Italian Health Care Providers' Self-Perception of Their Own Job Attitudes and Reflections on the Contraceptive Behaviors of Adolescent Patients

Using a qualitative method, our study aims to explore, identify, and describe Italian health care providers' reflections on the contraceptive behaviors of adolescents attending family health centers, and health care providers' self-perception of their own job attitudes toward these adolescent patients. Semi-structured interviews with 46 Italian health care providers were conducted and analyzed using thematic analysis. Two main themes emerged from the thematic data analysis regarding Italian health care providers' self-perceptions and reflections. The first main theme was labeled "adolescents' contraceptive behavior" and included two subthemes: "adolescents are confused and unprepared" and "contraception is a girls' responsibility." The second theme was labeled "job attitudes with adolescents," and included three subthemes: "to inform and to educate," "to build trustful relationships," and "to go beyond personal beliefs." The findings of this study showed that Italian health care providers perceive themselves as nonjudgmental and they interpret their own behavior as an attempt to answer adolescents' sexual and reproductive health (SRH) needs in an open-minded way. Their work with adolescent patients with relation to contraceptive behaviors is led by the desire to educate through building a significant and long-term relationship that could sustain these patients

Medindo a Percepção dos Estilos Parentais de Adolescentes Durante a Infância:: As Propriedades Psicométricas do Estilo Parental e do Questionário de Dimensões

The paper analyzes the psychometric properties of the G1 version of the Parenting Styles and Dimensions Questionnaire, a self-report instrument designed to investigate how adolescents or adults were parented during childhood. The sample included 1451 Italian adolescents in high school. Three studies tested the scale’s structure, invariance, and convergent validity. The first found slightly acceptable fit indexes for a 40-item scale measuring three factors (authoritative, authoritarian, and permissive styles); the factors presented good reliability (Ïc .62-.96). Multigroup confirmative analyses found factor loadings invariant in the father version, whereas 12 items resulted not invariant in the mother version (second study). Good convergent validity was found with the Parental Bonding Index and the Parental Monitoring Scale (third study). Discussion of results is provided within the parenting styles literature.Nos últimos 15 anos houve um interesse crescente na avaliação de estilos parentais de forma retrospectiva, especialmente com o Parenting Style and Dimensions Questionnaire (Questionário de Estilos Parentais). No entanto, poucos estudos efetuaram a análise psicométrica desta escala com análises fatoriais confirmatórias (AFC). O presente estudo analisou as características psicométricas do instrumento numa amostra de 1465 adolescentes italianos que avaliaram o estilo parental do pai e da mãe durante a sua infância. Foram utilizadas AFCs e análises multi-grupo para avaliar a estrutura e consistência da escala. Os resultados demonstram que 22 dos 62 itens não mediram bem a constructo. A versão final do instrumento, composto por 40 itens, apresenta propriedades psicométricas satisfatórias e validade convergente nas duas versões

Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

Dysregulated systemic inflammation is the primary driver of mortality in severe COVID-19 pneumonia. Current guidelines favor a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg·day-1. A comparative RCT with a higher dose and a longer duration of intervention was lacking

Disease-Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis

Objective: This study was undertaken to assess the impact of immunosuppressive and immunomodulatory therapies on the severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (PwMS). Methods: We retrospectively collected data of PwMS with suspected or confirmed COVID-19. All the patients had complete follow-up to death or recovery. Severe COVID-19 was defined by a 3-level variable: mild disease not requiring hospitalization versus pneumonia or hospitalization versus intensive care unit (ICU) admission or death. We evaluated baseline characteristics and MS therapies associated with severe COVID-19 by multivariate and propensity score (PS)-weighted ordinal logistic models. Sensitivity analyses were run to confirm the results. Results: Of 844 PwMS with suspected (n = 565) or confirmed (n = 279) COVID-19, 13 (1.54%) died; 11 of them were in a progressive MS phase, and 8 were without any therapy. Thirty-eight (4.5%) were admitted to an ICU; 99 (11.7%) had radiologically documented pneumonia; 96 (11.4%) were hospitalized. After adjusting for region, age, sex, progressive MS course, Expanded Disability Status Scale, disease duration, body mass index, comorbidities, and recent methylprednisolone use, therapy with an anti-CD20 agent (ocrelizumab or rituximab) was significantly associated (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.18-4.74, p = 0.015) with increased risk of severe COVID-19. Recent use (<1 month) of methylprednisolone was also associated with a worse outcome (OR = 5.24, 95% CI = 2.20-12.53, p = 0.001). Results were confirmed by the PS-weighted analysis and by all the sensitivity analyses. Interpretation: This study showed an acceptable level of safety of therapies with a broad array of mechanisms of action. However, some specific elements of risk emerged. These will need to be considered while the COVID-19 pandemic persists

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Love skills in adolescenza. Come promuovere e sviluppare competenze nelle relazioni sentimentali

Il volume offre un approfondimento sul tema delle relazioni sentimentali in adolescenza e sulla competenza romantica. Nell'ultimo capitolo del volume vengono proposti dei workshop ideati specificatamente per promuovere e potenziare la competenza romantica degli adolescenti attraverso un approccio partecipativo ed esperienziale