Healthcare-associated Clostridium difficile infection: role of correct hand hygiene in cross-infection control

Introduction - Clostridium difficile (CD) is the most common cause of health-care-associated infectious diarrhea and incidence and severity have increased in recent years. The main cause of hospital’s acquired cross infections can be attributed to incorrect hand hygiene. We described the epidemiology of CD infection (CDI) in a teaching hospital in Southern Italy during a two years surveillance period and evaluated the health-care workers compliance to hand hygiene.Methods - CDI Incidence rates were calculated as the number of patients with positive C. difficile toxin assay per 10,000 patient-days. Compliance with hand hygiene was the ratio of the number of performed actions to the number of opportunities observed. Approximately 400 Hand Hygiene (HH) opportunities/year /ward were observed.We finally checked out if any correlation could be found.Results - From January 2015 to December 2016 a total number of 854 CD determinations were performed in patients with clinical symptoms of diarrhea. The search for toxins A and B was positive in 175 cases (21,2 %), confirming the diagnosis of CDI.Compliance to hand hygiene was significantly inversely associated with the number of CDIs: the lower the compliance of  health-care workers with hand hygiene the higher was the number of cases of CDIs (p=0.003).Conclusion - According to our results proper handwashing of health-care workers appears to be a key intervention in interrupting CD cross infections regardless of age and type of department in which the patient is admitted. 

Video Game Addiction in Gambling Disorder: Clinical, Psychopathological, and Personality Correlates

Objective. We studied the prevalences of video game use (VGU) and addiction (VGA) in gambling disorder (GD) patients and compared them with subjects with non-video game use (non-VGU) in relation to their gambling behavior, psychopathology, and personality characteristics. Method. A sample of 193 GD patients (121 non-VGU, 43 VGU, and 29 VGA) consecutively admitted to our pathological gambling unit participated in the study. Assessment. Measures included the video game dependency test (VDT), symptom checklist-90-revised, and the temperament and character inventory-revised, as well as a number of other GD indices. Results. In GD, the observed prevalence of VG (use or addiction) was 37.3% (95% CI:30.7% ÷ 44.3),VGU 22.3% (95% CI:17.0% ÷ 28.7), and VGA 15% (95% CI:10.7% ÷ 20.7). Orthogonal polynomial contrast into logistic regression showed positive linear trends for VG level and GD severity and other measures of general psychopathology. After structural equation modeling, higher VG total scores were associated with younger age, general psychopathology, and specific personality traits, but not with GD severity. Patients' sex and age were involved in the mediational pathways between personality traits and VG impairment. Conclusions. GD patients with VG are younger and present more dysfunctional personality traits, and more general psychopathology. The presence of VG did not affect the severity of GD

Association between Dietary Phenolic Acids and Hypertension in a Mediterranean Cohort

Background: Certain foods rich in phenolic acids have been shown to reduce the risk of hypertension, but evidence from epidemiological studies focused on dietary phenolic acid intake is scarce. The aim of this study was to determine the association between dietary phenolic acid intake, as well as their major food sources, and hypertension in a Mediterranean cohort. Methods: Demographic and dietary data of 2044 adults living in Southern Italy were collected. Food frequency questionnaires and Phenol-Explorer were used to calculate dietary intake of polyphenols. Multivariate logistic regression analyses were used to test associations. Results: The mean intake of total phenolic acids in the cohort was 362.6 mg/day. Individuals in the highest quartile of phenolic acid intake (median intake = 522.2 mg/day) were less likely to have hypertension (OR (odds ratio) = 0.68, 95% CI (confidence interval): 0.46, 1.00). When taking into account individual subclasses of phenolic acids, only hydroxyphenylacetic acid was inversely associated with hypertension (highest vs. lowest quartile, OR = 0.63, 95% CI: 0.40, 0.96). Among dietary sources of phenolic acids considered in the analysis, only beer was significantly inversely associated with hypertension (highest vs. lowest quartile, OR = 0.32, 95% CI: 0.15, 0.68). Conclusions: The findings of this study suggest that dietary phenolic acids may be inversely associated with hypertension, irrespectively of their dietary source

High adherence to Mediterranean diet, but not individual foods or nutrients, is associated with lower likelihood of being obese in a Mediterranean cohort

Purpose: The aim of the present study was to evaluate the association between the Mediterranean diet and obesity in a Mediterranean cohort. Methods: The study population of MEAL (Mediterranean Healthy Eating, Ageing, and Lifestyle) study comprised 1814 men and women (18 + years) recruited in the city of Catania, southern Italy. Food intake was evaluated through a validated food frequency questionnaire and the Mediterranean diet adherence was assessed through the MEDI-LITE score. Results: Individuals highly adherent to the Mediterranean diet (highest quartile of the score) were less likely to be obese (OR 0.53, 95% CI 0.32, 0.89) despite there was no significant associations when considering men and women separately. The dietary profile of obese and non-obese individuals did not significantly differ, except for vitamin E, processed meat, and alcohol more consumed among non-obese ones. Among the food groups characterizing this dietary pattern, only satisfaction of the criterion for dairy products (< 1 serving/day) was significantly associated with lower odds of being obese. Among other covariates, current smoking was associated with obesity, while high physical activity and regular alcohol drinking were inversely associated. Some differences between men and women in the highest category of occupational status occurred, as the former were less likely, while the latter were more likely to be obese. Conclusions: Higher adherence to the Mediterranean diet as a whole dietary pattern, rather than its individual components, is associated with less likelihood of being obese. Level of evidence: Level V, cross-sectional descriptive study

Video Game Addiction in Gambling Disorder: Clinical, Psychopathological, and Personality Correlates

Objective: We studied the prevalences of video game use (VGU) and addiction (VGA) in gambling disorder (GD) patients and compared them with subjects with non-video game use (non-VGU) in relation to their gambling behavior, psychopathology, and personality characteristics. Method: A sample of 193 GD patients (121 non-VGU, 43 VGU, and 29 VGA) consecutively admitted to our pathological gambling unit participated in the study. Assessment: Measures included the video game dependency test (VDT), symptom checklist-90-revised, and the temperament and character inventory-revised, as well as a number of other GD indices. Results: In GD, the observed prevalence of VG (use or addiction) was 37.3% (95%CI:30.7% ÷ 44.3),VGU 22.3% (95%CI:17.0% ÷ 28.7), and VGA 15% (95%CI:10.7% ÷ 20.7). Orthogonal polynomial contrast into logistic regression showed positive linear trends for VG level and GD severity and other measures of general psychopathology. After structural equation modeling, higher VG total scores were associated with younger age, general psychopathology, and specific personality traits, but not with GDseverity. Patients" sex and age were involved in the mediational pathways between personality traits and VG impairment. Conclusions: GD patients with VG are younger and present more dysfunctional personality traits, and more general psychopathology. The presence of VG did not affect the severity of G

Is Gambling Disorder associated with impulsivity traits measured by the UPPS-P and is this association moderated by sex and age?

OBJECTIVES: Impulsivity is a construct that is strongly associated with Gambling Disorder (GD). The main objectives in the present study are: 1) to explore the role of sex and age on impulsivity levels in GD patients; 2) to identify the relationship of the different impulsivity facets with comorbid psychopathology and other personality traits in GD patients; and (3) to assess whether impulsivity is a predictor for the severity of GD. METHOD: The final sample consisted of 406 consecutive participants. All of them were seeking treatment for GD (88.4% male and 11.6% female) and completed the South Oaks Gambling Screen (SOGS), the UPPS-P Impulsive Behavior Scale, the Symptom Checklist (SCL-90-R), the Temperament and Character Inventory-R (TCI-R) as well as other clinical and psychopathological measures. RESULTS: Results show a negative linear trend between age and lower sensation seeking levels as well as lack of premeditation (the higher the age the lower the UPPS-P scores), and a positive linear trend between age and positive urgency (UR) (the higher the age the higher the UPPS-P score). However, no sex differences were found for the assessed impulsivity dimensions. Lack of perseverance was positively associated with obsessive-compulsive symptoms and harm avoidance trait, and negatively related to persistence and self-directedness traits. Positive UR and negative UR were positively correlated with general psychopathology and the total number of DSM-IV criteria, and negatively associated to the following personality traits: self-directedness and cooperativeness. Finally, only the sensation seeking and negative UR of the UPPS-P showed predictive capacity on the severity of the disorder (the higher the impulsivity scores the higher the illness severity). CONCLUSIONS: These findings highlight the association between impulsivity traits (measured by the UPPS-P) and GD in a large and consecutively recruited clinical sample with GD, taking into account the variables sex and age.publisher: Elsevier articletitle: Is gambling disorder associated with impulsivity traits measured by the UPPS-P and is this association moderated by sex and age? journaltitle: Comprehensive Psychiatry articlelink: http://dx.doi.org/10.1016/j.comppsych.2016.10.005 content_type: article copyright: © 2016 Elsevier Inc. All rights reserved.status: publishe

Jeu pathologique et troubles liés à l’utilisation de substances : effets de l’incidence à un jeune âge et de la personnalité

Objectifs : Comparer la consommation de substances, les comportements de jeu et les traits de personnalité de deux groupes d’individus ayant un trouble de jeu pathologique (patients jeunes et adultes) ; explorer l’apport du sexe, de l’âge et des traits de personnalités sur la consommation de substances et évaluer la capacité de prédire la consommation de substances à partir de l’âge et des traits de personnalité.Méthodes : L’échantillon était formé de 428 patients ayant un trouble de jeu pathologique (TJP), divisés en deux groupes selon l’âge (55 jeunes patients [âge ≤ 25 ans] et 373 patients d’âge moyen à avancé [âge > 25 ans]). Tous les patients ont été admis dans un département de psychiatrie et diagnostiqués selon les critères du DSM-IV. En outre, d’autres évaluations cliniques, dont le Diagnostic Questionnaire for Pathological Gambling en vertu des critères du DSM-IV, le South Oaks Gambling Screen (SOGS) et le Temperament and Character Inventory-Revised (TCI-R), ont été utilisées pour examiner les comportements de jeu, la consommation de substances et la personnalité.Résultats : À la comparaison des deux groupes d’âge, nous avons observé des différences statistiquement significatives pour plusieurs variables sociodémographiques. En outre, les plus jeunes patients ayant un TJP présentaient un taux plus élevé de consommation de substances (p = 0,010). Pour ce qui est des traits de personnalité, des différences ont été remarquées seulement à l’échelle de recherche de nouveautés (RN) où les patients plus jeunes obtenaient des cotes élevées (p = 0,006). Des cotes plus élevées (p =0,022) à l’échelle de recherche de nouveautés (RN) et plus basses (p = 0,028) à l’échelle d’auto-transcendance représentaient des traits de personnalité ayant une interrelation significative avec la consommation de tabac (p = 0,003). Toutefois, seul l’âge était associé à la consommation d’autres substances (p =0,003).Conclusions : Les résultats confirment que le trouble de jeu pathologique (TJP) est souvent concomitant avec la consommation de substances. L’interrelation du TJP et de la consommation de tabac, d’alcool et d’autres substances entraîne une gamme d’implications cliniques et liées à la personnalité, particulièrement chez les populations jeunes. Puisque plusieurs études ont démontré que le taux de TJP est plus élevé chez les jeunes, le début précoce du trouble est souvent lié à une gravité accrue et à une persistance des problèmes de jeu. En outre, la présence d’un double diagnostic (consommation de substances) pourrait compliquer la réponse aux traitements. Pour cette raison, l’étude des populations jeunes est d’un intérêt particulier afin de concevoir et de mettre en oeuvre des programmes de traitement qui abordent tous les problèmes liés aux profils cliniques de ce groupe d’âge.Objectives: To compare substance use, gambling behaviors and personality traits between two different groups of individuals with a gambling disorder (young and adult patients); to explore the contribution of sex, age and personality traits on substance use; and to evaluate the capacity of age and personality traits to predict substance use.Methods: The participants were 428 gambling disorder (GD) patients, divided into two groups based on age [55 young participants (age≤25 years) and 373 middle- to old-aged participants (age>25 years)]. All were consecutively admitted to a Psychiatry Department and diagnosed according to the DSM-IV criteria. In addition, the Diagnostic Questionnaire for Pathological Gambling according to DSM-IV criteria, the South Oaks Gambling Screen (SOGS), the Temperament and Character Inventory-Revised (TCI-R), and other clinical measures were used to examine gambling behaviors, substance use and personality.Results: When the two age groups were compared, statistically significant differences were observed in several sociodemographic variables. Furthermore, the younger GD patients presented higher rates of drug use (p=.010). Regarding the personality traits, differences were found only in the Novelty Seeking (NS) scale, where the younger patients presented elevated scores (p=.006). Higher scores (p=.022) in NS and lower ones (p=.028) in Self-Transcendence (ST) were the personality traits significantly associated with tobacco consumption (p=.003). However, only age was associated with other substance use (p=.003).Conclusions: The results confirm that GD often co-occurs with substance use. The association between GD and the consumption of tobacco, alcohol and other drugs has a series of clinical and personality implications, particularly for young populations. Since several studies have demonstrated that GD rates are higher among younger individuals, early onset of the disorder is often associated with greater severity and persistence of the gambling problems. In addition, the presence of a dual diagnosis (drug consumption) could complicate the response to treatment. It is therefore of special interest to continue the study of young populations in order to design and implement treatment programs that address all the problems linked to the clinical profiles in this age range.Objetivos: comparar el consumo de sustancias, los comportamientos de juego y los rasgos de personalidad de dos grupos de personas que presentan un problema patológico de juego (pacientes jóvenes y adultos); explorar el aporte del sexo, de la edad y de los rasgos de la personalidad en el consumo de sustancias y evaluar la capacidad predictiva de la edad y de los rasgos de la personalidad sobre el consumo de sustancias.Métodos: la muestra estaba formada por 428 pacientes que presentaban un problema de juego patológico (PJP), divididos en dos grupos según la edad (55 pacientes jóvenes [edad ≤ 25 años] y 373 pacientes de edad promedio a avanzada [edad > 25 años]). Todos los pacientes fueron admitidos en un departamento de psiquiatría y diagnosticados según los criterios del DSM-IV. Se utilizaron además otras evaluaciones clínicas, como el Cuestionario de Diagnóstico del Juego Patológico [Diagnostic Questionnaire for Pathological Gambling] en virtud de los criterios del DSM-IV, el Despistaje del Juego de South Oakelle (SOGS) [South Oaks Gambling Screen] y el Inventario de Temperamento y Carácter Revisado (TCI-R) [Temperament and Character Inventory-Revised (TCI-R)] para examinar los comportamientos de juego, el consumo de sustancias y la personalidad.Resultados: en la comparación de los dos grupos de edad se observaron diferencias estadísticamente significativas en varias variables socio-demográficas. Además, los pacientes más jóvenes con PJP presentaban un porcentaje más elevado de consumo de drogas (p=0,010). Con respecto a los rasgos de la personalidad, se notaron diferencias solamente en la escala de búsqueda de novedades, en la que los pacientes más jóvenes obtenían cotas elevadas (p=0,006). Las cotas más elevadas (p=0,022) en la escala de búsqueda de novedades y las más bajas (p=0,028) en la escala de auto-trascendencia representaban los rasgos de la personalidad que tenían una interrelación significativa con el consumo de tabaco (p=0,003). Sin embargo, solamente la edad estaba relacionada con el consumo de otras sustancias (p=0,003).Conclusiones: los resultados confirman que el problema de juego patológico (PJP) es a menudo concomitante con el consumo de sustancias. La interrelación del PJP y del consumo de tabaco, de alcohol y de otras sustancias tiene como consecuencia una serie de implicaciones clínicas relacionadas con la personalidad, particularmente en los jóvenes. Puesto que numerosos estudios demostraron que el porcentaje de PJP es más elevado entre los jóvenes, el comienzo precoz del problema está ligado a menudo a un aumento de la gravedad y a una persistencia de los problemas de juego. Por otra parte, la presencia de un doble diagnóstico (consumo de sustancias) podría complicar la respuesta a los tratamientos. Por esta razón, el estudio de las poblaciones jóvenes es de particular interés para concebir y poner en práctica programas de tratamiento que aborden todos los problemas relacionados con los perfiles clínicos de este grupo de edad

Video game addiction in gambling disorder: clinical, psychopathological, and personality correlates

Objective: We studied the prevalences of video game use (VGU) and addiction (VGA) in gambling disorder (GD) patients and compared them with subjects with non-video game use (non-VGU) in relation to their gambling behavior, psychopathology, and personality characteristics. Method: A sample of 193 GD patients (121 non-VGU, 43 VGU, and 29 VGA) consecutively admitted to our pathological gambling unit participated in the study. Assessment: Measures included the video game dependency test (VDT), symptom checklist-90-revised, and the temperament and character inventory-revised, as well as a number of other GD indices. Results: In GD, the observed prevalence of VG (use or addiction) was 37.3% (95%CI:30.7% ÷ 44.3),VGU 22.3% (95%CI:17.0% ÷ 28.7), and VGA 15% (95%CI:10.7% ÷ 20.7). Orthogonal polynomial contrast into logistic regression showed positive linear trends for VG level and GD severity and other measures of general psychopathology. After structural equation modeling, higher VG total scores were associated with younger age, general psychopathology, and specific personality traits, but not with GDseverity. Patients" sex and age were involved in the mediational pathways between personality traits and VG impairment. Conclusions: GD patients with VG are younger and present more dysfunctional personality traits, and more general psychopathology. The presence of VG did not affect the severity of G