School self-efficacy is affected by gender and motor skills: findings from an Italian study

Background: Perceived school self-efficacy (SE) is an important variable in students' activities as it affects their motivation and learning. Further, self-efficacy might represent a good predictor of performance, persistence and perseverance. Motor skills and other physical health determinants are extensively debated and linked to cognitive function in children of developmental age. However, inconclusive evidence supports a definitive relationship between perceived school SE and motor skills among schoolchildren. We conducted a cross-sectional study on 6-11-year-old schoolchildren to evaluate the extent by which perceived school SE and physical health determinants were related. Methods: A SE questionnaire and motor performance battery tests were administered to primary school pupils recruited from 154 sampled schools of northwest Italy. Perceived SE at school was assessed via 12 items from the Caprara's questionnaire. Motor performance scores were obtained from motor skill tests: 4 × 10 m shuttle run test, SRT; standing broad jump, SBJ; six-minute walking test, 6MWT. Results: A total of 3,962 children (M = 2,019; F = 1943) were studied and 68% were normal weight. Overall, a 58% of the sample perceived a high SE, while, as to gender differences, a greater percentage of females perceived high levels of school SE with respect to any other level (χ2 = 38.93, p < 0.0001). Results from multinomial logistic regression analysis revealed that: (i) females perceived higher SE compared to males; (ii) children who performed better in SRT and 6MWT showed higher levels of perceived school SE; (iii) no significant effect was registered for the body weight. Alternative strategies are encouraged to enhance SE through physical education: structured interventions might enhance both complex motor skills and high-order cognitive skills, like SE, in young children

Cardiorespiratory fitness assessment using the PREFIT test in Italian children: A preliminary dataset

BACKGROUND: The cardiorespiratory fitness (CRF) is one of the most important indicators of the health-related physical fitness components because it reflects the efficiency of the cardiovascular and respiratory systems. To indirectly assess CRF, the original protocol of the 20mSRT was adapted in a new version suitable for children called 20mSRT-PREFIT, providing performances comparable to the standards of the European area. In fact, CRF normative values are missing in the Italian context and therefore they would be meaningful to be assessed. We aimed to determine CRF from 20mSRT-PREFIT in a small sample of Italian pre-school children and to compare the outcomes with the available European references. METHODS: A convenience sample of 5-year-old pre-school children (N.=32, M/F ratio: 19/13) was freely recruited from a kindergarten of the northwest Italy. Children performed the 20mSRT-PREFIT and the number of full shuttles, exhaustion time, and maximum speed were collected to obtain CRF. RESULTS: Predicted VO2max was similar between Italian male and female groups. All other outcomes originating from the 20mSRT-PREFIT were consistent with those included in the available European databases. CONCLUSIONS: According to these preliminary indications, Italian pre-school children may have a CRF level equivalent to that one ascertained in other European countries. Thus, current rakings should be cautiously scrutinized, as they might inappropriately underrate Italian children’s performances

Six minute walk distance and reference values in healthy Italian children: A cross-sectional study

The 6-minute walking test (6MWT) is a simple assessment tool to evaluate exercise capacity. The result of the test is the distance that a subject can walk at a constant and normal pace within 6 minutes (6MWD) and reflects the aerobic/fitness performance related to walking function. Use of 6MWT has been relevant to assess exercise tolerance either in healthy children or in patients with, heart, lung and metabolic diseases. Our aim was to find 6MWT reference values in healthy Italian children. The 6MWT was performed in 5614 children aged 6-11 years recruited from primary Italian schools. Age related reference percentiles of the covered distance were gender-modeled. A linear and quadratic regression model was used to predict 6MWT performance. Males walked longer distances than females, respectively 598.8±83.9 m vs 592.1±77.6 m (p = 0.0016). According to the regression analysis, 6MWD was positively related to age, gender and height, while it was negatively related to body weight [(6MWD =-160.16 + 93.35× age (years)-4.05× age2 (years) +7.34× gender (m) +2.12× weight (kg) -2.50× height (cm)]. Reference values were established for the 6MWT in healthy children. The age related 6MWD percentiles provided a useful tool in the assessment of capacity in 6-11 year children, in fact they may be helpful to evaluate the effect of a given treatment or rehabilitation program and represent a feasible measure as to prevention within the primary school context. It was found a substantial difference from other countries for 6mwd values. In our study, factors such as age, weight and height were relevant for the prediction of 6MWD, similarly to other studies. Therefore, these variables should be taken into account in context of exercise performance

Six minute walk distance and reference values in healthy Italian children: A cross-sectional study

The 6-minute walking test (6MWT) is a simple assessment tool to evaluate exercise capacity. The result of the test is the distance that a subject can walk at a constant and normal pace within 6 minutes (6MWD) and reflects the aerobic/fitness performance related to walking function. Use of 6MWT has been relevant to assess exercise tolerance either in healthy children or in patients with, heart, lung and metabolic diseases. Our aim was to find 6MWT reference values in healthy Italian children. The 6MWT was performed in 5614 children aged 6-11 years recruited from primary Italian schools. Age related reference percentiles of the covered distance were gender-modeled. A linear and quadratic regression model was used to predict 6MWT performance. Males walked longer distances than females, respectively 598.8±83.9 m vs 592.1±77.6 m (p = 0.0016). According to the regression analysis, 6MWD was positively related to age, gender and height, while it was negatively related to body weight [(6MWD =-160.16 + 93.35× age (years)-4.05× age2 (years) +7.34× gender (m) +2.12× weight (kg) -2.50× height (cm)]. Reference values were established for the 6MWT in healthy children. The age related 6MWD percentiles provided a useful tool in the assessment of capacity in 6-11 year children, in fact they may be helpful to evaluate the effect of a given treatment or rehabilitation program and represent a feasible measure as to prevention within the primary school context. It was found a substantial difference from other countries for 6mwd values. In our study, factors such as age, weight and height were relevant for the prediction of 6MWD, similarly to other studies. Therefore, these variables should be taken into account in context of exercise performance

Association of autism onset, epilepsy, and behavior in a community of adults with autism and severe intellectual disability

Autism spectrum disorders (ASDs) are hard to characterize due to their clinical heterogeneity. Whether epilepsy and other highly prevalent comorbidities may be related to specific subphenotypes such as regressive ASD (i.e., the onset of symptoms after a period of apparently typical development) is controversial and yet to be determined. Such discrepancies may be related to the fact that age, level of cognitive functioning, and environmental variables are often not taken into account. We considered a sample of 20 subjects (i) between 20 and 55 years of age, (ii) with severe/profound intellectual disability, (iii) living in the same rural context of a farm community. As a primary aim, we tested for the association between epilepsy and regressive ASD. Secondly, we explored differences in behavioral and pharmacological profiles related to the presence of each of these conditions, as worse behavioral profiles have been separately associated with both epilepsy and regressive ASD in previous studies. An initial trend was observed for associations between the presence of epilepsy and regressive ASD (odds ratio: 5.33; 95% CI: 0.62–45.41, p-value: 0.086). Secondly, subjects with either regressive ASD or epilepsy showed worse behavioral profiles (despite the higher pharmacotherapy they received). These preliminary results, which need to be further confirmed, suggest the presence of specific associations of different clinical conditions in subjects with rarely investigated phenotypes

Official Data and Analytical Forecasts: Differences and Similarities Among Coronavirus Disease (COVID-19) Confirmed Cases and Deaths

The novel coronavirus disease (COVID-19) is spreading widely with an exponential growth infection rate in several countries Worldwide: up to May 5th, 2020, about 3,517,345 cases and 243,401 deaths have been confirmed (1). In Europe overall, about 1.5 million official cases have been reported, and Spain, Italy, and the United Kingdom are the most affected countries. From the 31th of January, in order to better control the virus spread, the Italian government declared an “emergency state,” which is characterized by the implementation of massive containment measures (2, 3). As now in China, the risk of COVID-19 spreading to other countries is a great concern, as well as the perspective of a secondary cases wave, and given that no vaccine is currently available, rapid and specific diagnostic procedures are an essential tool to allow accurate information of the disease. Furthermore, reliable and timely data are fundamental tools to guide the right political and health interventions and to better understand the virus spread. Since the first Italian spread of the disease from the highest risk area (Northern Italy) to the rest of the nation (the 2nd of March, 2020), the Italian Department of Civil Defense (DCD) have published official reports on COVID-19 distribution to all the Italian regions and provinces. The daily regional reports have provided data about number of tests executed (“Tamponi”) and the total COVID-19 cases (“Casi totali”), and details cover recoveries (“Dimessi/Guariti”) and the number of people who have died (“Deceduti”), who are hospitalized with symptoms (“Ricoverati con sintomi”), who are hospitalized in Intensive Care Units (ICUs) (“Terapia intensiva”), and who are in house isolation (“Isolamento domiciliare”). The smallest administrative units in which the data are aggregate are the Italian provinces. All these data are currently used by several scientists, stakeholders, and politicians to understand the daily disease evolution and forecast the possible disease spread in Italy

External Validation Confirms Validity of a Simple Model to Predict Bowel Outcome After Traumatic Spinal Cord Injury

Background. The prediction of functional outcomes after spinal cord injury (SCI) is essential to plan the rehabilitation phase and the social reintegration. Recently, 2 models to predict independent and reliable bowel management 1 year after traumatic SCI have been derived and validated in 2 cohorts of patients included in the European Multicenter Study about Spinal Cord Injury (EMSCI). Objective. We aimed to validate 2 prediction models for bowel outcome after traumatic SCI in a patient sample external to EMSCI. Methods. The simplified model (based on a single predictor, the International Standards for Neurological Classification of Spinal Cord Injury [ISNCSCI] total motor score) and the full model (based on 2 predictors, the ISNCSCI total motor score and item 3a of the Spinal Cord Independence Measure) were applied to the retrospectively collected data of 111 patients with traumatic SCI. Results. The simplified and the full models showed excellent discrimination with an area under the receiver operating characteristic curve of .939 (95% confidence interval (CI) .87-1.00) and .922 (95% CI 0.85-.99), respectively. Both models displayed similar results for sensitivity and negative predictive values; however, the simplified model showed higher values for specificity, positive predictive values, and accuracy. The calibration analysis showed a partial overlap between predicted probabilities and observed proportion, with better and acceptable calibration for the simplified model. Conclusions. Using an independent sample, our study demonstrates the validity of a simple model to predict independent and reliable bowel management 1 year after traumatic SCI

Reliability and validity of the international standards for neurological classification of spinal cord injury in patients with non-traumatic spinal cord lesions

Study design: Prospective, observational study. Objectives: The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) represent the gold standard for the assessment of patients with spinal cord injury (SCI) and their measurement properties have been evaluated in patients with traumatic lesions. Albeit the ISNCSCI are widely used also for the assessment and prognosis of patients with non-traumatic SCI, a validation of this grading system in this sample has never been performed. Therefore, the aim of this study is to evaluate the measurement properties of the ISNCSCI in a population of persons with non-traumatic SCI. Setting: Three Italian rehabilitation hospitals. Methods: The sample included 140 patients with non-traumatic SCI of different etiology, level and grade, for a total of 169 evaluations performed by two examiners. Cronbach’s Alpha was used to evaluate the internal consistency of the ISNCSCI various components. The agreement between two examiners of each center in the definition of different components was used to assess the inter-rater reliability. The construct validity was evaluated through the correlation of the ISNCSCI with the Spinal Cord Independence Measure (SCIM). Results: The ISNCSCI showed substantial internal consistency, and substantial inter-rater agreement for AIS grade, cumulative motor and sensory scores. The motor scores for upper and lower extremity showed fair to moderate correlation with SCIM self-care and motility subscores, respectively. The ISNCSCI total motor score correlated with the total SCIM score. Conclusions: Our study demonstrates that the ISNCSCI are a valid and reliable tool for the assessment of patients with non-traumatic SCI

Prediction of bowel management independence after ischemic spinal cord injury

Background: Ischemic spinal cord injury (SCI) belongs to the heterogeneous group of non-traumatic SCI, while the course of sensorimotor and functional recovery is comparable to traumatic SCI. Recently, we derived from data of patients with traumatic SCI a valid model to predict an independent and reliable bowel management one year after SCI. Aim: To evaluate the performance of this model to predict an independent and reliable bowel management one year following ischemic SCI. Design: Prognostic study - observational study. Setting: European Multicenter Study about Spinal Cord Injury (EMSCI) ClinicalTrials.gov: NCT01571531. Population: One hundred and forty-two patients with ischemic SCI of various level and severity of injury. Methods: The prediction model relied on a single predictor collected within 40 days from injury, the International Standards for Neurological Classification of Spinal Cord Injury total motor score. Bowel outcome one year after SCI derived from the dichotomization of the Spinal Cord Independence Measure (SCIM) item 7 scores. We defined a positive outcome as independent bowel management with regular movements and appropriate timing with no or rare accidents (score of 10 in SCIM version II and score of 8 or 10 in version III). Results: The model showed a fair discrimination with an area under the receiver operating characteristic (ROC) curve of 0.780 (95% confidence interval=0.702-0.860). In addition, the model displayed an acceptable accuracy and calibration. Conclusions: The study extends the validity of our rule to patients with ischemic SCI, thus providing the first model to predict an independent and reliable bowel management in this population. Clinical rehabilitation impact: The model may be employed in clinical practice to counsel patients, to define the rehabilitation aims and to estimate the need of assistance after discharge, as well as in the research field for the optimization of patients' allocation in the design of future clinical trials