Empathy at school project: Effects of didactics of emotions® on emotional competence, cortisol secretion and inflammatory profile in primary school children. A controlled longitudinal psychobiological study

Background

There is mounting evidence of the presence of chronic stress among children during primary school: girls and boys under the age of 15 years often experience anxiety, irritability and sleeping problems with negative consequences on scholastic climate and the spread of bullying and dropping out of school. The promotion of emotion regulation within school environment through innovative didactic methodologies represents a valuable tool for teachers and parents to reduce emotional distress and associated risk behaviours and to promote wellbeing.

Aim

Our research aims to explore the psychological and biological consequences of teaching emotional training in an experimental group of Italian Primary School children.

Methods

A sample of pupils (81 children aged between 6 and 8) was divided into an experimental group (33 subjects) and a control group (30 subjects). A further advanced group of 18 subjects, who have experienced the method in the previous school year, was also included. The experimental study lasted one school year (from October 2021 to May 2022). The following psychological tests were administered to all groups: TEC (Test of Emotion Comprehension) to measure the children's different emotional abilities and the Projective test (PT) 'A person in the rain', to identify the coping skills of children in a stressful condition. Morning salivary cortisol, IL-6 and TNF-alpha assays were conducted in all three groups. Psychological and biological tests were administered at the beginning of the study and at the end of the study.

Results

The MR-Anova model for TEC score showed that there was not a significant group effect [Fgroup = 2.24, p = 0.114]. Pairwise comparisons showed that mean score significantly increased only in the Experimental group (pB < 0.001) and at the end of the project there was a significant difference between Experimental group and Control group (pB = 0.012). The mean score of PT test increased significantly from baseline to the end of the project for the Experimental group (pB < 0.001) and for the Advanced group (pB = 0.004). At the end of the project, there were significant differences between the Experimental group and the Control group (pB = 0.004) and between the Advanced group and the Control group (pB < 0.001). Salivary cortisol analysis revealed a significant effect between subjects [Fgroup = 9.66; p < 0.001] and significant effects within subjects with the main effect of the time [Ftime = 35.41; p < 0.001] and the significant interaction "time x group" [Ftimexgroup = 3.38; p = 0.040]. Pairwise comparisons showed that cortisol levels decreased significantly over time only in the Experimental group (pB < 0.001). Regarding to IL-6 levels, there was not a significant effect between subjects [Fgroups = 0.0481; p = 0.953]. The mean level decreased significantly for each group from baseline to post project (pB < 0.001). With respect to TNF-alpha levels, the mean levels decreased over time for all groups (pB = 0.006 for Experimental group; pB < 0.001 either for the Advanced or Control group).

Conclusion

the results documented in the experimental groups who experienced didactics of emotion for at least one school year show a significant increase in children's ability to cope with reality, stress and anxiety, and an improvement of their emotional competence. Meanwhile, a significant reduction in the amount of salivary cortisol was observed in the experimental group at the end of the scholastic year; meantime a stable reduced amount of salivary cortisol in advanced group throughout the project was also observed. These findings show that an intervention through an emotional education program is able to regulate interpersonal skills and the stress axis response.

The impact of covid-19 pandemic on emergency services

Background

The SARS-Cov-2 pandemic has placed enormous strain on the global healthcare system. The strict containment measures have adversely affected population movements and mobility, daily activities, and the patterns of healthcare-seeking behavior. Although the Emergency and Admission Departments (EADS) activity has never been disrupted, the pandemic had a significant impact on the routine healthcare delivery. This study aims to assess the changes in healthcare delivery, with a focus on the elderly as a vulnerable component of the general population.

Design of the study

Retrospective study.

Methods

All non-COVID visits to the EAD of the Local Health Unit (ASL1) in Abruzzo (Italy) from 9 March to 3 May 2020 were analyzed. These were compared to the hospital admissions recorded in the same period of the previous year.

Results

We found a 60.4% reduction in overall visits during the study period and an increase in the hospitalization rate from 30% to 39%. Emergency department visits have declined markedly for less acute medical conditions, while we have observed a statistically significant increase in the hospitalization rates for all age groups. Moreover, in 2020 we recorded a decrease in the ratio non-urgent/non-deferrable medical conditions for each age group; while the percentage of hospitalizations for each registered red code increased for each group, particularly for the 65-74 age group.

Conclusions

The COVID-19 pandemic has significantly affected the care-seeking behavior of patients. During the COVID-19 epidemic, total hospital admissions have decreased, particularly for less severe illnesses, whereas the percentage of hospitalizations has increased. During 2020, hospital admissions for mild cases decreased, and patients presented to the EAD only in cases of acute medical condition, selecting those in need for more intensive care. However, several patients may have deferred necessary medical care even for potentially urgent conditions. Such reluctance to seek medical care may have caused delays in diagnosis. The impact of deferred care on patients' health is difficult to estimate at this time. This information will serve as a starting point for further research to improve healthcare management not only during emergency but also in non-emergency periods.

Hypersensitivity reactions to iodinate contrast media in Italy: a retrospective study. Characteristics of patients and risk factors

Summary

Objective. The purpose of the study was to describe the characteristics of patients experiencing hypersensitivity reactions (HRs) to iodinated contrast media (ICM) in a large Italian population and to investigate potential risks factors in order to obtain a risk stratification, helpful in the management of these patients. Methods. Data of 407 patients investigated in 9 Italian Allergy Centers for suspected HRs to ICM were analyzed and compared with a control group of 152 subjects that tolerated one or more ICM-enhanced examinations. The univariate and multivariate logistic regression model was used to evaluate associated factors. Results. The mean age of reactive patients was 61 years and 60% were female; 67% of patients reported immediate reactions and 35% experienced the reaction, more frequently with immediate onset, at the first examination in life. Iomeprol, iopromide and iodixanol were the most frequent culprit agents and 20% of patients showed a positive skin test result. Previous adverse reactions to ICM were reported by 15.6% of patients, whereas 35% of subjects experienced the reaction, more frequently immediate, after the first ICM-enhanced examination in their life. The multivariate analysis showed that male gender and age > 65 were associated with ICM reactions as protective factors [OR_adja = 0.51; 95% CI: 0.33-0.77 and OR_adja = 0.60; 95% CI: 0.39-0.92 respectively]. Cardio-vascular disease [OR_adja = 2.06; 95% CI: 1.22-3.50)], respiratory allergy [OR_adja = 2.30; 95% CI: 1.09-4.83)] and adverse drug reactions [OR_adja = 1.99; 95% CI: 1.05-3.77)] were identified as risk factors for ICM reactions. Food allergy was not significantly associated with reactions [OR_adja = 1.51; 5% CI: 0.41-5.56]. Conclusions. This is the largest study on Italian patients experiencing hypersensitivity reactions to ICM. Most results are in line with other studies, showing some association with factors that could influence the incidence of hypersensitivity reactions but not allowing an easy risk stratification.

Moderate Depression Promotes Posttraumatic Growth (Ptg): A Young Population Survey 2 Years after the 2009 L'Aquila Earthquake

Background:

Earthquakes can result in a range of psychopathology and in negative and positive consequences for survivors.

Objective:

To examine the association between clinical aftereffects (anxiety and depressive symptoms) and post-traumatic growth (PTG) among young survivors of the 2009 L’Aquila earthquake, Italy.

Method:

316 young earthquake survivors enrolled in the University of L’Aquila were evaluated two years after the natural disaster. Participants completed three main questionnaires, including Patient Health Questionnaire-9 items (PHQ-9), Self-Rating Anxiety Scale (SAS), and Posttraumatic Growth Inventory (PTGI).

Results:

59.6% of the student sample showed different levels of depression, whereas 13.3% reported anxiety symptoms. In both clinical dimensions (anxiety and depression), gender differences were found: female gender was confirmed risk factor for a clinical post-traumatic response. Personal PTG, demonstrated by 18% of the L’Aquila youths included in our sample, was predicted by moderate levels of depression (O.R. 2.7). In our model, gender, age, and anxiety did not show any predictive value.

Conclusion:

In a post-traumatic setting, the development of individual cognitive strategies is crucial, whereas after a natural disaster, paradoxically, a moderate depressive condition and the related distress could promote the drive to overcome the psychological consequences of the traumatic event.

Post traumatic stress disorder and coping in a sample of adult survivors of the Italian earthquake

The aim was to investigate the prevalence of post traumatic stress disorder (PTSD) in people who had left their damaged homes and were still living in temporary housing more than a year after the April 2009 L'Aquila (Italy) earthquake. In addition, we evaluated the differences in coping strategies implemented by persons who had and who did not have PTSD. A cross-sectional prevalence study was carried out on a sample of 281 people aged >18 years and living in temporary housing after the earthquake. The questionnaires used include the Davidson Trauma Scale and the Brief Cope. The prevalence of PTSD was 43%. Women and the non-employed were more vulnerable to PTSD, while, age and level of education were not associated with PTSD. Those with PTSD symptoms often employed maladaptive coping strategies for dealing with earthquake and had the highest scores in the domains of denial, venting, behavioral disengagement, self-blame. By contrast, those without PTSD generally had more adaptive coping mechanisms. Adults who were living in temporary housing after the earthquake experienced high rates of PTSD. The difference in coping mechanisms between those who have PTSD and those who do not also suggests that they influence the likeliness of developing PTSD.

Transversus abdominis plane block for analgesia after Cesarean delivery. A systematic review

Cesarean delivery is a major surgical procedure, after which a woman can experience substantial postoperative discomfort or pain. Inadequate postoperative analgesia is one of the most common reasons for poor patient satisfaction following cesarean delivery. Although spinal or systemic opioids are currently the gold standard to achieve effective analgesia, they are often associated with side effects. In the last few years there has been growing interest in abdominal plane blocks, with promising data on their efficacy. The transversus abdominis plane (TAP) block is a regional analgesic technique which is gaining acceptance in postoperative analgesia for lower abdominal surgeries. In this systematic review of articles published as of 31 December 2013, we searched the principal medical databases for randomized controlled trials that assessed the efficacy of ultrasound (US)-guided TAP block following cesarean delivery and reported on postoperative opioid consumption and pain score, opioid-related side-effects and patient satisfaction. Although controversy surrounds the utility of US-guided TAP block in cesarean section, evidence suggests that when correctly executed as part of a multimodal analgesic regimen, TAP block may reduce postoperative opioid consumption and opioid-related side effects, improving postoperative pain control and patient satisfaction. Further studies are necessary to explore this field of research.

Quality of life, psychological wellbeing and resilience: a survey on the Italian population living in a new lodging after the earthquake of April 2009

OBJECTIVE

The aim of this study is to estimate the quality of life and the psychological wellbeing as a result of the earthquake which occurred the 6th of April 2009 and that struck the population of the city of L'Aquila.

METHODS

A random sample of 281 subjects, from the population that had the possibility of living in a temporary lodging provided by the State, were interviewed after the earthquake, during the period between July and October 2010. Two self-administered questionnaires were used: the Psychological General Well-Being Index (PGWBI) and the Dispositional Resilience Scale (DRS II).

RESULTS

The women's health status is worse than the men's, this is true both on a general level (79,24 vs 70,55), and on different estimated dimensions. Health status is significantly worse in older age groups (F2;245=4,34, p=0,0140): the elderly appear to be more depressed (F2;245=6,52, p=0,0017) and to have less self-control (F2;245=3,06, p=0,0487) than the younger.

CONCLUSIONS

Generally women tend to experience greater emotional involvement in social and interpersonal relationships. Although many months have passed since the catastrophic event, feelings of disease and a sense of impotence (about life) are still persistent in people, even though they generally are hopeful about the future.

[Poverty and nutrition: a survey on the under age sons of the beneficiaries of the R.M.I. in the L'Aquila District Area]

The alimentary education, let alone the relative behaviour, represent an important preliminary statement for a children perfect growth. The results of a not healthy nutrition or alimentary mistakes can produce several problems. The study aims to analyze the child and adolescent nutrition for families with economic difficulties that receive a (social and economic) benefit called "Reddito Minimo di Inserimento" (RMI), within the L'Aquila district area. For the valuation of nutrition state, it has been used the BMI (Body Mass Index), with the necessary corrections for sex and age. From the made analysis, the children's about 33% is classifiable as "at risk of soprappeso" or as "soprappeso", with prevalence for the males, above all in the classes of younger ages, like the most recent studies on the children's nutrition.

[Quality of health care services as perceived by the customers: issues of method or context?]

Customer satisfaction is considered an important indicator of the quality of care. Its definition as well as the identification of the variables which affect it, rise many cultural and methodological issues. In order to give a contribution to the debate on such topics, we compared the patients' satisfaction detected before and after the transferral of the San Salvatore Hospital of L'Aquila to new and functional structures. The comparison aimed at evaluating the methodological and cultural entailments involved in customers satisfaction surveys, which focus the improvements in terms of health care as well as variation of satisfaction. The presence of contradictory elements in the expression of the satisfaction referred to the technical and informative aspects, seems to indicate that patients can express an high satisfaction degree independently from the real professional and technical quality performed. Such evidences, that anyway must be interpreted according with the methodological cautions of a non validated questionnaire, should foster stronger efforts in promoting sanitary education of the customers, devoted to the specific rights involved, as well as in making use of rigorous methodologies to detect the phenomenon.