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Individuals and communities worldwide have been affected by COVID-19, resulting in stress and emotional instability. Families faced a massive disruption of daily routines, with increased psychological problems for both parents and children. In this cross-sectional study, we explored the emotional impact that health crises have had on Italian families, and in particular on mothers. Nine hundred and seventy-five Italian mothers of children aged 3–18 years participated in this study by completing a survey about maternal and child mental health. The mother’s psychological state was assessed using the GHQ and the PSS, while the children’s psychological state with the SDQ. We also collected family socio-demographic information. We conducted a path analysis through structural equation modeling on this data, with the hypothesis that sociodemographic variables and mothers’ psychological state were related, as well as mothers’ psychological condition and children’s well-being. Our results demonstrated how, during the lockdown, mothers reported a worsening in their psychological state. Furthermore, we found that both educational level and housing type were positively associated with maternal psychological well-being, while remote working was associated with decreased well-being. Maternal mental health had a strong relationship with reported children’s psychological problems. Mothers’ perceived stress was related to decreased prosociality and increased hyperactivity, emotional difficulties, and behavioral problems, while mothers’ general discomfort and depression were related to increased peer problems and emotional problems. This result supports helping mothers find a new balance between work, family, and children as a way to improve family functioning and well-being, as well as children’s mental health and resilience.

We described physical activity measures and hourly patterns in patients with chronic obstructive pulmonary disease (COPD) after stratification for generic and COPD-specific characteristics and, based on multiple physical activity measures, we identified clusters of patients. In total, 1001 patients with COPD (65% men; age, 67 years; forced expiratory volume in the first second [FEV1], 49% predicted) were studied cross-sectionally. Demographics, anthropometrics, lung function and clinical data were assessed. Daily physical activity measures and hourly patterns were analysed based on data from a multisensor armband. Principal component analysis (PCA) and cluster analysis were applied to physical activity measures to identify clusters. Age, body mass index (BMI), dyspnoea grade and ADO index (including age, dyspnoea and airflow obstruction) were associated with physical activity measures and hourly patterns. Five clusters were identified based on three PCA components, which accounted for 60% of variance of the data. Importantly, couch potatoes (i.e. the most inactive cluster) were characterised by higher BMI, lower FEV1, worse dyspnoea and higher ADO index compared to other clusters (p < 0.05 for all). Daily physical activity measures and hourly patterns are heterogeneous in COPD. Clusters of patients were identified solely based on physical activity data. These findings may be useful to develop interventions aiming to promote physical activity in COPD.

We described physical activity measures and hourly patterns in patients with chronic obstructive pulmonary disease (COPD) after stratification for generic and COPD-specific characteristics and, based on multiple physical activity measures, we identified clusters of patients. In total, 1001 patients with COPD (65% men; age, 67 years; forced expiratory volume in the first second [FEV 1 ], 49% predicted) were studied cross-sectionally. Demographics, anthropometrics, lung function and clinical data were assessed. Daily physical activity measures and hourly patterns were analysed based on data from a multisensor armband. Principal component analysis (PCA) and cluster analysis were applied to physical activity measures to identify clusters. Age, body mass index (BMI), dyspnoea grade and ADO index (including age, dyspnoea and airflow obstruction) were associated with physical activity measures and hourly patterns. Five clusters were identified based on three PCA components, which accounted for 60% of variance of the data. Importantly, couch potatoes (i.e. the most inactive cluster) were characterised by higher BMI, lower FEV 1 , worse dyspnoea and higher ADO index compared to other clusters (p < 0.05 for all). Daily physical activity measures and hourly patterns are heterogeneous in COPD. Clusters of patients were identified solely based on physical activity data. These findings may be useful to develop interventions aiming to promote physical activity in COPD.

Background: Sleep disturbances are common in patients with chronic obstructive pulmonary disease (COPD) with a considerable negative impact on their quality of life. However, factors associated with measures of sleep in daily life have not been investigated before nor has the association between sleep and the ability to engage in physical activity on a day-to-day basis been studied. Aims: To provide insight into the relationship between actigraphic sleep measures and disease severity, exertional dyspnoea, gender and parts of the week; and to investigate the association between sleep measures and next day physical activity. Methods: Data were analysed from 932 patients with COPD (66% male, 66.4±8.3 years, FEV1% predicted=50.8±20.5). Participants had sleep and physical activity continuously monitored using a multisensor activity monitor for a median of 6 days. Linear mixed effects models were applied to investigate the factors associated with sleep impairment and the association between nocturnal sleep and patients' subsequent daytime physical activity. Results: Actigraphic estimates of sleep impairment were greater in patients with worse airflow limitation and worse exertional dyspnoea. Patients with better sleep measures (ie, non-fragmented sleep, sleeping bouts ≥225 min, sleep efficiency ≥91% and time spent awake after sleep onset <57 min) spent significantly more time in light (<0.01) and moderate-to-vigorous physical activity (<0.01). Conclusions: There is a relationship between measures of sleep in patients with COPD and the amount of activity they undertake during the waking day. Identifying groups with specific sleep characteristics may be useful information when designing physical activity-enhancing interventions.

Child maltreatment is a complex life experience occurs when a parent or caregiver does an intentional or potential damage to a child, including acts of commission and omission. Child abuse is not an uncommon event, but it is not always recognized. Identifying the real number of maltreated children is a challenge because of the large variability in reported prevalence data across studies. Unfortunately, in the United States, it affects 1 in 8 children, by the age of 18 years, annually. Paediatricians may encounter a variety of forms of maltreatment such as neglect, emotional, physical and sexual abuse. These aspects should be recognised, examined and evaluated by employing a systematic approach and focusing on basic needs of children that may not be met. Child maltreatment is a global problem with serious life-long physical and psychological or psychiatric outcomes. It is associated with important economic and social costs (such as physical and mental health, productivity losses, child welfare, criminal justice and special education costs) due to its high prevalence and its long-term and short-term consequences. In the United States, the average cost of nonfatal maltreatment is $210,012 per children and the cost of fatal maltreatment is $1,272,900. General Practitioners are quite prepared to face the problem of child maltreatment: since they have the opportunity to meet several members of the same family, they can detect stressors that put children at risk of maltreatment. All health professionals have the responsibility to protect children from abuse and neglect.

To assess the prevalence of femicides in Italy over the last three years and the potential long lasting effects of these traumatic events for the children of a woman who dies a violent death. The data used in this study come from an internet search for the number of femicides occurring in Italy between 1(st) January, 2012 and 31(st) October, 2014. The total number of femicides was 319; the average age of murdered women was 47.50 ± 19.26. Cold arms in the form of sharp object -mostly knives- have caused the death of 102/319 women; firearms were used in 87/319 cases; asphyxiation was the chosen method in 52/319 cases. About the place where the femicides occurred, 209/319 were committed inside the victim's house. Children of women who died a violent death were 417 with a total of 180 minors in less than three years. A total of 52/417 children were witness to the killing and, among these 30/52 were minors; in 18/417 cases, children were murdered together with their mother and among these 9/18 were minors. Long-term studies are needed to ascertain what happens to these children, to understand what are the most appropriate psychological treatments, the best decisions about the contact with their father and the best placement for these children.

AIM: School bullying is a proactive, intentional and repeated form of aggression. Approximately 20% of youths report being involved in bullying as perpetrators and/or victims. The purpose of this research was to investigate bullying prevalence in a sample of school Italian children in Rome. METHODS: A total of 721 children from 6th and 8th grades completed a self-report anonymous questionnaire adapted from the Revised Olweus Bully/Victim Questionnaire, including specific items to investigate about children bullying involvement at school. RESULTS: Prevalence of relational, physical and verbal bullying events resulted similar for 6th and 8th grades (5%, 3.6% and 3.9% versus 5.2%, 3% and 5.1% respectively). Boys compared to girls resulted more likely involved in bullying events, particularly in physical ones (4.9% versus 1.7%). The prevalence of both bullies and bully-victims was similar in boys and girls, regardless of age (53% and 47.4% among males versus 47% and 52.6% among females respectively). The 39.4% and 41.2% of students reported lack of intervention on victim’s behalf by teachers and schoolmates respectively. CONCLUSION: Data from our study support the importance of further education to provide effective prevention programming. Pediatricians can play an important role in detection of potential victims limiting long-term psychosomatic and psychosocial sequelae.