Assessing mother-to-infant attachment: the Italian adaptation of a self-report questionnaire

The mother-to-infant relationship is usually assessed by behavioural observation. In order to evaluate mothers\u2019 emotional and cognitive response to their infants, Condon and Corkindale [(1998) The assessment of parent-to-infant attachment: development of a selfreport questionnaire instrument, Journal of Reproductive and Infant Psychology, 16, 57\u201376] have developed a self-administered questionnaire. The aim of the present study is the Italian validation of the scale. The questionnaire contains 19 items each rated on a 5-point scale. A sample of women with infants between 2 and 4 months of age were recruited at two postnatal wards in Genoa (Italy). Construct validity was assessed by administering two additional questionnaires: the Symptom Rating Test by Kellner and Sheffield and the Early Infancy Temperament Questionnaire by Medoff-Cooper, Carey and Mc Devitt. A total of 210 women were evaluated. The distribution of scores tended to be skewed towards higher attachment scores and the range was 59 to 95. The mean of the total scale was 81.5 (SD~6.5) and Cronbach\u2019s alpha was 0.77. Attachment scores were negatively correlated with all the Symptom Rating Test subscales (r between 20.23 and 20.37; pv0.01). Mothers of children with difficult temperament had lower attachment scores (t~22.780; pv0.01). Factor analysis revealed six factors which accounted for 57% of the variance. The psychometric properties of the Italian version of the scale were similar to those of the original version. The three-factor structure found by Condon and Corkindale was not confirmed in the Italian version. The scores on the scale relate to other variables in a way that is consistent with attachment literature

Adherence to guidelines for management of children hospitalized for acute diarrhea

Background: The major burden of acute gastroenteritis (AGE) in childhood is related to its high frequency and the large number of hospitalizations, medical consultations, tests and drug prescriptions. The adherence to evidence-based recommendations for AGE management in European countries is unknown. The purpose of the study was to compare hospital medical interventions for children admitted for AGE with recommendations reported in the European Societies of Pediatric Gastroenterology, Hepatology and Nutrition and Pediatric Infectious Diseases guidelines. Methods: A multicenter prospective study was conducted in 31 Italian hospitals. Data on children were collected through an online clinical reporting form and compared with European Societies of Pediatric Gastroenterology, Hepatology and Nutrition and Pediatric Infectious Diseases guidelines for AGE. The main outcomes were the inappropriate hospital admissions and the percentage of compliance to the guidelines (full >90%, partial >80% compliance) based on the number and type of violations to evidence-based recommendations. Results: Six-hundred and twelve children (53.6% male, mean age 22.8 +/- 15.4 months) hospitalized for AGE were enrolled. Many hospital admissions (346/602, 57.5%) were inappropriate. Once admitted, 20.6% (126/612) of children were managed in full compliance with the guidelines and 44.7% (274/612) were managed in partial compliance. The most common violations were requests for microbiologic tests (404; 35.8%), diet changes (310; 27.6%) and the prescription of non-recommended probiotics (161; 14.2%), antibiotics (103; 9.2%) and antidiarrheal drugs (7; 0.6%). Conclusions: Inappropriate hospital admissions and medical interventions are still common in the management of children with AGE in Italy. Implementation of guidelines recommendations is needed to improve quality of care

Adherence to guidelines for management of children hospitalized for acute diarrhea.

BACKGROUND: The major burden of acute gastroenteritis (AGE) in childhood is related to its high frequency and the large number of hospitalizations, medical consultations, tests and drug prescriptions. The adherence to evidence-based recommendations for AGE management in European countries is unknown. The purpose of the study was to compare hospital medical interventions for children admitted for AGE with recommendations reported in the European Societies of Pediatric Gastroenterology, Hepatology and Nutrition and Pediatric Infectious Diseases guidelines. METHODS: A multicenter prospective study was conducted in 31 Italian hospitals. Data on children were collected through an online clinical reporting form and compared with European Societies of Pediatric Gastroenterology, Hepatology and Nutrition and Pediatric Infectious Diseases guidelines for AGE. The main outcomes were the inappropriate hospital admissions and the percentage of compliance to the guidelines (full >90%, partial >80% compliance) based on the number and type of violations to evidence-based recommendations. RESULTS: Six-hundred and twelve children (53.6% male, mean age 22.8 ± 15.4 months) hospitalized for AGE were enrolled. Many hospital admissions (346/602, 57.5%) were inappropriate. Once admitted, 20.6% (126/612) of children were managed in full compliance with the guidelines and 44.7% (274/612) were managed in partial compliance. The most common violations were requests for microbiologic tests (404; 35.8%), diet changes (310; 27.6%) and the prescription of non-recommended probiotics (161; 14.2%), antibiotics (103; 9.2%) and antidiarrheal drugs (7; 0.6%). CONCLUSIONS: Inappropriate hospital admissions and medical interventions are still common in the management of children with AGE in Italy. Implementation of guidelines recommendations is needed to improve quality of car