Experiential training course on spirituality for multidisciplinary palliative care teams in a hospital setting: a feasibility study.

BACKGROUND: There is widespread agreement about the importance of spiritual training programs (STPs) for healthcare professionals caring for cancer patients, and that reflecting on one's spirituality is the first step. Health professionals (HPs) working in hospitals must develop this dimension to guarantee the quality of life as well as spiritual and emotional support. In this paper, we propose a possible training format for hospital professionals and assess its implementation. METHODS: This is a phase 0-I study that follows the Medical Research Council (MRC) framework. The program was implemented for hospital palliative care specialists. The program included one theory lesson, three spiritual interactions, four pieces of reflective writing, and two individual follow-up sessions for each participant. The evaluation was performed quantitatively according to the MRC framework and qualitatively according to Moore's framework with data triangulation from interviews, reflective writings, and indicators. RESULTS: The program was implemented for palliative care physicians, nurses, psychologists, and bioethicists according to the plan, and the program components were highly appreciated by the participants. The results suggest the feasibility of a training course with some corrections, regarding both the components of the training and organizational issues. The qualitative analysis confirmed a shift in the meaning of the themes we identified. The trainees went from intrapersonal spirituality to interpersonal spirituality (engagement with the other person's spirituality, acknowledging their unique spiritual and cultural worldviews, beliefs, and practices), with colleagues, patients, and people close to them. The training had an impact on Moore's Level 3b. CONCLUSIONS: Spiritual training for hospital professionals working in palliative care is feasible. Having time dedicated to spirituality and the ongoing mentorship of spiritual care professionals were suggested as key elements. The next step is increasing awareness of spirituality from our hospital reality and creating a stable competent group (with nurses, chaplains, nuns, counselors, etc.) with the support of the management.

The influence of classroom seating arrangement on children's cognitive processes in primary school: the role of individual variables.

To date, despite the great debate regarding the best seating arrangement for learning in classrooms, no empirical studies have examined the direct effects of different seating arrangements on children's cognitive processes. This is particularly important nowadays that the COVID-19 measures include maintaining distance in the classroom. Aim of this study was experimentally investigating the effect of changing the seating arrangement (clusters vs. single desks), on logical reasoning, creativity and theory of mind, in children attending primary school. Furthermore, some individual characteristics (e.g., gender, loneliness, popularity) were analysed as potential moderators. Results on 77 participants showed that, when children were seated in single desks, their score in logical reasoning was globally higher. Furthermore, when seated in single desks, girls showed a better performance in the theory of mind, and lonelier children performed better in theory of mind and creativity. This on field experimental study suggests the importance of considering both the nature of the task and children's individual characteristics when deciding on a seating arrangement in the classroom.

"Achieve the best while rushing against time": A grounded theory study on caring for low-income immigrant cancer patients at end of life.

BACKGROUND: Between 2000 and 2020, Europe experienced an annual net arrival of approximately 1.6 million immigrants per year. While having lower mortality rates, in the setting of severe diseases, immigrants bear a greater cancer-related burden due to linguistic and cultural barriers and socio-economic conditions. Professionals face a two-fold task: managing clinical conditions while considering the social, economic, cultural, and spiritual sphere of patients and their families. In this regard, little is known about the care provision to low-income immigrant cancer patients in real contexts. AIM: To investigate the perspective of professionals, family members, and stakeholders on the caring process of low-income immigrant cancer patients at the end of life. DESIGN: A Constructivist Grounded Theory study. SETTING/PARTICIPANTS: The study, conducted at a Hospital in Northern Italy, involved 27 participants among health professionals, family caregivers, and other stakeholders who had recently accompanied immigrant cancer patients in their terminal phase of illness. RESULTS: Findings evidenced that professionals feel they were not adequately trained to cope with immigrant cancer patients, nonetheless, they were highly committed in providing the best care they could, rushing against the (short) time the patients have left. Analyses evidenced four main categories: "providing and receiving hospitality," "understanding each other," "addressing diversity," and "around the patient," which we conceptualized under the core category "Achieve the best while rushing against time." CONCLUSIONS: The model reveals the activation of empathic and compassionate behavior by professionals. It evidences the need for empowering professionals with cultural competencies by employing interpreters and specific training programs.

Microaggressions towards lesbian and transgender women: Biased information gathering when working alongside gender and sexual minorities.

OBJECTIVE: Microaggressions, a concept originally introduced for ethnic minorities, represent subtle day-to-day discrimination, damaging the psychological health and well-being of lesbian, gay, bisexual, and transgender individuals as well. This study aimed to assess whether microaggressions occur in psychotherapists' assessments of clients who identify as either lesbian or transgender woman when compared with those identifying as heterosexual woman. METHODS: The study included a sample of 135 licensed psychotherapists (110 cisgender women and 25 cisgender men). Participants were presented with an audio file of a woman introducing herself during her first therapy session. Three versions were presented: a transgender, a lesbian, and a heterosexual client. Participants were asked to assess the clinical relevance of 10 questions defined as neutral (N = 5) and microaggressive (N = 5), used to determine a clinical impression of the client. A repeated measure analysis of variance was conducted to understand the likelihood of clients of different gender identity and sexual orientation receiving microaggressions. RESULTS: Participants were more prone to consider microaggressive questions relevant where the client identified as either lesbian or transgender. CONCLUSIONS: The findings highlighted a bias against lesbian and trans women in evaluating the relevance and usefulness of clinical information while making a psychological assessment of a case.

Selective changes in moral judgment by noninvasive brain stimulation of the medial prefrontal cortex.

Multiple cortical networks intervene in moral judgment, among which the dorsolateral prefrontal cortex (DLPFC) and the medial prefrontal structures (medial PFC) emerged as two major territories, which have been traditionally attributed, respectively, to cognitive control and affective reactions. However, some recent theoretical and empirical accounts disputed this dualistic approach to moral evaluation. In the present study, to further assess the functional contribution of the medial PFC in moral judgment, we modulated its cortical excitability by means of transcranial direct current stimulation (tDCS) and tracked the change in response to different types of moral dilemmas, including switch-like and footbridge-like moral dilemmas, with and without personal involvement. One hundred participants (50 males) completed a questionnaire to assess the baseline levels of deontology. Next, participants were randomly assigned to receive anodal, sham, or cathodal tDCS over the medial prefrontal structures and then were asked to address a series of dilemmas. The results showed that participants who received anodal stimulation over the medial PFC provided more utilitarian responses to switch-like (but not footbridge-like) dilemmas than those who received cathodal tDCS. We also found that neurostimulation modulated the influence that deontology has on moral choices. Specifically, in the anodal tDCS group, participants' decisions were less likely to be influenced by their baseline levels of deontology compared with the sham or cathodal groups. Overall, our results seem to refute a functional role of the medial prefrontal structures purely restricted to affective reactions for moral dilemmas, providing new insights on the functional contribution of the medial PFC in moral judgment.

Connecting with a Slot Machine: Social Exclusion and Anthropomorphization Increase Gambling.

Two studies tested whether social exclusion can increase gambling behavior. In Study 1, participants were asked to relive a socially painful instance, a physically painful instance or a control condition and were then presented with a real online gambling device (i.e., a slot machine). The results revealed that participants who relived a socially painful instance played longer on the gambling device. In Study 2, we induced actual feelings of social disconnection and manipulated slot machine anthropomorphization. The results revealed a significant interaction between inclusionary status and anthropomorphism in predicting gambling. More specifically, excluded participants gambled longer when presented with an anthropomorphized slot machine. However, the gambling behavior of excluded and included participants was no different when participants were reminded that slot machines are inanimate objects. Finally, positive and negative game experience mediated the influence of both inclusionary status and anthropomorphism on gambling. Overall, this research identifies another potential vulnerability produced by experiences of social exclusion, namely, gambling behavior. Implications for pathological gambling and future research directions are outlined.

When Future Leads to a Moral Present: Future Self-Relatedness Predicts Moral Judgments and Behavior in Everyday Life.

Future self-perceptions seem to promote far-sighted decisions in intertemporal choices. Previous work suggested that future self-relatedness, the extent to which we feel similar and connected to our future self, is associated with moral concerns. We aimed to extend these findings to everyday moral judgments and behavior using experience sampling methods. In addition, we assessed how moral foundation concerns mediate the relationship between future self-relatedness and moral behavior. Participants (N = 151) reported their state-levels of future self-relatedness, individualizing, and binding moral foundations and answered whether they performed a moral action five times a day for seven days. Within- and between-participants future self-relatedness predicted daily fluctuations in individualizing and binding moral foundations concerns. On the behavioral level, only within-participants future self-relatedness predicted individualizing moral actions with individualizing moral foundations mediating this effect. Our findings suggest that within- and between-person changes in future self-relatedness might be used to predict everyday moral concerns and behavior.

Risk perception and behavioral intentions in facing compound climate-related hazards.

Compound climate-related events are a complex combination of climate drivers and hazards leading to a significant impact on natural and anthropic systems. Owing to their complexity and critical consequences, interdisciplinary undertaking is required to improve risk analysis, management, and communication. Although prior research in cognitive sciences extensively investigated risk perception in case of a single hazard, the analysis of compound hazards perception is still an open issue. Here, based on cognitive psychology insights, we empirically investigate how individuals' risk perception is shaped by the subjective relevance attributed to different causal cues entailed in a compound event scenario. The results revealed that the subjective validity assigned to specific evidence presented in the composite scenario leads perceived risk related to one of the outcomes (i.e., flooding and wildfire) to prevail over the other. Moreover, the relevance of different cues is likely to affect participants' automatic behavioral intentions (stay at home vs. evacuation).

A qualitative study with Italian patients exploring the spiritual dimension during a chronic disease.

BACKGROUND: Spirituality is a vast dimension influenced by cultural and personal differences. Little is known about the spirituality of patients suffering from a chronic disease in Italy from palliative care hospital settings. AIM: To investigate patients' perspectives about their spirituality during their illness. METHOD: The research question was: 'How does living with chronic disease inform/shape the spiritual dimension of patients?'. To address it, we conducted a qualitative interview study with thematic analysis. RESULTS: We enrolled 21 participants among patients suffering from rheumatic, haematologic, neurodegenerative and respiratory chronic diseases. Participants generally had great difficulty answering the questions researchers posed and often could not define 'spirituality'. We found different topics grouped under four main themes: definition of spirituality, internal dialogue, expression of spirituality in everyday life and take stock. Religion is not reported as an answer to spiritual suffering, even in a country that is felt religious-driven like Italy. DISCUSSION: Patients are generally not cognizant of this dimension even living with a chronic disease; consequently, they cannot express spiritual needs because they can't recognise them. Health professionals should identify this dimension and its characteristics to recognise potential spiritual suffering.

"Be careful what you do": How social threat influences social attention driven by reach-to-grasp movements.

Social attention is the ability to share with social partners the attentional focus on an object and to orient attentional resources after observing others' behaviors. In the present work, we analyzed whether social threat may influence social attention during the observation of social agents' reach-to-grasp movements. In two experimental studies, we adopted a Posner-like paradigm: participants were required to classify neutral stimuli appearing in a congruent or incongruent position with the actor's movement. Membership (ingroup vs. outgroup) and contextual cues (neutral vs. threatening objects) were manipulated. The results showed a robust action-cueing effect: responses to stimuli in a congruent position with the actor's action were faster than responses to incongruent stimuli. Interestingly, we found a stronger effect for the threatening outgroup (i.e., Iraqi) than for the ingroup (i.e., Italian), especially in presence of menacing objects. No effects were found when observing the non-threatening outgroup (i.e., Japanese).

Bringing Us Closer Together: The Influence of National Identity and Political Orientation on COVID-19-Related Behavioral Intentions.

A growing body of work has highlighted the importance of political beliefs and attitudes in predicting endorsement and engagement in prosocial behavior. Individuals with right-wing political orientation are less likely to behave prosocially than their left-wing counterparts due to high levels of Right-wing authoritarianism (RWA). Here, we aimed to extend prior work by testing how political values relate to COVID-19 discretionary behavioral intentions (i.e., prosocial and non-mandatory behaviors aimed at controlling the spread of the pandemic). Furthermore, we tested whether identification with the national group would influence the relationship between RWA and prosocial behavior. A cross-sectional study conducted on 350 Italian participants showed that right-wing political orientation had a negative effect on COVID-19 discretionary behavioral intentions via RWA. Furthermore, a moderated mediation model revealed that this effect was only significant for participants who are lowly identified with the national group. The results suggest that highlighting group belongingness might effectively motivate more conservative individuals to engage in prosocial behavior.

Self-Care as a Method to Cope With Suffering and Death: A Participatory Action-Research Aimed at Quality Improvement.

Introduction: Palliative care is an emotionally and spiritually high-demanding setting of care. The literature reports on the main issues in order to implement self-care, but there are no models for the organization of the training course. We described the structure of training on self-care and its effects for a Hospital Palliative Care Unit. Method: We used action-research training experience based mostly on qualitative data. Thematic analysis of data on open-ended questions, researcher's field notes, oral and written feedback from the trainer and the participants on training outcomes and satisfaction questionnaires were used. Results: Four major themes emerged: (1) "Professional role and personal feelings"; (2) "Inside and outside the team"; (3) "Do I listen to my emotions in the care relationship?"; (4) "Death: theirs vs. mine." According to participants' point of view and researchers' observations, the training course resulted in ameliorative adjustments of the program; improved skills in self-awareness of own's emotions and sharing of perceived emotional burden; practicing "compassionate presence" with patients; shared language to address previously uncharted aspects of coping; allowing for continuity of the skills learned; translation of the language learned into daily clinical practices through specific facilitation; a structured staff's support system for emotional experiences. Discussion: Self-care is an important enabler for the care of others. The core of our intervention was to encourage a meta-perspective in which the trainees developed greater perspicacity pertaining to their professional role in the working alliance and also recognizing the contribution of their personal emotions to impasse experienced with patients.

Negotiating the Beginning of Care: A Grounded Theory Study of Health Services for Amyotrophic Lateral Sclerosis.

A range of professional figures are needed to preserve the quality of life of people with amyotrophic lateral sclerosis. This study aimed to explore the beginning of the care process as negotiated by people with amyotrophic lateral sclerosis, their caregivers, and healthcare professionals. We designed the study according to the constructivist Grounded Theory method, collecting data through open-ended, semi-structured interviews, employing theoretical sampling and constant comparison, and performing conceptual coding as data analysis. By naming the core category "off-beat interfacing", we were able to show how the demands of the professionals concerned did not correspond to the ability of people with ALS and their proxies to process information, deal with requests, and be at ease in making decisions at the beginning of the shared care pathway. Three categories were generated: (i) navigating different paths, (ii) offering and experiencing a standard, non-personalized pathway, and (iii) anticipating decisions. The network of services must be organized according to guidelines, but must also contemplate a patient-family-centered approach that permits more personalized assistance.

Education for a biobased economy: Integrating life and social sciences in flexible short courses accessible from different backgrounds.

To achieve ambitious 21st-century goals and deal with high-level complexity, a bio-based economy is required to cross the boundaries of a single sector and integrate tools, language and knowledge drawn from different disciplines and sub-disciplines. The present contribution highlights how life scientists, social scientists, policymakers and industrial stakeholders should work together to make this technological reversal real and feasible. Importantly, going beyond theoretical and methodological integration, the paper underlines the necessity of developing a new and more flexible educational framework that might facilitate interdisciplinary combination. Specifically, the experience of the summer school "Towards a bio-based economy: science, innovation, economics, education" organized by the University of Milano Bicocca in collaboration with Chalmers University is described. The results reveal the need for high-level education programs likely to promote and guide society towards bio-based innovation.

"If I Am Straight You Are Askew": Labelling Heterosexuals as Straight Worsen Gay Men's Perception.

A robust stream of research has shown the detrimental influence of slurs and derogatory epithets on attitudes toward minority groups. Extending prior work, we explored the influence of positive labels ascribed to the majority group on the evaluation of the minority group. Specifically, three studies tested the possibility that the label "straight," generally linked with the concept of morality, would promote a negative evaluation of gay men. Study 1 exposed English speakers to an individual person described as straight (vs. heterosexual) while Study 2 exposed English speakers to a target person described as straight (vs. heterosexual vs. no label). Study 3 considered a non-English sample (i.e., Italian adults) and experimentally induced the association between the straight label and the concept of heterosexuality. In each study, participants were asked to express their attitudes toward a gay target after the manipulation. Results showed that heterosexual participants exposed to the label "straight" reported more negative attitudes toward gay men than heterosexual participants exposed to the label "heterosexual" (or when they were not exposed to any label). Critically, such an effect emerged only among highly religious participants. Implications for policies and prejudice reduction are discussed.

Trust predicts COVID-19 prescribed and discretionary behavioral intentions in 23 countries.

The worldwide spread of a new coronavirus (SARS-CoV-2) since December 2019 has posed a severe threat to individuals' well-being. While the world at large is waiting that the released vaccines immunize most citizens, public health experts suggest that, in the meantime, it is only through behavior change that the spread of COVID-19 can be controlled. Importantly, the required behaviors are aimed not only at safeguarding one's own health. Instead, individuals are asked to adapt their behaviors to protect the community at large. This raises the question of which social concerns and moral principles make people willing to do so. We considered in 23 countries (N = 6948) individuals' willingness to engage in prescribed and discretionary behaviors, as well as country-level and individual-level factors that might drive such behavioral intentions. Results from multilevel multiple regressions, with country as the nesting variable, showed that publicized number of infections were not significantly related to individual intentions to comply with the prescribed measures and intentions to engage in discretionary prosocial behaviors. Instead, psychological differences in terms of trust in government, citizens, and in particular toward science predicted individuals' behavioral intentions across countries. The more people endorsed moral principles of fairness and care (vs. loyalty and authority), the more they were inclined to report trust in science, which, in turn, statistically predicted prescribed and discretionary behavioral intentions. Results have implications for the type of intervention and public communication strategies that should be most effective to induce the behavioral changes that are needed to control the COVID-19 outbreak.

Perceiving one's nation: entitativity, agency and security in the international arena.

The perception of groups as real entities rather than mere aggregates of individuals has important consequences on intergroup relations. Social psychological research, in fact, shows that it affects stereotyping, identification process, and intergroup bias. Previous research has also shown that group entitativity is not a positive or negative group attribute per se; rather, it depends on the context and the relationship between the perceiver and the group. While enhancing entitativity leads to worse expectations about the out-group actions, high entitativity is a valued characteristic when associated with an ally or with the in-group. Indeed, enhancing in-group entitativity leads to stronger in-group identification. The specific reasons for why this is the case, however, remain to be ascertained. What is good about in-group entitativity? In the present contribution we propose that in-group entitativity may lead to perceive the group as a real entity provided with intentions and capacity for planned actions, notably ensuring the safety of its members by protecting them against external threats. We report two correlational studies conducted with American citizens (Study 1) and Italian citizens (Study 2), showing that in-group entitativity is associated with a higher level of identification, attribution of intentionality, and perceived security provided by the in-group. These findings were replicated in a third study-conducted with a role-play method on a fictitious scenario-in which entitativity was manipulated rather than measured. Study 3 also shows that artificially increasing the perception of in-group entitativity enhances perceived safety in an international context and reduces the perception of threat from an out-group. Findings are discussed in terms of possible implications for intergroup and international relations.

Turning Away From Averted Gazes: The Effect of Social Exclusion on Gaze Cueing.

Past studies showed increased sensitivity to other people's gaze after social exclusion. In the present research, across two studies, we tested whether social exclusion could affect the basic cognitive phenomenon of gaze-cueing effect, namely, the tendency to redirect visual attention to the same location that other people are looking at. To this purpose, participants were socially excluded or included using the Cyberball manipulation. In Study 1, after the manipulation, participants performed a gaze-cueing task in which an individual's gaze, oriented rightward or leftward, preceded a peripheral target stimulus requiring a simple categorization response. The gaze direction could be congruent or incongruent with the location of the target. Results revealed a reduced gaze-cueing effect for socially excluded than for socially included participants. In Study 2, where human gazes were replaced by arrow cues, such an interaction between social exclusion and trial congruency disappeared, indicating a specific effect of social stimuli. We interpreted these findings with the notion that excluded participants can perceive an averted gaze as a further sign of social exclusion, thus showing a reduced gaze-cueing effect.

Strategies in the information search process: interaction among task structure, knowledge, and source.

The authors explored the information search strategies of 145 individuals in the predecisional stage. Decision-making participants selected pieces of information from a list including relevant and irrelevant data. The authors investigated the influence of the individual's knowledge and information source. In Experiment 1, the authors experimentally manipulated the information source reliability. The results revealed that participants tended to use a sequential strategy when the authors presented information as supplied by a reliable source. In Experiment 2, the authors analyzed the interaction between information source and the individuals' knowledge. When participants believed the source to be reliable, even knowledgeable participants adopted a strategy as sequential as that chosen by naive individuals. In Experiment 3, a mediational model corroborated the hypothesis that the search strategy affects the final judgment. The results were consistent with the constructivist framework, which emphasizes the role of individual, task, and context in the decision-making process.

The Insidious Effects of Sexual Stereotypes in Clinical Practice.

The present study investigated the influence of sexual stereotyping on the diagnostic impressions and treatment expectations of gay and straight male patients. Italian male, straight, licensed psychotherapists (N = 152) were presented with clinical vignettes that described a gay (versus straight) male patient reporting either a straight-stereotypical disorder (i.e., rage dyscontrol) or a gay-stereotypical disorder (i.e., sexual compulsivity). Results revealed that treatment efficacy expectations were influenced by the patient's sexual orientation and the stereotypicality of the disorder. Specifically, psychotherapists anticipated fewer benefits from psychotherapy when gay patients reported a sexual disorder rather than a rage disorder. Furthermore, explicit and implicit levels of sexual prejudice did not play any role in driving such results. Taken together, these findings reveal that sexual stereotyping might exert its subtle effects among clinicians by influencing their clinical evaluations.