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.

Personality traits, workers' age, and job satisfaction: The moderated effect of conscientiousness

Job satisfaction has gained increasing interest in the world of work and a vast field of research has been stimulated regarding its antecedents. Among these, personality traits have received consistent and significant attention, with a particular emphasis on conscientiousness. To delve deeper and detail these aspects, in the present research, a moderation model was hypothesized, with the aim of investigating the effect of age on the association between conscientiousness (and its subdimensions scrupulousness and perseverance) and job satisfaction. The age-moderated interactions of the other Big Five personality traits were also explored. The study involved 202 Italian workers (92 men, 110 women) with a mean age of 44.82 years (SD = 10.56) who completed the Big Five Questionnaire and the Job Satisfaction Scale. The results showed a positive association between conscientiousness and job satisfaction. This was moderated by age to the extent that it was significant for younger and average-age workers and was less significant for older workers. Similar results were found for the subdomain of perseverance, while the relationship between scrupulousness and job satisfaction was not significant. Furthermore, no age-moderated interaction between the other Big Five personality traits and Job satisfaction were found. Such data supports interactive models that highlight the need to integrate personality traits with other factors in exploring the antecedents of job satisfaction. These findings provide additional elements to an understanding of the factors contributing to workers satisfaction, and could have important applicative implications in a framework for healthy organizations and the well-being movement.

Scrotal cutaneous metastasis from rectal squamous cell carcinoma: a rare evolution into a rare tumor

The scrotum is a rare site for metastases and represents less than 1% of the body's total surface area. Clinically, metastatic deposits in the scrotum can present in a variety of ways. They may appear as solitary cutaneous nodules, papules, plaques, or generalized induration or edema. Indeed, scrotum metastasis may be mistaken for other skin lesions since several dermatologic conditions can present with inflammation or dermatitis of the scrotum. Properly diagnosing cutaneous metastasis requires histopathological examination since the clinical appearances are, as described, highly variable and non-specific. We present a 63-year-old man with painless nodules on the scrotal skin. Excisional biopsy of the nodules revealed a metastasis from rectal squamous cell carcinoma. The incidence of this kind of tumors is estimated around 0.1-0.25 per 1000 colorectal neoplasms.

Which personality traits can mitigate the impact of the pandemic? Assessment of the relationship between personality traits and traumatic events in the COVID-19 pandemic as mediated by defense mechanisms

The COVID-19 pandemic has had a significant influence on the lives of people around the world and could be a risk factor for mental health diseases. This study aimed to explore the psychological impact of the COVID-19 pandemic by identifying patterns related to post-traumatic symptoms by considering personality and defensive styles. Specifically, it was hypothesized that neuroticism was negatively associated with impact of event, as opposed to extraversion, agreeableness, conscientiousness, and openness traits. The mediation role of mature, neurotic, and immature defenses in these relationships was also investigated. This study involved 557 Italian individuals (71.3% women, 28.7% men; Mage = 34.65, SD = 12.05), who completed an online survey including the Impact of Event Scale-Revised, Forty Item Defense Style Questionnaire (DSQ-40) and Ten Item Personality Inventory. Results showed a nonsignificant effect for extraversion and openness on impact of event. The negative influence of neuroticism was instead confirmed in a partial parallel mediation involving significant effects from immature and neurotic defenses in the indirect path. Finally, agreeableness and conscientiousness delineated two protective pathways regarding impact of event, determining two total parallel mediation models in which both these personality traits were negatively associated with immature defensive styles, and conscientiousness was also positively related to mature defenses. These findings provide an exploration post-traumatic symptom patterns during the COVID-19 pandemic, involving the big five personality traits and defense mechanisms. These results may be useful for developing interventions, treatments, and prevention activities.

Lung Transplantation for Acute Respiratory Distress Syndrome Related to COVID-19: The Lesson Learned from the First Two Cases

Purpose

The respiratory system, and namely the lung, is undoubtedly the preferential target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical pictures are extremely various, up to the intensive care unit (ICU) admission for acute respiratory distress syndrome (ARDS). Lung transplantation (LT) is a consolidate therapeutic option for end-stage chronic respiratory diseases. Its role in an acute setting is questionable, particularly due to lack of experiences, donor shortage, and the difficulty to fully evaluate the potential recipient. We report our preliminary experience with the first two cases of LT for SARS-CoV-2 related ARDS, trying to provide some food for thought.

Methods

We retrospectively analysed our first two cases of bilateral LT for ARDS after COVID-19. We recorded data on pre-transplantation clinical course, transplantation management and outcomes.

Results

The two patients had a similar clinical evolution of COVID-19. Transplantations were successful in both cases; the first patient is alive and in good condition 5 months after transplantation, while the second died 62 days after surgery. Table 1 shows clinical details and relevant time-points.

Conclusion

Our experience showed that LT for COVID-19 is feasible. Importantly, observing a dedicated protocol made the procedure safe for the healthcare staff involved. On the other hand, our second unsuccessful case poses relevant questions: first of all, lung transplantation should be reserved to highly selected patient, after careful clinical, infective as well as psychiatric evaluation. The ethical aspects should also be considered in this situation, with regard to the centre rate mortality on waiting list. Anyway, the potential role of LT in the acute and sub-acute/chronic settings suggests the need for maintaining LT centre active during pandemic. Finally, COVID-19, once more, imposes to share clinical experiences.

The Link between Attachment and Gambling in Adolescence: A Multiple Mediation Analysis with Developmental Perspective, Theory of Mind (Friend) and Adaptive Response

Introduction: Several studies have supported the evidence that attachment styles are a central factor in adolescent gambling problems. On this theoretical basis, the aim of the present study is to analyze a hypothesized mediation model exploring both the direct and indirect effects of insecure attachment on gambling disorder by investigating the role of the developmental perspective, theory of mind (friend) and adaptive response in that relationship. Method: The sample consists of 178 adolescents who underwent the Measures: South Oaks Gambling Screen-Revised for Adolescents and Friends and Family Interview. Result: The mediation analysis was conducted following Hayes' (2018) procedure, using Model 6. The results showed a significant association between insecure attachment and gambling disorder (β = 0.669; p < 0.001). The findings also highlighted a significant chained mediation model in which insecure attachment negatively influenced the developmental perspective (β = -0.742; p < 0.001), which affected the theory of mind toward one's own best friend (β = 0.352; p < 0.001). Conclusions: The results highlighted a significant role of insecure attachment in predicting the symptomatic expression of gambling among adolescents, specifically impacting the development perspective, theory of mind toward one's best friend and adaptive response to stress, which were linked to each other by a sequential influence. Therefore, our results showed that a poor developmental self-vision predicted a dysfunctional theory of mind toward the best friend. This could hinder the formation of positive peer relationships, which are crucial for the development of one's identity.

Pathways to post-traumatic growth in cancer patients: moderated mediation and single mediation analyses with resilience, personality, and coping strategies

BACKGROUND

Cancer diagnosis is a potentially traumatic experience, which could generate significant long-lasting emotional distress, but also positive changes linked to post-traumatic growth (PTG). This study aimed to analyze the role of resilience, coping, and personality in determining PTG or post-traumatic symptoms, and to test a moderated mediation model and a single mediation model in a sample of individuals diagnosed with cancer.

METHODS

A sample of 154 individuals diagnosed with cancer (M_age = 51.4, SD = 11.25) completed the Post-Traumatic Growth Inventory, Impact of Event Scale, Connor-Davidson Resilience Scale, Ten Item Personality Inventory, and Coping Orientation to Problems Experienced after providing written informed consent.

RESULTS

Results showed that the impact of resilience in PTG is partially mediated by positive attitude, with a significant and negative moderating effect of openness on the relationship between resilience and positive attitude. Furthermore, resilience negatively predicted the impact of trauma, with a partial mediation of avoidance strategies.

LIMITATIONS

The cross-sectional nature of the study, the use of only self-report measures, heterogeneity of the sample, and the risk of influence of unobserved prognostic variables should be kept in mind while interpreting the results.

CONCLUSIONS

The findings showed that the level of resilience predicted PTG or post-traumatic symptoms, both directly and indirectly, with different coping strategies as mediators. Furthermore, the lower the level of openness reported by participants, the higher the resilience induced by positive attitude. These findings may significantly contribute toward tailoring interventions for improving the mental health of cancer patients.

Mental health outcomes in patients with cancer diagnosis: Data showing the influence of resilience and coping strategies on post-traumatic growth and post-traumatic symptoms

The presented data provide a panoramic concerning the influence of different coping strategies in the relationship between resilience and post traumatic growth or post-traumatic symptoms in patients with a cancer diagnosis. These expand the results presented in the related research article of Gori et al. [1], entitled “Pathways to post-traumatic growth in cancer patients: moderated mediation and single mediation analyses with resilience, personality, and coping strategies”. A sample of 154 patients completed a survey, where the Post-Traumatic Growth Inventory, Impact of Event Scale-Revised, Connor-Davidson Resilience Scale, and Coping Orientation to Problems Experienced were included. All the measures for the data collection were in their Italian versions. Data were elaborated by performing single mediation analyses, considering each time the different coping strategies as mediators. The dataset (.xlsx) includes the survey scores, while the tables and figures provide the analysed data, where the mediation models are shown. These data may provide useful bases for future research concerning mental health outcomes in patients with cancer and for tailored programs in preventive or intervention perspectives.

The protective role of life satisfaction, coping strategies and defense mechanisms on perceived stress due to COVID-19 emergency: A chained mediation model

The coronavirus disease-19 (COVID-19) pandemic represents a worldwide emergency, which may have harmful consequences on people’s mental health. Parallel to research focused on risk factors, it could be useful to investigate the factors that help to cope with such crises at an emotional level. Therefore, this study aimed to strengthen the role of variables that protect from subjective distress during the COVID-19 pandemic, explore the pathways between satisfaction with life and perceived stress, and consider the role of coping strategies and defense mechanisms in this relationship. A sample of 1102 Italian participants who were experiencing the COVID-19 lockdown measures (Mage = 34.91, SD = 11.91) completed an online survey in which the Ten Item Perceived Stress Scale, Satisfaction with Life Scale, Coping Orientation to Problems Experienced Inventory and Forty-Item Defense Style Questionnaire were included. The data were analyzed using Pearson’s r correlations and moderation analysis. A chained-mediation model showed that the relationship between life satisfaction and perceived stress is partially mediated by approach coping, positive attitude and mature defenses. This study contributes toward gaining a better understanding of a protective pathway for mental health outcomes during the COVID-19 pandemic. The findings could be useful from both a preventive and an intervention perspective.

Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy

OBJECTIVES

The management of healthcare workers (HCWs) exposed to confirmed cases of coronavirus disease 2019 (COVID-19) is still a matter of debate. We aimed to assess in this group the attack rate of asymptomatic carriers and the symptoms most frequently associated with infection.

METHODS

Occupational and clinical characteristics of HCWs who underwent nasopharyngeal swab testing for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a university hospital from 24 February 2020 to 31 March 2020 were collected. For those who tested positive and for those who tested positive but who were asymptomatic, we checked the laboratory and clinical data as of 22 May to calculate the time necessary for HCWs to then test negative and to verify whether symptoms developed thereafter. Frequencies of positive tests were compared according to selected variables using multivariable logistic regression models.

RESULTS

There were 139 positive tests (8.8%) among 1573 HCWs (95% confidence interval, 7.5-10.3), with a marked difference between symptomatic (122/503, 24.2%) and asymptomatic (17/1070, 1.6%) workers (p < 0.001). Physicians were the group with the highest frequency of positive tests (61/582, 10.5%), whereas clerical workers and technicians had the lowest frequency (5/137, 3.6%). The likelihood of testing positive for COVID-19 increased with the number of reported symptoms; the strongest predictors of test positivity were taste and smell alterations (odds ratio = 76.9) and fever (odds ratio = 9.12). The median time from first positive test to a negative test was 27 days (95% confidence interval, 24-30).

CONCLUSIONS

HCWs can be infected with SARS-CoV-2 without displaying any symptoms. Among symptomatic HCWs, the key symptoms to guide diagnosis are taste and smell alterations and fever. A median of almost 4 weeks is necessary before nasopharyngeal swab test results are negative.

Switching from tenofovir disoproxil fumarate to tenofovir alafenamide or dual therapy-based regimens in HIV-infected individuals with viral load ≤50 copies/mL: does estimated glomerular filtration rate matter?

Our aim was to evaluate the association between recent eGFR values and risk of switching from TDF to TAF or dual therapy (DT) in real life. HIV-positive patients achieving HIV-RNA ≤50 copies/mL for the first time after starting a TDF-based regimen were included. Kaplan-Meier (KM) curves and Cox regression models were used to estimate the time from TDF to switch to TAF or DT. 1486 participants were included: median (IQR) age 36 (30-42) years; baseline CKD-EPI eGFR 99.92 (86.47-111.4) mL/min/1.73m². We observed a consistently higher proportion of people with HIV-RNA ≤50 copies/mL who switched from TDF to TAF rather than to DT. By competing risk analysis, at 2 years from baseline, the probability of switching was 3.5% (95% CI 2.6-4.7%) to DT and 46.7% (42.8-48.5%) to TAF. A significantly higher probability of switching to TAF was found for patients receiving INSTI at baseline versus NNRTIs and PI/b [KM, 65.6% (61.7-69.4%) vs. 4.0% (1.8-6.1%) and 59.9% (52.7-67.2%), respectively; P < 0.0001]. eGFR <60 mL/min/1.73m² both as time-fixed covariate at baseline or as current value was associated with a higher risk of switching to DT [aHR 6.68 (2.69-16.60) and 8.18 (3.54-18.90); P < 0.001] but not to TAF-based cART [aHR 0.94 (0.39-2.31), P = 0.897; and 1.19 (0.60-2.38), P = 0.617]. Counter to our original hypothesis, current eGFR is used by clinicians to guide switches to DT but does not appear to be a key determinant for switching to TAF.

Fatal respiratory infection due to ST308 VIM-1-producing Pseudomonas aeruginosa in a lung transplant recipient: case report and review of the literature

Background

Data regarding the prevalence of metallo-β-lactamases (MBLs) among Pseudomonas aeruginosa isolates in cystic fibrosis patients are scarce. Furthermore, there is limited knowledge on the effect of MBL production on patient outcomes. Here we describe a fatal respiratory infection due to P. aeruginosa producing VIM-type MBLs in a lung transplant recipient and the results of the subsequent epidemiological investigation.

Case presentation

P. aeruginosa isolates collected in the index patient and among patients temporally or spatially linked with the index patient were analyzed in terms of antibiotic susceptibility profile and MBL production. Whole-genome sequencing and phylogenetic reconstruction were also performed for all P. aeruginosa isolates producing VIM-type MBLs. A VIM-producing P. aeruginosa strain was identified in a lung biopsy of a lung transplant recipient with cystic fibrosis. The strain was VIM-1-producer and belonged to the ST308. Despite aggressive treatment, the transplant patient succumbed to the pulmonary infection due to the ST308 strain. A VIM-producing P. aeruginosa strain was also collected from the respiratory samples of a different cystic fibrosis patient attending the same cystic fibrosis center. This isolate harbored the blaVIM-2 gene and belonged to the clone ST175. This patient did not experience an adverse outcome.

Conclusions

This is the first description of a fatal infection due to P. aeruginosa producing VIM-type MBLs in a lung transplant recipient. The circulation of P. aeruginosa isolates harboring MBLs pose a substantial risk to the cystic fibrosis population due to the limited therapeutic options available and their spreading potential.

The relationship between dyadic adjustment and psychiatric symptomatology in expectant couples: An actor-partner interdependency model approach

BACKGROUND

Many researchers who evaluated psychological distress during the transition to parenthood agree in identifying pregnancy as the most sensitive period for the onset of psychiatric symptomatology for both parents. Furthermore, research highlights a correlation between symptoms experienced by fathers in relation to those experienced by mothers.

OBJECTIVE

The aim of this study was to investigate whether dyadic functioning influences the level of psychiatric symptomatology in couples expecting their first child. Participants were 137 couples expecting their first child; they were recruited at the San Filippo Neri and the Santo Spirito hospitals in Rome (ASLROMA1). We used an Actor-Partner Interdependence Model (APIM) to test the interdependence of both partners and the effect of dyadic relationships on psychiatric symptoms in the couple.

RESULTS

The overall test of distinguishability yielded a chi square value of 122.167 (23 df; p < .001). The actor-partner interdependence model showed significant paths between couple coping and psychiatric symptomatology. Specifically, we found that the quality of couple coping perceived by the mother negatively predicted maternal psychiatric symptomatology, and the quality of couple coping perceived by the father negatively predicted paternal psychiatric symptomatology. Furthermore, the quality of couple coping perceived by the father negatively predicted maternal psychiatric symptomatology.

CONCLUSIONS

The results of this study confirm that dyadic adjustment is an important element for the development of effective interpersonal relationships. These data highlight the importance of promoting psycho-educational and clinical courses and programs for the development of social support with future parents.

Balancing evidence and frontline experience in the early phases of the COVID-19 pandemic: current position of the Italian Society of Anti-infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which has rapidly become epidemic in Italy and other European countries. The disease spectrum ranges from asymptomatic/mildly symptomatic presentations to acute respiratory failure. At the present time the absolute number of severe cases requiring ventilator support is reaching or even surpassing the intensive care unit bed capacity in the most affected regions and countries.

OBJECTIVES

To narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and frontline opinions and to provide balanced answers to pressing clinical questions.

SOURCES

Inductive PubMed search for publications relevant to the topic.

CONTENT

The available literature and the authors' frontline-based opinion are summarized in brief narrative answers to selected clinical questions, with a conclusive statement provided for each answer.

IMPLICATIONS

Many off-label antiviral and anti-inflammatory drugs are currently being administered to patients with COVID-19. Physicians must be aware that, as they are not supported by high-level evidence, these treatments may often be ethically justifiable only in those worsening patients unlikely to improve only with supportive care, and who cannot be enrolled onto randomized clinical trials. Access to well-designed randomized controlled trials should be expanded as much as possible because it is the most secure way to change for the better our approach to COVID-19 patients.

Predictors of incomplete viral response and virologic failure in patients with acute and early HIV infection. Results of Italian Network of ACuTe HIV InfectiON (INACTION) cohort

OBJECTIVES

The aim of this study was to evaluate the factors that can influence an incomplete viral response (IVR) after acute and early HIV infection (AEHI).

METHODS

This was a retrospective, observational study including patients with AEHI (Fiebig stages I-V) diagnosed between January 2008 and December 2014 at 20 Italian centres. IVR was defined by: (1) viral blip (51-1000 HIV-1 RNA copies/mL after achievement of < 50 HIV-1 RNA copies/mL); (2) virologic failure [> 1000 copies/mL after achievement of < 200 copies/mL, or ≥ 200 copies/mL after 24 weeks on an antiretroviral therapy (ART)]; (3) suboptimal viral response (> 50 copies/mL after 48 weeks on ART or two consecutive HIV-1 RNA levels with ascending trend during ART). Cox regression analysis was used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for IVR.

RESULTS

In all, 263 patients were studied, 227 (86%) males, with a median [interquartile range (IQR)] age of 38 (30-46) years. During a median follow-up of 13.0 (5.7-31.1) months, 38 (14.4%) had IVR. The presence of central nervous system (CNS) symptoms was linked to a higher risk of IVR (HR = 4.70, 95% CI: 1.56-14.17), while a higher CD4/CD8 cell count ratio (HR = 0.13, 95% CI: 0.03-0.51 for each point increase) and first-line ART with three-drug regimens recommended by current guidelines (HR = 0.40, 95% CI: 0.18-0.91 compared with other regimens including four or five drugs, older drugs or non-standard backbones) were protective against IVR.

CONCLUSIONS

Patients with lower CD4/CD8 ratio and CNS symptoms could be at a higher risk of IVR after AEHI. The use of recommended ART may be relevant for improving short-term viral efficacy in this group of patients.

Mind and Body: Italian Validation of the Postural Awareness Scale

Postural awareness (PA) refers to a subjective conscious awareness of body posture and falls within the framework of mind-body integration. The aim of this research was to validate and evaluate psychometric properties of the Postural Awareness Scale (PAS) in an Italian population sample (n = 928; 45.04% men and 54.96% women; mean age = 29.96 years, standard deviation = 11.44). The results obtained with Velicer's Minimum Average Partial Test, Horn's Parallel Analysis, and exploratory factor analysis showed a two-factor solution, as supported by the confirmatory factor analysis: ease/familiarity with postural awareness and need for attention regulation with postural awareness. Furthermore, the findings highlighted both a good internal consistency (α = 0.76 for the total scale and α = 0.80, α = 0.79 for the two subscales) and a satisfactory construct validity. Furthermore, multivariate analysis of variance was carried out to assess differences in PA between specific subgroup. In particular, the positive effects of physical activity and healthy body weight were confirmed, whereas no significant differences related to gender or age were found. All these findings suggest that the Italian version of the PAS is a rapid instrument with good psychometric properties, which can be useful both for research and clinical practice.

Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.

Predisposition to Change Is Linked to Job Satisfaction: Assessing the Mediation Roles of Workplace Relation Civility and Insight

The globalization processes typical of liquid modern society require organizations to have high levels of flexibility, dynamism, and rapidity of change, testing the adaptability of workers with possible repercussions on well-being and productivity. Therefore, this study aimed to investigate the role of several psychological factors in favoring job satisfaction in a group of organizational workers (mean age = 46.24; SD = 9.99; 40.9% males and 59.1% females). Firstly, the impact of predisposition to change on job satisfaction through workplace relational civility (others with me) or insight orientation as independent mediating variables was analyzed. After that, this relationship was also studied by testing the effect that the simultaneous interaction of both mediators could have. Results show that workplace relational civility (others with me) significantly mediated the relationship between predisposition to change and job satisfaction, while no significance was found in the effect of insight when considered individually. However, the latter acquires greater relevance if placed in interaction with the other mediator, that is found to be the most proximal factor linking job satisfaction to the other more distal variables. Such findings might have a relevant role in strengthening preventive intervening, favoring positive results for greater well-being of both subjects and organizations.

Psychopathological Features and Drop-Out Predictors in a Sample of Individuals with Substance Use Disorder Under Residential Community Treatment

OBJECTIVE

Several studies have been conducted to investigate the relationship between addiction and crimes, but little is known about the treatment of individuals with substance use disorder (SUD) with criminal records. This study aimed to assess the treatment progress of a group of individuals with SUD who underwent treatment within a residential community, and to analyze their personality profiles to identify drop-out predictors.

METHOD

We evaluated 49 subjects using the Psychopathic Personality Inventory-Revised (PPI-R), the Psychological Treatment Inventory (PTI), the Barratt Impulsiveness Scale-11 (BIS-11), and the Toronto Alexithymia Scale (TAS-20) and carrying out various statistical analyses, including the t-test, Cohen's d, analysis of variance (ANOVA), and discriminant analysis.

RESULTS

Results are discussed within the context of previous studies on this topic. Our results showed that variables such impulsiveness, cold-heartedness, alexithymia, and psychopathic traits influenced the premature treatment abandonment of individuals with SUD and criminal records.

CONCLUSIONS

This study provides a further piece for the understanding of subjects with SUD and criminal records, suggesting the importance of a psychodynamic integrated approach, and showing the impact of some psychopathological features on treatment drop-out.