How socio-institutional contexts and cultural worldviews relate to COVID-19 acceptance rates: A representative study in Italy

Rationale Despite its importance to counter the COVID-19 pandemic, vaccination has raised hesitation in large segments of the population. This hesitation makes it important to understand the mechanisms underlying vaccine acceptance. To this end, the study adopts the Semiotic Cultural Psychology Theory, holding that social behaviors – and therefore, vaccination acceptance – depend on the cultural meanings in terms of which people interpret the social world. Objective The study aims at estimating the impact a) of the way people interpret the socio-institutional context of the pandemic and b) of the underlying cultural worldviews on vaccine acceptance. More particularly, the study tested the three following hypotheses. a) The meanings grounding the interpretation of the socio-institutional framework – that is, trust in institutions and political values – are an antecedent of vaccination acceptance. b) The impact of these meanings is moderated by the cultural worldviews (operationalized as symbolic universes). And c), the magnitude of the symbolic universes’ moderator effect depends on the uncertainty to which the respondent is exposed. The exposure to uncertainty was estimated in terms of socioeconomic status – the lower the status, the high the exposure to uncertainty. Methods An Italian representative sample (N = 3020) completed a questionnaire, measuring vaccination acceptance, the meanings attributed to the socio-institutional context – that is, political values and trust in institutions – and symbolic universes. Results The findings were consistent with the hypotheses. a) Structural equation modelling proved that vaccine acceptance was predicted by trust in institutions. b) Multigroup analysis revealed that symbolic universes moderated the correlation between trust in institutions and vaccine acceptance. And c), the moderation effect of symbolic universes proved to occur only in the segment of lower socio-economic status (i.e., the group exposed to higher uncertainty). Conclusions Vaccination acceptance is not only a medical issue; it is also dependent upon the rationalization of the socio-institutional context. Implications for the promotion of vaccination acceptance are discussed

{DNA} repair protein {DNA}-{PK} protects {PC}12 cells from oxidative stress-induced apoptosis involving {AKT} phosphorylation

Background Emerging evidence suggest that DNA-PK complex plays a role in the cellular response to oxidative stress, in addition to its function of double strand break (DSB) repair. In this study we evaluated whether DNA-PK participates in oxidative stress response and whether this role is independent of its function in DNA repair.Methods and results We used a model of H2O2-induced DNA damage in PC12 cells (rat pheochromocytoma), a well-known neuronal tumor cell line. We found that H2O2 treatment of PC12 cells induces an increase in DNA-PK protein complex levels, along with an elevation of DNA damage, measured both by the formation of gamma Eta 2 Alpha X foci, detected by immunofluorescence, and gamma H2AX levels detected by western blot analysis. After 24 h of cell recovery, gamma Eta 2 Alpha X foci are repaired both in the absence and presence of DNA-PK kinase inhibitor NU7026, while an increase of apoptotic cells is observed when DNA-PK activity is inhibited, as revealed by counting pycnotic nuclei and confirmed by FACS analysis. Our results suggest a role of DNA-PK as an anti-apoptotic factor in proliferating PC12 cells under oxidative stress conditions. The anti-apoptotic role of DNA-PK is associated with AKT phosphorylation in Ser473. On the contrary, in differentiated PC12 cells, were the main pathway to repair DSBs is DNA-PK-mediated, the inhibition of DNA-PK activity causes an accumulation of DNA damage.Conclusions Taken together, our results show that DNA-PK can protect cells from oxidative stress induced-apoptosis independently from its function of DSB repair enzyme

Encrusted cystitis in an immunocompromised patient: Possible coinfection by Corynebacterium urealyticum and E-coli

Encrusted cystitis is a severe chronic inflammatory disease of the bladder characterized by excessively alkaline urine and calcifications within the bladder wall. A case of a 60 year-old man affected by systemic lupus erythematosus (SLE), which developed encrusted cystitis due to Corynebacterium urealyticum with E. coli coinfection, shows that the treatment of encrusted cystitis with a endoscopic debulking of the encrusted stones and an antimicrobial therapy specific for C. urealyticum often is not sufficient for the complete resolution of symptoms

The Affective Regulation of Uncertainty: The Semiotic Dimensionality Model (SDM)

This paper presents a novel psychological model of the socio-cognitive management of uncertainty, the semiotic dimensional model (SDM). The SDM claims that uncertainty increases the momentum of affect-laden meanings in meaning-making. This is so because affective meanings provide a simplified interpretation of the world that restores the experience of being able to make sense of the reality destabilized by uncertainty. Moreover, the SDM models the affective meanings in terms of low-dimensional mental phase space (MPS). Each dimension of the MPS detects a facet of the context. The lower the MPS dimensionality, the lower the number of facets of the context processed, therefore, the more simplified the meaning-making is. We attained the first empirical validation of the SDM in a sample of 120 Italian people. First, the SDM assumption that the low-dimensional MPS is the computational descriptor of affective meaning was tested. Second, an experimental study was designed in which uncertainty was manipulated so as to assess its effects on the dimensionality of participants’ MPS. It was hypothesized that uncertainty induces a decrease in the MPS dimensionality. Results were consistent with both hypotheses. Theoretical implications of the SDM and its relationship with other theories are discussed and future research direction outlined

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys