The hospice as a learning space: a death education intervention with a group of adolescents.

BACKGROUND: The denial of death in Western society deprives young people of the tools to derive meaning from experiences of death and dying. Literature shows that death education may allow them to become familiar with this topic without causing negative effects. This article describes the effects of a death education course with adolescents, wherein participants were given the opportunity to meet palliative doctors and palliative psychologists at school and in a hospice, where they were able to converse with the families of the dying. METHODS: This study used mixed methods and included an evaluation of a death education intervention with longitudinal follow-up of outcomes. The course involved 87 secondary school students (experimental group) aged between 16 and 20 years. We also recruited a control group of 76 similarly-aged students to observe differences. The variables we examined were: alexithymia, representation of death, value attributed to life and spirituality. These were measured with the following instruments: the Toronto Alexithymia Scale-20, the Testoni Death Representation Scale, the Personal Meaning Profile and the Spiritual Orientation Inventory, respectively. To better understand how the students perceived the experience, we asked the experimental group to answer some open-ended questions. Their answers were analysed through thematic analysis. RESULTS: The study showed that death education and the hospice experience did not produce negative effects, but rather allowed students to decrease alexithymia, improving their ability to recognise and express emotions. Thematic analysis revealed that all participants perceived the experience as very positive. CONCLUSIONS: Our findings affirm that death education programs can be successfully implemented in high schools, and that they can usefully involve local hospices and palliative care professionals, especially physicians and psychologists.

The Invisible Discrimination: Biases in the Clinical Approach Regarding Migrants: A Study to Help Ethnopsychology Services and Clinicians.

The complexity of migration flows across the world has led to a redefinition of psychological and social services users. The access of migrants from different cultural backgrounds to clinical services or social health services has diversified the demand for concomitant help. Biases and misinterpretations have been created by unaccustomed professionals in this field, which could lead to serious consequences and invalidate diagnostic and treatment procedures. The purpose of this study is to summarize the evidence about errors or prejudices observed in clinical practices regarding the provision of social health services to people from different cultural backgrounds. Results show three main types of biases: racial stereotype activation, ethnocentrism and micro-aggressions. Some implications on the clinical setting were discussed, as being aware of these biases can help mental health professionals manage communication more consciously with users.

Dehumanization and burden of care among caregivers of terminally ill patients.

This article considers the relationship between dehumanization, ontological representation of death, trust in physicians, and burden of care on the part of caregivers of terminally ill patients. One hundred informal caregivers (relatives and friends) of patients hospitalized in four hospice facilities in northern Italy were involved. Of these, 77% were primary caregivers (those who mostly helped the patient). All of the participants were given a questionnaire comprising the Caregiver Burden Inventory (CBI) to determine caregivers' burden in their roles, the questionario post mortem (QPM) (post mortem questionnaire) for the effectiveness of and their trust in the medical nursing team of palliative care services, the Testoni death representation scale (TDRS) to detect their ontological representations of death and the humanity attribution test (HAT) to investigate their attributions of humanity to terminally ill patients. Per the literature, the present results demonstrated higher burden levels for female caregivers and primary caregivers. In informal caregiving, the dehumanization of patients does not have any advantage in reducing the burden of care. Further studies are required to compare formal and informal caregivers concerning the effect of dehumanization.

Mourning and Management of the COVID-19 Health Emergency in the Priestly Community: Qualitative Research in a Region of Northern Italy Severely Affected by the Pandemic.

Background: The COVID-19 pandemic is causing major social changes to which significant psychological effects are linked. During the first phase of the pandemic wave in Italy, whilst there was insufficient information about the phenomenon and the strategies to safeguard the population against it, many categories of people, whose professions required constant contact with the public, were affected by the contagion. Aims: The literature has shown how religiousness can support the management of stress due to diseases and health risks. In relation to this, the current study wanted to investigate how priests managed the early stages of the pandemic. This work, therefore, aimed to investigate the psychological experiences related to the contagion and the eventual death of colleagues as well as the resilience strategies activated by the priests during the process. Participants: The research involved 12 Catholic priests, all male and aged between 42 and 63 years. They came from the same pastoral community in one of the regions in Northern Italy that were most affected during the first phase of the pandemic. Those ministers had been constantly in contact with the faithful of their parishes since the breakout of the virus. Methodology: A qualitative research design was adopted, and in-depth interviews were conducted. The dialogues aimed at investigating the deep, personal and relational experiences of the priests, together with their concerns and the tools they adopted to manage anxiety. The texts obtained from the interviews were subjected to thematic analysis. Results: The areas studied concerned the experiences of the participants during the lockdown, the implications of social distancing and lack of funeral rituality and, finally, the importance of prayer as a resilience factor. Conclusions: In the current scenario dominated by the pandemic, it is significant and stimulating to understand and reflect on the functions and roles of the experiences of faith, particularly the act of elaborating the process of mourning due to COVID-19.

Factors Associated with HIV Drug Resistance in Dar es Salaam, Tanzania: Analysis of a Complex Adaptive System.

HIV drug resistance (HIVDR) is a complex problem with multiple interconnected and context dependent causes. Although the factors influencing HIVDR are known and well-studied, HIVDR remains a threat to the effectiveness of antiretroviral therapy. To understand the complexity of HIVDR, a comprehensive, systems approach is needed. Therefore, a local systems map was developed integrating all reported factors influencing HIVDR in the Dar es Salaam Urban Cohort Study area in Tanzania. The map was designed based on semi-structured interviews and workshops with people living with HIV and local actors who encounter people living with HIV during their daily activities. We visualized the feedback loops driving HIVDR, compared the local map with a systems map for Sub-Saharan Africa, previously constructed from interviews with international HIVDR experts, and suggest potential interventions to prevent HIVDR. We found several interconnected balancing and reinforcing feedback loops related to poverty, stigmatization, status disclosure, self-esteem, knowledge about HIVDR and healthcare system workload, among others, and identified three potential leverage points. Insights from this local systems map were complementary to the insights from the Sub-Saharan systems map showing that both viewpoints are needed to fully understand the system. This study provides a strong baseline for quantitative modelling, and for the identification of context-dependent, complexity-informed leverage points.

The Value of Dignity in Prison: A Qualitative Study with Life Convicts.

BACKGROUND: This research is based on the perspective of dignity according to Chochinov; thus, the life imprisonment of detainees is assimilated to a severe disease. METHODS: Ten male prisoners were interviewed trough Chochinov's Dignity Therapy, and the results were analysed using thematic analysis. RESULTS: Two areas of thematic prevalence emerged, namely, value of freedom, self-consciousness and education and their failure in jail, and life sentence as annihilation of life meaning and of the values of generativity and family. CONCLUSIONS: Life imprisonment has been described in its negativity by several respondents as a punishment worse than the death penalty. It has been compared to death itself, to a terminal illness, to torture and to a pain that grows over the years, with the awareness that despite the passing of time, you will not have the opportunity to return to your loved one and to a free life. In fact, prisoners live out their condition within a space in which any value that gives meaning to life risks being destroyed.

Predictors of caregiver burden in partners of patients with Parkinson's disease.

Aim of this study was to determine the predictors of caregiver burden among spouse caregivers of patients with Parkinson's disease (PD). Forty consecutive PD patients and their spouse caregivers were included. Patients were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), the Hoehn and Yahr scale (HY), the Mini-Mental State Examination (MMSE), the Neuropsychiatric Inventory (NPI), and the Geriatric Depression Scale (GDS). Stress and depressive symptoms among caregivers were evaluated using the Caregiver Burden Inventory (CBI) scale and the GDS. Only PD severity (HY) and mental symptoms (NPI) were significantly associated to caregiver distress. A major attention must be given to the early identification of factors generating stress in caregivers in order to improve caregiver quality of life and patient's care.

Quality of Work Life: Comparative Analysis Between two Public Workers Groups / Qualidade de Vida no Trabalho: Análise Comparativa Entre dois Grupos de Servidores Públicos

ABSTRACT The general objective of the study was to compare the analysis of the perception of Quality of Work Life of workers from two federal entities in the infrastructure area based on the Activity-centered Ergonomics Applied to QWL. A total of 3.136 workers participated in this research. As an instrument it was used an electronic version of the QWL Valuating Inventory. The result presents no significant differences in perception of the two groups of works in relation to the quality of life at work. The element work organization was the worst evaluated indicating alertness and risk of illness. The research indicates issues that deserve attention during the elaboration of QWL Policy and Program in the evaluated organizations.

RESUMO O objetivo geral do estudo foi comparar a percepção da Qualidade de Vida no Trabalho de trabalhadores de dois órgãos públicos da área de infraestrutura com base na Ergonomia da Atividade Aplicada à QVT. Participaram desta pesquisa 3.136 trabalhadores. Como instrumento foi utilizada uma versão eletrônica do Inventário de Avaliação de QVT. O resultado que não há diferenças significativas na percepção dos dois grupos em relação à qualidade de vida no trabalho. O elemento organização do trabalho foi o pior avaliado indicando alerta e risco de adoecimento. A pesquisa aponta questões que merecem atenção durante a elaboração da Política e Programa de QVT nas organizações avaliadas.

Ergonomics of virtual environments for clinical use.

Usability is defined by the International Standards Organization as "the effectiveness, efficiency and satisfaction with which a certain user may achieve a specific objective in a particular environment" (ISO DIS 9241-11). This definition highlights the need for considering the specific destination of a certain technology and reflects the current trends in Human-Computer Interaction (HCI). In compliance with these remarks, the evaluation will be described here of a Virtual Environment (VE) for the treatment of male sexual dysfunctions; the common assumption will be avoided according to which a VE is a space separated from its "real" surroundings [6, 7] and the full environment where the Virtual session takes place will be addressed instead. After a description of the conceptual framework adopted, the paper will dwell on one method among those deployed for the evaluation, namely the analysis of "situated actions". Four aspects will be dealt with: (a) the interplay of various concurrent settings during the virtual session; (b) the users' comprehension of the symbols used in the VE; (c) the structure of the relationship between users and guide; (d) the breakdowns during the human-VE interaction. The goals and the intended meanings of the simulation as set by the designers became the main parameters for the evaluation.