Parental Psychological Flexibility as a Mediating Factor of Post-Traumatic Stress Disorder in Children after Hospitalization or Surgery

Background: Illness, surgery, and surgical hospitalization are significant stressors for children. Children exposed to such medical events may develop post-traumatic medical syndrome (PMTS, pediatric medical traumatic stress) that could slow their physical and emotional recovery. Objective: This study examined the relationship between the level of parental psychological resilience and the development of PMTS in young children. Method: We surveyed 152 parents of children aged 1–6 who were admitted to the pediatric surgery department. Parents completed questionnaires in two phases. In the first phase, one of the parents completed the Acceptance and Action Questionnaire (AAQ-ll) and the Parental Psychological Flexibility (PPF) Questionnaire. In the second phase, about three months after discharge, the same parent completed the Young Child PTSD (Post Traumatic Stress Disorder) Checklist (YCPC) and the UCLA (Los Angeles, CA, USA) PTSD Reaction Index for DSM-5 Parent/Caregiver Version for Children Age 6 Years and Younger Evaluating Post-traumatic Disorder. In addition, the parent completed a Posttraumatic Stress Diagnostic Scale (PDS) questionnaire to assess the existence of post-traumatic symptoms in the parents. Results: The findings indicate that (1) a parent’s psychological flexibility is significantly associated with the level of personal distress (r = −0.45, p < 0.001), (2) a parents’ level of distress is significantly correlated with the child’s level of PTMS, and (3) a parent’s level of psychological flexibility is a significant mediating factor between the level of parental post-traumatic distress and the child’s level of PTMS. Conclusions: A parent’s psychological flexibility may act as a protective factor against the development of the child’s mental distress after hospitalization or surgery.

Influence of Genetic Polymorphisms in P2Y12 Receptor Signaling Pathway on Antiplatelet Response to Clopidogrel in Coronary Heart Disease

Backgrounds: Remarkable interindividual variability in clopidogrel response is observed, genetic polymorphisms in P2RY12 and its signal pathway is supposed to affect clopidogrel response in CHD patients. Methods: 539 CHD patients treated with clopidogrel were recruited. The platelet reaction index (PRI) indicated by VASP-P level were detected in 12-24h after clopidogrel loading dose (LD) or within 5-7 days after initiation of maintain dose (MD) clopidogrel. A total of 13 SNPs in relevant genes were genotyped in sample A (239 CHD patients). The SNPs which have significant differences in PRI will be validated in another sample (sample B, 300 CHD patients). Results: CYP2C19*2 increased the risk of clopidogrel resistance significantly. When CYP2C19*2 and CYP2C19*3 were considered, CYP2C19 loss of function (LOF) alleles were associated with more obviously increased the risk of clopidogrel resistance; P2RY12 rs6809699 C>A polymorphism was also associated with increased risk of clopidogrel resistance (AA vs CC: P=0.0398). This difference still existed after stratification by CYP2C19 genotypes. It was also validated in sample B. The association was also still significant even in the case of stratification by CYP2C19 genotypes in all patients (sample A+B). Conclusion: Our data suggest that P2RY12 rs6809699 is associated with clopidogrel resistance in CHD patients. Meanwhile, the rs6809699 AA genotype can increase on-treatment platelet activity independent of CYP2C19 LOF polymorphisms.

Parental Internalizing Psychopathology and PTSD in Offspring after the 2012 Earthquake in Italy

Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to predict PTSD in offspring, also testing the reverse pattern. Two years after the 2012 earthquake in Italy, 843 children and adolescents (9–15 years) living in two differently affected areas were administered a questionnaire on traumatic exposure and the UCLA PTSD Reaction Index. Anxiety, depression, and somatization were assessed in 1162 parents through the SCL-90-R. General linear model showed that, for offspring in the high-impact area, predictors of PTSD were earthquake exposure, past trauma, and parental internalizing symptoms, taken individually. An interaction between earthquake exposure and parental depression or anxiety (not somatization) was also found. In the low-impact area, youth PTSD was only predicted by earthquake exposure. The reverse pattern was significant, with parental psychopathology explained by offspring PTSD. Overall, findings support the association between parental and offspring psychopathology after natural disasters, emphasizing the importance of environmental factors in this relationship. Although further research is needed, these results should be carefully considered when developing mental health interventions.

The Psychological Wellbeing of Palestinian Children Living among Israeli Settlements in Hebron Old City

For more than ten decades, the Palestinian Occupied Territories are marked by a protracted political conflict. During this conflict, more than 300 settlements have been built inside West Bank, Gaza, and East Jerusalem “Occupied Palestinian Territories”, since that time the conflict between Palestinian and Israeli occupation forces is still ongoing. One of the most important results of this occupation and conflict is the suffering of Palestinian living among these Israeli settlements. Therefore, this study aimed at gaining insight into the impact of living within this situation on children and adolescents’ psychological wellbeing. 357 8-18 years old Palestinian children took part; Two self-report questionnaires: the UCLA-PTSD-Reaction Index, investigating symptoms of posttraumatic stress, and the Strengths and Difficulties Questionnaires, looking at overall psychological problems, were filed by children themselves, mothers, and teachers. Descriptive analyses investigated mental health differences between both variables, gender, and age, and the mental health outcomes. This study shows the important impact of being lived among Israeli settlements on the psychological wellbeing of Palestinian, above, girls, younger adolescents, also reported higher scores on both questionnaires, the study urges for more psychological care and support for family members – in particular children.

TEACHERS' SOCIAL AND EMOTIONAL HEALTH INDICATORS IN THE DISTANCE LEARNING SITUATION DURING THE COVID-19 PANDEMIC

There were 3 countries which participated in Erasmus+ project „Supporting teachers to face the challenge of distance teaching” (2020-1-LV01-KA226-SCH-094599) during last year. The aim of the project was to develop a well-functioning digital support system for teachers, promoting socio-emotional health and resilience. The main aim of this research was to outline a research problem on teacher well-being factors in three countries during the Covid-19 pandemic, when teachers worked remotely, and to further explore the problem in a focus group in Latvia. The following is a description of the study that was carried out in Latvia on the problems of teachers' social and emotional health factors during distance learning in 2020-2021. The study in Latvia took place in parallel with the study in Slovakia and Lithuania. This article describes the first part of the study in Latvia. One of the tasks of the study was to identify the factors that predicted teachers’ social and emotional health (SEH-T), to determine the relationships between teacher SEH, emotional burnout and teacher engagement in work indicators, and to perform a linguistic and psychometric adaptation of the teacher SEH-T (Social-emotional Health Survey – Teachers, Furlong and Gajdosova, 2019). Latvian teachers from different schools in Latvia participated in this study. Respondents completed three surveys: Teachers SEH-T (Social- emotional Health Survey – Teachers, Furlong and Gajdosova, 2018), Engaged Teachers Scale (ETS; Klassen, Yerdelen & Durksen, 2013) and the K. Maslach Burnout Survey – General Survey (MBI– GS, Maslach, Jackson & Leiter, 1996; Caune, 2004). The results showed that the translation of teachers' SEH-T survey into Latvian language had good internal coherence of articles, the article discrimination index indicator was statically significant, and the reaction index was within the normal range. Teachers SEH is positively predicted by teacher engagement indicators. Demographic and emotional burnout rates do not predict teachers' SEH-T scores. The results showed that there were statistically significant positive correlations between teacher SEH-T, teacher engagement, and emotional burnout rates. There were statistically significant negative correlations between teachers' SEH-T indicators, teacher involvement and emotional burnout indicators. Keywords: Teachers SEH, work engagement, emotional burnout

Polydioxanone-Based Membranes for Bone Regeneration

Resorbable synthetic and natural polymer-based membranes have been extensively studied for guided tissue regeneration. Alloplastic biomaterials are often used for tissue regeneration due to their lower immunoreactivity when compared with allogeneic and xenogeneic materials. Plenum® Guide is a synthetic membrane material based on polydioxanone (PDO), whose surface morphology closely mimics the extracellular matrix. In this study, Plenum® Guide was compared with collagen membranes as a barrier material for bone-tissue regeneration in terms of acute and subchronic systemic toxicity. Moreover, characterizations such as morphology, thermal analysis (Tm = 107.35 °C and crystallinity degree = 52.86 ± 2.97 %, final product), swelling (thickness: 0.25 mm ≅ 436% and 0.5 mm ≅ 425% within 24 h), and mechanical tests (E = 30.1 ± 6.25 MPa; σ = 3.92 ± 0.28 MPa; ε = 287.96 ± 34.68%, final product) were performed. The in vivo results revealed that the PDO membranes induced a slightly higher quantity of newly formed bone tissue than the control group (score: treated group = 15, control group = 13) without detectable systemic toxicity (clinical signs and evaluation of the membranes after necropsy did not result in differences between groups, i.e., non-reaction -> tissue-reaction index = 1.3), showing that these synthetic membranes have the essential characteristics for an effective tissue regeneration. Human adipose-derived stem cells (hASCs) were seeded on PDO membranes; results demonstrated efficient cell migration, adhesion, spread, and proliferation, such that there was a slightly better hASC osteogenic differentiation on PDO than on collagen membranes. Hence, Plenum® Guide membranes are a safe and efficient alternative for resorbable membranes for tissue regeneration.

Validating the Child Trauma Screen Among a Cross-Sectional Sample of Youth and Caregivers in Pediatric Primary Care

Pediatric primary care providers have an important role in addressing the health effects of trauma, yet routine screening is rare. This study evaluated whether the 10-item Child Trauma Screen (CTS) could identify youth experiencing posttraumatic stress disorder (PTSD) symptoms. Participants were 107 caregiver-youth pairs aged 7 to 17 years old, 55.8% male, and 76.4% Hispanic who were recruited at an urban pediatric primary care clinic. Youth and caregivers separately completed the CTS and the UCLA PTSD Reaction Index for DSM-5 (RI-5) prior to their medical visit. Half of youth experienced at least one type of trauma, and one sixth reported elevated PTSD symptoms. The CTS was highly correlated with the RI-5 on PTSD symptom severity, and correctly classified 85% of youth based on likely PTSD diagnosis. The brief CTS can accurately identify youth suffering from PTSD symptoms, and may be particularly feasible to implement in busy primary care practices.

Use of EMDR-Derived Self-Help Intervention in Children in the Period of COVID-19: A Randomized-Controlled Study

Self-help treatments are an important intervention tool, with high accessibility and ease of application. To our knowledge, no research has previously been conducted on any self-help intervention derived from eye movement desensitization and reprocessing (EMDR) therapy. In this study, we evaluated the mental health status of children not directly affected by the pandemic and investigated the effects of using an EMDR-derived self-help intervention in children as a low-intensity treatment. The mental health status of 178 children was evaluated online via the State-Trait Anxiety Inventory for Children (STAIC) and Childhood Posttraumatic Stress Reaction Index (CPTS-RI). Then, children were randomly assigned to intervention and waitlist. A booklet containing EMDR-derived techniques was sent via the school online portal and the intervention was conducted. Posttests were administered 4 weeks later. The attrition rate was 45.5%, with 97 children completing the trial (intervention: 52; waitlist: 45). At baseline, 76.4% of children showed posttraumatic stress symptoms (PTSS) above threshold. Results showed a statistically significant decrease in the posttest PTSS scores for the intervention group compared to waitlist. The intervention group had significant pre–post improvement on all but one subscale, while the waitlist group showed significant increase in state anxiety on the STAIC. In conclusion, posttraumatic stress was found to be high in children during the COVID-19 outbreak period, and EMDR-derived self-help intervention appeared to be an effective psychosocial intervention tool.