Vaccines and autism: a preliminary qualitative study on the beliefs of concerned mothers in Italy.

Purpose: While a large body of evidence has shown that the administration of the measles-mumps-rubella (MMR) vaccine is not associated with an increased risk of autism spectrum disorder (ASD), a hesitant attitude towards childhood vaccination is still present among the public. In this study, we aim to investigate the mothers' perceptions of the cause of their child's ASD in order to increase our understanding of vaccine hesitancy.Methods: This study draws on the analysis of 18 semi-structured interviews of mothers of children with ASD on the causes of autism.Results: The interview material was content-analysed. The main themes were 1) childhood vaccines; 2) genetics; 3) specific conditions of the mother or the newborn at the moment of delivery; 4) environmental factors such as the mother's lifestyle or her diet. The link between vaccines and autism was prevalent. About one third of the mothers reported that their child's ASD was a consequence of a combination of two or more factors, i.e., childhood vaccines and specific conditions of the newborn or the mother at the moment of delivery.Conclusion: This study provides preliminary insights into recurring sets of beliefs concerning the causes of ASD among the mothers of affected children.

Psychological interventions for people with hemophilia.

BACKGROUND: Managing hemophilia is challenging both in terms of medical treatment and its broad impact on many aspects of the individual's life, including self-perception. Several psychosocial issues are potentially relevant in the clinical management of hemophilia, including it being a chronic and incurable condition; e.g. people with hemophilia must adapt to optimally interact with peers and to practice sports - even choosing a sport represents an issue for perceived limitations, expectations and cultural influences on the individual and their family. People with hemophilia can react by denying their condition and its manifestations and not adhering to treatment. Due to the complexity of relationships surrounding genetic diseases, parents and relatives may have their own issues that contribute to making life easier or more difficult for the person with hemophilia. Anxiety, sadness and depression resulting in mental health disorders are reported in this population and may influence quality of life (QoL) depending on cultural background, religious beliefs, family support and other variables. OBJECTIVES: Primarily to assess the effectiveness of psychological therapies for improving the ability of people with hemophilia to cope with their chronic condition. SEARCH METHODS: We aimed to identify trials from the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, Embase and PsycINFO, CINAHL, MEDLINE and trial registries. We searched reference lists of included publications. Most recent search of the Group's register: 13 June 2019. SELECTION CRITERIA: Randomized controlled trials (RCTs) and quasi-RCTs in people with hemophilia of any age or gender, type A or B, any severity, with or without inhibitors, with or without HIV or hepatitis C virus. All psychological interventions for promoting emotional, intellectual and spiritual wellness. Individual, group or family group therapy interventions were eligible. DATA COLLECTION AND ANALYSIS: We independently assessed trials, extracted data and assessed the risk of bias and assessed the quality of the evidence using GRADE. MAIN RESULTS: Seven trials were included (362 participants randomized, data from 264 participants available for analysis); six of parallel design and one a partial cross-over design. One multicenter trial was conducted in Canada; the remaining six were single centre undertaken in the UK, USA, Iran and in the Netherlands. All trials had a high risk of bias for participant blinding and use of patient-reported outcomes. Evidence was retrieved on four interventions: psycho-education (DVD plus information booklet versus information booklet alone; computerised learning versus no intervention); cognitive therapy (auto-hypnosis (self-hypnosis) versus control); and behavioural therapy (relaxation (progressive or self control) versus no treatment). We also aimed to assess psychodynamic therapy and systemic therapy, but no trials were identified. Heterogeneity of the outcome measures and measurements precluded meta-analyses. No trial reported the cost of the psychological intervention and family adjustment. DVD plus information booklet compared to information booklet alone One trial (108 participants) showed coping strategies may lower pre-contemplation scores and negative thoughts, mean difference (MD) -0.24 (95%CI -0.48 - 0.00, low-certainty evidence), however, other measures of coping strategies in the same trial suggest little or no difference between groups, e.g. contemplation, MD (-0.09, 95%CI -0.32 - 0.14, low-certainty evidence). The same trial measured QoL and showed little or no difference between treatment groups for the physical domain, MD 0.59 (95% CI -3.66 to 4.84, low-certainty evidence), but may improve scores in the mental health domain for those receiving the booklet plus DVD compared to booklet alone, MD (4.70, 95% CI 0.33 to 9.07, low-certainty evidence). Mood or personal well-being were not reported. Computerised learning compared to no intervention Two trials (57 participants) reported on interventions aimed at children and adolescents and their impact on promoting a sense of self-efficacy (primary outcome 'Mood and personal well-being'), but only one showed an increase, MD 7.46 (95%CI 3.21 to 11.71, 17 participants, very low-certainty evidence); the second did not report control group data. One trial (30 participants) showed the intervention did not improve self-efficacy in adults, but appropriate data could not be extracted. Two trials (47 participants) reported coping strategies; one only reported within-group differences from baseline, the second showed an increase from baseline in coping strategies in the Internet program group compared to the no intervention group (disease-specific knowledge, MD 2.45 (95% CI 0.89 to 4.01); self-management ability and transition readiness, MD 19.90 (95% CI 3.61 to 36.19; low-certainty evidence). One trial reported QoL but with insufficient information to calculate changes from baseline; no difference in post-treatment scores was seen between groups, MD -8.65, 95% CI -18.30 to 1.00, very low-certainty evidence). Auto-hypnosis (self-hypnosis) compared to control There were two older trials that reported on this intervention (50 participants) focusing mainly on the secondary outcome 'physical health'; only one trial reported the primary outcome 'mood and personal well-being' (only within-group differences in the treatment group). Coping strategies and QoL were not assessed in the trials. Relaxation (progressive or self control) compared to no treatment Only one trial (seven participants) from 1985, was included which focused on 'physical health' and did not report on any of our primary outcomes. AUTHORS' CONCLUSIONS: Not all of the seven included trials analysed the effects of the interventions on our primary outcomes (mood and personal well-being, coping strategies and QoL). Three trials were conducted in the 1970s and 1980s using techniques of auto-hypnosis or relaxation and, in accordance with the needs and therapeutic possibilities of the time, they focused on secondary outcomes, e.g. frequency of bleeding (physical health) and adherence to the intervention. The four newer trials assessed psycho-educational interventions all mediated by the use of technologies (DVD or computer) and often created according to age needs of the target group. In these cases, attention was shifted to our pre-defined primary outcomes. This review has identified low- and very low-certainty evidence, prompting caution in its interpretation. The major problem we encountered was the heterogeneity of trial designs, of interventions and of outcome measures used across the trials. We strongly suggest that researchers consider developing a core outcome set to streamline future research; randomization was proven to be safe and acceptable, and blinding should be considered for those assessing patient-reported outcomes.

Representações Sociais de Mulher Cigana entre População Não-Cigana Brasileira e Italiana: Ancoragem Psicológica e Social / Social Representations of the Gypsy Woman among Non-Gypsy Brazilian and Italian Population: Psychological and Social Anchoring

RESUMO Referenciados pela abordagem não consensual da Teoria das Representações Sociais, objetivou-se investigar os processos de ancoragem psicológica e social frente às representações sociais de mulher cigana, o que permite analisar a modulação dos objetos sociais a partir do posicionamento interindividual e das experiências compartilhadas pelos sujeitos da representação segundo seu contexto sociocultural de inserção. Participaram do estudo 643 sujeitos não ciganos, brasileiros e italianos, com idade média de 22,81 anos (DP=5,73). Aplicando a análise de correspondência lexical, o processo de ancoragem psicológica indicou a formulação de oito clusters, que caracterizam diferentes representações, segundo as dimensões: mágico-religiosa, maternidade e cuidado com o grupo-família, exclusão social e figuras do feminino. Por meio da análise do processo de ancoragem social, verificou-se que variáveis como contato, sexo e nacionalidade atuam na modulação dessas diferentes representações sobre o objeto, produzindo ambiguidades que, historicamente, têm orientado processos de discriminação contra grupos ciganos.

ABSTRACT Based on the non-consensual approach of the Theory of Social Representations, the present study aimed to investigate the processes of social and psychological anchoring regarding the social representations of the gypsy woman, dimension which allows analyzing the modulation of the social objects from the interindividual positioning and the experiences shared by subjects of the representation according to their sociocultural context of insertion. The study included 643 non-gypsy, Brazilian and Italian individuals with mean age of 22.81 years (SD=5.73). Once lexical correspondence analysis was conducted, the process of psychological anchoring indicated the formation of eight clusters, which characterize different representations, according to the following dimensions: magical-religious, maternity and care of the family-group, social exclusion, and female figures. Through the analysis of the social anchoring process, we verified that variables such as contact, gender, and nationality act in the modulation of these different representations over the object, producing ambiguities that have historically led to processes of discrimination against gypsy groups.

Psychosocial factors affecting uptake of prenatal genetic testing: a pilot study.

OBJECTIVE: This study aims to explore the psychosocial factors which influenced the undergoing of prenatal genetic testing (PGT) in a sample of pregnant women. METHOD: An online questionnaire was emailed to a convenient sample of 105 pregnant women, recruited from among those attending two antenatal education programmes and via snowball sampling. RESULTS: A minority of respondents underwent chorionic villous sampling and amniocentesis (12 and 11, respectively). Advanced maternal age was related to undertaking PGT. The path analysis model (χ(2) (16, N = 97) = 19.01, ns; TLI = 0.95; RMSEA = 0.04; WRMR = 0.64) confirmed that three dimensions, namely having a more supporting attitude towards PGT (ß = 0.54, p < 0.001), perceiving PGT as reliable (ß = 0.29, p < 0.05) and the request for more scientific information (ß = 0.22, p < 0.01), related to test uptaking. CONCLUSION: Empirical researches investigating pregnant women's beliefs and attitudes relating to actual test uptake could help genetic counsellors and policy makers to better understand their client's profile in relation to the determining factors affecting the undertaking of PGT.

Prenatal genetic testing: an investigation of determining factors affecting the decision-making process.

Despite the increase in popularity of prenatal genetic testing, relatively little is known about the role psychological factors play in the decision-making process. In this analogue study, a sample of Italian female university students was used to investigate determining factors that predict the intention of undergoing prenatal genetic testing. Structural Equation Modelling was used to describe the dynamic interplay between knowledge, beliefs, attitudes and health-related behaviour such as prenatal genetic testing. Following the Theory of Reasoned Action, three dimensions predicted the intention to undergo prenatal genetic testing: the need for more scientific information, a positive attitude towards genetic testing, and the inclination to terminate pregnancy after receiving a positive test result. Results showed that less religious women tended to be more in favour of prenatal tests and in undertaking such tests. This preliminary study provides genetic counsellors and policy makers with a clearer picture of their clients' motives and attitudes behind the decision-making process of prenatal genetic testing, contributing to improving both the communication process between counsellors and their clients and the organization of genetic services.