Well-being, distress and health status in a population of adolescent students

The present work explores the psychosocial issues emerging from a large cross-sectional study aimed to assess the prevalence, clinical manifestations, and psychosocial correlates of hyperandrogenism in a population of Italian high school students. Participants were 1804 adolescents, aged between 15 and 19 years, who volunteered to fill in a package of self-report questionnaires (including the Psychosocial Index, the Symptom Questionnaire and Ryff���s Psychological Well-Being scales for the assessment of psychological aspects) and undergo a comprehensive physical examination. Significant gender differences were found with regard to psychological distress, with females reporting higher scores compared with males, but not on well-being dimensions. The relationships of well-being to distress were found to be complex. Although inversely associated, well-being and ill-being appeared to be distinct domains of mental functioning. The evaluation of the moderating effects of well-being in the association between stress and psychological distress indicated that well-being may act as a protective factor, contributing to less pronounced psychological distress as stress levels increased. Higher rates of somatic complaints were found among current smokers. However, substance use (i.e., smoking and drug use) was also found to be positively associated with some well-being dimensions. A considerable number of participants were found to present with disordered eating symptoms, particularly females, and associated higher stress levels and lower quality of life. Sport activities were found to favourably affect psychological health. As to clinical signs of hyperandrogenism, a significant impairment in psychosocial functioning was found among females, whereas no effects on psychological measures could be detected among males. Subgroups of adolescents with distinct clinical and psychological characteristics could be identified by means of cluster analysis. The present study provides new insights into better understanding of the complex relationships between well-being, distress and health status in the adolescent population, with important clinical implications.

Enhancing Workers��� Well-Being. Scientific and social relevance of managing stress in the workplace

Purpose. Despite work-related stress is one of the most studied topic in organizational psychology, many aspects as for example the use of different measures (e.g. subjective and objective, qualitative and quantitative) are still under debate. According to this, in order to enhance knowledge concerning which factors and processes contribute to create healthy workplaces, this thesis is composed by four different studies aiming to understand: a) the role of relevant antecedents (e.g. leadership, job demands, work-family conflict, social support etc.) and outcomes (e.g. workplace phobia, absenteeism etc.) of work-related stress; and b) how to manage psychosocial risk factors in the workplace. The studies. The first study focused on how disagreement between supervisors and their employees on leadership style (transformational and transactional) could affect workers well-being and work team variables. The second and third study used both subjective and objective data in order to increase the quality of the reliability of the results gained. Particularly, the second study focused on job demand and its relationship with objective sickness leave. Findings showed that despite there is no direct relationship between these two variables, job demand affects work-family conflict, which in turn affect exhaustion, which leads to absenteeism. The third study analysed the role of a new concept never studied before in organizational settings (workplace phobia), as a health outcome in the JD-R model, demonstrating also its relationship with absenteeism. The last study highlighted the added value of using the mixed methods research approach in order to detect and analyse context-specific job demands which could affects workers��� health. Conclusion. The findings of this thesis answered both to open questions in the scientific literature and to the social request of managing psychosocial risk factors in the workplace in order to enhance workers well-being.

Precarious employment and social reproduction: the impact on health and well-being

This dissertation aims to make a theoretical and empirical contribution to the debate on precarious employment, social reproduction and the impact on health and well-being. In recent years, numerous studies have examined the effect of precarious employment as a social determinant on health and well-being, focusing on gender differences in this phenomenon. Within this framework, the research design is to investigate this topic quantitatively in the United Kingdom using longitudinal data to assess the long-term effects of precarious employment and informal care work on health. More specifically, the aim of this thesis is to investigate the impact of precarious employment on health and to analyze gender differences within this phenomenon, particularly in relation to the role of informal care work. The analysis shows that precarious employment is indeed associated to a detrimental effect on health and that this effect is stronger for women���s mental health. Additionally, the analysis shows that time spent on informal care work explains part of the gender gap in mental health, and that informal care and the number of hours spent on it are associated with worse mental health for women. Finally, during the first few months of Covid-19, for both men and women, performing more hours of care work on average is associated with worse mental health, showing that it is not so much the change from fewer to more hours that affects health, but rather those who do more hours on average, hence the long-term effect of being an intensive informal carer.

The application of a new psychotherapeutic strategy for enhancing eudaimonic well-being in children with mood and anxiety disorders

The aim of the dissertation was to test the feasibility of a new psychotherapeutic protocol for treating children and adolescents with mood and anxiety disorders: Child-Well-Being Therapy (CWBT). It originates from adult Well-Being Therapy protocol (WBT) and represents a conceptual innovation for treating affective disorders. WBT is based on the multidimensional model of well-being postulated by Ryff (eudaimonic perspective), in sequential combination with cognitive-behavioral therapy (CBT). Results showed that eudaimonic well-being was impaired in children with affective disorders in comparison with matched healthy students. A first open investigation aimed at exploring the feasibility of a 8-session CWBT protocol in a group of children with emotional and behavioural disorders has been implemented. Data showed how CWBT resulted associated to symptoms reduction, together with the decrease of externalizing problems, maintained at 1-year follow-up. CWBT triggered also an improvement in psychological well-being as well as an increasing flourishing trajectory over time. Subsequently, a modified and extended version of CWBT (12-sessions) has been developed and then tested in a controlled study with 34 patients (8 to 16 years) affected by mood and anxiety disorders. They were consecutively randomized into 3 different groups: CWBT, CBT, 6-month waiting list (WL). Both treatments resulted effective in decreasing distress and in improving well-being. Moreover, CWBT was associated with higher improvement in anxiety and showed a greater recovery rate (83%) than CBT (54%). Both groups maintained beneficial effects and CWBT group displayed a lower level of distress as well as a higher positive trend in well-being scores over time. Findings need to be interpret with caution, because of study limitations, however important clinical implications emerged. Further investigations should determine whether the sequential integration of well-being and symptom-oriented strategies could play an important role in children and adolescents��� psychotherapeutic options, fostering a successful adaptation to adversities during the growth process.

The role of proactive coping strategies and perceived health status for Social well-being and life-project in old age.

The latter part of the 20th century was a period characterized by a fundamental demographic transition of western society. This substantial and structural demographic change proposes several challenges to contemporary society and fosters the emergence of new issues and challenges. Among these, none is more crucial than the comprehension of the mechanisms and the processes that lead people to positive aging. Rowe and Kahn���s model of successful aging highlights the interplay between social engagement with life, health, and functioning for a positive aging experience. Other systemic models of successful aging (Kahana et al., 1996; 2003; Stevernik et al., 2006) emphasize the role of internal and external resources for attaining positive aging. Among these, the proactive coping strategies are indicated as important active strategies for avoiding the depletion of resources, counterbalancing the declines and maintaining social and civic involvement. The study has analyzed the role of proactive coping strategies for two facets of positive aging, the experience of a high social well-being and the presence of personal projects in fundamental life domains. As expected, the proactive coping strategies, referred to as the active management of the environment, the accumulation of resources and the actualization of human potentials are confirmed as positive predictors of high level of social well-being and of many personal projects focused on family, culture, leisure time, civic and social participation. Perceived health status give a significant contribution only to the possession of many personal projects. Gender and level of school education give also a significant contribution to these two dimensions of positive aging, highlighting how positive aging is rooted not only in the possession of personal resources, but also in historical models of education and in positive longitudinal chains related to early development.

Prevention of binge drinking in young adolescents through the promotion of a balanced level of psychological well-being: be-dry

This doctoral thesis presents a project carried out in secondary schools located in the city of Ferrara with the primary objective of demonstrating the effectiveness of an intervention based on Well-Being Therapy (Fava, 2016) in reducing alcohol use and improving lifestyles. In the first part (chapters 1-3), an introduction on risky behaviors and unhealthy lifestyle in adolescence is presented, followed by an examination of the phenomenon of binge drinking and of the concept of psychological well-being. In the second part (chapters 4-6), the experimental study is presented. A three-arm cluster randomized controlled trial including three test periods was implemented. The study involved eleven classes that were randomly assigned to receive well-being intervention (WBI), lifestyle intervention (LI) or not receive intervention (NI). Results were analyzed by linear mixed model and mixed-effects logistic regression with the aim to test the efficacy of WBI in comparison with LI and NI. AUDIT-C total score increased more in NI in comparison with WBI (p=0.008) and LI (p=0.003) at 6-month. The odds to be classified as at-risk drinker was lower in WBI (OR 0.01; 95%CI 0.01���0.14) and LI (OR 0.01; 95%CI 0.01���0.03) than NI at 6-month. The odds to use e-cigarettes at 6-month (OR 0.01; 95%CI 0.01���0.35) and cannabis at post-test (OR 0.01; 95%CI 0.01���0.18) were less in WBI than NI. Sleep hours at night decreased more in NI than in WBI (p = 0.029) and LI (p = 0.006) at 6-month. Internet addiction scores decreased more in WBI (p = 0.003) and LI (p = 0.004) at post-test in comparison with NI. Conclusions about the obtained results, limitations of the study, and future implications are discussed. In the seventh chapter, the data of the project collected during the pandemic are presented and compared with those from recent literature.

The dark and bright side of remote work: social isolation, concentration, and performance of remote workers

This dissertation, comprised of three separate studies, focuses on the relationship between remote work adoption and employee job performance, analyzing employee social isolation and job concentration as the main mediators of this relationship. It also examines the impact of concern about COVID-19 and emotional stability as moderators of these relationships. Using a survey-based method in an emergency homeworking context, the first study found that social isolation had a negative effect on remote work productivity and satisfaction, and that COVID-19 concerns affected this relationship differently for individuals with high and low levels of concern. The second study, a diary study analyzing hybrid workers, found a positive correlation between work from home (WFH) adoption and job performance through social isolation and job concentration, with emotional stability serving respectively as a buffer and booster in the relationships between WFH and the mediators. The third study, even in this case a diary study of hybrid workers, confirmed the benefits of work from home on job performance and the importance of job concentration as a mediator, while suggesting that social isolation may not be significant when studying employee job performance, but it is relevant for employee well-being. Although each study provides autonomously a discussion and research and practical implications, this dissertation also presents a general discussion on remote work and its psychological implications, highlighting areas for future research

Pedagogy of healthcare interactions. A study on pediatric well-child visits as culture-oriented and culture-making sites

This study investigates interactions between parents and pediatricians during pediatric well-child visits. Despite constituting a pivotal moment for monitoring and evaluating children���s development during the critical ���first thousand days of life��� and for family support, no study has so far empirically investigated the in vivo realization of pediatrician-parent interactions in the Italian context, especially not from a pedagogical perspective. Filling this gap, the present study draws on a corpus of 23 videorecorded well-child visits involving two pediatricians and twenty-two families with children aged between 0 and 18 months. Combining an ethnographic perspective and conversation analysis theoretical-analytical constructs, the micro-analysis of interactions reveals how well-child visits unfold as culture-oriented and culture-making sites. By zooming into what actually happens during these visits, the analysis shows that there is much more than the ���mere��� accomplishment of institutionally relevant activities like assessing children���s health or giving parents advice on baby care. Rather, through the interactional ways these institutional tasks are carried out, parents and pediatricians presuppose, ratify, and transmit culturally-informed models of ���normal��� growth, ���healthy��� development, ���good��� caring practices, and ���competent��� parenting, thereby enacting a pervasive yet unnoticed educational and moral work. Inaugurating a new promising line of inquiry within Italian pedagogical research, this study illuminates how a) pediatricians work as a ���social antenna���, bridging families��� private ���small cultures��� and broader socio-cultural models of children���s well-being and caregiving practices, and b) parents act as agentive, knowledgeable, (communicatively) competent, and caring parents, while also sensitive to the pediatrician���s ultimate epistemic and deontic authority. I argue that a video-based, micro-analysis of interactions represents a heuristically powerful instrument for raising pediatricians��� and parents��� awareness of the educational and moral density of well-child visits. Insights from this study can constitute a valuable empirical resource for underpinning medical and parental training programs aimed at fostering pediatricians��� and parents��� reflexivity.

Rapporti fra fattori ambientali e proteine di parete in Bifidobacterium

The normal gut microbiota has several important functions in host physiology and metabolism, and plays a key role in health and disease. Bifidobacteria, which are indigenous components of gastrointestinal microbiota, may play an important role in maintaining the well-being of the host although its precise function is very difficult to study. Its physiological and biochemical activities are controlled by many factors, particularly diet and environment. Adherence and colonization capacity are considered as contributing factors for immune modulation, pathogen exclusion, and enhanced contact with the mucosa. In this way, bifidobacteria would fortify the microbiota that forms an integral part of the mucosal barrier and colonization resistance against pathogens. Bifidobacteria are not only subjected to stressful conditions in industrial processes, but also in nature, where the ability to respond quickly to stress is essential for survival. Bifidobacteria, like other microorganisms, have evolved sensing systems for/and defences against stress that allow them to withstand harsh conditions and sudden environmental changes. Bacterial stress responses rely on the coordinated expression of genes that alter various cellular processes and structures (e.g. DNA metabolism, housekeeping genes, cell-wall proteins, membrane composition) and act in concert to improve bacterial stress tolerance. The integration of these stress responses is accomplished by regulatory networks that allow the cell to react rapidly to various and sometimes complex environmental changes. This work examined the effect of important stressful conditions, such as changing pH and osmolarity, on the biosynthesis of cell wall proteins in B. pseudolongum subsp. globosum. These environmental factors all influence heavily the expression of BIFOP (BIFidobacterial Outer Proteins) in the cell-wall and can have an impact in the interaction with host. Also evidence has been collected linking the low concentration of sugar in the culture medium with the presence or absence of extracromosomal DNA.

Tutela dei minori e recupero della genitorialit��: il caso dell'accoglienza in comunit��

La tesi di Matteo Allodi intende analizzare alcune pratiche socio-assistenziali rivolte a minori e famiglie in difficolt�� relative a progetti di accoglienza presso alcune strutture residenziali. In particolare, Matteo Allodi si sofferma su progetti di accoglienza elaborati presso alcune Comunit�� familiari la cui metodologia d���intervento si caratterizza per un orientamento verso un modello di lavoro sociale di tipo sussidiario nell���ottica del recupero dei legami e delle competenze genitoriali. La tesi affronta nella prima parte la dimensione teorica relativa a un approccio progettuale di intervento sociale che, mettendo al centro le relazioni dei soggetti in gioco, possa promuovere la loro attivazione in funzione della realizzazione dell���obiettivo del recupero della genitorialit��. Allodi si concentra dal punto di vista teorico sulle modalit�� di realizzazione di un servizio alla persona guidato dal principio di sussidiariet��, ovvero orientato alla valorizzazione delle capacit�� riflessive degli attori. Nella seconda, parte Allodi presenta l���indagine condotta in alcune Comunit�� di tipo familiare di Parma. La strategia iniziale d���indagine �� quella del case study. Allodi sceglie di indagare il fenomeno partendo da un���osservazione partecipata di orientamento etnometodologico integrata con interviste agli attori privilegiati. In questa fase si �� proceduto a una prima ricerca qualitativa, attraverso la metodologia dello studio di caso, che ha permesso di entrare in contatto con alcune tipologie di strutture residenziali per minori al fine di completare il quadro generale del fenomeno delle Comunit�� familiari e impostare una prima mappatura esplorativa. La ricerca prosegue con uno studio longitudinale prospettico volto a monitorare e valutare il lavoro di rete della comunit�� e dei servizi, osservando principalmente la mobilitazione verso l���autonomia e l���empowerment dei soggetti (minori) e delle reti ancorate al soggetto (single case study). Si �� voluto comprendere quali modalit�� relazionali gli attori della rete di coping mettono in gioco in funzione del ���cambiamento sociale���.

Inserimento eterofamigliare supportato di adulti sofferenti di disturbi psichici: Valutazione degli esiti

L���Inserimento Eterofamigliare Supportato di Adulti (IESA) sofferenti di disturbi psichici consiste nell���accogliere persone in cura presso i servizi psichiatrici territoriali, nel proprio domicilio, integrandole nelle proprie relazioni famigliari. Obiettivo �� migliorare la qualit�� di vita dell���utente e favorirne l���integrazione nella comunit��. Obiettivo. Valutare gli esiti dello IESA, con un disegno di ricerca longitudinale, considerando: psicopatologia, benessere psicologico, funzionamento sociale e familiare. Metodologia. 40 soggetti: 20 pazienti e 20 ospitanti. La valutazione clinica �� stata effettuata all���inizio della convivenza e al follow-up di 1, 3, 6 e 12 mesi. Strumenti utilizzati: BPRS, VGF, PWB, SQ, FAD. Analisi statistica: Modello Lineare Generale (GLM) con l���Analisi della Varianza per prove ripetute e calcolo dell���effect-size. Risultati. 15 pazienti maschi e 5 femmine, 17 italiani. 11 soddisfano i criteri diagnostici (DSM-IV-TR) per schizofrenia e disturbi psicotici, 5 per i disturbi dell���umore e 4 per i disturbi di personalit��. Dopo l���inserimento 3 sono stati i ricoveri e 4 le visite psichiatriche urgenti. 8 pazienti modificano/diminuiscono la terapia e 3 la sospendono. Aumenta il benessere psicologico (PWB); diminuiscono i sintomi psicopatologici (BPRS ed SQ) e migliora il funzionamento globale (VFG). Il gruppo dei famigliari composto da 11 uomini e 9 donne, 19 di nazionalit�� italiana; con et�� media di 55 anni. 8 sono coniugati, 6 celibi/nubili, 4 divorziati e 2 vedovi. 9 hanno figli, 11 lavorano e 8 sono pensionati. Nei famigliari aumenta il benessere psicologico (PWB), migliora il funzionamento famigliare (FAD) e la valutazione del funzionamento globale (VGF) rimane costante nel tempo. Discussioni e conclusioni. Il progetto IESA sembra migliorare la psicopatologia, con una diminuzione dei comportamenti maladattativi e un aumento delle capacit�� relazionali dell���ospite favorendone l���integrazione. Inoltre, lo IESA sembra diminuire i costi della cronicit�� psichiatrica: diminuzione degli accessi al Pronto Soccorso, delle visite psichiatriche urgenti e delle giornate di ricovero.

Giardini per rivivere: orticoltura e giardinaggio a fini terapeutici in contesti sanitari

Questa tesi riassume il lavoro di ricerca da me effettuato per studiare i meccanismi della relazione uomo - pianta su cui si basa l���orticoltura terapeutica, le sue modalit�� di attuazione e le risposte dei pazienti al lavoro in giardino. La ricerca si �� svolta in due diversi giardini terapeutici con pazienti adulti con varie tipologie di disabilit�� fisica o psichica. Partendo dalla analisi delle basi teoriche su cui si fonda l���ortoterapia, l���obiettivo era di capire come creare le condizioni migliori per ottenere i massimi benefici dall���uso dell���orticoltura e del giardinaggio per il benessere delle persone. Due elementi sono apparsi fondamentali per il raggiungimento degli obiettivi terapeutici: il primo �� lo stretto legame esistente tra la forma del giardino e delle piante e la sua funzione terapeutica; il secondo sta nella necessit�� di creare nel paziente una connessione profonda con il giardino e il lavoro con le piante �� risultato essere un fattore determinante per farlo. Utilizzando questionari e osservazioni degli utenti, sono stati raccolti ed elaborati dati relativi al benessere dei pazienti durante e dopo le attivit�� in giardino e si �� cercato di trovare un indice, individuato poi nella variazione di percezione del pollice verde, che potesse essere utilizzato per esprimere la soddisfazione del paziente. Infine si �� cercato di capire come potesse variare la capacit�� ristorativa del giardino, in funzione della frequenza di visita e dell���attivit�� che vi si svolgeva, attraverso la somministrazione della versione italiana della scala PRS a chi era impegnato nelle attivit�� di orticoltura e giardinaggio, a chi passeggiava nel parco e a chi invece non lo frequentava regolarmente ma lo conosceva bene: �� risultato che le tre modalit�� di fruizione del giardino davano ai fruitori un potenziale rigenerativo diverso e significativamente pi�� alto per chi metteva le mani nella terra.

Dal Bes ad Urbes: I piani di performance e di trasparenza nelle citta'

Obiettivo del lavoro �� quello di legare tra di loro due aspetti che storicamente sono sempre stati scollegati. Il primo �� il lungo dibattito sul tema ���oltre il PIL���, che prosegue ininterrottamente da circa mezzo secolo. Il secondo riguarda l���utilizzo dei sistemi di misurazione e valutazione della performance nel settore pubblico italiano. Si illustra l���evoluzione del dibattito sul PIL facendo un excursus storico del pensiero critico che si �� sviluppato nel corso di circa cinquanta anni analizzando le ragioni assunte dagli studiosi per confutare l���utilizzo del PIL quale misura universale del benessere. Cogliendo questa suggestione l���Istat, in collaborazione con il CNEL, ha avviato un progetto per individuare nuovi indicatori da affiancare al PIL, in grado di misurare il livello non solo della crescita economica, ma anche del benessere sociale e sostenibile, con l���analisi degli indicatori riferiti a 12 domini di benessere individuati. Al progetto Istat-CNEL si �� affiancato il progetto UrBES, promosso dall���Istat e dal Coordinamento dei sindaci metropolitani dell���ANCI, che hanno costituito una rete di citt�� metropolitane per sperimentare la misurazione e il confronto sulla base di indicatori di benessere urbano equo e sostenibile, facendo proprio un progetto del Comune di Bologna e di Laboratorio Urbano (Centro di documentazione, ricerca e proposta sulle citt��), che ha sottoposto a differenti target un questionario on line, i cui risultati, con riferimento alle risposte fornite alle domande aperte, sono stati elaborati attraverso l���utilizzo di Taltac, un software per l���analisi dei testi, al fine di individuare i ���profili��� dei rispondenti, associando i risultati dell���elaborazione alle variabili strutturali del questionario. Nell���ultima parte i servizi e progetti erogati dal comune di Bologna sono stati associati alle dimensioni UrBES, per valutare l���impatto delle politiche pubbliche sulla qualit�� della vita e sul benessere dei cittadini, indicando le criticit�� legate alla mancanza di dati adeguati.