Minority stress and mental health in gay and lesbian youth: A comparative study of Italy and Spain.

The present study was carried out based on the minority stress model. The purpose was to compare Italian and Spanish gay and lesbian youth on minority stressors and mental health outcomes and test the minority stress model in Italy and Spain. The sample consisted of 490 participants (307 Italians, Mage = 25.30 and 183 Spanish, Mage = 27.57). They completed an online questionnaire measuring everyday discrimination, coming out to family members, coming out to friends/one's social network, internalized sexual stigma, depression, and anxiety. A multivariate analysis of covariance was performed to explore the effect of nationality on all measures. Structural equation modeling was applied to test the direct and indirect (through internalized sexual stigma) effects of stressors on mental health outcomes. The results demonstrate an impact of nationality on three dimensions: Spanish youth presented higher levels of everyday discrimination, while Italian youth had lower levels of both coming out to family members and coming out to friends/one's social network. Further, in both countries, all stressors had both direct and indirect (through internalized sexual stigma) associations with depression and anxiety. These findings have some social implications: studying the effect of nationality can be useful in suggesting changes in political and social macrosystems. Additionally, studying the associations among these variables is helpful for intervening more efficiently, for example, clinically, on the impact of minority stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Equipping Youth to Think and Act Responsibly: The Effectiveness of the "EQUIP for Educators" Program on Youths' Self-Serving Cognitive Distortions and School Bullying Perpetration.

School bullying is a serious public health concern in many countries worldwide. Over recent decades, several effective anti-bullying prevention programs have been developed. This study aimed to evaluate the effectiveness of an adapted version of the "Equipping Youth to Help One Another (EQUIP) for Educators" (EfE) program in reducing adolescents' engagement in school bullying perpetration by correcting their use of self-serving cognitive distortions (CDs). Furthermore, guided by the vantage sensitivity framework, we investigated whether the intervention effects varied depending on the adolescents' gender and environmental sensitivity. A quasi-experimental pre-test/post-test with a control group design involved 354 Italian middle and high school adolescents (51.7% males; Mage = 14.86, SD = 2.54). Both the control (n = 187) and experimental group (n = 167) completed self-report questionnaires, before and after the intervention. Structural equation modeling revealed a significant moderated mediation effect: highly sensitive males participating in the EfE program decreased their engagement in bullying by reducing CDs, compared to females and those with low- and medium- sensitivity. These findings support the effectiveness of the EfE program in equipping youth to think and act more responsible and shed light on "why" and "for whom" the intervention might work better to counteract school bullying during adolescence.

Individual and Environmental Correlates of Adolescents' Moral Decision-Making in Moral Dilemmas.

While extensive research has been conducted on adults' judgments in moral sacrificial dilemmas, there is little research on adolescents. The present study aimed at: (1) adding further empirical evidence about adolescents' moral decisions (deontological vs. utilitarian) in sacrificial moral dilemmas and (2) investigating how these moral decisions relate with gender, school grade, emotional traits (callous-unemotional traits), context-related experiences (perceived parental rejection and community violence exposure), and moral-related factors (moral disengagement and universalism value). A sample of 755 Italian adolescents (54.7% females; Mean age=16.45, SD=1.61) attending the second and the fifth year of secondary school took part in the study. Two sacrificial trolley-type dilemmas (where harmful actions promote the greater good) were presented. In the "switch" scenario (impersonal sacrificial dilemma), the choice is whether to hit a switch to save five people killing only one person. In the "footbridge" scenario (personal sacrificial dilemma), the choice is whether to push a large man off a footbridge saving five persons. For each scenario, participants had to indicate whether the proposed action was "morally acceptable" or not. Data were analyzed performing generalized linear mixed models. Our results showed that: (1) Adolescents were more likely to indicate as admissible to hit the switch rather than to push the large man; (2) male adolescents, compared to females, were more likely to say it was morally acceptable to intervene in the footbridge dilemma, whereas younger adolescents said it was morally acceptable both in the switch and the footbridge situations; and (3) higher levels of callous-unemotional traits, perceived parental rejection, and moral disengagement, on the one hand, and lower levels of universalism, on the other hand, were associated to higher admissibility to intervene in the footbridge scenario. Higher community violence exposure was associated with a lower propensity to intervene in the switch scenario. Overall, the present study expands the research on sacrificial dilemmas involving a sample of adolescents. The findings support previous studies concerning the role of emotions in making moral decisions but, at the same, open new perspectives regarding the role of contextual experiences and moral-related factors.

Mortality and clinical outcome of Italian patients undergoing orthopaedic surgery: effect of peri-operative blood transfusion.

BACKGROUND: Blood transfusion is a relevant issue for elderly and frail patients, as they are often anaemic and have chronic diseases. Transfusion of red blood cells (RBC) can potentially affect morbidity and mortality of elderly patients undergoing major orthopaedic surgery. MATERIALS AND METHODS: We carried out a retrospective analysis of 2,593 patients undergoing major orthopaedic surgery between 2013 and 2017 in a single research institution in the Region of Apulia. The aims of the study were: 1) to describe the characteristics of transfused patients according to a restrictive or liberal strategy of transfusion and haemoglobin (Hb) triggers and targets; 2) to investigate the effect of RBC transfusion on mortality and complications. RESULTS: Older, women and patients with American Society of Anesthesiologists (ASA) score 3-4 were more often transfused. Those with lower admission Hb level had a higher risk of being transfused. Hb triggers were associated with the patients' age. A restrictive transfusion strategy was significantly more frequent in patients undergoing primary knee replacement and in those with higher estimated blood loss. We did not observe any significant difference of complications in patients transfused with a liberal vs restrictive strategy. Logistic regression correcting for potential confounders revealed that sex (males more than females), duration of stay in hospital, hip fracture and Charlson score >4 were good predictors of complications and/or mortality. Mortality was significantly higher in males and in older patients with ASA score 3-4. DISCUSSION: In this large cohort of Italian patients undergoing major orthopaedic surgery males were significantly more exposed than women to complications and in-hospital mortality. Furthermore, those undergoing urgent surgery because of hip fracture had a 3-fold higher chance of complications. Charlson score >4 and ASA 3-4 are good predictors of complications and mortality, respectively.

Pathways Linking Exposure to Community Violence, Self-serving Cognitive Distortions and School Bullying Perpetration: A Three-Wave Study.

School bullying is a social phenomenon stemming from a complex interrelationship between the individuals and their environments. Underpinned by the social-ecological models, this study investigated the mediation of self-serving cognitive distortions (CDs) in the relationship between community violence exposure, as a victim and as a witness, and bullying perpetration. Bidirectional associations between violence exposure and bullying perpetration, and between CDs and bullying perpetration over time were also hypothesized. The study used a three-waves cross-lagged panel modeling in a sample of 829 Italian high school adolescents (46% males; Mage [Time 1; T1] = 12.71; Standard deviation [SD] = 1.68). The results showed that being exposed to community violence as a witness at T1 increased the development of CDs at Time 2 (T2), which in turn promoted the bullying perpetration at Time 3 (T3). Being exposed to community violence as a victim was not a significant predictor of CDs and bullying perpetration over time. Bidirectional associations were found between witnessing violence and bullying perpetration, and between CDs and bullying perpetration. The association between community violence exposure and individual moral cognitions over time plays a crucial role in predicting bullying perpetration. These findings highlight the need to consider both contextual and individual factors in understanding and preventing bullying perpetration.