Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies

Perfectionism and community-identity integration: the mediating role of shame, guilt and self-esteem

Supplemental material for the paper published in Current Psychology: 10.1007/s12144-021-01499-

How good it would be to turn back time: Adult attachment and perfectionism in mothers and their relationships with the processes of parental identity formation

In the present study the relationships between dimensions of parental identity (commitment, in-depth exploration, reconsideration of commitment), romantic adult attachment (anxiety and avoidance in a relationship) and perfectionism (self-oriented, other-oriented, and socially prescribed) were analyzed. 206 mothers aged 22 to 40 participated in the study (M = 33.33, SD = 3.68). The results revealed that both adult attachment and perfectionism correlate with parental identity. In particular, attachment-related anxiety and other-oriented perfectionism can be treated as independent, specific predictors of an increased crisis of parental identity, manifested in low identification with the role of the parent and in regret of becoming one. The article discusses theoretical and practical implications of the research and suggestions for further studies

Trajectories of Parental Burnout in the First Year of the COVID-19 Pandemic

Materials used to prepare the publication 'Trajectories of Parental Burnout in the First Year of the COVID-19 Pandemic

Child-oriented and partner-oriented perfectionism explain different aspects of family difficulties.

The aim of the study was to verify the relationship between child-oriented and partner-oriented perfectionism, and their associations with narcissism and with difficulties in the romantic and parental domains. A total of 459 individuals participated, 264 women and 195 men (Mage = 33.88, SD = 4.39). Child-oriented perfectionism and partner-oriented perfectionism were related to each other and positively correlated with narcissism. Partner-oriented perfectionism turned out to be a specific predictor of difficulties in the romantic relations, whereas child-oriented perfectionism was found to be a predictor of difficulties in parental relation. The results suggest that studies on other-oriented perfectionism should take into consideration concrete individuals at whom perfectionistic expectations are directed (e.g. partner and children). This will enable a more precise investigation of the influence of perfectionism on family life and a better understanding of the social consequences of other-oriented perfectionism

Child-oriented and partner-oriented perfectionism explain different aspects of family difficulties

Objective: The aim of the present study was to verify the relationship between partner-oriented and children-oriented perfectionism, and their associations with narcissism and with difficulties in the romantic and parental domains. Differences between women and men were also analyzed. Method: 459 individuals participated, 264 women and 195 men (Mage = 33.88, SD = 4.39). All participants were Polish, had at least one child and were in a romantic relationship. In this cross-sectional, questionnaire study the Dyadic Almost Perfect Scale was applied along with its new adaptation, developed to measure children-oriented perfectionism: the Children Dyadic Almost Perfect Scale. Results: Partner dyadic perfectionism and children dyadic perfectionism, both in women and in men, were related to each other and positively correlated with narcissism. Partner-oriented perfectionism turned out to be a specific predictor of difficulties in the romantic relation, whereas children-oriented perfectionism was found to be a predictor of difficulties in the parental relation. Conclusion: The results suggest that studies on dyadic perfectionism should take into consideration concrete individuals at whom perfectionistic expectations are directed (e.g., partner and children). This will enable a more precise investigation of the influence of perfectionism on family life and a better understanding of the social consequences of other-oriented perfectionism

Regretting parenthood

Here you can find preprints, postprints, and data associated with my studies on predictors and consequences of regretting the decision on becoming a paren