Clinical outcomes in patients undergoing coronary artery bypass grafting with preferred use of the radial artery

BACKGROUND

The use of the radial artery (RA) for coronary artery bypass grafting (CABG) is still not widely accepted. The purpose of this study was to evaluate the impact of preferred RA utilization on clinical outcomes.

METHODS

Data on 138 consecutive patients undergoing CABG using the RA (in addition to the internal mammary artery) were prospectively collected and compared to 228 patients undergoing CABG without the RA.

RESULTS

The mean age was 56 +/- 10 years (range 29 to 79 years). Preoperatively 91% (126/138) were in CCS angina Class III/IV, 45% (66/138) were nonelective, and 14% (20/138) were reoperations. An average of 3.5 +/- 0.9 grafts per patient were performed, of which 2.5 +/- 0.5 (71%) were arterial. The RA was used for single distal vessel in 103 patients, for sequential grafting in 35, and overall for 1.3 distal targets per patient. There were no perioperative deaths, reoperation for bleeding, MI, or CVA. Six patients (4%) had minor RA harvest-related complications. The length of hospital stay was 5.6 +/- 3.1 days. Hospital outcomes were similar to a cohort of patients undergoing CABG without RA. Mean follow-up for 99% (137/138) of patients was 7.1 +/- 4.3 months (range 1 to 18 months). Long-term major complications included one sudden death (0.7%) and three MIs (2.2%). At the time of follow-up, 95% (1311137) were in CCS angina Class I/II. Routine thallium stress test performed in 93 patients showed normal perfusion in 98%. There were no long-term major vascular or neurological deficits related to RA harvest.

CONCLUSIONS

The use of RA in patients undergoing CABG is safe and effective. These excellent early clinical outcomes justify liberal use of the RA, although long-term follow-up is required to establish its ultimate role as a preferred conduit.

Can the family drawing be a useful tool for assessing attachment representations in children? A systematic review and meta-analysis

A systematic review and meta-analysis were conducted to evaluate the quality and validity of Family Drawings (FD) with an Attachment-Based Coding System in assessing attachment representations among pre-school and school-age children. A literature search in notable databases identified 645 records, of which 20 were eligible after screening and quality assessment. Results showed: 1) ABCD attachment distribution in community children was: 48% secure, 20% avoidant, 21% ambivalent, 11% disorganized. Security prevailed both in classifications and Fury et al.' scales. 2) No significant differences according to the cultural background; 3) At-risk/clinical children showed higher insecurity than community ones using scales; 4) Girls were more secure than boys. In conclusion, FD may be a culture-fair method to assess attachment representations in children. Global scales seem more reliable than ABCD classifications for discriminating at-risk and clinical children, but further studies on these groups are needed.

Emotional-behavioral problems, attachment and verbal skills in late-adopted adolescents: The role of pre-adoption adversities and adoption variables

BACKGROUND

There are few studies on late-adopted adolescents' outcomes -e.g., emotional-behavioral problems, attachment and cognitive status- and their possible predictive factors, none from Italy.

OBJECTIVE

This paper aimed to investigate emotional-behavioral problems, attachment representations, and verbal skills in late-adopted adolescents in Italy and to explore the predictive role of pre-adoption adversities and adoption variables for worse adoptees' outcomes.

PARTICIPANTS AND SETTING

The study included N = 79 late-adopted (mean age at adoption = 6 years) adolescents, between 11 and 18 years, placed via both intercountry and domestic adoption.

METHODS

Parents provided information about pre-adoption and adoption history and filled the Children's Behavior Checklist 6-18 for measuring participants' emotional-behavioral problems. Attachment representations were assessed through the Friend and Family Interview administered directly to adolescents, like the verbal comprehension index of the Wechsler Intelligence Scale for Children (4th edition) for measuring participants' verbal IQ.

RESULTS

Maltreatment and its interaction with multiple placements were the main predictors of other problems-i.e., social, thought, and identity difficulties (respectively, p = .007 and p = .029)-while intercountry adoption was the unique predictor of both externalizing and total problems (respectively, p = .047 and p = .015). However, domestic adoption was the most important predictor both for higher insecurity and disorganized attachment representations and lower verbal skills (all p < .044); even stronger if domestic adoption interacted with pre-adoptive institutionalization.

CONCLUSIONS

Pre-adoption adversities as well as domestic vs. intercountry adoption, but not the age at placement, contributed to adolescent adoptees' developmental outcomes.

A systematic review of nature connectedness in adolescents and young adults: Fostering environmental responsibility and sustainable practices

Investigating the connection with nature is essential for understanding how young people perceive and engage with their environment. This systematic review aimed to assess the psychological and social science literature on the connection with nature in adolescents and young adults, with the objective of exploring how this connection might impact their development. Following PRISMA guidelines, a comprehensive search across multiple databases identified 352 articles in total, with 38 meeting the inclusion criteria. Each article was evaluated for characteristics such as population type, study design, aims, and key findings. Thematic analysis revealed three key areas: pro-environmental behavior, sustainability and connection with nature, the role of technology, and gender differences in connection with nature. The findings suggest that fostering a connection with nature may be a powerful strategy for enhancing youth well-being, while also supporting social integration in diverse and evolving urban settings.

Laparoscopic colectomy: at what cost?

The purpose of this study was to compare laparoscopic to open colectomy with respect to: 1) morbidity and mortality, 2) adequacy of resection for cancer (margins and number of nodes), 3) operative time, 4) postoperative time for tolerating diet and discharge, and 5) total hospital charges. A historical control group of open colon surgery patients was used. Laparoscopic colectomy was completed in 18/24 patients and 6 were converted to open colectomy. There were no operative or perioperative mortalities. In procedures for cancer, all margins were free of tumor. The average number of nodes in the laparoscopic group (LC) was higher than in open colectomy (OC) group. The average operative time was slightly longer in the LC group compared to the OC group. Postoperative length of stay was shorter in the LC group, and considerably shorter in the elective LC group. Corrected average total hospital cost was lower in the LC group than in the OC group. Laparoscopic colectomy has acceptable morbidity and mortality, is cost-efficient and seems to provide adequate resection for cancer, although long-term data will be crucial to this issue.

The role of community resilience as a protective factor in coping with mental disorders in a sample of psychiatric migrants

Background

Over the past decade migration to Italy has increased significantly for various reasons including armed conflicts. Generally, the migration process is exposed to different risk factors during different periods of migration, which can compromise well-being and promote the onset or exacerbation of mental disorders. A community with resources and the perception of one's community as resilient can be important protective factor in the context of migration.

Purpose

This study aims to understand which variables in migration predict an increase in perceived community resilience and to understand the role of community resilience in the relationship between mental disorders and subjective well-being in a sample of 100 adult migrants at the first consultation interview in the ambulatories of Psychiatry Unit.

Methods

After defining the inclusion and exclusion criteria, migrants were asked to fill out self-report questionnaires to collect socio-demographic data and to assess perception of mental disorders, perceived community resilience and perception of subjective well-being. Descriptive analysis, simple regression, and moderation analyses were conducted to test the hypotheses.

Results

The results show that the variable meaning attributed to the community with reference to the host community, migration with someone, and longer duration of stay in Italy contribute to increased perceptions of community resilience. In addition, a direct negative effect of mental disorders on subjective well-being and the moderating role of community resilience in relationship between mental disorders and subjective well-being have been demonstrated.

Conclusions

This result underscores the importance of perceived community resilience in mitigating the negative effects of mental disorders on subjective well-being. Perceiving one's community as more resilient seems to protect against the impact of mental disorders on subjective well-being. Our results support an ecological model of migrants' mental health that values the community and its resources in coping with mental disorders in the context of migration.