Maternal Parenting Stress and Preschoolers’ Social-Emotional Competence and Behavioural Difficulties: A Variable- and Person-Centred Approach

Background: The present study examined the relations between maternal parenting stress and preschoolers’ psychosocial adjustment, using both a variable-centred and a person-centred approach. Methods: The study had three main purposes: (a) evaluating the associations of maternal parenting stress with children’s social-emotional competence and behavioural difficulties, as perceived by their mothers; (b) inquiring the existence of different children’s clusters based on their level of social-emotional competence and behavioural difficulties; (c) exploring differences in maternal parenting stress linked to cluster membership. Participants were 91 Italian mothers, aged from 22 to 47 years old (M = 35.14, SD = 5.80), having a preschool child from 3 to 6 years old (M = 4.6, SD = 0.80). Results: Overall, results showed that maternal parenting stress was negatively associated with children’s social-emotional competence, and positively associated with their behavioural difficulties. A cluster analysis allowed identifying four children’s profiles characterized by different levels of social-emotional competence and behavioural difficulties: Maladjusted, Troubled, Adjusted and Controversial. Conclusions: Results also evidenced differences among clusters in maternal parenting stress. Ultimately, this study suggests that interventions may consider reducing maternal parenting stress to promote children’s psychosocial adjustment

Impact of monopolar and bipolar endometrial resection on abnormal uterine bleeding

Study Objective. To compare two procedures for endometrial resection: resectoscopy with monopolar knife versus resectoscopy with bipolar knife. Patients and methods. 76 perimenopausal patients affected by DUB (Dysfunctional Uterine Bleeding), no longer wishing to remain pregnant and having failed to respond to pharmacological treatment, underwent endometrial ablation with monopolar loop (group A: 38 women) or bipolar loop (group B: 38 women). Operative parameters, complication rate, menstrual outcome were considered. Results. Operative time was no different between groups. The amount of distention fluid adsorbed was significantly higher in group A than in group B, and late cumulative complication rate was 44% in group A and 24% in group B. Menstrual cycle was, overall, controlled in both groups. Conclusions. Bipolar electrode is as effective as monopolar electrode for endometrial resection, but was safer than monopolar knif

Gonadotrophin-releasing hormone analogue or dienogest plus estradiol valerate to prevent pain recurrence after laparoscopic surgery for endometriosis: a multi-center randomized trial.

Abstract Objectives To evaluate the efficacy of dienogest + estradiol valerate (E2V) and gonadotrophin-releasing hormone analogue (GnRH-a) in reducing recurrence of pain in patients with chronic pelvic pain due to laparoscopically diagnosed and treated endometriosis. Design Multi-center, prospective, randomized study. Setting Three university departments of obstetrics and gynecology in Italy. Population Seventy-eight women who underwent laparoscopic surgery for endometriosis combined with chronic pelvic pain. Methods Post-operative administration of dienogest + E2V for 9 months (group 1) or GnRH-a monthly for 6 months (group 2). Main outcome measures A visual analogue scale was used to test intensity of pain before laparoscopic surgery at 3, 6 and 9 months of follow up. A questionnaire to investigate quality of life was administered before surgery and at 9 months of follow up. Results The visual analogue scale score did not show any significant differences between the two groups (p = 0.417). The questionnaire showed an increase of scores for all women compared with pre-surgery values, demonstrating a marked improvement in quality of life and health-related satisfaction with both treatments. No significant differences were found between the groups. The rate of apparent endometriosis recurrence was 10.8% in group 1 and 13.7% in group 2 (p = 0.962). Conclusion Both therapies seemed equally efficacious in preventing endometriosis-related chronic pelvic pain recurrence in the first 9 months of follow-up

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Objective The primary aim of the study was to analyze the endometrioma recurrence rate in patients who under- went laparoscopic excision followed by postoperative long- term regimen of oral contraceptives (OCs). Materials and methods 168 patients who underwent a conservative laparoscopic surgery for endometrioma, dur- ing the period between September 2009 and August 2010 in three university hospitals were studied. A long-term OCs therapy was offered to all women following surgery. Patients were randomly divided into three groups accord- ing to different progestins used (desogestrel, gestodene, dienogest). Women who refused a postoperative hormonal therapy served as control. Follow-up visits and transvaginal scan were planned at 1, 3, 6, 12, and 24 months after surgery. All patients who showed an ultrasound persistence of the endometrioma at 1 month follow-up were excluded from clinical analysis. Results Of the 168 patients, 131 completed the 24 months follow-up. Endometrioma recurrence was found in 21 (12.5 %) of all patients, it was unilateral in 17 cases while bilateral in 4 cases. The rate of recurrent endome- trioma was statistically significant in non-users compared to the long-term OCs treated patients. Conclusion The current data suggest the usefulness of long-term OCs regimen after conservative surgery for the prevention of ovarian endometrioma recurrence. As a sta- tistical significant difference could not be observed between OCs groups, further study on the individual mol- ecules is required in order to really understand the effect of each of them

Maternal Parenting Practices and Psychosocial Adjustment of Primary School Children

This study was aimed at evaluating the associations between maternal parenting practices (positive, negative/inconsistent, and punitive), children’s difficulties (such as conduct problems, emotional symptoms, peer problems, and hyperactivity), and prosocial behaviors. Participants were 131 Italian mothers of primary school children; mothers were aged between 26 and 52 years (M = 38.38, SD = 5.46); children (54% girls) were aged between 6 and 10 years (M = 7.15, SD = 0.98). Mothers completed two scales assessing their parenting practices and their children’s psychosocial adjustment. A path analysis was run to test the hypothesized model. The results showed the following: (a) maternal positive parenting was negatively and significantly related to children’s conduct problems and hyperactivity, and positively and significantly to children’s prosocial behavior; (b) maternal negative/inconsistent parenting was positively and significantly related to children’s conduct problems, emotional symptoms, and hyperactivity; (c) maternal punitive parenting was positively and significantly related to children’s conduct problems and emotional symptoms. Moreover, the results showed that, according to the mothers’ perceptions, boys tended to exhibit higher levels of hyperactivity and peer problems and lower levels of prosocial behaviors than girls. Overall, this study highlights the unique role of different maternal parenting practices in the psychosocial adjustment of primary school children

Impact of deleterious variants in other genes beyond BRCA1/2 detected in breast/ovarian and pancreatic cancer patients by NGS-based multi-gene panel testing: looking over the hedge

Background: Hereditary breast cancer (BC), ovarian cancer (OC), and pancreatic cancer (PC) are the major BRCA-associated tumours. However, some BRCA1/2-wild-type (wt) patients with a strong personal and/or family history of cancer need a further genetic testing through a multi-gene panel containing other high- and moderate-risk susceptibility genes. Patients and methods: Our study was aimed to assess if some BC, OC, or PC patients should be offered multi-gene panel testing, based on well-defined criteria concerning their personal and/or family history of cancer, such as earliness of cancer onset, occurrence of multiple tumours, or presence of at least two or more affected first-degree relatives. For this purpose, 205 out of 915 BC, OC, or PC patients, resulted negative for BRCA1/2 and with significant personal and/or family history of cancer, were genetically tested for germline pathogenic or likely pathogenic variants (PVs/LPVs) in genes different from BRCA1/2. Results: Our investigation revealed that 31 (15.1%) out of 205 patients harboured germline PVs/LPVs in no-BRCA genes, including PALB2, CHEK2, ATM, MUTYH, MSH2, and RAD51C. Interestingly, in the absence of an analysis conducted through multi-gene panel, a considerable percentage (15.1%) of PVs/LPVs would have been lost. Conclusions: Providing a multi-gene panel testing to BRCA1/2-wt BC/OC/PC patients with a strong personal and/or family history of cancer could significantly increase the detection rates of germline PVs/LPVs in other cancer predisposition genes beyond BRCA1/2. The use of a multi-gene panel testing could improve the inherited cancer risk estimation and clinical management of patients and unaffected family members

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries