Is the Pentagon-Copying Task More than a Cognitive Feature? Associations with Handgrip Strength, Gait Speed, and Frailty in Older Adults.

BACKGROUND: The pentagon copy is a sensitive item to the prediction of cognitive decline and dementia. Cognitive and physical/motor decline are able to accelerate the evolution of each other by representing a common pathway toward frailty. OBJECTIVES: The objective of the study was to investigate the association of the pentagon-copying task with physical and motor performances and with frailty, in a sample of older adults. METHOD: This observational, cross-sectional, and single-center study was conducted in a Geriatric Outpatients Clinic. Subjects aged ≥65 years were consecutively recruited, on a voluntary basis. Subjects with positive psychiatric history, with a severe neurocognitive disorder, with severe limitations on the upper limbs and/or reporting sensory deficits were excluded. The pentagon-copying task was scored from the Mini-Mental State Examination; the Qualitative Scoring Pentagon Test (QSPT) was also used. Handgrip strength was measured; a 46-item Frailty Index was calculated; in subjects with autonomous walking, a 4-meter gait speed was also measured. RESULTS: The study included 253 subjects (mean age 80.59 ± 6.89 years). Subjects making a wrong pentagon copy showed greater odds of exhibiting a strength deficit (OR = 3.57; p = 0.001) and of being frail (OR = 4.80; p < 0.001), and exhibited a slower gait. The QSTP score was significantly correlated with handgrip strength (r = 0.388) and gait speed (r = 0.188) and inversely correlated with frailty (r = -0.428); the QSTP score was significantly different between the quartiles of handgrip strength and frailty. CONCLUSIONS: The pentagon-copying task might also be confirmed as a quick screening tool of aging trajectories toward frailty by jointly evaluating cognitive and physical performances.

The psychological impact of the COVID-19 pandemic and the role of resilience: cross cultural differences between Brazil, Italy, and the United States.

OBJECTIVE: Restrictive measures consequent to the COVID-19 pandemic have had a significant psychological impact on everyday life in the general population, even though differences between countries remain poorly investigated. The present study sought to examine the different psychological impacts and resilience of the pandemic among three of the most heavily hit countries: Brazil, Italy, and the United States. METHODS: This cross-sectional study separately involved three national community populations, namely the Brazilian, the Italian, and the American population. Participants aged 18 years or older were recruited through a shared online survey. Participants self-completed the Connor-Davidson Resilience Scale (CD-RISC-10) and the Center for Epidemiological Studies-Depression Scale (CES-D); post-traumatic stress was additionally assessed using the Impact of Event Scale-Revised (IES-R). Three separate Analyses of Covariance (ANCOVA) were performed in order to investigate differences in the levels of resilience, post-traumatic stress, and depression among the three populations. RESULTS: The study included in total 734 participants (mean age = 27.60 ± 11.69 years; 77% of females). Results of ANCOVA comparisons showed significant differences between the three groups in the variable measuring resilience, post-traumatic stress symptoms, and depression. As for resilience, results of post-hoc tests showed significant differences between the groups from Brazil and Italy and between the groups from Brazil and USA. As for the post-traumatic stress symptoms, results showed significant differences between the USA and Brazil groups and between the USA and Italy groups. As for the depression symptoms, results showed significant differences between the USA and Brazil groups. CONCLUSIONS: Overall, these findings may help to increase understanding of the psychological impact of COVID-19 in Brazil, Italy, and the USA. Interventions to prevent mental disorders among general populations should take into account these findings.

Emotion regulation strategies and difficulties in older adults: A systematic review.

OBJECTIVES: The purpose of this systematic review was to assess the types of emotion regulation (ER) strategies used and difficulties in emotion regulation experienced by older adults, within the theoretical frameworks proposed by Gross, and by Gratz and Roemer, respectively. METHODS: A systematic search was conducted using principal electronic scientific databases (PubMed, Scopus, and Web of Science). The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. RESULTS: The final number of articles included was 44. Older adults reported a higher use of adaptive ER strategies, as well as fewer difficulties in ER, compared with younger adults. Findings from this review also suggest that the use of maladaptive ER strategies can also expose older adults to psychological distress, and may affect their adaptation to negative disease-related outcomes more common in later life. CONCLUSIONS: Older adults generally showed a greater emotional control compared with younger subjects. Adaptive control strategies, rather than maladaptive control strategies, were correlated with more positive outcomes for psychological distress and adaptation to chronic diseases. CLINICAL IMPLICATIONS: Understanding the nature of ER processes in older adults may contribute to implement tailored interventions aimed at reinforcing adaptive ER processes.

Changes in Cognitive and Functional Status and in Quality of Life of Older Outpatients during the COVID-19 Pandemic.

BACKGROUND: Older adults denoted one of the populations that mostly suffered from the consequences of the COVID-19 pandemic. The cost of confinement was paid in terms of social isolation, distance from relatives and friends, lack of social support, and limited access to the healthcare system, which had a negative impact on health of older adults with comorbidities and frailty. OBJECTIVES: The purpose of the present study was to report the consequences of the COVID-19 pandemic on cognitive performances, functional status, and health-related quality of life among frail outpatients, compared to pre-pandemic status. METHOD: The current sample was part of a larger sample of frail and pre-frail outpatients, who were first evaluated at the clinic between April and May 2019 and who underwent a first follow-up evaluation between April and May 2020. Those outpatients who have undergone the first follow-up evaluation were contacted between April and May 2021 and were asked to voluntarily participate in a second telephone-based evaluation. Cognitive performances (through Mini Mental State Examination - MMSE), functional independency in basic and instrumental daily activities, physical and mental components of health-related quality of life (SF-12 PCS and SF-12 MCS, respectively) were evaluated and compared to previous evaluations. RESULTS: Seventy one outpatients (mean age of 80.69 years) completed the present follow-up evaluation. Patients reported significantly lower cognitive performances (mean MMSE 19.37; p < 0.001), lower physical quality of life (mean score 31.69; p < 0.001), and lower mental quality of life (mean score 38.79; p < 0.001) compared to both pre-pandemic baseline and the first follow-up. Moreover, patients showed a significantly reduced independency in basic daily activities (mean score 3.8; p = 0.004), and a significantly reduced independency in managing telephone (p = 0.012) and medications (p = 0.035), compared to baseline. CONCLUSIONS: The COVID-19 pandemic has been a prolonged stressor over time, which has markedly affected health-related quality of life of outpatients, and it can be considered a stressor that might have contributed to the patients' greater cognitive and functional vulnerability.

Psychotic Experiences and Sleep Quality in the Emerging Adulthood: The Interplay Between Emotional Neglect, Bodily Threat, and Defense Mechanisms.

ABSTRACT: The present study investigated the integrated role of emotional neglect, bodily threat, and defense mechanisms in understanding sleep quality and psychosis experiences in a sample of emerging adults. A sample of 898 emerging adults (295 males) with an age range between 19 and 30 years participated in this study. The emotional neglect and bodily threat factors of the Traumatic Experiences Checklist, the Defense Style Questionnaire-40, the Pittsburgh Sleep Quality Index, and the psychosis factor of the Inventory of Personality Organization were administered. Results of path analyses showed that the emotional neglect and bodily threat factors predicted lower sleep quality. A path from emotional neglect and bodily threat to sleep quality via defense styles was also found. The defense styles mediated the relationships between emotional neglect and bodily threat factor with psychosis experiences. These findings provide new insight into the psychological mechanisms underlying the onset of poor sleep quality and psychotic experiences during emerging adulthood.

Expressive flexibility and health-related quality of life: The predictive role of enhancement and suppression abilities and relationships with trait emotional intelligence.

This study aims to examine the ability to flexibly enhance and suppress emotional expression, known as expressive flexibility, in relation to physical and psychological health, as well as trait emotional intelligence (EI). A sample of 503 Italian (Mage = 28.65 ± 9.26 years, 85.1% females) participants completed the Italian version of Flexible Regulation of Emotional Expression (FREE) Scale, the TEIQue-SF, and the Short Form-12 Health Survey. Confirmatory factor analysis indicated that the Italian version of FREE showed adequate psychometric properties. In both genders, results of correlational analyses indicated that enhancement ability was associated with well-being, emotionality, and sociability, whereas suppression ability was associated with self-control. Regression analyses, controlling for age and gender, indicated that suppression and inversely enhancement abilities, predicted the perceived psychological but not physical health. Well-being, self-control, and sociability also contributed to explaining variance in the model. The interaction effect of enhancement and suppression was not significantly associated with either physical or psychological health. Overall, these results suggest that enhancement and suppression abilities differentially contribute to psychological health when trait EI is accounted for. Clinical implications and future directions for research on expressive flexibility are discussed.

Neuropsychological Assessment in the Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus. An Important Tool for the Maintenance and Restoration of Neuronal and Neuropsychological Functions.

Idiopathic normal pressure hydrocephalus (iNPH) is a progressive clinical syndrome that includes gait disturbances, urinary incontinence, and cognitive impairment. iNPH shows similarities to other neurodegenerative disorders, primarily Alzheimer's Disease (AD). Definition of the neuropsychological profile of iNPH and the qualitative analysis of systematic mistakes made in cognitive tests could represent a valid method for systematizing possible specific markers of iNPH dementia and differentiating it from other dementias. To evaluate the role and the efficacy of a neuropsychological protocol, designed at our institution, based on psychometric analysis and qualitative assessment, in the differential diagnosis of iNPH from AD dementia, we prospectively enrolled 12 patients with suspected iNPH, 11 patients with AD, and 10 healthy controls (HC) who underwent neuropsychological assessment. The assessment was done with the Mini Mental State Examination (MMSE), Mental Deterioration Battery (MDB), Frontal Assessment Battery (FAB), and the Deux Barrage Test. Evaluation in the iNPH group was performed before extended lumbar drainage (ELD), 48 h after ELD, and 1 week and 3 months after the insertion of a ventriculoperitoneal shunt (VPS). Statistical analysis demonstrated the cognitive profile of iNPH, which was mainly characterized by executive function and immediate verbal memory impairment compared with AD. Additionally, the neuropsychological markers were different between the two groups. The qualitative analysis of systematic mistakes made on the tests demonstrated differences in cognitive performances between the iNPH, AD, and HC cohorts. Neuropsychological assessment and qualitative evaluation could represent a useful tool for achieving effective management and restoration of functions in patients with iNPH.

Perception of, attitudes toward, and knowledge of epilepsy among teachers and high school and college students in Sicily.

The study was aimed at investigating perception of, attitudes toward, and knowledge of epilepsy among college students of the University of Messina in Sicily (Italy), high school students, and teachers from Sicily in order to structure health educational programs to remediate inadequate knowledge and stigma about epilepsy. Participants in this study consisted of 932 subjects (571 males, 361 females) aged between 13 and 63 years old (M 21.75 ± 8.7): 571 college students aged between 18 and 35 years old (M 21.54 ± 2.59), 62 teachers aged between 38 and 63 years old (M 51.18 ± 6.27), and 299 high school students aged between 13 and 19 years old (M 16.05 ± 1.67). Measures were two anonymous questionnaires to collect sociodemographic information and to assess knowledge of, attitudes toward, and perception of epilepsy. Analyses were performed with descriptive statistical analysis (mean, standard deviation, frequency counts, and percentages) and Mann-Whitney U-test nonparametric for two independent samples. This study provides general information about psychosocial aspects of epilepsy in Sicily which provides the basis for further studies and the development of interventions to eliminate prejudices against persons with epilepsy and related myths.

Longitudinal associations of depression, anxiety, and stress among healthcare workers assisting patients with end-stage cancer during the COVID-19 pandemic: the moderator role of emotional exhaustion.

BACKGROUND: This study aimed to analyze the moderating role of emotional exhaustion in the relationships between longitudinal associations of depression, anxiety, and stress among healthcare workers assisting end-of-life cancer patients during the COVID-19 pandemic. METHODS: A longitudinal study involving a final sample of 122 healthcare workers (61.5% females, mean age = 39.09 ± 11.04 years) was conducted. These participants completed the Maslach Burnout Inventory (MBI) and the Depression Anxiety Stress Scales-21 (DASS-21). RESULTS: Results of correlation analysis showed that emotional exhaustion was correlated with both T1 and T2 measures of depression, anxiety, and stress. Results of the moderation analysis indicated that emotional exhaustion moderated the relationships between consecutive measures of depression and anxiety. Each of the moderation models explained about half of the variance for depression and anxiety. When considering stress, results did not show a moderating role for emotional exhaustion. CONCLUSIONS: Overall, the results of this study highlight that emotional exhaustion moderated depression and anxiety over time. Psychological interventions to promote psychological mental health among healthcare workers assisting patients with end-stage cancer should carefully consider these findings.

Longitudinal Associations Between Resilience and Mental Health During the Covid-19 Pandemic.

Objective: Research on the psychological impact of the COVID-19 pandemic has pointed out that lockdowns had small effects on the overall mental health, despite considerable heterogeneity among studies is present. Psychological resilience may be responsible for an amount of variance in individual reactions to the pandemic, despite the fact that its longitudinal associations with mental health symptoms remain unclear. This study sought to investigate changes in resilience and its relationships with depression, anxiety, and stress during the COVID-19 pandemic. Method: A total of 814 participated in this longitudinal study via an online survey during the first lockdown consequent to the COVID-19 pandemic (T1) and during the third wave (T2). The Resilience Scale and the Depression Anxiety Stress Scales - 21 were administered. Sociodemographic data and COVID-19 related information were also collected. Results: Psychological resilience decreased during the third wave of the pandemic, whereas depression and stress increased. Moreover, psychological resilience had a direct effect only on depression during the third wave, while its effect on anxiety and stress is mediated by the mental health during the first lockdown. Conclusions: The mental health symptoms worsened during the third wave, while protective factors such as resilience decreased. Individuals showing high resilience experienced lower depression, anxiety, and stress over time. Psychological intervention that enhances resilience should be embraced in the action of health care authorities to reduce the impact of pandemic.

Breaking the Silence: Exploring Peritraumatic Distress and Negative Emotions in Male and Female Physical Domestic Violence Victims.

Background: Domestic violence is a widespread problem affecting individuals, families, and communities worldwide. Peritraumatic distress is associated with post-traumatic stress disorder and other mental health problems among victims, but research on men's experiences is limited. Objective: We analyzed data from 48 physical domestic violence victims (16 males and 32 females) to compare their levels of peritraumatic distress and negative emotions, and to examine the types of aggressors they faced. Methods: We used descriptives to summarize sample characteristics and Peritraumatic Distress Inventory scores and used statistical tests such as Mann-Whitney U, Shapiro-Wilk, Levene's test, contingency tables, and chi-square to investigate differences and associations between variables. Results: Female victims of domestic violence had significantly higher scores on the Peritraumatic Distress Inventory than male victims and experienced significantly higher levels of negative emotions than male victims, including impotence/inability to react, sadness, anger/frustration, loss of control, fear, guilt, and shame. Husbands and domestic partners were the most frequent aggressors against female victims, while wives and ex-wives were the most frequent aggressors against male victims. In addition, partners were found to be the most frequent type of aggressor in the sample. Descriptive statistics, box plots, and scatter plots were used to provide a clear picture of the sample characteristics. Conclusion: Female victims of domestic violence reported higher levels of peritraumatic distress and negative emotions compared to men victims. Partners were the most frequent type of aggressor in the sample.

Body dysmorphic disorder and psychotherapeutic interventions: a systematic literature review.

Introduction: Body dysmorphism disorder (BDD) is a disabling mental disorder characterized by an anxious preoccupation with a perceived defect in physical appearance. Objective: This systematic review arose with the main objective of identifying the most effective psychotherapeutic intervention in the treatment of BDD. Methods: From February to October 2022, we conducted a systematic review aimed at identifying the psychotherapeutic intervention for BDD, the search for these concepts was on PubMed. There were no language limitations, only time limitations, we delved into studies published in the databases between 2015 and 2022. Results: We identified a total of 393 unique records. Of these, 43 full-text articles were evaluated for eligibility, and seven of these met the inclusion criteria and were included in the final systematic review. Conclusions: Cognitive-behavioral therapy has been shown to be effective compared with other therapies, especially when combined with drug therapy. The results confirm that BDD-NET (INTERNET-based CBT) led to significant improvement of symptoms in patients with body dysmorphism. In conclusion, we can say that cognitive-behavioral therapy, whether in direct or online form, appears to be the most effective treatment for this disorder.

Prolonged Grief Disorder and Symptoms of Anxiety and Depression among Bereaved Family Caregivers in the Context of Palliative Home Care.

Background: This study aimed to investigate the prevalence and the psychological comorbidity of PGD among bereaved family caregivers of palliative care cancer patients. We also examined the discriminant validity of two simple and reliable tools in correctly categorized individuals with PGD. Methods: A cross-sectional study was conducted with 157 bereaved participants (77.1% females, mean age = 43.50 ± 14.04 years, mean time since the loss = 3.59 years) recruited from three palliative home care services. These participants completed the Prolonged Grief Scale (PG-13) and the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of PGD within the sample was 4.46% (i.e., = 7/157). Participants scored higher than the cut-off on the PG-13 and the HADS-D. Symptoms of PGD were positively correlated with depression levels. The ROC curve analysis showed that the HADS-D was outstanding in categorizing individuals with prolonged grief disorder from those without PGD. A HADS-D score of ≥7.5 was able to categorize participants with a sensitivity of 0.90 and a specificity of 0.73. Conclusions: Overall, these results highlight the relationship between grief and depression symptoms and their exceptional discriminant validity among correctly identified individuals with PGD.

Love Addiction - Current Diagnostic and Therapeutic Paradigms in Clinical Psychology. (v2).

Background: We have investigated and analyzed the latest research on love addiction in the fields of clinical psychology, diagnosis, psychotherapy and treatment. Methods: From 30 November 2021 to July 2022 a review was conducted aimed at identifying the current diagnostic paradigms associated with this new behavioral dependence, investigating in depth what has not yet emerged, searching for strong and weak correlations with related theoretical constructs, comorbidities, investigate which evaluation scales are currently used and outline a guiding design that allows you to move between current scientific discoveries, searching for relevant studies in the databases PubMed, National Center for Biotechnology Information (NCBI), PsycINFO, MDPI, APA, ScienceDirect, and ReserchGate. Results: We identified a total of 102 unique articles. Among these, 22 full-text articles were assessed for eligibility and 5 of these met the eligibility criteria and were, therefore, included in the final systematic review. Conclusions: Group psychotherapy has proved to be a valid alternative, in fact the scientific landscape suggests that most group therapies are successful because these dynamics involve the reward and attachment systems in the brain in most subjects. Although there is currently no official classification for this type of addiction, the continuing interests of clinical psychology open up new scenarios for achieving greater psychophysical well-being.

Fear of COVID-19 and future orientation: Different profiles in dealing with the pandemic and associations with loneliness and posttraumatic growth.

OBJECTIVE: This study aimed to examine the profiles of reaction to the COVID-19 pandemic based on the combination of fear and future orientation, as well as their sociodemographic, situational, and relational predictors. We also compared posttraumatic growth between the profiles. METHOD: A sample of 640 Italian participants completed the Multidimensional Assessment of COVID-19-Related Fears (MAC-RF), the Future Orientation Scale (FOS), the UCLA Loneliness Scale-Version 3, and the Posttraumatic Growth Inventory (PTGI). RESULTS: Latent profile analysis indicated a 4-class solution as the best-fitting model. The first profile ("Detached") comprised 9.9% of the sample and was characterized by both low fear and future orientation. The second profile ("Hopeful") concerned 49.9% of the sample and it featured low fear and high future orientation. The third profile ("Constructively Preoccupied") involved 35.5% of the sample and was distinguished by high fear and high future orientation. The fourth profile ("Fearful") included 4.6% of the sample and was marked by high fear and low future orientation. Multinomial logistic regressions indicated that the female gender was more likely to be associated with the Constructively Preoccupied profile, while older age was more likely to be associated with the Hopeful one. Higher perceived loneliness was associated with all profiles except the Hopeful. Results of comparisons showed substantial differences in posttraumatic growth between the profiles. The Constructively Preoccupied profile showed the greatest posttraumatic growth. CONCLUSIONS: Overall, these results point out the various profile of reaction to the pandemic and that adopting a person-oriented approach could enhance their grasp. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Anxiety, Depression, Emotion Regulation, and Daytime Sleepiness: Are There Links Between These Factors? Network Analysis on an Italian Sample During the Covid-19 Pandemic.

Objective: The COVID-19 pandemic has contributed to the occurrence of psychological disturbances, such as depressive and anxiety symptomatology, thereby significantly impacting individuals' lifestyles by disrupting sleep patterns. This study aimed to elucidate the interconnections between emotion regulation, depression, anxiety, and daytime sleepiness. Method: We recruited 632 community adults who underwent an online survey of self-report questionnaires, including the Depression Anxiety Stress Scale (DASS-21), the Difficulties in Emotion Regulation Scale (DERS), and the Epworth Sleepiness Scale (ESS).A network analysis was performed to examine and visually represent the pattern of relationships between psychological distress, emotion regulation, and daytime sleepiness. Results: The DERS Strategy dimension showed high values across all centrality indices, indicating it as the most influential node in the network. In addition, the DASS Depression and DERS Goals dimensions exhibited high betweenness values, emerging as points of connection between the other nodes within the network structure. Conclusions: Our primary findings underscore the connection between psychological distress and emotion regulation, specifically between depressive symptoms, a lack of emotional clarity, and difficulty in the flexible use of emotional strategies. These specific constructs hold promising potential as valuable targets for both assessment and the development of effective interventions during highly challenging situations such as the COVID-19 pandemic.

Reflective functioning and dissociative experiences: A comparison study between adolescents at "high-risk" of psychosis and healthy controls.

Background: Despite the established contribution to psychological well-being in young subjects, the investigation of reflective functioning and dissociative experiences in help-seekers adolescents still appears an unmet need. Objective: The study aimed to assess reflective functioning and dissociative symptoms in help-seekers adolescents, and compare them to gender-matched healthy controls. Methods: The Reflecting Functioning Questionnaire (RFQ) was used to investigate mentalizing; the Adolescent Dissociative Experience Scale (A-DES) was used to explore dissociative symptoms. Results: The study involved 102 adolescents (mean age 18.06 ± 1.78 years), split into "help-seekers" (N= 51; mean age 19 ± 1.98 years) and healthy controls (N= 51; mean age 17.12 ± 0.84). "Help-seekers" adolescents showed lower RFQ-certainty scores (mean 3.39 ± 2.47), compared to healthy controls (mean 6.73 ± 5.01). Furthermore, "help-seekers" adolescents reported higher scores on RFQ-uncertainty (mean 7.73 ± 4.38), compared to healthy controls (mean 5.14 ± 4.17), which indicates a greater lack of knowledge about mental states (hypomentalizing). Eventually, "help-seekers" adolescents showed significantly worse dissociative symptoms (A-DES total mean score 3.49 ± 2.04), compared to healthy controls (A-DES total mean score 2.06 ± 1.43). Conclusion: The importance of an assessment in early adolescence denotes a topic of increasing concern, in order to identify failures in reflective functioning and the onset of dissociative experiences among help-seekers adolescents, toward the implementation of tailored psychological interventions.

Qualitative study on the perception of combustible cigarettes, e-cigarettes and heated tobacco cigarettes among pregnant women.

The research proposes to investigate the psychological reasons that may explain women's addiction to smoking during pregnancy and the perception of combustible cigarettes, electronic cigarettes and heated tobacco cigarettes. The sample included 30 participants who smoke or people who previously smoked who chose to quit or continue smoking during pregnancy. The data was gathered via a semi-structured interview and developed from three research questions: feelings, opinions and perceptions of pregnant women toward e-cigarettes, heated tobacco cigarettes, and combustible cigarettes. The study used thematic qualitative analysis for the methodological formulation of the results. The Standards for Reporting Qualitative Research Standards (QRRS) checklist was used. In this qualitative research, three psychological reasons for the onset of smoking were found and analyzed: feelings of stress, nervousness, and loneliness. According to the results: 40.91% of the women who smoked combustible cigarettes decided to keep on smoking and 59.09% decided to quit, 16.67% of participants who use heated tobacco cigarette decided to continue during pregnancy and the remaining 83.33% decide to stop; lastly, there is a condition of fairness for adults who use e-cigarette, 50% decided to continue smoking during pregnancy and the other 50% decided to stop smoking. The data indicate that those who continue to smoke during pregnancy are participants who smoke combustible cigarettes, stating that they reduce the amount of smoke inhaled. Meanwhile, participants who use heated tobacco cigarettes or e-cigarettes are certain that they pose less risk than combustible cigarettes; nevertheless, most of them decide to quit smoking during pregnancy. Another important aspect that has been noted is that of formal abandonment treatments, as quite unexpectedly, there has been a unanimous recognition of strong distrust toward the possible risks to the unborn child. There is a lot of distrust and little knowledge of official smoking cessation therapies, and because of this, participants stated that they can quit smoking whenever they want and only with their own willpower. Five categories and related themes emerged from the thematic analysis, such as reasons for starting with themes such as stress, irritation, loneliness, adolescence and integration; reasons for attachment to topics such as habit and carelessness about one's health; perceptions of traditional cigarettes compared to e-cigarettes and heated cigarettes with related topics such as sensory experiences and side effects; feelings and use of official smoking cessation therapies with issues as willpower and knowledge; information on the effects of smoke during pregnancy and breastfeeding, including risk information.

Postprandial Hypotension and Impaired Postprandial Sustained and Selective Attention in Older Inpatients: Is There a Link?

OBJECTIVES: The study aimed to investigate the prevalence of postprandial hypotension (PPH) in older inpatients, to verify the overall postprandial behavior of blood pressure and attentional performances, and to explore the overall associations between blood pressure (including PPH) and attentional performances. Eventually, we aimed to investigate differences on PPH, blood pressure values and attentional performances based on the subjects' frailty status. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A sample of older inpatients at the Geriatric Unit of the University Hospital of Messina (Italy). METHODS: Basal, preprandial, and postprandial blood pressures (75 minutes after the meal) were measured for each patient; PPH was detected according to its empirical definition. Global cognitive functioning, and sustained and selective attention were assessed; a 46-item Frailty Index was calculated. RESULTS: The sample consisted of 112 inpatients (54 females), with a mean age of 80.9 years. The prevalence of PPH was 30.4%; in the postprandial window, a reduction in blood pressure between 10 and 20 mm Hg and a reduction of >20 mm Hg were reported by 27.1% and 29.9% of inpatients, respectively. In the postprandial evaluation, sustained and selective attention markedly decreased. No significant associations were found between PPH occurrence and the postprandial dip of attentional performances, and no significant cognitive differences were found between inpatients with and without PPH. On the other hand, reduced postprandial attentional performances were associated especially with preprandial lower systolic and diastolic blood pressure values. Ultimately, no significant differences in PPH occurrence were found between frail and nonfrail inpatients; frail inpatients significantly exhibited also an overall lower cognitive functioning. CONCLUSIONS AND IMPLICATIONS: In our sample, PPH and impaired postprandial attentional performances were not associated, even though this association deserves further investigation. In hospitalized older adults, the accurate management of blood pressure levels appears relevant, because we evidenced that low blood pressure (especially preprandial) was associated with poor attentional functioning. Although the plausible occurrence of several interfering and confounder factors was observed in an acute care setting, we consider that the screening of attentional functioning among hospitalized older patients could be helpful.

Music therapy and psychological-clinical impact in surgery: a systematic review.

Background: Music therapy is a discipline that makes use of music, active or passive, to produce beneficial effects on the psyche of subjects. The field of use of music therapy has recently been broadened with the introduction of music therapy interventions to treat various problems, such as anxiety and stress, arising from pre- and post-operative psychophysical conditions. This review aims to examine the use of music therapy and its outcomes in the context of surgery in recent years. Methods: The main procedure was to search for studies on various scientific platforms such as PubMed, Medline, PsycINFO and CINAHL.Many studies pertaining to the topic in question were examined and from the variety of articles available, thirty-four were selected that fully reflected the focus of this review. Conclusions: The use of music therapy is still little exploited in hospital conditions such as the one reported in this review, but despite its reduced use compared to other treatments, it has proved to be an effective technique for reducing anxiety and stress prior to surgery and for improving psychophysical conditions following surgery. Above all, the absence of side effects is emphasised since it is a nonpharmacological treatment. Further research is needed for additional confirmation of the effectiveness of music therapy mainly because this method is still being explored worldwide.