Andrea Bonanomi

Paths of cognitive and language development in healthy preterm infants

OBJECTIVE Despite the presence of many studies on difficulties related to premature birth, findings on developmental outcomes are heterogeneous. This could be explained from a biological and environmental point of view, but also from a methodological one. The aims of this study were as follows: assess cognitive and linguistic performance using the BSID-III in a population of healthy preterm infants at 24 and 36 months (corrected age); analyze whether the correction for prematurity should be applied, decide when to stop using corrected age and evaluate possible improvements between 24 and 36 months. METHODS Developmental outcome was assessed at 24 and 36 months (corrected age) with the BSID-III in 75 healthy preterm (GA=32.5±1.97; BW=1631.55±453.92) and 69 term-born children (GA=39.77±1.00; BW=3298.95±457.27). RESULTS Preterm infants had significantly lower scores than those of term infants in Cognitive (COG) and Language (LANG REC, LANG EC) scales of the BSID-III at both 24 and 36 months, considering both corrected (CA) and chronological (UCA) age. At 24 months, significant differences between corrected and chronological scores were found for each BSID-III scale, while at 36 months, significant differences between corrected and chronological scores were found for LANG scales. Only the scores in the COG scale were statistically different between 24 and 36 months (F=4.894, P=0.009, η(2)=0.075). Considering only the preterm sample at 24 months, the differences between CA and UCA scores in the COG scale were significantly correlated to GA (p=0.000) and days in hospital (p=0.002;), while differences between CA and UCA scores in the LANG ESP scale were significantly correlated to GA (p=0.010), days in hospital (p=0.001), and birth weight (p=0.007). At 36 months, no significant correlations were found. CONCLUSIONS Preterm birth is followed by poorer cognitive and language outcomes during infancy than full-term birth. Age correction of prematurity is useful if the child is under 2 years of age; however, our findings raise concerns about the need for age correction, considering that at later ages, healthy preterm children have a higher rate of developmental delay compared with term infants. With regard to cognitive development, preterm children seem to recover from their initial disadvantage; however, with regard to linguistic development, data confirm that preterm infants are at risk for language difficulties.

Premature birth: complexities and difficulties in building the mother–child relationship

Abstract Aim: This paper aims to investigate if the dyadic interactive behaviours were influenced by parental stress and feelings both in preterm and full-term mother–child dyads. Methods: 45 mothers (age = 35.29 ± 5.38) and fathers (age = 36.77 ± 6.89) of preterm infants (GA = 30.25 ± 2.95; BW = 1288.02 ± 488.76), and 36 mothers (age = 32.60 ± 4.56) and fathers (age = 35.54 ± 5.16) of full-term (GA = 39.88 ± 1.38; BW = 3156.39 ± 493.81) were involved. Parents filled out the Impact of Event Scale Revised (IES-R), Profile of Mood States (POMS) and Parenting Stress Index Short Form (PSI-SF) and interactive behaviours (Global Rating Scale) was videotaped after 3 months. Results: Mothers of preterm children showed higher level of Intrusiveness (Mpreterm = 4.07 ± .74, Mfullterm = 4.39 ± .51, t = 2.22, p = .029) and Remoteness (Mpreterm = 4.45 ± .83, Mfullterm = 4.79 ± .34, t = 2.51, p = .015) than mothers of term children. In preterm mothers’ lower levels of Sensitivity, higher levels of Intrusiveness, Remoteness and Depression are associated with the presence of negative feelings and parental stress in both parents. Moreover, higher children Distress is associated to parental negative feelings, paternal stress and post-traumatic symptoms. A higher score of parental negative feelings and parental stress predicted lower scores in Global RatingScale dimensions. Conclusions: Our results underline that preterm birth could be a risk factor for the co-construction of interactive exchanges between mother and premature baby. This study could help practitioners to better consider parental roles and to carry out specific supportive interventions for both parents and children.

The role of Patient Health Engagement model (PHE-model) in affecting patient activation and medication adherence: A structural equation model

Background Increasing bodies of scientific research today examines the factors and interventions affecting patients’ ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients’ ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed. Objective To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway. Material and methods This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation (Patient Activation Measure 13 –short form); ii) Patient Health Engagement model (Patient Health Engagement Scale); iii) patient adherence (4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients’ emotional feelings (Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship (Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed. Results According to the theoretical model we hypothesized, research results confirmed that patients’ activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients’ quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis. Conclusions Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing the quality of care. The Patient Health Engagement Model might acts as a mechanism to increase patient activation and adherence.

Se io fossi Ben: adolescenti a confronto con una ipotetica gravidanza

Scopo del presente contributo e quello di esplorare, tramite una simulazione role-playing computerizzata, l’atteggiamento di un campione di adolescenti maschi (N = 125; eta media = 16.87) in merito ad una ipotetica gravidanza non pianificata. Tre sono gli obiettivi: (1) descrivere le reazioni emotive e cognitive degli adolescenti e la scelta da loro presa rispetto alla gravidanza; (2) individuare gli atteggiamenti degli adolescenti nei confronti della genitorialita adolescenziale e della relazione con la partner; (3) valutare il ruolo giocato dai seguenti fattori nel predire la scelta di proseguire o meno la gravidanza: (a) atteggiamenti personali nei confronti della genitorialita adolescenziale e della relazione con la partner, (b) attribuzione di importanza agli aspetti positivi e negativi della prosecuzione della gravidanza e dell’interruzione volontaria di gravidanza, (c) percezione dell’atteggiamento genitoriale nei confronti della gravidanza non pianificata. I risultati mettono in luce la presenza di tre atteggiamenti nei confronti della genitorialita adolescenziale e della relazione con la partner: idealizzazione della genitorialita, rifiuto dell’impegno e riflessione sull’evento. L’idealizzazione della genitorialita e il rifiuto dell’impegno, l’attribuzione di importanza agli aspetti positivi e negativi di interrompere la gravidanza, un atteggiamento genitoriale favorevole alla gravidanza e un atteggiamento materno di aperto sostegno giocano un ruolo rilevante nel guidare il processo decisionale rispetto a tale evento.

Retrospective Paternal and Maternal Parenting Styles, Regulatory Self-Efficacy and Adolescent Risk Taking

ABSTRACT This study aims to calculate a scaled risk-taking behavior index and to test a model in which maternal and paternal parenting styles affect risk-taking behavior with a mediation of adolescents’ regulatory self-efficacy. Participants were 816 adolescents (44% males) responding to a self-report questionnaire about their risk-taking behavior, regulatory self-efficacy, and retrospective memories of paternal and maternal parenting styles. Results suggested an item rating in the index showing that behaviors considered less risky referred to alcohol use and the unplanned first sexual intercourse, whereas behaviors considered more risky referred to the lack of use of contraceptives and the age of the first sexual intercourse. Results revealed a significant indirect effect of authoritative and authoritarian styles on risk-taking behavior. These styles shaped the adolescents’ regulatory self-efficacy, which in turn predicted adolescent risk-taking behavior. Results underline the complex interplay of relationships between parents and their children.

The effects of changes in job insecurity on daily consumption and major life decisions

Traditionally, research on job insecurity (JI) has focused on organizational consequences and employees’ psychophysical well-being. However, some recent studies explored potential extraorganizational outcomes of JI in relation to consumption and major life decisions. The present study, drawing on Conservation of Resource Theory, overcomes the limits of previous works by examining the effects of changes in JI through a simulation experiment design. Using a sequence of two different scenarios, 377 participants were asked to evaluate their JI and their inclination towards daily consumption and some major life decisions. Findings confirm that changes in JI affect such extraorganizational outcomes. It is also suggested that an improvement in job security leads to an increase in both consumption and major life decisions, which – in absolute values – is higher compared to the decrease that follows a reduction of job security.

A New Index for the Comparison of Different Measurement Scales

In psychometric sciences, a common problem is the choice of a good response scale. Every scale has, by its nature, a propensity to lead a respondent to mainly positive- or negative- ratings. This paper investigates possible causes of the discordance between two ordinal scales evaluating the same goods or services. In psychometric literature, Cohen’s Kappa is one of the most important index to evaluate the strength of agreement, or disagreement, between two nominal variables, in particular in its weighted version. In this paper, a new index is proposed. A proper procedure to determine the lower and upper triangle in a non-square table is also implemented, as to generalize the index in order to compare two scales with a different number of categories. A test is set up with the aim to verify the tendency of a scale to have a different rating compared to a different one. A study with real data is conducted.

A Simplified Latent Variable Structural Equation Model with Observable Variables Assessed on Ordinal Scales

The communication is related to a wide empirical research promoted by the Universita Cattolica del Sacro Cuore of Milan (UCSC) aimed at acquiring an insight into the real work possibilities of its graduates in the last seven years, as well as the appreciation and satisfaction of the firms which offered them a job position. The group of 1,264 firms which have a special connection with UCSC, regarding new job appointments, was considered and they were given a questionnaire, using web for sending and answering. The analysis of the 203 complete answers was conducted by having recourse to a structural equation model with latent variables.