ObjectiveTo explore the effects of oxytocin administration on social cognition and social engagement in patients with behavioral variant frontotemporal dementia.MethodsIn a within-subject, double-blind, placebo-controlled, randomized crossover trial, patients with behavioral variant frontotemporal dementia completed the primary outcome measures, facial emotion and intention recognition tasks. Secondary outcomes included evaluation of drug safety and tolerability and changes in social engagement, assessed through caregiver ratings of social behavior. Exploratory outcomes included anger-bias in emotion misclassification and a LIWC-based analysis of speech during a semi-structured interview.ResultsOxytocin was safe, well-tolerated, and improved social engagement in naturalistic contexts: caregivers reported positive changes, including increases in awareness, spontaneous initiative, socio-affective engagement, and reductions in appetite/impulsivity. Exploratory analyses suggested that oxytocin reduced the tendency to misclassify fearful and sad expressions as angry and reduced the use of first-person pronouns during spontaneous speech. However, the study detected no improvements in the emotion recognition and observed decreased accuracy in recognizing harmful intentions.ConclusionExploratory findings suggest that oxytocin reduces threat-bias, promotes social engagement, and decreases self-focused language, while no improvements were detected on experimental measures of social cognition. The results highlight the safety and potential of innovative oxytocin-based pharmacological interventions and the value of incorporating naturalistic assessments, such as ecological social interactions and language analysis, to optimize the detection of therapeutic effects in neurodegenerative diseases. Oxytocin may hold promise for enhancing social engagement in behavioral variant frontotemporal dementia, although its effects on language use and higher-order cognitive processes require further investigation.

Despite the widespread integration of ICT into education, research linking students' everyday ICT use to mathematics performance has yielded inconsistent results. A key gap in the existing literature is the limited attention to factors such as actual digital literacy and the specific purposes for which ICT is used. This study addresses this gap by examining the relationship between students' performance in the International Computer and Information Literacy Study (ICILS) and their results in the national mathematics assessment. The analysis is based on data from 2309 students who participated in the national mathematics assessment in fifth grade and again took both the ICILS and the national mathematics assessment in eighth grade. A structural equation model incorporating the study variables explained 43% of the variance in students' mathematics scores. After controlling for socioeconomic status (SES) and prior mathematics achievement, the findings indicate that digital literacy significantly contributes to mathematics performance. Specifically, students with higher ICILS scores at the beginning of the school year achieved better mathematics outcomes by the end. In contrast, the frequency of ICT use for study or social communication was not linked to digital literacy or improved mathematics performance. These findings suggest that enhancing students' ICT skills is a promising strategy for improving mathematics performance. The study highlights that growing up with digital devices does not automatically equate to sophisticated digital skills. It supports the argument that the focus of the "digital divide" should shift toward differences in the development of digital skills, rather than merely access to technology.

Purpose Potentially inappropriate prescriptions are associated with an increased risk of drug-drug interactions, adverse events, and unfavorable clinical outcomes, especially in older adults. Although different tools to improve appropriate prescribing have been developed to support healthcare professionals, their application and the barriers to their use remain insufficiently explored. This study aimed to assess Italian healthcare professionals’ knowledge of these tools and identify obstacles to their adoption. Methods The study used a purposefully designed questionnaire to assess knowledge, adoption, and barriers related to appropriateness tools. The tools included were identified through a literature review and subsequently refined via expert consensus. Open-ended responses were analyzed using a conventional content analysis approach, and the analyses focused on differences across professional groups. Results The survey collected 657 responses from pharmacists (35%), nurses (26%), general practitioners (22%), geriatricians/internists (9%), and other physicians (8%). The Beers and STOPP/START criteria were used by 38% and 34% of participants, respectively, with geriatricians and other physicians being the primary users. Additionally, 34% of participants reported using specific software integrated into their institutional computer systems. Among 294 respondents identifying barriers to appropriate prescribing, the most common were lack of time (14%), lack of knowledge (10%), and accessibility/costs of digital tools (8%). Key facilitators included specific training (38%), integrated software/apps (29%), and more time with patients (11%). Conclusions The adoption of tools supporting appropriate prescribing remains limited among healthcare professionals in Italy, with significant differences among professionals. Policymakers and healthcare institutions should focus on education, interprofessional collaboration, and user-friendly digital solutions to improve prescribing process and patient safety.

Background/Objectives: This study of endophenotypes represents a new research approach to overcome the limits of a syndromic model to psychiatric diseases. The Affective Neuroscience Personality Scales (ANPS, 31) is a self-report questionnaire used to facilitate the transition from the syndromic to the endophenotypic model through the assessment of basic emotional systems described by Panksepp (1): SEEKING, PLAY, CARE, FEAR, RAGE, PANIC, and LUST. The ANPS was used with adults, but it may be important to investigate the expression of basic emotional systems in childhood clinical disorders. Methods: The present study compares the ANPS scores of a group of children (n = 71) with internalizing disorders (diagnoses of depression and anxiety) with those of a normative group (n = 208) (8-13 years). Conclusions: We found that the group with internalizing disorders showed significantly lower scores for SEEKING and PLAY and significantly higher scores for ANGER and SADNESS than the control group. Furthermore, depressed children reported significantly lower scores in the SEEKING, PLAY, CARE scales and higher scores in the ANGER and SADNESS scales than healthy children. The children with anxiety disorder had significantly lower scores in the SEEKING and PLAY scales and higher scores in the FEAR and SADNESS scales than control children. No significant effect was found in reference to the age of the children. The results indicate that the ANPS might be a useful instrument to assess the expression of emotional endophenotypes in childhood.

Background: New strategies for respiratory syncytial virus (RSV) prevention are available and are in development, but their acceptance is crucial to their effectiveness. Objectives: This systematic review aims to summarize current quantitative and qualitative evidence regarding knowledge and attitudes relating to RSV prevention. Methods: Six databases (PubMed, Scopus, APA PsycArticles; APA PsycInfo; CINAHL Complete; Psychology and Behavioral Sciences Collection) and two preprint repositories (medRxiv and Preprints) were searched up until 23 December 2024 (PROSPERO: CRD42024602351). Results: Sixty-one articles were included, focusing on vaccination for the elderly and adults at risk (n = 10) or pregnant people (n = 24, of which 8 also examined preferences for maternal vs. infant immunization) and infant immunization (n = 27, of which 16 focused on palivizumab, with 6 focusing on adherence to its monthly administration). Eighteen articles assessed attitudes in healthcare professionals. Overall, findings showed limited knowledge and awareness of RSV but generally positive attitudes towards prevention strategies and moderate to high intentions and uptake rates. Protection against the disease and perceived severity promoted acceptance, whereas concerns about side effects hindered it. Maternal vaccination was more acceptable than infant immunization. Conclusions: Attitudes towards RSV prevention options were generally favorable. Should more options become available, preferences may depend on which options are available, their characteristics, and how they are framed and presented. These insights highlight the importance of education on RSV grounded in decision-making literature, while recognizing the likely favorable reception of preventive measures across target age-populations.

Background: Clinical reasoning (CR) is fundamental in medical education. However, the Italian curriculum has not incorporated a structured CR format yet. Therefore, we introduced the Clinical Case Discussions (CCD), to medical students attending the University of Bologna as a tool for developing CR abilities. CCDs are a case-based peer-teaching format, simulating the diagnostic process using published patient cases. Methods: Students of all clinical years of the University of Bologna Medical School were invited to voluntarily participate in a two-day CCD training program. They completed pre- and post-training questionnaires assessing their expectations before and impressions after the training and comparing learning outcomes to their usual classes. Results: Twenty-one students participated in this pilot program. Before the training, more than half of the participants expressed either interest or a strong interest in all proposed learning objectives. Afterward, 84.6% of the students stated that the training much exceeded (63.5%) or exceeded (23.1%) their expectations considering its utility for their future medical activities. A total of 92.3% strongly agreed (84.6%) or agreed (7.7%) to have improved their CR. Conclusions: Although this pilot program had some intrinsic limitations, the students’ positive feedback on this CCD format (combining the benefits of case-based learning and peer teaching) encourages further research on its potential role in the Italian curriculum.

Several studies indicate a link between personal distress and vulnerability to depression. The literature also suggests that personal distress is associated with emotion dysregulation and that emotion dysregulation plays a role in depression. However, which of the various emotion regulation difficulties mediates the relationship between personal distress and depression remains unexplored. This study therefore aims to investigate the mediating role of specific emotion regulation difficulties in the relationship between personal distress and depression. Of the 702 initially recruited participants, 635 completed a survey comprising the Interpersonal Reactivity Index, the Difficulties in Emotion Regulation Scale, and the Beck Depression Inventory. A mediation analysis was used to explore which emotion regulation difficulties mediate the relationship between personal distress and depression. Over a quarter (27%) of participants reported moderate-severe depression symptoms. Difficulties in accessing adaptive emotion regulation strategies and in having a clear understanding about one's own emotions partly mediated the relationship between personal distress and depression symptoms. Our results are the first to indicate that personal distress is linked to depression risk through specific emotion regulation difficulties in medical students. They also highlight possible modifiable skills that could be targeted by prevention intervention.

Introduction: Evaluation of post-nephrectomy social health in living kidney donors is essential. This systematic review examines their emotional need for social relatedness post-donation. Methods: Following the PRISMA guidelines, we systematically searched Scopus, CINAHL, and PsycINFO. Results: Among the screened records, 32 quantitative and 16 qualitative papers met the inclusion criteria. Quantitative research predominantly utilized questionnaires featuring generic items on social functioning. However, a minority delved into emotional and social dimensions, aligning with qualitative studies emphasizing the importance of social connection and perceived social support post-donation. Specifically, post-donation changes in connecting with others encompass a sense of belongingness, heightened autonomy, shifts in concern for the recipient’s health, and continued care by shielding the recipient from personal health issues. Social acknowledgment and social support from both close and extended networks are reported as relevant for recovery after nephrectomy. Discussion: These findings underscore the necessity for targeted measures of emotional needs and social functioning to effectively assess post-donation adjustment. They also inform the identification of key health themes for kidney donor Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) questions.

Previous research suggests that emotion recognition is influenced by social categories derived by invariant facial features such as gender and inferences of trustworthiness from facial appearance. The current study sought to replicate and extend these findings by examining the intersection of these social categories on recognition of emotional facial expressions. We used a dynamic emotion recognition task to assess accuracy and response times in the happiness and anger categorization displayed by female and male faces that differed in the degree of facial trustworthiness (i.e., trustworthy- vs. untrustworthy-looking faces). We found that facial trustworthiness was able to modulate the own-gender bias on emotion recognition, as responses to untrustworthy-looking faces revealed a bias towards ingroup members. Conversely, when faces look trustworthy, no differences on emotion recognition between female and male faces were found. In addition, positive inferences of trustworthiness lead to faster recognition of happiness in females and anger in males, showing that facial appearance was able to influence also the intersection between social categories and specific emotional expressions. Together, these results suggest that facial appearance, probably due to the activation of approach or avoidance motivational systems, is able to modulate the own-gender bias on emotion recognition.

INTRODUCTION:Several studies have called for attention to medical students' well-being. Building on the neuroevolutionary affective neuroscience perspective that views primary emotional systems as central to well-being and the foundation of personality, this study investigated the facets of medical students' psychological well-being that are challenged and the relationships between emotional traits, psychological well-being, and depression.METHODS:In a single-center cross-sectional study, medical students' primary emotional traits (SEEKING, FEAR, ANGER, SADNESS, CARE, PLAY and Spirituality), psychological well-being dimensions (autonomy, environmental mastery, positive relations, self-acceptance, purpose in life, and personal growth), and depressive symptoms were assessed using the Affective Neuroscience Personality Scale; the Psychological Well-being Scale, which provides normative data; and the Beck Depression Inventory.RESULTS:Compared with the normative data, the medical students perceived lower psychological autonomy, positive relations, and self-acceptance but higher purpose in life. The medical students' emotional traits were related to specific psychological well-being facets and depression. SEEKING and, inversely, FEAR were related to well-being across dimensions and depressive symptoms.CONCLUSION:Our findings are the first to show a link between emotional traits and specific facets of psychological health in medical students. Thus, this study encourages medical teachers to set learning environments that target multiple facets of well-being that harness primary emotional traits.

Background: As a contribution to developing interprofessional education (IPE) synergy between medical education systems in the European Higher Education Area (EHEA), this review aims to describe the IPE experiences for undergraduate medical students implemented in EHEA member countries. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted on SCOUPS and MEDLINE databases. Inclusion criteria were peer-reviewed English language articles about undergraduate medical students, interprofessional education, and EHEA countries, published January 2000–September 2022. Results: The 32 included studies were from 14 of the 49 EHEA countries. In most of the studies, the theoretical background leading the intervention was not reported (n = 25), and in several studies (n = 16) the students were from two professions only. The reported outcomes were related to self-assessment knowledge about IPE and satisfaction about the program. In 24 studies, the assessment was based on the study’s ad hoc measures only. Limitations ranged from selection bias to lack of objective measures. Conclusion: Future directions should envision developing IPE among EHEA countries, including agreement and consistency across EHEA countries in reporting theories, educational methods, and standardized IPE evaluation measures.

© The Author(s), 2020. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. Psychological distress in hospitalized patients without COVID-19 symptoms: the role of fear of infection and remote contact with informal caregivers

Social context has been shown to influence pain perception. This study aimed to broaden this literature by investigating whether relevant social stimuli, such as faces with different levels of intrinsic (based on physical resemblance to known individuals) and episodic (acquired through a previous experience) familiarity, may lead to hypoalgesia. We hypothesized that familiarity, whether intrinsic or acquired through experience, would increase pain threshold and decrease pain intensity. Sixty-seven participants underwent pain induction (the cold pressor test) viewing previously seen faces (Episodic Group) or new faces (Non-episodic Group) that differed in the level of intrinsic familiarity (high vs low). Pain threshold was measured in seconds, while pain intensity was measured on a rating scale of 0 to 10. The results did not show an effect of episodic familiarity. However, compared to low, high intrinsic familiar faces had an attenuating effect on pain intensity, even after controlling for pain expectation. These results suggest that physical features conveying a higher feeling of familiarity induce a top-down hypoalgesic modulation, in line with the idea that familiarity may signal safety and that the presence of familiar others reduce perceived threat-related distress. This study provides further evidence on the social modulation of pain and contributes to the literature on first impressions' influence on social behavior. Perspective: Consistent with the idea that familiar others signal safety and reduce the sense of threat, facial features conveying familiarity induce a top-down hypoalgesic modulation. This knowledge may contribute to understanding differences in pain perception in experimental and clinical contexts.(R) 2023 The Author(s). Published by Elsevier Inc. on behalf of United States Association for the Study of Pain, Inc

Introduction Several studies report that medical students are at high risk of depression. Despite the variability in students’ vulnerability to depression, the role of individual differences in depression risk among medical students has hardly been investigated. Studies outside of medical student populations have shown that individual differences in attachment style and emotion regulation participate in vulnerability to depression. Objectives This study investigates to what extent medical students’ depressive symptoms are related to differences in students’ insecure attachment styles and their perception of reduced access to emotion regulation strategies. Methods In a cross-sectional quantitative study, undergraduate medical students at the beginning of their second academic year completed online questionnaires measuring their attachment style, difficulties in emotion regulation, and depressive symptoms. Results Out of the 390 medical students invited, 267 participated in the survey. Higher secure attachment was associated with fewer depressive symptoms. Medical students’ insecure attachment style and emotion dysregulation were significantly related to depressive symptoms. Difficulties in employing strategies to disengage from one’s own negative affect partly mediated the effects of two dimensions of insecure anxious attachment—need for approval and preoccupation with relationships—on depressive symptoms. Discussion Anxious attachment style and limited access to emotion regulation strategies participate in medical students’ depressive symptoms. These findings highlight the need for acknowledging medical students’ attachment style and students’ perceived access to emotion regulation strategies for the early identification of and intervention programs for the risk of depression.

Introduction A significant reorganization of working activities including those of teaching hospitals occurred after COVID-19 outbreak, leading to the need to re-assess the current status of training after the pandemic. This study aimed to investigate the state of general surgery (GS) residency in Italy. The impact of COVID-19 on GS residents was also assessed. Methods Between October and November 2020, an anonymous online survey was distributed to GS residents across Italy. Email addresses were provided by the Regional Committees of the Italian Polyspecialistic Society of Young Surgeons. The residents completed a set of questions regarding their training schedule and three standardized questionnaires to measure burnout and psychological distress. Results Overall, 1709 residents were contacted and 648 completed the survey. Almost two-thirds of the residents (68.4%, n = 443) reported to not reach the minimum annual operative case volume. According to ordinal logistic regression analysis, two of the most perceived effects of COVID-19 by trainees on training were reduction of surgical activities (OR = 2.21, p < 0.001) and increased concerns about future employment (OR = 1.14, p = 0.025). Loss of training opportunities was also associated with a significant increase of distress (OR = 1.26, p = 0.003) but not with burnout. Conclusions This study provided a snapshot of the situation of GS residents in Italy after COVID-19 outbreak. Reduction of activities due to pandemic highlighted the need to improve the level of surgical education in our country by implementing all the new available tools for training and ensuring at the same time the well-being of the residents.

Personality neuroscience is focusing on the correlation between individual differences and the efficiency of large‐scale networks from the perspective of the brain as an interconnected network. A suitable technique to explore this relationship is the magnetoencephalography (MEG), but not many MEG studies are aimed at investigating topological properties correlated to personality traits. By using MEG, the present study aims to evaluate how individual differences described in Cloninger's psychobiological model are correlated with specific cerebral structures. Fifty healthy individuals (20 males, 30 females, mean age: 27.4 ± 4.8 years) underwent Temperament and Character Inventory examination and MEG recording during a resting state condition. High harm avoidance scores were associated with a reduced centrality of the left caudate nucleus and this negative correlation was maintained in females when we analyzed gender differences. Our data suggest that the caudate nucleus plays a key role in adaptive behavior and could be a critical node in insular salience network. The clear difference between males and females allows us to suggest that topological organization correlated to personality is highly dependent on gender. Our findings provide new insights to evaluate the mutual influences of topological and functional connectivity in neural communication efficiency and disruption as biomarkers of psychopathological traits.

The coronavirus pandemic has increased hospitalizations in Italy. Hospitals with COVID-19 units admit patients affected by the virus along with patients with pathologies unrelated to COVID-19. Government safety guidelines limit informal caregivers' direct contact with hospitalized patients,1 who can contact those caregivers using digital devices (e.g., tablets, mobile phones). However, older patients are likely unused to social interactions through such technologies. Patients without COVID-19 face fear of COVID-19 infection and distress of separation from loved ones.2 Several studies indicate that reactivity to social separation and seeking of social contacts are linked to individual differences in attachment style, which affects health-related outcomes.3, 4 From March through July 2020, we asked hospitalized patients without COVID-19 (N = 98; mean age: 79.63 ± 10 years; 70 women; clinical conditions: fractures 31%, heart disease 9%, pneumonia 7%) to complete the following: (i) the Attachment Style Questionnaire, measuring five dimensions of attachment style (confidence/secure attachment, discomfort with closeness, need for approval, preoccupation with relationships, and relationships as secondary);4 (ii) a set of questions about COVID-19, measuring separation distress (3 items) and fear of contracting COVID-19 infection (2 items) on a 5-point Likert scale, as well as questions about frequency of contacts with informal caregivers during hospitalization; and (iii) the Stanford Expectations of Treatment Scale5 (IRB: 264-2020-OSS-AUSLBO; 265-2020-OSS-AUSLBO). Using multiple regression analyses, we considered separation distress levels, treatment expectations, and frequency of contacts with caregivers as dependent variables. Independent variables were Fear of COVID-19 and Attachment Styles, controlling for age and gender. Both the need for approval (β = 0.27, P < 0.05) and fear of COVID-19 infection (β = 0.32, P < 0.05) were positively associated with patients' social separation distress (F(8,89) = 6.92; P < 0.01; adjR2 = 0.33). Confidence (β = 0.51, P < 0.05) and, inversely, age (β = −0.26, P < 0.05) were associated with remote contacts with caregivers (F(8,89) = 4.31; P < 0.01; adjR2 = 0.22). Confidence (β = 0.41; P < 0.05), and, inversely, fear of COVID-19 infection (β = −0.22; P < 0.05) were associated with positive expectations about one's treatment (F(8,89) = 3.09; P < 0.01; adjR2 = 0.15). Along with the fear of COVID-19 infection, individual differences in attachment style were related to separation distress, remote communication, and attitude toward the treatment in elderly patients without COVID-19. The higher patients scored on need for approval and fear of infection, the more they reported separation distress, highlighting the dependence of anxiously attached patients on direct contact with their loved ones. Notably, older patients had fewer remote contacts with caregivers. In contrast, the higher patients scored on confidence (secure attachment), the more they reported technology-mediated remote communication and a positive attitude toward their treatment, suggesting that secure attachment is associated with a positive attitude towards social and environmental resources during hospitalization. We therefore advocate considering attachment style differences in those facing hospitalization during pandemics. Hospital guidelines should include the psychological assessment and treatment of all patients, with and without the target infection, to enhance everyone's psychological adaptation to hospitalization during pandemics. Open Access Funding provided by Universita degli Studi di Bologna within the CRUI-CARE Agreement. [Correction added on 30 May 2022, after first online publication: CRUI funding statement has been added.]

The Affective Neuroscience Personality Scale (ANPS, Davis & Panksepp, 2011) is a self-report that measures in adults the expression of six primary emotional systems (SEEKING, RAGE, FEAR, LUST, CARE, PANIC, PLAY) described by Panksepp (1998, 2006 and 2011) and corresponding to specific subcortical areas. The present study aims to explore, through the ANPS, the expression of emotional systems in a sample of 208 school-age children and to measure the concurrent validity of the ANPS with the "Big-Five Children" test. The results show a stability of primary emotional systems during the age and a good concurrent validity of the instrument. Further validation studies on larger populations are needed.