Comparison of EsophyX2.0 and MUSE systems for transoral incisionless fundoplication: Technical aspects and outcomes up to 3 years.

OBJECTIVES: We compared the efficacy and safety of transoral incisionless fundoplication (TIF) with the EsophyX2.0 and MUSE systems for treatment of gastroesophageal reflux disease (GERD). METHODS: TIF outcomes from prospective protocols (Esophy2.0X: 2007-2012; MUSE: 2015-2019) were retrospectively compared regarding technical success, moderate/severe adverse events, morpho-functional findings up to 1 year, and clinical outcomes up to 3 years. Inclusion criteria were: (i) at least 6-month symptomatic GERD, full/partial response to proton pump inhibitors (PPI), esophagitis, and nonerosive reflux disease/hypersensitive esophagus (both protocols); (ii) hiatal hernia <3 cm (Esophy2.0X) and ≤2.5 cm (MUSE); and (iii) Barrett's esophagus <3 cm (MUSE). RESULTS: In the 50 EsophyX2.0 and 46 MUSE procedures, technical success and adverse event rates were similar, but MUSE-related adverse events (4.4%) were life-threatening. At 12 months, hiatal hernia recurred more frequently after EsophyX2.0 (P = 0.008). At 6 months, significantly fewer total and acid refluxes were reported after both TIF, but not more significantly at 1 year. Symptoms improved after both TIF up to 1 year (P < 0.0001), but to a greater extent in MUSE patients up to 3 years (P < 0.0001 vs. P < 0.01 for EsophyX2.0). The rates of 3-year off-PPI therapy patients were 73.5% in the MUSE and 53.3% in the EsophyX2.0 series (P = 0.069). CONCLUSION: Although no conclusion could be drawn from this limited study, the MUSE technique seemed more effective in the long term in patients with hiatal hernia; however, there were more severe adverse events than with EsophyX2.0.

Addressing the effect of concern with COVID-19 threat on prejudice towards immigrants: The sequential mediating role of need for cognitive closure and desire for cultural tightness.

The link between threat and anti-immigrant prejudice is well-established. Relatedly, recent research has also shown that situational threats (such as concern with COVID-19 threat) increase anti-immigrant prejudice through the mediating role of desire for cultural tightness. This study aims to further our understanding of the psychological processes underlying the relation between concern with COVID-19 threat and increased negative attitudes towards immigrants by considering the mediational role of an individual epistemic motivation (i.e., the need for cognitive closure). A study was conducted on a large sample of Italian respondents covering all the Italian regions. Findings revealed that high concern with COVID-19 threat led to increased negative attitudes towards immigrants through the sequential mediating role of higher need for cognitive closure, leading in turn to higher desire for cultural tightness. Implications of these findings for a timely contextualized study of anti-immigrant prejudice will be highlighted.

Coeliac disease and psychiatric comorbidity: epidemiology, pathophysiological mechanisms, quality-of-life, and gluten-free diet effects.

Coeliac Disease (CD) is an autoimmune disease in which an environmental factor, gluten, triggers a pathological reaction. It results in intra- and entra-intestinal manifestations of disease, including, most frequently, diarrhoea, weight loss, and anaemia. CD occurs in ∼1% of the western population, being one of the most common autoimmune lifelong disorders, and may present with a variety of psychiatric comorbidities. Psychiatric comorbidity in CD often complicates the diagnosis, reduces the quality-of-life, and worsens the prognosis of affected patients. This review summarizes the epidemiological studies that underline this connection, and focuses on the potential mechanisms related to this comorbility, such as nutritional deficiencies, immune responses, interference in brain processes, and dysfunctions in the gut-brain axis. Factors that play a central role on patients' quality of life, psychological well-being and adherence are presented. Finally, evidence of regression in psychiatric symptoms following the introduction of a gluten-free diet is underlined as well.

Significance loss brings to extreme self-care related behaviors: the role of interpersonal influence and obsessive (vs. harmonious) passion.

Building on Significance Quest Theory we hypothesized that significance loss feelings can bring people to extreme self-care related behaviors via (a) the susceptibility to interpersonal influence, and (b) the development of a predominance of obsessive (vs. harmonious) passion toward the self-care. To test these hypotheses, we ran one cross-sectional study among voluntary participants (N = 401). Results confirmed our hypotheses, suggesting that physical appearance is perceived as a fruitful and useful route to maintain or even restoring ones' personal sense of significance. Notably, these results shed light on another scope that can be exploited to achieve social significance (i.e., physical appearance) through extremism, and could represent a starting point to design practical intervention to reduce the examined extreme behaviors.

Motivation to Avoid Uncertainty, Implicit Person Theories about the Malleability of Human Attributes and Attitudes toward Women as Leaders vs. Followers: A Mediational Analysis.

This research investigated the relation between motivation to avoid uncertainty, as reflected in the need for cognitive closure, implicit theories about the malleability of human attributes, and attitudes toward women as leaders vs. followers. In a cross-sectional study (N = 470) conducted in Italy, we hypothesized and found that the need for cognitive closure directly enhanced the belief that women are compatible with followership roles rather than leadership roles. Furthermore, the results from a mediational analysis revealed that the relation between the need for cognitive closure and the belief that women are compatible with followership roles rather than leadership was mediated by implicit person theories (i.e., the conviction that people features are malleable vs. unchangeable). Notably, we obtained these results while controlling for participants' gender, educational level, and age. The theoretical and practical implications are discussed.

Intergroup Contact Is Associated with Less Negative Attitude toward Women Managers: The Bolstering Effect of Social Dominance Orientation.

This cross-sectional study examined the intergroup contact hypothesis in the workplace by enrolling 150 Italian employees. Within the framework of social dominance theory, the purpose of this study was to test the assumption that individuals with higher levels of social dominance orientation are more likely to exhibit prejudice against women in managerial positions and benefit more from intergroup contact with a female supervisor. In particular, we found that individuals with higher levels of social dominance orientation exhibited more negative attitudes towards women in manager positions, but this effect only appeared when their superiors were women, as opposed to men. In addition, participants with higher social dominance orientation experienced more positive outcomes from intergroup contact, resulting in less negative attitudes toward women managers, than those with lower social dominance orientation. Overall, these findings yield insights into how intergroup contact affects individuals with prejudice tendencies, indicating that contact with the targeted group (i.e., women in managerial positions) is negatively associated with negative attitudes towards the group, even when the prejudice is driven by social dominance orientation. These results could shed light on new routes to design practical intervention aimed at solving prejudice towards women in leadership roles.

Means substitutability in personal significance restoration.

Drawing on Significance Quest Theory, we hypothesized that when people experience a loss of significance related to a specific life domain, they will aim to restore their significance by acting in an extreme manner in a different life domain. To test this hypothesis, we ran two cross-sectional studies using samples of employed people in romantic relationships. Study 1 tested if people experiencing a loss of significance in the romantic relationship domain were more prone to extremism at work. Study 2 tested whether people experiencing work-related significance loss were more prone to engage in obsessive relational intrusion (ORI) toward their romantic partner. Results from both studies confirmed our hypothesis, suggesting that both amorous relationships and careers are perceived as fruitful in maintaining or restoring ones' sense of personal significance, even if the original loss of significance is derived from an unrelated domain. Notably, this research represents one of the first tests of the key assumption of Significance Quest Theory entailing the substitutability of means through which one can attain or renew their sense of significance.

Broad Spectrum project: factors determining the quality of antibiotic use in primary care: an observational study protocol from Italy.

INTRODUCTION: The overuse of antibiotics is causing worldwide spread of antimicrobial resistance (AMR). Compared with other countries, Italy has both high antibiotic consumption rates and high rates of AMR. Due to the fact that around 90% of antibiotics are prescribed by general practitioners (GPs), this study aims to measure the impact of knowledge, attitudes and sociodemographic and workplace-related factors on the quality of antibiotic prescriptions filled by GPs in the Italian Region of Sardinia. METHODS AND ANALYSIS: Knowledge, attitude, sociodemographic and workplace-related factors deemed to influence physicians prescribing behaviour will be evaluated in a cross-sectional study conducted among all GPs of the Italian Region of Sardinia (n=1200). A knowledge and attitudes questionnaire (Knowledge and Attitudes on Antibiotics and Resistance - Italian version: ITA-KAAR) accompanied by a sociodemographic form will be linked to drug prescription data reimbursed by the National Health System. European Surveillance of Antibiotic Consumption quality indicators for outpatient antibiotic use will be calculated from drug prescription records. Every GP will be deemed to have demonstrated an adequate quality of prescriptions of antibiotics if half of the indicator score plus one is better than the median of the region. A multivariate Poisson regression model with robust variance estimation will be used to evaluate the impact of the determinants of antibiotic prescriptions on the actual prescribing quality of each physician. ETHICS AND DISSEMINATION: The project has been approved by the ethics committee of the Regional Health Trust of Sardinia (176/2019/CE, 24 September 2019). The results will be useful to inform evidence-based interventions to tackle irrational antibiotic use in the community.