An addictive disorders severity model: a chained mediation analysis using structural equation modeling

BACKGROUND

The clinical relevance of the degree of severity in addiction disorders supports the need to investigate the variables underlying this aspect of the phenomenon.

OBJECTIVE

This study aimed to explore the relationships between factors that may influence the severity of addiction disorder, with a particular focus on temperamental disinhibition, emotion dysregulation, interpersonal vulnerability, and their interactions.

METHODS

A clinical sample of 502 (77% males and 22% females) was involved. All participants received a DSM-5 clinical diagnosis of "Substance-Related and Addictive Disorders" and were recruited from the Italian National Health System. The collected data were analyzed by implementing a chained mediation model using structural equation modeling.

RESULTS

The statistical appropriateness of the hypothesized latent 4- factors model was confirmed. Specifically, temperamental disinhibition (composed of impulsiveness, compulsiveness, and obsessiveness), emotion dysregulation (composed of affect dysregulation, alexithymia, and dissociation), interpersonal vulnerability (composed of traumatic experiences, preoccupied, avoidant and unresolved attachment), and Addictive Disorders Severity (composed by substance use severity, alcohol use severity, gambling severity, and Internet use severity) were the four factors which have been identified. Furthermore, a total chained mediation model emerged, where emotion dysregulation and interpersonal vulnerability mediated the relationship between temperamental disinhibition and Addictive Disorders Severity.

CONCLUSIONS

Our findings offer a better understanding of the variables associated with addictive disorder severity, providing important indications for therapeutic interventions.

What Is the Role of Psychological Factors in Long COVID Syndrome? Latent Class Analysis in a Sample of Patients Recovered from COVID-19

Background: This study aimed to identify clusters of long COVID-19 symptoms using latent class analysis and investigate the psychological factors involved in the onset of this syndrome. Method: Five hundred and six subjects recovering from COVID-19 completed a series of standardized questionnaires to evaluate the personality traits, alexithymia, and post-traumatic stress. Results: Five classes were identified: Brain fog (31.82%), No symptoms (20.95%), Sensory disorders (18.77%), Breath impairment (17.59%), and Multiple disorders (10.87%). Women reported post-COVID-19 respiratory symptoms and multiple disorders to a greater extent than men. Hospitalized subjects were more likely to report persistent symptoms after COVID-19 than asymptomatic or home-treated subjects. Antagonism, hyperarousal, and difficulty identifying emotions significantly predicted post COVID-19 symptoms. Conclusions: These findings open new questions for research on long COVID-19 and how states of emotional dysregulation can alter the physiological processes of the body and contribute to the onset of organic pathologies.

The Gratitude Resentment and Appreciation Test-Revised Short (GRAT-RS): A Multidimensional Item Response Theory Analysis in Italian Workers

Gratitude is a promising resource from a healthy organizational perspective. It is related to many positive outcomes at work. The Gratitude Resentment and Appreciation Test-Revised Short (GRAT-RS) is the most widely used self-report questionnaire to detect gratitude. The present study examined GRAT-RS (the Italian version) by implementing multidimensional item response theory (MIRT) analyses to explore its psychometric properties. The participants were 537 Italian workers. Confirmatory factor analyses (CFA) of the GRAT-RS and MIRT analyses using the Grade Response Model were run. The MIRT discrimination and MIRT difficulty parameters were calculated. A test information function (TIF) and measure of reliability associated with (TIF) scores were also implemented. CFA highlighted that a bifactor model showed the best fit. Hence, MIRT analyses were carried out by implementing a bifactor model. The MIRT bifactor structure showed a good data fit with discrimination parameters ranging from good to excellent and adequate reliability. The good psychometric properties of GRAT-RS were confirmed, highlighting the questionnaire as a reliable tool to measure gratitude in Italian workers.

Assessment of professional self-efficacy in psychological interventions and psychotherapy sessions: Development of the Therapist Self-Efficacy Scale (T-SES) and its application for eTherapy

OBJECTIVE

This study aimed to develop the Therapist Self-Efficacy Scale (T-SES), and test its validity in a sample of Italian mental health therapists, to assess their professional self-efficacy concerning their practice of eTherapy in a synchronous video-based setting.

METHODS

A sample of 322 Italian mental health professionals (37.6% psychologists, 62.4% psychotherapists; M_age  = 38.48, SD = 8.509) completed an online survey.

RESULTS

The T-SES showed a clear, one-factor structure with good psychometric properties. Significant associations were found with insight orientation, general self-efficacy, self-esteem, and personality traits of openness, conscientiousness, and agreeableness. The results showed no differences between psychologists and psychotherapists, or differences based on years of experience.

CONCLUSION

The T-SES is an agile and versatile self-report measure for mental health professionals to assess their self-efficacy concerning their therapeutic activity, which can provide information for tailoring training for eTherapy.

Insecure adult attachment and reflective functioning as mechanisms of the relationship between traumatic life events and suicidal ideation: A path analysis

The relationship between traumatic life events and increased suicide risk has been well reported in literature. However, the complex nature of suicidality phenomena still hinders our ability to comprehend the mediation mechanism underlying this association. In this study, we examined the mediating role of adult attachment and reflective functioning in the relationship between traumatic life events and suicidal ideation. Nine hundred and fifty Italian adults completed an online survey evaluating traumatic life events, adult attachment, reflective functioning and suicidal ideation. The path analysis showed that the positive relationship between traumatic life events and suicidal ideation was partially mediated by attachment anxiety and reflective functioning. From a clinical point of view, these results support the relevance of evaluating and improving patients’ ability to mentalize as a part of psychotherapeutic intervention aimed at reducing suicidality in people with a history of traumatic experiences and attachment anxiety.

Are Defense Styles Mediators between traumatic Experiences and Maladaptive Daydreaming?

Maladaptive daydreaming (MD) is a new proposed mental disorder in which an excessive absorption in vivid, narrative fantasies generates impairments in various life domains. This study aimed to examine the role of traumatic life experiences and immature, neurotic, and mature defense styles in MD. Three hundred and fifty-six Italian adults, ranging in age from 18 to 60 years completed an online survey, including measures of MD, traumatic life events, and defense styles. A multiple mediation model showed that immature, neurotic, and mature defense styles fully mediated the relationship between traumatic life experiences and MD. These findings suggest that clinical interventions for people with a history of traumatic experience who developed MD should aim to help them acquire more adaptive coping strategies to deal with traumatic memories.

Satisfaction with life in workers: A chained mediation model investigating the roles of resilience, career adaptability, self-efficacy, and years of education

Satisfaction with life is a core dimension of well-being that can be of great importance in the workplace, in light of the close link between worker health and organizational success highlighted by the perspective of healthy organizations. This study aimed at analyzing the factors associated with satisfaction with life, focusing on the role of resilience, career adaptability, self-efficacy, and years of education. A sample of 315 workers (67% women; Mage = 34.84 years, SD = 12.39) filled out the Satisfaction with Life Scale, General Self-Efficacy Scale, Career Adapt-Abilities Scale, the 10-item Connor-Davidson Resilience Scale, and a demographic questionnaire. Data were analyzed by implementing a chained mediation model. Results showed a significant and positive relationship between resilience and satisfaction with life, partially moderated by the chained effect of career adaptability and self-efficacy, controlling for education. When inserted as a covariate, education showed a significant and negative association with satisfaction with life. Such findings contribute to enriching the field of research on the factors that contribute to the well-being of workers and may have important practical implications for interventions in organizations.

Towards Meaning in Life: A Path Analysis Exploring the Mediation of Career Adaptability in the Associations of Self-Esteem with Presence of Meaning and Search for Meaning

In the contemporary world of work, workers are engaged more frequently in career choices to cope with changing work and working conditions. In this scenario, the well-being of workers is under threat. This study aims to examine the effect of career adaptability as a preventive resource on the relationship between self-esteem and meaning in life. Three-hundred Italian workers (67.3% females, mean age = 41.90; SD = 12.54) completed an online survey enclosing the Career Adapt-Abilities Scale, the Rosenberg self-esteem scale, and the Meaning in Life Questionnaire. Data were analyzed through a path analysis by implementing a mediation model to test the hypothesized relationship. The results show that career adaptability partially mediated the relationship between self-esteem and meaning in life, both considering the presence of meaning and the search for meaning dimensions. The findings expand current knowledge on the relationship between self-esteem, career adaptability and meaning in life in workers with implications for research and intervention.

Gratitude in Organizations: Psychometric Properties of the Italian Version of the Gratitude Resentment and Appreciation Test-Revised Short (GRAT-RS) in Workers

In a healthy organization's framework and strength-based prevention perspectives, gratitude represents an important resource. Gratitude is a worthy construct able to promote the well-being of both workers and organizations. Gratitude is also an interesting variable in relation to success, efficiency and productivity in organizations that can be increased through specific training. Gratitude is, therefore, considered a promising resource for both individuals and organizations. This study aims at analyzing the psychometric properties of the Italian version of the Gratitude Resentment and Appreciation Test-Revised Short (GRAT-RS). Participants were 359 Italian workers from different public and private organizations. Factor structure, internal consistency, and concurrent validity were analyzed. Confirmatory factor analysis supported a multidimensional bifactor structure. Good internal consistency and concurrent validity were established. Results indicated that the Italian version of the Gratitude Resentment and Appreciation Test-Revised Short (GRAT-RS) is a valid instrument to detect gratitude in the Italian context with workers.

Insight orientation scale: A promising tool for organizational outcomes-A psychometric analysis using item response theory

Insight is a construct carried out into different theoretical orientations with increasing application out of the boundaries of clinical psychology. Recent studies have investigated insight also as a promising variable for organizational outcomes. Given the relevance of Insight in promoting change, this paper aimed at describing the psychometric analysis of one of the shortest, most agile, and most versatile tool for measuring some of the characteristics of insight, the Insight Orientation Scale (IOS), using Item Response Theory. To achieve this goal, we applied a Mixed Rash Model to the IOS. Data from 1,445 individuals were analyzed by the means of WIN-MIRA and Multilog. Based on the likelihood statistics (CAIC) we assumed a three-class solution for the IOS. Results also indicated that the greater part of items had good discrimination and threshold parameters. These findings confirmed psychometric stability of the IOS highlighting its measurement precision, supporting its utility in both research and practice.

The Sustainable Development Goals Psychological Inventory: A Network Analysis in Italian University Students

The Sustainable Development Goals Psychological Inventory (SDGPI) is a recently developed self-report questionnaire that assesses interest, motivation, and self-efficacy associated with each of the 17 Sustainable Development Goals (SDGs) advanced by the United Nations. This study aims to investigate, via network analysis, (a) the relationships between interest, motivation, and self-efficacy for each SDG and (b) the most central SDGs. To this end, 417 Italian university students (73.9% females and 26.1% males; mean age: 22.20; DS = 3.02) were assessed through the SDGPI, and two network structures were estimated. The first network structure investigates links (edges) between interest, motivation, and self-efficacy in relation to each specific SDG. The second network structure investigates most central SDGs as the sum of interest, motivation, and self-efficacy for each specific SDG. Regarding results, the first network structure showed that five SDGs had strong and statistically significant edges between interest, motivation, and self-efficacy; seven SDGs had strong and statistically significant edges between interest and motivation but not self-efficacy; five SDGs had no statistically significant edges linking the other dimensions. The second network structure revealed that SDG 2 (Zero Hunger) and SDG 7 (Affordable and clean energy) were the most central nodes. Implications for research, tailor-made interventions, and prevention were discussed.

The Protective Role of Mature Defense Mechanisms on Satisfaction with Life in the COVID-19 Era: A Moderated Mediation Analysis

The COVID-19 pandemic significantly influenced people’s lives, with non-negligible consequences for the perception of well-being. This study sought to examine the effect of anxiety, post-traumatic impairment, and mature defenses on life satisfaction during the COVID-19 pandemic. One thousand three hundred thirty-nine Italian individuals (30% male; 70% female; Mage = 34.70; SD = 11.83) completed an online survey enclosing the Satisfaction with Life Scale, State-Trait Anxiety Inventory—Form X3, Impact of event scale—revised, and the Forty Item Defense Style Questionnaire. To test the hypothesized relationship, data were analyzed by applying a moderated-mediation analysis, a regression-based approach. Results showed that the negative effect of anxiety on life satisfaction was partially mediated by post-traumatic impairment, with a significant moderation effect of mature defenses on the relationship between post-traumatic impairment and life satisfaction. Specifically, with higher levels of mature defenses, the effects of post-traumatic impairment on consequences of the COVID-19 emergency on well-being. Furthermore, the protective role of mature defenses in facing post-traumatic impairment was shown. Such data may have applicative implications in different contexts in a management perspective of the different pandemic phases, contributing to more effective positive strength-based preventive actions to also support positive healthy organizations.

The Big Three Perfectionism Scale–Short Form: An item response theory analysis of Italian workers

Background

The present study examined the psychometric properties of the Big Three Perfectionism Scale–Short Form (BTPS-SF) using Rasch and Mokken item response theory (IRT) analyses, which have not previously been applied to the BTPS-SF.

Materials and methods

A total of 401 Italian workers (Mage = 46.78; SD = 10.1; male = 48.9%; female = 51.1%) completed the BTPS-SF questionnaire. We conducted confirmatory factor analyses of the BTPS-SF and IRT analyses using the generalized partial credit model (GPCM) and Mokken scale analysis. Discrimination and difficulty parameters were calculated. The Loevinger coefficient of scalability was computed. Item characteristic curves (ICC), test information function (TIF), and differential item functioning (DIF) for gender were calculated.

Results

A three-factor solution revealed the best fit. Thus, IRT analyses were performed for each BTPS-SF factor: rigid perfectionism (RP), self-critical perfectionism (SP), and narcissistic perfectionism (NP). All the items showed Loevinger coefficients from medium to strong and discrimination parameters from medium to very high. No DIF for gender was found.

Conclusion

The Big BTPS-SF shows good psychometric properties for Italian workers. Future research is warranted to examine the findings in workers from different countries.

Work as Meaning Inventory: A network analysis in Italian workers and students

The present study examined the Italian version of the Work as Meaning Inventory and Work as Meaning Inventory for University students through a network perspective. Network analysis was applied to 505 Italian workers assessed via the Work as Meaning Inventory and 214 Italian university students assessed via the Work as Meaning Inventory for University students. The comparison between the factor and network model of both Work as Meaning Inventory and Work as Meaning Inventory for University students showed a higher fit for network models. Network analysis revealed that both Work as Meaning Inventory and Work as Meaning Inventory for University students items enclosed in the Positive meaning dimension had the highest centrality; the most connected item with the overall network was the item 2 (work/study that contributes to personal growth) able to link together the three dimensions (positive meaning, meaning-making through work, greater good motivations). Findings suggested that a network approach can provide a promising realm to expand the understanding of meaning at work and meaning at study.

POS0254 IMMUNE RESPONSE TO SARS-CoV-2 INFECTION IN PATIENTS WITH RHEUMATIC MUSCULOSKELETAL DISEASES: THE MAINSTREAM STUDY

Background

Rheumatic musculoskeletal diseases (RMD) are pathological conditions characterized by an impaired immunological system that is determinant both in the pathogenesis and in the inadequate response to infections. The use of disease-modifying anti-rheumatic drugs (DMARDs), which include conventional synthetic (cs) or biologic and targeted synthetic (b/ts) DMARDs, contribute to compromise immunological reactivity.

Objectives

To analyze the immune response to SARS-CoV-2 in patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) receiving treatment with DMARDs and to investigate the effect of the different classes of drugs on humoral and cellular response.

Methods

Patients were tested for anti-SARS-CoV-2 IgG, IgM and IgA antibodies to nucleoprotein (N) and receptor-binding domain (RBD) through ELISA and neutralization assays. Then, we performed a flow cytometry analysis of monocytes, NK cells, B and T lymphocytes from PBMCs of serologically positive patients. We also included a cohort of non-RMD individuals recovered from COVID-19 as a reference group of non-immunosuppressed subjects. A first recruitment occurred in May-June 2020 (T1) and a second recruitment, 3-4 months after (T2), allowed to evaluate the persistence of the antibody response over time and to investigate the cellular immune response to SARS-CoV-2 in RMD patients having resolved the infection.

Results

During T1, 358 patients with RA (n=200) or SpA (n=158) were recruited. Mean age was 52.8, 64% were female. All patients were treated with DMARDs, 299 with b/tsDMARDs and 59 received csDMARDs alone. One third was also receiving corticosteroids (CS). At T2, 36 subjects were recruited. We found a seroprevalence rate of 18.4%, which did not significantly differ between RA and SpA groups, and between patients treated with b/ts-DMARD or csDMARDs, either alone or in combination with CS (Table 1). Antibody levels of RMD patients were lower than non-RMD individuals (Figure 1), with CTLA4-Ig-treated patients having the lowest IgG levels. This difference was less marked in symptomatic RMD patients. 72% of seropositive patients elicited neutralizing sera. Despite an overall decrease in anti-RBD and anti-N titers, more than two-third of patients maintained antibodies titers above positivity threshold at T2. Concerning cellular response, we found that CD8+ T-cells frequency was overall comparable between RMD and non-RMD convalescents, and did not differ in b- or cs-DMARD treated ones. Conversely, CD4+ T-cell frequencies were significantly lower in RMD patients, especially those treated with anti-IL6R and CTLA4-Ig. B-cell subpopulations (class-switched, memory, and IgG+ memory B-cells) had sustained frequencies in anti-TNFα treated patients, while they had a trend of reduction in patients treated with anti-IL6R and CTLA4-Ig.

Table 1.

Anti-RBD seroprevalence

TotalSeropositive, n(%)IgM (n)(%)IgG (n)(%)IgA (n)(%)COVID19 symptomatic772532.51924.71722.11722.1COVID19 asymptomatic2814114.6*238.2*134.6 *269.3*RA20036192311.520102713.5SpA15830191912106.31610.1b/ts-DMARD2995518.43511.72483612cs-DMARD591118.6711.9610.2711.9csDMARD+b/tsDMARD1122623.287.187.198a-TNFa1733721.42514.5169.12112.1a-IL-6R35822.9514.3617.1822.9CTLA4-Ig42511.937.112.447.1

*P value < 0,005

Figure 1.

Magnitude of the anti-RBD and anti-N antibody response

Conclusion

Our data provide a comprehensive picture of the humoral and cellular immune responses to SARS-CoV-2 infection in RMD patients. We showed that DMARDs treatments did not alter a successful antibody response to the virus and did not hamper the antibody neutralizing ability. However, the magnitude of antibody response was slightly reduced compared to non-RMD individuals, especially in patients receiving CTLA4-Ig. We did not observe marked differences in the B- and T-cell populations between RMD patients compared to non-RMD individuals. However, in patients receiving anti-TNFα we found a higher relative abundance of effector adaptive population compared to other bDMARDs.

Acknowledgements

The project was co-financed by Lombardy 2014-2020 Operational Program under the European Regional Development Fund.

Disclosure of Interests

None declared

Decent work in Italy: A network analysis

The present study investigated the Italian version of the Decent Work Scale (DWS) with a sample of 645 workers (females = 65.1%; mean age = 43.9 years; SD = 10.9) according to a network perspective. We compared factorial and network models and estimated the regularized partial correlations for the five DWS domains: physically and interpersonally safe working conditions (SC), access to healthcare (AH), adequate compensation (AC), hours that allow for free time and rest (FT) and organizational values complement family and social values (CV). The results highlighted that the network model showed the best fit to the data. Among the most central domains in the network, the high centrality of CV suggests that this domain could represent an effective target for actions addressed to fostering decent work in Italy. In contrast, the low centrality of AC and FT underlines the urgent need to advocate for more decent remunerations and working hours in Italy.

The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis

PURPOSE

Although a link between problematic online pornographic use (POPU) and insomnia symptoms has been established, psychological and psychopathological mechanisms underlying this relationship are still not clear. Psychological stress and emotion dysregulation have been pointed out as relevant in the development and maintenance of insomnia. This study aims to explore the associations between POPU, psychological stress, emotion dysregulation and insomnia symptoms and to understand the mediating role of psychological stress and emotion dysregulation in the relationship between POPU and insomnia symptoms.

PARTICIPANTS AND METHODS

A sample of 776 Italian adults aged 19-48 years (51.4% female; M age = 28.49; SD = 7.33) completed questionnaires regarding demographics, COVID-19-related variables, POPU, psychological stress, emotion dysregulation, and insomnia symptoms.

RESULTS

After controlling for demographic covariates and COVID-19-related variables, multiple mediation model showed that higher psychological stress and emotion dysregulation fully mediated the link between POPU and insomnia.

CONCLUSION

The findings underscore the significance of the negative consequences of POPU and underline the importance of working on this and its effects on psychological stress and emotion dysregulation to limit insomnia.

Alexithymia, Dissociation, and Family Functioning in a Sample of Online Gamblers: A Moderated Mediation Study

The diffusion of the internet and technological progress have made gambling on online platforms possible, also making it more anonymous, convenient, and available, increasing the risk of pathological outcomes for vulnerable individuals. Given this context, the present study explores the role of some protective and risk factors for problematic gambling in online gamblers by focusing on the interaction between alexithymia, dissociation, and family functioning. A sample of 193 online gamblers (Mage = 28.8 years, SD = 10.59; 17% females, 83% males) completed the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale-II, and Family Adaptability and Cohesion Evaluation Scales-IV through an online survey. MANOVA, ANOVA and moderated mediation analyses were carried out to analyse the data. Significant differences in cohesive family functioning, alexithymia and dissociation have been found between online gamblers with problematic, at-risk or absent levels of gambling disease. Furthermore, the results showed a significant and positive association between alexithymia and problematic online gambling, partially mediated by dissociation, with the moderation of cohesive family functioning. Such data may have relevant clinical implications, highlighting the interaction of some core personal and environmental variables that may be involved in the etiology of online pathological gambling and could be kept in mind to tailor preventive interventions.

The Relationship between Alexithymia, Dysmorphic Concern, and Exercise Addiction: The Moderating Effect of Self-Esteem

As with other addictions, exercise addiction can severely impact individuals' lives and have significant psychophysical consequences. Consequently, the study of the mechanisms involved in this psychopathological condition has great clinical and practical relevance. Therefore, the goal of the present study was to explore the risk factors and protective factors for exercise addiction, with a particular focus on the roles of alexithymia, body image concerns, and self-esteem. A sample of 288 regular exercisers (mean age = 28.35 years, SD = 8.26; 72% females, 18% males) completed the Exercise Addiction Inventory, 20-Item Toronto Alexithymia Scale, Body Image Concern Inventory, and Rosenberg Self-Esteem Scale. Data were analyzed by implementing a moderated mediation model. Results showed a significant and positive association between alexithymia and exercise addiction, totally mediated by body image concerns. Furthermore, self-esteem showed a relevant moderating effect, such that at high levels of self-esteem the effect of alexithymia on body image concerns became insignificant. Such data have important implications, highlighting some core variables on which it might be useful to keep a focus in order to elaborate tailored interventions, from both preventive and treatment perspectives.

The impact of COVID‐19 lockdown on perceived stress: The role of defence mechanisms and coping strategies

The COVID‐19 pandemic represents a unique global challenge. To deter its spread, several countries have put lockdown and physical distancing measures in place that could have potentially harmful consequences on people's mental health. Therefore, the aim of this study is to explore the relationship between anxiety and perceived stress in individuals who were experiencing the COVID‐19 lockdown measures, while also analyzing the impact of coping strategies interacting with defence mechanisms. A sample of 1408 individuals (M_age = 34.69; SD = 11.87) completed the Ten Item Perceived Stress Scale, State‐Trait Anxiety Inventory—Form X3, Coping Orientation to Problems Experienced and Forty‐Item Defense Style Questionnaire, after providing written informed consent. Results highlighted the significant impact of state anxiety levels on perceived stress, both directly and indirectly. The indirect pathways have been explored by performing three mixed serial‐parallel mediation analyses, where significant associations between coping strategies (Social Support, Avoidance Strategies, Positive Attitude, Problem‐solving and Turning to Religion) and mature, neurotic, or immature defences have been found. These findings may contribute to orientate prevention and intervention activity during the several management phases of COVID‐19.

Occupational Fatigue: Relationship With Personality Traits and Decent Work

Psychology of working theory (PWT) and psychology of working framework (PWF) offered a psychological view of decent work. The present study examined the associations among personality traits, decent work and Occupational Fatigue Exhaustion Recovery Scale (OFER). Two hundred and thirty four participants filled out the Big Five Questionnaire, the Italian version of the Decent Work Scale, and the Italian version of the OFER Scale. Hierarchical regressions showed that decent work explained incremental variance beyond personality traits with respect to OFER both considering total score and its three dimensions (chronic fatigue, acute fatigue, persistent fatigue). The present study underlined the value of decent work in relation to occupational fatigue beyond the contributions of personality, in particular in relation to the dimensions of Adequate compensation and Free time and rest for less occupational fatigue (both as total and as dimensions).

Durability of Dolutegravir-Based Regimens: A 5-Year Prospective Observational Study

This study evaluates the frequency and causes of dolutegravir (DTG) discontinuation along 5 years of follow-up, in both antiretroviral treatment (ART)-naive and experienced people living with HIV (PLWH). This is a prospective multi-center cohort study enrolling PLWH on DTG from July 2014 until November 2020. DTG-durability was investigated using the Kaplan-Meier survival curve. The Cox proportional-hazards model was used for estimating the hazard ratio (HR) of DTG discontinuation for any cause, and for adverse events (AEs). Nine hundred sixty-three PLWH were included, 25.3% were women and 28.0% were ART-naive. Discontinuations for any causes were 10.1 [95% confidence interval (95% CI) 8.9-11.5] per 100 person-years, similar in most regimens, with the apparent exception of tenofovir alafenamide/emtricitabine+DTG (p < 0.0001). In the multivariable Cox regression model, non-Caucasian ethnicity, age ≥50 years, and lower estimated glomerular filtration rate (eGFR) were associated with a higher probability of DTG interruption. The incidence rate of virological failure was 0.4 (95% CI 0.2-0.7) per 100 person-years, while the estimated discontinuation rate for AEs was 4.0 (3.2-4.9) per 100 person-years. Thirty-four DTG interruptions were due to grade ≥3 events (10 central nervous system, 6 hypersensitivity, 3 renal, 3 myalgia/asthenia, 3 abdominal pain, 2 gastrointestinal, and 7 other events). People with lower body mass index, age ≥50 years, and lower eGFR were at higher risk of AEs, while dual combinations were protective (HR 0.41 compared with abacavir/lamivudine/DTG, 95% CI 0.22-0.77). In this prospective observational study, we found high DTG durability and a low rate of virological failures. Dual therapies seemed protective toward AEs and might be considered, when feasible, a suitable option to minimize drug interactions and improve tolerability.

Using the Goldilocks Principle to model coral ecosystem engineering

The occurrence and proliferation of reef-forming corals is of vast importance in terms of the biodiversity they support and the ecosystem services they provide. The complex three-dimensional structures engineered by corals are comprised of both live and dead coral, and the function, growth and stability of these systems will depend on the ratio of both. To model how the ratio of live : dead coral may change, the ‘Goldilocks Principle’ can be used, where organisms will only flourish if conditions are ‘just right’. With data from particle imaging velocimetry and numerical smooth particle hydrodynamic modelling with two simple rules, we demonstrate how this principle can be applied to a model reef system, and how corals are effectively optimizing their own local flow requirements through habitat engineering. Building on advances here, these approaches can be used in conjunction with numerical modelling to investigate the growth and mortality of biodiversity supporting framework in present-day and future coral reef structures.