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Nella produzione di monofilamenti in polietilene ad alta densità (HDPE), le fasi di stiro e stabilizzazione sono realizzate da forni con elevati consumi di energia termica e bassa efficienza. L’ottimizzazione dei processi può avvenire solo se vi è un’approfondita conoscenza dei fenomeni di trasmissione del calore tra fili e fluido circostante (aria o acqua). I coefficienti di scambio termico dipendono dalla distanza di separazione tra i filamenti che attraversano il forno, come dalla temperatura e dalla velocità relativa tra fili e fluido; le variazioni di questi parametri, se ben gestite nell’ambito di precisi range, consentono di agire efficacemente sulle dimensioni del forno e quindi sui consumi di energia termica. Le simulazioni termofluidodinamiche condotte prendono in esame due particolari modelli commerciali di forno, uno ad acqua e l’altro ad aria. I risultati ottenuti evidenziano che una distanza di 2,5 mm tra i fili permette di massimizzare il coefficiente di scambio termico convettivo, pari a circa 5000 W/(m2 K) nel caso dell’acqua e a circa 470 W/(m2 K) per l’aria. La potenza necessaria a realizzare i processi è pari a circa 47 kW nel caso della vasca ad acqua e di 17 kW in quello del forno ad aria. Si osserva, dunque, che, per i due modelli di forno esaminati, anche se le condizioni di scambio termico dell’acqua sono molto migliori rispetto all’aria, la possibilità di adottare temperature più elevate di quest’ultima permette una riduzione della potenza totale: il modello di forno ad aria è alimentabile con una potenza pari a circa il 36% di quella necessaria al modello di vasca ad acqua.

Sensibilità crescente alle tematiche di inquinamento ambientale e necessità di risparmiare energia e ricorrere alle fonti di energia rinnovabile rappresentano le motivazioni di fondo alla base della scelta della risorsa geotermica a media entalpia per la produzione di energia elettrica. Allo stato attuale, gli avanzamenti tecnologici consentono di sfruttare risorse prima non disponibili e di sviluppare impianti termoelettrici rispettosi dell’ambiente. Gli studi dei quali si rende conto in questo lavoro, evidenziano come il ciclo Kalina possa porsi come candidato di rilievo per la produzione di energia elettrica se accoppiato con risorse geotermiche a medio-bassa entalpia o se alimentato con cascami termici derivanti da processi industriali. L’impianto a ciclo Kalina KCS-34, di cui qui si effettua una descrizione e l’analisi termodinamica è modellato con il software di Cycle-Tempo 5.0, si alimenta con la risorsa geotermica e utilizza come fluido evolvente una miscela binaria di acqua ed ammoniaca. Il modello termodinamico, validato confrontando i risultati forniti dalla simulazione con i dati di esercizio dell’impianto di Husavik (Islanda) è tarato sulle condizioni ambientali della risorse geotermica italiana e consente di analizzare le performance dell’impianto al variare della portata e della temperatura del geofluido. Il rendimento di primo principio dell’impianto si attesta su percentuali variabili dal 7% al 12% quantificando in numeri significativi i vantaggi energetici ottenuti con il ricorso a fonti di energia termica a temperatura compresa tra 90 e 150 °C.

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage ≥3 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening.

Background Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR 30% from baseline was evaluated. Results The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening. Electronic supplementary material The online version of this article (10.1186/s12882-018-1136-6) contains supplementary material, which is available to authorized users.

By two-three months, infants show active social expressions during face-to-face interactions. These interactions are important, as they provide the foundation for later emotional regulation and cognition, but little is known about how infant social expressiveness develops. We considered two different accounts. One emphasizes the contingency of parental responsiveness, regardless of its form; the other, the functional architecture account, emphasizes the preparedness of both infants and parents to respond in specific ways to particular forms of behaviour in their partner. We videotaped mother-infant interactions from one to nine weeks, and analysed them with a micro-analytic coding scheme. Infant social expressiveness increased through the nine-week period, particularly after 3 weeks. This development was unrelated to the extent of maternal contingent responsiveness, even to infant social expressions. By contrast, specific forms of response that mothers used preferentially for infant social expressions - mirroring, marking with a smile- predicted the increase in these infant behaviours over time. These results support a functional architecture account of the perceptual and behavioural predispositions of infants and parents that allows young infants to capitalize on relatively limited exposure to specific parental behaviours, in order to develop important social capacities.

Anxious mothers' parenting, particularly transfer of threat information, has been considered important in their children's risk for social anxiety disorder (SAnxD), and maternal narratives concerning potential social threat could elucidate this contribution. Maternal narratives to their preschool 4- to 5-year-old children, via a picture book about starting school, were assessed in socially anxious (N = 73), and nonanxious (N = 63) mothers. Child representations of school were assessed via doll play (DP). After one school term, mothers (Child Behavior Checklist [CBCL]) and teachers (Teacher Report Form) reported on child internalizing problems, and child SAnxD was assessed via maternal interview. Relations between these variables, infant behavioral inhibition, and attachment, were examined. Socially anxious mothers showed more negative (higher threat attribution) and less supportive (lower encouragement) narratives than controls, and their children's DP representations SAnxD and CBCL scores were more adverse. High narrative threat predicted child SAnxD; lower encouragement predicted negative child CBCL scores and, particularly for behaviorally inhibited children, Teacher Report Form scores and DP representations. In securely attached children, CBCL scores and risk for SAnxD were affected by maternal anxiety and threat attributions, respectively. Low encouragement mediated the effects of maternal anxiety on child DP representations and CBCL scores. Maternal narratives are affected by social anxiety and contribute to adverse child outcome.

Background: The ability to regulate emotions is a key developmental achievement acquired during social interactions and associated with better behavioral and social outcomes. We examined the influence of culture on child emotion regulation (ER) and aggression and on early parenting practices, and the role of parenting in child ER. Methods: We assessed 48 mother-infant dyads from three cultures (1 UK, 2 South African) at infant age of 3 months for maternal sensitivity during face-to-face interactions and responses to infant distress during daily life, and at 2 years for child ER strategies and maternally reported aggression. Results: There were cultural differences in child ER, and these were associated with differences in levels of aggression. Maternal strategies in response to early infant distress also differed by culture and predicted later child ER. Maternal sensitivity during face-to-face interactions was not associated with culture and showed no clear relationship with child ER. Conclusion: Cultural differences in maternal responses to infant distress mediated differences in child ER that are, in turn, related to differences in child Aggression.

Si è condotto un confronto sperimentale per la determinazione della potenza sonora di un deumidificatore per uso residenziale tra la tecnica tradizionale basata sul rilievo della pressione sonora e quella intensimetrica. I risultati evidenziano le possibilità di indagine offerte dall’una e dall’altra tecnica di misura sottolineando come tramite l’intensimetria acustica sia consentita la determinazione quantitativa di mappe superficiali dei livelli di potenza e di direttività della sorgente.

E’ stata condotta un’indagine acustica mediante tecnica intensimetrica pervenendo ad una caratterizzazione di dettaglio delle emissioni sonore prodotte da una unità per il condizionamento dell’aria. Nel rispetto della norma ISO 9614-2 è stato dapprima determinato il livello di potenza sonora complessivo della sorgente per poi eseguire una mappatura dei livelli di potenza sonora parziali sulla superficie di misura al fine di individuare le zone a maggior emissione di rumore e ridurre il disturbo acustico da essa prodotto nella configurazione di impianto. Sono stati, infine, elaborati campi vettoriali di direttività (mediante calcolo e caratterizzazione spaziale del vettore intensità acustica media) che descrivono le modalità di propagazione delle onde acustiche prodotte dalla macchina nello spazio circostante. Viene sottolineato come il dettaglio raggiunto da questo tipo di indagine consenta celermente ed efficientemente di proporre soluzioni efficaci per l’abbattimento delle emissioni sonore. La progettazione di sistemi di abbattimento ad hoc a partire dai risultati dell’analisi intensimetrica diviene mirata ed incisiva.

The basic purpose of the new Italian D.Lgs. 192/2005 and 311/2006 about energy efficient buildings is to adopt the necessary measures to respect commitments about environmental protection and primary energy resources savings, taken with the endorsement of the Kyoto Protocol. New approaches in residential and industrial air-conditioning systems can play a fundamental role to achieve these goals: the use of innovative heat pumps in buildings represent a good solution to this, due to their flexibility and to the higher efficiencies reached in last years. A comparative energy and exergy analysis has been carried out among the most promising solutions (such intercooled continuous load adjusting, two-stage condensation, cascade cycle systems) to investigate the real energy savings achieved.

The new scroll driven chiller provided with an inverter for continuous load adjusting has been analyzed in order to investigate effective efficiency curves in all of the interesting working conditions, both at full and partial loads. Many analytical and experimental models propose efficiency calculation methods that sometimes result hard to be applied in the design process. So, a new simplified design method has been proposed, based on a global efficiency decrease range field, to reach optimal energy savings and to catch proper information about real chiller performance.

The study aimed at exploring certain aspects of the development of children born from pregnancies affected by the Vanishing Twin Syndrome, a specific kind of early spontaneous pregnancy reduction. Specifically, the children’s motory activity and the parent-child relationship, with particular attention to parental perception, were investigated. The sample consisted of 53 children, aged between 1 and 11 years, encountered at the Centre for Sterility of the Arcispedale Santa Maria Nuova in Reggio Emilia. Through telephone interviews, information was gathered on the socioanagraphical data, the pregnancy, the development of the children and the quality of their school experiences. Furthermore, the motory scale of QUIT (Italian Questionnaires of Temperament, Axia, 2002) was administered, to measure the children’s motory activity along with the Vulnerable Child Scale (Forsyth et al., 1996) to measure parental perception of the children’s vulnerability. The data show that the ‘survived’ children have a significantly lower motory activity compared to the Italian population, they have a high incidence of scholastic initial problems, problems predominantly connected to separation from parents. The parents, moreover, show an extremely low perception of vulnerability in the ‘survived’ child, in contrast with literature, according to which a higher perception would be expected. This perception of ‘invulnerability’ in the ‘survived’ children, we hypothesize, could be a defence against the cumulative traumas of infertility and the co-twin’s death; associated to the difficulties in separation found within the parent-child relationship, it could favor an ambiguity which thwarts the development of independence, the processes of individuation and of learning.

La presente ricerca si pone l’obiettivo di studiare con maggiore attenzione alcuni aspetti psicologici della Vanishing Twin Syndrome, cioè della particolare situazione in cui una gravidanza inizialmente riconosciuta come gemellare (o comunque multipla) dà come esito finale un parto singolo (o comunque di ordine inferiore alla stima iniziale). Un dato interessante emerso dai risultati è la maggiore incidenza di problemi dello sviluppo nel gruppo di bambini tra i 7 e gli 11 anni (il gruppo di età maggiore tra quelli considerati). E’ stata inoltre rilevata un’associazione fra gli scarsi punteggi ottenuti alla Scala Motoria del QUIT e le difficoltà scolastiche dei bambini, ricavate dalla scheda anamnestica.

Mother-infant interactions, including culturally specific features, have been found to predict child socio-emotional development (e.g., social communication and emotion regulation (ER)). However, research is lacking on the specific processes involved. We used a cross-cultural, longitudinal design, and a microanalytic coding approach to address this issue. Fifty-two mother-infant dyads were recruited from the UK ( N = 21) and Italy ( N = 31), representing Northern European and Mediterranean cultures, respectively. While these cultures share core features of parent-child relationships, their values about emotional expressiveness differ. We observed face-to-face mother-infant interactions at 2 months (T1), and coded infant socio-emotional behavior and maternal responses. Children were seen again at 2 years (T2), when their ER in the face of frustration, using the Barrier Task, was assessed, and the occurrence of different “mature” strategies (communicative and autonomous) coded. Results revealed common features of interactions at T1 (infant socio-emotional expressions, and maternal positive responses), but also cultural variation in the frequency of different infant cues (more pre-speech in UK infants, more smiles in Italians), and of maternal responses to them. While greater overall maternal responsiveness at T1 predicted more mature ER in general at T2, cultural differences in early responsiveness to specific infant behaviors predicted later group differences in children’s use of particular ER strategies, with UK children using more communicative strategies, and Italians more autonomous. Findings indicate that positive maternal behaviors that are common across cultures (e.g., responsiveness) promote overall successful child emotion regulation, while culturally specific features of interactions are associated with how child socio-emotional outcomes are expressed.

Negative maternal affect (e.g., depression and anxiety) has been associated with shorter breastfeeding duration and poorer breastfeeding intention, initiation, and exclusivity. Other affective states, including guilt and shame, have been linked with formula feeding practice, though existing literature has yet to be synthesised. A narrative synthesis of quantitative data and a framework synthesis of qualitative and quantitative data were conducted to explore guilt and/or shame in relation to infant feeding outcomes. Searches were conducted on the DISCOVER database between December 2017 and March 2018. The search strategy was rerun in February 2020, together yielding 467 studies. The study selection process identified 20 articles, published between 1997 and 2017. Quantitative results demonstrated formula feeders experienced guilt more commonly than breastfeeding mothers. Formula feeders experienced external guilt most commonly associated with healthcare professionals, whereas breastfeeding mothers experienced guilt most commonly associated with peers and family. No quantitative literature examined shame in relation to infant feeding outcomes, warranting future research. The framework synthesis generated four distinct themes which explored guilt and/or shame in relation to infant feeding outcomes: ‘underprepared and ineffectively supported’, ‘morality and perceived judgement’ (breastfeeding), ‘frustration with infant feeding care’ and ‘failures, fears and forbidden practice’ (formula feeding). Both guilt and shame were associated with self‐perception as a bad mother and poorer maternal mental health. Guilt and shame experiences were qualitatively different in terms of sources and outcomes, dependent on infant feeding method. Suggestions for tailored care to minimise guilt and shame, while supporting breastfeeding, are provided.

A pilot randomized controlled trial (RCT) was conducted in El Salvador of an intervention ('Thula Sana') previously shown to enhance maternal sensitivity and infant security of attachment in a South African sample. In El Salvador, trained community workers delivered the intervention from late pregnancy to 6 months postpartum as part of a home-visiting programme. The sample comprised 64 pregnant adolescent women, aged 14-19 years, living in predominantly rural settings. They were randomised to receive either the intervention or normal care. Demographic information was collected at baseline and, immediately post-intervention, blind assessments were made of parental sensitivity and infant emotion regulation. The intervention was found to have a substantial positive impact on maternal sensitivity. Further, compared to control group, infants in the intervention group showed more regulated behaviour: in a social challenge task they showed more attempts to restore communication, and in a non-social challenge task they showed more social and goal-directed behaviour. This replication and extension of the South African findings in a small El Salvador sample shows promise and justifies the conduct of a large-scale RCT in a Central or South American context.Un ensayo piloto controlado al azar se llevó a cabo en El Salvador sobre una intervención (‘Thula Sana’) que previamente había mostrado en un grupo muestra sudafricano el mejoramiento de la sensibilidad materna y la seguridad de la afectividad del infante. En El Salvador, trabajadores entrenados de la comunidad llevaron la intervención como parte de un programa de visitas a casa a partir de la última etapa del embarazo hasta seis meses después del parto. El grupo muestra estuvo compuesto por 64 mujeres adolescentes embarazadas, de entre 14 y 19 años, que vivían en áreas predominantemente rurales. Ellas fueron asignadas al azar para recibir o la intervención o el cuidado normal. Al inicio, se recogió la información demográfica e, inmediatamente después de la intervención, se llevaron a cabo evaluaciones ciegas sobre la sensibilidad de la progenitora y la regulación de la emoción del infante. Se determinó que la intervención tenía un impacto positivo considerable sobre la sensibilidad materna. Es más, comparados con el grupo de control, los infantes en el grupo de intervención mostraron una conducta más regulada: en una tarea de reto social mostraron más intentos de restaurar la comunicación, y en una tarea que no era de reto social, mostraron una conducta más sociable y enfocada en el objetivo. La reproducción y extensión de los resultados sudafricanos en un pequeño grupo muestra en el Salvador es prometedora y justifica que se lleve a cabo un ensayo controlado al azar (RCT) a mayor escala dentro de un contexto centro o suramericano.The Impact of a Mother-Infant Intervention on Parenting and Infant Response to Challenge: a pilot randomized controlled trial with Adolescent Mothers in El Salvador Un essai randomisé contrôlé pilote a été fait au Salvador, d'une intervention (‘Thuna Sana’) dont on avait précédemment démontré dans un échantillon Sud-Africain qu'elle améliore la sensibilité maternelle et la sécurité de l'attachement du nourrisson. Au Salvador des agents communautaires formés ont fourni l'intervention de la fin de la grossesse à six mois postpartum, comme faisant partie d'un programme de visite à domicile. L’échantillon a consisté en 64 adolescentes enceintes, âgées de 14 à 19 ans, vivant principalement en milieux ruraux. Elles ont été randomisées afin de recevoir soit l'intention soit les soins normaux. Les renseignements démographiques ont été recueillis au début de l’étude et, immédiatement après l'intervention des évaluations aveugles ont été faites de la sensibilité parentale et de la régulation de l’émotion du bébé. Nous avons trouvé que l'intervention s'est avérée avoir un impact positif important sur la sensibilité maternelle. De plus, comparés au groupe contrôle, les nourrissons du groupe d'intervention ont fait preuve de plus de comportement régulé: lors d'une tâche de défi sociale ils ont fait preuve de plus de tentatives pour restaurer la communication et durant une tâche de défi non-social ils ont fait preuve d'un comportement plus social et plus orienté vers un but. Cette réplique et extension des résultats Sud-Africains dans un petit échantillon du Salvador est prometteur et justifier un essai randomisé contrôlé à large échelle dans un contexte Sud-Américain et en Amérique Centrale.Der Einfluss einer Mutter-Kind-Intervention auf Elternkompetenzen und die kindliche Reaktion auf Herausforderung: Eine randomisierte kontrollierte Pilotstudie mit jugendlichen Müttern in El Salvador In El Salvador wurde eine randomisierte kontrollierte Pilotstudie mit einer Intervention („Thula Sana“) durchgeführt, bei der zuvor an einer südafrikanischen Stichprobe gezeigt werden konnte, dass sie sowohl mütterliche Sensibilität als auch kindliche Bindungssicherheit verbessert. Geschulte Sozialarbeiter:innen führten die Intervention von der späten Schwangerschaft bis sechs Monate nach der Geburt im Rahmen eines Hausbesuchsprogramms durch. Die Stichprobe umfasste 64 schwangere, jugendliche Frauen im Alter von 14 bis 19 Jahren, die in überwiegend ländlichen Regionen lebten. Sie wurden randomisiert entweder der Interventionsgruppe oder einer Kontrollgruppe zugeteilt, die die übliche Betreuung erhielt. Zu Studienbeginn wurden demografische Daten gesammelt und unmittelbar nach der Intervention wurden verblindet Beurteilungen der elterlichen Sensibilität und der kindlichen Emotionsregulation vorgenommen. Es wurde festgestellt, dass die Intervention einen signifikanten positiven Einfluss auf die mütterliche Sensibilität hat. Im Vergleich zur Kontrollgruppe zeigten Säuglinge in der Interventionsgruppe ein stärker reguliertes Verhalten: Bei einer Aufgabe mit sozialer Herausforderung zeigten sie mehr Versuche, die Kommunikation wiederherzustellen, und bei einer Aufgabe mit einer nicht-sozialen Herausforderung zeigten sie mehr soziales und zielgerichtetes Verhalten. Diese Replikation und Erweiterung der südafrikanischen Ergebnisse in einer kleinen salvadorianischen Stichprobe sind vielversprechend und können die Grundlage für groß angelegten RCT`s in mittel- oder südamerikanischen Kontexten darstellen.母-子介入が養育と乳児の挑戦課題への反応に及ぼす影響:エルサルバドルの青年期の母親を対象にした予備的無作為化比較試験 すでに南アフリカの対象者に関して報告されている、母親の感受性と乳児の安定したアタッチメントを向上させるための介入“トゥラサナ”の予備的な無作為化比較試験がエルサルバドルで実施された。エルサルバドルでは、訓練を受けた自治体の職員が家庭訪問プログラムの一環として、妊娠後期から産後6か月まで介入を提供した。対象者は、主に農村部に住む14〜19歳の青年期の妊婦64名であった。対象者は、この介入もしくは通常のケアのいずれかを受けるように無作為に振分けられた。ベースラインとして人口統計学的情報が収集され、介入直後に、養育の感受性と乳児の感情調整について盲検評価が行われた。この介入は、母親の感受性に実質的な正の影響を与えることがわかった。さらに、介入群の乳児は対照群と比較して、より調整された行動を示した。すなわち、社会的挑戦課題ではコミュニケーションを回復するためにより多くの試みを示し、非社会的挑戦課題において、より社会的で目標志向的な行動を示した。エルサルバドルの小規模サンプルにおいて南アフリカでの実施知見の再現と拡張が見られたことは、中南米の状況における大規模なRCT (無作為化比較試験) の実施に見込みと正当性があることを示している。.在萨尔瓦多进行了一项试验性的随机对照试验, 对先前在南非样本中开展的一种干预措施 (“Thula Sana”) 进行了研究, 以提高孕产妇依恋的敏感性和婴儿依恋的安全性。在萨尔瓦多, 作为家访计划的一部分, 经过培训的社区工作人员, 对孕产妇从妊娠晚期到产后六个月开展了干预措施。样本包括64名怀孕的青少年妇女, 年龄在14至19岁之间, 主要生活在农村地区。他们被随机分配为接受干预组或常规护理组。试验开始时收集了人口统计信息, 并在干预后立即对育儿敏感性和婴儿情绪调节进行盲测。研究发现, 这项干预措施对孕产妇的敏感性有很大的积极影响。此外, 与对照组相比, 干预组的婴儿表现出更为规范的行为:在社交挑战任务中, 他们表现出更多恢复沟通的尝试;在非社交挑战任务中, 他们表现出更多的社交和目标导向行为。在萨尔瓦多的一个小样本中复制和扩展了南非的研究结果, 这预示着试验的成功, 并证明了在中美洲或南美洲进行大规模RCT的合理性。.تأثير تدخل تجريبي مع ثنائيات الأم والطفل على عملية الرعاية الوالدية واستجابة الرضع للتحدي: تجربة استطلاعية معشاة ذات شواهد مع الأمهات المراهقات في السلفادور أجريت تجربة استطلاعية معشاة ذات شواهد في السلفادور على التدخل التجريبي (Thula Sana) الذي سبق أن أظهر تأثيراً على عينة جنوب أفريقيا من حيث تعزيز حساسية الأمهات وأمان التعلق لدى الرضع. وفي السلفادور، قام العاملون المجتمعيون المدربون بالتدخل من مرحلة الحمل المتأخر إلى فترة ما بعد الولادة لمدة ستة أشهر كجزء من برنامج الزيارات المنزلية. واشتملت العينة على 64 من المراهقات الحوامل، اللاتي تتراوح أعمارهن بين 14 و 19 سنة، ويعشن في بيئات ريفية في الغالب. وتم توزيع العينة عشوائياً إلى مجموعة تجريبية تتلقى التدخل أو مجموعة ضابطة تتلقى الرعاية العادية. وتم جمع المعلومات الديمغرافية عند نقطة البداية، وأجريت، بعد التدخل مباشرة، تقييمات عمياء لحساسية الوالدين وتنظيم المشاعر عند الرضع. وتبين أن هذا التدخل له أثر إيجابي كبير على حساسية الأمهات. وعلاوة على ذلك، وبالمقارنة مع المجموعة الضابطة، أظهر الرضع في مجموعة التدخل سلوكاً أكثر تنظيماً: ففي مهمة التحدي الاجتماعي أظهروا المزيد من المحاولات لاستعادة التواصل، وفي مهمة التحدي غير الاجتماعي أظهروا سلوكاً اجتماعياً وموجهاً نحو الأهداف. وهذا التكرار والامتداد لنتائج جنوب أفريقيا في عينة صغيرة من السلفادور يدعم إجراء تجارب على نطاق واسع في مجتمعات أمريكا الوسطى أو الجنوبية.

This study evaluated the impact of a parenting intervention on children’s cognitive and socioemotional development in a group of caregivers and their 21-to-28-month-old children in a low-income South African township. A randomized controlled trial compared an experimental group (n=70) receiving training in dialogic book-sharing (8weekly group sessions) with a wait-list control group (n=70). They were assessed before the intervention, immediately following it, and at a six month follow-up. The intervention had positive effects on child language and attention, but not behavior problems, prosocial behavior, or theory of mind. Intervention caregivers were less verbally and psychologically harsh, showed more sensitivity and reciprocity and more complex cognitive talk. This program benefitted parenting and child development and holds promise for low-income contexts.

The meaning, mechanism, and function of imitation in early infancy have been actively discussed since Meltzoff and Moore's (1977) report of facial and manual imitation by human neonates. Oostenbroek et al. (2016) claim to challenge the existence of early imitation and to counter all interpretations so far offered. Such claims, if true, would have implications for theories of social-cognitive development. Here we identify 11 flaws in Oostenbroek et al.'s experimental design that biased the results toward null effects. We requested and obtained the authors' raw data. Contrary to the authors' conclusions, new analyses reveal significant tongue-protrusion imitation at all four ages tested (1, 3, 6, and 9 weeks old). We explain how the authors missed this pattern and offer five recommendations for designing future experiments. Infant imitation raises fundamental issues about action representation, social learning, and brain-behavior relations. The debate about the origins and development of imitation reflects its importance to theories of developmental science.

It is estimated that postpartum depression affects up to 25% of men. Despite such high prevalence, the majority of studies on postpartum depression are focused on mothers, and the role of paternal depression and its effects on infant development have been overlooked by researchers and clinicians. The present study aimed to fill this gap by investigating the effect of paternal postpartum depression on father-infant interactions. In addition, we examined whether differences in face recognition mediated the effects of paternal postpartum depression on father-infant interactions. A total of 61 father-infant dyads (17 postpartum depression, 44 controls) took part in the study. Results revealed that compared to controls, fathers with postpartum depression had a worse pattern of interaction with their infants on measures of responsiveness, mood, and sensitivity; they also had greater difficulty in recognizing happy adult faces, but greater facility in recognizing sad adult faces. Depressed fathers attributed greater intensities to sad adult and infant faces. The tendency to attribute greater intensity to sad adult faces was confirmed as a partial mediator of the effect of paternal postpartum depression on measures of father responsiveness and as a full mediator of the effects of paternal depression on father sensitivity. Clinical implications and suggestions for further studies are discussed.Se estima que la depresión posterior al parto afecta hasta un 25% de los hombres. A pesar de tan alta prevalencia, la mayoría de los estudios sobre la depresión posterior al parto se enfocan en las madres, y los investigadores y clínicos han pasado por alto el papel de la depresión paterna y sus efectos en el desarrollo del infante. El presente estudio se propuso llenar ese vacío investigando el efecto que la depresión paterna posterior al parto tiene en las interacciones papá-infante. Adicionalmente, examinamos si las diferencias en reconocer las caras mediaron los efectos que la depresión paterna posterior al parto tiene en las interacciones papá-infante. Sesenta y una díadas papá-infante (17 en el grupo de depresión posterior al parto, 44 en el grupo de control) participaron en el estudio. Los resultados revelaron que, comparados con el grupo de control, los papás con depresión posterior al parto presentaban un peor patrón de interacción con sus infantes en medidas de capacidad de respuesta, estado de ánimo y sensibilidad; ellos también tuvieron mayores dificultades en reconocer caras adultas felices, pero con mayor facilidad reconocieron caras adultas tristes. Los padres deprimidos atribuyeron una mayor intensidad a las caras tristes de adultos e infantes. Se confirmó la tendencia de atribuir una mayor intensidad a las caras adultas tristes como un mediador parcial del efecto que la depresión paterna posterior al parto tiene sobre la calidad de respuesta del papá y como un completo mediador de los efectos que la depresión paterna tiene sobre la sensibilidad del papá. Se discuten las implicaciones y sugerencias clínicas para futuros estudios.On estime que la dépression postpartum affect jusqu’à 25% des hommes. En dépit d'une telle prévalence élevée la majorité des études sur la dépression postpartum porte sur les mères et le rôle de la dépression paternelle et de ses effets sur le développement du nourrisson a été négligé par les chercheurs et les cliniciens. Cette étude s'est donné pour but de remplir ce fossé en recherchant l'effet de la dépression postpartum sur les interactions père-nourrisson. De plus, nous avons examiné si les différences dans la reconnaissance faciale ont assuré la médiation des effets de la dépression paternelle postpartum sur les interactions père-nourrisson. 61 dyades père-bébé (17 dépression postpartum, 44 contrôles) ont pris part à l’étude. Les résultats ont révélé que, comparés aux contrôles, les pères avec la dépression postpartum faisaient état d'un pattern d'interaction avec leur bébé pire sur les mesures de réactivité, d'humeur et de sensibilité. Ils avaient aussi plus de difficulté à reconnaître les visages adultes heureux mais une plus grande facilité à reconnaître les visages adultes tristes. Les pères déprimés ont attribué de plus grandes intensités aux visages tristes de l'adulte et du bébé. La tendance à attribuer une plus grande intensité aux visages tristes de l'adulte a été confirmée comme un médiateur partiel de l'effet de la dépression paternelle postpartum sur la réaction du père et comme un médiateur total sur les effets de la dépression paternelle sur la sensibilité du père. Les implications cliniques et des suggestions de recherche sont discutées.Es wird geschätzt, dass bis zu 25% der Männer von einer postpartalen Depression betroffen sind. Trotz dieser hohen Prävalenz konzentriert sich die Mehrheit der Studien über postpartale Depression auf Mütter, und die Rolle der väterlichen Depression und ihre Auswirkungen auf die Säuglingsentwicklung wurden von Forschern und Klinikern übersehen. Die vorliegende Studie zielte darauf ab, diese Lücke zu schließen, indem sie die Auswirkungen der väterlichen postpartalen Depression auf die Interaktion zwischen Vater und Säugling untersucht. Zusätzlich untersuchten wir, ob Unterschiede in der Gesichtserkennung die Auswirkungen der väterlichen postpartalen Depression auf die Interaktion zwischen Vater und Säugling mediierten. 61 Vater-Säuglings-Dyaden (17 mit postpartaler Depression, 44 Kontrollen) nahmen an der Studie teil. Die Ergebnisse zeigten, dass Väter mit postpartaler Depression im Vergleich zur Kontrollgruppe ein schlechteres Interaktionsmuster mit ihren Säuglingen in Bezug auf die Responsivität, Stimmung und Sensitivität hatten; sie hatten auch größere Schwierigkeiten bei der Erkennung glücklicher Gesichter von Erwachsenen, während ihnen die Erkennung trauriger Gesichter von Erwachsenen leichter fiel. Depressive Väter schrieben traurigen Gesichtern von Erwachsenen und Säuglingen größere Intensitäten zu. Die Tendenz, traurigen Gesichtern von Erwachsenen eine größere Intensität zuzuschreiben, wurde als partieller Mediator der Auswirkungen der väterlichen postpartalen Depression auf die Responsivität des Vaters und als vollständiger Mediator der Auswirkungen der väterlichen Depression auf die Sensitivität des Vaters bestätigt. Klinische Implikationen und Vorschläge für weitere Studien werden diskutiert.男性の産後うつ病の父親-乳児相互作用への影響:顔認識の仲立ちする役割 産後うつ病は男性の最大25%に影響を及ぼす疾患と推定されている。男性の産後うつ病はこのように有病率が高いにもかかわらず、大半の研究は母親に焦点が当てられている。そのため男性のうつ病の役割とそれが乳児の発達に及ぼす影響は、研究者や臨床家に見過ごされてきた。本研究は、父親-乳児相互作用に対して父親の産後うつ病が及ぼす影響を調査しこの格差を埋めることを目的としている。それに加えて、私たちは顔認識の違いが父親-乳児相互作用に対する父親の産後うつ病の影響を仲立ちするかどうかについて検討した。父親と乳児の61組(産後うつ病群17、対象群44)が研究に参加した。結果は、対象群に比べ、産後うつ病の父親は、反応性、気分および感受性尺度において、乳児との相互作用のパターンが劣悪であった。さらに楽しい大人の顔を認識することは極めて困難であるが、悲しい大人の顔を認識することは極めて容易であった。うつ病の父親は悲しい大人と乳児の顔に極めて強い感度を示した。悲しい大人の顔に極めて強い感度を示す傾向は、父親の産後うつ病が父親の反応性に部分的な仲立ち、また父親の感受性に全面的な仲立ちとして影響していることが確認された。臨床的意義と今後の研究への示唆について考察した。.男性產後抑鬱對父嬰互動的影響:面部訊息處理的中介作用 據估計, 產後抑鬱症影響高達25％的男性。儘管如此普遍, 大多數關於產後抑鬱症的研究都集中在母親身上, 研究人員和臨床醫生忽視了父系抑鬱症的作用及其對嬰兒發育的影響。本研究旨在通過調查父親產後抑鬱對父嬰互動的影響來填補這一空白。此外, 我們檢查了面部識別的差異是否介導了父親產後抑鬱對父嬰互動的影響。 61個父嬰組合 (產後抑鬱症17個, 對照組44個) 參加這項研究。結果顯示, 與對照組相比, 產後抑鬱症的父親在測量反應性丶情緒和敏感度方面與嬰兒的互動模式較差;他們在識別快樂的成人面孔方面也有較大的困難, 但在識別悲傷的成人面孔方面表現較好。抑鬱的父親對悲傷的成人和嬰兒臉孔反應較強。較大強化悲傷成人面孔的傾向, 被確認為父親產後抑鬱對父親反應影響的部分中介, 並且是父親抑鬱對父親敏感性影響的完全中介變數。作者討論研究結果的臨床意義和對進一步研究的建議。.الاكتئاب بعد الولادة عند الرجال وآثاره علي التفاعل بين الأب والرضيع: الدور الوسيط للتعرف على الوجه تشير التقديرات إلى ان الاكتئاب بعد الولادة يؤثر علي ما يصل إلى 25 ٪ من الرجال. وعلي الرغم من هذا الانتشار المرتفع ، تركز معظم الدراسات المتعلقة باكتئاب ما بعد الولادة علي الأمهات ، وقد أغفل الباحثون والأطباء دور الاكتئاب الأبوي وأثاره علي نمو الرضع. تهدف الدراسة الحالية إلى سد هذه الفجوة عن طريق التحقيق في تاثير الاكتئاب الأبوي بعد الولادة علي تفاعلات الأب والرضيع. بالاضافه إلى ذلك ، درسنا ما إذا كانت الاختلافات في التعرف علي الوجوه توسطت آثار الاكتئاب الأبوي بعد الولادة علي تفاعلات الأب والرضيع. اشتملت عينة الدراسة على 61 من ثنائيات الأباء والرضع (17 من حالات الاكتئاب بعد الولادة ، 44 كمجموعة ضابطة). وكشفت النتائج انه ، مقارنه بالمجموعة الضابطة ، كان لدي الاباء المصابين باكتئاب ما بعد الولادة نمطا اسوأ من التفاعل مع أطفالهم الرضع على مقاييس الاستجابة والمزاج والحساسية ؛ كما كان لديهم أيضا صعوبة أكبر في التعرف على وجوه البالغين السعيدة ، ولكن سهولة أكثر في التعرف على وجوه الكبار الحزينة. وأبدى الاباء المكتئبون تركيزاً أكبر على وجوه البالغين والرضع الحزينة. وأكد الميل إلى التركيز الأكبرعلى وجوه البالغين الحزينه على وجود تأثير وسيط جزئي لاكتئاب الآباء بعد الولادة علي استجابه الأب وكوسيط كلي لآثار الاكتئاب الأبوي علي حساسية الأب. وتناقش الدراسة التطبيقات الإكلينيكية والاقتراحات لمزيد من الدراسات.

The meaning, mechanism, and function of imitation in early infancy have been actively discussed since Meltzoff and Moore's (1977) report of facial and manual imitation by human neonates. Oostenbroek etal. (2016) claim to challenge the existence of early imitation and to counter all interpretations so far offered. Such claims, if true, would have implications for theories of social-cognitive development. Here we identify 11 flaws in Oostenbroek etal.'s experimental design that biased the results toward null effects. We requested and obtained the authors’ raw data. Contrary to the authors’ conclusions, new analyses reveal significant tongue-protrusion imitation at all four ages tested (1, 3, 6, and 9 weeks old). We explain how the authors missed this pattern and offer five recommendations for designing future experiments. Infant imitation raises fundamental issues about action representation, social learning, and brain–behavior relations. The debate about the origins and development of imitation reflects its importance to theories of developmental science.

Parent-infant social interactions start early in development, with infants showing active communicative expressions by just two months. A key question is how this social capacity develops. Maternal mirroring of infant expressions is considered an important, intuitive, parenting response, but evidence is sparse in the first two months concerning the conditions under which mirroring occurs and its developmental sequelae, including in clinical samples where the infant’s social expressiveness may be affected. We investigated these questions by comparing the development of mother-infant interactions between a sample where the infant had cleft lip and a normal, unaffected, comparison sample. We videotaped dyads in their homes five times from one to ten weeks and used a microanalytic coding scheme for maternal and infant behaviours, including infant social expressions, and maternal mirroring and marking responses. We also recorded maternal gaze to the infant, using eye-tracking glasses. Although infants with cleft lip did show communicative behaviours, the rate of their development was slower than in comparison infants. This group difference was mediated by a lower rate of mirroring of infant expressions by mothers of infants with cleft lip; this effect was, in turn, partly accounted for by reduced gaze to the infant’s mouth, although the clarity of infant social expressions (indexed by cleft severity) and maternal self-blame regarding the cleft were also influential. Results indicate the robustness of parent-infant interactions but also their sensitivity to specific variations in interactants’ appearance and behaviour. Parental mirroring appears critical in infant social development, likely supported by the mirror neuron system and underlying clinical and, possibly, cultural differences in infant behaviour. These findings suggest new avenues for clinical intervention.

BackgroundAdult gaze plays an important role in early infant development, and infants are highly sensitive to its presence and direction. Little is known, however, about how adults look at infants while interacting with them. Using eye-tracking technology, this study investigated maternal gaze during naturalistic interactions, and how it was influenced by infant age, focusing on the transition from the first to the second month when social expressiveness emerges, and by infant facial configuration, focusing on the effect of cleft lip. BackgroundThirty infants (10 with a cleft lip), and their mothers, were seen at 1, 3, 5, 7, and 9 weeks. Mothers were asked to interact with their infants while wearing eye-tracking glasses. Fixation duration and count were calculated for general (infant face, body, and surrounding environment), and infant facial (eyes, mouth, other) areas. BackgroundAt all ages, mothers gazed almost exclusively towards their infant's face, but this was reduced in the presence of a cleft lip. Within the infant's face, the eyes attracted the greatest attention, for all mothers, at all ages. From the first to the second month, all mothers increased their visual attention towards their infant's mouth. Regardless of infant age, the presence of a cleft lip was associated with decreased maternal gaze to the infant's mouth. BackgroundThis study provides novel findings concerning maternal gaze to infant faces during naturalistic interactions. Maternal gaze changes with infant age, in line with established shifts in social development, and according to infant facial configuration. Decreased gaze to the mouth area associated with infant cleft lip might affect maternal responsiveness, and suggests new dimensions to target in supporting these mothers.

In order to evaluate the influence of the texture characteristics of agricultural nets on the air flow passing through, a micro wind tunnel was built in the “Testing and Engineering Laboratory” at the Sachim SRL, an Italian HDPE technical textiles manufacturer. The wind tunnel allowed setting up the inclination of the net samples inside with respect to the air flow (90° perpendicular, 60°, 45°, 30°). First results in terms of coefficient of discharge of 4 flat woven round monofilament HDPE nets are reported in this paper. The net response to the air flow was based on the discharge coefficient approach based on BernoulliRSQUOs theory. Results confirmed the parabolic dependence of the pressure drop on the square of the velocity and on the porosity by means of the parameter (1-ε2)/ε2. Concerning the influence of inclination of the net on loss coefficient, a correlation with sen2θ was found, described by an exponential regression curve depending on the porosity of the net.

Three arguments are advanced from human and nonhuman primate infancy research for the exaptation of ingestive mouth movements (tongue protrusion and lip smacking) for the purposes of social communication: their relation to affiliative behaviours, their sensitivity to social context, and their role in social development. Although these behaviours may have an aerodigestive function, such an account of their occurrence is only partial.

Background: Consistent with evidence from high-income countries (HICs), we previously showed that, in an informal peri-urban settlement in a low-middle income country, training parents in book sharing with their infants benefitted infant language and attention (Vally, Murray, Tomlinson, & Cooper,). Here, we investigated whether these benefits were explained by improvements in carer–infant interactions in both book-sharing and non-book-sharing contexts. We also explored whether infant socioemotional development benefitted from book sharing. Methods: We conducted a randomized controlled trial in Khayelitsha, South Africa. Carers of 14–16-month-old infants were randomized to 8weeks’ training in book sharing (n=49) or a wait-list control group (n=42). In addition to the cognitive measures reported previously, independent assessments were made at base line and follow-up of carer–infant interactions during book sharing and toy play. Assessments were also made, at follow-up only, of infant prosocial behaviour in a ‘help task’, and of infant imitation of doll characters’ nonsocial actions and an interpersonal interaction. Eighty-two carer–infant pairs (90%) were assessed at follow-up. (Trial registration ISRCTN39953901). Results: Carers who received the training showed significant improvements in book-sharing interactions (sensitivity, elaborations, reciprocity), and, to a smaller extent, in toy-play interactions (sensitivity). Infants in the intervention group showed a significantly higher rate of prosocial behaviour, and tended to show more frequent imitation of the interpersonal interaction. Improvements in carer behaviour during book sharing, but not during toy play, mediated intervention effects on all infant cognitive outcomes, and tended to mediate intervention effects on infant interpersonal imitation. Conclusions: Training in book sharing, a simple, inexpensive intervention that has been shown to benefit infant cognitive development in a low-middle income country, also shows promise for improving infant socioemotional outcomes in this context. Benefits are mediated by improvements in carer–infant interactions, particularly in book-sharing contexts.

Objective To evaluate the psychosocial support perceived by couples during assisted reproductive technology (ART) treatments. Design Prospective follow-up of patients undergoing ART. Setting Department of Obstetrics and Gynecology, S. Maria Nuova Hospital, Reggio Emilia, Italy. Patient(s) Eighty-three women and 83 men admitted for ART. Intervention(s) Patients completed a sociodemographic questionnaire and the Multidimensional Scale of Perceived Social Support at the beginning of ovarian stimulation, upon oocyte pick-up, and 1 month after ET. Main Outcome Measure(s) Perception of psychosocial support. Result(s) Men, compared with women, consistently reported poorer perception of psychosocial support, especially from friends and significant others; family support showed no difference. Women showed a decrease in perceived support, especially from friends, in cases of failure. Both reported less support from significant others if they had previously already undergone ART treatments. Conclusion(s) Men might feel excluded from the treatment because of the greater attention to women, leading to feelings of isolation from friends and partners. Women suffer particularly in cases of failure that reconfirms the trauma of infertility. These psychological risk factors underline the usefulness of psychological support for these couples, especially in cases of prolonged infertility.

We test the hypothesis that parents who conceived twins by assisted reproduction technology (ART), but experienced loss of one twin, have a different parental–child relationship compared with ART parents following a singleton pregnancy. We used the 1994–2005 ART database of the Centre for Infertility of the Arcispedale Santa Maria Nuova in Reggio Emilia, Italy to identify families of 53 singleton births after the ‘vanishing’ twin syndrome. The controls comprised 106 families who conceived and delivered singletons, matched for gestational age (≥ 28 ≤ 31, ≥ 32 ≤ 36, ≥ 37 weeks), maternal age (< 35, ≥ 35 ≤ 40, > 40 years), child's age (1–3, 4–6, and 7–11 years) and child's gender. We completed 3 tests: a sociodemographic questionnaire, the QUIT — Italian Questionnaires of Temperament — motor scale, and the Child Vulnerability Scale. We found that children in the study had significantly more difficulties at the beginning of nursery school (p= .002) and kindergarten (p= .0005), with more frequent anxiety of separation from the parents (nursery school,p= .009; kindergarten,p= .001). We found a lower mean QUIT motor score for the 7- to 11-year-old children when compared to the general Italian normative values, suggesting that parents perceived their children as having more motor difficulties. In contrast, analysis of the Child Vulnerability Scale showed that significantly more parents (15.1%) from the controls perceived their child as vulnerable compared to those from the study group (3.8%),p= .034. We conclude that despite the perceived motor difficulties and the difficulties in the process of individuation–separation that appear at the beginning of the different educational circumstances, parents of singletons following the ‘vanishing’ twin syndrome perceive their children as ‘invincible’, and thus less vulnerable compared to controls.

Background: The ability to regulate emotions is a key developmental achievement acquired during social interactions and associated with better behavioral and social outcomes. We examined the influence of culture on child emotion regulation (ER) and aggression and on early parenting practices, and the role of parenting in child ER. Methods: We assessed 48 mother-infant dyads from three cultures (1 UK, 2 South African) at infant age of 3 months for maternal sensitivity during face-to-face interactions and responses to infant distress during daily life, and at 2 years for child ER strategies and maternally reported aggression. Results: There were cultural differences in child ER, and these were associated with differences in levels of aggression. Maternal strategies in response to early infant distress also differed by culture and predicted later child ER. Maternal sensitivity during face-to-face interactions was not associated with culture and showed no clear relationship with child ER. Conclusion: Cultural differences in maternal responses to infant distress mediated differences in child ER that are, in turn, related to differences in child aggression.

This study explored the influence of both assisted reproductive technology (ART) and reduced quality of life (QoL) during pregnancy on postpartum blues (PPB). Sixty-three sub-fertile patients who conceived through ART and 72 women who naturally conceived were enrolled in this prospective study. At 22nd and 32nd gestational weeks, women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Short-Form 36 (SF-36), to investigate depressive symptoms and QoL, respectively; EPDS was again used at 15 days after birth to assess PPB. At both time points, higher EPDS scores and lower mental well-being scores (SF-36) significantly predicted PPB. The number of previous ART cycles emerged as the strongest predictor, whereas no significant effect was observed for the conceiving method. The results suggest the usefulness of assessing QoL during pregnancy and considering previous ART failures in preventing PPB.

AimThe purpose of the study was to investigate whether an intervention which focused on enhancing the quality of the mother-infant relationship would prevent the development of postnatal depression (PND) and the associated impairments in parenting and adverse effects on child development.BackgroundRecent meta-analyses indicate modest preventive effects of psychological treatments for women vulnerable to the development of PND. However, given the strong evidence for an impact of PND on the quality of the mother–infant relationship and child development, it is notable that there are limited data on the impact of preventive interventions on these outcomes. This is clearly a question that requires research attention. Accordingly, a randomised controlled trial (RCT) was conducted of such a preventive intervention.MethodsA large sample of pregnant women was screened to identify those at risk of PND. In an RCT 91 were randomly assigned to receive the index intervention from research health visitors, and 99 were assigned to a control group who received normal care. In an adjacent area 76 women at risk of PND received the index intervention from trained National Health Service (NHS) health visitors. The index intervention involved 11 home visits, two antenatally and nine postnatally. They were supportive in nature, with specific measures to enhance maternal sensitivity to infant communicative signals, including items from the Neonatal Behavioral Assessment Scale. Independent assessments were made at 8 weeks, 18 weeks, and 12 and 18 months postpartum. Assessments were made of maternal mood, maternal sensitivity in mother–infant engagement, and infant behaviour problems, attachment and cognition.FindingsThe RCT revealed that the index intervention had no impact on maternal mood, the quality of the maternal parenting behaviours, or infant outcome, although there were suggestions, on some self-report measures, that those with a lower level of antenatal risk experienced benefit. This was also the case for the intervention delivered by trained NHS health visitors. The findings indicate that the approach investigated to preventing PND and its associated problems cannot be recommended.

As induction of pediatric anesthesia can elicit anxiety in children and parents alike, this study was aimed at evaluating the effectiveness of clown intervention in decreasing maternal anxiety and stress in the preoperative phase. Before anesthesia induction, 25 children were randomly assigned to clown intervention and 25 to a control group with a routine procedure. In the waiting room and after separation from the child, maternal anxiety and stress were measured. The results showed that after separation, only in the clown group, maternal state anxiety significantly decreased and the tendency to somatization did not increase. Moreover, after clown intervention, older children’s mothers significantly reduced the level of perceived stress. As clown intervention can positively influence maternal anxiety and stress in the preoperative period, its promotion in clinical–hospital environments is recommended.

Background Parenting factors have been implicated in the aetiology and maintenance of child anxiety. Most research has been correlational with little experimental or longitudinal work. Cross-cultural comparison could be illuminating. A comparison of Italian and British children and their mothers was conducted. Methods A sample of 8- to 10-year old children, 60 Italian and 49 English, completed the Spence Child Anxiety Scale. Mothers also completed two questionnaires of parenting: the Skills of Daily Living Checklist (assessing maternal autonomy granting) and the Parent-Child Interaction Questionnaire (assessing maternal intrusiveness). Parenting was assessed in two video-recorded blindly rated mother-child interaction tasks, the 'belt-buckling tasks and the 'etch-a-sketch', providing objective indices of overcontrol, warmth, lack of autonomy granting, and overprotection. Results There were no differences between the children in overall anxiety and specific forms of anxiety. Parenting, however, was markedly different for the two countries. Compared to English mothers, on the two questionnaires, Italian mothers were significantly less autonomy granting and more intrusive; and in terms of the observed indices, a significantly greater proportion of the Italian mothers displayed a high level of both overprotection and overcontrol, and a low level of autonomy granting. Notably, Italian mothers evidenced significantly more warmth than English mothers; and maternal warmth was found to moderate the impact of self-reported maternal intrusiveness on the level of both overall child anxiety and the level of child separation anxiety; and it also moderated the relationship between both observed maternal intrusiveness and overall child anxiety and observed maternal overprotectiveness and child separation anxiety. Conclusions Although, compared to the British mothers, the Italian mothers were more likely to evidence high levels of parenting behaviours previously found to be anxiogenic, the high levels of warmth displayed by these mothers to their children appears to have neutralised the adverse impact of these behaviours. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

Background The assessment of the embryo quality is crucial to maintain an high pregnancy rate and to reduce the risk of multiple pregnancy. The evaluation of the pronuclear and nucleolar characteristics of human zygote have been proposed as an indicator of embryo development and chromosomal complement. The aim of the current study was to assess the role of pronuclear morphology evaluation in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) cycles. Methods Retrospective clinical analysis on 755 non-elective transfers of only one embryo (ET). Embryo assessment was performed in days 1 and 2. Clinical and biological data were recorded and analyzed according to embryo and/or pronuclear morphology. Results Both pronuclear and embryo morphology were significantly related to clinical pregnancy and live-birth rates. No significant difference in clinical pregnancy and live-birth rates was detected when the pronuclear and embryo morphology assessments were combined. Embryo morphology and maternal age were the only independent predictors of favorable outcome by logistic regression analysis. Conclusions Pronuclear evaluation is effective to select the best zygotes if ET is performed at day 1, whereas it did not improve the clinical outcomes when combined with embryo morphology evaluation in day 2.

Objective To compare the levels of and changes in quality of life (QoL) during pregnancy between couples who conceived spontaneously and couples who underwent successful treatment by assisted reproductive technology (ART). Methods In a survey at the Santa Maria Nuova Hospital, Reggio Emilia, Italy, between September 11, 2009, and May 25, 2011, 230 individuals (57 ART couples and 58 couples who conceived spontaneously) completed Short-Form 36 on QoL at 22 and 32 gestational weeks. Results Compared with men, women had lower scores in most dimensions of QoL regardless of the method of conception; women also showed a decrease in physical and social QoL during pregnancy that was not evident among men. Compared with non-ART couples, ART couples had lower physical (especially women) and social QoL; ART couples also showed a decrease in social QoL from the second to the third trimester that was not observed among non-ART couples. Conclusion The results underline the higher burden that pregnancy represents for women on a physical and social level. ART treatment seems to increase the negative impact of pregnancy on QoL in the couple as a whole; early support in adjusting to the realities and demands of pregnancy might prove beneficial for these future parents.

Introduzione. La letteratura evidenzia che i bambini nati di età gestazionale estremamente bassa (ELGA ≤ 28 settimane), presentano maggiori probabilità di incorrere in ritardi evolutivi e disturbi relazionali. Nell’ambito del Progetto Strategico sui rischi associati alla nascita gravemente pretermine, la presente indagine fornisce i dati preliminari inerenti lo stress genitoriale e i vissuti materni rispetto allo sviluppo del proprio bambino. Metodo. Il campione include 19 madri, di cui 8 di nati pretermine ELGA, senza danni motori/neurologici permanenti. A 12 e 18 mesi del bambino (corretti per i nati ELGA) le madri hanno compilato il Parenting Stress Index, inerente il livello di distress percepito rispetto al proprio ruolo genitoriale e alla relazione con il figlio, e le CBCL - Child Behavior Checklist 1/2-5, inerenti la percezione materna del funzionamento comportamentale, affettivo e sociale del bambino. Risultati. L’intero campione mostra punteggi nella norma nei due strumenti. Nei prematuri emerge una percezione materna dell’interazione genitore-bambino più disfunzionale rispetto ai controlli, sia a 12 (p=0,045) che a 18 mesi (p=0,027). Tra i due assessment, le madri dei controlli mostrano un calo nel distress genitoriale, mentre nei prematuri le madri mostrano un aumento a 18 mesi (p=0,048). Nella CBCL/1/2-5, i prematuri ottengono valori minori dei controlli nelle scale Externalizing (p=0,045) e Somatic Complaints (p=0,025). La scala Somatic Complaints della CBCL/1/2-5 mostra correlazioni positive con la percezione materna di: una disfunzionale interazione genitore-bambino, nei controlli (r=0,798; p=0,003); il proprio bambino come difficile, nei prematuri (r=0,570; p=0,042). Conclusioni. Sebbene in un range di normalità, i risultati mostrano come nei nati ELGA vi sia un ritardo nello sviluppo della motivazione a fare da solo e nell’esternalizzazione dei comportamenti di ostinazione e protesta psicosomatica, fisiologici a 18 mesi, come da noi già evidenziato in precedenti lavori. Ciò si accompagna a una percezione materna del nato pretermine come maggiormente problematico.