Parents and children during the COVID-19 lockdown: the influence of parenting distress and parenting self-efficacy on children’s emotional well-being

On March 10, 2020, Italy went into lockdown due to the Coronavirus Disease-19 (COVID-19) pandemic. The World Health Organization highlighted how the lockdown had negative consequences on psychological well-being, especially for children. The present study aimed to investigate parental correlates of children’s emotion regulation during the COVID-19 lockdown. Within the Social Cognitive Theory framework, a path model in which parenting self-efficacy and parental regulatory emotional self-efficacy mediated the relationship between parents’ psychological distress and both children’s emotional regulation, and children’s lability/negativity, was investigated. A total of 277 parents of children aged from 6 to 13 years completed an online survey that assessed their psychological distress, regulatory emotional self-efficacy, and parenting self-efficacy. Parents reported also children’s emotional regulation and lability/negativity. A structural equation model (SEM) using MPLUS 8.3 was tested. Results showed that the hypothesized model exhibited excellent fit, chi-square (83) = 140.40, p < 0.01, RMSEA = 0.05, CFI = 0.97, TLI = 0.96, SRMR = 0.04. The influences of parents’ psychological distress and parents’ regulatory emotional self-efficacy on children’s emotional regulation and lability/negativity were mediated by parenting self-efficacy. The mediation model was invariant across children’s biological sex and age, and geographical residence area (high risk vs. low risk for COVID-19). Results suggested how parents’ beliefs to be competent in managing parental tasks might be a protective factor for their children’s emotional well-being. Implications for intervention programs are discussed

The buffering role of paternal parenting stress in the relationship between maternal parenting stress and children's problematic behaviour

The present study aimed at exploring the relationship between parenting stress and children's problematic behaviour in the families of 99 children aged 8–11 years. Parenting stress was assessed by parents, using the Parenting Stress Index, and children's problematic behaviour was assessed by teachers, using the Strengths and Difficulties Questionnaire. A moderation regression analysis showed a conditioning effect of paternal parenting stress in the relationship between maternal parenting stress and children's problematic behaviour. In the presence of high levels of paternal parenting stress, the relationship between maternal parenting stress and children's problematic behaviour was significant and strong (p =.01). When paternal parenting stress levels were low, the relationship between maternal parenting stress and children's problematic behaviour was not significant (p =.49). The results underlined that paternal parenting stress may buffer the relationship between maternal parenting stress and children's problematic behaviour. Clinical implications are discussed

Survival and Recurrence of Endocarditis following Mechanical vs. Biological Aortic Valve Replacement for Endocarditis in Patients Aged 40 to 65 Years: Data from the INFECT-Registry

Background: Infective endocarditis (IE) is a serious disease, and in many cases, surgery is necessary. Whether the type of prosthesis implanted for aortic valve replacement (AVR) for IE impacts patient survival is a matter of debate. The aim of the present study is to quantify differences in long-term survival and recurrence of endocarditis AVR for IE according to prosthesis type among patients aged 40 to 65 years. Methods: This was an analysis of the INFECT-REGISTRY. Trends in proportion to the use of mechanical prostheses versus biological ones over time were tested by applying the sieve bootstrapped t-test. Confounders were adjusted using the optimal full-matching propensity score. The difference in overall survival was compared using the Cox model, whereas the differences in recurrence of endocarditis were evaluated using the Gray test. Results: Overall, 4365 patients were diagnosed and operated on for IE from 2000 to 2021. Of these, 549, aged between 40 and 65 years, underwent AVR. A total of 268 (48.8%) received mechanical prostheses, and 281 (51.2%) received biological ones. A significant trend in the reduction of implantation of mechanical vs. biological prostheses was observed during the study period (p < 0.0001). Long-term survival was significantly higher among patients receiving a mechanical prosthesis than those receiving a biological prosthesis (hazard ratio [HR] 0.546, 95% CI: 0.322–0.926, p = 0.025). Mechanical prostheses were associated with significantly less recurrent endocarditis after AVR than biological prostheses (HR 0.268, 95%CI: 0.077–0.933, p = 0.039). Conclusions: The present analysis of the INFECT-REGISTRY shows increased survival and reduced recurrence of endocarditis after a mechanical aortic valve prosthesis implant for IE in middle-aged patients

Different strategies for mechanical VENTilation during CardioPulmonary Bypass (CPBVENT 2014): Study protocol for a randomized controlled trial

Background: There is no consensus on which lung-protective strategies should be used in cardiac surgery patients. Sparse and small randomized clinical and animal trials suggest that maintaining mechanical ventilation during cardiopulmonary bypass is protective on the lungs. Unfortunately, such evidence is weak as it comes from surrogate and minor clinical endpoints mainly limited to elective coronary surgery. According to the available data in the academic literature, an unquestionable standardized strategy of lung protection during cardiopulmonary bypass cannot be recommended. The purpose of the CPBVENT study is to investigate the effectiveness of different strategies of mechanical ventilation during cardiopulmonary bypass on postoperative pulmonary function and complications. Methods/design: The CPBVENT study is a single-blind, multicenter, randomized controlled trial. We are going to enroll 870 patients undergoing elective cardiac surgery with planned use of cardiopulmonary bypass. Patients will be randomized into three groups: (1) no mechanical ventilation during cardiopulmonary bypass, (2) continuous positive airway pressure of 5 cmH2O during cardiopulmonary bypass, (3) respiratory rate of 5 acts/min with a tidal volume of 2-3 ml/Kg of ideal body weight and positive end-expiratory pressure of 3-5 cmH2O during cardiopulmonary bypass. The primary endpoint will be the incidence of a PaO2/FiO2ratio <200 until the time of discharge from the intensive care unit. The secondary endpoints will be the incidence of postoperative pulmonary complications and 30-day mortality. Patients will be followed-up for 12 months after the date of randomization. Discussion: The CPBVENT trial will establish whether, and how, different ventilator strategies during cardiopulmonary bypass will have an impact on postoperative pulmonary complications and outcomes of patients undergoing cardiac surgery. Trial registration: ClinicalTrials.gov, ID: NCT02090205. Registered on 8 March 2014

Italian adolescents’ adjustment before and during the coronavirus disease 2019: A comparison between mothers’ and adolescents’ perception

The current cross-sectional study aimed to analyse adolescents’ adjustment during and before the lockdown caused by the coronavirus disease 2019 pandemic, by evaluating levels of emotional problems and hyperactivity as referred by adolescents themselves. A further purpose was to compare adolescents’ and mothers’ perception about adolescents’ adjustment. Participants comprised 206 adolescents (50.5% females; mean age&nbsp;=&nbsp;12.2; SD&nbsp;=&nbsp;3.3) and their mothers (mean age&nbsp;=&nbsp;43.9; SD&nbsp;=&nbsp;5.9). Findings showed that levels of emotional symptoms and hyperactivity in adolescents during the pandemic were significantly higher than before. This worsening was consistently detected by both mothers and adolescents themselves. Two main conclusions are highlighted by the current research: During the first wave of the COVID-19 pandemic, adolescents participating to this study detected a worsening in their well-being; mothers’ perceptions of their adolescents’ psychological problems may be considered reliable and consistent with the offspring’s point of view. Practitioner points: Italian adolescents’ adjustment during the COVID-19 outbreak has been little investigated. The current study highlighted a worsening in adolescents’ well-being, in terms of higher emotional symptoms and hyperactivity, with respect to the pre-pandemic period. This worsening was consistently highlighted by both adolescents themselves and their mothers

Internet addiction: The role of parental care and mental health in adolescence

Internet addiction in adolescence is a social issue which is being increasingly discussed worldwide. Hence, deepening the knowledge of its development is necessary to prevent shortand long-term negative outcomes. This study involving 266 adolescents (mean age = 16.1 years, SD = 1.4) aimed at analyzing the relationship between quality of parental care, Internet addiction and adolescents’ mental health, by means of the following self-report tools: the Parental Bonding Instrument, the Internet Addiction Test, and the Strengths and Difficulties Questionnaire. The findings, collected through structural equation model analyses, showed that perceived care from both father and mother had significant indirect effects on Internet addiction problems through adolescents’ mental health problems. Furthermore, Internet addiction problems were demonstrated to be negatively associated with maternal care but not with paternal care. The study provides empirical support to the need of family-based prevention and intervention programs to take care of Internet addiction

Parents' psychological factors promoting children's mental health and emotional regulation during the COVID-19 lockdown

A marzo 2020 l’Italia è andata in lockdown per la diffusione della pandemia COVID-19. Diversi studi hanno mostrato come la pandemia ha effetti negativi sul benessere psicologico dei bambini. Questo studio ha indagato come i genitori possono promuovere il benessere psicologico dei bambini, per capire come aiutarli a gestire questa situazione senza precedenti. 277 genitori di bambini tra 6 e 10 anni hanno compilato una survey online. Le analisi MANCOVA mostrano che bambini con più ansia/depressione, più labilità/negatività e meno regolazione emotiva hanno genitori con più malessere psicologico, meno autoefficacia genitoriale e nella regolazione delle emozioni (tutte le p &lt; .01). I genitori sono importanti fattori di protezione per la salute mentale dei figli durante il lockdown.On March 9th, 2020 Italy went into lockdown due to the spread of COVID-19 pandemic. Several studies showed how the pandemic had a negative impact on children's psychological well-being. The present research studied how parents can promote their children's psychological well-being, in order to understand how to help parents in managing this unprecedented situation. A total of 277 parents of children aged 6 to 13 years old completed an online survey. MANCOVA analyses showed that children with more anxiety and depression, more lability/negativity and less emotional regulation had parents with more psychological distress, less regulatory emotional self-efficacy, and less parenting self-efficacy (all p &lt; .01). Parents were important protective factor for their children's mental health during the lockdown

Parental Mediation of COVID-19 News and Children’s Emotion Regulation during Lockdown

The COVID-19 outbreak resulted in a large amount of emotionally charged messaging that is believed to have a tremendous psychological impact, particularly on children and early adolescents. The present study examined the relationships between children’s exposure to COVID-19 news, children’s emotional responses to the news, parental styles of mediating COVID-19 news, and children’s emotional functioning during the COVID-19 lockdown in Italy in April 2020. An online survey was completed by 277 parents (Mage = 43.36; SDage = 4.76; mothers = 89.5%) with children aged 6 to 13 years. Regression analyses showed that the parental active mediation style was associated with higher emotion regulation and lower lability/negativity, whereas the restrictive style was associated with higher lability/negativity and the social coviewing style was associated with lower emotion regulation. The results provide evidence for how adults using an active style can mediate messages to reduce children’s emotional difficulties during events with high emotional involvement

Perioperative pain management in cardiac surgery: A systematic review

BACKGROUND: Every year, more than 1.5 million patients, who undergo cardiac surgery worldwide, are exposed to a series of factors that can trigger acute postoperative pain associated with hemodynamic instability, respiratory complications, and psychological disorders. Through an evaluation of literature data about postoperative pain in cardiac surgery we define unmet needs and potential objectives for future research on this often-underestimated problem. METHODS: Following PRISMA Guidelines, a systematic literature search was carried out by two independent researchers on Scopus, CINAHL, the Cochrane Library, and PubMed using the key words: (perioperative OR postoperative) analgesia AND "cardiac surgery." Papers concerning children, or published prior to 2000, were considered ineligible, as well as abstracts, animal studies, and studies written in languages other than English. RESULTS: Fifty-four papers were selected and subsequently divided into two main categories: systemic analgesic drugs and regional anesthesia techniques. CONCLUSIONS: Over the past 17 years, opioids are still the most extensively used therapy, whereas we found only few trials investigating other drugs (e.g. paracetamol). Regional anesthesia techniques, especially thoracic epidural analgesia and intrathecal morphine administration, can effectively treat pain, but have not yet showed any significant impact on major clinical outcomes, with several concerns related to their potential complications. To date multimodal analgesia with implementation of regional analgesia seems to be the best choice. In the future, better-designed studies should consider other drugs stratifying groups according to comorbidities and risk factors, as well as using standardized units of measurement