Giovanni Piumatti

Since the 1990s, terms such as ‘parasite singles’, ‘the kangaroo generation’ and ‘NEET’ (Not in Employment, Education or Training) have been used by the mass media of Japan, South Korea and China to address the topic of whether young adults of this generation are refusing to grow up. This topic has aroused heated discussion. Japanese scholar Yamada coins the term ‘parasite singles’ to refer to the many unmarried adults in Japan who continue to live with their parents. These young adults resemble parasites by living off their parents with low ...

Objective. To examine the factorial structure of the Jefferson Scale of Empathy–Medical student version (JSE-S) and assess items’ discriminatory ability at higher and lower empathy levels in medical student populations from different countries and languages.Methods. JSE-S datasets were retrieved from previous studies of 4,113 first- and/or second-year medical students from Switzerland, Portugal, Italy, Brazil, France, Spain, New Zealand, UK, Ireland, Mexico, and Peru. Parallel principal component analyses and item response theory were applied.Results. Excluding item 18, the Compassionate Care subscale emerged in five samples (Switzerland, Portugal, Italy, France and UK/Ireland), Perspective Taking in three (Switzerland, Portugal and UK/Ireland) and Walking in Patient’s Shoes in five (Switzerland, Portugal, Spain, UK/Ireland and Mexico/Peru). All subscales had items providing overlapping information. The JSE-S subscales had reliable high test performance at low empathy levels, while when the JSE-S increased, the standard error also increased.Conclusion. There was no consistent support across countries for the JSE-S three-factorial structure. Items provided redundant information and discriminatory power decreased when aiming to differentiate students at high empathy levels.Practice Implications. A JSE-S revision to improve cross-cultural comparability, results’ generalisability and validity should focus on suppressing or reformulating items that cannot differentiate medical students’ empathy.

A bstract: Purpose: Our objective was to assess adolescent’s Health-Related Quality of Life (HRQoL) and psychological distress, from their own and their parents’ perspective, and to examine associated risk factors during the COVID-19 pandemic in Geneva, Switzerland. Methods: A random sample of adolescents, aged 14-17 years, and their families was invited to a serosurvey in November and December 2020. Adolescents’ HRQoL was evaluated using the validated adolescent-reported KIDSCREEN-10 and parent-reported KINDL ^® scales. Psychological distress was assessed with self-reported sadness and loneliness, and using the KINDL ^® emotional well-being scale. Risk factors for adolescents’ low HRQoL and psychological distress were identified using generalized estimating equations and both adolescents’ and their parents’ perceptions were compared. Results: Among 240 adolescents, 11% had a low HRQoL, 35% reported sadness and 23% reported loneliness. Based on parents’ perception, 12% of the adolescents had a low HRQoL and 16% a low emotional well-being. Being a girl (aOR=3.29; 95%CI: 1.64-6.57), increased time on social media (aOR=2.05; 95%CI: 1.08-3.88), parents’ average to poor mood (aOR=2.81; 95%CI: 1.21-6.56) and average to poor household financial situation (aOR=2.30; 95%CI: 1.00-5.29) were associated with an increased risk of sadness. Mismatches between adolescents’ and their parents’ perception of HRQoL were more likely for girls (aOR = 2.88; 95%CI: 1.54-5.41) and in households with lower family well-being (aOR = 0.91; 95%CI: 0.86-0.96). Conclusion: A meaningful proportion of adolescents experienced low well-being during the second wave of COVID-19. Adolescents living in underprivileged or distressed families seemed particularly affected. Monitoring is necessary to evaluate the long-term effects of the pandemic on adolescents. Implications and Contribution: This study describes the psychological well-being of a population-based sample of adolescents in Geneva, Switzerland amid the COVID-19 pandemic, and identifies adolescents at risk of distress. This study provides further insight by comparing adolescents’ well-being as reported by themselves and their parents.

Objectives This cohort study including essential workers, assessed the□risk and incidence of SARS-CoV-2□infection during the second surge of COVID-19 according to baseline serostatus and occupational sector. Methods Essential workers were selected from a seroprevalence survey cohort in Geneva, Switzerland and were linked to a state centralized registry compiling SARS-CoV-2 infections. Primary outcome was the number of virologically-confirmed infections from serological assessment (between May and September 2020) to January 25, 2021, according to baseline antibody status and stratified by three pre-defined occupational groups (occupations requiring sustained physical proximity, involving brief regular contact or others). Secondary outcomes included the incidence of infection. Results 10457 essential workers were included (occupations requiring sustained physical proximity accounted for 3057 individuals, those involving regular brief contact, 3645, and 3755 workers were classified under “Other essential occupations”). After a follow-up period of over 27 weeks, 5 (0.6%) seropositive and 830 (8.5%) seronegative individuals had a positive SARS-CoV-2 test, with an incidence rate of 0.2 (95% CI 0.1 to 0.6) and 3.2 (95% CI 2.9 to 3.4) cases per person-week, respectively. Incidences were similar across occupational groups. Seropositive essential workers had a 93% reduction in the hazard (HR of 0.07, 95% CI 0.03 to 0.17) of having a positive test during follow-up with no significant between-occupational group difference. Conclusions A ten-fold reduction in the hazard of being virologically tested positive was observed among anti-SARS-CoV-2 seropositive essential workers regardless of their sector of occupation, confirming the seroprotective effect of a previous SARS-CoV2 exposure at least six months after infection. What is already known about this subject?Risk of SARS-CoV-2 reinfection is low in the general population and among healthcare workers. What are the new findings?A ten-fold reduction of risk of being virologically tested positive reinfection is observed among anti-SARS-CoV-2 seropositive essential workers of different activity sectors, regardless of their occupation-related risk of exposure. How might this impact on policy or clinical practice in the foreseeable future?Vaccination could be delayed in individuals with previous history of SARS-CoV-2 infection with serologic confirmation, regardless of their occupational exposure. These observations need to be confirmed for new SARS-CoV-2 variants.

Background: No consensus exists on whether medical students develop towards more deep (DA) or surface learning approaches (SA) during medical training and how this impacts learning outcomes. We investigated whether subgroups with different trajectories of learning approaches in a medical students’ population show different long-term learning outcomes. Methods: Person-oriented growth curve analyses on a prospective cohort of 269 medical students (M_age=21years, 59 % females) traced subgroups according to their longitudinal DA/SA profile across academic years 1, 2, 3 and 5. Post-hoc analyses tested differences in academic performance between subgroups throughout the 6-year curriculum until the national high-stakes licensing exam certifying the undergraduate medical training. Results: Two longitudinal trajectories emerged: surface-oriented (n = 157; 58 %), with higher and increasing levels of SA and lower and decreasing levels of DA; and deep-oriented (n = 112; 42 %), with lower and stable levels of SA and higher but slightly decreasing levels of DA. Post hoc analyses showed that from the beginning of clinical training, deep-oriented students diverged towards better learning outcomes in comparison with surface-oriented students. Conclusions: Medical students follow different trajectories of learning approaches during a 6-year medical curriculum. Deep-oriented students are likely to achieve better clinical learning outcomes than surface-oriented students.

Aims: To examine psychometric properties of the Daily Drinking Questionnaire (DDQ) in a Mediterranean “wet” drinking culture. Methods: Three studies were conducted using random samples drawn from a representative sample of Italian young adults (N = 5,955; females = 62%; mean age = 27): Study 1 explored the factorial structure of weekly alcohol consumption; in Study 2 multi-group confirmatory factor analysis tested measurement invariance across gender; Study 3 applied item response theory analysis to: a) assess how each item discriminated between different alcohol consumption levels; and b) determine if drink propensity on a given day of the week varied according to individual characteristics. Results: In Study 1, a one-factor solution with no clear differentiation between weekdays and weekend alcohol use was found. Study 2 confirmed measurement invariance of the one-factor solution across gender. Results of Study 3 indicated that alcohol use on weekdays (Monday to Thursday) provided more information on overall alcohol consumption than alcohol use on weekends (Friday to Sunday). Discussion: Cultural differences of alcohol use are reflected in relatively simple alcohol measures, such as the DDQ. In contrast with peers from “dry” drinking cultures, Italian young women and men do not clearly differentiate between weekdays and weekend drinking. In Italy, the DDQ best captures participants' average alcohol consumption levels rather than light or heavy, and should be used in national epidemiological research accordingly.

Background: Physicians’ communication skills (CS) are known to significantly affect the quality of health care. Communication skills training programs are part of most undergraduate medical curricula and are usually assessed in Objective Structured Clinical Examinations (OSCE) throughout the curriculum. The adoption of reliable measurement instruments is thus essential to evaluate such skills. Methods: Using Exploratory Factor Analysis (EFA), Multi-Group Confirmatory Factor Analysis (MGCFA) and Item Response Theory analysis (IRT) the current retrospective study tested the factorial validity and reliability of a four-item global rating scale developed by Hodges and McIlroy to measure CS among 296 third- and fourth-year medical students at the Faculty of Medicine in Geneva, Switzerland, during OSCEs. Results: EFA results at each station showed good reliability scores. However, measurement invariance assessments through MGCFA across different stations (i.e., same students undergoing six or three stations) and across different groups of stations (i.e., different students undergoing groups of six or three stations) were not satisfactory, failing to meet the minimum requirements to establish measurement invariance and thus possibly affecting reliable comparisons between students’ communication scores across stations. IRT revealed that the four communication items provided overlapping information focusing especially on high levels of the communication spectrum. Conclusions: Using this four-item set in its current form it may be difficult to adequately differentiate between students who are poor in CS from those who perform better. Future directions in best-practices to assess CS among medical students in the context of OSCE may thus focus on (1) training examiners so to obtain scores that are more coherent across stations; and (2) evaluating items in terms of their ability to cover a wider spectrum of medical students’ CS. In this respect, IRT can prove to be very useful for the continuous evaluation of CS measurement instruments in performance-based assessments.

Several medical education studies suggest that deep approaches to learning (DA) are associated with better academic performance, whereas surface approaches (SA) are associated with worse academic p...