = 2.65, SD = 0.972, and M = 2.26, SD = 0.864. The result of the Paired Samples t-Test returned a t=3.614, df= 99 CONCLUSIONS: This result indicates a statistically significant difference in the change in the propensity to report, even if for small values. NURSING IMPLICATIONS: The technology cannot solve the problem of underreporting alone. To solve this problem it is necessary to act on several front.

Negative interactions among nurses: An explorative study on lateral violence and bullying in nursing work settings.

BACKGROUND: Lateral violence and bullying affect nurses' professional and health status. Worldwide prevalence ranges from 1% to 87%. AIM: To investigate prevalence and risk factors of lateral violence and bullying among Italian nurse peers in different work settings, inside and outside hospitals. METHODS: Web survey using the 17-item "Negative Interactions Among Nurses Questionnaire." Emails were sent to 5,009 nurses in three Tuscan public health care institutions. RESULTS: Response rate was 18.6% (n = 930). Twenty-six respondents were removed as they reported working with no peer colleagues. Negative interactions were experienced by 35.8% (n = 324), 42.3% of whom (n = 137) were bullied. Psycho-physical consequences of negative interactions were reported by 59% (n = 191). Victims who thought of leaving nursing were 21.9% (n = 71). CONCLUSIONS: Lateral violence and bullying among nurses are consistently present in all studied settings. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers could play a crucial role in preventing negative interactions among nurses. Strategies could include continuing education programs to promote awareness of this problem; implementation of an anonymous reporting system for bullying; introduction of occupational psychologists in wards with larger numbers of reported negative interactions and bullying; and increasing changes in staff composition within shifts.

Prevalence of osteoporosis in the Italian population and main risk factors: results of BoneTour Campaign.

BACKGROUND: BoneTour is a campaign conducted throughout the Italian territory for the assessment of Italian people bone status and for the prevention of osteoporosis. METHODS: A total of 7305 sequential subjects of both sexes were screened, collecting clinical data through the FRAX™ questionnaire, and measuring heel bone stiffness by Quantitative Ultrasonography (QUS). The 10-year risk for hip and major osteoporotic fractures was calculated taking into account personal or family history of fragility fracture, smoking, alcohol abuse, rheumatoid arthritis, prolonged steroids assumption. Additional risk factors were evaluated, including early menopause, poor sunlight exposure, low dietary calcium intake, physical inactivity, number of pregnancies, months of lactation, tobacco cigarettes smoked per year, specific causes of secondary osteoporosis. Through a correlation study, the influence of each factor on the development of osteoporosis was analyzed. RESULTS: As many as 18 % of women suffer from osteoporosis, as defined by QUS T-score. The calculation of FRAX™ confirmed the weight of the already known risk factors. The correlation study revealed the significance of some additional factors, such as hyperthyroidism, nephrolithiasis, Crohn disease, ulcerative colitis, celiac disease, poor sun exposure, and oophorectomy before age 50. CONCLUSIONS: The high prevalence of secondary osteoporosis in the Italian population clearly indicates the importance of additional risk factors not yet included in the FRAX™ algorithm, for which preventive measures should be considered. Screening campaigns may allow both early diagnosis and access to treatment.

The first italian validation of the most widespread health literacy assessment tool: the Newest Vital Sign.

OBJECTIVE: This work represents the first attempt to validate, for the Italian population, the most widespread health literacy assessment tool: the Newest Vital Sign (NVS). DESIGN: The UK version of this tool was adapted for Italy using a translation/back-translation process. A web-based survey was then administered to a multidisciplinary panel of experts to assess its face validity. Finally, a preliminary study of construct validity was conducted, focusing on efficiency, comprehensibility, reliability, and sensitivity of the items of the test. For the evaluation of these dimensions we adopted Pearson's r correlation and calculated the average scores obtained for the subscales. RESULTS: Data analysis shows that the NVS-IT can be considered, under every aspect, an adequate tool for the assessment of individual health literacy grade level, given the optimal correlation among the experts' judgments and the average scores above the acceptability threshold. CONCLUSION: Our study aims to encourage use of the NVS for the Italian population and, furthermore, introduce a scientific approach to health literacy, an issue that is gaining interest even in our country, though, to date, this has mainly resulted in the production of theoretical works.

Adapting to the Evolving Digital Landscape: Development and Validation of the VirtHuLab Self Efficacy Scale.

Measuring people's self-efficacy in navigating the digital world has become essential in an age where the Internet permeates every aspect of life. This paper describes the creation and validation of the VISES (Virthulab Internet Self-Efficacy Scale), an instrument designed for the modern Internet environment. The way we work, communicate, and access information is changing as a result of the digital revolution, and VISES encapsulates the abilities and self-assurance needed to succeed in this Web 4.0 era. The study investigated the connections between VISES scores, Internet usage habits, net frustration, self-disparagement, and Internet addiction using a rigorous methodology. The study included a sample of 773 participants who could speak Italian (66.5% women). Participants were 31.38 years old on average (standard deviation = 11.19). The 3-factor structure of VISES, which demonstrated strong reliability for each subscale, was discovered by confirmatory factor analysis (CFA). According to the study, there is a substantial positive link between the VISES Internet self-efficacy ratings and both the frequency and duration of online use. Additionally, VISES scores exhibited positive associations with expected outcomes of Internet use, including social outcomes, personal entertainment, and personal information. The negative link between VISES scores and net frustration and self-disparagement emphasized the importance of self-efficacy in reducing negative emotional and cognitive states while using the Internet. Surprisingly, the association between VISES scores and Internet addiction was found for just one of the dimensions of VISES.

COL1A1 Sp1 variation and bone phenotypes in an Italian population.

BACKGROUND: Osteoporosis is the most common metabolic bone disorder of the elderly, affecting the normal bone turnover with an increased bone resorption and subsequent higher risk of fragility fractures. Collagen type 1 is the most represented protein in bone matrix. A genetic variation (Sp1) in intron 1 of COL1A1 gene has been associated to modulation of expression of the alpha 1 chain of collagen type 1 and it is considered a candidate polymorphism for predisposition to osteoporosis status and fragility fractures. Association studies, in ethnically different populations, are needed to strongly confirm the role of this polymorphism in bone metabolism. MATERIALS AND METHODS: We enrolled over 2,000 Italian individuals and studied their bone mineral density (BMD) and fractures in relation to age, sex and body mass index (BMI). Moreover, we analyzed the distribution of Sp1 polymorphism in these individuals and associated it to normal bone status, osteopenic condition or osteoporosis diagnosis, BMD and the presence of low-trauma fractures. RESULTS: The most rare ss genotype showed a trend for osteoporosis diagnosis with respect to both normal and osteopenic status. The same genotype resulted to be associated to lower values of BMD both at spine and femur sites. No association was found with fractures. DISCUSSION: In conclusion the presence of the homozygote ss genotype seemed to predispose to osteoporosis diagnosis and to be more frequent in subjects with lower spine and femur BMD values.

The Relationship between Orthorexia Nervosa and Obsessive Compulsive Disorder.

Orthorexia nervosa (ON) is characterized by an intense avoidance of foods considered unhealthy, obsession with healthy eating behaviors, and pathological fixation on healthy foods. Although there are still debates in the literature about the psychological factors and symptoms of ON, it should be noted that many of the symptoms share common features with obsessive compulsive disorder (OCD). The aim of the present study was to investigate the relationship between ON and OCD with its subtypes. In this framework, the cross-sectional study was conducted with an opportunistic sample of 587 participants (86% women and 14% men), with an average age of 29.32 (s.d. = 11.29; age range = 15-74). Our work showed that almost all OCD subtypes were largely correlated with ON. The lowest correlation was for "Checking" and the highest for "Obsession". Overall, the OCD subtypes (i.e., Indecisiveness, Just Right, Obsession, and Hoarding) were more strongly associated with ON measures, while subtypes Checking and Contamination, although positively associated, had lower correlation coefficients.

Cognitive Empathy and the Dark Triad: A Literature Review.

This literature review aims to analyze studies published by researchers on the topic of the relationship between the psychological constructs of the Dark Triad and Cognitive Empathy. This study hypothesizes how having good cognitive empathic skills could benefit people who demonstrate Dark Triad traits, as this could facilitate the implementation of manipulative strategies. Through the process of identifying studies via databases and registers, 23 studies were included in this literature review, and the results and theories brought forward by the researchers find more agreement regarding the individual components of the Dark Triad than the whole construct: narcissism seems to have, for the most part, relatively small and typical positive correlations (more than 50% of correlations), Machiavellianism has relatively small and typical negative relationships (about 80% of correlations), and psychopathy has relatively large negative relationships (about 90% of correlations). This study conveys that Machiavellians and psychopaths, having reduced empathic abilities, use manipulation techniques that do not have to do with empathy (for example seduction, intimidation etc.), while narcissists would be, among these three dimensions, those most likely to understand others' states of mind and thus be able to use this knowledge to their advantage-although there are doubts about the veracity of the statements and answers given by narcissists in the tests administered to them. This literature review could be a valid aid to professionals dealing with people who exhibit Dark Triad traits; understanding how those exhibiting Dark Triad traits manage their empathic abilities, the areas in which the various dimensions show deficits or not, and how they act to implement their manipulative and controlling tactics could aid in the development of more effective helping strategies to be utilized in therapy settings.

Predictors of Vaccination Intentions and Behaviour during the COVID-19 Pandemic in Italy.

The present research aimed at understanding individuals' vaccination intentions and protective behaviours against COVID-19 through two different studies. In Study 1 (N = 213, 73% women; mean age = 24.03) the Protection Motivation Theory model was tested considering the fear of COVID-19 as a possible mediator between threat appraisal (in terms of both health and social life) and intentions to get vaccinated when the vaccination was not yet available. Study 2 (N = 1111, 68.9% women; mean age = 38.33) was conducted when the vaccine became available for the entire population. Through this study, by adopting the 5C model of vaccine hesitancy as a theoretical framework, we aimed to understand how people who got vaccinated and the ones who did not differed, considering fear of vaccination, personality and vaccination hesitancy. In Study 1, social limitations, perceived severity and COVID-19 perceived vulnerability were significantly and positively related to fear of COVID-19. Contrary to what we expected, fear of COVID-19 was not a significant predictor of vaccination intention, which was predicted by both response efficacy and self-efficacy. In Study 2, in line with previous studies, vaccine hesitancy was negatively related to vaccination. More specifically, the social-oriented dimension of collective responsibility was the strongest predictor of effective behaviour. Our findings provide insights into the complexity of vaccine acceptance and emphasise the need for targeted interventions to promote vaccination and mitigate the spread of infectious diseases.

The Social Correlates to Callous-Unemotional Traits in a Sample of High School Students.

Callous-Unemotional (CU) traits are strongly related to early-onset and severe levels of conduct problems. However, much less research has focused on their association with potential problems in adolescents' social relationships. Further, it is important to determine if CU traits explain variance in important social variables, independent of conduct problems or general personality dimensions related to sociability, like agreeableness. In the current study, we examined the association of CU traits with a range of social variables in a community sample of Italian adolescents (N = 563; 460 girls; mean age = 15.80, SD = 1.50). Measures for the social variables included assessment of peer rejection, adolescents' prosocial behaviors, satisfaction in peer relationships, and feelings of connection with school and classmates. We also obtained self-report ratings of CU traits, conduct problems (CP) and agreeableness. Analyses showed that CU traits were significantly associated with all the social variables. After controlling for CP and agreeableness, CU traits were still positively associated with ratings of peer rejection and negatively associated with prosocial behavior and satisfaction in relationships with peers. However, the negative associations with feelings of connection to school and peers were no longer significant. These findings provide further support for the clinical usefulness of CU traits and further evidence for potential targets of intervention, particularly focused on the adolescent's relational skills.

Eye-tracking correlates of the Implicit Association Test.

Raising awareness of environmental challenges represents an important issue for researchers and scientists. As public opinion remains ambiguous, implicit attitudes toward climate change must be investigated. A custom Single-Category Implicit Association Test, a version of the Implicit Association Test, was developed to assess climate change beliefs. It was administered to 20 subjects while eye movements were tracked using a smart glasses system. Eye gaze patterns were analysed to understand whether they could reflect implicit attitudes toward nature. Recurrence Quantification Analysis was performed to extract 13 features from the eye-tracking data, which were used to perform statistical analyses. Significant differences were found between target stimuli (words related to climate change) and bad attributes in reaction time, and between target stimuli and good attributes in diagonal length entropy, suggesting that eye-tracking may provide an alternative source of information to electroencephalography in modeling and predicting implicit attitudes.

Dark Personality Traits and Counterproductive Work Behavior: A PRISMA Systematic Review.

Nowadays it is important for companies to keep their profits and productivity high. This can be achieved by creating a good environment in which employees can perform at their best. Unfortunately, counterproductive work behavior (CWB) is widespread in the workplace and poses a serious threat to both organizational performance and employee well-being. Among the many potential risk factors for CWB, the Dark Triad (DT) personality traits (Machiavellianism, narcissism, and psychopathy) have received increasing attention in recent years. To assess the robustness and magnitude of the association between DT and CWB, we conducted a systematic review of the available literature on DT and CWB using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines after a thorough search of several databases, 21 papers were included. The results showed that DT and CWB are positively associated. Psychopathy exhibited the strongest positive association with CWB, followed immediately by Machiavellianism and narcissism. Moreover, Machiavellianism and psychopathy showed positive correlations with both forms of CWB (organisational and interpersonal), whereas narcissism was positively correlated only with interpersonal CWB. Our findings highlight that even though organisations could benefit from people with DT at the performance level, there could be serious implications for well-being and an appropriate work environment due to CWB.

Sleep Quality and Its Relationship to Anxiety and Hardiness in a Cohort of Frontline Italian Nurses during the First Wave of the COVID-19 Pandemic.

INTRODUCTION: The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances. MATERIALS AND METHODS: A descriptive-exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State-Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI). RESULTS: a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = -0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score. DISCUSSION AND CONCLUSION: Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses.