An exploration of the differential effects of parents\u2019 authoritarianism dimensions on pre-school children\u2019s epistemic, existential, and relational needs.

Research on adult populations has widely investigated the deep differences that characterize individuals who embrace either conservative or liberal views of the world. More recently, research has started to investigate these differences at very early stages of life. One major goal is to explore how parental political ideology may influence children's characteristics that are known to be associated to different ideological positions. In the present work, we further investigate the relations between parents' ideology and children cognitive processing strategies within the framework of political ideology as motivated social cognition (Jost et al., 2003) and the dual process model of political ideology (Duckitt et al., 2002). Specifically, epistemic (implicit attitudes toward order vs. chaos), existential (negativity and threat bias), and relational needs (conformity measure) were assessed in pre-school children (N = 106; 4-6 years). For each child at least one parent completed both the Social Dominance Orientation (SDO) and the Right Wing Authoritarianism (RWA) measures. Interestingly, results indicated that mothers' and fathers' responses had unique associations with children's socio-cognitive motivations, and different findings emerged in relation to the two facets of parental authoritarianism, namely dominance (i.e., SDO) and submission (i.e., RWA). More specifically, children's existential needs appeared to be more related to mothers' RWA scores, whereas children's epistemic needs appeared to be more related to fathers' SDO. Finally, parents' RWA and SDO scores appeared to have opposite effects on children's relational needs: children's conformity increased at increasing levels of mothers' RWA and decreased at increasing levels of fathers' SDO. Overall, however, results were relatively weak and several links between the responses of parents and their children were not significant, suggesting caution in drawing strong conclusions about the impact of parents' ideology. Limitations and future developments will be discussed

Anticipation of cognitive conflict is reflected in microsaccades: Evidence from a cued-flanker task

Microsaccade frequency has recently been shown to be sensitive to high-level cognitive processes such as attention and memory. In the present study we explored the effects of anticipated cognitive conflict. Participants were administered a variant of the flanker task, which is known to elicit cognitive interference. At the beginning of each trial, participants received a colour cue providing information about the upcoming target frame. In two thirds of the trials, the cue reliably informed the participants that in the upcoming trial the flankers either matched the central target letter or not. Hence, participants could accurately anticipate whether cognitive conflict would arise or not. On neutral trials, the cue provided no useful information. The results showed that microsaccadic rate time-locked to cue onset was reduced on trials in which an upcoming cognitive conflict was expected. These findings provide new insights about top-down modulations of microsaccade dynamics

Space-based and object-centered gaze cuing of attention in right hemisphere-damaged patients

Gaze cuing of attention is a well established phenomenon consisting of the tendency to shift attention to the location signaled by the averted gaze of other individuals. Evidence suggests that such phenomenon might follow intrinsic object-centered features of the head containing the gaze cue. In the present exploratory study, we aimed to investigate whether such object-centered component is present in neuropsychological patients with a lesion involving the right hemisphere, which is known to play a critical role both in orienting of attention and in face processing. To this purpose, we used a modified gaze-cuing paradigm in which a centrally placed head with averted gaze was presented either in the standard upright position or rotated 90° clockwise or anti-clockwise. Afterward, a to-be-detected target was presented either in the right or in the left hemifield. The results showed that gaze cuing of attention was present only when the target appeared in the left visual hemifield and was not modulated by head orientation. This suggests that gaze cuing of attention in right hemisphere-damaged patients can operate within different frames of reference

Altered social attention in anorexia nervosa during real social interaction

The capacity to devote attentional resources in response to body-related signals provided by others is still largely unexplored in individuals with Anorexia Nervosa (AN). Here, we tested this capacity through a novel paradigm that mimics a social interaction with a real partner. Healthy individuals (Experiment 1) and individuals with AN (Experiment 2) completed a task with another person which consisted in performing, alternatively, rapid aiming movements to lateralised targets. Generally, this task leads to a form of Inhibition of Return (IOR), which consists of longer reaction times when an individual has to respond to a location previously searched by either himself (individual IOR) or by the partner (social IOR) as compared to previously unexplored locations. IOR is considered as an important attentional mechanism that promotes an effective exploration of the environment during social interaction. Here, healthy individuals displayed both individual and social IOR that were both reliable and of the same magnitude. Individuals with AN displayed a non-significant individual IOR but a reliable social IOR that was also significantly stronger than individual IOR. These results suggest the presence of a reduced sensitivity in processing body-related stimuli conveyed by oneself in individuals with AN which is reflected in action-based attentional processes

@IT2020: An innovative algorithm for allergen immunotherapy prescription in seasonal allergic rhinitis

Background: Allergen immunotherapy (AIT) is the only disease-modifying treatment in patients with seasonal allergic rhinoconjunctivitis (SAR). Its efficacy depends on the precise identification of the triggering allergen. However, diagnostics based on retrospective clinical history and sensitization to whole extracts (SWE) often leads to equivocal results. Objectives: To assess the usability and impact of a recently established algorithm for a clinical decision support system (@IT2020-CDSS) for SAR and its diagnostic steps [anamnesis, SWE (skin prick test or serum IgE), component resolved diagnosis, CRD, and real-time digital symptom recording, eDiary] on doctor's AIT prescription decisions. Methods: After educational training on the @IT2020-CDSS algorithm, 46 doctors (18 allergy specialists, AS, and 28 general practitioners, GP) expressed their hypothetical AIT prescription for 10 clinical index cases. Decisions were recorded repeatedly based on different steps of the algorithm. The usability and perceived impact of the algorithm were evaluated. Results: The combined use of CRD and an eDiary increased the hypothetical AIT prescriptions, both among AS and GP (p < .01). AIT prescription for pollen and Alternaria allergy based on anamnesis and SWE was heterogeneous but converged towards a consensus by integrating CRD and eDiary information. Doctors considered the algorithm useful and recognized its potential in enhancing traditional diagnostics. Conclusions and clinical implications: The implementation of CRD and eDiary in the @IT2020-CDSS algorithm improved consensus on AIT prescription for SAR among AS and GP. The potential usefulness of a CDSS for aetiological diagnosis of SAR and AIT prescription in real-world clinical practice deserves further investigation

Heterogeneous validity of daily data on symptoms of seasonal allergic rhinitis recorded by patients using the e‐diary AllergyMonitor®

Background: Patient-generated symptom and medication scores are essential for diagnostic and therapeutic decisions in seasonal allergic rhinitis (SAR). Previous studies have shown solid consistencies between different scores at population level in real-life data and trials. For clinicians, the evaluation of individual data quality over time is essential to decide whether to rely on these data in clinical decision-making. Objective: To analyze the consistency of different symptom (SS) and symptom medication scores (SMSs) at individual level in two study cohorts with different characteristics and explore individual patient trajectories over time. Methods: Within the pilot phase of the @IT.2020 project on diagnostic synergy of mobile health and molecular IgE assessment in patients with SAR, we analyzed data of 101 children and 93 adults with SAR and instructed them to record their symptoms and medication intake daily via the mobile app AllergyMonitor®. We then assessed the correlation between different SMS and a visual analogue scale (VAS) on the impact of allergy symptoms on daily life at population and individual level. Results: At population level, the Rhinoconjunctivitis total symptom score (RTSS) correlated better with VAS than the combined symptom and medication score (CSMS). At individual level, consistency among RTSS and VAS was highly heterogeneous and unrelated to disease severity or adherence to recording. Similar heterogeneity was observed for CSMS and VAS. Conclusions: The correlation of clinical information provided by different disease severity scores based on data collected via electronic diaries (e-diaries), is sufficient at population level, but broadly heterogeneous for individual patients. Consistency of the recorded data must be examined for each patient before remotely collected information is used for clinical decision making

Intra-and extra-hospitalization monitoring of vital signs. Two sides of the same coin. Perspectives from Lims and Greenline study operators

Background: In recent years, due to the epidemiological transition, the burden of very complex patients in hospital wards has increased. Telemedicine usage appears to be a potential high-impact factor in helping with patient management, allowing hospital personnel to assess conditions in out-of-hospital scenarios. Methods: To investigate the management of chronic patients during both hospitalization for disease and discharge, randomized studies (LIMS and Greenline-HT) are ongoing in the Internal Medicine Unit at ASL Roma 6 Castelli Hospital. The study endpoints are clinical outcomes (from a patient’s perspective). In this perspective paper, the main findings of these studies, from the operators’ point of view, are reported. Operator opinions were collected from structured and unstructured surveys conducted among the staff involved, and their main themes are reported in a narrative manner. Results: Telemonitoring appears to be linked to a reduction in side-events and side-effects, which represent some of most commons risk factors for re-hospitalization and for delayed discharge during hospitalization. The main perceived advantages are increased patient safety and the quick response in case of emergency. The main disadvantages are believed to be related to low patient compliance and an infrastructural lack of optimization. Conclusions: The evidence of wireless monitoring studies, combined with the analysis of activity data, suggests the need for a model of patient management that envisages an increase in the territory of structures capable of offering patients subacute care (the possibility of antibiotic treatments, blood transfusions, infusion support, and pain therapy) for the timely management of chronic patients in the terminal phase, for which treatment in acute wards must be guaranteed only for a limited time for the management of the acute phase of their diseases

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin