On the advantages and disadvantages of choice: future research directions in choice overload and its moderators.

Researchers investigating the psychological effects of choice have provided extensive empirical evidence that having choice comes with many advantages, including better performance, more motivation, and greater life satisfaction and disadvantages, such as avoidance of decisions and regret. When the decision task difficulty exceeds the natural cognitive resources of human mind, the possibility to choose becomes more a source of unhappiness and dissatisfaction than an opportunity for a greater well-being, a phenomenon referred to as choice overload. More recently, internal and external moderators that impact when choice overload occurs have been identified. This paper reviews seminal research on the advantages and disadvantages of choice and provides a systematic qualitative review of the research examining moderators of choice overload, laying out multiple critical paths forward for needed research in this area. We organize this literature review using two categories of moderators: the choice environment or context of the decision as well as the decision-maker characteristics.

Videoconferencing analytic psychodrama in treating young adults' psychological suffering: preliminary results.

The study aims to explore the effects that videoconferencing Analytic Psychodrama (AP) has on the psychological wellbeing and emotional competence of young adults who are suffering from mental health problems. Twenty-two undergraduate students, asking for help at the Psychological Counselling Service of the University of Bologna for anxiety-depressive problems, took part in the three online groups that met weekly from October 2020 to July 2021. The Clinical Outcomes in Routine Evaluation Outcome Measure, the Trait Emotional Intelligence Questionnaire Short Form, the Toronto Alexithymia Scale, the Interpersonal Reactivity Index, and the Group Climate Questionnaire were used as test-retest questionnaires for clinical outcomes, emotional competence, and group climate evaluations. There was a statistically significant difference between the pre-test and 10-month scores for patients in clinical outcomes. Alexithymia significantly decreased and emotional intelligence and group engagement increased post-intervention. Videoconferencing AP sounds promising for alleviating psychological problems and to improve young adults' emotional competence.

Entrepreneurship on Social Networking Sites: The Roles of Attitude and Perceived Usefulness.

BACKGROUND: Social media platforms are a significant growth opportunity for enterprises, especially for microenterprises, due to the possibility of establishing direct contact with their customers. We investigate the psychological reasons that drive entrepreneurs towards the use of social networking sites (SNSs) for their business, following two important social psychology theories: the theory of planned behaviour and the technology acceptance model. We also tested for two personality traits: openness to experience and dominance. METHODS: Data were acquired by examining 325 microentrepreneurs who decided to use either SNSs or traditional sales methods for their businesses. RESULTS AND CONCLUSIONS: Our results confirm that of all the behavioural antecedents tested, perceived usefulness and attitude towards SNSs' effect on business proved to be the best predictors of the intention to use (or continue using) SNSs for business activity. Implications and suggestions for future research are also discussed.

Retrospective analysis of outcomes and complications after Korus hemiarthroplasty in elderly patients with neck femur fractures.

BACKGROUND: Femoral neck fractures (FNF) is one of the most common traumatic events in elderly patients: the choice of an appropriate treatment is necessary to decrease the related mortality and to achieve the best possible outcomes. Nowadays, it is still debated whether or not to cement the stem in hemiarthroplasty and above all, which stem to use to best respect the integrity of the elderly bone. METHODS: From January 2017 to December 2019, a bi-centric study utilizing prospectively collected databases of elderly patients with FNF treated with uncemented Korus stem hemiarthroplasty was performed. Patients were preoperatively classified according to ASA score. Patients' clinical and X-ray follow-up was at 1, 3, 6, 12 months. Harris Hip Score (HHS) was used for analysed clinical improvement. On the X-rays, we analysed iatrogenic fractures, osteolysis area and radiolucent lines in the stem region during follow up. RESULTS: 233 patients were identified. Median follow-up was 12 months. Over time, 51 patients died (21.88%). Mean age was 89,56 ± 6,25. 75 patients had ASA score of 2 (32.3%), 102 patients a score of 3 (43.7%), 56 an ASA score of 4 (24,0%). The main Harris hip score was 68,66 ± 8.53 at 1 month of follow-up, 71,74 ± 9.65 after 3 months, 72,50 ± 10.66 at 6 months and 75,61 ± 9.63 at 12 months control. CONCLUSIONS: Hydroxyapatite coated stem with an accurate design guarantee early fixation, good clinical and radiographic results, low rate of re-intervention and mortality rate and a satisfying return to pre-injury activities.

Tronco-conical locking plate in distal radius fractures.

INTRODUCTION: Volar locked plates represent the most popular fixation technique for distal radius fracture (DRF). However, threaded screw-hole angular stability mechanism has some issues. The purpose of our study is to evaluate clinical and radiological outcome of a tronco-conical locking mechanism for volar plating of DRF. MATERIALS AND METHODS: Eighty patients with DRF treated with tronco-conical locking volar plates between May 2013 to December 2017 in two institutions were collected. We analysed clinical and radiological outcomes and peri-operative complications, like loss of reduction, fragment displacement, deformation or implant-related problems and surgical and other general complications. RESULTS: 78 patients were available for at final follow-up. The average follow-up period was 11.4 months (range, 6-18 months). All fractures healed within three months. Five cases of final reductions were defined unsatisfying. According to Gartland and Werley's scoring system at final follow up, 36 patients had excellent results, 40 patients had good results, one patient had fair and one patient had poor results. Five complications were observed. No complications were observed during surgical plate removal. CONCLUSION: Complications found in our study are not related to tronco-conical locking mechanism and are like those found in the literature. Further studies are needed to evaluate functional results or radiographic parameters of this new type of angular stability mechanism. Tronco-conical locking plate is an attractive alternative threaded screw-hole angular stability mechanism.

ST-Segment Elevation Acute Myocardial Infarction Complicated by Cardiogenic Shock: Early Predictors of Very Long-Term Mortality.

BACKGROUND: Cardiogenic shock (CS) is the leading cause of in-hospital mortality in ST-segment elevation myocardial infarction (STEMI). Only limited data are available on the long-term outcome of STEMI patients with CS undergoing contemporary treatment. We aimed to investigate long-term mortality and its predictors in STEMI patients with CS and to develop a risk score for long-term mortality prediction. METHODS AND RESULTS: We retrospectively included 465 patients with STEMI complicated by CS and treated with primary angioplasty and intra-aortic balloon pump between 2005 and 2018. Long-term mortality, including both in-hospital mortality and all-cause mortality following discharge from the index hospitalization, was the primary endpoint. The long-term mortality (median follow-up 4 (2.0-5.2) years) was 60%, including in-hospital mortality (34%). At multivariate analysis, independent predictors of long-term mortality were age (HR 1.41, each 10-year increase), admission left ventricular ejection fraction (HR 1.51, each 10%-unit decrease) and creatinine (HR 1.28, each mg/dl increase), and acute kidney injury (HR 1.81). When these predictors were pooled together, the area under the curve (AUC) for long-term mortality was 0.80 (95% CI 0.75-0.84). Using the four variables, we developed a risk score with a mean (cross-validation analysis) AUC of 0.79. When the score was applied to in-hospital mortality, its AUC was 0.79, and 0.76 when the score was applied to all-cause mortality following discharge. CONCLUSIONS: In STEMI patients with CS, the risk of death is still substantial in the years following the index event. A simple clinical score at the time of the index event accurately predicts long-term mortality risk.

Associations of Job Insecurity With Perceived Work-Related Symptoms, Job Satisfaction, and Turnover Intentions: The Mediating Role of Leader-Member Exchange and the Moderating Role of Organizational Support.

This study wants to examine effects of job insecurity on several work-related outcomes (perceived work-related symptoms, job satisfaction, and turnover intentions) by developing a moderated mediation model. The model emphasizes the role played by the quality of leader-member exchange (LMX) in mediating the relation between perceived job insecurity and outcomes related to work, and the moderating role of perceived organizational support (POS) in influencing the mediation. Survey data from 510 workers at Italian organizations were collected, and regression was used to evaluate the hypotheses. After age, gender, education, and organizational tenure were controlled, results showed that perceived quality of LMX carried the effect of job insecurity on all outcomes, and that this relationship was stronger for employees who reported higher levels of POS. This study makes important theoretical and practical contributions to job insecurity, LMX, and POS research, underlining the importance of promoting the leader-member relationship's quality in an ethical and supportive work environment.

A preliminary experience with a new intramedullary nail for trochanteric fractures.

BACKGROUND AND AIM OF THE WORK: The worldwide incidence of fractures of the proximal end of the femur is increasing as the average age of the population rises. The current surgical gold treatment standard is intramedullary nail fixation. The Authors present their experience with the D-Nail system for intertrochanteric femur fractures. METHODS: From January 1st to February 21st 2020 (breakout of COVID-19 pandemic) 34 patients were treated with the D-Nail system: 11 with basicervical fractures, 16 with intertrochanteric stable fractures and 7 with intertrochanteric unstable fractures. In 11 cases, a single cephalic screw was used; in 23 cases, two of them were used. Distal locking was executed in 7 patients. Follow-up time ranged from 2 to 3 months. RESULTS: None of the reported intra- or post-operative complication was linked to the fixation device or the surgical technique. Patients were monitored with clinical and radiological checkups using modified Harris Hip Score to accurately evaluate the fluctuations in the rehabilitation period. CONCLUSION: The main advantages of this synthesis device are the proximal hole's peculiar shape, which allows the possibility to position one or two cephalic screws on the same nail, and the silicon coating, which provides numerous biological advantages. Distal locking was executed in selected cases only, based on fracture type. Optimum treatment involves rapid execution of surgery, minimal trauma during surgery, maximum mechanical stability, and rapid weight-bearing. Although our case number is small and follow-up time brief, our results are encouraging.

The Italian Covid-19 Phase 2 in Piacenza: results of the first semester of 2020 and future prospective of new orthopedics surgical procedures.

INTRODUCTION: During the pandemic, Piacenza's Orthopedic and Traumatology Dep. firstly dealt with the emergency with the complete closure of all the elective surgical and outpatient activities.As general population, also healthcare workers were affected by Coronavirus, increasing difficulties of epidemic management.The aim of our study is to evaluate the activity trend of the first 6months of 2020 in our hospital.Data will be compared to the two semesters of 2019, in order to have two objective samples. MATERIALS AND METHODS: We retrospectively analyzed all the orthopedics surgical procedures performed at Guglielmo da Saliceto Hospital (Piacenza, Emilia Romagna, Northern Italy)between 1/1/20 and 30/06/20. 2019 semesters (1/01/20-30/6/20 and 1/07/20-31/12/20) have been used as control group to evaluate the activity trend of the first six months of 2020, compared to the two semesters of 2019. RESULTS: We noticed a significant increase of domestic and retirement houses accidents, a consistent increase in one-month mortality rate of 2020 first semester and a decrease of mean hospitalization time.About surgical procedures, we detect a drop in the total number: in the first semester of 2020 we performed 499 (-39.9%) surgeries less than the first semester of 2019 and 337 (-30.9%) then the second one. Traumatology recorded a decrease of 27.6% than the first semester of 2019 (-204 surgeries) and of 26.3% than the second one (-191 surgeries).Concerning orthopedic procedures, in comparison to the first semester of 2019 we registered a reduction of 57.6% (-295 surgeries) and of 40.2% to the second semester (-146 surgeries). DISCUSSION AND CONCLUSION: Covid-19 forced a reorganization of the Italian Health System that led to a clear reduction of surgical procedures performed in the orthopedic and traumatology department.The "Phase 2" can't be consider the last step of the emergency.We surely will have to get used to live with this enemy, at least until we will find an effective cure or a vaccine.

Conical coupling angular stable plate fixation: a retrospective study.

BACKGROUNDS: Conical coupling represents an alternative to screw coupling on angular stable plate fixation. Aims of the present study was to evaluate clinical effectiveness  and ease of plate removal of conical coupling locking plates into different scenario regarding quality of bone, type of fracture and operative technique. METHODS: From May 2013 to December 2017, 198 patients with 206 fractures underwent open reduction and internal fixation with conical locking plate. In most cases fixation involved wrist (38%) and clavicle (24%) fractures but a varied type of fractures and bone were included in the study. RESULTS: Ten complications related to plate fixation were observed (5,1%). Two case of intra-articular positioning of screws of wrist plate. One case of loss of reduction and breakage of wrist plate due to an inappropriate proximal fracture fixation.  Five cases of complications involved clavicle fixation: three cases of non-union, one case of peri-implant fracture, one screw loosening. One non-union of distal tibial fracture, one non-union in olecranon fracture were finally observed. Thirty-four patients that have symptoms that could be traceable to the implants in-situ underwent plate removal. No complications were observed during surgical plates removal. Conical coupling angular stability plate represents an actractive alternative to threaded angular stability plate.  Bush titanium insert, eliminating the problems of cold welding and cross-threading, simplifies surgical screws and plate removal.

Conservative Treatment of Chronic Achilles Tendinopathy: A Systematic Review.

Achilles tendinopathy is a common musculoskeletal disorder. Athletes, runners and jumpers, and the sedentary are frequently affected. Numerous are the therapeutic choices to manage these kinds of disorders. The aim of this review is to analyze the available literature to document the up-to-date evidence on conservative management of Achilles tendinopathy. A systematic review of two medical electronic databases was performed by three independent authors, using the following inclusion criteria: conservative treatment consisted of pharmacologic, physical therapy without operative treatment, with more of 6 months symptoms and a minimum average of 6-months follow-up. Studies of any level of evidence, reporting clinical results, and dealing with Achilles tendinopathy and conservative treatment were searched for. A total of n = 1228 articles were found. At the end of the first screening, following the previously described selection criteria, we selected n = 94 articles eligible for full-text reading. Ultimately, after full-text reading and a reference list check, we selected n = 29 articles. Achilles tendinopathy is a frequent musculoskeletal disorder and several conservative treatments have been proposed, but no therapy is universally accepted, except for eccentric exercise training, which is the gold standard and a commonly used protocol.

Differential Effects of Workaholism and Work Engagement on the Interference Between Life and Work Domains.

This study analyzed the differences between workaholism and work engagement in relation to their influence on work-life interference. Workaholism is an addiction to work, characterized by obsessive attitude towards job, whereas work engagement concerns a positive pattern of thoughts and feelings about one's job; these two constructs thus represent pathological and healthy forms of heavy work investment, respectively. As a consequence, it was expected that workaholism and work engagement would have different effects on perceived interference between work and life domains. We assessed levels of workaholism, work engagement, work-to-life interference, and life-to-work interference in a sample of 212 Italian workers. Results from structural equation modeling showed an inverse symmetry involving patterns and magnitudes of the relations observed: work engagement was more negatively related to life-to-work interference than work-to-life interference, whereas workaholism was more positively related to work-to-life interference than life-to-work interference. Implications about findings of the study are discussed.

The role of organizational trust and organizational support on employees' well-being.

BACKGROUND: In available scientific literature, the impact of organizational trust and perceived organizational support on employees' wellbeing has mainly been investigated without focusing on the different targets they can refer to. OBJECTIVES: The aim of the study is to test the direct role of these variables as precursors of well-being, job satisfaction and turnover intentions, by distinguishing two different levels in trust and support: the first one stemming from the employees' own team (in which employees have direct and daily interpersonal relationships, and within which they build their work experience), the second stemming from the organization itself. METHODS: In this study, a survey was administered to more than 1,000 employees of a Sicilian hospital. The relationships between the variables were studied through the use of hierarchical regression analysis. RESULTS: Trust and perceived support are both significant predictors of mental and physical health (team trust: ß=.088; organizational trust: ß=.110; team support: ß=.245; organizational support: ß=.082), job satisfaction (team trust: ß=.245; organizational trust: ß=.222; team support: ß=.209; organizational support: ß=.168) and turnover intentions (team trust: ß=- .086; organizational trust: ß=-.164; team support: ß=-.166; organizational support: ß=.064). However, the support at the team level is a more important predictor, while trust is a stronger predictor at the organizational level. CONCLUSIONS: Distinguishing between team and organizational levels of trust and support allows to better understand the relationship between trust and support and wellbeing and organizational outcomes such as job satisfaction and turnover intentions. Practical implications, as well as future research, should therefore refer to the different levels of such predictors.

Open Tibial Fracture in a Non-Compliant Patient: A Case Report.

Open tibial fractures represent the most frequent fractures of long bones, comprising approximately 1.9% of all fractures. Although locked intramedullary nailing is the gold standard for treating closed and unstable tibia diaphyseal fractures, for most exposed fractures, an external fixator can first be used, followed by conversion through an intramedullary nail. The present report describes the case of a 17-year-old male who presented with a complex multi-segmented displaced tibia fracture, type 42-C3, with exposure of IIIB type according to the Gustilo-Anderson classification, and with an attached disrupted fracture of peroneal malleolus, type 44-B2. External fixation was the preferred treatment method. Before the definitive surgical treatment, the patient had a second accident that caused refracture and damage to the soft tissues and external fixation system. This prolonged the time estimated for the conversion from the external fixator to the intramedullary nail. The reported case shows the use of various treatment steps with different timelines and an intervention with vacuum-assisted closure therapy for soft tissue healing as well as subsequent intramedullary nailing in order to reach the definitive healing of a non-compliant patient. These combined methods achieved an acceptable reduction and good stability of such a complex fracture.

[ A rare complication of thrombolytic therapy: spinal epidural hematoma. A case report ]. / Una rara complicanza della terapia trombolitica: l'ematoma spinale epidurale. Descrizione di un caso.

Spinal epidural hematoma is a rare complication of thrombolytic therapy (only 9 cases described in the literature). We report the case of a 59-year-old female with hypertension, admitted to the coronary care unit for acute inferior myocardial infarction and treated with tissue-type plasminogen activator 100 mg in 90 min, intravenous heparin 25,000 U, aspirin 100 mg, and metoprolol 50 mg orally once daily. On the third day she suffered from sudden and violent dorsal pain, followed 22 hours later by paraplegia. Magnetic resonance imaging showed a large posterior spinal epidural hematoma, with compression and anterior dislocation of the spinal cord. The patient underwent neurosurgery. After 1 year, she still cannot walk. In patients treated with thrombolytic therapy and presenting with sudden and violent spinal pain, the physician should take into consideration the diagnosis of epidural hemorrhage. Early neurosurgery can save the patient and facilitate neurological recovery.